Who Benefits from Late Night Radiology Shifts?

Overnight radiology shifts increase image report reading rates and processing, but radiologists who burn the midnight oil tend to struggle with diagnostic performance. According to a study published in the Journal of the American College of Radiology, tired radiologists working late at night spend more time on cases and miss more abnormalities than radiologists working during the day.

Health care facilities are requiring radiologists to generate image reports at faster rates in order to speed up patient turn around and expedite their time in emergency rooms. However, working long hours late at night can have physiological consequences on physicians including irregular sleep cycle, diabetes, poor cardiovascular health, and heightened risk of cancer.

Researchers from Emory University Midtown Hospital used eye trackers to study the image reading behavior of five faculty radiologists and seven resident radiologists as they examined bone radiographs during two regular shifts. The first shift was from 8 am to 5 pm, and the second started at 10 pm and went to 7 am.

Both faculty and residents had difficulties focusing on the fracture target. The researchers found that both groups overall took 45 percent longer to view images, 24 percent longer to fixate on the fracture, and a “60 percent increase in gaze fixations.”  When they were tired, faculty spent on average 14.9 seconds fixating on the target; during the day however, the mean time was 11.1 seconds. Residents took even longer, with 15.5 seconds while fatigued and 11.8 fully rested. Although radiologists spent more time looking at a case while tired, they were less likely to report accurate diagnoses. After their late-night shifts, both groups of radiologists were tired, physically uncomfortable, and felt unmotivated.