Public Health

Pregnant teen girl holding small stuffed bear

Get a doula: New study examines a human-centered doula support program for pregnant teens

Pregnant teen girl holding small stuffed bear

By prioritizing the lived experiences of young parents, researchers found that health care interventions can be more effective, impactful and tailored to the real needs of adolescent mothers.

Pregnancy during adolescence presents unique challenges that can lead to suboptimal health outcomes for both the mother and child. A new study from researchers at Children’s National Hospital highlights an innovative approach to supporting pregnant teens by utilizing human-centered design (HCD) to create a comprehensive doula support program. The study demonstrates how prioritizing the lived experiences of young parents can lead to more effective and impactful healthcare interventions.

How will this work benefit patients?

This problem-solving framework focuses on understanding the needs and experiences of the people most affected by an issue. By applying this method, researchers developed a tailored doula support program designed specifically for pregnant teens. The study followed the three fundamental phases of HCD: inspiration, ideation and implementation.

During the inspiration phase, researchers gathered insights from teen parents about their needs and preferences. The ideation phase involved brainstorming potential solutions based on these insights, leading to the creation of a pilot doula program called Beyond the Bump. The final implementation phase saw the program launched to provide real-world support for young mothers.

“Beyond the Bump offers personalized support to pregnant teens through dedicated doulas who provided guidance before, during and after childbirth,” says Yael Smiley, MD, pediatrician at Children’s National and lead author of the study. “By listening to the voices of pregnant teens and designing interventions based on their needs, healthcare professionals can create more effective and sustainable support systems.”

The program served 12 participants and yielded promising results, including low rates of cesarean sections and high rates of breastfeeding initiation — both indicators of positive birth outcomes. Notably, both program participants and doulas reported positive experiences with Beyond the Bump. The feedback suggests that having a dedicated support system tailored to the specific needs of young mothers can significantly improve their overall pregnancy and postpartum experience.

How does this work move the field forward?

The study’s findings suggest that similar human-centered design approaches could be applied to other healthcare initiatives aimed at vulnerable populations. Beyond the Bump may serve as a model for healthcare providers looking to enhance support for pregnant teens and improve maternal and child health outcomes.

“As healthcare continues to evolve, prioritizing patient-centered solutions will be crucial in creating meaningful and impactful interventions,” says Dr. Smiley. “This study demonstrates that when programs are built with the community in mind, the potential for positive change is significant.”

Other Children’s National researchers include: Christiana Jolda, MSW, LICSW, Jaytoya Manget, NP, DNP, FNP

Illustration of a brain, stethoscope and computer chip

Global expert consensus defines first framework for building trustworthy AI in health care

Illustration of a brain, stethoscope and computer chip

The guidelines are the first globally acknowledged framework for developing and deploying health care AI applications and gauging whether the information they generate can be trusted or not.

More than 100 international experts in the application of artificial intelligence (AI) in health care published the first set of consensus guidelines that outline criteria for what it means for an AI tool to be considered trustworthy when implemented in health care settings.

The guidelines, published in the journal the BMJ, are the first globally acknowledged framework for developing and deploying health care AI applications and gauging whether the information they generate can be trusted or not.

What this means

Called the FUTURE-AI framework, the consensus guidelines are organized based on six guiding principles:

  • Fairness
  • Universality
  • Traceability
  • Usability
  • Robustness
  • Explainability

The cadre of experts reviewed and agreed upon a set of 30 best practices that fall within the six larger categories. These practices address technical, clinical, socio-ethical and legal aspects of trustworthy AI. The recommendations cover the entire lifecycle of health care AI: design, development and validation, regulation, deployment and monitoring.

The authors encourage researchers and developers to take these recommendations into account in the proof-of-concept phase for AI-driven applications to facilitate future translation to clinical practice.

Why it matters

“Patients, clinicians, health organizations and authorities need to know that information and analysis generated by AI can be trusted, or these tools will never make the leap from theoretical to real world application in a clinical setting,” says Marius George Linguraru, DPhil, MA, MSc, Connor Family Professor for Research and Innovation in the Sheikh Zayed Institute for Surgical Innovation at Children’s National Hospital and co-author of the guidelines. “Bringing so many international and multi-disciplinary perspectives together to outline the characteristics of a trustworthy medical AI application is part of what makes this work unique. It is my hope that finding such broad consensus will shed light on the greater good  AI can bring to clinics and help us avoid problems before they ever impact patients.”

The FUTURE-AI consortium was founded by Karim Lekadir, PhD, ICREA Research Professor at the University of Barcelona in 2021 and now comprises 117 interdisciplinary experts from 50 countries representing all continents, including AI scientists, clinical researchers, biomedical ethicists and social scientists. Over a 2-year period, the consortium established these guiding principles and best practices for trustworthy and deployable AI through an iterative process comprising an in-depth literature review, a modified Delphi survey and online consensus meetings. Dr. Linguraru contributed with a unique perspective on AI for pediatric care and rare diseases.

What’s next

The authors note that, “progressive development and adoption of medical AI tools will lead to new requirements, challenges and opportunities. For some of the recommendations, no clear standard on how these should be addressed yet exists.”

To tackle this uncertainty, they propose FUTURE-AI as a dynamic, living framework. This includes a dedicated website to allow the global community to participate in the FUTURE-AI network. Visitors can provide feedback based on their own experiences and perspectives. The input gathered will allow the consortium to refine the FUTURE-AI guidelines and learn from other voices.

