Details:

Alternative Title:
Contemp Clin Trials
Personal Author:
Blackwell, Terri ; Kriesel, Dana R. ; Vittinghoff, Eric ; O’Brien, Conor S. ; Sullivan, Jason P. ; ... More +
Blackwell, Terri ; Kriesel, Dana R. ; Vittinghoff, Eric ; O’Brien, Conor S. ; Sullivan, Jason P. ; Viyaran, Natalie C. ; Rahman, Shadab A. ; Lockley, Steven W. ; Barger, Laura K. ; Halbower, Ann C. ; Poynter, Sue E. ; Wright, Kenneth P. ; Yu, Pearl L. ; Zee, Phyllis C. ; Landrigan, Christopher P. ; Czeisler, Charles A. ; Stone, Katie L. Less -
Corporate Authors:
ROSTERS Study Group
Description:
Introduction:

While the Accreditation Council for Graduate Medical Education limited first year resident-physicians to 16 consecutive work hours from 2011–2017, resident-physicians in their second year or higher were permitted to work up to 28 hours consecutively. This paper describes the Randomized Order Safety Trial Evaluating Resident-physician Schedules (ROSTERS) study, a clustered-randomized crossover clinical trial designed to evaluate the effectiveness of eliminating traditional shifts of 24 hours or longer for second year or higher resident-physicians in pediatric intensive care units (PICUs).

Methods:

ROSTERS was a multi-center non-blinded trial in 6 PICUs at US academic medical centers. The primary aim was to compare patient safety between the extended duration work roster (EDWR), which included shifts ≥24 hours, and a rapidly cycling work roster (RCWR), where shifts were limited to a maximum of 16 hours. Information on potential medical errors was gathered and used for classification by centrally trained physician reviewers who were blinded to the study arm. Secondary aims were to assess the relationship of the study arm to resident-physician sleep duration, work hours and neurobehavioral performance.

Results:

The study involved 6577 patients with a total of 38821 patient days (n=18749 EDWR, n=20072 RCWR). There were 413 resident-physician rotations included in the study (n=203 EDWR, n=210 RCWR). Resident-physician questionnaire data were over 95% complete.

Conclusions:

Results from data collected in the ROSTERS study will be evaluated for the impact of resident-physician schedule roster on patient safety outcomes in PICUs, and will allow for examination of a number of secondary outcome measures.


Subject:
[+]
Article
Medical Errors
Patient Safety
Pediatric Intensive Care Unit
Randomized
Sleep
Work Hours

Source:
Contemp Clin Trials. 80:22-33
Pubmed ID:
30885799
Pubmed Central ID:
PMC6482052
Document Type:
Journal Article
Funding:
R01 OH010300/OH/NIOSH CDC HHS/United States ; U01 HL111478/HL/NHLBI NIH HHS/United States ; U01 HL111691/HL/NHLBI NIH HHS/United States
R01 OH010300/OH/NIOSH CDC HHS/United States ; U01 HL111478/HL/NHLBI NIH HHS/United States ; U01 HL111691/HL/NHLBI NIH HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:7d5dba7ca0489a9c58b6aca7762ada8ed4dbbea9cd1d0bb18ccbf59ee35727db
File Type:

Supporting Files

• 	nihms-1525449-f0001.gif	gif
  	nihms-1525449-f0001.jpg	jpeg
  	nihms-1525449.nxml	xml

More +