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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

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

Conditions
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Sleep Deprivation, Depression

Intervention / Treatment
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* Other: Reduced work hour schedule


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Interns rotating at Providence St. Vincent Medical Center ICU Exclusion Criteria: Diagnosis of narcolepsy
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention Schedule<br>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<br>* Interns on the intervention schedule work an average of 60 hours per week over 4 weeks, with maximum shift length 16 hours.<br>|
| No Intervention: Traditional Schedule<br>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. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Internship and Residency, Medical Errors, Burnout, Professional, Burnout, Depression, Actigraphy, Personnel Staffing and Scheduling, Sleep Deprivation, Workload, Humans, Adult, Male, Female, Intensive Care Units, Prospective Studies, Crossover Studies, Work Schedule Tolerance, Disorders of Excessive Somnolence, Guideline Adherence, Internal Medicine Education