Tag Archive for: Tarini

newborn baby with bandaid on heel

JAMA Pediatrics editorial: A better approach for newborn screening

The medical community has an opportunity to update its approach to newborn screening (NBS) to be prepared for emerging technological advancements that will help diagnose children with rare diseases from their first weeks of life, according to an editorial from a leading Children’s National Hospital researcher published in JAMA Pediatrics.

“In health care, we are seeing ways in which we can identify more children who have rare diseases even earlier, in the newborn period, rather than waiting for children to develop symptoms or experience irreversible changes,” said Beth Tarini, M.D., M.S., M.B.A., associate director of the Center for Translational Research. “We have continued innovations in screening technology – with more on the way – that can be added to the screening programs overseen by all 50 states. Updating how we approach newborn screening presents an incredible opportunity for doctors and their patient-families.”

Why it matters

Newborn screening happens before the baby leaves the hospital, generally with a prick of the heel to take a small sample of blood to look for several dozen rare, debilitating disorders such as sickle cell disease, congenital hypothyroidism and cystic fibrosis. The current screening system has grown successfully for roughly 60 years and creates a network of state programs. Along the way, researchers have had extensive debates about which disorders to include, based on whether there are treatments and options for patients.

Dr. Tarini, a pediatrician who has done extensive research on NBS and related policies, said that the existing screening programs across all 50 states should be modernized, with federal research support and funding, to create a unified “learning newborn screening system” that derives information from the 4 million babies born each year and provides feedback to the medical community about best practices for babies who are diagnosed with a rare disease or at risk for developing one.

“A new approach will require resources and infrastructure, but as the technology advances, we should change our system to leverage the experience of doctors, patients, and NBS programs across the country,” Dr. Tarini said. “We have the will, the experience and the ability to transform the care for children with rare disease.”

Read the full editorial in JAMA Pediatrics.

baby getting heel prick

Researchers study murky findings in newborn screening panels with $3.7m NIH grant

baby getting heel prick

Children’s National received a grant to investigate the impact of newborn screening on families who receive an uncertain prognosis.

The National Institutes of Health (NIH) awarded Children’s National Hospital a $3.7 million grant to investigate the impact of newborn screening on the growing population of families who leave the testing with an uncertain prognosis.

Following the families longitudinally allows for a real-time view of the experiences of these children, sometimes referred to as “patients in waiting.”

Newborn screening is part of a universal, mandatory state health program that helps to identify inherited conditions that can affect a child’s health and survival. Millions of babies are screened annually for genetic, metabolic and endocrine disorders, using a few drops of blood from a prick to the heel; additional tests are done at the bedside such as hearing and heart screening. Sometimes, however, the results create medical odysseys and flag conditions that may never result in symptoms.

“For its first 50 years, newborn screening presented relatively consistent outcomes,” said principal investigator Beth Tarini, M.D., M.S., M.B.A., who serves as the associate director of the Center for Translational Research at Children’s National. “However, in the 21st century, new screening tests have created more ambiguous findings. As a result, we cannot accurately predict what type of symptoms a child may develop, when or if they will develop them, or how severe they will be. This is a lot to ask parents to deal with after the birth of a new child who appears otherwise healthy.”

Why it matters

The uncertainty can take a significant toll on parents by creating fear, anxiety and the medicalization of a child. However, to date, little long-term data exist to inform the care for these children. Ethically, that gap leaves clinicians unsure of how to weigh the benefit and harm of mandatory newborn screening programs. From a policy perspective, the drought of information leads to questions about how best to add disorders to newborn screening panels – an issue that will likely only grow as technology allows us to test for more conditions.

“We have a new group of children growing up and wondering when – or if – they will ever develop signs or symptoms of a disease,” Dr. Tarini said. “For some families, the information is an opportunity. For others, it becomes a burden. We owe it to these families to understand their experience and chart a sensible path forward to help them.”

