Scholarship

The Yale PHM faculty lead and participate in a spectrum of scholarly projects including quality improvement, medical education, medical ethics, clinical care, quantitative and qualitative research. Our hospitalists present their work annually at the national Pediatric Academic Societies meeting, Pediatric Hospital Medicine meeting, the Association of Pediatric Program Directors meeting, among others.

In 2023, the Journal Pediatrics, announced the Top Pediatric Hospital Medicine Articles in the journal since 1948. An article by Yale PHM hospitalists (Grossman MR, Berkwitt AK, Osborn RR, et al. An initiative to improve the quality of care of infants with neonatal abstinence syndrome. Pediatrics. 2017;139(6):e20163360) was recognized as one of these articles. This is the accompanying commentary by the Section of Hospital Medicine:

Neonatal abstinence syndrome emerged in the early 2000s as an increasingly common diagnosis in pediatric hospital medicine due to the national opioid epidemic. The article by Grossman et al resulted in a marked transformation in care. The method of care described, now commonly called “eat, sleep, console,” resulted in dramatic reductions in the number of infants treated with opioids (from 98% to 14%) and the mean length of stay (from 22 days to 6 days) at a single center. These findings have since been replicated at other centers and have been widely implemented, resulting in a profound change in the care of a vulnerable population.

Here are some peer-reviewed publications from the hospitalist faculty:

Neonatal Abstinence Syndrome

Grossman MR, Lipshaw MJ, Osborn RR, Berkwitt AK. A Novel Approach to Assessing Infants With Neonatal Abstinence Syndrome. Hosp Pediatr. 2018 Jan;8(1):1-6. doi: 10.1542/hpeds.2017-0128. PMID: 29263121.
Jilani SM, Jones HE, Grossman M, Jansson LM, Terplan M, Faherty LJ, Khodyakov D, Patrick SW, Davis JM. Standardizing the Clinical Definition of Opioid Withdrawal in the Neonate. J Pediatr. 2022 Apr;243:33-39.e1. doi: 10.1016/j.jpeds.2021.12.021. Epub 2021 Dec 20. PMID: 34942181.
Drago MJ, Shabanova V, Hochreiter D, Grossman M, Mercurio M. Does Maternal Incarceration Impact Infants with Neonatal Abstinence Syndrome? Matern Child Health J. 2022 May;26(5):1095-1103. doi: 10.1007/s10995-021-03356-4. Epub 2022 Jan 28. PMID: 35088297.
McRae K, Sebastian T, Grossman M, Loyal J. Parent Perspectives on the Eat, Sleep, Console Approach for the Care of Opioid-Exposed Infants. Hosp Pediatr. 2021 Apr;11(4):358-365. doi: 10.1542/hpeds.2020-002139. Epub 2021 Mar 3. PMID: 33658244.
Grossman MR, Berkwitt AK, Osborn RR, Citarella BV, Hochreiter D, Bizzarro MJ. Evaluating the effect of hospital setting on outcomes for neonatal abstinence syndrome. J Perinatol. 2020 Oct;40(10):1483-1488. doi: 10.1038/s41372-020-0621-5. Epub 2020 Feb 21. PMID: 32086436.
Grossman MR, Berkwitt AK, Osborn RR. Racial association and pharmacotherapy in neonatal opioid withdrawal syndrome: thinking beyond genetics. J Perinatol. 2020 Apr;40(4):689-690. doi: 10.1038/s41372-020-0607-3. Epub 2020 Feb 19. PMID: 32076112.

Newborn Care

Loyal J, Danziger P, Wood KE. Midwives' Perspectives about Vitamin K Prophylaxis Against Vitamin K Deficiency Bleeding of the Newborn. Matern Child Health J. 2022 May 12:1–8. doi: 10.1007/s10995-022-03423-4. Epub ahead of print. PMID: 35551587; PMCID: PMC9095437.
Loyal J, Aragona E. Trends in and Documentation of Refusal of Common Routine Newborn Interventions: 2013-2019. Hosp Pediatr. 2021 Sep;11(9):962-967. doi: 10.1542/hpeds.2021-005977. Epub 2021 Aug 11. PMID: 34380669.
Aragona E, West D, Loyal J. Well-Newborn Unit Director Experiences During the COVID-19 Pandemic: A BORN Study. Hosp Pediatr. 2021 Sep;11(9):e170-e181. doi: 10.1542/hpeds.2021-005862. Epub 2021 Aug 10. PMID: 34376484.
Hochreiter D, Kuruvilla D, Grossman M, Silberg J, Rodriguez A, Lary L, Panosky K, Loyal J. Improving Guidance and Maternal Knowledge Retention After Well-Newborn Unit Discharge. Hosp Pediatr. 2022 Feb 1;12(2):148-156. doi: 10.1542/hpeds.2021-006307. PMID: 35075487.
Grossman MR, Berkwitt AK, Osborn RR. Questioning Our Approach to Hyperbilirubinemia. Hosp Pediatr. 2022 Apr 1;12(4):e137-e139. doi: 10.1542/hpeds.2021-006441. PMID: 35362053.
Loyal J, Wood KE. Advancing the Evidence Base in the Care of Term and Late Preterm Infants. Hosp Pediatr. 2021 Sep;11(9):e189-e191. doi: 10.1542/hpeds.2021-006203. Epub 2021 Aug 2. PMID: 34341065.
Leff M, Loyal J. The Term Newborn: Alternative Birth Practices, Refusal, and Therapeutic Hesitancy. Clin Perinatol. 2021 Aug;48(3):647-663. doi: 10.1016/j.clp.2021.05.012. PMID: 34353585.
Loyal J, Shapiro ED. Refusal of Intramuscular Vitamin K by Parents of Newborns: A Review. Hosp Pediatr. 2020 Mar;10(3):286-294. doi: 10.1542/hpeds.2019-0228. Epub 2020 Feb 4. PMID: 32019806; PMCID: PMC7041551.
Gievers LL, Holmes AV, Loyal J, Larson IA, Oliveira CR, Waldman EH, Khaki S. Ethical and Public Health Implications of Targeted Screening for Congenital Cytomegalovirus. Pediatrics. 2020 Jul;146(1):e20200617. doi: 10.1542/peds.2020-0617. PMID: 32591436.
Aby J, Kim J, Lai L, Flaherman V, Loyal J. Variation in Management of Cutaneous Lumbosacral Findings in Newborns. Hosp Pediatr. 2020 Jun;10(6):496-501. doi: 10.1542/hpeds.2019-0264. Epub 2020 May 13. PMID: 32404330.

