Health Promoting Work Schedules: The Effect of Abolishing Quick Returns
HeWoS
Towards a Sustainable Work Force in the Healthcare Sector for the 21st Century: Health-promoting Work Schedules (HeWoS)
1 other identifier
interventional
2,700
1 country
1
Brief Summary
Introduction In shift work, quick returns refer to transitions between two shifts with less than 11 hours available rest time. Twenty-three per cent of employees in European countries reported having quick returns. Quick returns are related to short sleep duration, fatigue, sleepiness, work-related accidents, and sickness absence. The present study is the first randomized controlled trial (RCT) to investigate the effect of a work schedule without quick returns for six months, compared to a work schedule that maintains quick returns during the same time frame. Methods and analysis A parallel-group cluster RCT in a target sample of more than 4000 healthcare workers at Haukeland University Hospital in Norway will be conducted. More than 70 hospital units will be assessed for eligibility and randomized to a work schedule without quick returns for six months or continue with a schedule that maintains quick returns. The primary outcome is objective records of sickness absence; secondary outcomes are questionnaire data (n ≈ 4000 invited) on sleep and functioning, physical and psychological health, work-related accidents, and turnover intention. For a subsample, sleep diaries and objective sleep registrations with radar technology (n ≈ 50) will be collected. Ethics and dissemination The study protocol was approved by the Regional Committee for Medical and Health Research Ethics in Western Norway (2020/200386). Findings from the trial will be disseminated in peer-reviewed journals and presented at national and international conferences. Exploratory analyses of potential mediators and moderators will be reported. User-friendly outputs will be disseminated to relevant stakeholders, unions and other relevant societal groups.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P75+ for not_applicable
Started Jan 2021
1 active site
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Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
December 31, 2020
CompletedStudy Start
First participant enrolled
January 1, 2021
CompletedFirst Posted
Study publicly available on registry
January 5, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
May 31, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
May 31, 2022
CompletedFebruary 16, 2022
February 1, 2022
1.4 years
December 31, 2020
February 15, 2022
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
Sickness absence
Sickness absence data will be retrieved from the local register at the hospital. Sickness absence will mainly be analysed in terms of the total number of sickness absence days and periods (spells) for a given period before compared to during the intervention period.
For example, sickness absence in the last three months of the intervention period will be compared with three months the year before the intervention started, matched in terms of season.
Secondary Outcomes (10)
Insomnia
Questionnaires are answered before and towards the end of the six-month intervention period
Shift work disorder
Questionnaires are answered before and towards the end of the six-month intervention period
Fatigue
Questionnaires are answered before and towards the end of the six-month intervention period
Job satisfaction
Questionnaires are answered before and towards the end of the six-month intervention period
Mental Health
Questionnaires are answered before and towards the end of the six-month intervention period
- +5 more secondary outcomes
Other Outcomes (1)
Unwanted / negative effects
Possible negative outcomes of the intervention will be measured after the intervention period.
Study Arms (2)
With quick returns
NO INTERVENTIONThe control condition in this trial implies that employees maintain the same number of quick returns as in previous years for the six-month intervention period. Hospital units in the control group are not expected to experience any increase in the number of quick returns.
Without quick returns
EXPERIMENTALThe intervention entails implementing a shift schedule which abolishes quick returns for a six-month intervention period. The number of quick returns in the various hospital units in this trial varies from 329-2356 per year. The intervention means that this number is abolished or reduced as much as possible. For practical reasons it is reasonable to expect that for many of the units it may be a matter of reducing rather than completely abolishing quick returns, as ensuring adequate staffing (e.g., due to sickness absence), often on short-notice make it impossible to comply with the rule of avoiding quick returns. The human resources department at the hospital assisted shift planners in scheduling shift schedules without quick returns.
Interventions
The intervention entails implementing a shift schedule which abolishes or substantially reduces the number of quick returns (less than 11 hours of rest between two shifts) for a six-month intervention period.
Eligibility Criteria
You may qualify if:
- Employees must be healthcare workers at the above-mentioned hospital units.
- Employees must have \>50% position.
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Norwegian Institute of Public Healthlead
- University of Bergencollaborator
Study Sites (1)
Haukeland University Hospital
Bergen, Vestland, 5015, Norway
Related Publications (3)
Djupedal ILR, Harris A, Svensen E, Lie SA, Wang ALH, Pallesen S, Waage S, Nielsen MB, Sunde E, Bjorvatn B, Holmelid O, Vedaa O. Shift Schedule With Fewer Short Daily Rest Periods and Sickness Absence Among Health Care Workers: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2025 Sep 2;8(9):e2531568. doi: 10.1001/jamanetworkopen.2025.31568.
PMID: 40952742DERIVEDDjupedal ILR, Harris A, Svensen E, Pallesen S, Waage S, Nielsen MB, Sunde E, Bjorvatn B, Holmelid O, Vedaa O. Effects of a work schedule with abated quick returns on insomnia, sleepiness, and work-related fatigue: results from a large-scale cluster randomized controlled trial. Sleep. 2024 Jul 11;47(7):zsae086. doi: 10.1093/sleep/zsae086.
PMID: 38581363DERIVEDVedaa O, Djupedal ILR, Svensen E, Waage S, Bjorvatn B, Pallesen S, Lie SA, Nielsen M, Harris A. Health-promoting work schedules: protocol for a large-scale cluster randomised controlled trial on the effects of a work schedule without quick returns on sickness absence among healthcare workers. BMJ Open. 2022 Apr 15;12(4):e058309. doi: 10.1136/bmjopen-2021-058309.
PMID: 35428642DERIVED
Related Links
MeSH Terms
Conditions
Condition Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Anette Harris, PhD
University of Bergen, Norway
Central Study Contacts
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- SINGLE
- Who Masked
- OUTCOMES ASSESSOR
- Masking Details
- All statistical analyses will be done by a researcher who is masked to group allocation.
- Purpose
- PREVENTION
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER GOV
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
December 31, 2020
First Posted
January 5, 2021
Study Start
January 1, 2021
Primary Completion
May 31, 2022
Study Completion
May 31, 2022
Last Updated
February 16, 2022
Record last verified: 2022-02
Data Sharing
- IPD Sharing
- Will share
- Shared Documents
- STUDY PROTOCOL, SAP, ICF
- Time Frame
- De-identified data that underlie the results reported from the trial described in this protocol will be available to researchers from accredited research institutions. Access to data will be limited to investigators who provide a methodologically sound proposal and will be limited to a specified time period (commencing about 3 months after publication of a respective Article and ending after 5 years).
- Access Criteria
- To ensure compliance with the General Data Protection Regulation, data processing must be covered by the European Commission's standard contractual clauses for the transfer of data, which must be signed by the data requesters. Proposals and requests for data access should be directed to the corresponding author of the respective Article.
De-identified data that underlie the results reported from the trial described in this protocol will be available to researchers from accredited research institutions. Access to data will be limited to investigators who provide a methodologically sound proposal and will be limited to a specified time period (commencing about 3 months after publication of a respective Article and ending after 5 years). To ensure compliance with the General Data Protection Regulation, data processing must be covered by the European Commission's standard contractual clauses for the transfer of data, which must be signed by the data requesters. Proposals and requests for data access should be directed to the corresponding author of the respective Article. User-friendly output from the trial will be disseminated to stakeholder and other relevant organisations.