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Travis Whitfill

MPH, MACE, MPhil
Associate Research Scientist in Pediatrics

Contact Information

Travis Whitfill, MPH, MACE, MPhil

Mailing Address

  • 100 York Street

    New Haven, CT 06511

    United States

ImPACTS
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Research Summary

Our recent research has shown critical deficiencies in acute pediatric care in United States' Emergency Departments. My research focus is in identifying and improving areas of deficiencies in hospitals and healthcare systems compared to nationally published guidelines or high-performing pediatric care centers.

Extensive Research Description

Assessing pediatric emergency care

A key goal of my research is measuring the quality of pediatric emergency care. One of my key contributions to the literature was an epidemiologic study of 318 million pediatric Emergency Department (ED) visits from 2006 to 2014. The study found major gaps in mortality in low pediatric volume EDs compared to high pediatric volume EDs. Importantly, these observations in poorer mortality and other measures in low volume EDs have been the focus of further work to close the gap between high and low pediatric volume EDs.

Another key contribution of my work has been around the pediatric readiness survey (PRS) as a measurement tool for pediatric readiness. We recently published a study in Pediatric Critical Care Medicine that described the association of the PRS and with patient outcomes in a prospective, countrywide study that was conducted in Latvia. This study adds critical evidence around the utility of the PRS as a measurement tool for pediatric emergency care.


Interventions, tools and policies to improve pediatric emergency care

My primary research interest uses technology and innovative techniques to improve the quality of pediatric care. The research interest relies on the use of simulation as a research methodology. I have developed analytical techniques to use simulation-based assessments to describe differences in care across a large spectrum of Emergency Departments (EDs). As an example of this, I am well known in the field of pediatric emergency medicine for the use of radar plots to display multiple measures of pediatric care across many hospitals. I have been central in a large ~200-center study examining differences in care across EDs across the United States to measure and compare—and improve—the quality of care in acutely ill pediatric patients.

We’ve measured significant improvements in pediatric readiness in EDs around the country. I recently finished an analysis of a dataset of 36 EDs across the US where we used a simulation-based intervention to improve pediatric readiness, and we saw a 16-point improvement in the 36 EDs (p<0.001).

Disaster medicine

One of my key interests is in disaster preparedness for pediatrics and using novel tools to improve pediatric disaster triage preparedness. We have published a series of papers on a videogame-based pediatric disaster triage training tool, 60 Seconds to Survival. We have shown that this videogame-based approach is able to improve disaster triage skills in EMS personnel. Additionally, I performed cost-effectiveness analyses to show that this tool was more cost-effective at improving pediatric disaster triage skills compared to a traditional, live simulation. This videogame-based approach can be easily scaled up to train remote health systems pediatric disaster triage (e.g., COVID19-related disasters).

Telemedicine and Technology for Improvement of Pediatric Care

Finally, I have collaborated on a series of studies on exploring modes of telemedicine to improve the delivery of pediatric care in several different settings. We have demonstrated the benefit of telemedicine in improving neonatal resuscitation in the ED (in a simulated setting) and have studied the nuances of telemedicine delivery. Additionally, we have used telesimulations between Yale at Latvia to train a local instructor in the country to conduct simulations locally.

Coauthors

Research Interests

Data Collection; Data Display; Delivery of Health Care; Organizational Innovation; Pediatrics; Quality of Health Care; Quality Improvement

Public Health Interests

Community Engagement

Research Image

Deficiencies in care between Pediatric Emergency Departments and General Emergency Departments

Using in situ simulation at approximately 30 Emergency Departments (EDs) across the US, we identified major deficiencies in care between Pediatric EDs and General EDs. These differences were most notable in Pediatric Readiness, septic shock preparedness, cardiac arrest preparedness, and teamwork

