Faculty Profile

Division of Seep Medicine, Brigham and Women's Hospital
Harvard Work Hours, Health, and Safety Group
Children's Hospital Inpatient Pediatrics Service, Division of General Pediatrics, Children's Hospital Boston

Since 1998, I have been studying the quality of the healthcare system (particularly in the inpatient setting) and patient safety. Over the past five years, I have developed a particular interest in the effects of provider sleep deprivation on patient and provider safety. The Harvard Work Hours, Health, and Safety Study has consequently been conducting a series of studies to quantify the relationships between provider sleep loss and safety. We found in a randomized trial conducted at BWH that interns working traditional 30 hour shifts on a regular basis made 36% more serious medical errors, and more than five times as many serious diagnostic errors, as those whose scheduled work was limited to 16 consecutive hours (NEJM, 2004). A related nationwide study led by Laura Barger, Ph.D. found that interns driving home after working shifts >24 hours had more than twice the odds of crashing their cars (NEJM, 2005). Currently, we are engaged in ongoing studies and policy efforts to implement safer work hours for physicians, and to study the effects of long work hours in other occupational groups.

2001-2004    Supinda Bunyavanich, MD. Medical student, Harvard Medical School, Boston, MA. 
2001-2004    Colleen Sabatini, MD, MPH. Medical student, Harvard Medical School, Boston, MA. resident at Massachusetts General Hospital.
2002-2004    Sarah McBride, MD, hospitalist fellow, Children’s Hospital Boston, Boston, MA. 
2002-2004    John Cronin, MD, research fellow, Brigham and Women’s Hospital, Boston, MA.
2002-2007    Kathleen Walsh, MD, MSc, general pediatrics fellow, Boston Medical Center, Boston, MA.
2003-2005    Kshitij Mistry, MD, intensive care fellow, Children's Hospital Boston, Boston, MA.
2003-2007    Patrick Conway, MD, resident, Children's Hospital Boston, Boston, MA, and Robert Wood Johnson Scholar, University of Pennsylvania, Philadelphia, PA.
2003-2008    Amy Fahrenkopf, MD, MPH, resident and hospitalist fellow, Children's Hospital Boston, Boston, MA.
2004-2006    Sarah Edwards, research assistant, Children’s Hospital Boston / Brigham and Women’s Hospital.
2004-2006    Michael Gaies, MD, MPH, chief resident, Children’s Hospital Boston.
2007-present    Carl Eriksson, MD, chief resident and critical care fellow, Children’s Hospital Boston.
2007-present    Adam Levine, MD, emergency medicine resident, Brigham and Women’s Hospital.
2008-present    Josna Adusumilli, MD, sleep medicine fellow, Brigham and Women’s Hospital.
2008-present    Mary Beth Gordon, MD, hospitalist and health services research fellow, Children’s Hospital Boston.
2008-present    Amy Jost, MD, health services research fellow, Children’s Hospital Boston.

Charles A. Czeisler, PhD, MD
Past Mentors: Charles Homer, MD; Donald Goldmann, MD

1998-2000 AHCPR, Fellow
Institutional - Primary Care Research

1999-2000 Harvard Risk Management Foundation, Co-Investigator        
Pediatric Medication Errors and Adverse Drug Events
                     
1999-2000 Harvard Pilgrim Health Care Foundation, Co-PI                  
Impact of an Inpatient Service led by Pediatric Hospitalists

2000-2003 National PatientSafety Foundation, Co-Investigator                                 
Serious Pediatric Medication Errors: Evaluation and Prevention Strategies

2001-2005 AHRQ/NIOSH (R01), Project Leader          
Impact of Fatigue on ICU Patient and Resident Safety

2002-2003 Medimmune, Inc., PI            
Bronchiolitis: Preventable Hospital Costs and Adverse Events

2002-2007 AHRQ (K08), PI            
Effects of Sleep Loss and Night Work on Patient Safety

2003-2004 Harvard Risk Management Foundation, Mentor, Co-Investigator     
Communication during Post-operative Patient Hand Off Events in the Pediatric Intensive Care Unit

2003-2004 Lovejoy Resident Research Fund, Children’s Hospital, Mentor, Co-Investigator    
Housestaff Burnout and Depression and its Effects on Patient Safety

2003-2004 Lovejoy Resident Research Fund, Children's Hospital, Mentor, Co-Investigator    
Hospitalist Management of Common Pediatric Illnesses: Predictors of Variability
                
2003-2004 Harvard Risk Management Foundation, Co-PI            
Implementation of a Pediatric Intermediate Care Unit:Effects on Patient Safety 