Read the full manuscript outlining all 30 best practices: FUTURE-AI: international consensus guideline for trustworthy and deployable artificial intelligence in healthcare

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U.S. News & World Report voting

U.S. News & World Report badgeChildren’s National is ranked one of the top 10 pediatric hospitals in the nation by U.S. News & World Report. Our faculty and staff are proud of the impact made on the lives of children and families in our community. Your participation in the U.S. News & World Report annual reputational survey validates the quality of care we provide and reflects the mutual respect and trust we share as healthcare professionals.

How to determine your voting eligibility

Voting for the U.S. News & World Report Best Children’s Hospitals rankings can be done only through Doximity.

To participate, physicians must:

  • Be board-certified and meet the eligibility criteria for the voting categories.
  • For child and adolescent psychologists, your account must be up to date with your specialty and subspecialty correctly marked.
  • Be a credential-verified member of Doximity (you must have an active and claimed Doximity profile).
  • Have all certifications and board documents currently up-to-date in your Doximity profile.

View the full eligibility criteria

How to claim your Doximity profile to vote

  • You have to claim your profile on Doximity.com to participate in the online survey. If you have not yet claimed your Doximity profile, go to Doximity.com, and click “Find My Profile.”
  • Once your profile has been claimed, you must confirm your email address and board certifications.
  • Verified Doximity members will receive an email inviting them to participate in the U.S. News survey.
  • For more information on how to claim your profile, visit Doximity.com

How to update and verify existing Doximity account information

Your Doximity profile must have up-to-date licenses, certifications and board documents.

  • Once you are logged in, your profile will automatically be in “Edit Mode.” You are able to add new items or edit existing information.
  • Update your Doximity profile and ensure your information is current.

Once registered, users wishing to participate in the online survey should:

  • Watch for an email from Doximity about the annual member survey.
  • Even if you don’t see the email, if you are a registered Doximity user, you can still vote by logging in to Doximity.com with your username and password during the voting period.
  • Once logged in, look for a U.S. News graphic or button on the homepage and click on it.
  • The survey asks users to name the hospitals that provide the best care in your respective specialty, without consideration to location or cost. Pediatric specialists will list 10 hospitals. The order in which you list the hospitals does not matter.

Please note: Children’s National Hospital is listed as “Children’s National Hospital Washington, DC” on the survey.

Visit Doximity’s FAQs if you have issues or questions about registration or claiming your profile.

How to cast your vote

In February 2025 when voting opens, all survey-eligible physicians will receive a notification on the Doximity app for Android or iOS. If you do not use the Doximity app, you will receive an email when voting opens.

  1. Log in to your Doximity account at doximity.com or via the mobile app.
  2. Click the Notifications icon or tap the “Submit your Nominations” button on the homepage. You can also search for “U.S. News Best Hospitals”
  3. Select 10 hospitals in your respective specialty that you believe provide the best care in the United States.
  4. Submit your vote

Having technical issues?

If you have difficulty registering with Doximity or completing the survey, please visit Doximity support for assistance.

Vote

The 2025 U.S. News & World Report Best Children’s Hospitals reputation voting will open in mid-February. Look for your Doximity notification to vote.

white pills and a pill bottle

Extended-release buprenorphine for treatment of adolescent opioid use disorder

white pills and a pill bottle

A new case series published in the Journal of Addiction Medicine highlights the need for more studies of extended-release buprenorphine for treatment of opioid use disorder (OUD) in adolescents under 18 years old.

A new case series published in the Journal of Addiction Medicine highlights the need for more studies of extended-release buprenorphine for treatment of opioid use disorder (OUD) in adolescents under 18 years old.

Why it matters

In recent years there has been an increase in adolescent OUD and adolescent opioid overdose deaths. Extended-release buprenorphine has been shown to be a safe and effective medication in adults but not offered to adolescents due to lack of safety data. Larger studies are needed to establish the safety and efficacy of extended-release buprenorphine for treatment in this population.

The big picture

In this case series, the researchers discuss six cases of patients younger than 18 years old with severe OUD who receive(d) treatment of extended-release buprenorphine at the Children’s National Hospital Addictions Program and Howard University Hospital. All patients reported a history of smoking fentanyl as their primary method of use.

Initial treatment began with sublingual buprenorphine-naloxone but then transitioned to extended-release buprenorphine. The authors stated, “Transition to extended-release buprenorphine was most frequently done due to patient nonadherence with a daily sublingual buprenorphine medication regimen, ongoing fentanyl use and concerns surrounding the difficulty with administration of the sublingual buprenorphine.”

How does this work move the field forward?

Extended-release buprenorphine is not an FDA approved intervention due to lack of safety data in patients younger than 18. Overall, little clinical research is being done in adolescents with OUD.

“Given the current overdose crisis among adolescents caused by fentanyl and the rising number of kids with OUD, more intervention options are needed,” says Sivabalaji Kaliamurthy, MD, director of the Addictions Program at Children’s National and lead author of the study. “We are hoping that this work will decrease provider hesitance to offer this intervention and will also provide data to help with insurance coverage.”

Children’s National leads the way

Dr. Kaliamurthy says, “The uniqueness of this work comes from our ability as a hospital to provide appropriate care for children struggling with severe addiction, navigating and overcoming significant barriers along the way that other programs have struggled to address. We are offering a treatment that is effective and the kids in treatment are doing well.”