Selected Publications

  • Emergency Care for Children in the United States: Epidemiology and Trends Over Time.Whitfill T, Auerbach M, Scherzer DJ, Shi J, Xiang H, Stanley RM. Emergency Care for Children in the United States: Epidemiology and Trends Over Time. The Journal Of Emergency Medicine 2018, 55: 423-434. PMID: 29793812, DOI: 10.1016/j.jemermed.2018.04.019.
  • Statewide Pediatric Facility Recognition Programs and Their Association with Pediatric Readiness in Emergency Departments in the United States.Whitfill TM, Remick KE, Olson LM, Richards R, Brown KM, Auerbach MA, Gausche-Hill M. Statewide Pediatric Facility Recognition Programs and Their Association with Pediatric Readiness in Emergency Departments in the United States. The Journal Of Pediatrics 2020, 218: 210-216.e2. PMID: 31757472, DOI: 10.1016/j.jpeds.2019.10.017.
  • Establishing and Maintaining Multi-Site Studies in Healthcare Simulation ResearchWhitfill T, Gross I, Auerbach MA. “Establishing and Maintaining Multi-Site Studies in Healthcare Simulation Research.” Healthcare Simulation Research: A Practical Guide. Eds.: Nestel D, Hui J, Kunkler K, Calhoun AW, Scerbo MW. New York: Springer. 2019.
  • Recoding the metagenome: microbiome engineering in situ.Whitfill T, Oh J. Recoding the metagenome: microbiome engineering in situ. Current Opinion In Microbiology 2019, 50: 28-34. PMID: 31622928, DOI: 10.1016/j.mib.2019.09.005.
  • Cost-effectiveness of a video game versus live simulation for disaster trainingWhitfill T, Auerbach M, Diaz MCG, et alCost-effectiveness of a video game versus live simulation for disaster trainingBMJ Simulation and Technology Enhanced Learning Published Online First: 04 October 2019. doi: 10.1136/bmjstel-2019-000497
  • A Simulation-Based Quality Improvement Initiative Improves Pediatric Readiness in Community Hospitals.Whitfill T, Gawel M, Auerbach M. A Simulation-Based Quality Improvement Initiative Improves Pediatric Readiness in Community Hospitals. Pediatric Emergency Care 2018, 34: 431-435. PMID: 28719479, DOI: 10.1097/PEC.0000000000001233.
  • Improving Pediatric Administrative Disaster Preparedness Through Simulated Disaster Huddles.Gross IT, Goldberg SA, Whitfill T, Liebling S, Garcia A, Alfano A, Hasdianda A, Cicero MX. Improving Pediatric Administrative Disaster Preparedness Through Simulated Disaster Huddles. Disaster Medicine And Public Health Preparedness 2021, 15: 352-357. PMID: 32172716, DOI: 10.1017/dmp.2020.10.
  • Pediatric Readiness in the Emergency Department and Its Association With Patient Outcomes in Critical Care: A Prospective Cohort Study.Balmaks R, Whitfill TM, Ziemele B, Blumberga M, Upenieks R, Vegeris I, Grope I, Pavare J, Auerbach MA, Gross IT. Pediatric Readiness in the Emergency Department and Its Association With Patient Outcomes in Critical Care: A Prospective Cohort Study. Pediatric Critical Care Medicine : A Journal Of The Society Of Critical Care Medicine And The World Federation Of Pediatric Intensive And Critical Care Societies 2020, 21: e213-e220. PMID: 32132503, DOI: 10.1097/PCC.0000000000002255.
  • Comparison of Two Telemedicine Delivery Modes for Neonatal Resuscitation Support: A Simulation-Based Randomized Trial.Gross IT, Whitfill T, Redmond B, Couturier K, Bhatnagar A, Joseph M, Joseph D, Ray J, Wagner M, Auerbach M. Comparison of Two Telemedicine Delivery Modes for Neonatal Resuscitation Support: A Simulation-Based Randomized Trial. Neonatology 2020, 117: 159-166. PMID: 31905354, DOI: 10.1159/000504853.