2004-2005 Lovejoy Resident Research Fund, Children's Hospital, Mentor, Co-Investigator    
A Randomized Trial to Teach Procedural Skills to Pediatric Residents

2004-2005 Thrasher Foundation, Co-Investigator     
Bronchiolitis in the ED: Low-risk Discharges and High-risk Admissions

2004-2006 National Institute of Justice (NIJ), Co-Investigator    
Testing the Effectiveness of a Comprehensive Fatigue Management Program for the Boston Police
    
2004-2007 CDC (R01), Co-Investigator    
Effectiveness of a Sleep Disorders Treatment Program to Improve Police Officer Safety
                        
2005-2008 AHRQ (U18), PI            
Implementing Reduced Work Hours for All ICU House Staff to Improve Patient Safety
                        
2007-2008 DURIP (Department of Defense University Research Instrmnt. Program – Air Force Office of Scientific Research), Co-PI            
Translating the science of alertness and performance from laboratory to field: Using state-of-the-art monitoring, imaging, and performance enhancement technologies to improve the alertness and safety of the military and civilian workforce
          
2007-2010 CDC (R01), Co-Investigator    
Evaluation of the potential for translation to practice of a sleep disorders management program for police

2008- Harvard Risk Management Foundation, PI
Implementing a Comprehensive Signout Program in a Pediatric Hospital

Cappuccio FP, Bakewell A, Taggart FM, Ward G, Chen J, Sullivan JP, Edmunds M, Pounder R, Landrigan CP, Lockley SW, Peile E.  Implementing a 48h EWTD-compliant rota for junior doctors in the UK does not compromise patients’ safety: a single-blind intervention study.  In press, QJM.

Landrigan CP, Conway PH, Stucky ER, Chiang VW, Ottolini MC. Variation in pediatric hospitalists' use of proven and unproven therapies: a study from the Pediatric Research in Inpatient Settings (PRIS) network.
J Hosp Med. 2008 Jul;3(4):292-8. [PMID: 18698602]

Walsh KE, Landrigan CP, Adams WG, Vinci RJ, Chessare JB, Cooper MR, Hebert PM, Schainker EG, Bauchner H. Effect of Computer Order Entry on Prevention of Serious Medication Errors in Hospitalized Children.
Pediatrics 2008; 121:e421-427.

Landrigan CP, Fahrenkopf AM, Lewin D, Sharek PJ, Barger LK, Eisner M, Edwards S, Chiang VW, Wiedermann BL, Sectish TC.  Effects of the Accreditation Council for Graduate Medical Education Duty Hour Limits on Sleep, Work Hours, and Safety.
Pediatrics 2008; 122: 250-258.

Fahrenkopf AM, Sectish TC, Barger LK, Sharek PJ, Lewin D, Chiang VW, Edwards S, Wiedermann BL, Landrigan CP. Rates of Medication Errors Among Depressed and Burned Out Residents: A Prospective Cohort Study.
MJ 2008; 336: 488-491. Epub 2008 Feb 7.

Gaies MG, Landrigan CP, Hafler JP, Sandora TJ. Assessing Procedural Skills Training in Pediatric Residency Programs.
Pediatrics. 2007 Oct;120(4):715-22. [PMID: 17908757]

Srivastava R, Landrigan CP, Ross-Degnan R, Soumerai  SB, Homer DJ, Goldmann DA, Muret-Wagstaff S. Impact of a Hospitalist System on Length of Stay and Cost for Children with Common Conditions.
Pediatrics. 2007 Aug;120(2):267-74. [PMID: 17671051]

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. 2006 Nov;118(5):1872-9. [PMID: 17079557]

Conway PH, Edwards S, Stucky ER, Chiang VW, Ottolini MC, Landrigan CP. Variations in management of common inpatient pediatric illnesses: hospitalists and community pediatricians.
Pediatrics. 2006 Aug;118(2):441-7. [PMID: 16882793]

Lockley SW, Landrigan CP, Barger LK, Czeisler CA. When Policy Meets Physiology: The Challenge of Reducing Resident Work Hours.
Clin Orthop Relat Res. 2006 Aug;449:116-27. [PMID: 16770285]

Landrigan CP, Barger LK, Cade BE, Ayas NT, Czeisler CA. Interns' compliance with accreditation council for graduate medical education work-hour limits.
JAMA. 2006 Sep 6;296(9):1063-70. [PMID: 16954485]

