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Institution: Children's Hospital, Boston (2002-2004); Brigham and Women's Hospital (2005-2007)
Grant Title: Effects
of Sleep Loss and Night Work on Patient Safety
Grant Number: K08 HS013333
Total Award: $629,000
Project Description: The purpose of this study was
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 quantified the roles of time of day, time on duty, and sleep inertia
in medical error. This study added substantially to the understanding of sleep
and patient safety by identifying the relative contributions of each of these
Career Goals:Dr. Landrigan is an Assistant Professor of Pediatrics at the Harvard Medical School. He received his MD from Mount Sinai Medical School in New York and served in residency in Pediatrics at Children's Hospital Boston. He later received his MPH from Harvard School of Public Health. Dr. Landrigan is considered an expert in resident work hours and his K-supported research played a major role in the Institute of Medicine (IOM)
launching an investigation in this area.
Progress to Date: This grant has been
completed. In the first study, the Accreditation Council for Graduate Medical Education (ACGME) work hour standards were found to have little effect on residents' work hours, sleep, or patient safety. In the second study, resident depression was found to have a strong relationship with patient safety.
Highlights and Specific Accomplishments:
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.
Fortescue EB, Kaushal
R, Landrigan CP, et al. Prioritizing
strategies for preventing medication errors and adverse drug events in pediatric
inpatients. Pediatrics 2003. 111:722-29.
Willson DF, Landrigan CP,
Horn SD, Smout RJ. Complications in infants hospitalized for bronchiolitis or
respiratory syncytial virus pneumonia. Journal of Pediatrics 2003.
Landrigan C. To LP or not LP: Effects of overwork and communication
failures on patient safety. AHRQ Web M&M [serial online]. October 2003. http://www.webmm.ahrq.gov/cases.aspx?ic=34.
Lockley SW, Cronin JW, Evans
EE, Cade BE, Lee CJ, Landrigan CP, et al. Effect of reducing interns' weekly
work hours on sleep and attentional failures. New England Journal of Medicine 2004.
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.
McBride SA, Chiang VW,
Goldmann DA, Landrigan CP. Bronchiolitis: Preventable hospital adverse
events. Pediatrics 2005. 116:603-8.
Rothschild JM, Landrigan
CP, Cronin JW, et al. The critical care safety study: The incidence and
nature of adverse events and near-misses in intensive care. Critical Care
Medicine 2005. 33:1694-700.
Rothschild JM, Hurley AC, Landrigan
CP, et al. Recovery from medical errors: The critical care nursing safety
net. Joint Commission Journal on Quality and Patient Safety 2006. 32:63-72.
Landrigan CP, Conway P, Edwards S, Srivastava R. Pediatric
hospitalists: A systematic review of the literature. Pediatrics 2006.
Conway P, Edwards S, Stucky
ER, Chiang VW, Ottolini MC, Landrigan CP. Variations in management of
common inpatient pediatric illnesses: Hospitalists and community pediatricians. Pediatrics 2006. 118:441-7.
Walsh KE, Adams WG, Bauchner
H, Vinci RJ, Chessare JB, Cooper MR, Hebert PM, Schainker EG, Landrigan CP.
Medication errors related to computer order entry in children. Pediatrics
Landrigan CP, Barger LK, Cade BE, et al. Interns' compliance with
accreditation council for graduate medical education work-hour limits. Journal of the American Medical Association 2006. 296:1063-70.
Srivastava R, Landrigan CP,
Ross-Degnan R, et al. Impact of a hospitalist system on length of stay and cost
for children with common conditions. Pediatrics 2007. 120:267-74.
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