Pediatric Research: Critical Care

Katherine Biagas, MD

Research Interests and Contributions

Dr. Biagas' principle contribution to research has been in the field of functional and neurocognitive outcomes of Pediatric Intensive Care Unit (PICU) survivors. She was the Lead co-Investigator of the NHLBI-funded Heart and Lung Failure Pediatric INsulin Trial (HALFPINT), a randomized control trial of glycemic control in children with critical illness. An a priori outcome of the study was to measure neurodevelopmental, functional, and quality of life outcomes of critically ill children from the 32-centers of the HALFPINT trial at one year after hospitalization. To date, this work is the only multi-center trial to demonstrate associations between outcomes (principally health-related quality of life deficits) and medical events in the PICU. Dr. Biagas remains an active leader in this field and has directed a group of investigators conducting a scoping review of the literature concerning Cognitive Outcomes of PICU survivors. This work has been done as part of Dr. Biagas' participation in the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) research consortium. Furthermore, Dr. Biagas directs the Division of Pediatric Critical Care Medicine's participation in PALISI multi-collaborative work as a Site-Investigator for other clinical studies. Lastly, she is Chair of an Institutional Review Board (IRB) Committee at Stony Brook University.

Current Active Projects:

• Determining long-term functional outcomes of PICU survivors
• Leadership of an Ethics Core group for a multi-center Adaptive Platform Treatment Trial of children with critical illness
• Site-Investigator in a multi-center observational study of safety practice surrounding intubation (placement of a breathing tube) in critically ill infants and children with respiratory failure

Research Techniques:

• Support junior investigators in investigator-initiated work
• Well-versed in quantitative, qualitative, and mixed-methods studies, having conducted clinical investigations in the first two of these
• Well-versed in the ethical and administrative issues associated with Research Regulation

Summary

Dr. Katherine Biagas, Clinical Professor in Pediatrics, is a nationally recognized Pediatric Intensivist with over 30 years of experience. Dr. Biagas is a a graduate of the University of Pittsburgh, School of Medicine and completed Pediatrics residency and Pediatric Critical Care fellowship at Northwestern University and the University of Pittsburgh, respectively. She was a faculty member in the Department of Pediatrics at Yale University for over 7 years, followed by 19 years on the faculty at Columbia University Irving School of Medicine. She was recruited to Stony Brook University in January, 2019, to serve as the Chief of Pediatric Critical Care Medicine and the Vice Chair for Faculty Affairs. She subsequently became a Chair of the Stony Brook IRB after numerous years of such service. Dr. Biagas is a committed medical educator, having held numerous positions including starting the fellowship at Columbia University and leading it for 18 years. She is currently pursuing an EdD degree in Adult Learning and Leadership at Teachers College, Columbia University. Her doctoral dissertation is exploring the impact of the EHR and SMS devices on fellows and education programs. Finally, Dr. Biagas conducts active research in the field of functional outcomes after PICU stay, mentoring junior- and mid-level faculty in this work.

Announcements:

• Undergraduate and Medical School/Healthcare Sciences students interested in qualitative studies and studies of functional patient outcomes are invited. Any student interested in a research experience may contact the PI by email and submit their CV and personal statement.
• Residents and Fellows interested in qualitative studies, outcomes studies, or in performing comprehensive literature reviews are encouraged to contact the PI and inquire about current research opportunities.

Contact Information:

Katherine.Biagas@stonybrookmedicine.edu
HSC T-11-041
101 Nicolls Road
Stony Brook, NY  11794

Ryan S Hirschfeld, MD

Research Interests and Contributions

Dr. Ryan Hirschfeld's scholarly work is focused on the outcomes of children with complex chronic health conditions and their family member caregivers after being hospitalized in the pediatric intensive care unit. Among the international community of pediatric critical care practitioners, there is growing awareness and attention directed toward residual health issues that children may encounter following critical illness, which has potential to impact the psychological, emotional, and social wellbeing of family systems. By conducting research initiatives that engage families of children with chronic complex conditions, Dr. Hirschfeld's work aims to describe the ways in which families are impacted by their child's continuing care needs after an episode of critical illness and to identify gaps in family-based support and resources among families navigating the transition of care from the ICU to the home-based care environment.