What’s next

The four-year study will bring together researchers at Children’s National and Case Western University to analyze data and patient interviews from families in Virginia, Iowa and Oregon. The research team will include experts in newborn screening, genetics, health services, genetic counseling, psychology, bioethics and biostatistics.

PAS Logo

Children’s National Hospital at the 2022 Pediatric Academic Societies Meeting

Are you attending the 2022 Pediatric Academic Societies meeting this week? There will be over 20 Children’s National Hospital-affiliated participants at this year’s meeting. We have compiled their sessions into a mini schedule below.

Name Department Role Topic Date Time
Kristen Sgambat, Ph.D., R.D. Center for Translational Research Speaker Fueling our patients for success: Optimizing nutritional support for kids with kidney disease 4/22/2022 2:30 PM
Priti Bhansali, M.D., M.Ed. Child Health Advocacy Institute Co-speaker APA Division Directors/Faculty Development Combined SIG 4/23/2022 8:00 AM
Karen Smith, M.D., M.Ed.
Neha Shah, M.D., M.P.H.
Workshop co-leaders Don’t Struggle In Solitude: Recovery and Peer Support after Unanticipated Outcomes, Errors, and Difficult Conversations 4/23/2022 8:00 AM
Ian Chua, M.D., M.H.P.E.
Gabrina Dixon, M.D., M.Ed.
Margarita Ramos, M.D., M.S.
Workshop co-leaders Finding the DEI in LGBTQIA: Incorporating LGBTQIA diversity in your environment 4/23/2022 8:00 AM
Kevin M. Cook, Ph.D. Co-presenter Early exposure to the extra-uterine environment in premature infants is associated with altered functional brain connectivity compared to in-utero age-matched fetuses 4/23/2022 8:15 AM
Gabrina Dixon, M.D., M.Ed.
Terry Kind, M.D., M.P.H.
Workshop co-leaders Changing the system: Best practices in supporting and advancing underrepresented in medicine (UIM) medical students 4/23/2022 10:00 AM
Yao Wu, Ph.D. Oral abstract presenter Impaired prenatal brain growth predicts adverse neurodevelopmental outcomes in infants with congenital heart disease 4/23/2022 10:00 AM
Lee S. Beers, M.D. General and Community Pediatrics Moderator Scholarship in the Domain of Child Health Advocacy: Making It Work in the Academic Medical Center 4/23/2022 10:00 AM
Chaya Merrill, Dr.P.H. Center for Translational Research Speaker Using data to advance advocacy in the academic medical center 4/23/2022 10:00 AM
Yuan-Chiao Lu, Ph.D. Oral abstract presenter Delayed Fetal Cortical Maturation Predicts 18-Month Neurodevelopment in Infants with Congenital Heart Disease 4/23/2022 10:15 AM
Olanrewaju O. Falusi, M.D., M.Ed. Child Health Advocacy Institute Speaker Generating currency for advancement and professional development in the domain of advocacy 4/23/2022 10:15 AM