You can read the full study The Use of Extended-Release Buprenorphine in the Treatment of Adolescent Opioid Use Disorder: A Case Series in the Journal of Addiction Medicine.

Doctors performing cardiac surgery at Children's National Hospital

Socioeconomic disadvantage associated with higher long-term mortality after heart surgery

Doctors performing cardiac surgery at Children's National Hospital

Children who had heart surgery and come from less advantaged neighborhoods in the Washington, D.C., region are much more likely to die in the long term than those from neighborhoods with more wealth and opportunity.

Children who had heart surgery and come from less advantaged neighborhoods in the Washington, D.C., region are much more likely to die in the long term than those from neighborhoods with more wealth and opportunity. The finding was part of a presentation, Socioeconomic Disadvantage Is Associated with Higher Long-Term Mortality After Cardiac Surgery, presented by Jennifer Klein, MD, MPH, cardiologist at Children’s National Hospital, during the Society of Thoracic Surgeons (STS) Annual Meeting in Los Angeles.

What is it?

Clinical and demographic data were collected for 2,546 people who underwent corrective surgery for congenital heart disease over a 15-year period (2007-2022) in a single-center retrospective analysis. Using the Child Opportunity Index (COI), an index that uses environmental/health, educational, and socioeconomic domains to assess patients’ neighborhoods, the two lowest COI quintile neighborhoods were designated as “disadvantaged” while the two highest COI quintile neighborhoods were designated as “advantaged.” Multivariable mixed model analyses were conducted to understand the factors associated with overall mortality.

The research showed that patients from disadvantaged neighborhoods suffered in a great proportion both overall mortality [n=168 (13.6%) vs 66 (8.4%), p< 0.001] and major complications [n=168 (13.6%) vs 81 (10.3%), p< 0.001]. The positive association between neighborhood disadvantage and long-term mortality was maintained in stepwise logistic regression multivariable analysis after controlling for differences between surgical complexity and other clinical risk factors.

What it means

“Previous research has shown disparities like this,” says Dr. Klein. “What’s significant here is that the disparity for children from disadvantaged neighborhoods grows over time. That means corrective interventions won’t be implemented in the operating room or within the first 30 days after surgery. They need to happen in a cardiologist’s office, in the schools, and in the community long after a child goes home from the hospital.”

The findings from this particular study are also noteworthy as they are the first to include significantly greater numbers of patients who are more likely to experience this risk (48.5% of the study group). Previous research has sought to look at this research question but analysis may have been skewed by an over-representation of socioeconomically advantaged patients.

What’s next

Differences in mortality risk continue to grow greater as more time passes, the authors note, indicating that the disparity is not a product of surgical technique or disparities in care delivery at the time of surgery.

Instead, their outcomes are being influenced by factors outside the operating room. This opens a new avenue of research focused on identifying the “why.”

“What happens after they go home?” Klein asks. “Can they access medications? Do they come back for follow-up appointments? Can they afford food?”

Read the abstract, Socioceconomic Disadvantage Is Associated with Higher Long-Term Mortality After Cardiac Surgery, which was presented during a speed session at the STS Annual Meeting. A full manuscript will be published soon.

Marius George Linguraru

Marius George Linguraru appointed as president of the MICCAI Society

Marius George Linguraru

“MICCAI has been a professional home for me throughout my career and I am deeply honored to have a chance to give back to the organization,” said Dr. Linguraru.

We’re pleased to announce that Marius George Linguraru, DPhil, MA, MSc, Connor Family professor and endowed chair in Research and Innovation at Children’s National, has been elected as president of the Medical Image Computing and Computer Assisted Intervention (MICCAI) Society board of directors. Dr. Linguraru has been involved in the society since he attended his first MICCAI conference in 2001. He was elected to the board of directors in 2021 and chairs the Career Development Working Group. Dr. Linguraru was instrumental in establishing the MICCAI Mentorship Program, the MICCAI Start-up Village and the AFRICAI Special Interest Group. He also served as the program chair of MICCAI 2024, which received and reviewed a record number of paper submissions. He will begin his three-year term as president on February 1, 2025. Watch Dr. Linguraru’s brief inaugural message to members here.

“MICCAI has been a professional home for me throughout my career and I am deeply honored to have a chance to give back to the organization,” said Dr. Linguraru. “I believe the society is poised not just to meet the challenges of the next few years, but to thrive as an essential leadership forum for the growth of medical image computing, computer assisted intervention and artificial intelligence in healthcare.”

Dr. Linguraru leads the AI research initiatives at Children’s National and serves as principal investigator in the Sheikh Zayed Institute for Pediatric Surgical Innovation. His award-winning team builds artificial intelligence applications to expand health equity and access to pediatric healthcare when diseases are rare and resources are limited. Through partnerships between Children’s National and Virginia Tech and Microsoft, Dr. Linguraru also plays an integral role in exploring how generative AI can improve pediatric care.

Meanwhile, Caroline Essert, PhD, MSc, completes her term as president of the MICCAI Society on January 31, 2025.

“It has been an honor to contribute to the growth and vibrancy of this incredible community,” said Dr. Essert. “I extend my warmest welcome to Dr. Linguraru as the incoming president of the MICCAI Board. I am confident that under his leadership, the MICCAI Society will reach new heights and continue to serve as a beacon of excellence in our field.” Read her full farewell message here.

