Landrigan, Christopher
Institution: Children's Hospital, Boston
Grant Title: Effects of Sleep Loss and
Night Work on Patient Safety
Grant Number: K08 HS013333
Duration: 5 years (2002-2007)
Total Award: $629,000
Project Description: The purpose of this study is
to examine the manner in which interns' work schedules and sleep deprivation
impact patient safety. Using a
comprehensive, prospective error detection approach along with state-of-the-art
technologies for the measurement of sleep, Dr. Landrigan will quantify the
roles of time of day, time on duty, and sleep inertia in medical error. This study will substantially add to the
understanding of sleep and patient safety by identifying the relative
contributions of each of these factors, which will be important for the
development of appropriate fatigue and error countermeasures.
Career Goals: Dr. Landrigan is an Assistant
Professor of Pediatrics at Harvard Medical School, Research and Fellowship Director of the Inpatient
Pediatrics Service at Children's Hospital Boston, and Director of the Sleep an
d Patient Safety Program at Brigham and Women's Hospital. His
immediate career goal is to develop expertise in the impact of sleep
deprivation and night work on patient safety.
He has a background in health services research and the study of
medication errors, but is obtaining further training in sleep physiology,
patient safety, and human factors engineering to optimally understand the
interaction of sleep deprivation with error.
Progress to Date: Data are being analyzed with
the intent of establishing the independent contributions of 24-hour cycles to
errors, and the associations of errors with time-on-duty and sleep
inertia. Data collection is underway for
the second year's worth of observational data.
A new protocol was developed to directly measure the effects of the duty
hour standards in three pediatric hospitals. Dr. Landrigan is the Principal Investigator (PI) on a recently awarded
Partnerships in Implementing Patient Safety Grant from the Agency for Healthcare Research and Quality (AHRQ), to further
implement reductions in work hours for ICU house staff.
Future Plans: Dr. Landrigan will complete
initial analysis of the year two data collected in the Brigham and Women's intensive care unit (ICU)
intervention study and will analyze the data collected in the duty hours
study. Manuscript preparation and data
dissemination efforts will continue.
Highlights and Specific Accomplishments:
- Professional
Societies:
- Member, American Academy of Pediatrics Provisional Section on Hospital Care.
- Member, Ambulatory Pediatrics Association.
- Assistant Professor of Pediatrics, Harvard Medical School.
- Director, Sleep and Patient Safety Program, Brigham and Women's Hospital.
- Research Director, Children's Hospital, Boston, MA.
- Plenary speaker:
Medical Errors, American Academy of Pediatrics annual meeting, San Francisco 2001.
K-Generated Publications:
- Landrigan CP, Muret-Wagstaff S, Chiang VW, et al. Effect of a Pediatric Hospitalist System on Housestaff Education and Experience. Archives of Pediatrics and Adolescent Medicine 2002;156:877-83.
- Landrigan CP, Srivastava R, Muret-Wagstaff S, et al. Impact of a Health Maintenance Organization Hospitalist System in Academic Pediatrics. Pediatrics 2002;110:720-8.
- Fortescue EB, Kaushal R, Landrigan CP, et al. Prioritizing Strategies for Preventing Medication Errors and Adverse Drug Events in Pediatric Inpatients. Pediatrics 2003;111:722-9.
- Kaushal R, Landrigan CP, Bates DW. Improving Patient Safety in Massachusetts. In: Moore RT, editor. Massachusetts Memos to the Governor. Bloomington, Indiana; 2003. p. 98-113.
- Willson DF, Landrigan CP, Horn SD, Smout RJ. Complications in Infants Hospitalized for Bronchiolitis or Respiratory Syncytial Virus Pneumonia. Journal of Pediatrics 2003;143:S142-9.
- Landrigan C. To LP or not LP: Effects of Overwork and Communication Failures on Patient Safety. AHRQ Web M&M [serial online]. October 2003. Available at http://www.Webmm.ahrq.gov/cases.aspx. Accessed November 13, 2003.
- Lockley SW, Cronin JW, Evans EE, et al. Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures. New England Journal of Medicine 2004;351:1829-37.
- Landrigan CP, Rothschild JM, Cronin JW, et al. Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units. New England Journal of Medicine 2004;351:1838-48.
AHRQ Research Portfolio: Quality and Patient Safety; Socio-economics of Health
Care; Training
AHRQ Goals: Safety and Quality
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