title: Sleep science, schedules, and safety in hospitals: challenges and solutions for pediatric providers.
abstract: Sleep deprivation is common among resident physicians and clinical fellows. Current evidence about sleep science, performance, shift work, and medical errors consistently demonstrates positive impact from reduction of excessive duty hours, particularly when shift length is shortened. This article provides an overview of this literature, highlighting research on diminished physician cognitive performance due to sleep deprivation and the increase in the number of medical errors that is seen under these conditions. Accreditation Council on Graduate Medical Education trainee duty hour guidelines are reviewed. Practical approaches to evidence-based scheduling of shift-work are also discussed, with attention to improving patient safety.
authors.affiliation: Division of Hospital Medicine, Department of Pediatrics, UCSF Benioff Children's Hospital, University of California San Francisco School of Medicine, San Francisco, CA 94143-0110, USA. rosenbluthg@peds.ucsf.edu
authors.forename: Glenn
authors.initials: G
authors.lastname: Rosenbluth
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Landrigan
mesh_terms: D002648:Child; D005221:Fatigue / Q000209:etiology; D006739:Hospital Administration; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D019300:Medical Errors / Q000517:prevention & control; D061214:Patient Safety; D010372:Pediatrics; D010561:Personnel Staffing and Scheduling / Q000592:standards*; D012890:Sleep; D012892:Sleep Deprivation / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D014481:United States; D014940:Work Schedule Tolerance; D016526:Workload / Q000592:standards*