title: Effects of a night-team system on resident sleep and work hours.
abstract: OBJECTIVE
  In 2009, Children's Hospital Boston implemented a night-team system on general pediatric wards to reduce extended work shifts. Residents worked 5 consecutive nights for 1 week and worked day shifts for the remainder of the rotation. Of note, resident staffing at night decreased under this system. The objective of this study was to assess the effects of this system on resident sleep and work hours.
  
  
  METHODS
  We conducted a prospective cohort study in which residents on the night-team system logged their sleep and work hours on work days. These data were compared with similar data collected in 2004, when there was a traditional call system.
  
  
  RESULTS
  In 2004 and 2009, mean shift length was 15.22 ± 6.86 and 12.92 ± 5.70 hours, respectively (P = .161). Daily work hours were 10.49 ± 6.85 and 8.79 ± 6.42 hours, respectively (P = .08). Nightly sleep time decreased from 6.72 ± 2.60 to 4.77 ± 2.46 hours (P < .001). Total sleep time decreased from 7.50 ± 3.13 to 5.47 ± 2.34 hours (P < .001).
  
  
  CONCLUSIONS
  Implementation of a night-team system was unexpectedly associated with decreased sleep hours. As residency programs create work schedules that are compliant with the 2011 Accreditation Council for Graduate Medical Education duty-hour standards, resident sleep should be monitored carefully.
authors: Harvard Pediatric Health Services Research Fellowship, Children's Hospital Boston, Boston, MA 02115, USA.
authors: Kao-Ping
authors: KP
authors: Chua
authors: Mary Beth
authors: MB
authors: Gordon
authors: Theodore
authors: T
authors: Sectish
authors: Christopher P
authors: CP
authors: Landrigan
mesh_terms: D006801:Humans; D007396:Internship and Residency; D010372:Pediatrics; D010561:Personnel Staffing and Scheduling; D011446:Prospective Studies; D012890:Sleep; D016526:Workload / Q000706:statistics & numerical data*