Effects of Sleep Loss and Night Work on Patient Safety

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DESCRIPTION: (provided by applicant) Dr. Landrigan is an Instructor of Pediatrics at Harvard Medical School and an Assistant in Medicine at Children's Hospital, Boston. Following a pediatric residency, he completed fellowship training in health services research and a Master's in Public Health. He currently supervises a general pediatric service for 3-4 months per year. The remainder of the time, he pursues health services research in the quality of inpatient care. His principal areas of interest are medical error and housestaff working conditions. He is a project leader on an AHRQ-funded study, "Effects of Extended Work Hours on ICU Patient Safety." Dr. Landrigan's immediate 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 requires further training in sleep physiology, patient safety, and human factors engineering to optimally understand the interaction of sleep deprivation with error. He will take formal courses in sleep and circadian physiology, will continue training in patient safety at the Center for Patient Safety at the Brigham and Women's Hospital, and will pursue advanced training in human factors engineering. He will receive intensive mentoring by Drs. Charles A. Czeisler and Donald A. Goldmann, national leaders in sleep deprivation and health services research, respectively. His long-term career goals are 1) to become a national leader in the study of sleep deprivation, human factors, and medical error; and 2) to implement and evaluate strategies to improve working conditions and patient safety. Dr. Landrigan's research proposal is to study 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. The results of this research may have significant implications for the traditional call schedules of medical trainees and the organization of hospital care at night.