Shift Schedules and Intern Work Hours, Patient Numbers, Conference Attendance, and Sleep at a Single Pediatric...

Area of Science:

• Medical Education
• Pediatrics
• Sleep Medicine

Background:

• The 2011 Accreditation Council on Graduate Medical Education (ACGME) duty hour standards aimed to improve resident well-being and patient safety.
• The impact of these standards on pediatric interns' work hours, patient care, and sleep quality requires further investigation.

Purpose of the Study:

• To prospectively compare the effects of a 2011 ACGME duty hour-compliant shift schedule versus a 2003 ACGME duty hour-compliant call schedule.
• To evaluate changes in intern work hours, patient load, conference attendance, and sleep duration, pattern, and quality.

Main Methods:

• Pediatric interns were assigned to either a shift or call schedule for 4 alternate months during the winter of 2010-2011.
• Data on work hours, patient numbers, conference attendance, and sleep parameters were systematically collected and tracked.

Main Results:

• Interns on the shift schedule worked fewer hours weekly (73.2-71.6 hours) compared to the call schedule (79.6 hours).
• Shift interns managed more patients daily (8.1 vs 6.2) during high census periods and had improved sleep duration (7.2 vs 6.3 hours) and consistency.
• Conference attendance was significantly lower for interns on the shift schedule during high census months.

Conclusions:

• A shift schedule compliant with 2011 ACGME standards effectively reduced intern work hours and enhanced sleep.
• Despite decreased conference attendance, patient care opportunities remained robust, with unchanged or increased patient numbers.
• The findings suggest a trade-off between structured learning time and improved resident well-being under the new duty hour regulations.