EMS Sleep Health Study and Webtool for Scheduling [Traffic Tech]
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Summary
This report summarizes findings from a National Highway Traffic Safety Administration (NHTSA) project aimed at mitigating fatigue among emergency medical services (EMS) clinicians. The study was motivated by the high prevalence of poor sleep quality and fatigue in the EMS workforce, which is associated with increased risks of injury, medical errors, and impaired driving performance. EMS personnel frequently work irregular, extended shifts (up to 48 hours) and rotating schedules that disrupt circadian rhythms. The project, conducted in three phases, focused on Phase 2, which evaluated a fatigue mitigation training program, and Phase 3, which developed a web-based scheduling tool based on biomathematical modeling. The Phase 2 sleep health study utilized a cluster-randomized, wait-list control design involving 36 EMS agencies and 678 clinicians. Participants were assigned to either immediate access to a 10-module online training program covering topics such as sleep physiology, fatigue recognition, and alertness strategies, or a wait-list control group that received access after three months. The study lasted six months, though recruitment was paused during the early stages of the COVID-19 pandemic. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI). When analyzing data based on initial group assignment, there were no significant differences in PSQI scores or other fatigue measures between the intervention and control groups at either the 3-month or 6-month follow-ups. However, a secondary analysis based on adherence revealed that clinicians who viewed a higher number of modules (High adherence: 8–10 modules) showed a significant improvement in sleep quality at the 3-month mark compared to those who viewed none. This association was not significant at the 6-month follow-up. Phase 3 involved the development of a webtool for EMS shift scheduling, calibrated using the Sleep, Activity, Fatigue, and Task Effectiveness – Fatigue Avoidance Scheduling Tool (SAFTE-FAST). The tool was calibrated using objective sleep and work data from 37 EMS clinicians. The webtool allows users to input schedule details, such as shift duration, start times, and napping permissions, to generate fatigue risk levels and effectiveness predictions. Effectiveness scores estimate performance based on reaction time, with thresholds derived from aviation and railroad standards (e.g., 77% effectiveness equivalent to 18.5 hours of wakefulness). Beta testing indicated the tool was easy to understand but required simplification in input steps and output text. The study concludes that while the training program did not show significant group-level effects, higher adherence correlated with improved sleep quality in the short term, suggesting potential for fatigue education programs. The scheduling webtool provides a practical mechanism for EMS agencies to implement Fatigue Risk Management Systems by identifying vulnerable schedules. These tools, combined with evidence-based guidelines from Phase 1, offer components to help reduce fatigue and improve safety in the EMS sector, though further refinement and wider dissemination are recommended.
Key finding
The education and training program did not significantly improve sleep quality or reduce fatigue compared to the wait-list control group, although higher adherence to the training modules was associated with improved sleep quality at the three-month follow-up.
Methodology
lab_experiment
Sample size: 678
Provenance
The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via bulk_ingest_rosap on 2026-05-23 (6 acquisition events logged).
| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | rosap | — | — | 2 | 2026-05-23 |
| archive | success | — | — | — | 1 | 2026-05-23 |
| extract | success | cached | — | — | 2 | 2026-06-10 |
| clean | success | — | — | — | 1 | 2026-06-01 |
| chunk | success | — | — | — | 1 | 2026-06-01 |
| embed | success | — | — | — | 1 | 2026-06-02 |
| enrich | success | — | — | — | 1 | 2026-05-23 |
| promote | success | — | — | — | 1 | 2026-05-23 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 3 | 2026-06-10 |
| tag | success | vector_similarity | — | — | 19 | 2026-06-11 |
| verify | success | — | — | — | 2 | 2026-06-10 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.
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