Medical Education

Vermette D, Doolittle B. What Educators Can Learn from the Biopsychosocial-Spiritual Model of Patient Care: Time for Holistic Medical Education. J Gen Intern Med. 2022 Jun;37(8):2062-2066. doi: 10.1007/s11606-022-07491-8. Epub 2022 Mar 31. PMID: 35357678; PMCID: PMC8969815.
Goldman MP, Palladino LE, Malik RN, Powers EM, Rudd AV, Aronson PL, Auerbach MA. A Workplace Procedure Training Cart to Augment Pediatric Resident Procedural Learning. Pediatr Emerg Care. 2022 Feb 1;38(2):e816-e820. doi: 10.1097/PEC.0000000000002397. PMID: 35100781.
Dean A, Foradori DM, Kumar S, Player B, Hochreiter D, Hainstock L, Kumta J, Gold J, Fromme HB. How Perceived Burnout Alters Frontline Educators' Assessments in the Clinical Learning Environment. Acad Pediatr. 2022 Apr;22(3):495-500. doi: 10.1016/j.acap.2021.12.014. Epub 2021 Dec 17. PMID: 34929385.
Rubin A, Osborn RR, Nowicki MJ, Surber K, Rashty JL, Shefler A, Parent KS, Monroe KK, Mychaliska KP. Patient- and Family-centered Rounding: A Single-site Look into the Room. Pediatr Qual Saf. 2021 Jun 23;6(4):e421. doi: 10.1097/pq9.0000000000000421. PMID: 34235350; PMCID: PMC8225381.
Osborn R, Grossman M, Berkwitt A. The Effect of Sitting Versus Standing on Family Perceptions of Family-Centered Rounds. Hosp Pediatr. 2021 Nov;11(11):e313-e316. doi: 10.1542/hpeds.2021-005999. Epub 2021 Oct 4. PMID: 34607885.
Goldenberg MN, Hersh DC, Wilkins KM, Schwartz ML. Suspending Medical Student Clerkships Due to COVID-19. Med Sci Educ. 2020 Jun 3:1-4. doi: 10.1007/s40670-020-00994-1. Epub ahead of print. PMID: 32837784; PMCID: PMC7266676.
Dahlquist HC, Hafler JP, Hersh DC. A Pilot Study of a Direct Teaching Observation Tool for Residents. Yale J Biol Med. 2020 Aug 31;93(3):419-422. PMID: 32874147; PMCID: PMC7448393.
Loyal J, Fenick A. Entering the Workforce: An Innovative Curriculum to Prepare Pediatric Residents for Life After Training. Acad Pediatr. 2020 Nov-Dec;20(8):1217-1220. doi: 10.1016/j.acap.2020.06.007. Epub 2020 Jun 12. PMID: 32534871.
Du N, Rosenberg J, Mohareb A, Agrawal P, Brown C, Cheng FY. Teaching the Yale Health Education and Literacy for Asylees and Refugees: An Innovative Educational Initiative About Refugee Health for Medical Trainees. Acad Pediatr. 2021 Mar;21(2):384-386. doi: 10.1016/j.acap.2020.09.003. Epub 2020 Sep 8. PMID: 32916340; PMCID: PMC7937769.
Goldenberg MN, Hersh DC, Wilkins KM, Schwartz ML. Suspending Medical Student Clerkships Due to COVID-19. Med Sci Educ. 2020 Jun 3:1-4. doi: 10.1007/s40670-020-00994-1. Epub ahead of print. PMID: 32837784; PMCID: PMC7266676.