  • Pediatric Disaster Triage: Multiple Simulation Curriculum Improves Prehospital Care Providers' Assessment Skills.Cicero MX, Whitfill T, Overly F, Baird J, Walsh B, Yarzebski J, Riera A, Adelgais K, Meckler GD, Baum C, Cone DC, Auerbach M. Pediatric Disaster Triage: Multiple Simulation Curriculum Improves Prehospital Care Providers' Assessment Skills. Prehospital Emergency Care : Official Journal Of The National Association Of EMS Physicians And The National Association Of State EMS Directors 2017, 21: 201-208. PMID: 27749145, DOI: 10.1080/10903127.2016.1235239.
  • Improving Simulated Pediatric Airway Management in Community Emergency Departments Using a Collaborative Program With a Pediatric Academic Medical Center.Abu-Sultaneh S, Whitfill T, Rowan CM, Friedman ML, Pearson KJ, Berrens ZJ, Lutfi R, Auerbach MA, Abulebda K. Improving Simulated Pediatric Airway Management in Community Emergency Departments Using a Collaborative Program With a Pediatric Academic Medical Center. Respiratory Care 2019, 64: 1073-1081. PMID: 31015388, DOI: 10.4187/respcare.06750.
  • Characteristics and Severity of Agitation Associated With Use of Sedatives and Restraints in the Emergency Department.Wong AH, Crispino L, Parker JB, McVaney C, Rosenberg A, Ray JM, Whitfill T, Iennaco JD, Bernstein SL. Characteristics and Severity of Agitation Associated With Use of Sedatives and Restraints in the Emergency Department. The Journal Of Emergency Medicine 2019, 57: 611-619. PMID: 31594740, DOI: 10.1016/j.jemermed.2019.07.019.
  • Disparities in Adherence to Pediatric Sepsis Guidelines across a Spectrum of Emergency Departments: A Multicenter, Cross-Sectional Observational In Situ Simulation Study.Kessler DO, Walsh B, Whitfill T, Gangadharan S, Gawel M, Brown L, Auerbach M. Disparities in Adherence to Pediatric Sepsis Guidelines across a Spectrum of Emergency Departments: A Multicenter, Cross-Sectional Observational In Situ Simulation Study. The Journal Of Emergency Medicine 2016, 50: 403-15.e1-3. PMID: 26499775, DOI: 10.1016/j.jemermed.2015.08.004.
  • Differences in the Quality of Pediatric Resuscitative Care Across a Spectrum of Emergency Departments.Auerbach M, Whitfill T, Gawel M, Kessler D, Walsh B, Gangadharan S, Hamilton MF, Schultz B, Nishisaki A, Tay KY, Lavoie M, Katznelson J, Dudas R, Baird J, Nadkarni V, Brown L. Differences in the Quality of Pediatric Resuscitative Care Across a Spectrum of Emergency Departments. JAMA Pediatrics 2016, 170: 987-994. PMID: 27570926, DOI: 10.1001/jamapediatrics.2016.1550.
  • 60 Seconds to Survival Video Game: A Multi-Site Study to Improve Prehospital Pediatric Disaster TriageCicero MX, Whitfill T, Overly F, Baird J, Walsh B, Yarzebski J, Riera A, Adelgais K, Meckler GD, Baum C, Cone DC, Auerbach M. 60 Seconds to Survival Video Game: A Multi-Site Study to Improve Prehospital Pediatric Disaster Triage. AEM Education and Training. 2018 (In Press).
  • 60 Seconds to Survival: A Multisite Study of a Screen-based Simulation to Improve Prehospital Providers Disaster Triage Skills.Cicero MX, Whitfill T, Walsh B, Diaz MC, Arteaga G, Scherzer DJ, Goldberg S, Madhok M, Bowen A, Paesano G, Redlener M, Munjal K, Kessler D, Auerbach M. 60 Seconds to Survival: A Multisite Study of a Screen-based Simulation to Improve Prehospital Providers Disaster Triage Skills. AEM Education And Training 2018, 2: 100-106. PMID: 30051076, PMCID: PMC5996818, DOI: 10.1002/aet2.10080.