Subechhya Pradhan, Ph.D. Oral abstract presenter Abnormal in-vivo brain biochemistry in fetuses with complex congenital heart disease 4/23/2022 10:30 AM
Lenore R. Jarvis, M.D., M.Ed. Emergency Medicine and Trauma Services Speaker Academic advocacy for the subspecialist 4/23/2022 10:30 AM
Jillian E. Nickerson, M.D., M.S. Emergency Medicine and Trauma Services Presenter Utilizing an Online Module Platform to Teach Newborn Delivery and Resuscitation Skills to Pediatric Emergency Medicine Providers 4/23/2022 10:30 AM
Lee S. Beers, M.D. General and Community Pediatrics Presenting Author Leadership in legislative advocacy at the national level 4/23/2022 11:00 AM
Kevin M. Cook, Ph.D. Oral abstract presenter Relative neighborhood disadvantage is associated with increased functional network segregation in fetal brains 4/23/2022 11:15 AM
Jung-Hoon Kim, Ph.D. Presenting Author Gestational age-related changes in the fetal functional connectome: in utero evidence for the global signal 4/23/2022 1:00 PM
Ioannis Koutroulis, M.D., Ph.D., M.B.A. Emergency Medicine and Trauma Services Oral abstract presenter Immunometabolism in septic encephalopathy: a novel therapeutic target 4/23/2022 1:00 PM
Terry Kind, M.D., M.P.H. General and Community Pediatrics Workshop co-leaders Making Meaning from the Data: Exploring Coding in Qualitative Research 4/23/2022 1:00 PM
Josepheen D. Cruz, M.D., Ph.D. Oral abstract presenter Cortical thickness changes in fetuses exposed to heightened maternal psychological distress 4/23/2022 1:30 PM
Monika Goyal, M.D., M.S.C.E. Emergency Medicine and Trauma Services Moderator Adolescent Medicine II 4/24/2022 8:00 AM
Binny Chokshi, M.D., M.Ed.
Yael Smiley, M.D.
Workshop co-leaders Applying The Collective Impact Model to Pediatric Health Interventions 4/24/2022 8:00 AM
Aisha Barber, M.D. M.Ed. Hospital Medicine Workshop co-leaders Demystifying DEI in Recruitment: Strategies for Creating a Diverse and Inclusive Residency and Fellow Training Environment 4/24/2022 8:00 AM
Panagiotis Kratimenos, M.D., Ph.D. Neonatology Oral abstract presenter Maternal Immune Activation and Hypoxia Induces Cerebellar Injury 4/24/2022 8:45 AM
Monika Goyal, M.D., M.S.C.E. Emergency Medicine and Trauma Services Co-moderator Emergency Medicine I 4/24/2022 10:00 AM
Priti Bhansali, M.D., M.Ed. Hospital Medicine Workshop co-leaders Making the Most of Peer Mentors within a Diverse Developmental Network: Supporting Scholarship and Academic Advancement 4/24/2022 10:00 AM
Ian Chua, M.D., M.H.P.E.
Gabrina Dixon, M.D., M.Ed.
Karen Smith, M.D., M.Ed.
Hospital Medicine

