Effects of Reducing the Number of Quick Returns (< 11 h off Between Shifts) on Turnover Intention and Job Satisfaction: a Cluster-Randomized Controlled Trial Among Healthcare Workers

Erlend Sunde; Ingebjørg Louise Rockwell Djupedal; Øystein Vedaa; Ståle Pallesen; Bjørn Bjorvatn; Siri Waage; Morten Birkeland Nielsen; Stein Atle Lie; Bjarte Birkeland Kysnes; Anette Harris

doi:10.1007/s10926-026-10383-x

Effects of Reducing the Number of Quick Returns (< 11 h off Between Shifts) on Turnover Intention and Job Satisfaction: a Cluster-Randomized Controlled Trial Among Healthcare Workers

J Occup Rehabil. 2026 Apr 3. doi: 10.1007/s10926-026-10383-x. Online ahead of print.

Authors

Erlend Sunde¹, Ingebjørg Louise Rockwell Djupedal^{2

3}, Øystein Vedaa^{4

5}, Ståle Pallesen^{6

7}, Bjørn Bjorvatn^{7

8}, Siri Waage^{7

8}, Morten Birkeland Nielsen^{6

9}, Stein Atle Lie¹⁰, Bjarte Birkeland Kysnes⁶, Anette Harris^{6

9}

Affiliations

¹ Department of Health Promotion, The Norwegian Institute of Public Health, Zander Kaaesgate 7, 5015, Bergen, Norway. erlend.sunde@fhi.no.
² Department of Research Administrative Support, The Norwegian Institute of Public Health, Bergen, Norway.
³ Department of Research, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
⁴ Department of Health Promotion, The Norwegian Institute of Public Health, Zander Kaaesgate 7, 5015, Bergen, Norway.
⁵ Solli District Psychiatric Centre, Bergen, Norway.
⁶ Department of Psychosocial Science, University of Bergen, Bergen, Norway.
⁷ Haukeland University Hospital, Norwegian Competence Center for Sleep Disorders, Bergen, Norway.
⁸ Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
⁹ Research Group for Work Psychology and Physiology, The National Institute of Occupational Health, Oslo, Norway.
¹⁰ Department of Clinical Dentistry, University of Bergen, Bergen, Norway.

PMID: 41933114
DOI: 10.1007/s10926-026-10383-x

Abstract

Purpose: To investigate the effects of reducing quick returns (i.e., < 11 h between shifts) on turnover intention and job satisfaction, and to explore potential moderating factors.

Methods: A cluster-randomized controlled trial was conducted at a Norwegian university hospital, where 66 units were randomly assigned to an intervention or control group. Participants, comprising healthcare workers (n = 1314; 85.2% female) contracted to ≥ 50% of full-time positions, were followed over six months. The intervention group was assigned to a work schedule with fewer quick returns, while the control group maintained its level of quick returns. Turnover intention and job satisfaction were assessed at baseline and follow-up using validated self-report measures. Linear mixed models were used to evaluate intervention effects and potential moderators.

Results: The intervention group halved the number of quick returns from baseline (mean = 13.2, SD = 8.7) to follow-up (mean = 6.7, SD = 6.0), while the control group showed minimal change (baseline mean = 13.2, SD = 8.7; follow-up mean = 12.0, SD = 9.3). No overall effects were found on turnover intention and job satisfaction. However, moderator analyses revealed that among workers aged 30-41 years, the intervention reduced turnover intention (p = .003, Cohen's d = -0.54), primarily observed among workers aged 30-41 years with no children at home, and improved job satisfaction (p = .003, Cohen's d = 0.54). Additionally, beneficial effects on turnover intention were found among workers with commuting times exceeding 45 min.

Conclusions: Reducing quick returns improved job satisfaction and reduced turnover intention in specific subgroups. These findings highlight the importance of considering factors such as age, family status, and commuting time, when planning shift schedules in healthcare settings.

Trial registration: ClinicalTrials.gov identifier: NCT04693182 (registered 12/31/2020).

Keywords: Daily rest; Recovery; Shift work; Short rest; Work schedule; Working time.

Associated data

ClinicalTrials.gov/NCT04693182

Abstract

Associated data

Grants and funding