Landrigan CP, Conway P, Edwards S, Srivastava R. Pediatric Hospitalists: A Systematic Review of the Literature.
Pediatrics. 2006 May;117(5):1736-44 [PMID: 16651332]

Lye PS, Rauch D, Ottolini M, Landrigan CP, Chiang V, Srivastava R, Muret-Wagstaff S, Ludwig S. Pediatric Hospitalists: Report of a Leadership Conference.
Pediatrics. 2006 Apr;117(4):1122-30. [PMID: 16585306]

Rothschild JM, Hurley AC, Landrigan CP, Cronin JW, Martell-Waldrop K, Foskett C, Burdick E, Czeisler CA, Bates DW. Recovery from Medical Errors: The Critical Care Nursing Safety Net. Joint Commission Journal on Quality and Patient Safety. 2006 Feb;32(2):63-72. [PMID: 16568919]

McBride SA, Chiang VW, Goldmann DA, Landrigan CP. Preventable adverse events in infants hospitalized with bronchiolitis.
Pediatrics. 2005 Sep;116(3):603-8. [PMID: 16140699]

Rothschild JM, Landrigan CP, Cronin JW, Kaushal R, Lockley SE, Burdick E, Stone PH, Lilly CM, Katz JT, Czeisler CA, Bates DW. The Critical Care Safety Study: The Incidence and Nature of Adverse Events and Near-Misses in Intensive Care.
Crit Care Med. 2005 Aug;33(8):1694-700. [PMID: 16096443]

Lockley SW, Cronin JW, Evans EE, Cade BE, Lee CJ, Landrigan CP, Rothschild JM, Katz JT, Lilly CM, Stone PH, Aeschbach D, Czeisler CA. Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures.
New Engl J Med. 2004 Oct 28;351(18):1829-37. [PMID: 15509816]

Landrigan CP, Rothschild JM, Cronin JW, Kaushal R, Burdick E, Katz JT, Lilly CM, Stone PH, Lockley SW, Bates DW, Czeisler CA. Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units.
New Engl J Med. 2004 Oct 28;351(18):1838-48. [PMID: 15509817]

Willson DF, Landrigan CP, Horn SD, Smout RJ. Complications in Infants Hospitalized for Bronchiolitis or Respiratory Syncytial Virus Pneumonia.
J Pediatr. 2003 Nov;143(5 Suppl):S142-9. [PMID: 14615713]

Fortescue EB, Kaushal R, Landrigan CP, McKenna KJ, Clapp MD, Federico F, Goldmann DA, Bates DW. Prioritizing Strategies for Preventing Medication Errors and Adverse Drug Events in Pediatric Inpatients.
Pediatrics. 2003 Apr;111(4 Pt 1):722-9. [PMID: 12671103]

Olsen SJ, Bleasdale SC, Magnano AR, Landrigan C, Holland BH, Tauxe RV, Mintz ED, Luby S. Outbreaks of Typhoid Fever in the United States, 1960-1999.
Epidemiology and Infection. 2003 Feb;130(1):13-21. [PMID: 12613741]

Bunyavanich S, Landrigan CP, McMichael AJ, Epstein PR. The Impact of Climate Change on Child Health.
Ambulatory Pediatrics. 2003 Jan-Feb;3(1):44-52. [PMID: 12540254]

Landrigan CP, Srivastava R, Muret-Wagstaff S, Soumerai SB, Ross-Degnan D, Graef JW, Homer CJ, Goldmann DA. Impact of a Health Maintenance Organization Hospitalist System in Academic Pediatrics.
Pediatrics. 2002 Oct;110(4):720-8. [PMID: 12359785]

Landrigan CP, Muret-Wagstaff S, Chiang VW, Nigrin DJ, Goldmann DA, Finkelstein JA. Effect of a Pediatric Hospitalist System on Housestaff Education and Experience.
Archives of Pediatrics and Adolescent Medicine. 2002 Sep;156(9):877-83. [PMID: 12197794]

Srivastava R, Landrigan C, Gidwani P, Harary O, Muret-Wagstaff S, Homer CJ. Pediatric Hospitalists in Canada and the United States: A Survey of Pediatric Academic Department Chairs.
Ambulatory Pediatrics. 2001 Nov-Dec;1(6):338-9. [PMID: 11888425]

Kaushal R, Bates DW, Landrigan C, McKenna KJ, Clapp MD, Federico F, Goldmann DA. Medication Errors and Adverse Drug Events in Pediatric Inpatients.
JAMA. 2001 Apr 25;285(16):2114-20. [PMID: 1131110]