A5084735883- Electronic Health Records Systems
- Influenza Virus Research Studies
- Patient Safety and Medication Errors
- Emergency and Acute Care Studies
- Healthcare Technology and Patient Monitoring
- Vaccine Coverage and Hesitancy
- Sepsis Diagnosis and Treatment
- Pneumonia and Respiratory Infections
- Health Sciences Research and Education
- Respiratory viral infections research
- Healthcare Systems and Technology
- Health Policy Implementation Science
- Ethics in Clinical Research
- Quality and Safety in Healthcare
- Adolescent Sexual and Reproductive Health
- Tuberculosis Research and Epidemiology
- Clinical practice guidelines implementation
- Healthcare cost, quality, practices
- Clinical Reasoning and Diagnostic Skills
- Health Systems, Economic Evaluations, Quality of Life
- Hospital Admissions and Outcomes
- Hemoglobinopathies and Related Disorders
- Hepatitis B Virus Studies
- Meta-analysis and systematic reviews
- Simulation-Based Education in Healthcare
Emory University
2016-2025
Children's Healthcare of Atlanta
2018-2025
Emory University Hospital
2023
Henrietta Egleston Hospital for Children
2023
Children's Hospital of Philadelphia
2015-2019
Centre Pour le Développement des Vaccins-Mali
2012-2017
Yale University
2007-2010
Despite the heightened risk of serious influenza during infancy, vaccination is not recommended in infants younger than 6 months. We aimed to assess safety, immunogenicity, and efficacy maternal immunisation with trivalent inactivated vaccine for protection against a first episode laboratory-confirmed influenza.We did this prospective, active-controlled, observer-blind, randomised phase 4 trial at six referral centres community health Bamako, Mali. Third-trimester pregnant women (≥28 weeks'...
Background Influenza causes substantial morbidity and annual vaccination is the most important prevention strategy. Accurately measuring vaccine effectiveness (VE) difficult. The clinical syndrome closely associated with influenza virus infection, influenza-like illness (ILI), not specific. In addition, laboratory confirmation infrequently done, available rapid diagnostic tests are imperfect. objective of this study was to estimate joint impact test sensitivity specificity on VE for three...
Abstract Measures to decrease contact between persons during an influenza pandemic have been included in response plans. We used stochastic simulation models explore the effects of school closings, voluntary confinements ill and their household contacts, reductions contacts among long-term care facility (LTCF) residents on pandemic-related illness deaths. Our findings suggest that closings would not a substantial effect outcomes absence measures reduce out-of-school contacts. However, if...
Importance Red blood cell (RBC) transfusion is a common medical intervention to treat anemia in very preterm neonates; however, best practices, such as thresholds, remain uncertain. Objective To develop recommendations for clinicians on the use of RBC transfusions neonates. Evidence Review An international steering committee reviewed evidence from systematic review 6 randomized clinical trials (RCTs) that compared high vs low hemoglobin-based or hematocrit-based thresholds. The reached...
Accuracy of Pulse Oximetry-Based Home Baby Monitors][3][4] This study measured the accuracy pulse oximetry-based consumer baby monitors using an FDA-cleared oximeter as a reference.
The 21st Century Cures Act has accelerated adoption of OpenNotes, providing new opportunities for patient and family engagement in their care. However, these regulations present challenges, particularly pediatric health systems aiming to improve information sharing while minimizing risks associated with adolescent confidentiality safety.Describe lessons learned preparing OpenNotes across a system during 4-month trial period (referred as "Learning Mode") which clinical notes were not shared...
High-flow nasal cannula (HFNC) use in bronchiolitis may prolong length of stay (LOS) if weaned more slowly than medically indicated. We aimed to reduce HFNC treatment (LOT) and inpatient LOS by 12 hours 0- 18-month-old patients with on the pediatric hospital medicine service.After identifying key drivers slow weaning, we recruited a multidisciplinary "Wean Team" provide education influence provider weaning practices. then implemented respiratory therapist-driven protocol supportive...
Background: Engagement of clinicians who understand clinical workflows and technology constraints can accelerate the development implementation better electronic health record (EHR) designs that improve quality reduce burnout. Provider builder programs informatics education for a broader coalition specialties. Objective: In this State Art / Best Practice paper, we aim to (1) propose provider maturity model informed by experience three institutions using single EHR vendor (Epic Systems©) (2)...