  • Adherence to Pediatric Cardiac Arrest Guidelines Across a Spectrum of Fifty Emergency Departments: A Prospective, In Situ, Simulation-based Study.Auerbach M, Brown L, Whitfill T, Baird J, Abulebda K, Bhatnagar A, Lutfi R, Gawel M, Walsh B, Tay KY, Lavoie M, Nadkarni V, Dudas R, Kessler D, Katznelson J, Ganghadaran S, Hamilton MF. Adherence to Pediatric Cardiac Arrest Guidelines Across a Spectrum of Fifty Emergency Departments: A Prospective, In Situ, Simulation-based Study. Academic Emergency Medicine : Official Journal Of The Society For Academic Emergency Medicine 2018, 25: 1396-1408. PMID: 30194902, DOI: 10.1111/acem.13564.
  • Reporting Guidelines for Health Care Simulation Research: Extensions to the CONSORT and STROBE Statements.Cheng A, Kessler D, Mackinnon R, Chang TP, Nadkarni VM, Hunt EA, Duval-Arnould J, Lin Y, Cook DA, Pusic M, Hui J, Moher D, Egger M, Auerbach M. Reporting Guidelines for Health Care Simulation Research: Extensions to the CONSORT and STROBE Statements. Simulation In Healthcare : Journal Of The Society For Simulation In Healthcare 2016, 11: 238-48. PMID: 27465839, DOI: 10.1097/SIH.0000000000000150.
  • The Correlation of Workplace Simulation-Based Assessments With Interns' Infant Lumbar Puncture Success: A Prospective, Multicenter, Observational Study.Auerbach M, Fein DM, Chang TP, Gerard J, Zaveri P, Grossman D, Van Ittersum W, Rocker J, Whitfill T, Pusic M, Kessler DO. The Correlation of Workplace Simulation-Based Assessments With Interns' Infant Lumbar Puncture Success: A Prospective, Multicenter, Observational Study. Simulation In Healthcare : Journal Of The Society For Simulation In Healthcare 2016, 11: 126-33. PMID: 27043098, DOI: 10.1097/SIH.0000000000000135.
  • A Collaborative In Situ Simulation-based Pediatric Readiness Improvement Program for Community Emergency Departments.Abulebda K, Lutfi R, Whitfill T, Abu-Sultaneh S, Leeper KJ, Weinstein E, Auerbach MA. A Collaborative In Situ Simulation-based Pediatric Readiness Improvement Program for Community Emergency Departments. Academic Emergency Medicine : Official Journal Of The Society For Academic Emergency Medicine 2018, 25: 177-185. PMID: 28977717, DOI: 10.1111/acem.13329.
  • Safety Threats During the Care of Infants with Hypoglycemic Seizures in the Emergency Department: A Multicenter, Simulation-Based Prospective Cohort Study.Walsh BM, Gangadharan S, Whitfill T, Gawel M, Kessler D, Dudas RA, Katznelson J, Lavoie M, Tay KY, Hamilton M, Brown LL, Nadkarni V, Auerbach M. Safety Threats During the Care of Infants with Hypoglycemic Seizures in the Emergency Department: A Multicenter, Simulation-Based Prospective Cohort Study. The Journal Of Emergency Medicine 2017, 53: 467-474.e7. PMID: 28843460, DOI: 10.1016/j.jemermed.2017.04.028.
  • 60 seconds to survival: A pilot study of a disaster triage video game for prehospital providers.Cicero MX, Whitfill T, Munjal K, Madhok M, Diaz MCG, Scherzer DJ, Walsh BM, Bowen A, Redlener M, Goldberg SA, Symons N, Burkett J, Santos JC, Kessler D, Barnicle RN, Paesano G, Auerbach MA. 60 seconds to survival: A pilot study of a disaster triage video game for prehospital providers. American Journal Of Disaster Medicine 2017, 12: 75-83. PMID: 29136270, DOI: 10.5055/ajdm.2017.0263.
  • The Impact of Telemedicine on Teamwork and Workload in Pediatric Resuscitation: A Simulation-Based, Randomized Controlled Study.Butler L, Whitfill T, Wong AH, Gawel M, Crispino L, Auerbach M. The Impact of Telemedicine on Teamwork and Workload in Pediatric Resuscitation: A Simulation-Based, Randomized Controlled Study. Telemedicine Journal And E-health : The Official Journal Of The American Telemedicine Association 2019, 25: 205-212. PMID: 29957150, DOI: 10.1089/tmj.2018.0017.
