Great Debates—Shift Work Versus One Day at a Time: 12- Versus 24-Hour Call Duration in Acute Care Surgery

Abstract

Optimal shift length for acute care surgery remains an ongoing debate that takes into consideration the impact of fatigue on performance, patient outcomes, and provider well-being. The data is conflicting on whether 12- or 24-hour calls are best. Proponents for the 24-hour shift model cite that it fosters superior continuity of care with fewer handoffs, enhances surgical training and does not negatively impact patient outcomes. Supporters of the 12-hour shift model cite enhanced focus, reduced errors, and promotion of patient safety without compromising training requirements or skill acquisition. A thorough look at the practice environment, frequency of calls, and handoff processes are needed to decide on whether a 12- or 24-hour call schedule will be utilized for trainees and attendings.