Ronish Gupta1,2, Kaylee Eady2, Katherine Moreau3, Jason R Frank4, Hilary K Writer1,2. 1. Department of Pediatrics, University of Ottawa, Ottawa, Ontario. 2. Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario. 3. Faculty of Education, University of Ottawa, Ottawa, Ontario. 4. Office of Specialty Education, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario.
Abstract
BACKGROUND AND OBJECTIVES: Resident duty hours remain a controversial topic in the literature. Competing interests include patient safety, resident education, and resident well-being. No studies, however, have sought family members' perspectives on duty hours in the paediatric context. This study aimed to explore family members' knowledge of trainee duty hours, and their perspectives on the balance between shift duration and hand-off frequency. METHODS: We surveyed family members of patients admitted ≥ 24 hours in the paediatric intensive care unit at an academic center. We simultaneously collected daily logs of hours worked by trainees. Descriptive statistics were used to analyze survey responses and trainee duty hours. RESULTS: One-hundred and one family members responded (75%). Respondents demonstrated knowledge of trainees working long duty hours but reported lower averages than the trainee logs (55 versus 66 hours per week and 16 versus 24 hours per shift). Elements related to both potential trainee fatigue and hand-offs raised concern in more than half of respondents. When asked to choose between a familiar trainee working a prolonged shift, or an unfamiliar trainee at the start of their shift, respondents were divided (52% versus 48%, respectively). CONCLUSIONS: Family members of critically ill paediatric patients are aware that trainees provide patient care while working long duty hours with minimal sleep. Despite this awareness, long shifts retain value with some families, possibly due to continuity. Changes to duty hours and hand-off frequency may pose an unrealized harm on family-centered care, as well as patient-provider relationships, and further study is warranted.
BACKGROUND AND OBJECTIVES: Resident duty hours remain a controversial topic in the literature. Competing interests include patient safety, resident education, and resident well-being. No studies, however, have sought family members' perspectives on duty hours in the paediatric context. This study aimed to explore family members' knowledge of trainee duty hours, and their perspectives on the balance between shift duration and hand-off frequency. METHODS: We surveyed family members of patients admitted ≥ 24 hours in the paediatric intensive care unit at an academic center. We simultaneously collected daily logs of hours worked by trainees. Descriptive statistics were used to analyze survey responses and trainee duty hours. RESULTS: One-hundred and one family members responded (75%). Respondents demonstrated knowledge of trainees working long duty hours but reported lower averages than the trainee logs (55 versus 66 hours per week and 16 versus 24 hours per shift). Elements related to both potential trainee fatigue and hand-offs raised concern in more than half of respondents. When asked to choose between a familiar trainee working a prolonged shift, or an unfamiliar trainee at the start of their shift, respondents were divided (52% versus 48%, respectively). CONCLUSIONS: Family members of critically ill paediatric patients are aware that trainees provide patient care while working long duty hours with minimal sleep. Despite this awareness, long shifts retain value with some families, possibly due to continuity. Changes to duty hours and hand-off frequency may pose an unrealized harm on family-centered care, as well as patient-provider relationships, and further study is warranted.
Authors: David Ouyang; Jonathan H Chen; Gomathi Krishnan; Jason Hom; Ronald Witteles; Jeffrey Chi Journal: Am J Med Date: 2016-04-18 Impact factor: 4.965
Authors: Katri V Typpo; M Hossein Tcharmtchi; Eric J Thomas; P Adam Kelly; Leticia D Castillo; Hardeep Singh Journal: Pediatr Crit Care Med Date: 2012-09 Impact factor: 3.624
Authors: John J Mercuri; Neil E Okey; Raj J Karia; Richard H Gross; Joseph D Zuckerman Journal: J Am Acad Orthop Surg Date: 2016-11 Impact factor: 3.020
Authors: Srijan Sen; Henry R Kranzler; Aashish K Didwania; Ann C Schwartz; Sudha Amarnath; Joseph C Kolars; Gregory W Dalack; Breck Nichols; Constance Guille Journal: JAMA Intern Med Date: 2013-04-22 Impact factor: 21.873
Authors: Jennifer W Mack; Susan D Block; Matthew Nilsson; Alexi Wright; Elizabeth Trice; Robert Friedlander; Elizabeth Paulk; Holly G Prigerson Journal: Cancer Date: 2009-07-15 Impact factor: 6.860