Reducing shift length from 24 hours to 16 hours was well received by Canadian anesthesiology trainees, who felt the change improved their quality of life, reduced fatigue, and enhanced their education. This shift length reduction for interns was a core component of the 2011 duty hour reforms in the United States. Recent studies have shown that the regulations had no effect on patient-level clinical outcomes.

The implementation of formal root cause analysis was associated with substantial improvements in most measured patient outcomes on acute pain services at three hospitals. The rates of overall events, respiratory depression, severe hypotension, and pump programming errors decreased, but incidence of severe pain increased.

Patient-controlled analgesia (PCA) is generally quite safe, but prior studies have shown that errors associated with PCA frequently result in patient harm. Due to several critical incidents associated with PCA errors, this Canadian hospital system implemented a multifaceted safety program including use of smart infusion pumps, standardized order sets, and mandatory error reporting. These interventions resulted in a significant reduction in PCA errors, chiefly by reducing pump programming errors (the most common type of error before the intervention). A PCA error with devastating clinical consequences is discussed in an AHRQ WebM&M commentary.