To learn more about the MICCAI Society, click here.

collage of news logos

Children’s National in the News: 2024

collage of news logosIn 2024, Children’s National Hospital continued to make remarkable strides across diverse areas of pediatric medicine, from groundbreaking technological innovations to critical health advocacy. The following compilation showcases ten significant stories that demonstrate the breadth and depth of the hospital’s impact, as featured in major national news outlets including NBC Nightly News, CNN, The Washington Post, The New York Times, NPR, The Today Show, Healio, and POLITICO. Delve into our 2024 news highlights for more.

1. World’s smallest pacemaker gives new hope to babies with heart defects

Charles Berul, M.D., and a patient family talk about the pill-sized pacemaker that saved the life of Abby, an infant born with deadly heart defects. (NBC Nightly News)

2. ‘A $10 death trip’: Fentanyl is killing teens. Meet one fighting for his life

Sivabalaji Kaliamurthy, M.D., addiction psychiatrist and director of the Addictions Program, spoke to CNN about the impact of drug addiction on teen health and the lack of resources available to treat opioid use disorder. (CNN)

3. Health panel urges interventions for children and teens with high BMI

Susma Vaidya, M.D., M.P.H., associate medical director of the IDEAL Clinic, shared her concerns about childhood obesity treatment recommendations issued today by a leading panel of independent U.S. health experts. (The Washington Post)

4. An Rx for food? Doctor’s offices offer groceries to those in need

Shideh Majidi, M.D., M.S.C.S., and Emily Frymark, clinical dietitian, spoke about how the food pharmacy, created in partnership with the Capital Area Food Bank, benefits patients with diabetes and other chronic conditions. (The Washington Post)

5. First patient begins newly approved sickle cell gene therapy

Kendric Cromer, a 12-year-old boy being treated at Children’s National Hospital, became the first person in the world with sickle cell disease to begin a commercially approved gene therapy that may cure the condition. “This is a big effort,” says David Jacobsohn, M.D., ScM, M.B.A. (The New York Times)

6. ‘We created this problem’: A pediatric surgeon on how gun violence affects children

Mikael Petrosyan, M.D., associate chief of General and Thoracic Surgery, discusses the stress medical staff face when treating young victims of gun violence. (NPR)

7. 7th grade boy rings bell after final round of chemotherapy

Landon, an 11-year-old patient, rang the bell at Children’s National Hospital with family, friends, doctors and nurses cheering after finishing his final round of chemotherapy. (The Today Show)

8. Study: One in three adolescents experience ‘period poverty’

Monika Goyal, M.D., M.S.C.E., pediatric emergency medicine specialist and co-director of the Center for Translational Research, emphasized the need for awareness in addressing period poverty in teenagers and young adults. (Healio)

9. The AI assurance labs are coming

Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer, participates in a panel discussion covering AI data collection, associated risks, reliance and other topics related to artificial intelligence. (POLITICO)

10. First day of a ‘new life’ for a boy with sickle cell

Children’s National patient Kendric Cromer, 12, became one of the first children ever to be treated with a newly approved gene therapy that will free him from the sickle cell disease that has stolen his childhood. (The New York Times)

2024 with a lightbulb instead of a zero

The best of 2024 from Innovation District

2024 with a lightbulb instead of a zero2024 marked another groundbreaking year for Children’s National Hospital, showcasing remarkable advances across the spectrum of pediatric medicine, research and healthcare innovation. From pioneering surgical procedures to breakthrough artificial intelligence applications, the institution continued to push the boundaries of what’s possible in children’s healthcare. Read on for our list of the most popular articles we published on Innovation District in 2024.

1. Prenatal COVID exposure associated with changes in newborn brain

A study led by researchers at Children’s National Hospital showed that babies born during the COVID-19 pandemic have differences in the size of certain structures in the brain, compared to infants born before the pandemic. The findings suggest that exposure to the coronavirus and being pregnant during the pandemic could play a role in shaping infant brain development.
(3 min. read)

2. Children’s National Hospital again ranked among the best in the nation by U.S. News & World Report

Children’s National Hospital was ranked as a top hospital in the nation by the U.S. News & World Report 2024-25 Best Children’s Hospitals annual rankings. This marks the eighth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.
(2 min. read)

3. Children’s National performs first ever HIFU procedure on patient with cerebral palsy

In January 2023, a team of multidisciplinary doctors performed the first case in the world of using bilateral high intensity focused ultrasound (HIFU) pallidotomy on Jesus, a 22-year-old patient with dyskinetic cerebral palsy. The procedure is part of a clinical trial led by Chima Oluigbo, M.D., pediatric neurosurgeon at Children’s National Hospital.
(3 min. read)

4. Novel ultrasound device gets FDA breakthrough designation with Children’s National support

A novel ultrasound device developed by Bloom Standard received the Food and Drug Administration’s valued breakthrough device designation with the help of Children’s National Hospital. The device that enables autonomous, hands-free ultrasound scans to be performed anywhere, by any user.
(2 min. read)

5. First-of-its-kind pilot study on the impacts of Lyme disease in pregnancy and infant development

Understanding the effects of Lyme disease on the developing fetal brain is essential to ensure timely prenatal and postnatal treatments to protect the fetus and newborn. In response to this need, Children’s National Hospital is leading a pilot study to establish the groundwork needed for a larger study to determine the effect of in utero exposure to Lyme disease on pregnancy and early childhood neurodevelopmental outcomes.
(3 min. read)