  • Do you see what I see? A randomized trial of simulation-based master training with videolaryngoscopy for neonatal intubationJohnston L, Chen R, Whitfill T, Bruno C, Levit O, et al. Do you see what I see? A randomized trial of simulation-based master training with videolaryngoscopy for neonatal intubation. BMJ Simulation & Technology Enhanced Learning. 2016;
  • Development of a Child Abuse Checklist to Evaluate Prehospital Provider Performance.Alphonso A, Auerbach M, Bechtel K, Bilodeau K, Gawel M, Koziel J, Whitfill T, Tiyyagura GK. Development of a Child Abuse Checklist to Evaluate Prehospital Provider Performance. Prehospital Emergency Care : Official Journal Of The National Association Of EMS Physicians And The National Association Of State EMS Directors 2017, 21: 222-232. PMID: 27700209, DOI: 10.1080/10903127.2016.1229824.
  • Do you see what I see? A randomised pilot study to evaluate the effectiveness and efficiency of simulation-based training with videolaryngoscopy for neonatal intubationJohnston LC, Chen R, Whitfill TM, et alDo you see what I see? A randomised pilot study to evaluate the effectiveness and efficiency of simulation-based training with videolaryngoscopy for neonatal intubationBMJ Simulation and Technology Enhanced Learning 2015;1:12-18.
  • Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture.Kessler D, Pusic M, Chang TP, Fein DM, Grossman D, Mehta R, White M, Jang J, Whitfill T, Auerbach M. Impact of Just-in-Time and Just-in-Place Simulation on Intern Success With Infant Lumbar Puncture. Pediatrics 2015, 135: e1237-46. PMID: 25869377, DOI: 10.1542/peds.2014-1911.
  • Reporting guidelines for health care simulation research: extensions to the CONSORT and STROBE statements.Cheng A, Kessler D, Mackinnon R, Chang TP, Nadkarni VM, Hunt EA, Duval-Arnould J, Lin Y, Cook DA, Pusic M, Hui J, Moher D, Egger M, Auerbach M. Reporting guidelines for health care simulation research: extensions to the CONSORT and STROBE statements. Advances In Simulation (London, England) 2016, 1: 25. PMID: 29449994, PMCID: PMC5806464, DOI: 10.1186/s41077-016-0025-y.
  • Use of sedatives and restraints for treatment of agitation in the emergency department.Wong AH, Crispino L, Parker J, McVaney C, Rosenberg A, Ray JM, Whitfill T, Iennaco JD, Bernstein SL. Use of sedatives and restraints for treatment of agitation in the emergency department. The American Journal Of Emergency Medicine 2019, 37: 1376-1379. PMID: 30598374, DOI: 10.1016/j.ajem.2018.12.027.
  • What Parents Want: Does Provider Knowledge of Written Parental Expectations Improve Satisfaction in the Emergency Department?Zoltowski KS, Mistry RD, Brousseau DC, Whitfill T, Aronson PL. What Parents Want: Does Provider Knowledge of Written Parental Expectations Improve Satisfaction in the Emergency Department? Academic Pediatrics 2016, 16: 343-9. PMID: 26854207, PMCID: PMC6915063, DOI: 10.1016/j.acap.2016.01.020.
  • Improving Pediatric Diabetic Ketoacidosis Management in Community Emergency Departments Using a Simulation-Based Collaborative Improvement Program.Abulebda K, Whitfill T, Montgomery EE, Kirby ML, Ahmed RA, Cooper DD, Nitu ME, Auerbach MA, Lutfi R, Abu-Sultaneh S. Improving Pediatric Diabetic Ketoacidosis Management in Community Emergency Departments Using a Simulation-Based Collaborative Improvement Program. Pediatric Emergency Care 2021, 37: 543-549. PMID: 30870337, DOI: 10.1097/PEC.0000000000001751.
  • Do you see what I see? Insights from using google glass for disaster telemedicine triage.Cicero MX, Walsh B, Solad Y, Whitfill T, Paesano G, Kim K, Baum CR, Cone DC. Do you see what I see? Insights from using google glass for disaster telemedicine triage. Prehospital And Disaster Medicine 2015, 30: 4-8. PMID: 25571779, DOI: 10.1017/S1049023X1400140X.
