Medicine Critical Care Program Research and Innovation

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In the Medicine Critical Care Program (MCCP) at Boston Children’s Hospital, our faculty of physicians and scientists conduct research that spans the spectrum from cellular to clinical. We are dedicated to pushing the leading edge of research in order to develop new technologies and new therapies with federal founding, foundational funding and national leadership to advance the field.

Our researchers are currently focused on:

  • Glucose control with intravenous insulin in order to discern whether there is a reduction in length of critical illness and mortality by keeping the blood sugar in one of two different ranges.
  • Creative and cutting-edge therapies for critical asthma, involving the use of a gas mixture of helium and oxygen to help deliver medicine down deeper into the lungs more easily and efficiently
  • Non-invasive ventilatory strategies in babies and children with respiratory failure
  • Clinical applications of non-invasive hemodynamic monitoring
  • Automating subcutaneous insulin delivery in children with Type I Diabetes Mellitus, and intravenous insulin delivery in critically ill children including use of novel continuous glucose monitoring technologies, with a specific emphasis on minimizing hypoglycemia.   
  • Understanding the pathophysiology of cerebral edema in diabetic ketoacidosis and permanent memory impairment in children with Type I Diabetes Mellitus who develop diabetic ketoacidosis.
  • Innovative drugs and delivery systems to find new and sustained ways to deliver medicine to critically ill children and development of a revolutionary approach that will draw out specific harmful compounds or molecules in the blood during severe infections.
  • Examination of the cellular and molecular signaling that occurs when lungs are injured, whether it be by an infection or a mechanical ventilator.
  • Pediatric global health education with a specific focus on institutional partnerships, and triage of pediatric patients into intermediate care unit.

MCCP Researchers at Boston Children's:

  • Michael Agus, MD
  • Danielle DeCourcey, MD
  • Debra Hillier, MD
  • Lara Kothari, MD
  • Benjamin Matthews, MD
  • Elliot Melendez, MD
  • Tony Olivero, MD
  • Christiana Russ, MD
  • Garry Steil, PhD
  • Jackson Wong, MD

Safety & Quality

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At the Medicine Critical Care Program (MCCP) at Boston Children’s Hospital, we make every effort possible to develop scientifically sound methods of evaluating the quality of care we provide to the children in our units.

Within the MCCP there exists a robust and multidisciplinary safety and quality program that is led by Dr. Elliot Melendez, meets monthly and has numerous safety and quality initiatives currently including:

THINK Program

During a typical evaluation, a physician assesses a patient’s symptoms and makes a list of possible diagnoses based on the information collected. The THINK Program is an innovative approach to educating residents on how to provide the most accurate diagnosis by avoiding cognitive errors during the evaluation process.

THINK is a diagnostic checklist that stands for: True probability; Hidden diagnoses; Infrequent offenders; Not miss diagnosis; Knowledge of the disease. With each of these steps, clinicians must ask themselves: “Am I thinking about this in the right way?” “Does the clinical story make sense?” “Am I missing something?”

THINK allows doctors to take a “time-out” from the analysis of a patient in order to check and reevaluate their primary diagnosis and to ensure that all members of the child’s medical team at Boston Children's are on the same page.

“Good Catch” Program

The “Good Catch” Program exists in both the Intermediate Care Program and the Medical-surgical Intensive Care Unit.  This program is used to celebrate an instance where an employee was able to identify an error before it affected the treatment process.

PALS Certification

All the nurses in our units at Boston Children's are certified in Pediatric Advanced Life Support (PALS).   The PALS program was created by the American Heart Association (AHA) and the American Academy of Pediatrics (AAP) as a way to ensure that professional health care providers have the special skills and trainings needed in order to effectively treat the unique needs of children and infants who require critical care.

We provide monthly, two-day courses for certification in Pediatric Advanced Life Support (PALS), to ensure that we provide the highest level of emergency preparedness to our staff.

Simulation

Simulation is an integral part of the MCCP at Boston Children’s. Twice a month in the ICP and twice a month in the MICU, members of our faculty perform a simulated emergency scenario. This ensures that our staff is continually trained every week on crisis resources and emergency response.

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The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
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