November 2021
Dear Colleagues,
 
I hope you all had a wonderful Thanksgiving holiday and were able to relax for a few days. For those that are currently celebrating Hanukkah I hope it has been meaningful and joyous.
 
I want to provide an update about the regional campus of UNC Children’s in Wilmington. Much of this activity is culminating this month and will represent a major change in our scope and footprint as a children’s care system.

In late December, Coastal Children’s Services/Coastal Children’s Neonatology providers will officially become UNC faculty. For more information about this group please see their current website https://www.ccsnc.net.

This group will operate as a UNC Children’s Wilmington Multispecialty Division with a local division chief; these specialists will also be closely integrated with the specific specialty division here in Chapel Hill.   

Thank you to all of the faculty based in Chapel Hill who have traveled to Wilmington over the years and decades!
 
We are interviewing a record number of medical students for residency. We are interviewing 400 medical students in total. Thank you to Meg Kihlstrom for leading this effort and for all who are participating in these interviews. For the first time, we have a separate match for our pediatric physician scientist training program. Also, fellowship matches will occur this month! Stay tune.
 
We continue to expand UNC Children’s research portfolio and have also expanded our grants management group. Check out our new awards, achievements and publications below!
 
Our unsung hero this month is Randi Winter! She has been an exceptional Division Administrator for Pulmonology. We will miss you Randi!
 
Finally, I would like to personally say how much I am going to miss Julie Byerley and Andrea Hayes. Both are incredible, inspirational leaders who always put children and families first. We will miss you!
 
I look forward to seeing everyone at the Department of Pediatrics Holiday Party on Sunday, December 5, at 3pm! The Old Lystra Inn is primarily outdoors, so please dress accordingly!
 
Thank you for all of the hard work to promote the health of children and their families.
 
Gratefully,
UNC Children's Missions Update
Please Welcome our New Children's Providers!
Advanced Practice Provider
Pediatric Endocrinology

Taylor Murphy joined Pediatric Endocrinology on November 29th. Ms. Murphy received her BSN from Duke University in 2010 and went on to complete her MSN at the University of North Carolina at Chapel Hill School of Nursing in 2015. Since 2017, she has worked as a Nurse Practitioner in Pediatric Endocrinology and Diabetes at the Mount Sinai Hospital Hall Center for Pediatric Endocrinology & Diabetes in New York. Welcome Taylor!
Associate Professor
Neonatal-Perinatal Medicine

On November 30, 2021, Misty Good, MD, MS, FAAP joined the department as the new Division Chief of Neonatal-Perinatal Medicine. She comes to us from Washington University in St. Louis. She earned an undergraduate degree in Biological Sciences from the University of Southern California before pursuing a combined MD/MS program at the American University of the Caribbean in St. Maarten, Netherland Antilles. After completing her medical and graduate degrees, she completed her residency and a year as Chief Resident at the Children's Hospital of Illinois. Dr. Good completed her Neonatal-Perinatal fellowship training, at the Children's Hospital of Pittsburgh in 2011. Welcome Misty!
Assistant Professor of Anesthesiology
Pediatric Anesthesiology

Dr. Sisk comes to from the University of Oklahoma where he was an Assistant Professor for 5 years. He completed his residency at the University of Toledo Medical Center and his pediatric anesthesiology fellowship at the University of Michigan in Ann Arbor. Dr Sisk's professional career thus far has already demonstrated a passion for quality improvement initiatives and resident and fellow education. He comes to North Carolina with his wife Marissa and their 2 year old daughter Genovieve. Welcome Joe!
Assistant Professor of Neurology
Child Neurology

Dr. Broman-Fulks has joined the faculty in the Department of Neurology. He received is medical degree form the Medical University of South Carolina in 2015. He came to UNC Chapel Hill for his Residency in Pediatrics from 2015-2017 and his residency in Pediatric Neurology form 2017-2019. He remained at UNC as a Chief Resident in Pediatric Neurology through 2020. We are excited to have him back at UNC. Welcome Home Jordan!
UNC Children’s: Improving Pediatric Sepsis Outcomes (IPSO) 2021 Executive Report

UNC Children’s Hospital aims to improve early recognition and defining time zero documentation to align with our sepsis pathway. Our focus is within the inpatient and emergency services setting of care and using a team based approach for CY2021. Below are a few highlights - click here for the full report
 