 

Workshop co-leaders The Art of Negotiation: Applying Negotiation Frameworks to Get More of What You Want in Your Academic Career 4/24/2022 10:00 AM
Matthew Magyar, M.D. Hospital Medicine Oral abstract presenter The association between social needs and unscheduled healthcare utilization among a nationally representative sample of children with asthma 4/24/2022 10:00 AM
Lena A. Saleh, M.D., M.P.H. Oral abstract presenter Machine Learning to Predict the Need for Intensive Care for Pediatric Asthma Exacerbation 4/24/2022 10:30 AM
Christina R. Rojas, M.D. Emergency Medicine and Trauma Services Oral abstract presenter Pediatric Emergency Department Undertriage for Patients with Limited English Proficiency 4/24/2022 10:30 AM
Ololade Okito, M.D. Neonatology Workshop co-leaders Best Practices in DEI Recruitment: Holistic Review and Addressing Systemic Bias 4/25/2022 8:00 AM
Jennifer H. Klein, M.D. Presenter Geography of pediatric health: Using geospatial analysis tools in pediatric care 4/25/2022 8:00 AM
Anand Gourishankar, M.B.B.S., M.R.C.P., M.A.S. Hospital Medicine Presenter Geospatial analysis in pediatric health: Principles, pitfalls, and practice 4/25/2022 8:00 AM
Sarah D. Schlatterer, M.D., Ph.D. Neurology Oral abstract presenter Autonomic Dysfunction and Hemodynamic Instability Precedes Cardiac Arrest in Infants with Congenital Heart Disease 4/25/2022 8:15 AM
Chaya Merrill, Dr.P.H. Presenter Mapping neighborhood-level inequities using the Childhood Opportunity Index 4/25/2022 8:20 AM
Jennifer H. Klein, M.D. Speaker Geospatial distribution of congenital heart disease 4/25/2022 8:40 AM
Ioannis Koutroulis, M.D., Ph.D., M.B.A. Emergency Medicine and Trauma Services Panelist APA Urgent Care SIG 4/25/2022 10:00 AM
Priti Bhansali, M.D., M.Ed. Hospital Medicine Workshop co-leaders From Mediocre to Masterly: Using Cognitive Interviewing to Improve the Validity of Your Survey 4/25/2022 10:00 AM
Beth A. Tarini, M.D., M.S. General and Community Pediatrics Speaker SPR Presidential Plenary: “Transforming the Culture of Pediatric Research: We Are the Problem and the Solution 4/25/2022 10:00 AM
Deena Berkowitz, M.D., M.P.H. Emergency Medicine and Trauma Services Speaker 2. UC fellowships and accreditation: the APA pipeline 4/25/2022 10:30 AM
John T. Kulesa, M.D. Hospital Medicine Oral abstract presenter A Descriptive Model for Prioritization and Resource Allocation in Academic Global Health Partnerships 4/25/2022 10:30 AM
Ariella Slovin, M.D. General and Community Pediatrics Speaker APA Well-being and Vitality SIG 4/25/2022 1:00 PM
Melissa Baiyewu, M.H.A., C.H.E.S.
Lin Chun-Seeley, M.A.
Desiree D. de la Torre, M.P.H., M.B.A.
Olanrewaju O. Falusi, M.D., M.Ed.
Chaya Merrill, Dr.P.H.
General and Community Pediatrics Workshop co-leaders Training Faculty Members to Model and Teach Health Equity: A New Faculty Development Curriculum 4/25/2022 1:00 PM
Ariella Slovin, M.D. General and Community Pediatrics Speaker Wellness and Vitality SIG: Overview of endeavors to date and status report on well-being of APA Members 4/25/2022 1:30 PM
Beth A. Tarini, M.D., M.S. General and Community Pediatrics Speaker Navigating Research Careers Through the Currents of Policy and Politics 4/25/2022 1:36 PM
Rebecca S. Lundberg, M.D. Oral abstract presenter Early parenteral nutrition support and preterm cerebellar metabolic maturation 4/25/2022 2:00 PM
Aisha Barber, M.D., M.Ed. Hospital Medicine Workshop co-leader Moving with the Tide: Taking Steps Toward Anti-Racism and Equity 4/233/22 1:00 PM

 

Could whole-exome sequencing become a standard part of state newborn screening?

smiling baby boy

There are concerns about implementing whole-exome sequencing since it takes away the child’s right to decide if they want to know — or not — about their specific inherited disease.

It is still premature to standardize an innovative methodology known as whole-exome sequencing (WES) as part of state newborn screening programs, argues Beth A. Tarini, M.D., M.S., associate director for the Center of Translational Research at Children’s National Hospital, in a new editorial published in JAMA Pediatrics.

About 4 million infants are born annually in the United States. Newborn screening is a mandatory state-run public health program that screens infants for inherited diseases in the first days of life so they can receive treatment before irreversible damage occurs. Several of these screening tests are done on blood drawn from an infant’s heel.

WES holds the potential to screen infants for thousands of disorders and traits, including those that appear in adulthood. But there are concerns about implementing WES since it takes away the child’s right to decide if they want to know — or not — about their specific inherited disease. There is also the unknown effect that it could have on their ability to obtain health insurance.

“As caretakers for their children, parents have the challenge of deciding what kind of information, including genetic, will be valuable for their child,” says Dr. Tarini. “As a society, we have the responsibility of deciding where the healthcare dollars get the best return – especially when it comes to children. We need to start that conversation for universal genomic sequencing of newborns sooner rather than later.”

