Rapid Cycling Work Roster Improves Resident Sleep Practices
In addition, decreases seen in weekly work hours and in the occurrence of >16 consecutive hour shifts
THURSDAY, June 6, 2019 (HealthDay News) -- A rapidly cycling work roster (RCWR) is effective in reducing weekly work hours and the occurrence of >16 consecutive-hour shifts as well as improving sleep duration of resident physicians, according to a study published online May 20 in SLEEP.
Laura K. Barger, Ph.D., from Brigham and Women's Hospital in Boston, and colleagues randomly assigned 302 senior resident physicians (postgraduate year 2 and higher) to an extended-duration work roster (EDWR) with extended-duration (≥24 hours) shifts or RCWR, in which scheduled shift lengths were limited to ≤16 consecutive hours. Residents completed 370 one-month pediatric intensive care unit rotations in six U.S. academic medical centers. Sleep was measured using wrist-worn actigraphs.
The researchers found that resident physicians worked fewer total hours per week during the RCWR versus EDWR (61.9 versus 68.4). Seventy-three percent of work hours occurred within shifts of ≤16 consecutive hours during RCWR; whereas during the EDWR, 38 percent of work hours occurred on shifts of ≤16 consecutive hours. On RCWR, resident physicians slept significantly more per week versus during EDWR (52.9 versus 49.1 hours). For RCWR, the percentage of 24-hour intervals less than four hours of actigraphically measured sleep was 9 percent compared with 25 percent during the EDWR.
"Although inclusion of the six operational health care sites increases the generalizability of these findings, there was heterogeneity in schedule implementation," the authors write.