Login to Access Video or Poster Abstract: MP92-18
Sources of Funding: None

Introduction

Mitigating resident fatigue is central to the design and implementation of residency programs, especially when using a home call system. Existing studies of resident sleep habits and fatigue are mostly limited to in-house call and rely on self-reporting. We quantified time spent asleep for residents employing a home call system, and examined how the volume and type of pages received affected sleep nightly.

Methods

Urology residents in a single-institution residency were provided with a FitBit Charge HR device to collect objective sleep data over a six-month period. Each page received during this period after 16:00 and before 08:00 was counted and categorized as either &[Prime]clinic&[Prime] (outpatient calls from the after-hours answering service), &[Prime]floor&[Prime] (calls from the inpatient Urology ward), and &[Prime]other&[Prime] (calls regarding off-floor consults). Data analysis was carried out using IBM® SPSS® Statistics 23 and Numbers.

Results

Residents received a total of 1068 overnight pages while on call. The least senior resident received 321 pages (avg. 7.0/night), followed by 288 (avg. 6.0/night), 265 (avg. 6.3/night), and 194 (avg. 5.0/night) for the next three more senior residents, respectively. On average, residents slept 400 minutes while on call, compared to 434 minutes while not on call (p<0.05). Increased total volume of pages was associated with 4.71 fewer minutes asleep nightly per page for all residents (r=-0.32, n=145, p<0.05). Pages in the &[Prime]other&[Prime] category were associated with 7.74 fewer minutes asleep per page for all residents (r=-0.24, n=145, p<0.05). On individual analysis, pages to the least senior resident from the &[Prime]floor&[Prime] category were associated with 9.02 fewer minutes asleep (r=-0.35, n=44, p<0.05). This correlation did not reach significance for the other residents.

Conclusions

The most senior resident received the least average pages and the least senior resident received the most, an interesting finding given that call nights were evenly distributed. Residents slept less on call in general. Time asleep was reduced with increasing page volume, most severely when pages were from the &[Prime]other&[Prime] category, suggesting residents needed more time to address pages regarding patients they were unfamiliar with. Calls from the floor were most detrimental to sleep for the least senior resident, suggesting experience is a factor in efficient overnight call management.

Funding

None