Trainee doctor clinics after 24-hour shifts: Effects on patient satisfaction and prescription errors

Introduction: Sleep deprivation impacts clinical performance. However, literature is conflicting, with insufficient focus on patient outcomes. The aim of this study was to assess if patient satisfaction and prescription errors in outpatient clinics were adversely affected when consulting post-call versus non-post-call registrars. Methods: This prospective, quantitative study was set in a large teaching hospital in Singapore. Between November 2015 and February 2016, patients from clinics run by a registrar after 24-hour shift were recruited to post-call group. Patients from non-post-call clinics run by the same registrar were controls. Outcome measures were patient satisfaction, using 5-item 4-point Likert scale questionnaire, and prescribing error rate, defined as number of errors over number of orders. Differences were analysed using chi-squared test. Results: 103 of 106 (97%) patients in 9 post-call clinics and 93 of 105 (90%) patients in 9 non-post-call clinics were recruited. Questionnaire completion rate was 99%. 536 and 526 prescriptions were ordered in post-call and non-post-call groups, respectively. Percentage of top-box responses (greatest satisfaction) was higher in post-call group overall (79.3% versus 62.4%, p