Analyzing incoming page timestamps to estimate trainee sleep patterns

Sleep deprivation is highly prevalent among surgical trainees and associated with decreased clinical performance. The goal of this study was to demonstrate a method of analyzing incoming page timestamps to estimate the sleep patterns of trainees during a home-call shift.

This was a retrospective study of all incoming pages to an Ophthalmology Service at a single tertiary care hospital from January 1, 2019, to December 31, 2019. The time and date of each incoming communication was recorded. The Kaplan-Meier estimator was used to determine the cumulative probability of receiving a page over the course of an at-home call shift.

The mean number (± standard deviation) of incoming communications received during an overnight home-call shift (5 p.m.-8 a.m.) was 3.5 ± 2.5 (range, 0-15). The median time to first page was 1.4 hours (IQR, 0.4-4.0 hours). There was a significant difference between the number of pages received on weekdays compared to weekends (4.0 ± 2.5 vs 2.3 ± 2.1; P < 0.001). The cumulative probability of receiving a page during a shift was 91.5% (95% CI, 88.1%-95.6%). The probability of a 9-, 8-, 7-, or 6-hour interval without receiving an incoming page was 63.7%, 71.7%, 80.8%, and 87.6%, respectively.

Analyzing timestamps may serve as a valuable tool for training programs to design home-call schedules that optimize the sleep patterns of trainees and ensure that fatigue does not negatively impact the quality of education and patient care.