May 5th, 2004

Could Nuclear Power and Space Exploration Improve Hospitals?

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Taking cues from other industries, researchers from Ohio State University are hoping to curb shift-change errors while still reducing worker fatigue at hospitals throughout the United States.

Looking closely at high-risk environments like railroad dispatching, nuclear power, ambulance dispatch and even space exploration courtesy of the Johnson Space Center, researchers are focusing on the techniques these industries use to make the transition from one shift to the next move smoothly.

One of the key problems is the transfer of information from outgoing worker to incoming worker, something that the medical industry saw as a reason to potentially not shorten working shifts for medical workers. But in July 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted a program that capped the number of hours a medical resident could work in a week at 80 hours which equated to more shift changes but potentially more rested workers.

“When research showed that extreme fatigue was causing medical residents to make errors, one of the arguments against letting them work shorter hours was that patients may not get continuity of care,” Emily Patterson, a visiting researcher at Ohio State’s Institute for Ergonomics, said in Medical News Today. “But there are other high-risk industries that already have a shift mindset. They could have forced people to work longer hours for continuity’s sake, but they didn’t. We looked at those industries to see what they could teach health care.”

Worker fatigue in shift-work environments, like health care, has been linked to increases in worker injuries and errors and decreases in worker productivity and accuracy. Studies have also shown that workers whose work schedules don’t fall between the traditional nine-to-five regularly log in fewer hours of sleep per night and have a greater risk for developing musculoskeletal disorders (MSDs).

Some of the strategies that Patterson and the other OSU researchers believe are important to smooth shift changes include strong two-way communications, targeted transfers of responsibility, and a specific designation of when the new worker takes over the reigns.

Aside from the lack of errors and diminished worker fatigue, OSU researchers also note another benefit of shift changes



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