Our Children’s Sepsis Program team would like to thank you for your support and provide you with an update on our work. Since last quarter the Children’s Pediatric Sepsis Committee lead by April Glick has:
  • Developed a fine-tuned process for internal case reviews of UNC’s sepsis hospital onset and severe sepsis deaths. In this process, gaps between physician documentation and reported Vizient deaths have been identified. Currently, the team is facilitating cross-departmental resources to work together in a new process to educate improving physician documentation that affects coding outcomes.
  • Worked towards revising the Children’s Sepsis Program Charter to realign all stakeholders and highlight our priorities and barriers for FY2022.
  • Continued to adapt to sepsis quality improvement with nursing efforts, steps to establish strong relationships and to intentionally advocate building our sepsis core team with subject matter experts from each unit.
  • Attached are our Children’s Sepsis Program Projects for FY2022

Heidi Troxler is leading a Sepsis Express Workout focused on sepsis recognition and response in the PICU November 11th, 2021. Jenny Boyd and Lisa Tibbetts will sponsor this initiative, and Dr. Afsaneh Pirzadeh and April Glick will be process owners.
The Financial Impact of Sepsis on Children in 2020:

  • 36 cases of IPSO Critical Sepsis identified
  • 3 Sepsis attributed mortalities
  • 6 Hospital-onset cases identified
  • Est. cost for critical sepsis: $2.3 - 3.1 M
The Financial Impact of Sepsis on Children beginning January 1st, 2021 & ending June 30th 2021:
  • 11 cases of IPSO Critical Sepsis identified
  • 2 Sepsis attributed mortalities
  • 1 Hospital-onset cases identified
  • Est. cost for critical sepsis: $0.7 - 0.9M
Severe sepsis/septic shock estimated cost per episode = $65,000 - $85,000 multiplied by the number of IPSO Critical Sepsis episodes.
 
 
UNC Significant Improvement in IPSO Quality Measures
 
  • Use of the interprofessional sepsis huddle is increasing. (One of the 5 Key Processes.) 
  • Time from antibiotic order to administration is decreasing for IPSO Suspected Infection patients.
Quarter 2, 2021 IPSO data analysis
 
  • 637 cases reviewed
  • 24 IPSO severe sepsis
  • 112 IPSO non-severe sepsis
  • 0 IPSO sepsis related death
Quarter 3, 2021 IPSO data analysis

  • 736 cases reviewed
  • 39 IPSO severe sepsis
  • 101 IPSO non-severe sepsis
  • 2 IPSO sepsis related death confirmed by physician review
Heidi Troxler Promoted to Director for Quality, Safety and Programs

Congratulations to Heidi Troxler on her promotion to Director for Quality, Safety and Programs for Children’s Services! In this new role Heidi will provide oversight and direction for Children’s quality and safety throughout the care continuum as well as support numerous programs within the service line.

We are excited to announce Heidi’s promotion as well as the impact this new role will have in supporting and driving quality care for those we serve. Heidi will formally transition to her new role the week of November 29th. Congratulations Heidi!
Perry Announced as Medical Director, Outpatient Quality and Safety, UNC Children’s Hospital

Martha Fairbanks Perry, MD, has been named Medical Director, Outpatient Quality and Safety for UNC Children’s Hospital. This position will report directly to The Chief Quality Officer for UNC Children’s and Vice Chair for Quality and Safety for the Department of Pediatrics. This appointment reflects Dr. Perry’s continued commitment to serve as a leader in all aspects of outpatient quality and safety in the UNC Children’s service line. It also reaffirms the aspiration she shares with all of UNC Children’s to eliminate patient harms during the provision of care and obtain outcomes that position us as a national leader while in service of the children of North Carolina and beyond.

Dr. Perry is a general pediatrician and adolescent specialist at the NC Children’s Hospital. She attended Princeton University for undergrad and the University of Massachusetts for medical school. She remained in New England to complete the Boston Combined Residency Program in Pediatrics. Dr. Perry then began her Adolescent Medicine Fellowship at the University of California at San Francisco before returning to Boston Children’s Hospital to complete the final six months of her training. UNC was fortunate to have Dr. Perry join our team in May of 2017. In addition to her clinical roles, she is also a member of the Pediatric Education leadership team as an Associate Program Director. In this capacity she is a class advisor and director of the Adolescent Medicine rotation.

