Investigating the Impact of Home Call on Sleep, Burnout, and Surgeon Well-Being
Navigating the Night: How good is Home Call, really?
Being a surgeon demands unwavering commitment, necessitating round-the-clock availability for emergencies. Traditionally, in-house call (IHC) required surgeons to reside within hospital premises, while the advent of home call allowed surgeons to be on call from home. Despite its perceived convenience, the implications of home call on surgeon well-being, particularly in terms of sleep quality and burnout, warrant deeper exploration.
The exigencies of surgical practice, characterized by prolonged work hours and high-stress scenarios, predispose surgeons to burnout—a multifaceted phenomenon encompassing emotional exhaustion, de-personalization, and reduced personal accomplishment. Burnout among healthcare professionals has profound ramifications, ranging from diminished job satisfaction to compromised patient care quality. While previous studies have elucidated the adverse effects of IHC on sleep patterns and burnout among surgeons, the impact of home call remains relatively under-explored.
A recent prospective observational study1 sought to investigate the impact of home call on sleep quality, feelings of restedness, and burnout among acute care surgeons. A cohort comprising 224 acute care surgeons participated in the study over a comprehensive six-month duration. Employing a multifaceted approach, the study integrated physiological tracking devices, daily surveys, and the administration of the Maslach Burnout Inventory to comprehensively evaluate sleep patterns, restedness, and burnout levels. Within-participant analyses were conducted to discern variations in these parameters during periods of home call.
Results
The study yielded compelling insights into the intricate relationship between home call and surgeon well-being. Notably, even nights of home call devoid of hospital calls were associated with sleep disruption, with exacerbated sleep deprivation observed when surgeons received calls necessitating a return to the hospital. Moreover, irrespective of call activity, feelings of restedness diminished, while burnout levels escalated significantly. These findings underscore the pervasive impact of home call on surgeon well-being, transcending conventional perceptions of its benign nature.
Discussion
The implications of the study underscore the imperative of contextualizing the effects of home call within the broader framework of surgeon well-being. While home call offers flexibility and convenience, it concurrently imposes formidable challenges, notably in terms of sleep quality and burnout. Consequently, efforts to mitigate these adverse effects and foster a healthier work environment are indispensable. This entails a nuanced approach to call scheduling and proactive measures to bolster surgeon resilience and mitigate burnout risks associated with home call.
Despite the invaluable insights gleaned from the study, several limitations warrant acknowledgment. Foremost among these is the exclusive focus on acute care surgeons, limiting generalization to other surgical sub-specialties. Additionally, the binary nature of survey responses regarding call activity failed to capture nuanced nuances in call frequency and intensity, potentially obscuring the nuanced relationship between call activity, sleep disruption, and burnout.
Conclusion
In conclusion, the study underscores the multifaceted impact of home call on surgeon well-being, emphasizing the need for a holistic approach to call scheduling and workforce management. By acknowledging and addressing the challenges posed by home call, healthcare institutions can optimize call schedules, promote surgeon health and resilience, and ultimately enhance patient care quality.
Hot Take Summary
Home call poses substantial challenges to surgeon well-being, transcending conventional perceptions of its benign nature. Acknowledging and addressing these challenges is pivotal for fostering a healthier work environment and ensuring optimal patient care delivery.
Coleman, J. J., Robinson, C. K., von Hippel, W., Lawless, R. A., McMasters, K. M., & Cohen, M. J. (2024). Home is not always where the sleep is: Effect of home call on sleep, burnout, and surgeon well-being. Journal of the American College of Surgeons, 238(4), 417–422. https://doi.org/10.1097/xcs.0000000000000975