In 2008, the Institute of Medicine recommended a number of changes in medical residency programs to provide better patient care and resident training: Limit shifts without sleep to 16 hours, require five-hour naps for longer shifts, increase the number of days off, improve supervision and cut down on moonlighting.

But the recommendations—which followed on rules by a national body that governs medical training—won’t come cheap, according to a New England Journal of Medicine study published this week: If implemented fully, they will cost $1.6 billion.

The estimate, which tallies the cost of hiring replacement workers, is just slightly lower than the $1.7 billion the IOM projected the changes could cost. And if the government were to pick up the tab, it would be a large toll on the already strained Medicare system, which—contributing $8.4 billion in 2007—is the largest funder of U.S. residency programs.

We've been hearing for some time now about the proliferation of drug-resistant staph infections caused by bacteria that are stronger than antibiotics. Today there's an indication that in at least one small portion of the universe, the infections are actually on the decline.

The rate of methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections from central lines (intravenous catheters) in hospital intensive care units (ICUs) dropped by half between 1997 and 2007, according to research in tomorrow's Journal of the American Medical Association (JAMA). It’s unclear exactly how many Americans become sick with MRSA in ICUs every year, but an estimated 94,360 Americans contracted such infections in 2005, just over a quarter of them caught in the hospital, according to CDC research published two years ago in JAMA. MRSA is responsible for 5.6 percent of all central line-caused infections.

Don't underestimate the value of good bookkeeping. A new study says that your chance of dying and suffering complications is lower in hospitals and clinics that computerize patient charts and drug orders.

There were 15 percent fewer deaths, and patients treated for heart attacks, congestive heart failure or pneumonia or who had coronary bypass surgery were 16 percent less likely to suffer complications in hospitals that kept records in a centralized computer system, according to research published in this week's Archives of Internal Medicine. The findings were based on the records of 167,233 patients aged 50 and older at 72 hospitals in Texas and on doctor ratings of the information technology at those facilities.

The results held even after researchers (from the University of Texas Southwestern Medical Center, Johns Hopkins School of Medicine and the University of Maryland) controlled for the seriousness of conditions and whether a hospital was an academic center or a cash-strapped "safety-net" facility for the indigent.

Giving antibiotics to patients in hospital intensive care units (ICUs) to prevent—rather than fight—bacterial infections may reduce the number of patient deaths, Dutch scientists report today in The New England Journal of Medicine. Despite the findings, some researchers remain skeptical whether the possible risks (most notably spurring new antibiotic-resistant germs) outweigh the benefits of plying patients with antibiotics instead of using other more benign strategies such as hand-washing, isolating contagious patients and scrubbing hospitals with antiseptic cleansers.

You’ve been tagged.

Hospitals are increasingly using electronic-monitoring equipment to track patients, employees and medical devices to prevent them from going the way of the Junior Mint Seinfeld’s Kramer infamously dropped into an open surgical patient.

The e-tracking software has been used for more than a decade by hospitals to prevent baby kidnappings, the Wall Street Journal reports today. But now hospitals are tagging patients with radio-frequency identification (RFID) devices to, among other things, cut down on emergency room waiting time by keeping track of how long each person has been in the ER. They're tagging employees to get a handle on departments that need staff or can spare them. And equipment is tagged so it can be easily located – and to prevent surgeons from inadvertently leaving it inside patients.