Current Active Projects:

• The experiences of caregivers of children with complex medical needs during ICU aftercare and their perceptions of family impact: A pilot study
• A pilot program of a post-ICU telehealth-based follow-up for children with complex chronic health conditions
• Survey of caregiver perceptions of a telehealth-based ICU after care follow-up program
• Primary care provider perceptions of post-ICU discharge visits for children with complex chronic conditions: A survey study

Research Techniques:

• Proof of concept work of pilot projects
• Prospective observational studies using mixed quantitative and qualitative methods
• Survey-based projects

Summary

Dr. Ryan Hirschfeld has dual certification in pediatric critical care and palliative care medicine. His clinical research interests reside in the intersection of these specialties. He is aligned with the Pediatric Chronic Critical Illness Collaborative, a multistakeholder network uniting parents and research clinicians in the mission to advance research aimed at addressing the needs of children living with chronic complex conditions and their families. His prior research has focused on describing communication challenges that exist among multi-specialty stakeholders involved in the inpatient care of children with chronic critical illness.

Announcements:

• Undergraduate and Medical School/Healthcare Sciences students with interest in research that involves children with complex chronic conditions and their family member caregivers. Any student interested in a research experience may contact the PI by email and submit their CV and personal statement.
• Residents and Fellows interested in research focused on family-oriented outcomes in the context of pediatric chronic illness or transitions of care from the inpatient to community-based setting following critical illness, you are encouraged to contact the PI and inquire about current research opportunities.

Contact information:

Ryan.Hirschfeld@stonybrookmedicine.edu
Stony Brook University Hospital
Health Sciences Center, T11-087D

Uchechi Oddiri, MD

Research Interests and Contributions

Dr. Uchechi Oddiri is a clinician educator and educational scholar with specific interests in learner and medical provider well-being in the learning and clinical environments. Her scholarly endeavors focus on the impact systemic racism has on provider well-being and flourishing.

Current Active Projects:

• The Design and Implementation of a Multi-Unit Critical Care Course for 4th Year Medical Students
• Academic Pediatric Assosiation (APA) Anti-racism & Equity Toolkit Integration into the Clinical Practices of Healthcare Providers
• Ethno-Racial Trauma Experienced by Healthcare Providers and its Impact on Clinician Well-being: A Scoping Review
• Top Articles in Pediatric Medical Education: Narrative Reviews

Research Techniques:

Dr. Oddiri's research projects incorporate the following research methodologies:

• Observational methods
• Interventional methods
• Investigator-initiated work
• Qualitative methods
• Reviews

Summary

Dr. Uchechi Oddiri is a Clinical Assistant Professor of Pediatrics and Pediatric Intensivist at Stony Brook Children's Hospital. She serves as the Pediatric Post-Clerkship Director in the Renaissance School of Medicine at Stony Brook University. Her educational philosophy focuses on fostering a dynamic, culturally humble and psychologically safe learning environment that promotes critical thinking and lifelong learning by engaging trainees in collaborative experiential learning and problem-solving, Her research pursuits and national collaborations focus on the intersection between systemic racism and clinician well-being and flourishing. To address this topic, Dr. Oddiri aims to determine how ethno-racial trauma, defined as the psycho-emotional injury caused by the mistreatment or discrimination of a person based on their race or ethnicity, impacts provider well-being.

Announcements:

• Undergraduate and Medical School/Healthcare Sciences students interested in research on learner or provider well-being may contact Dr. Oddiri by email and submit their CV and personal statement.
• Residents and Fellows interested in medical education, DEI-focused topics, and provider well-being are encouraged to contact Dr. Oddiri and inquire about current research opportunities.

Contact information:

Email: Uchechi.Oddiri@stonybrookmedicine.edu
Office: 101 Nicolls Road HSC T11-040, Stony Brook, NY  11794-811

Rahul Panesar, MD

Research Interests and Contributions

Simulation-based medical education (SBME) has provided opportunities for health care personnel to learn life-saving skills and knowledge that can be applied in rare but critical events. Research into different techniques of SBME can provide insight on how best to teach these skills and train future nurses and physicians. We have conducted work in high-fidelity and in-situ SBME to further advance the field, with development of novel methods that are being used currently.

