Intensive Care Unit Resident Scheduling Trial Comparing 16-Hour and 24-Hour Overnight Duty Schedules in Canadian ICUs

What this Trial Is About

Researchers are investigating the effects of different overnight work schedules for doctors in training (residents) working in intensive care units (ICUs) in Canada. The study aims to understand how 16-hour shifts compare to 24-hour shifts in terms of patient safety, resident education, and resident wellbeing. This research addresses concerns about how tired residents might affect patient care, learning, and burnout, with a focus on providing high-quality evidence relevant to Canadian healthcare settings. The study compares two common ICU resident schedules: 16-hour overnight shifts versus 24-hour shifts. Each ICU site will use both schedules for 52 weeks in a randomized order. Residents on the 16-hour schedule work overnight calls without preceding daytime shifts, while those on the 24-hour schedule work an 8-hour day followed by a 16-hour overnight call. Both groups receive formal handover training to support safe patient care. Consent is obtained for resident-specific measurements. Participants include ICU patients, residents, supervisors, and frontline ICU staff. Researchers will assess patient outcomes such as hospital mortality up to 90 days after ICU admission and adverse events during ICU stays. Resident education will be evaluated through tests of clinical reasoning and procedural skills, while wellbeing will be measured using assessments of burnout, sleepiness, and health ratings. Data collection occurs during residents' 4-week ICU rotations, with analyses accounting for differences between ICUs. The study's results aim to guide policies balancing patient safety, resident training, and wellbeing.

Intensive Care Unit Resident Scheduling Trial