6. Earliest hybrid HLHS heart surgery kids thrive 5 years later

Five years ago, Cayden was born 6 weeks early weighing less than four pounds and at risk of dying from her critical congenital heart disease. Today, she’s a happy five-year-old. Early diagnosis of her hypoplastic right ventricle, double inlet left ventricle and critical coarctation of the aorta allowed for the team at Children’s National Hospital to create a careful plan for safe delivery and to offer an innovative hybrid HLHS surgical approach at the hospital within 24 hours after she was born.
(1 min. read)

7. Wayne J. Franklin, M.D., F.A.C.C., named senior vice president of the Children’s National Heart Center

Children’s National Hospital appointed Wayne J. Franklin, M.D., F.A.C.C., as the new senior vice president (SVP) of the Children’s National Heart Center. In this role, Dr. Franklin oversees the full spectrum of heart care services including cardiac imaging and diagnostics, interventional cardiology, electrophysiology, cardiac anesthesia, cardiac surgery and cardiac intensive care.
(2 min. read)

8. Artificial – and accelerated – intelligence: endless applications to expand health equity

By pioneering artificial intelligence (AI) innovation programs at Children’s National Hospital, Marius George Linguraru, D.Phil., M.A., M.Sc., and the AI experts he leads are ensuring patients and families benefit from a coming wave of technological advances. The team is teaching AI to interpret complex data that could otherwise overwhelm clinicians.
(4 min. read)

9. Evidence review: Maternal mental conditions drive climbing death rate in U.S.

Painting a sobering picture, a research team led by Children’s National Hospital culled years of data demonstrating that maternal mental illness is an under-recognized contributor to the death of new mothers. They called for urgent action to address this public health crisis.
(3 min. read)

10. Nathan Kuppermann, M.D., M.P.H., named chief academic officer and chair of Pediatrics

Children’s National Hospital appointed Nathan Kuppermann, M.D., M.P.H., as its new executive vice president, chief academic officer and chair of Pediatrics. In this role, Dr. Kuppermann oversees research, education and innovation for the Children’s National Research Institute as well as academic and administrative leadership in the Department of Pediatrics at George Washington University School of Medicine & Health Services.
(2 min. read)

11. First global clinical trial achieves promising results for hypochondroplasia

Researchers from Children’s National Hospital presented findings from the first clinical trial of the medication vosoritide for children with hypochondroplasia – a rare genetic growth disorder. During the phase 2 trial, researchers found vosoritide increased the growth rate in children with hypochondroplasia, allowing them to grow on average an extra 1.8 cm per year.
(2 min. read)

12. Pioneering research center aims to revolutionize prenatal and neonatal health

Since its establishment in July 2023, the Center for Prenatal, Neonatal & Maternal Health Research at Children’s National Hospital has gained recognition through high-impact scientific publications, featuring noteworthy studies exploring the early phases of human development.
(3 min. read)

Alda Mizaku

Meet Children’s National’s new Chief Data and Artificial Intelligence Officer

Alda Mizaku

In June, Alda Mizaku, M.S., became the hospital’s first chief data and AI officer.

Artificial intelligence (AI) is revolutionizing healthcare and will shape the future of pediatrics. It can drive efficiency, supercharge research and improve patient outcomes. Harnessing AI safely and ethically takes thoughtful leadership. In June, Alda Mizaku, M.S., became the hospital’s first chief data and AI officer. Previously, she led data engineering and analytics at Mercy Health in St. Louis for 11 years. We asked Mizaku about her work and vision for Children’s National.

Q: What excites you about your new role?

A: I am passionate about the opportunity to leverage technology to create better experiences for children and families. Embracing innovation can help us create more health equity for our community. This is an exciting time in healthcare. I’m committed to leading the way with compassionate and cutting-edge solutions. This includes realizing the full potential of medical data from electronic healthcare records and other sources. AI can help us develop treatment plans tailored specifically for each child. It also can make proactive recommendations to coordinate patient care.

Q: What have you seen AI accomplish in medicine and how do you envision its growth and impact in pediatrics?

A: AI yields helpful insights to understand each patient’s individual needs. It takes complex medical data and makes it more useful. It can help us diagnose disease and improve care coordination for each patient family. AI fits very well into pediatrics because children’s hospitals put a lot of effort into research and development. For example, in rare disease, there’s an emphasis on building models to understand a condition’s genetic composition. AI gives us the opportunity to find solutions and intervene more quickly to change lives. This is the future of pediatric medicine.

Q: How will children’s national use AI to improve patient care?

A: We have been busy creating an enterprise cloud data platform. It will allow us to bring all of the hospital’s data into one place and create one true source of information.
This one-stop shop will make it much easier for our researchers and care providers to access the information they need to make a difference for patients. AI will help with operational efficiencies. It will give us a clearer picture of which units across the institution are busy or have extra capacity. It can recommend ways to eliminate bottlenecks. This reduces wait times and allows us to help more patients.

Q: How can AI help our faculty?

A: The beauty of AI is that it can help faculty focus more on patient care and less on their administrative tasks.
Jessica Herstek, M.D., our chief medical informatics officer, is leading our pilot of an AI-based ambient listening technology that creates notes during patient encounters. The clinician focuses on their patient. Later, they can refine and approve the notes.

