Demand for emergency services has resulted in an increased number of physicians experiencing burnout. Burnout rates amongst emergency medicine physicians consistently exceed that of other specialties, with shift work being a large contributor to the phenomenon. Casino-shift scheduling has addressed this issue in several emergency departments (EDs). Casino-shift scheduling is modeled around circadian rhythm theory which shows that anchor sleep helps to preserve circadian rhythm and normalize sleep patterns. To account for this, casino-shift models schedule overnight coverage with two six-hour shifts, to allow both physicians to obtain some sleep within the 01:00 to 06:00 am anchor period. While the benefits of the model have been demonstrated concerning physician well-being, there is a paucity of evidence assessing if this model has any effect on quality measures such as patient flow. Given the importance of patient flows to ED functioning, the objective of our study was to determine the effect of a casino-shift trial on overnight patient flow variables in a tertiary ED.
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Johnston et al. (2024) studied this question.
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