Quality Improvement

Glick AF, Foster LZ, Goonan M, Hart LH, Alam S, Rosenberg RE. Using Quality Improvement Science to Promote Reliable Communication During Family-Centered Rounds. Pediatrics. 2022 Apr 1;149(4):e2021050197. doi: 10.1542/peds.2021-050197. PMID: 35362064.
De Angulo NR, Penwill N, Pathak PR, Ja C, Elster MJ, Hochreiter D, Newton JM, Wilson KM, Kaiser SV. Quality and Safety in Hospital Pediatrics During COVID-19: A National Qualitative Study. Hosp Pediatr. 2021 Dec 22:e2021006115. doi: 10.1542/hpeds.2021-006115. Epub ahead of print. PMID: 34939112.
Pashankar DS, Zhao AM, Bathrick R, Taylor C, Boules H, Cowles RA, Grossman M. A Quality Improvement Project to Improve First Case On-time Starts in the Pediatric Operating Room. Pediatr Qual Saf. 2020 Jun 24;5(4):e305. doi: 10.1097/pq9.0000000000000305. PMID: 32766485; PMCID: PMC7339335.
Emerson BL, Setzer E, Bechtel K, Grossman M. Improving Patient Experience Scores in a Pediatric Emergency Department. Pediatr Qual Saf. 2021 Jun 23;6(4):e417. doi: 10.1097/pq9.0000000000000417. PMID: 34235347; PMCID: PMC8225380.

Clinical Care

Gielissen KA, Taylor EP, Vermette D, Doolittle B. Thriving among Primary Care Physicians: a Qualitative Study. J Gen Intern Med. 2021 Dec;36(12):3759-3765. doi: 10.1007/s11606-021-06883-6. Epub 2021 May 28. PMID: 34047922; PMCID: PMC8642558.
Tieder JS, Sullivan E, Stephans A, Hall M, DeLaroche AM, Wilkins V, Neuman MI, Mittal MK, Kane E, Jain S, Shastri N, Katsogridakis Y, Vachani JG, Hochreiter D, Kim E, Nicholson J, Bochner R, Murphy K; Brief Resolved Unexplained Event Research and Quality Improvement Network. Risk Factors and Outcomes After a Brief Resolved Unexplained Event: A Multicenter Study. Pediatrics. 2021 Jul;148(1):e2020036095. doi: 10.1542/peds.2020-036095. Epub 2021 Jun 24. PMID: 34168059.
Penwill NY, Roessler De Angulo N, Pathak PR, Ja C, Elster MJ, Hochreiter D, Newton JM, Wilson KM, Kaiser SV. Changes in pediatric hospital care during the COVID-19 pandemic: a national qualitative study. BMC Health Serv Res. 2021 Sep 11;21(1):953. doi: 10.1186/s12913-021-06947-7. PMID: 34511079; PMCID: PMC8435183.
Bochner R, Tieder JS, Sullivan E, Hall M, Stephans A, Mittal MK, Singh N, Delaney A, Harper B, Shastri N, Hochreiter D, Neuman MI; BRIEF RESOLVED UNEXPLAINED EVENT RESEARCH AND QUALITY IMPROVEMENT NETWORK. Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event. Pediatrics. 2021 Nov;148(5):e2021052673. doi: 10.1542/peds.2021-052673. Epub 2021 Oct 4. PMID: 34607936.
Natarajan EV, Aronson PL, Berkwitt AK. The Cost of Diagnostic Delay and Error. Hosp Pediatr. 2021 Mar;11(3):e38-e41. doi: 10.1542/hpeds.2020-003046. PMID: 33632747.
Osborn R, Doolittle B, Loyal J. When Pediatric Hospitalists Took Care of Adults During the COVID-19 Pandemic. Hosp Pediatr. 2021 Jan;11(1):e15-e18. doi: 10.1542/hpeds.2020-001040. PMID: 33380462.
Wong KH, Murray T, Osborn R, Soffer GK. Unmasking symptomatic dermatographism in the time of COVID-19. Postgrad Med J. 2021 Jun;97(1148):402. doi: 10.1136/postgradmedj-2020-138688. Epub 2020 Sep 10. PMID: 32913035.
Palmaccio SJ, Rodriguez AL, Drago MJ, Mercurio MR. An Evidence-Based Ethical Approach to Parental Refusal of Screening Tests: The Case of Asymptomatic Neonatal Hypoglycemia. J Pediatr. 2021 Feb;229:278-282. doi: 10.1016/j.jpeds.2020.09.012. Epub 2020 Sep 17. PMID: 32950534; PMCID: PMC7497804.

News & Blogs

Ostfeld-Johns S. There will be a successful COVID-19 vaccine, but we must not rush it. September 13, 2020. Hartford Courant.
Ostfeld-Johns S. Multisystem inflammatory syndrome in children related to Covid-19 isn’t the mystery it’s made out to be. July 16, 2020. STAT
Loyal J. and Malcolm J. There’s no such thing as a Black cloud. November 24, 2020. Yale Pediatrics' Paw Prints Blog