Dr. Pantaleoni is a Clinical Assistant Professor of Pediatrics in the division of Pediatric Hospital Medicine. She devotes her clinical time as a General Pediatric Hospitalist to the care of hospitaized children and their families at both Lucile Packard Children's Hospital and El Camino Hospital, in the Packard El Camino unit (PEC). She is also an Educator 4 CARE (E4C) at Stanford University School of Medicine and greatly enjoys fostering clinical skill development and professional identity formation with the Stanford medical students. Her scholarly interests surround undergraduate medical education, humanism in medicine and physician wellness.
- Pediatric Hospital Medicine
Clinical Assistant Professor, Pediatrics
Board Certification: American Board of Pediatrics, Pediatric Hospital Medicine (2019)
Medical Education: University of California Davis School of Medicine (2007) CA
Board Certification: American Board of Pediatrics, Pediatrics (2010)
Residency: Lucile Packard Children's Hospital (2010) CA
Improving Communication with Primary Care Physicians at the Time of Hospital Discharge.
Joint Commission journal on quality and patient safety
2017; 43 (2): 80-88
Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital.A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs. Emphasis was placed on frontline provider (resident physicians) involvement in the improvement process, creating standards, and error proofing. Root cause analysis identified several key drivers of the problem, and successive countermeasures were implemented beginning in August 2013 aimed at achieving the target of 80% attempted verbal communication within seven days before or after (usually 24-48 hours) on the pediatric medical services. Run charts were generated tracking the outcome of PCP communication.On the pediatric medical services, the goal of 80% communication was met and sustained during a seven-month period starting October 2013, a statistically significant improvement. In the eight months prior to October 2013, hospitalwide PCP communication prior to discharge averaged 59.1% (n = 5,397) and improved to 76.7% (n = 4,870) in the seven months after (p <0.001). Fifteen of 19 specialty services had a significant increase in discharge communication after October 2013.Lean improvement methodology (including structured problem solving using A3 thinking), intensive frontline provider involvement, and process-oriented electronic health record work flow redesign led to increased verbal PCP communication at around the time of a patient's discharge.
View details for DOI 10.1016/j.jcjq.2016.11.005
View details for PubMedID 28334566
The Value of Clinical Teachers for EMR Implementations and Conversions.
Applied clinical informatics
2015; 6 (1): 75-79
Effective physician training is an essential aspect of EMR implementation. However, it can be challenging to find instructors who can present the material in a clinically relevant manner. The authors describe a unique physician-training program, utilizing medical students as course instructors. This approach resulted in high learner satisfaction rates and provided significant cost-savings compared to alternative options.
View details for DOI 10.4338/ACI-2014-09-IE-0075
View details for PubMedID 25848414
View details for PubMedCentralID PMC4377561
Successful Physician Training Program for Large Scale EMR Implementation.
Applied clinical informatics
2015; 6 (1): 80-95
End-user training is an essential element of electronic medical record (EMR) implementation and frequently suffers from minimal institutional investment. In addition, discussion of successful EMR training programs for physicians is limited in the literature. The authors describe a successful physician-training program at Stanford Children's Health as part of a large scale EMR implementation. Evaluations of classroom training, obtained at the conclusion of each class, revealed high physician satisfaction with the program. Free-text comments from learners focused on duration and timing of training, the learning environment, quality of the instructors, and specificity of training to their role or department. Based upon participant feedback and institutional experience, best practice recommendations, including physician engagement, curricular design, and assessment of proficiency and recognition, are suggested for future provider EMR training programs. The authors strongly recommend the creation of coursework to group providers by common workflow.
View details for DOI 10.4338/ACI-2014-09-CR-0076
View details for PubMedID 25848415
View details for PubMedCentralID PMC4377562
Burnout in pediatric residents over a 2-year period: a longitudinal study.
2014; 14 (2): 167-172
Burnout is a work-related syndrome characterized by emotional exhaustion (EE), depersonalization (DP), and lack of personal accomplishment (PA). We hypothesized that the transition into an environment of high physical, intellectual, and emotional demands of the medical profession would lead to an increase in the prevalence of burnout in pediatric residents, which would remain high throughout residency.The Maslach Burnout Inventory (MBI) was administered to pediatric residents at Lucile Packard Children's Hospital 6 times between February 2010 and February 2012. These times corresponded to the start of residency, mid-intern year, end-intern year, mid-junior year, end-junior year, and mid-senior year.Mean values of burnout components changed significantly between the start of residency and mid-intern year. EE increased from 15.8 to 24.5 (P < .001), DP increased from 4.5 to 9.2 (P < .001), and PA decreased from 40.2 to 38.3 (P = .04). Similarly, the prevalence of burnout increased from 17% to 46% (P = .012), or 2% to 24% (P = .002) using more restrictive criteria, between the start of residency and mid-intern year. Significant changes in mean scores or prevalence of burnout were not found between any other consecutive times throughout residency.This longitudinal study documented a significant increase in the components of burnout among pediatric residents between the start of residency and mid-intern year, which persisted through the PGY2 and PGY3 years. Further studies are warranted to identify correlates of resident burnout and to develop preventative strategies to reduce its occurrence.
View details for DOI 10.1016/j.acap.2013.12.001
View details for PubMedID 24602580
Medical education in the electronic medical record (EMR) era: benefits, challenges, and future directions.
2013; 88 (6): 748-752
In the last decade, electronic medical record (EMR) use in academic medical centers has increased. Although many have lauded the clinical and operational benefits of EMRs, few have considered the effect these systems have on medical education. The authors review what has been documented about the effect of EMR use on medical learners through the lens of the Accreditation Council for Graduate Medical Education's six core competencies for medical education. They examine acknowledged benefits and educational risks to use of EMRs, consider factors that promote their successful use when implemented in academic environments, and identify areas of future research and optimization of EMRs' role in medical education.
View details for DOI 10.1097/ACM.0b013e3182905ceb
View details for PubMedID 23619078
Inhaled nitric oxide and sildenafil therapy for a pediatric patient with multiple pulmonary arterovenous malformations
Journal of Pediatric Intensive Care
2013; 2: 181-185
View details for DOI 10.3233/PIC13065