Researcher | Research Overview
The Critical Care, Anesthesia, and Perioperative Extension (CAPE) Program is a comprehensive and longitudinal care practice group for children with significant special health care needs, technology dependence and medical complexities. Services include consultation and support to families and institutions who are considering homecare of ventilator assisted children, long-term coordination of care including home visits, and perioperative consultation and planning around critical care recovery and rehabilitation. Transitional care, coordination with community services, and education out-reach are also offered to improve the quality of life for these children and their families.
Health services research efforts to date have focus on extensive evaluation of health-related quality of life, impact on family, clinical outcomes, care models and resource utilization for the cohort of children enrolled in the Critical Care, Anesthesia, Perioperative Extension (CAPE) and Home Ventilation Program, which I established in 2007. Partnering with colleagues in other disciplines, I have pursued clinical investigation for cohorts of children with chronic respiratory failure, including multi-institutional therapeutic trials in spinal muscular atrophy, nutritional assessment and provision in chronic illness, and preliminary tracheal microbiome studies. In 2017, I established the Chronic Critical Illness and Long-term Ventilation subgroup within the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI).
Researcher | Research Background
I am a pediatric critical care physician with a special interest in children with chronic technology dependence. Through research, clinical interventions, and teaching, I have extended critical care services beyond the confines of the intensive care unit to optimize outcomes, quality of care, and resource utilization for these children and their families. My clinical background and training reflect a consistent interest in the continuum of acute and chronic pediatric illness. After completing pediatric training, I pursued an extended critical care fellowship to allow for additional clinical experience as a staff physician at a pediatric rehabilitation center as well as in the complex care services at Boston Medical Center and Boston Children’s Hospital (BCH). My health services and clinical research efforts focus on the interface between critical care services and children with chronic respiratory insufficiency and other complex special heath care needs. After completing general pediatrics training, I pursued and published the first descriptive study of children with neurodevelopmental disabilities in the pediatric intensive care (ICU) setting. My qualitative needs assessment study for the parents of children with disabilities in the ICU was published in Critical Care Medicine, one of the premier journals in our field. Findings informed the development of a year-long curriculum in a local Program to Enhance Relational and Communications Skills (PERCS).