Clinical Assistant Professor of Pediatrics; Division of Neonatal and Developmental Medicine.
Experienced Pediatrician/Neonatologist with training as a Stanford Biodesign Innovation Fellow interested in promoting medtech innovation in neonatology, pediatrics and women's health. Research interests also include: neonatal resuscitation, simulation, human factors, information data displays.
Center for Advanced Pediatric and Perinatal Education (CAPE) Faculty
Fellowship:Lucile Packard Children's Hospital at Stanford University Medical CenterCA
Board Certification: Pediatrics, American Board of Pediatrics (2013)
Residency:Lucile Packard Children's Hospital (2013) CA
Medical Education:State University of New York at Buffalo School of Medicine (2010) NY
MD, Lucile Packard Children's Hospital at Stanford University, Neonatal-Perinatal Medicine (2016)
MD, Lucile Packard Children's Hospital at Stanford University, Pediatrics Resident (2013)
MD, SUNY Buffalo School of Medicine and Biomedical Sciences, Medicine (2010)
BS, Brown University, Neuroscience (2003)
Current Research and Scholarly Interests
Currently, I am a Neonatal-Perinatal Medicine Fellow and am committed to improving the health and safety of neonates. My research interests include neonatal resuscitation and redesigning clinical spaces/data displays to improve patient care. I am particularly interested in using simulation as a training and research methodology to accelerate the learning process from novice trainee to expert practitioner.
I have identified, Dr. Lou Halamek as my fellowship mentor. He is the former neonatology fellowship program director at Lucile Packard Children’s Hospital at Stanford University, and the founder and medical director of the Center for Advanced Pediatric and Perinatal Education (CAPE) at Stanford. CAPE is a state-of-the-art facility that provides a realistic delivery and resuscitation room with microphones, cameras, and a computerized neonatal patient simulator, separated from a control room by a one-way mirror. These facilities have been in operation since 2002 and have been used to train hundreds of healthcare providers in the complex task of neonatal resuscitation.
I spend my non-clinical time conducting research projects at CAPE in addition to gaining other skills for my career, including becoming an experienced NRP instructor and continuing to use simulation as a research methodology.
Improving diagnostic accuracy and efficiency by optimization of bedside data display: A human factors approach, Stanford University
Current methods of bedside data display in intensive care units requires healthcare professionals to assimilate multiple sources of data located in separate physical and virtual locations in order to respond to time sensitive changes in clinical status. Such a system fails to facilitate pattern recognition essential for the trainee learning experience; thus is suboptimal for both ensuring patient safety and enhancing skill acquisition. Other high-risk industries have developed strategies to address these safety and human performance issues. In the commercial aviation industry, flight cockpits are designed to facilitate expedient assimilation of time sensitive data (“the glass cockpit”) and their implementation has been shown to reduce crew mental workload, prevent accidents/errors and enhance cost savings. Such a strategy may yield similar results when applied in healthcare. The aim of this study is to evaluate if simultaneous data display (patient problem list, vital sign trends/current vital signs, pertinent laboratory results, and most recent radiographs) at the patient bedside improves diagnostic accuracy and efficiency in a simulated neonatal intensive care environment.
Welch Road, Palo Alto, CA
- Lou Halamek, Professor, Lucile Packard Children's Hospital
Impact of a novel decision support tool on adherence to Neonatal Resuscitation Program algorithm
2015; 88: 52-56
Studies have shown that healthcare professionals (HCPs) display a 16-55% error rate in adherence to the Neonatal Resuscitation Program (NRP) algorithm. The aim of this study was to evaluate adherence to the Neonatal Resuscitation Program algorithm by subjects working from memory as compared to subjects using a decision support tool that provides auditory and visual prompts to guide implementation of the Neonatal Resuscitation Program algorithm during simulated neonatal resuscitation.Healthcare professionals (physicians, nurse practitioners, obstetrical/neonatal nurses) with a current NRP card were randomized to the control or intervention group and performed three simulated neonatal resuscitations. The scenarios were evaluated for the initiation and cessation of positive pressure ventilation (PPV) and chest compressions (CC), as well as the frequency of FiO2 adjustment. The Wilcoxon rank sum test was used to compare a score measuring the adherence of the control and intervention groups to the Neonatal Resuscitation Program algorithm.Sixty-five healthcare professionals were recruited and randomized to the control or intervention group. Positive pressure ventilation was performed correctly 55-80% of the time in the control group vs. 94-95% in the intervention group across all three scenarios (p<0.0001). Chest compressions were performed correctly 71-81% of the time in the control group vs. 82-93% in the intervention group in the two scenarios in which they were indicated (p<0.0001). FiO2 was addressed three times more frequently in the intervention group compared to the control group (p<0.001).Healthcare professionals using a decision support tool exhibit significantly fewer deviations from the Neonatal Resuscitation Program algorithm compared to those working from memory alone during simulated neonatal resuscitation.
View details for DOI 10.1016/j.resuscitation.2014.12.016
View details for Web of Science ID 000352508400023
View details for PubMedID 25555358
The Neonatal Resuscitation Program: Current Recommendations and a Look at the Future
INDIAN JOURNAL OF PEDIATRICS
2014; 81 (5): 473-480
The Neonatal Resuscitation Program (NRP) consists of an algorithm and curriculum to train healthcare professionals to facilitate newborn infants' transition to extrauterine life and to provide a standardized approach to the care of infants who require more invasive support and resuscitation. This review discusses the most recent update of the NRP algorithm and recommended guidelines for the care of newly born infants. Current challenges in training and assessment as well as the importance of ergonomics in the optimization of human performance are discussed. Finally, it is recommended that in order to ensure high-performing resuscitation teams, members should be selected and retained based on objective performance criteria and frequent participation in realistic simulated clinical scenarios.
View details for DOI 10.1007/s12098-013-1332-0
View details for Web of Science ID 000335739000011
View details for PubMedID 24652267
A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children
ARCHIVES OF PEDIATRICS & ADOLESCENT MEDICINE
2008; 162 (3): 239-245
To assess the effects of reducing television viewing and computer use on children's body mass index (BMI) as a risk factor for the development of overweight in young children.Randomized controlled clinical trial.University children's hospital.Seventy children aged 4 to 7 years whose BMI was at or above the 75th BMI percentile for age and sex.Children were randomized to an intervention to reduce their television viewing and computer use by 50% vs a monitoring control group that did not reduce television viewing or computer use.Age- and sex-standardized BMI (zBMI), television viewing, energy intake, and physical activity were monitored every 6 months during 2 years.Children randomized to the intervention group showed greater reductions in targeted sedentary behavior (P < .001), zBMI (P < .05), and energy intake (P < .05) compared with the monitoring control group. Socioeconomic status moderated zBMI change (P = .01), with the experimental intervention working better among families of low socioeconomic status. Changes in targeted sedentary behavior mediated changes in zBMI (P < .05). The change in television viewing was related to the change in energy intake (P < .001) but not to the change in physical activity (P =.37).Reducing television viewing and computer use may have an important role in preventing obesity and in lowering BMI in young children, and these changes may be related more to changes in energy intake than to changes in physical activity.
View details for Web of Science ID 000253672100007
View details for PubMedID 18316661
View details for PubMedCentralID PMC2291289