Accountability remains important. Just because we’re leveraging technology, it doesn’t remove accountability for staff.
AI assists providers and reinforces their role in care. Medical innovations that leverage AI also can increase their efficiency.
For example, liquid biopsy technologies use AI to study blood samples and detect cancer. This helps patients avoid time-consuming scans and painful traditional biopsies. We can detect disease or its recurrence much earlier in a less invasive way. This enhances care.

Q: What are some challenges we face on the road to implementing AI?

A: Embracing AI systems may involve giving up some comfort in the way that we’ve always done things. It opens up possibilities, but it requires some change. Our challenge is to make sure we have three things in place to create scalable, sustainable solutions. The first is having high-quality, integrated data. The second is collaboration. The third is change management.

We will take an inclusive approach to implementing changes, working side by side with clinical and operational leaders. When we present solutions, it will be collaborative. Comprehensive training also plays a key role. We must address misconceptions about AI’s capabilities and foster a common understanding of its most effective uses.
Our recipe for success will be openness to contributing to better outcomes for our patients.
We need to collect high-quality data consistently across different units. Variations don’t translate well to scalable solutions crucial to generative AI. When we look at the big picture, it’s clear we can come together to provide the best care.

Q: Why is this work important to you?

A: Technology and its capacity to transform lives has always captivated me. Growing up in Albania, my dad led the pharmacy at the local hospital.
Sometimes I would ride in the ambulance when he needed to go to the hospital urgently. I was around 7 years old at the time, and it left a deep impression.
I recognized that each member of the team played a significant role in caring for the patient. This experience inspires my work to this day.

Read more stories like this one in the latest issue of Believe magazine.

Attendees at the Children's National-Microsoft session

Children’s National and Microsoft unite to reimagine pediatric care with AI

Children’s National Hospital is teaming up with Microsoft to harness the power of generative AI and revolutionize healthcare solutions. Over the course of an intensive two-day prototype session guided by Microsoft experts, Children’s National developers explored innovative use cases in predictive analytics, decision support, workflow automation, patient engagement and personalized medicine. This collaboration aims to enhance the quality and efficiency of care, ultimately improving outcomes for young patients.

What they’re saying

“We are empowering innovation at Children’s National through the synergy of human creativity and GenAI, we are on a journey to redefine what’s possible in pediatric healthcare,” said Alda Mizaku, VP & chief data and artificial intelligence officer at Children’s National.

“We’re proud to be part of Children’s National’s journey toward building a data-driven, innovative infrastructure. Recent strides, such as launching Children’s AI journey and piloting physician-led AI initiatives, underscore their commitment to delivering exceptional care through cutting-edge Microsoft solutions,” said Tyler Bryson, corporate vice president at Microsoft.

What was developed

Children’s National’s developers created the following GenAI Use Cases for the Rapid Prototype:

  • Use Case 1: Inpatient Stay Insights
    Create personalized summaries of hospital stays using AI. It analyzes clinical records and data to generate narratives for different personas, such as providers, coders, parents, patients and care managers.
  • Use Case 2: Next Best Action
    Proactive care by generating personalized recommendations for a patient’s continued care, streamlining care coordination, improving outcomes and enhancing communication between healthcare providers, care managers and patients.
  • Use Case 3: Beacon – Internal Policies and Procedures
    Beacon, a GenAI-powered assistant that chats with our internal knowledge base. It can answer questions and give information from our policies, procedures, manuals and other content.
  • Use Case 4: Personalized Medication Consultation
    Create a personalized medication consultation, aimed at enhancing the medication alert system through tailored alerts and guidance to providers, while taking into account patient’s clinical data and institutional patterns.

Reflecting on the development of these use cases, Children’s National hospitalist and chief informatics officer Jessica Herstek, M.D., said “We aim to develop scalable and sustainable solutions to everyday challenges in pediatric health care. For this prototype session, we brought together teams from across our organization with clinical, operational, and technical skills to test the possibilities and fallibilities of AI-enabled tools and explore how we can push ourselves and our technology partners to support the needs of our patients and families and the workflows of our doctors and nurses.”

Why is this exciting? What’s next?

Mizaku says this is a pivotal moment in Children’s journey towards revolutionizing pediatric healthcare. As we move forward, we commit to developing generative AI capabilities that are not only scalable and robust but also specifically tailored to meet the unique needs of our young patients. Our focus will be on practical applications that enhance care delivery while also improving efficiencies for our staff and internal teams.

A special thanks to our Microsoft partners: Tyler Bryson, Tyler Flatt, Jordan Lipp, Natalie Pearce, Todd Painter, Paul Fisher and Mahjabin Ahmed.

Children’s National Hospital participants: Catherine Pearcy, Nolen Morton, Brittany Duah, Ann Hoffman, Walter Buckner, Dr. Jessica Herstek, Ranjodh Badh, Geetanjali Vashist, Shivaram Muruga, Dr. Rachel Selekman, Dr. Paul Michel, Dr. Kenneth McKinley, Simmy King, Dr. Mihailo Kaplarevic, Aymen Mehai, Dr. Syed Anwar, Parida Abhijeet, Dr. Xinyang Liu, Andrew Maddox, Amy Quinn, Mike McLaughlin, Samm Sherman, Alda Mizaku, Shannon Cross, Shahzaib Ismail, Aric Campling, Frederick Zilmer, and Johnie Henry.

