2023 Department of Pediatrics Academic Annual Report

Doctor of Science in Healthcare Leadership programs. Some of her current quality-improvement efforts include: a redesign of the UAB Medicine pathway for evaluation and treatment of patients presenting to the ED with chest pain, development of a standardized approach to identification and classification of potential serious safety events at UAB, including implementation of a structured root cause analysis process, and development and implementation of a care management model for patients with diabetes mellitus at UAB, including a real-time patient-level dashboard. She is a co-investigator on a competitive Center for Clinical and Translational Science (CCTS) application titled, “Data-driven decision support to proactively prioritize diabetes cases in the face of a staffing shortage.” Jeremy Loberger, M.D., leads the ventilation liberation efforts. He routinely publishes results from ventilation data on children in the PICU at Children’s of Alabama. He is the co-principal investigator that launched the first multicenter pediatric ventilation liberation collaborative in July 2023—VentLib4Kids. The collaborative currently includes 19 ICUs (PICUs and cardiac intensive care units (CICUs)) from the United States and Canada. The aim of the collaborative is to improve guideline-focused care for all children receiving invasive mechanical ventilation. Emily Dodenhoff, M.D., has a joint appointment with the Department of Medicine, Division of Palliative Care. She is working with Dr. Hayes to help develop a new Pediatric Delirium Screening tool, and she has started extracorporeal membrane oxygenation (ECMO) Palliative Trigger Consults. Luke Burton, M.D., is the assistant PICU ultrasound director. He is studying laryngeal ultrasound in the prediction of post-extubation stridor. He has been an instructor at the Society of Critical Care Medicine’s neonatal and pediatric point-of-care ultrasound course and has given several national and international ultrasound lectures. He also has interest in right ventricular failure and has given lectures and published in this area. Additionally, he is the medical director for Children’s CareFlight critical care transport team. SIMULATION/EDUCATION RESEARCH Chrystal Rutledge, M.D., has developed an important simulation outreach program, COACHES (Children’s of Alabama Community Healthcare Education Simulation Program), to assist hospitals throughout the state of Alabama with pediatric emergency preparedness. She provides guidance and education to the critical care transport team and assists with development and revision of transport protocols and guidelines. She is evaluating the impact of this program on diabetic ketoacidosis management in community hospitals. Nancy Tofil, M.D., and Dr. Rutledge published work evaluating the role of rapid cycle deliberate practice (RCDP) on the quality of Pediatric Advanced Life Support (PALS) skills in pediatric residents and the effect of training time compared to their first PALS certification. They found that regardless of the duration since certification, skills were poor and could be greatly enhanced with RCDP training. In addition, as part of the INSPIRE (International Network for Simulation-based Pediatric Innovation, Research, Education) CPR (cardiopulmonary resuscitation) Investigators group, research found that over a 12-minute CPR scenario, chest compression depth did not decline. Jordan Newman, M.D., and Nick Rockwell, M.D., serve as assistant directors of the Simulation Center. Both are site investigators for the international Standardized Communication during Cardiac Arrest to Improve Chest Compressions (SCORE) study evaluating the impact of standardized communication surrounding pauses during chest compressions. Dr. Newman received a Kaul Pediatric Research Institute Quality Improvement Award to develop a first five-minute cart to improve bedside nurse training. Priya Prabhakaran, M.D., provides education to providers on pediatric critical care in resource limited settings. She is part of the faculty for Pediatric Emergency and Critical Care (PECC) program in Kenya, which is the only recognized training program in pediatric critical care in East Africa. As part of the Pediatric Critical Care in Resource Limited Settings group, (PCCirLS.com) which is a global network of pediatric critical care faculty from around the world, she is actively involved with the development of a virtual curriculum with synchronous and asynchronous arms and is one of the content editors. This program serves learners from Haiti, Rwanda, Nigeria, Ghana and Ethiopia. She is also part of the faculty for the Pediatrics Basic program that is conducted in many resource-limited Dr. Kong is the site PI for several multicenter trials and was part of several important publications in 2023, many of them centering on COVID-19 infection, MIS-C and outcomes in children. The group published in key medical journals, including NEJM and JAMA Pediatrics. She is also the site PI for the NIH-funded “Prone and Oscillation Pediatric Clinical Trial” (PROSpect) with the aim of identifying the most optimal positional and/or ventilation practice that leads to improved patient outcomes in critically ill children with severe acute respiratory distress syndrome. Madhura Hallman, M.D., is the site PI for the NIH-funded Post-Intensive Care Syndrome-pediatrics (PICS-p) study through the PALISI network. This is a prospective longitudinal cohort study that aims to evaluate patient and family outcomes and the trajectory of recovery in children who survive critical illness over a period of two years. As part of the POST-PICU investigators through PALISI, Dr. Hallman is involved in efforts to develop a core outcomes set to describe post-intensive care recovery in children and the newly formed Social Determinants of Health interest group. Dr. Richter is the site PI for the NIH-funded “ARDS in Children and ECMO Initiation Strategies Impact on Neuro-Development” (ASCEND) study, which aims are to determine the functional status of children following usual care in children requiring ECMO for pediatric acute respiratory distress syndrome (PARDS) relative to children who receive protocolized respiratory care for PARDS according to the NIH-funded “Prone and Oscillation Pediatric Clinical Trial” (PROSpect) and ECMO for protocol failure. 2023 PUBLICATIONS HIGH-IMPACT PUBLICATIONS Crit Care Med. 2023 Jan 1;51(1):117-126. Prediction of Difficult Laryngoscopy Using Ultrasound: A Systematic Review and Meta Analysis. Vidit Bhargava, Nicholas A Rockwell, Daniel Tawfik, Bereketeab Haileselassie, Cristina Petrisor, Erik Su. settings with a train-the-trainer model for pediatricians who take care of acute sick children. CLINICAL SCIENCE RESEARCH/NATIONAL RESEARCH COLLABORATIVES

2023 Academic Annual Report

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