Work Hour Reductions, Medical Errors, and Intern Well-Being at Providence St. Vincent Medical Center Intensive Care Unit

Sponsor

Providence Health & Services (Other)

Overall Status

Completed

CT.gov ID

NCT00996320

Collaborator

Providence St. Vincent Department of Medicine (Other), Providence Center for Outcomes Research and Education (Other)

Enrollment

Location

Arms

Duration (Months)

1.8

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

The purpose of this study is to determine whether reducing intern work hours and eliminating extended shifts in the intensive care unit will reduce prescribing errors and improve intern well-being.

Condition or Disease	Intervention/Treatment	Phase
Sleep Deprivation Depression	Other: Reduced work hour schedule	N/A

Detailed Description

Each intern enrolled will complete three 4-week rotations in the intensive care unit (ICU) at Providence St. Vincent Medical Center. Each intern will complete at least one traditional schedule and one intervention schedule. The traditional schedule consists of an 80-hour work week with overnight call every third night. The longest shift on the traditional schedule is 30 hours. The intervention schedule consists of a 60-hour work week which eliminates overnight call by assigning a variety of shifts ranging from 8 to 16 hours in length.

Study Design

Study Type:

Interventional

Actual Enrollment :

22 participants

Allocation:

Randomized

Intervention Model:

Crossover Assignment

Masking:

Single (Outcomes Assessor)

Primary Purpose:

Prevention

Official Title:

Effect of Reducing ICU Interns' Work Hours on Sleep, Intern Well-Being, and Medical Errors

Study Start Date :

Jun 1, 2008

Actual Primary Completion Date :

Jun 1, 2009

Actual Study Completion Date :

Jun 1, 2009

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intervention Schedule Interns on the intervention schedule work the a modified ICU schedule averaging about 60 hours per week over 4 weeks, with maximum scheduled shift length 16 hours.	Other: Reduced work hour schedule Interns on the intervention schedule work an average of 60 hours per week over 4 weeks, with maximum shift length 16 hours.
No Intervention: Traditional Schedule Interns on the traditional schedule work the usual ICU schedule averaging about 80 hours per week over 4 weeks, with maximum shift length 30 hours.

Arm

Intervention/Treatment

Experimental: Intervention Schedule

Interns on the intervention schedule work the a modified ICU schedule averaging about 60 hours per week over 4 weeks, with maximum scheduled shift length 16 hours.

Other: Reduced work hour schedule

Interns on the intervention schedule work an average of 60 hours per week over 4 weeks, with maximum shift length 16 hours.

No Intervention: Traditional Schedule

Interns on the traditional schedule work the usual ICU schedule averaging about 80 hours per week over 4 weeks, with maximum shift length 30 hours.

Outcome Measures

Primary Outcome Measures

Multiple Sleep Latency Test [Measured once a month for each intern while on ICU rotation, at least 14 days into the scheduled 28 day cycle]

Secondary Outcome Measures

Hours slept per night measured by actigraphy [Daily]
Pharmaceutical order error rate [Daily]
Burnout measured by Maslach Burnout Inventory [Measured once per month for each intern while on ICU rotation, at least 14 days into the 28 day rotation]
Beck Depression Inventory, Second Edition (BDI-II) [Measured once per month for each intern while on ICU rotation, at least 14 days into the 28 day rotation]
Hours worked per shift on the traditional and intervention schedules [Daily]