Intensive Care Unit Resident Scheduling Trial

Launched by THE HOSPITAL FOR SICK CHILDREN · Nov 21, 2019

Keywords

ClinConnect Summary

The Intensive Care Unit Resident Scheduling Trial is studying how different work schedules for doctors in training (called residents) affect both patient care and the residents' well-being. The trial compares two common shift lengths: 16 hours and 24 hours. Researchers want to find out if one schedule is better for patients in the ICU, who are very sick and need careful attention, and how these shifts impact the residents' ability to learn and their overall health.

To participate in the study, patients must be admitted to the ICU during the trial period, and residents should be in specific training programs for specialties like internal medicine or surgery. The study will measure various outcomes, such as patient safety and satisfaction, as well as residents’ fatigue levels and learning experiences. By gathering this information, the trial aims to help improve patient care and training for future doctors in Canada.

Gender

ALL

Eligibility criteria

• Inclusion Criteria for ICUs:
• • Admit adult patients (≥18 years);
• • Are anticipated to have sufficient rotating residents from Royal College of Physicians and Surgeons of Canada -accredited training programs to provide overnight in-house coverage for at least 20 overnight periods in 28 days; and
• • Are willing to participate in the study (schedule randomization, measurements).
• Inclusion Criteria for Patients:
• • • Patients admitted to ICU during either period of the study.
• Inclusion Criteria for Residents:
• • Are enrolled in an accredited specialty training program of the Royal College of Physicians and Surgeons of Canada (internal or emergency medicine, surgery, anaesthesia, other, but not critical care medicine),
• • Are able to perform overnight in-house duty with supervision from critical care trainees and intensivists, and
• • Have the first 4 weeks of their ICU rotation entirely in one period. Residents who have participated in the study previously will not complete the competency assessments, however will be eligible to participate in the wellbeing and description of learning activities.
• Inclusion Criteria for Supervisors:
• • • Are Physicians responsible for the supervision of residents and other trainees in the ICU, and include Critical Care Trainees and Staff Physicians.
• Inclusion Criteria for ICU frontline staff:
• • • Are Registered nurses, registered respiratory therapists, pharmacists, social workers, physiotherapists and occupational therapists, who provide care in the ICU.
• Exclusion Criteria for ICUs:
• • ICUs with no rotating residents performing overnight in-house duty.
• • ICUs that are anticipating a major change in ICU staffing (e.g. in-house intensivist added or removed, in-house fellow added or removed) or
• • Are unwilling to have either resident schedule randomized, to provide study measurements or both.
• Exclusion Criteria for Patients:
• • • Patients will be excluded if they are in the ICU at the start of a study period.
• Exclusion Criteria for Residents:
• • Residents enrolled in a critical care medicine accredited specialty training program,
• • Who are not able to perform overnight in-house duty,
• • Where the first 4 weeks of their ICU rotation are not in one period,
• • Where the length of their ICU rotation is less than 4 week.