What Happens on call Doesn’t Stay on call. The Effects of In-House Call on Acute Care Surgeons’ Sleep and Burnout

Coleman, Jamie J.; Robinson, Caitlin; Hippel, William von; Holmes, King K.; Kim, Jeongeun; Pearson, Samuel; Lawless, Ryan; Hubbard, Alan; Cohen, Mitchell J.

doi:10.1097/sla.0000000000005971

Cited by 2 publications

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References 48 publications

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“…18 Analogously, a recent study investigating acute care surgery (ACS) shift work identified that the sleep interruptions associated with in-house call and decreased time between calls were also associated with BO. 40 The ACS model has become commonplace within academic and community hospitals. This all-encompassing surgeon as a solution to clinical coverage deficits may be adversely influencing their mental health.…”

Section: Discussionmentioning

confidence: 99%

“…This provided a numerical score for each of the three domains. 7,28 The scores are stratified as low (<23), moderate, [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41] and high (>41) based on recommendations by the Professional Quality of Life Scale, version 5 publishers. Lower BO and STS scores are associated with lower CF.…”

Section: Methodsmentioning

confidence: 99%

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Trauma surgeons experience compassion fatigue: A major metropolitan area survey

Hoefer,

Tatebe,

Patel

et al. 2024

J Trauma Acute Care Surg

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Introduction Compassion Fatigue (CF), the physical, emotional, and psychological impact of helping others, is composed of three domains: Compassion Satisfaction (CS), Secondary Traumatic Stress (STS), and Burnout (BO). Trauma surgeons (TS) experience work-related stress resulting in high rates of CF which can manifest as physical and psychological disorders. We hypothesized that TS experience CF and there are potentially modifiable systemic factors to mitigate its symptoms. Methods All TS in a major metropolitan area were eligible. Personal and professional demographic information was obtained. Each participant completed six validated surveys: 1) Professional Quality of Life Scale (Pro-QOL), 2) Perceived Stress Scale (PSS), 3) Multidimensional Scale of Perceived Social Support (MSPSS), 4) Adverse Childhood Events (ACE) Questionnaire, 5) Brief Coping Inventory (BCI), and 6) Toronto Empathy Questionnaire (TEQ). CF subscale risk scores (low:<23, moderate:23-41, high:>41) were recorded. Linear regression analysis assessed the demographic and environmental factors association with BO, STS, and CS. Variables significant on univariate analysis were included in multivariate models to determine the independent influence on BO, STS, and CS. Significance was p ≤ 0.05. Results There were 57 TS (response rate:75.4% (n = 43); Caucasian: 65% (n = 28), male:67% (n = 29)). TS experienced CF (BO:26 (IQR: 21-32), STS:23 (IQR: 19-32), CS:39 (IQR: 34-45)). The PSS score was significantly associated with increased BO (Coef: 0.52, 95% CI: 0.28-0.77) and STS (Coef: 0.44. 95% CI: 0.15-0.73), and decreased CS (Coef: -0.51, 95% CI: -0.80- -0.23) (p < 0.01). Night shifts were associated with higher BO (Coef: 1.55, 95% CI: 0.07-3.03, p = 0.05), conversely day shifts were associated with higher STS (Coef: 1.94, 95% CI: 0.32-3.56, p = 0.03). Higher TEQ scores were associated with greater CS (Coef: 0.33, 95% CI: 0.12-0.55, p < 0.01). Conclusion TS experience moderate BO and STS associated with modifiable system- and work-related stressors. Efforts to reduce CF should focus on addressing sources of workplace stress and promoting empathic care. Level of Evidence III, Prognostic and Epidemiological

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Trauma surgeons experience compassion fatigue: A major metropolitan area survey

Hoefer,

Tatebe,

Patel

et al. 2024

J Trauma Acute Care Surg

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Home Is Not Always Where the Sleep Is: Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being

Coleman,

Robinson,

von Hippel

et al. 2024

Journal of the American College of Surgeons

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Background: In-house calls contribute to loss of sleep and surgeon burnout. While acknowledged to have an opportunity cost, home call is often considered less onerous, with minimal effects on sleep and burnout. We hypothesized home call would result in impaired sleep and increased burnout in acute care surgeons (ACS). Study Design: Data from 224 ACS were collected over six months. Participants wore a physiological tracking device and responded to daily surveys. The Maslach Burnout Inventory was administered at the beginning and end of the study. Within-participant analyses were conducted to compare sleep, feelings of restedness, and burnout as a function of home call. Results: 171 surgeons took 3,313 home calls, 52.5% were associated with getting called and 38.5% resulted in a return to the hospital. Home call without calls was associated with 3 minutes of sleep loss (p<.01), home call with ≥1 call resulted in a further 14 minutes of sleep loss (p<.0001), and home call with a return to the hospital led to an additional 70 minutes of sleep loss (p<.0001). All variations of home call resulted in decreased feelings of restedness (p’s<.0001) and increased feelings of daily burnout (p’s<.0001; Figure 1). Conclusion: Home call is deleterious to sleep and burnout. Even home call without calls or returns to the hospital is associated with burnout. Internal assessments locally should incorporate frequency of calls and returns to the hospital when creating call schedules. Repeated nights of home call can result in cumulative sleep debt, with adverse effects on health and well-being.

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What Happens on call Doesn’t Stay on call. The Effects of In-House Call on Acute Care Surgeons’ Sleep and Burnout

Cited by 2 publications

References 48 publications

Trauma surgeons experience compassion fatigue: A major metropolitan area survey

Trauma surgeons experience compassion fatigue: A major metropolitan area survey

Home Is Not Always Where the Sleep Is: Effect of Home Call on Sleep, Burnout, and Surgeon Well-Being

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