A5046392847- Ethics and Legal Issues in Pediatric Healthcare
- Palliative Care and End-of-Life Issues
- Childhood Cancer Survivors' Quality of Life
- Family and Patient Care in Intensive Care Units
- Ethics in medical practice
- Child and Adolescent Health
- Ethics in Clinical Research
- Migration, Health and Trauma
- Medical Malpractice and Liability Issues
- Interpreting and Communication in Healthcare
- Respiratory Support and Mechanisms
- Organ Donation and Transplantation
- Cultural Competency in Health Care
- Infant Development and Preterm Care
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Disaster Response and Management
- Neonatal Respiratory Health Research
- Opioid Use Disorder Treatment
- Conflict Management and Negotiation
- Patient-Provider Communication in Healthcare
- Simulation-Based Education in Healthcare
- Child Abuse and Trauma
- Effects of Radiation Exposure
Children's Hospital of Los Angeles
2011-2025
University of Southern California
2011-2023
Keck Hospital of USC
2021
Southern California University for Professional Studies
2021
Northwestern University
2014-2020
Lurie Children's Hospital
2014-2020
Anna Needs Neuroblastoma Answers
2020
National Center for Advancing Translational Sciences
2016
Abstract Background Children with complex chronic medical conditions benefit from early introduction of palliative care services and advanced planning for symptom management to support quality life decision‐making. This study evaluated whether introducing during primary appointments (1) was feasible; (2) increased access improved knowledge care; (3) facilitated planning. Methods Pilot a multi‐modal intervention including targeted education providers (PCPs), an informational packet families...
Patients and families with limited English proficiency (LEP) face barriers to health care service access, experience lower quality care, suffer worse outcomes.LEP is an independent driver of disparities exacerbates other social determinants health.Disparities due language are particularly unjust because LEP morally irrelevant a source unfair, unnecessary disadvantage.Clinicians organizations have duties intervene, which this article describes.To claim one AMA PRA Category 1 Credit TM for the...
Shared decision-making (SDM) depends on high-quality communication between the physician and decision maker. The shared beliefs, values, behaviors, traditions that make up an individual's culture affect way he or she communicates receives information impacts complex decision-making. Cultural differences medical providers patients their families may lead to wrong assumptions, disparate priorities, a lack of goals, conflict. When it comes SDM in cross-cultural encounters, we recommend...
Purpose of review Children with medical or surgical critical illness injury require skillful attention to physical, emotional, psychological, and spiritual needs, whereas their families need support guidance in facing life-threatening life-changing events gut-wrenching decisions. This article reviews current evidence best practices for integrating palliative care into the pediatric intensive unit (PICU), a focus on patients. Recent findings Palliative is integrated tiered approach, primary...
Objectives: Communication breakdowns in PICUs contribute to inadequate parent support and poor post-PICU outcomes. No interventions supporting communication have demonstrated improvements parental satisfaction or psychologic morbidity. We compared parent-reported outcomes from parents receiving a navigator-based intervention (PICU Supports) with those an informational brochure. Design: Patient-level, randomized trial. Setting: Two university-based, tertiary-care children’s hospital PICUs....
Pediatric ethicists hold a privileged position of influence within health care institutions. Such confers corresponding responsibility to address barriers the and flourishing all children. A major barrier children’s is racism. can, should, leverage their racism both in institutional policy provision pediatric care. Health care’s historical continued contributions fostering sustaining racist values systems mean that those medical fields— regardless race, ethnicity, gender, age, or...
Repeated exposure to death and dying increases health care professionals' risk for burnout secondary traumatic stress. Pediatric critical providers are at particularly high because the of children associated with even greater psychological impact.A charge nurse in pediatric intensive unit identified a need additional staff support after patient events.The aim this quality improvement project was design implement debriefing process, Rapid Review Resuscitation, 40-bed, high-acuity an urban...
Background and Aim: We report the process of creating a new palliative care service at large, urban children's hospital. Our aim was to provide detailed guide developing an inpatient consultation service, along with reporting on challenges, lessons, evaluation. Methods: examined hiring personnel marketing strategies, clinical database facilitated ongoing quality review identified trends, survey project assessed provider satisfaction how referring physicians used service. Results Conclusion:...
Biorepository research in children raises numerous ethical questions that are heightened the pediatric intensive care unit (PICU) setting. We conducted a cross-sectional, interview-based study of 20 adolescent/young adult (A/YA) PICU patients and 75 parents to elucidate perspectives on biorepository research. A/YAs had positive attitude toward biobanking. In young adults, comprehension was higher for knowledge choice withdraw participate lower purpose, procedures, risks, benefits...
Objectives: Parents value clear communication with PICU clinicians about possible patient and family outcomes (prognostic conversations). We describe parent attending physician reports agreement regarding the occurrence of prognostic conversations. queried parents physicians conversation content, which healthcare providers had conversations, whether wanted more information. Design: Prospective cross-sectional survey study. Setting: University-based 40-bed PICU. Participants: patients...
Identifying ethically allowable options for infants with trisomy 18 has become more challenging as medical standards of practice shift, based on emerging scientific data and changing societal perceptions disability. Lack a stable professional standard ought not prevent ethicists from facilitating consensus; rather, these "unsettled cases" require an individualized, narrative approach that allows the values family particularities each case to provide necessary additional moral grounding.
Objectives: When healthcare systems are overwhelmed, accurate assessments of patients’ predicted mortality risks needed to ensure effective allocation scarce resources. Organ dysfunction scores can serve this essential role, but their evaluation in context has been limited so far. In study, we sought assess the performance three organ both critically ill adults and children at clinically relevant thresholds timeframes for resource compare it with two published prioritization schemas. Design:...
Background Up to 80% of pediatric intensive care unit (PICU) patients experience new morbidities upon discharge. Patients and families rely on clear communication prepare for post-PICU morbidities. Methods Surveys were given at PICU discharge parents attending physicians who developed multi-organ dysfunction within 24 hours admission whose completed an initial survey 5 10 days after admission. Participants asked about prognostic conversations regarding mortality; patient physical, cognitive,...
A case of conflict in pediatric end-of-life decision making is presented to compare the complementary roles clinical ethics consultants and palliative care specialists. The progression illustrates differing structures, goals, methods majority such teams. strengths each consultation are emphasized. Particularly centers where services not available, it can be important for careproviders focus on alliance-building a longitudinal relationship with patients families.