  • Effects of alcohol-based hand hygiene solutions on breath alcohol detection in the emergency department.Emerson BL, Whitfill T, Baum CR, Garlin-Kane K, Santucci K. Effects of alcohol-based hand hygiene solutions on breath alcohol detection in the emergency department. American Journal Of Infection Control 2016, 44: 1672-1674. PMID: 27614708, DOI: 10.1016/j.ajic.2016.05.036.
  • The effect of an International competitive leaderboard on self-motivated simulation-based CPR practice among healthcare professionals: A randomized control trial.Chang TP, Raymond T, Dewan M, MacKinnon R, Whitfill T, Harwayne-Gidansky I, Doughty C, Frisell K, Kessler D, Wolfe H, Auerbach M, Rutledge C, Mitchell D, Jani P, Walsh CM. The effect of an International competitive leaderboard on self-motivated simulation-based CPR practice among healthcare professionals: A randomized control trial. Resuscitation 2019, 138: 273-281. PMID: 30946919, DOI: 10.1016/j.resuscitation.2019.02.050.
  • Community-based in situ simulation: bringing simulation to the masses.Walsh BM, Auerbach MA, Gawel MN, Brown LL, Byrne BJ, Calhoun A. Community-based in situ simulation: bringing simulation to the masses. Advances In Simulation (London, England) 2019, 4: 30. PMID: 31890313, PMCID: PMC6925415, DOI: 10.1186/s41077-019-0112-y.
  • Structures of the Bacillus subtilis glutamine synthetase dodecamer reveal large intersubunit catalytic conformational changes linked to a unique feedback inhibition mechanism.Murray DS, Chinnam N, Tonthat NK, Whitfill T, Wray LV, Fisher SH, Schumacher MA. Structures of the Bacillus subtilis glutamine synthetase dodecamer reveal large intersubunit catalytic conformational changes linked to a unique feedback inhibition mechanism. The Journal Of Biological Chemistry 2013, 288: 35801-11. PMID: 24158439, PMCID: PMC3861631, DOI: 10.1074/jbc.M113.519496.
  • SlmA forms a higher-order structure on DNA that inhibits cytokinetic Z-ring formation over the nucleoid.Tonthat NK, Milam SL, Chinnam N, Whitfill T, Margolin W, Schumacher MA. SlmA forms a higher-order structure on DNA that inhibits cytokinetic Z-ring formation over the nucleoid. Proceedings Of The National Academy Of Sciences Of The United States Of America 2013, 110: 10586-91. PMID: 23754405, PMCID: PMC3696773, DOI: 10.1073/pnas.1221036110.
  • Structures of regulatory machinery reveal novel molecular mechanisms controlling B. subtilis nitrogen homeostasis.Schumacher MA, Chinnam NB, Cuthbert B, Tonthat NK, Whitfill T. Structures of regulatory machinery reveal novel molecular mechanisms controlling B. subtilis nitrogen homeostasis. Genes & Development 2015, 29: 451-64. PMID: 25691471, PMCID: PMC4335299, DOI: 10.1101/gad.254714.114.
  • Molecular basis for a protein-mediated DNA-bridging mechanism that functions in condensation of the E. coli chromosome.Dupaigne P, Tonthat NK, Espéli O, Whitfill T, Boccard F, Schumacher MA. Molecular basis for a protein-mediated DNA-bridging mechanism that functions in condensation of the E. coli chromosome. Molecular Cell 2012, 48: 560-71. PMID: 23084832, DOI: 10.1016/j.molcel.2012.09.009.
  • Therapeutic treatment of skin disease with recombinant commensal skin microorganismsWhitfill TM, Munivar AM, inventors. Azitra Inc., assignee. Therapeutic treatment of skin disease with recombinant commensal skin microorganisms. PCT WO2015184134. 2014 May 30.
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