Emergency department nurse with patient

Investment in pediatric emergency care could save over 2,100 lives annually

Emergency department nurse with patient

By becoming highly “pediatric ready,” emergency departments could prevent the deaths of 2,143 children each year with an annual cost between $0 and $12 per child resident, depending on the state.

In emergencies, children have distinct needs. Yet 83% of emergency departments (EDs) nationwide are not fully prepared to meet them. A new study has found that bridging that gap, known as becoming highly “pediatric ready,” could prevent the deaths of 2,143 children each year with an annual cost between $0 and $12 per child resident, depending on the state.

“Our country can afford it, and we owe it to our children to do it,” says the study’s senior author Nathan Kuppermann, M.D., chair of Pediatrics and chief academic officer at Children’s National Hospital.

The research team – led by Oregon Health & Science University and Children’s National – analyzed data from 4,840 EDs, focusing on 669,019 children at risk for death upon seeking care. Using predictive models, they assessed how every ED achieving high pediatric readiness – defined as scoring at least 88 out of 100 on the National Pediatric Readiness Project assessment – could impact mortality rates.

“The National Pediatric Readiness Project outlines essential pediatric capabilities for EDs, such as the availability of essential pediatric equipment and pediatric-specific training,” says Dr. Kuppermann, an emergency medicine physician. “While a perfect score of 100 is ideal, past research shows a score of 88 or higher can reduce mortality risk by up to 76% for ill children and 60% for injured children.”

Why it matters

In Maryland, an additional cost of $1.10 per child could save 17 pediatric lives annually, adjusted for population size. In Virginia, $2.42 per child could save 29 lives annually, and $1.59 per child in the District of Columbia could save 16 lives annually. The research team said strategies for implementing the findings would require regulation, incentives and policy-based initiatives.

“This study builds on a growing body of research demonstrating that every hospital can and must be ready for children’s emergencies,” says lead author Craig Newgard, M.D., M.P.H., an emergency physician at Oregon Health & Science University. “For the first time, we have comprehensive national and state-by-state data that emphasizes both the urgency and feasibility of this work.”

The patient benefit

Nathan Kuppermann

“Our country can afford it, and we owe it to our children to do it,” says the study’s senior author Nathan Kuppermann, M.D., chair of Pediatrics and chief academic officer at Children’s National Hospital.

By applying the potential reduction in mortality associated with high readiness to the number of children at risk of death, the researchers identified the number of lives that could be saved each year. State-specific estimates, adjusted for population size, ranged from 0 preventable deaths in Delaware to 69 in South Dakota.

“Achieving high readiness levels can be challenging for small emergency departments with fewer resources, typically in more rural areas. The result is significant inequity and large healthcare deserts in pediatric emergency care across the United States,” Dr. Kuppermann says. “Yet we found the cost of elevating care to the highest quartile of pediatric readiness is not very high.”

What’s next

The study authors estimate achieving universal high pediatric readiness across the United States would cost approximately $207 million annually. Per-child costs by state to raise ED readiness from current levels ranged from $0 to $12 per year.

“This research emphasizes the urgent need for widespread investment in pediatric readiness,” says Kate Remick, M.D., co-author and emergency physician with the Dell School of Medicine at the University of Texas at Austin. “The National Pediatric Readiness Project has provided a roadmap for improvement. But we need the full engagement of clinicians, healthcare administrators, policymakers and families to make universal pediatric readiness a reality.”

The study outlines several strategies to improve pediatric emergency care, such as integrating high pediatric readiness into hospital accreditation requirements and incentivizing readiness through performance-based reimbursement models.

This study was funded by a Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) Emergency Medical Services for Children Targeted Issue grant (H34MC33243-01-01) and an HHS National Institutes of Health (NIH) Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) grant (R24 HD085927). The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HHS, HRSA, NIH, or the U.S. Government.

Refinery in Corpus Christi , Texas

Ten sustainable steps to mitigate the climate crisis

Refinery in Corpus Christi , Texas

A new manuscript published in the Cambridge University Press outlines 10 actionable steps that infectious diseases professionals can take to reduce their environmental impact.

The U.S. healthcare sector contributes disproportionately to greenhouse gas emissions. A new manuscript published in the Cambridge University Press outlines 10 actionable steps that infectious diseases professionals can take to reduce their environmental impact, from better waste management to promoting telehealth and advocating for hospital-wide sustainability initiatives.

Shreya Doshi, M.D., pediatric fellow at Children’s National Hospital, shares some key highlights from this manuscript below:

Q: What’s been the hold-up in the field?

A: Despite the healthcare sector’s significant contribution to greenhouse gas emissions, we are not doing enough as a community, a nation and as an industry. Much more needs to be done, and a lack of awareness is a major barrier. To truly protect children’s health and keep them out of hospitals, we must focus on reducing harm to their environment. Currently, the healthcare industry is responsible for approximately 8.5 percent of total emissions in the U.S.

Q: How will this benefit patients?

A: By adopting sustainable practices, healthcare systems can reduce pollution and its related health effects. Simultaneously, the resource-efficient use of medical supplies and medications can also lead to more cost-effective care without compromising patient safety, ultimately leading to better health outcomes.

