Summaries of Independent Scientist (K) Awards

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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