The Pereira et al. study, appearing in the new edition of JAMA Pediatrics and referenced in Dr. Tarini’s editorial, is the first to demonstrate no significant harm in the initial 10 months of life after performing WES under the best conditions of access to resources and a controlled environment.

While the Pereira et al. study has limited data on the effects of WES on families from underrepresented backgrounds, Dr. Tarini notes that it does provide a critical first step in this area of pediatric genomic research and for policy decision-making about the widespread implementation of WES in newborns.

“Moving forward, the U.S. will have to make a collective decision about the value of WES for newborns,” says Dr. Tarini. That value calculus cannot be made without consideration of the general state of healthcare for infants. As she points out, “This is not an easy question to answer in a country whose infant mortality ranks 34th according to the Organization for Economic Co-operation and Development (OECD).”

Dr. Tarini’s research identifies ways to optimize the delivery of genetic services to families and children, particularly newborn screening. She has also chaired state newborn screening committees and served on several federal newborn screening committees.

Newborn baby laying in crib

How a baby with classic galactosemia was nearly missed: When the test succeeds but system fails

Newborn baby laying in crib

Run at the state-level, mandatory newborn screening (NBS) programs detect a host of hereditary disorders so that infants can be treated before further damage, or even death, occurs.

Newborn screening (NBS) programs are critical to public health. Run at the state-level, mandatory NBS programs detect a host of hereditary disorders so that infants can be treated before further damage, or even death, occurs.

While much attention is paid to testing technology, programs must still meet basic minimum requirements to reliably identify and treat all affected individuals including minimum reporting requirements, case surveillance and a dedicated short-term follow-up program. In newborn screening, success is systematic.

A new report “How a baby with classic galactosemia was nearly missed: When the test succeeds but system fails,” published in the American Journal of Medical Genetics, takes a look at an individual case that almost slipped through the cracks of a local NBS program.

One disorder detected by NBS is classic galactosemia (CG), which arises from a deficiency in the galactose-1-phosphate uridyltransferase (GALT) enzyme, leaving infants unable to metabolize galactose-1-phosophate, a monosaccharide abundantly present in milk. CG can result in fatal liver failure, sepsis and coagulopathy if the affected infant is not switched to soy-based formula within the first week of life.

CG can be detected through a combination of enzyme assay, DNA analysis and galactose quantification. However, NBS programs differ in testing protocols for CG by state, and not all NBS programs conduct all of these tests. This is of particular relevance to the Washington, D.C., metropolitan area, a regional nexus where crossing state and district lines for medical care is common.

The report describes how a D.C.-born infant was screened for CG through all three tests. While his galactose levels were normal, his GALT was low and DNA testing revealed homozygosity for a CG mutation known as K285N. In tandem, the latter two indicators constitute a true positive result for CG, and necessitate the proper issuance of referrals, precautions and follow-up, which failed to occur in this case.

The infant breastfed and displayed notable lethargy, and parents were directed to a local emergency department in a neighboring state which does not screen for CG with DNA testing.

The providers there were unfamiliar with the DNA results, and after new labs came back normal, the NBS results were deemed as “likely falsely positive” for CG. Fortunately, a provider at the community hospital forwarded the NBS results to the Children’s National Rare Disease Institute (CNRDI). Upon review, CNRDI metabolic specialists immediately sought to rectify the situation by reaching out to the family with proper instructions and arranging a clinical evaluation, which occurred 10 days after birth.

While this case had a fortunate ending, the report highlights the potential deficiencies in NBS programs, which have historically been among America’s most successful public health initiatives. The proper and timely functioning of NBS systems is contingent upon the functioning of its constituent parts, including testing, diagnosis, follow-up, management and stakeholder education.

While test results were accurate in this case, systemic shortcomings left a patient in danger. As the authors state, “Programs must keep in mind that the true success of newborn screening extends beyond just the test itself…to improve safety and care outcomes we must focus on the system.”

