Shining a Spotlight on Inquiry and Collaboration

Posted on Nov 14, 2017

Neil Goldenberg, M.D., Ph.D., left, discusses an abstract with Jeremy Kauffman, M.D.

Two October events at Johns Hopkins All Children’s showcased innovation and collaboration that are driving improvements in care.

6th Annual Johns Hopkins All Children’s Research Symposium

Three intensive care units, the Johns Hopkins All Children’s LifeLine critical care transport team and the Johns Hopkins School of Engineering share common ground: each played a role in the innovative research projects selected as winners at the Sixth Annual Johns Hopkins All Children’s Research Symposium.

More than 30 clinical, basic and translational research projects conducted at Johns Hopkins All Children’s Hospital were presented at the symposium, which has grown in size, scope and quality each year as the academic health system continues to accelerate its research mission. Research initiatives will continue with the 2018 opening of a new 230,000 square-foot Research and Education Building.

Neil Goldenberg, M.D., Ph.D., professor of pediatrics and medicine at Johns Hopkins University School of Medicine, and Johns Hopkins All Children’s director of research, reflected on the robust progress of the past six years. “The research findings presented at this year’s annual symposium demonstrate the spirit of inquiry and innovation at Johns Hopkins All Children’s. From predictors of survival in heart transplantation to novel findings that may help prevent the recurrence of venous blood clots in children and young adults, the findings presented at this year’s Symposium illustrated collaborative research that is guided by a sharp focus on improving children’s health outcomes, patient experience and value of care,” Dr. Goldenberg remarked.

The Symposium highlighted the wide range of opportunities for collaborative research that involves multiple disciplines, institutes and Hopkins campuses, with participation at many levels of career development―students, residents, fellows, junior faculty and senior investigators. 

Pediatric critical care specialist Anthony Sochet, M.D., received the top abstract award in the faculty category for his work on development of a shared mental model and checklist tool to improve the handover process when a patient is transferred to Johns Hopkins All Children’s from another hospital. His research team included other critical care and pediatric transport medicine physicians, a Johns Hopkins All Children’s LifeLine transport team nurse, and a pediatric resident from the University of South Florida. Their approach to standardizing shared communication among the four-person team improved handover quality and participation, and led to a novel method of measuring handover quality. Dr. Sochet’s research has been accepted for publication in the journal Pediatric Critical Care Medicine.

In the category of student- and trainee-led research, the top abstract award was shared by two different studies focused on outcomes in pediatric cardiac surgery. During a summer research project, Notre Dame University undergraduate Genevieve Tuite analyzed data from 179 heart transplants performed at Johns Hopkins All Children’s since 1995. Working with mentor Jeffrey Jacobs, M.D. (professor of surgery at Johns Hopkins University School of Medicine, and co-director of the Johns Hopkins All Children’s Heart Institute) and a team that included physicians, clinical and research nurses, computational scientists and other specialists, she identified an improvement in the transplant program’s outcomes beginning in 2006, when the transplant program began using a new approach to immunotherapy to prevent possible rejection. The change allowed the program to achieve excellent outcomes even while accepting transplant candidates who had been turned away from other centers due to their elevated risk of rejecting the donor heart. Sanjukta Bose, a graduate student in engineering at Johns Hopkins University, worked with clinical and research staff in St. Petersburg (led by Dr. Jacobs) and Baltimore (under the mentorship of Rai Winslow, Ph.D., professor of biomedical engineering), to study the high-resolution vital sign data captured by bedside monitors for critically ill infants in the pediatric cardiovascular intensive care unit. She developed an algorithm based on these data that, if validated, could alert clinicians several hours in advance to the potential for cardiac arrest.

Invited speakers discussed simulation-based research (Jennifer Arnold, M.D., director of medical simulation at Johns Hopkins All Children’s), advancements in the management of congenital diaphragmatic hernia (CDH; pediatric surgeon David Kays, M.D., director of the CDH and ECMO programs at Johns Hopkins All Children’s) and a promising technique for optical monitoring of cerebral blood flow in patients with congenital heart disease (Daniel Licht, M.D., Ph.D., pediatric neurologist at Children’s Hospital of Philadelphia). In the keynote address, Anne Murphy, M.D., and Elizabeth Matsui, M.D., vice chairs for research in the Department of Pediatrics at Johns Hopkins, described the history of pediatric research at Hopkins and the role of collaborative research at Johns Hopkins All Children’s in future advancements in children’s health.

Focusing on Quality Improvement

Concurrent with the research symposium and in recognition of National Healthcare Quality Week, the Johns Hopkins All Children’s Division of Patient Safety and Quality held its annual quality improvement (QI) poster display. QI is critical to delivering high value care through a focus on process, outcome and cost. QI projects at Johns Hopkins All Children’s are conducted by multidisciplinary teams using systematic methods to make changes that will lead to improved processes, better patient outcomes, better system performance and improved professional development. Among the 18 quality improvement projects featured at the poster session, a winner was selected in the unit-based and for the hospital-wide category.

The winning unit-based project came from the NICU and was led by respiratory therapist Julia Krzyzewski, pediatric nurse practitioner and certified wound care nurse Kris Rogers, and neonatologist Joana Machry, M.D.  Premature infants may receive mechanical ventilation that saves lives but can damage tiny lungs. A non-invasive alternative helps protect the lungs, but securing the breathing device around a baby’s nose and mouth may cause pressure injuries to an infant’s fragile skin. The project leaders worked with other nurses, respiratory therapists and members of the Pulmonary Task Force to develop and implement best practices for skin protection in these patients.

The winning hospital-wide project used sustainable processes to increase the total amount of hospital waste that is recycled, providing economic and environmental benefits. Thanks to staff education and robust recycling strategies, the cost of waste disposal fell by more than 50 percent and recycling as a percentage of the total waste stream grew from 14 to 86 percent in a three-year period. Karen Gallizzi, value analysis manager, and Michael Dansberger, director of environmental services, led this initiative with environmental service staff, in partnership with nursing and executive champion Anna Stratigos.

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