Abstract Objective To assess the prevalence of recommended design elements in implemented electronic health record (EHR) interruptive alerts across pediatric care settings. Materials and Methods We conducted a 3-phase mixed-methods cross-sectional study. Phase 1 involved developing codebook for alert content classification. 2 identified most frequently at participating sites. 3 applied to classify alerts. Inter-rater reliability (IRR) descriptive statistics contents were reported. Results...
Background: Pediatric cancer patients with fever and neutropenia are at risk for bacterial sepsis, traditionally requiring extended hospital stays on antibiotics until neutrophil counts recover. According to a new validated scoring system, subset of these is lower eligible early discharge reduced IV antibiotic exposure. Objective: Reduce length stay (LOS) febrile neutropenic using clinical decision support (CDS) identify low patients. Methods: A CDS system was developed (1) screen rule, (2)...
Hospitalized children are at increased risk of influenza-related complications; however, influenza vaccine coverage remains low among this group. We aim to evaluate the effectiveness a suite clinical decision support (CDS) strategies improve inpatient vaccination in children. conducted retrospective cohort study hospitalized eligible for seasonal vaccine. evaluated influence various CDS on administration rates from September 1, 2018, through May 2022, using mixed-effects logistic regression...
Incidence data on pediatric chronic kidney disease (CKD) is incomplete. We developed electronic health record (EHR)-based algorithms (e-phenotypes) to identify cases and provide incidence estimates of 5 leading causes CKD. E-Phenotypes using common standardized clinical terminology were built contained utilization, diagnostic, procedural, age, time-period inclusion exclusion criteria for autosomal dominant polycystic (ADPKD), Alport Syndrome (AS), congenital anomalies the urinary tract...
Importance : Pediatric sepsis accounts for over 72,000 US hospitalizations annually with significant mortality and morbidity. Many pediatric hospitals struggle to promptly identify treat sepsis. This study demonstrates the feasibility of a multi-tiered artificial intelligence (AI) enhance clinical decision-making within complex emergency department (ED) workflow. Objectives To develop validate local AI model predicting critical among ED patients who received fluid bolus disposition Intensive...
Objective: To identify disease processes in which patients experienced the greatest rates of emergency department (ED) revisit disparities by race, ethnicity, language, insurance, and Childhood Opportunity Index. Methods: We performed a retrospective, cross-sectional study ED visits at comprehensive pediatric health system encompassing three EDs. included all (0 to 18 y) encounters that led discharge home (2018 2022). The primary outcome was within 7 days index encounter. multivariable...
Background: Central line-associated bloodstream infections (CLABSIs) are associated with substantial pediatric morbidity and mortality. The capacity to predict which children central lines at greatest risk of CLABSI could inform surveillance prevention efforts. Our team previously published in silico predictive models for CLABSI. Objective: To prospectively implement a model achieve adequate performance offline validation implementation clinical practice. Methods: most performant were deep...
Epidemiological studies from sub-Saharan Africa show that genital infection with Schistosoma haematobium [corrected] may increase the risk for HIV in young women. Therefore, preventing schistosomiasis has potential to reduce transmission Africa. We developed a model of female and infections we fit epidemiological data prevalence coinfection rural Zimbabwe. used evaluate cost-effectiveness multifaceted community-based intervention and, consequently, Zimbabwe, perspective health payer. The...
Epidemiological data from Zimbabwe suggests that genital infection with Schistosoma haematobium may increase the risk of HIV in young women. Therefore, treatment praziquantel could be a potential strategy for reducing infection. Here we assess cost-effectiveness as novel intervention against infection.We developed mathematical model female schistosomiasis (FGS) and infections fitted to cross-sectional FGS prevalence 1999. We validated our epidemic projections using antenatal clinic on...
Abstract Background Therapeutic duplication, the presence of multiple agents prescribed for same indication without clarification when each should be used, can contribute to serious medical errors. Joint Commission standards require that orders contain clarifying information about order given. In our system, as needed (PRN) acetaminophen and ibuprofen are major contributors therapeutic duplication. Objective The objective this study is design evaluate effectiveness clinical decision support...
Abstract Background Medical errors in blood product orders and administration are common, especially for pediatric patients. A failure modes effects analysis our health care system indicated high risk from the electronic ordering process. Objectives There two objectives of this study as follows: (1) To describe differences design original order sets (original design), new designed by expert committee (DEC), a third-version developed through user-centered (UCD). (2) compare number type...