The dangers of July
No, it’s not just hospital lore—the “July effect” is real. Mortality typically does increase while efficiency decreases during the month because of hospital staff changeovers, according to a review of 39 previous studies posted on the Annals of Internal Medicine website.
During the summer, a new set of interns, residents and fellows arrive at teaching hospitals, causing an abrupt decline in workforce experience, according to an article summary.
University of California at San Francisco researchers, including lead author Dr. John Young and patient-safety expert Dr. Robert Wachter, identified 39 English-language studies from the U.S., Canada, the United Kingdom, Hong Kong and Australia published between 1989 and July 2010 that examined academic-related turnover of physicians in training, used a control group for comparison, and reported the effect of that changeover on patient mortality, morbidity, medical errors and efficiency of care, the report said.
“It is important to note that the ‘July effect’ entails both a drop in the clinical experience of the physicians in the system and a decrease in the number of physicians who are familiar with the clinical system,” the authors concluded, and they suggested interventions such as “avoiding cognitive overload and fatigue,” strategies to prevent system disruption (such as staggered scheduling) and more effective system design.