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EWTD-Introduction

Effect Of European Working Time Directive On Training And Outcome Following Coronary Artery Bypass Grafting. Mohamad  Bashir,  Mark  Field,  Abbas  Rashid,  Matthew Shaw, Aung  Oo Liverpool Heart & Chest Hospital. EWTD-Introduction.

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EWTD-Introduction

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  1. Effect Of European Working Time Directive On Training And Outcome Following Coronary Artery Bypass Grafting Mohamad  Bashir,  Mark  Field,  Abbas  Rashid,  Matthew Shaw, Aung  Oo Liverpool Heart & Chest Hospital

  2. EWTD-Introduction The European Work Time Directive (EWTD) started in August 2004. In August 2009, full EWTD implementation resulted in a 48 hour “Maximum Legal Average” working week.

  3. OBJECTIVES & METHODS • Examine the effect of the 2004 (EWTD) (56 hours) on: • Trainee vs. consultant led cases • Adverse outcome: • bleeding • prolonged ventilation • myocardial infarction • in-hospital mortality • Propensity methodology

  4. Patients EuroSCORE - Pre EWTD Patients EuroSCORE - Post EWTD

  5. Year of Training & Patients EuroSCORE – Pre EWTD Year of Training &Patients EuroSCORE – Post EWTD

  6. Pre & Post EWT Directive – Adjusted CABG Outcome Data

  7. Kaplan-Meier curve Pre EWT Directive Post EWT Directive

  8. RESULTS • Outcomes of trainee led cases before & after the EWTD: • Preoperative patient demographics and risk factors were not significantly different (based on Euroscore) • Training opportunity (i.e. trainee led cases against total number of trainee assisted cases) was not different • Primary outcome measure of in-hospital mortality was not different • Secondary outcome measures (bleeding, prolonged ventilation, myocardial infarction) was not different • Outcomes of consultant led cases: • were not adversely affected by the EWTD • did not differ significantly from trainee outcomes

  9. CONCLUSIONS The EWTD had no significant adverse effect on training opportunities and in-hospital mortality of trainee led cases & adverse outcomes.

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