Effect of a work schedule without short rest time (<11h) between two shifts - a randomized controlled trial among healthcare workers

According to the Working Environment Act § 10-8, employees are in principle entitled to 11 hours off between two consecutive work periods¹. Exceptions to this have been made for employees who work shifts, and Norwegian surveys have shown that about 80% of nurses report having short rest period between two shifts (<11 hours) in their work schedule². This most often occurs between an evening shift followed by a day shift and is in the English literature referred to as quick returns.

The research that has been done on the consequences of quick return-shifts so far shows an association between quick return-shifts and a number of negative health outcomes^3-9, but it is not yet known whether exposure to quick return-shifts is the cause of these health outcomes. This study is the first randomized controlled trial examining the effect of removing quick return-shifts from the work schedule. The study was conducted in an ecological research design, where healthcare workers at Haukeland University Hospital in Bergen (n = approx. 4,000) were randomized to either (1) a work schedule without quick return-shifts or (2) a work schedule with the same number of quick return-shifts as before, for a period of 6 months.

The main purpose of the study is to investigate whether healthcare workers who have a work schedule without short rest period (<11 hours) between two shifts have a change in sick leave. Furthermore, the study will, among other things, examine the effect of this change on turnover intention, work-related accidents/incidents, sleep and health, satisfaction with work schedule, general job satisfaction and family-job conflict.

The University of Bergen, the Norwegian Institute of Public Health, Helse Bergen and representatives from the employee organizations (Norwegian Nurses' Association, Fagforbundet, Delta and Fellesorganisasjonen) have jointly prepared the framework for the survey. The project is supported by the Norwegian Research Council and the University of Bergen and is approved by the Regional Committees for Medical and Health Research Ethics (REK).

Further information about the project 

• Information for the participants in the project
• Information about the project on The Research Council of Norway's webpages (project number 303671)  
• Look up ethical approval of the project on The Regional Committees for Medical and Health Research Ethics's webpages (application number 200386)
• Informasjon about the project on Clinical Trials

Results from the project

Vedaa Ø, 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;12(4):e058309. doi: 10.1136/bmjopen-2021-058309. https://pubmed.ncbi.nlm.nih.gov/35428642/