In This Issue
Research Spotlight:
CPCE's 2019
Year-in-Review
CPCE In the News:
Population Health Strategies Improved Patient Experience & Reduced Hospital Stays for Kids on Medicaid
Upcoming Events
Recent Publications
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CPCE's 2019 Year-in-Review Highlights
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We hosted
7 seminars
,
16 Works-in-Progress sessions
,
and
12 staff engagement events
.
Highlights included seminars by
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Our faculty and staff published
nearly 300 peer-reviewed publications
in a wide variety of journals.
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We added
15 faculty
and
nearly 40 staff members,
and welcomed Alex Fiks, MD, MSCE
as
our 3rd
Director
in our
12 year
history of innovative pediatric clinical effectiveness research and collaboration.
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We funded
5 pilot projects,
worth
over $73,000
.
In our
last issue
, we told you about four projects awarded in cooperation with
PolicyLab.
In the
spring
, we awarded a project to evaluate experiences of parents of kidney transplant candidates. View the full list of
past awards.
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We published
26 issues
of CPCE E-News
(view the
archive
),
plus 12 internal newsletters,
had >
157,000 Twitter impressions
,
273 new Twitter followers
,
and
tweeted 196 times
.
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What a great year! Thank you for following along
with all of our progress in 2019.
We can't wait to see what 2020 brings.
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Population Health Strategies Improved Patient Experience & Reduced Hospital Stays for Kids on Medicaid
A CHOP-based
study found that targeted interventions can deliver better patient experience, improved health outcomes and value to the Medicaid system. The intervention sought to identify high-risk, Medicaid-enrolled children with special health care needs and provide solutions that would keep them out of the hospital or reduce their stays if they were admitted. "As health care systems grow larger, integrated care teams and technology that supports those teams are going to be critically important to ensure we're helping families navigate ever more complex institutions, whether adult or pediatric in nature," said
David Rubin, MD, MSCE, lead author on the study and director of Population Health Innovation and PolicyLab. "Fundamentally, what we are talking about is identifying those patients who need the most proactive care, surrounding them with an expert team—from physicians, to nurses, to social workers, to navigators—and then equipping that team with supportive technology. In doing that, we saw that we can deliver the type of care our patients want while providing value and efficiency throughout the whole health care system." In addition to Dr. Rubin, the study team included CPCE core faculty members
Chén Kenyon, MD, MSHP,
Emily Gregory, MD, MHS, and
Ron Keren, MD, MPH, and several PolicyLab team members. The study was published in
JAMA Network Open.
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Upcoming Events
Adaptive Designs for Phase I Oncology Clinical Trials: options and challenges
Date: January 8, 2019
Time: 12:00 - 1:00 pm
Location: Roberts Center, 1st floor, 1-120A
The Clinical Trials Research Affinity Group presents
Yimei Li, PhD
, Research Biostatistician with the Division of Oncology at CHOP, and Assistant Professor of Biostatistics and Pediatrics, University of Pennsylvania Perelman School of Medicine.
Pursuit of Evidence-Based Infection Supportive Care for Immunocompromised Children: A Journey OF and FOR a Lifetime
Date: January 10, 2020
Time: 12:00 - 1:00 pm
Location: Roberts, 2nd Floor, 2-170
Domestic Violence, Guns, and Children: Putting Policies into Action
Date: January 15, 2020
Time: 12:00 - 1:30 pm
Location: online
Hosted by CHOP’s Violence Prevention Initiative (VPI), this webinar will educate pediatric providers so that they understand the current policy landscape related to domestic violence and guns in the home and can best support patient families who may be in crisis. CPCE and PolicyLab core faculty member
Joanne Wood, MD, MSHP is among the presenters. Learn more and register
here.
PolicyLab Morning Speaker Series featuring Rinad Beidas, PhD
Date: January 16, 2020
Time: 9:00 - 10:00 am
Location: Roberts Center for Pediatric Research, 1st floor, room 1-120A
Rinad Beidas, PhD is associate professor of psychiatry and medical ethics and health policy at the Perelman School of Medicine at the University of Pennsylvania. She is the founder and director of the Penn Implementation Science Center at the Leonard Davis Institute (PISCE@LDI). Her presentation will focus on harnessing implementation science to realize the promise of evidence-based practice. She will describe the foundations of implementation science and explain the application of implementation science principles to the transportation of evidence-based practices for child psychiatric disorders in community settings.
