Study concept and design: Starmer, Sectish, Simon, Keohane, Wassner, Harper, Landrigan.
Acquisition of data: Starmer, Simon, Wassner.
Analysis and interpretation of data: Starmer, Simon, McSweeney, Chung, Yoon, Lipsitz, Landrigan.
Drafting of the manuscript: Starmer, Yoon, Lipsitz.
Critical revision of the manuscript for important intellectual content: Starmer, Sectish, Simon, Keohane, McSweeney, Chung, Lipsitz, Wassner, Harper, Landrigan.
Statistical analysis: Starmer, Yoon, Lipsitz, Landrigan.
Obtained funding: Starmer, Landrigan.
Administrative, technical, or material support: Starmer, Sectish, Simon, Keohane, Wassner, Harper, Landrigan.
Study supervision: Starmer, Sectish, Lipsitz, Landrigan.
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Landrigan reported receiving monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for delivering lectures on sleep deprivation, physician performance, handoffs, and safety. No other authors reported disclosures.
Funding/Support: This study was supported by the Controlled Risk Insurance Company Risk Management Foundation Grant Program as well as a grant from the Boston Children’s Hospital Program for Patient Safety and Quality Research Grant Program. Dr Starmer was supported by grants T32 HP10018, a National Research Service Award in Pediatrics and 1K12HS019456-01 from the Oregon Comparative Effectiveness Research K12 Program through the Agency for Healthcare Research and Quality. Dr Landrigan is partially supported by the Child Health Corporation of America for his work as a member of the PRIS Network Executive Council. Some support for statistical analyses provided in part by the Oregon Clinical and Translational Research Institute (OCTRI) and grant UL1TR000128 from the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health (NIH).
Role of the Sponsor: The sponsors of the study had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; or the preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
Additional Contributions: We thank Lauren Steffel, MD (Stanford University, Stanford School of Medicine), Caroline Hodgkins, MPH (University of Michigan), Shannon Cottreau, BSN, RN, CPN (Boston Children’s Hospital), and Lora Bemiss, BSN (Boston Children’s Hospital), for assistance with enrollment and data collection; Matt Wien, BS (Brigham and Women’s Hospital), for assistance with development and programing of study databases; Ellen McGrath, RN (Boston Children’s Hospital), and Mark Berry, MA, CCRC (Boston Children’s Hospital), for assistance with study coordination and intervention deployment; Zunqiu Chen, MS (Oregon Health and Science University), Lindsay McFarlane, BA (Boston Children’s Hospital), Gisele Charron, BS (Boston Children’s Hospital), for statistical support and data analysis; Julie Barenholtz, MSW (Boston Children’s Hospital, New England Research Institutes), for building study databases and data analysis; Robert Kenney, MD (Boston Children’s Hospital), and Gajen Sunthara, MS (Boston Children’s Hospital), for development and programing of the computerized handoff tool; Nancy Spector MD, (St Christopher’s Hospital for Children, Drexel University School of Medicine), Rajendu Srivastava, MD, MPH (University of Utah School of Medicine, Primary Children’s Medical Center), Lisa Tse, BA (Boston Children’s Hospital), and Elizabeth Noble, BA (Boston Children’s Hospital) for careful review of manuscript drafts; and all the resident physicians at Boston Children’s Hospital who agreed to participate in the study. Dr Steffel, Mss Hodgkins, Cottreau, Bemiss, and McFarlane, Mr Chen, and resident study participants received compensation through grant support for their contributions. Messrs Wien, Berry, Sunthara, Mss McGrath, Charron, Barenholtz, and Noble, and Drs Kenny, Spector, and Srivastava did not receive financial compensation for contributions.