Optimizing Sleep/Wake Related Cognitive Efficacy
Condition: Laborist; Sleep; Cognition; Fatigue
MeSH terms: Fatigue
Study type: Interventional

Summary: 
      This is a pilot study designed to elucidate sleep/wake patterns and associated cognitive
      efficacy of laborists involved in shift work at Mayo Clinic Rochester.
    

Detailed description: 
      Each of the ten physicians working laborist shifts will be asked to wear an actigraphy watch
      (ReadiBand- Fatigue Science, Vancouver, BC) continually for three weeks in the winter
      2014-2015 for initial data collection. A brief sleep education intervention based on
      aerospace and military fatigue countermeasure training will be given at a one hour
      departmental grand rounds presentation on April 20, 2015. This intervention will be based on
      ACGME requirements for fatigue education for residents and will also address the latest data
      on sleep and health, as well as fatigue countermeasures of nap recommendations, sleep
      banking, and sleep hygiene. An additional two weeks of data will then be collected.

      Data will be de-identified and entered into the Fatigue Science algorithm, which is validated
      to detect sleep quantity and quality. This algorithm allows labelling of data to reflect
      which type of shift, as well as its sequence in the schedule. For example, sleep/wake cycles
      of the fourth night shift of a series can be identified as such, so that wakefulness during a
      fourth night shift is not artificially compared to wakefulness during a first night of night
      shifts. Average efficacy during each type of shift, as well as average efficacy during each
      shift in a series of one type of shift can then be calculated. Efficacy is reported as a
      percentage, based on a nomogram established through military wakefulness task exercises and
      validated to correlate with blood alcohol level and with likelihood of human factor accident
      risk through the Department of Defense, US Army, US Navy, US Marine Corps, and Federal
      Railroad Association.

      Calculated data on shift efficacy will significantly contribute to the growing literature on
      the strengths of the laborist model, and will help with internal schedule structure to
      continue to maximize efficacy. As laborist programs develop and expand, the investigators may
      also be forerunners in describing optimal scheduling and staffing for programs of similar
      size and scope. Ultimately, additional studies will use this innovative technology to
      elucidate the assumed but not scientifically established relationship between sleep/wake
      based cognitive efficacy and patient safety by superimposing the investigators' wakefulness
      data on the investigators' tracked adverse events. This would be landmark in the
      investigators' field and has the potential to effect groundbreaking safety measures in the
      investigators' training and staffing.
    

Intervention name(s): Fatigue avoidance education
Intervention type(s): Behavioral
Intervention description(s): Grand Rounds presentation of consequences of fatigue and fatigue avoidance techniques
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Health Services Research
Keywords: laborist; efficacy; sleep; fatigue; SAFTE; cognition