Optimal Shift Duration and Sequence: Recommended Approach for Short-Term Emergency Response Activations for Public Health and Emergency Management

Abstract

Since September 11, 2001, and the consequent restructuring of the US preparedness and response activities, public health workers are increasingly called on to activate a temporary round-the-clock staffing schedule. These workers may have to make key decisions that could significantly impact the health and safety of the public. The unique physiological demands of rotational shift work and night shift work have the potential to negatively impact decisionmaking ability. A responsible, evidence-based approach to scheduling applies the principles of circadian physiology, as well as unique individual physiologies and preferences. Optimal scheduling would use a clockwise (morning-afternoon-night) rotational schedule: limiting night shifts to blocks of 3, limiting shift duration to 8 hours, and allowing 3 days of recuperation after night shifts.

The Cost of Shift Work on Employee Health and Performance: Can Organizations Afford to Ignore the Consequences?

“…Some of the research on shift work indicates that night shift and rotating shift work is not just associated with sleep deficits but, also, with impaired judgment and human error. Studies have documented a list of serious incidents that took place due to human error in the early morning hours: the Chernobyl nuclear plant disaster, the Exxon Mobile 25 These errors in judgment have been shown to take place in hospitals as well. 26 While errors made in BPO organizations that convert documents from one format to another or develop software may not have such grave consequences as the aforementioned ones documented, they may still result in a significant loss of revenue and reputation for the organization involved.…”

“…42 Although managers interviewed at both companies were unaware that performance levels during the night shift might be impaired as a result of fatigue and other health problems employees suffered, employees were aware that their performance, and hence the incentives they earned, suffered on the night shift.…”

“…48 Understanding that circadian rhythms can be adjusted can help determine how shifts should be rotated and the amount of light needed in the workplace to ensure employees are alert during work hours and are able to sleep for an uninterrupted period afterward. 49 …”

“…50 Thus, studies suggest that individuals take between four to six weeks to adjust to any change and, therefore, recommend at least four consecutive weeks of night shift. However, since individuals often revert to their normal schedule on their days off, they may not fully adjust to the night shift even when assigned to an extended period of night shift.…”

“…Although research conducted in the United States has documented the links between shift work and ill-health, both rotating shifts and graveyard shifts are an inescapable fact of many industries. 8 Thus, the purpose of this paper is to posit possible solutions that might be explored in future research to increase employee satisfaction, promote coping strategies, and, therefore, improve both performance levels and attrition rates.…”