In her new role, Dr. Perry will help identify and prioritize strategic priorities for outpatient quality and safety. She has been a leader in quality improvement initiatives in the outpatient setting most notably in developing protocols for screening for STIs among adolescents. With advanced certification in Lean/Six Sigma Improvement methods, her leadership skills and deep knowledge of the importance of a high quality and safe outpatient experience that is seamless for patient and provider alike make her the ideal person to tackle this new challenge. This appointment reflects Dr. Perry’s continued commitment to serve as a leader in all aspects of outpatient quality and safety in the UNC Children’s service line. It also reaffirms the aspiration she shares with all of UNC Children’s to eliminate patient harms during the provision of care and obtain outcomes that position us as a national leader while in service of the children of North Carolina and beyond.

We look forward to seeing Dr. Perry in this new leadership position.
Aliaga Appointed New Director of Interprofessional Education and Practice

Dr. Sofia Aliaga has been named as the new Director for Interprofessional Education and Practice within the School of Medicine. The Office of Interprofessional Education and Practice (OIPEP) supports a campus-wide initiative for the intentional integration of interprofessional learning and collaboration. The purpose of the Office is to design and support creative and meaningful ways to enhance student learning, build faculty scholarship and help departments meet accreditation goals. This position serves in partnership with the Assistant Provost for OIPEP and the other directors of the OIPEP schools. The OIPEP leadership team is comprised of a dedicated group of UNC-CH faculty, staff, and students from across campus who are committed to working collaboratively to create change and inspire a new generation of leaders to work better together. The OIPEP team operates from a stance of integrity, trust, and respect; demonstrating mutual support and collaboration through an innovative, holistic vision. Congratulations Sofia!
Good and Laughon Elected to American Pediatric Society

Recently, the council members of the American Pediatric Society (APS) formally elected Dr. Misty Good and Dr. Matthew Laughon from the Division of Neonatal-Perinatal Medicine to active membership with the society.

Active membership in the APS is reserved for individuals residing in the United States or Canada who have distinguished themselves as child health leaders, teachers, scholars, policymakers, and/or clinicians and whose important contributions are recognized nationally or internationally. The APS is the oldest academic pediatric society in North America and is dedicated to honoring those who have made major contributions to pediatrics.

Congratulations, Matt and Misty!
Alexander, Sanderson & Smitherman Elected to SPR

The Council of the Society for Pediatric Research (SPR) has recently elected to SPR membership, three UNC Children's Physicians. Drs. Andrew Smitherman and Thomas Alexander of the Pediatric division of Hematology/Oncology, and Dr. Keia Sanderson in the Medicine division of Nephrology and Hypertension and Director of Pediatric Dialysis.

SPR works to facilitate active communications among and between researchers, promote research collaborations through mentoring and knowledge sharing, and advocate for funding and policies supportive of research. The SPR is committed to creating a multi-disciplinary network of diverse researchers to improve child health. Congratulations Smitty and Thomas!
Steiner Named to Pediatric Leadership Development Program 

The Association of Medical School Pediatric Department Chairs (AMSPDC) invited Dr. Mike Steiner to join the 2022-2023 Pediatric Leadership Development Program (PLDP). The PLDP fellowship program aims to help develop the next generation of pediatric chairs in North America, ensuring that they will be well poised to lead our profession through the rapidly changing environment of academic medicine and health care in general. Congratulations Mike!
Check Out our New Awards, Achievements, and Publications
Misty Good, MD, MPH - Neonatal-Perinatal Medicine - with her arrival at UNC Dr. Good brings with her a significant research enterprise. Her laboratory focuses on the cellular and molecular mechanisms in the gastrointestinal disease affecting premature infants. Dr. Good developed a large multi-center biorepository for infants with Necrotizing Enterocolitis (NEC) to evaluate the biological signature of infants with NEC, and institute strategies to prevent NEC altogether. Her long-term goal is to elucidate the signaling pathways regulating the uncontrolled immune response seen in NEC and develop strategies to attenuate or prevent the disease. She was awarded grant funding in August 2021, NIH NIDDK R01DK124614 "Non-invasive analysis of methylated cell free DNA in necrotizing enterocolitis" Total costs $2,529,660 and was awarded grant funding in September 2021, NIH NICHD R01HD105301 "Neonatal gut-on-a-chip platform for high content drug testing and precision medicine" Total costs $2,425,881
Wesley Jackson MD - Neonatal-Perinatal Medicine - Dr. Jackson has reached several important milestones in his clinical trial work. Dr. Jackson is the operations lead and protocol chair for the NHLBI funded SILDI-SAFE study (Safety of Sildenafil in Premature Infants With Severe Bronchopulmonary Dysplasia; https://www.clinicaltrials.gov/ct2/show/NCT04447989). The trial protocol was recently published in BMC Pediatrics ( https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7735412/). This study is a 120 participant, randomized, placebo controlled, sequential dose escalating study to evaluate the safety of sildenafil in premature infants with severe bronchopulmonary dysplasia. The SILDI-SAFE study has 5 active sites, with 25 more to be activated in the next 6 months. Dr. Jackson and his team just enrolled the first participant at Emory University. Dr. Chuck Esther, Division of Pediatric Pulmonlogy, and Dr. Matt Laughon, Professor in the Division of Neonatal-Perinatal Medicine, are also team members.
 
