Elizabeth Morey Blecharczyk

All Publications

• Pediatric Resident Perspectives on How to Teach about Neonatal Health Inequities: A Multi-Site Exploratory Study. Academic pediatrics Punjabi, S., Konecny, C., Molina, E., Webb, R., Karvonen, K. L., Gomez, S. F., Briscoe, H., Blankenburg, R., Blecharczyk, E., CINC Study Team 2025: 102841

  Abstract

  OBJECTIVES: To examine pediatric residents' perspectives and education on neonatal health inequities, thereby identifying training needs and opportunities to improve health inequities for newborns.METHODS: We performed an IRB-approved multi-institutional, qualitative study. Over 18 months, we conducted 10 focus groups across Bay Area institutions. We developed focus group guides using literature review, expert consensus, and feedback from health equity experts. Focus groups were audio-recorded and transcribed verbatim. We used thematic analysis to code transcripts and develop themes until reaching thematic sufficiency, employing reflexivity and member checking.RESULTS: Five key themes emerged across 44 pediatric resident focus group participants. 1) Residents spotlight how neonatal inequities influence patient outcomes, finding difficulties in addressing them in real-time due to systems-level barriers and limited action-oriented knowledge. 2) Residents express a high level of moral distress and cognitive dissonance over the perceived inability to fully address inequities in the clinical setting, seeking a safe space to communicate these emotions. 3) Residents desire protected time for longitudinal reflection and action-oriented education about inequities throughout residency. 4) Residents emphasize the importance of faculty role modeling their knowledge and approach to addressing inequities, highlighting a need for ongoing faculty development. 5) Collaboration with multidisciplinary care team members, families, and community partners is central to a well-rounded curriculum.CONCLUSION: These findings underscore the need to enhance action-based health equity education in pediatric training. Addressing these identified themes can improve resident preparedness to mitigate health disparities in neonatal care, fostering equitable outcomes for newborns.

  View details for DOI 10.1016/j.acap.2025.102841

  View details for PubMedID 40280324

• Increasing in-person medical interpreter utilization in the NICU through a bundle of interventions. Journal of perinatology : official journal of the California Perinatal Association Feister, J., Razdan, S., Sharp, D., Punjabi, S., Blecharczyk, E., Escobar, V., Gay, P. M., Scala, M., Bonifacio, S. 2024

  Abstract

  In-person medical interpretation improves communication with patients who have preferred language other than English (PLOE). Multi-dimensional barriers to use of medical interpreters limit their use in the NICU.Medical teams in our NICU were not consistently using in-person medical interpreters, leading to ineffective communication with families with PLOE.Interventions included staff educational sessions and grand rounds regarding equitable language access, distribution of interpreter request cards to families, and allocation of dedicated in-person interpreters for NICU rounds. Interpreter utilization was calculated by total requests per Spanish-speaking person day in the NICU.Interpreter utilization increased five-fold during the intervention period (from 0.2 to 1.0 requests per Spanish-speaking person day).We substantially increased our unit in-person interpreter utilization through a bundle of multifaceted interventions, many of which were low-cost. NICUs should regard dedicated medical interpreters as a critical part of the care team.

  View details for DOI 10.1038/s41372-024-01915-5

  View details for PubMedID 38424233

  View details for PubMedCentralID 1955368

• Development of a Multi-site Curriculum for Inequities in Newborn Care (CINC) Informed by Pediatric Resident and Community Engagement. Academic pediatrics Punjabi, S., Blankenburg, R., Blecharczyk, E., CINC Study Team 2023

  View details for DOI 10.1016/j.acap.2023.06.019

  View details for PubMedID 37353193

• Standardized Evaluation of Cord Gases in Neonates at Risk for Hypoxic Ischemic Encephalopathy. Hospital pediatrics Blecharczyk, E., Lee, L., Birnie, K., Gupta, A., Davis, A., Van Meurs, K., Bonifacio, S., Frymoyer, A. 2021

  Abstract

  BACKGROUND: Umbilical-cord acidemia may indicate perinatal asphyxia and places a neonate at increased risk for hypoxic ischemic encephalopathy (HIE). Our specific aim was to develop a standardized clinical care pathway, ensuring timely identification and evaluation of neonates with umbilical-cord acidemia at risk for HIE.METHODS: A standardized clinical care pathway to screen inborn neonates ≥36 weeks with abnormal cord blood gases (a pH of ≤7.0 or base deficit of ≥10) for HIE was implemented in January 2016. Abnormal cord blood gases resulted in a direct notification from the laboratory to an on-call physician. Evaluation included a modified Sarnat examination, postnatal blood gas, and standardized documentation. The percentage of neonates in which physician notification, documented Sarnat examination, and postnatal blood gas occurred was examined for 6 months before and 35 months after implementation.RESULTS: Of 203 neonates with abnormal cord gases in the post-quality improvement (QI) period, physician notification occurred in 92%. In the post-QI period, 94% had a documented Sarnat examination, and 94% had postnatal blood gas, compared with 16% and 11%, respectively, of 87 neonates in the pre-QI period. In the post-QI period, of those evaluated, >96% were documented within 4 hours of birth. In the post-QI period, 15 (7.4%) neonates were cooled; 13 were in the NICU at time of identification, but 2 were identified in the newborn nursery and redirected to the NICU for cooling.CONCLUSIONS: A standardized screening pathway in neonates with umbilical-cord acidemia led to timely identification and evaluation of neonates at risk for HIE.

  View details for DOI 10.1542/hpeds.2021-006135

  View details for PubMedID 34854918

• Case 1: Rapidly Rising Bilirubin Level in a 3-day-old Term Infant. NeoReviews Tise, C. G., Joshi, N. S., Erice-Taganas, A. D., Blecharczyk, E. M. 2020; 21 (10): e687–e690

  View details for DOI 10.1542/neo.21-10-e687

  View details for PubMedID 33004562