Faculty mentor/PI email address
jim010@aol.com
Is your research Teaching and Learning based?
1
Keywords
Emergency medicine; shift work; patient safety; cognitive fatigue; clinical handoffs; human factors; complex adaptive systems
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Emergency department shift duration has long been debated as a determinant of patient safety. While longer shifts may increase cognitive fatigue, shorter shifts may increase the frequency of patient handoffs, which themselves introduce communication risk. Objective: To conceptualize emergency department shift length as a safety paradox arising from the balance between fatigue and handoff-related communication risks. Conceptual Framework: We propose the Emergency Department Shift Length Safety Paradox model illustrating the nonlinear relationship between shift duration and patient safety. Implications: Optimal shift design may depend on balancing fatigue risk and communication risk within a complex adaptive healthcare system. Conclusion: Emergency department shift safety emerges from the interaction of cognitive performance, communication structures, and operational dynamics rather than from shift duration alone.
Disciplines
Emergency Medicine | Medicine and Health Sciences | Quality Improvement
Included in
The Safety Paradox of Emergency Department Shift Length: Why the Relationship Between Hours Worked and Patient Safety Is More Complex Than It Appears
Background: Emergency department shift duration has long been debated as a determinant of patient safety. While longer shifts may increase cognitive fatigue, shorter shifts may increase the frequency of patient handoffs, which themselves introduce communication risk. Objective: To conceptualize emergency department shift length as a safety paradox arising from the balance between fatigue and handoff-related communication risks. Conceptual Framework: We propose the Emergency Department Shift Length Safety Paradox model illustrating the nonlinear relationship between shift duration and patient safety. Implications: Optimal shift design may depend on balancing fatigue risk and communication risk within a complex adaptive healthcare system. Conclusion: Emergency department shift safety emerges from the interaction of cognitive performance, communication structures, and operational dynamics rather than from shift duration alone.