A clinical report by a team of authors, mainly comprised of Children’s National clinicians, was published earlier this month in the American Journal of Medical Genetics. Authors include Sarah Viall, PPCNP, MSN, a pediatric nurse practitioner in the Rare Disease Institute; Nicholas Ah Mew, M.D., director of the Inherited Metabolic Disorders Program; and Beth A. Tarini, M.D., M.S., associate director of the Center for Translational Research.

Drs. Tarini, Steinhorn, and Beers

Children’s National Hospital: Starting the new year with strong leadership

Drs. Tarini, Steinhorn, and Beers

Drs. Tarini, Steinhorn and Beers are also in leadership roles within professional societies, elected by their peers, further highlighting the strength of the leadership at Children’s National and professional respect within the health care community.

Three Children’s National Hospital executives are also in leadership roles within professional societies, elected by their peers, further highlighting the strength of the leadership at Children’s National and professional respect within the health care community.

Lee Savio Beers, M.D., FAAP, medical director of Community Health and Advocacy at the Child Health Advocacy Institute (CHAI) at Children’s National, was elected by her peers to become president-elect of the American Academy of Pediatrics (AAP) beginning Jan. 1, 2020. Dr. Beers will then serve as AAP president in 2021 for a one-year term.

“I am humbled and honored to have the support of my peers in taking on this newest leadership role,” says Dr. Beers. “AAP has been a part of my life since I first became a pediatrician, and my many leadership roles in the DC chapter and national AAP have given me a glimpse of the collective good we pediatricians can accomplish by working together toward common strategic goals.”

Dr. Beers is looking forward to continuing her work bringing together the diverse voices of pediatricians, children and families as well as other organizations to support improving the health of all children.

Robin Steinhorn, M.D., senior vice president of the Center for Hospital-Based Specialties at Children’s National was elected by her peers to become Vice President and President-elect of the American Pediatric Society (APS) in May 2018 and she is currently serving her role as the Society’s president, which began in May 2019.

“This is a tremendous honor. I look forward to leveraging the collective leadership and research accomplishments by our members to improve the health of infants and children throughout the U.S.,” said Dr. Steinhorn.

Dr. Steinhorn is particularly passionate about mentoring faculty and supporting the growth and career development of young neonatologists and scientists, with several having developed their own research laboratories and assumed division and department leadership positions. She was selected as a ‘Top Doctor’ by Northern Virginia Magazine in 2019.

Beth A. Tarini, M.D., MS, associate director, Center for Translational Research at The Children’s Research Institute, became vice president of the Society for Pediatric Research (SPR) in May 2019. Dr. Tarini will transition to President-Elect in May 2020 and become President in May 2021.

Dr. Tarini’s personal mission during this tenure will be to ensure that more pediatric researchers get to know SPR and are so excited about the organization that they become active members.

Dr. Tarini says she looks forward to working with other SPR leaders to find ways to build more productive, collaborative professional networks among faculty, especially emerging junior faculty. “Facilitating ways to network for research and professional reasons across pediatric research is vital – albeit easier said than done. I have been told I’m a connector, so I hope to leverage that skill in this new role,” says Dr. Tarini.

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Beth Tarini

Getting to know SPR’s future President, Beth Tarini, M.D., MS

Beth Tarini

Quick. Name four pillar pediatric organizations on the vanguard of advancing pediatric research.

Most researchers and clinicians can rattle off the names of the Academic Pediatric Association, the American Academy of Pediatrics and the American Pediatric Society. But that fourth one, the Society for Pediatric Research (SPR), is a little trickier. While many know SPR, a lot of research-clinicians simply do not.

Over the next few years, Beth A. Tarini, M.D., MS, will make it her personal mission to ensure that more pediatric researchers get to know SPR and are so excited about the organization that they become active members. In May 2019 Dr. Tarini becomes Vice President of the society that aims to stitch together an international network of interdisciplinary researchers to improve kids’ health. Four-year SPR leadership terms begin with Vice President before transitioning to President-Elect, President and Past-President, each for one year.