2020 Martin Luther King, Jr. Health Equity Symposium
Date: January 22, 2020
Time: 12:00 - 1:00 pm
Location: Smilow Center for Translational Research, Arthur H. Rubenstein Auditorium
The Penn Medicine Office of Inclusion and Diversity present the annual Martin Luther King Jr. Health Equity Symposium. Keynote Address by Dr. Leandris Liburd, Director of the Office of Minority Health and Health Equity at the Centers for Disease Control. Register
here.
Update on antibiotic stewardship in the United States
Date: January 30, 2020
Time: 12:00 - 1:00 pm
Location: CHOP Main Hospital, Stokes Auditorium
Lauri Hicks, DO
will present for the CPCE and PolicyLab Seminar Series. Dr. Hicks is a medical epidemiologist in the Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention (CDC). She is also a Captain in the US Public Health Service. For more information or to RSVP, e-mail
CPCE@email.chop.edu
.
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Recent Publications
This review by
Caitlin Elgarten, MD and
Richard Aplenc, MD, PhD, MSCE highlights recent insights into risk stratification and therapeutic approaches for patients with pediatric acute myeloid leukemia (AML). They note that despite advances in therapy over the past decades, overall survival for children with AML has not exceeded 70%, and conclude that further incorporation of genomic and molecular data will allow for additional refinements in risk stratification in order to tailor treatment, improve survival, and decrease treatment-related toxicity.
In this fourteenth article in a series of descriptive papers summarizing various dimensions of health care for children and youth in America,
James Guevara, MD, MPH and others analyzed data from the Medical Expenditure Panel Survey (MEPS), an ongoing nationally representative set of surveys sponsored by the Agency for Healthcare Research and Quality (AHRQ). The reports focus on a different theme each year in order to stimulate policy and research interest in a particular topic. This year’s report focused on obesity and healthcare utilization across a broad array of types of care and socio-demographic characteristics. Their results indicated that obesity affects 19% of children aged 7-17 years overall, with higher prevalence in children who were poor, male, Hispanic or black race-ethnicity, publicly insured, with poorer health status, from the South, or from non- Metropolitan Statistical Area (MSA) locations. These results are generally consistent with other studies. A novelty of this study is the finding that children with obesity were less likely to have a preventive dental visit, across subgroups and ages included in the study. This suggests opportunities for further research, policy and clinical practice interventions.
Immunosuppressive medications following any transplant are necessary to prevent rejection, but involve a lifetime commitment and a number of adverse risks. In cases of life-saving organ transplants, the benefits of transplant far outweigh the risks associated with immunosuppressive medications. In non-life threatening cases, however, the risk-benefit ratio is less clear. In 2015, a CHOP patient was the first to undergo a successful pediatric bilateral hand transplant surgery. The patient was deemed an appropriate candidate in part because he had previously received a kidney transplant and was already taking immunosuppressive medications. A new decision analysis by
Sandra Amaral, MD, MHS,
Chris Feudtner, MD, PhD, MPH and others indicates that bilateral hand transplant is the marginally optimal treatment strategy compared to prosthetics for pediatric patients. Key determinants of the future optimal strategy will be whether immunosuppressive regimens become safer, and whether prosthetics become more acceptable and functional for pediatric patients.
A study conducted by
Christopher Bonafide, MD, MSCE,
Ron Keren, MD, MPH and others sought to determine whether mobile telephone calls were associated with pediatric intensive care nurses’ errors in medication administration. The retrospective cohort study used telecommunications and electronic health record data collected from August 1, 2016 through September 30, 2017 and included PICU 257 nurses and the 3308 patients to whom they administered medications. The authors found that incoming calls on nurses’ institutional mobile telephones occurring in the 10 minutes before medication administration were significantly associated with increased risk of error. The risk was higher during night shifts and among nurses with fewer than 6 months’ experience, and it also varied by nurse to patient ratio and level of patient care required. These results suggest some parameters for interventions to reduce frequency and adverse consequences of mobile telephone interruptions.
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About CPCE
We are a pediatric research center dedicated to discovering and sharing knowledge about best practices in pediatric care by facilitating, organizing and centralizing the performance of clinical effectiveness research -- research aimed at understanding the best ways to prevent, diagnose and treat diseases in children. CPCE’s multidisciplinary team conducts research on a diverse range of clinical effectiveness topics.
CPCE E-News is edited by
Holly Burnside. Please feel free to contact us with questions or feedback.
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