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Journal of Hospital Medicine Research Explores Behavioral Nudges to Minimize Patient Sleep Disruption

January 08, 2019

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Representing the fastest growing specialty in modern healthcare, the Society of Hospital Medicine (SHM) is the leading medical society for hospitalists and their patients.

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Study Demonstrates the Importance of a Full Team Approach for Sustainability

The Journal of Hospital Medicine, the official peer-reviewed journal of the Society of Hospital Medicine (SHM), published a study today entitled “Effectiveness of SIESTA on Objective and Subjective Metrics of Nighttime Hospital Sleep Disruptors,” which focuses on improving the inpatient overnight experience through routine changes, nursing education and electronic health record (EHR) modifications.

“While other efforts have been undertaken to improve sleep for hospitalized patients, it remains a problem,” notes Vineet Arora, MD, MAPP, MHM and lead author for the study. “We leveraged the use of the electronic health record to nudge physicians to choose sleep-friendly options and coached nurses to advocate for patients when appropriate. The combination of the two was what led to the biggest improvements for patients.”

Sleep for Inpatients: Empowering Staff to Act (SIESTA) was developed through patient surveys and staff focus groups, identifying overnight vitals, medication administration and phlebotomy as major barriers to patient sleep. This study’s outcomes are consistent with other research highlighting the alteration of EHR systems to influence physician behavior; what makes this study unique is the utilization and empowerment of the nursing staff to foster longer-lasting results.

The study reads, “While the initial decrease in nocturnal room entries post-SIESTA eventually faded, sustainable changes were observed only after SIESTA was added to nursing huddles, which illustrates the importance of using multiple methods – both electronically and in person – to nudge staff.”

“The hospital environment is filled with disruptions that interfere with a patient’s sleep, which can significantly impair his or her ability to process provider instructions and meaningfully participate in care decisions,” says Samir S. Shah, MD, MSCE, SFHM, Editor-in-Chief of the Journal of Hospital Medicine. “Dr. Arora and colleagues highlight that many of these disruptions are within the control of medical providers and offer practical guidance on how to leverage a team-based approach to modify the hospital environment. This approach is generalizable to most hospital settings.”

Click here to access the study and visit for additional research. 

About the Society of Hospital Medicine:

Representing the fastest growing specialty in modern healthcare, the Society of Hospital Medicine (SHM) is the leading medical society for more than 62,000 hospitalists and their patients. SHM is dedicated to promoting the highest quality care for all hospitalized patients and overall excellence in the practice of hospital medicine through quality improvement, education, advocacy and research. Over the past decade, studies have shown that hospitalists can contribute to decreased patient lengths of stay, reductions in hospital costs and readmission rates, and increased patient satisfaction.

About the Journal of Hospital Medicine:

The Journal of Hospital Medicine is the premier, ISI-indexed publication for the specialty of hospital medicine and official journal of the Society of Hospital Medicine. Published by Frontline Medical Communications, the journal advances excellence in hospital medicine as a defined specialty through the dissemination of research, evidence-based clinical care, and advocacy of safe, effective care for hospitalized patients. For more information, please visit and follow the Journal of Hospital Medicine on Twitter @JHospMedicine.