Dr. Tarini says she looks forward to working with other SPR leaders to find ways to build more productive, collaborative professional networks among faculty, especially emerging junior faculty. “Facilitating ways to network for research and professional reasons across pediatric research is vital – albeit easier said than done. I have been told I’m a connector, so I hope to leverage that skill in this new role,” says Dr. Tarini, associate director for Children’s Center for Translational Research.

“I’m delighted that Dr. Tarini was elected to this leadership position, and I am impressed by her vision of improving SPR’s outreach efforts,” says Mark Batshaw, M.D., Executive Vice President, Chief Academic Officer and Physician-in-Chief at Children’s National. “Her goal of engaging potential members in networking through a variety of ways – face-to-face as well as leveraging digital platforms like Twitter, Facebook and LinkedIn – and her focus on engaging junior faculty will help strengthen SPR membership in the near term and long term.”

Dr. Tarini adds: “Success to me would be leaving after four years with more faculty – especially junior faculty – approaching membership in SPR with the knowledge and enthusiasm that they bring to membership in other pediatric societies.”

SPR requires that its members not simply conduct research, but move the needle in their chosen discipline. In her research, Dr. Tarini has focused on ensuring that population-based newborn screening programs function efficiently and effectively with fewer hiccups at any place along the process.

Thanks to a heel stick to draw blood, an oxygen measurement, and a hearing test, U.S. babies are screened for select inherited health conditions, expediting treatment for infants and reducing the chances they’ll experience long-term health consequences.

“The complexity of this program that is able to test nearly all 4 million babies in the U.S. each year is nothing short of astounding. You have to know the child is born – anywhere in the state – and then between 24 and 48 hours of birth you have to do testing onsite, obtain a specific type of blood sample, send the blood sample to an off-site lab quickly, test the sample, find the child if the test is out of range, get the child evaluated and tested for the condition, then send them for treatment. Given the time pressures as well as the coordination of numerous people and organizations, the fact that this happens routinely is amazing. And like any complex process, there is always room for improvement,” she says.

Dr. Tarini’s research efforts have focused on those process improvements.

As just one example, the Advisory Committee on Heritable Disorders in Newborns and Children, a federal advisory committee on which she serves, was discussing how to eliminate delays in specimen processing to provide speedier results to families. One possible solution floated was to open labs all seven days, rather than just five days a week. Dr. Tarini advocated for partnering with health care engineers who could help model ways to make the specimen transport process more efficient, just like airlines and mail delivery services. A more efficient and effective solution was to match the specimen pick-up and delivery times more closely with the lab’s operational times – which maximizes lab resources and shortens wait times for parents.

Conceptual modeling comes so easily for her that she often leaps out of her seat mid-sentence, underscoring a point by jotting thoughts on a white board, doing it so often that her pens have run dry.

“It’s like a bus schedule: You want to find a bus that not only takes you to your destination but gets you there on time,” she says.

Dr. Tarini’s current observational study looks for opportunities to improve how parents in Minnesota and Iowa are given out-of-range newborn screening test results – especially false positives – and how that experience might shake their confidence in their child’s health as well as heighten their own stress level.

“After a false positive test result, are there parents who walk away from newborn screening with lingering stress about their child’s health? Can we predict who those parents might be and help them?” she asks.

Among the challenges is the newborn screening occurs so quickly after delivery that some emotionally and physically exhausted parents may not remember it was done. Then they get a call from the state with ominous results. Another challenge is standardizing communication approaches across dozens of birthing centers and hospitals.

“We know parents are concerned after receiving a false positive result, and some worry their infant remains vulnerable,” she says. “Can we change how we communicate – not just what we say, but how we say it – to alleviate those concerns?”