Assessing the Impact of a Change to the Work Schedule of Resident Physicians: a Mixed Methods Study
试验速览
- 阶段
- 不适用
- 入组人数
- 80
- 试验地点
- 1
- 主要终点
- Preventable adverse events
研究概览
简要总结
The purpose of this study is to determine the impact of eliminating traditional resident work shifts (i.e. greater than 24 hours in length) on patient safety and resident educational outcomes. In addition, the investigators will explore with key stakeholders (patients and their families, nurses, resident physicians and attending physicians) their experiences when residents are undertaking shifts greater than 24 hours in length as compared to 16 hours or less.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Health Services Research
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Residents completing Intensive Care Unit rotations
- •For focus groups and interviews, patients and families members admitted during the study period and nurses and attending physicians working during the study period
排除标准
- 未提供
研究组 & 干预措施
Traditional work schedule
Residents in the intensive care unit perform overnight shifts in excess of 24 hrs every fourth night
Intervention work schedule
Residents in the Intensive Care Unit perform shifts less than 16 hours in length and have at least 8 hours off between shifts
干预措施: Intervention work shift (Behavioral)
结局指标
主要结局
Preventable adverse events
时间窗: Occurring during course of ICU admission and within first 72 hours of ICU discharge if event is attributable to process of care in the ICU
The primary outcome is the rate of preventable adverse events per 1000 patient days. An adverse event will be defined as any unplanned injury arising as a consequence of medical care that is associated with morbidity, requires treatment, prolongs hospital stay, or results in disability at discharge. Adverse events are not caused by the disease process itself, but do include any procedural or therapeutic complications. Preventable adverse events will be defined as those adverse events that could have been avoided given current knowledge and standards of care.
次要结局
- Quantity of scheduled and unscheduled learning activities residents participate in(End of each 28 day rotation)
- Resident leisure time, sleep, and time spent in the hospital(End of each 28 day rotation)
- Professionalism(End of each 28 day rotation)
- Nursing impact(Over course of study (12 months))
- Attending physician workload(Over course of study (12 months))
- Perceived continuity of care(Over course of study (12 months))
- Quality of life(End of each 28 day rotation)
- Resident knowledge acquisition and retention(End of each 28 day rotation)
- Patient satisfaction(Within two weeks of ICU discharge)
- Job satisfaction/Stress(End of each 28 day rotation)