As a health services researcher, my work focuses on how healthcare systems and the way we deliver healthcare affect patient outcomes. In particular, I’m focused on developing and testing new approaches to enhance care delivery for pediatric patients in chronic and acute healthcare settings. I’m especially interested in approaches that assist families and medical providers in obtaining and better using data and knowledge to personalize care. I also work to improve care delivery by supporting providers and hospitals in improving the care they provide using quality improvement methods. I have significant expertise in leading multi-center quality improvement projects where I support multidisciplinary teams from leading health systems across the country to implement strategies to improve health outcomes for high-risk neonates and their families.
I decided to become a neonatology physician after seeing the joy childbirth brings to a family. I like supporting babies as they transition to life outside of the uterus. I want to help critically ill babies through their acute phase of illness and watch them improve and go home. Through my research, I found significant variation in outcomes and healthcare delivery across medical facilities. These variations in delivery opened my eyes to the many issues around the quality of healthcare in the United States, such as overuse, underuse and misuse of care. I became passionate about using research and quality improvement approaches to solve these issues.
My research and quality improvement work focuses on improving the quality of care we provide through action-oriented strategies. For instance, I’m investigating the use of N-of-1 trials to conduct comparative effectiveness research designed to help patients and clinicians obtain the knowledge needed to personalize treatment approaches and improve outcomes. In addition, I am conducting research to examine how learning networks can be used to improve quality at scale across many organizations.
The quality improvement work I do aims to solve the most complex and serious quality problems that impact patients' and families' outcomes in the neonatal intensive care unit (NICU). At the Cincinnati Children’s Hospital Medical Center, I serve as the co-director of quality for the Perinatal Institute. In this role, I support a range of quality improvement projects across 14 hospitals, where we provide newborns with healthcare services.
Furthermore, I work alongside the Ohio Perinatal Quality Collaborative and the Vermont Oxford Network to support a multitude of multidisciplinary teams that aim to make quantifiable improvements in medical care for babies and families. I am a leading expert in the role of context in successful quality improvement.
I led the development of the Model for Understanding Success in Quality (MUSIQ), which is utilized broadly throughout the U.S. and internationally to support researchers and those conducting local improvement efforts in identifying the contextual barriers and facilitators that must be addressed for their improvement projects to be successful. Our manuscript describing the model has been cited more than 350 times, while the systematic review of our research that informed the development of the MUSIQ model has been cited nearly 600 times.
I received the 2018 Cincinnati Children’s Research Foundation Faculty Award-Research Team Achievement as part of the Learning Networks Team. My research has been published in numerous journals, such as Pediatrics, Journal of Perinatology, Milbank Quarterly, and BMJ Quality and Safety.
Understanding variations in evidence-based care practices across hospitals; examining strategies for increasing the implementation of evidence into practice in perinatal care; using a systems lens to understand and ultimately change behavior at the individual, group, organizational, and environmental levels of the health care system.
Associate Professor, UC Department of Pediatrics
Neonatology, Pulmonary Biology