Current Active Projects:

An Escape Room to Teach Resuscitation: The First Five Minutes of a Pediatric Code

Research Techniques:

• Proof of concept: designing and implementing an escape room with puzzles emphasizes the American Heart Association protocols for resuscitation in the first five minutes of a pediatric cardiopulmonary arrest. The puzzles used given the need for effective communication, delegation of tasks, and strategic thinking under a time constraint with competing priorities is inherent to both
• Observational studies: reviewing video and audio of high-fidelity simulations for team performance of crisis resource management skills
• Prototype designs: design and development of low-cost wireless technologies to enhance fidelity of simulations

Summary

Dr. Rahul Panesar is an Associate Professor of Clinical Pediatrics and the Medical Director of the Pediatric Intensive Care Unit. He is credentialed through the Society for Simulation in Healthcare as a Simulation Educator and has published several peer-reviewed works in this field. Dr. Panesar is interested in different methods of using simulation in high fidelity environments as well as in-situ clinical settings.

Announcements:

Medical School/Healthcare Sciences students as well as residents and fellows interested in learning about simulation-based medical education may contact Dr. Rahul Panesar by email and submit their CV and personal statement.

Contact Information:

Rahul S. Panesar, MD, FAAP, CHSE

Associate Professor of Clinical Pediatrics
Renaissance School of Medicine at Stony Brook University
Director, Pediatric Simulation Program
Medical Director, Pediatric Intensive Care Unit
Division of Pediatric Critical Care Medicine

Stony Brook Children's Hospital
HSC T-11, Suite 040
Stony Brook, NY  11794-8111
rahul.panesar@stonybrookmedicine.edu

Randi Trope, DO

Research Interests and Contributions

Dr. Randi Trope's research primarily focuses on quality improvement work within the department of pediatrics. Multiple quality projects can be occurring simultaneously and can last anywhere from six months to two years per project.

Current Active Projects:

• American Academy of Pediatrics BARCK QI Collaborative (Better Assessment & Response to Croup in Kids)
• American Society of Hospital Pharmacists (ASHP) Pediatric Standardize 4 Safety (S4S) workgroup
• Decreasing length of stay in pediatric patients requiring medication treatment for iatrogenic drug withdrawal
• Reducing the override rate in automated medication dispensing cabinets in pediatrics
• Increasing compliance with fecal calprotectin testing in pediatric patients with inflammatory bowel disease (IBD)
• Decreasing time to insulin order entry in pediatric patients with diabetes
• Decreasing incidence of hyperchloremia in pediatric patients with diabetic ketoacidosis

Research Techniques:

Quality techniques will be utilized to evaluate processes and identify opportunities for improvement including process maps, fish-bone diagrams (Ishikawa), swim lane maps, and Failure Mode Effects Analysis (FMEA). Change will occur through implementation of Plan-Do-Study-Act (PDSA) cycles. Data analysis will occur through utilization of control charts that will help identify special cause variation which in turn allows for evaluation of PDSA cycles for effectiveness.

Summary

Dr. Randi Trope, a Clinical Assistant Professor, is an expert in Pediatric Critical Care Medicine and has been active in the field since completing training in 2004. Her clinical interests are in sedation management and continuous renal replacement therapy (CRRT). Dr. Trope is also the Vice-Chair of Quality and Safety for the Department of Pediatrics. She earned her MBA in Quality Management and has a particular focus on medication safety. Dr. Trope serves on the advisory board of several national organizations, including the Institute for Safe Medication Practices (ISMP) and the Standardize 4 Safety (S4S) Committee for Pediatrics, promoting medication safety. Dr. Trope is actively involved in promoting quality management throughout the Pediatrics Department and engages in teaching activities to promote quality improvement projects. She is passionate about ensuring that the care provided throughout pediatrics is done efficiently and safely.

Announcements:

• Undergraduate and Medical School/Healthcare Sciences students interested in any form of quality improvement projects, either ongoing or one you would like to initiate, within the department of pediatrics may contact Dr. Trope by email and submit their CV and personal statement.
• Residents and Fellows interested in quality work are also encouraged to contact Dr. Trope and inquire about current and future quality improvement opportunities.

Contact information:

Randi.Trope@stonybrookmedicine.edu
101 Nicolls Road
Department of Pediatric Critical Care Medicine, HSC - 11
Stony Brook, NY  11794