Dr. Jackson also recently completed Cohort 1 of the Caffeine for Hypoxic-Ischemic Encephalopathy Study (https://clinicaltrials.gov/ct2/show/NCT03913221) at UNC, enrolling the first 9 participants. The study is supported by the Thrasher Research Fund and is an 18 participant, open label, dose ranging study of caffeine as an adjuvant therapy in term infants receiving therapeutic hypothermia for hypoxic ischemic encephalopathy. Dr. Jackson holds the Investigational New Drug (IND) from the US FDA for caffeine for this indication. This study will evaluate the pharmacokinetics and safety of caffeine and will serve as critical preliminary work for the next phase trial.
Matthew Laughon, MD, MPH - Neonatal-Perinatal Medicine - recently gave an invited lecture at the IX INTERNATIONAL NEONATOLOGY SYMPOSIUM in Buenos Aires, Argentina. His (virtual) talk entitled “Persistent Ductus Arteriosus: Active Treatment or Expectant Management” had over 500 attendees.
Don Nakayama, MD, MBA - Pediatric Surgery - the Alpha Omega Alpha publication, The Pharos, published Dr. Nakayama's work "Rice, beriberi, and Meiji Japan" in their Autumn 2021 edition.
Cynthia Powell, MD - Pediatric Genetics & Metabolism - was instrumental in UNC Children's new designation as a NORD Rare Disease Center of Excellence. As a NORD RD CoE, you will be part of a unique network of exceptional institutions dedicated to outstanding treatment for rare disease patients and collaboration to improve standards of care, advance research, and increase awareness about rare diseases in the broader medical and patient communities. Read More>>
Genny Taylor, MD - Neonatal-Perinatal Medicine - was recently invited by The Critical Path Institute to present a talk and serve as a panelist at the 2021 Cure Drug Repurposing Collaboratory annual meeting. She presented “Neonatal Global Rank Score Development and Future Applications” to attendees of the Special Populations session, including pediatric physician scientists, regulatory representatives, and parent advocacy groups. She is supported as a Co-investigator on the Global Pediatric Clinical Trials Network Global Rank Score Subaward (FDA U18FD006298 A03-3742). To learn more, review c-path.org or use the following links to access recordings of her talk and the panel discussion.
Congratulations to our Pediatric Pulmonology Division! In 2020, UNC was cited as the top ranking institution for both numbers of published manuscripts and citations in the journal Pediatric Pulmonology, in its annual publisher’s report. Other institutions in the top 5 of this ranking included the University of Colorado, Cincinnati Children’s Medical Center, Children’s Hospital of Philadelphia, and Pontificia Universidad Catolica de Chile. Check out these publications from the past month from the faculty in Pediatric Pulmonology.
Randi Winter
Division Administrator

Nominated by Terry Noah, MD

The Pediatric Pulmonology Division would like to recognize an Unsung Hero: Ms. Randi Winter, our Division Administrator (DA) for the past 8 years, who will be leaving us Dec. 1 to take on a new position with UNC Health Alliance as a Project Coordinator. 

As the Pulmonology DA, Randi has had a significant and positive influence on nearly every activity in the Division including our clinical services, research activities, and fellowship training program.  She has continuously improved our administrative operations, no easy task with our steady growth over this time period, and with all the complexities introduced by the COVID-19 pandemic. Randi has been a steady influence and highly effective administrator and colleague during all of this. Her calm and always thoughtful approach has been a blessing to all of us. We wish her the best in her new position and hope to see her back in Pediatrics someday!
She will certainly be missed!!