Q: How is Children’s National leading in this space? How unique is this work?

A: This work stands out by focusing on simple, actionable steps that everyone can take, while emphasizing the leadership role that infection preventionists, antimicrobial stewards, and other ID professionals can play in advancing healthcare sustainability. We also have a hospital-wide Sustainability Council that fosters interdisciplinary collaboration. To get involved, email Sustainabilitycouncil@childrensnational.org to join!

You can read the full study, 10 sustainable steps infectious disease professionals can take to mitigate the climate crisis, in the Cambridge University Press.

2024-25 US News Badges

Children’s National again ranked among the best in the nation by U.S. News & World Report

2024-25 US News BadgesChildren’s National Hospital in Washington, D.C., was ranked as a top hospital in the nation by the U.S. News & World Report 2024-25 Best Children’s Hospitals annual rankings. This marks the eighth straight year Children’s National has made the Honor Roll list. The Honor Roll is a distinction awarded to only 10 children’s hospitals nationwide.

This year, U.S. News ended ordinal rankings on its Honor Roll. Instead of assigning a numerical rank from 1 to 10, all hospitals on the Honor Roll will be recognized as having attained the highest standards of care in the nation.

In addition, Children’s National tied for #1 pediatric hospital in the Mid-Atlantic region, which includes New York, New Jersey, Delaware, Pennsylvania, the District of Columbia, West Virginia and Virginia. It’s also best in the Mid-Atlantic in Neonatology.

For the fourteenth straight year, Children’s National ranked in 10 specialty services. New this year, U.S. News included behavioral health as a service line in the rankings. Since it’s the first year, there are no ordinal rankings for behavioral health, but the Children’s National program was named one of the top 50 programs in the country.

“In my first year here, I witnessed what makes Children’s National so special — our commitment to collaboration, empowering one another, and charting a bold path forward for pediatric care,” said Michelle Riley-Brown, MHA, FACHE, president and chief executive officer of Children’s National. “I’m proud U.S. News again recognized Children’s National as one of the top in the nation and the highest-ranked pediatric hospital in D.C., Maryland and Virginia. Together, we’ll continue to push the boundaries of care, research and innovation to make a difference for those who matter most — the kids.”

The annual rankings are the most comprehensive source of quality-related information on U.S. pediatric hospitals and recognizes the nation’s top 50 pediatric hospitals based on a scoring system developed by U.S. News.

“For nearly two decades, U.S. News has published Best Children’s Hospitals to empower the parents and caregivers of children with complex medical needs,” said Ben Harder, chief of health analysis and managing editor at U.S. News. “Children’s hospitals appearing on the U.S. News Honor Roll have a track record of delivering unparalleled specialized care.”

The bulk of the score for each specialty service is based on quality and outcomes data. The process includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with the most complex conditions.

The Children’s National specialty services that U.S. News ranked in the top 10 nationally are:

The other four specialties ranked among the top 50 are Behavioral Health, Cardiology and Heart Surgery, Pulmonology and Lung Surgery, and Urology.

boy on cot in emergency shelter

New federally supported hub to advance solutions for pediatric health emergencies

boy on cot in emergency shelterClinicians caring for children are often left to rely on off-label devices and medications approved for adults, especially during public health crises, national disasters and other emergencies. To address this critical gap, Children’s National Hospital is launching a 10-year partnership with the federal Biomedical Advanced Research and Development Authority (BARDA) — valued at $1.5 million per year, with the possibility of an additional funding boost of up to $515 million.

This new pediatric-focused hub will be known as the SPARK Hub — or the Hub for Special Populations Acceleration, Research and Knowledge for Innovations in Pediatrics. It will join a network of four existing BARDA hubs to develop various tools for national health emergencies, including infectious disease outbreaks or chemical, biological, radiological and nuclear attacks. The new opportunity for Children’s National positions the organization as a leader among those working to ensure clinicians and their patients have the resources they need in crises, approved for kids and ready for clinical use.

BARDA is part of the Administration for Strategic Preparedness and Response within the U.S. Department of Health and Human Services (HHS), which leads the nation’s medical and public health preparedness, response and recovery efforts during disasters and public health emergencies. The new SPARK Hub led by Children’s National seeks to accelerate innovations that can detect, prevent or respond to the medical consequences of a health security threat for children. SPARK’s scope includes drugs, biologics, devices, diagnostics and digital health solutions that improve prevention, readiness and response.

Kolaleh Eskandanian, Ph.D., M.B.A., P.M.P., vice president and chief innovation officer at Children’s National and principal investigator of SPARK Innovations in Pediatrics, said the hospital was honored to take on this role, which “underscores our commitment to advancing the health and safety of children during public health emergencies.”

“To tackle the complex challenges in developing pediatric medical countermeasures, we have assembled an exceptional team of pediatrician-scientists,” Dr. Eskandanian said. “Their expertise will be instrumental as we partner with BARDA on this vital mission, ensuring that our most vulnerable populations receive the care and protection they deserve.”

Children’s National will lead the hub with its SPARK partners: BioHealth Innovation, Consortia for Improving Medicine with Innovation and Technology (CIMIT) at Mass General Brigham, and University Hospitals Rainbow Babies and Children’s. Johnson & Johnson Innovation JLABS and BLUE KNIGHT™ join the team as strategic industry partners.

The BARDA Accelerator Network aims to provide comprehensive support to health security innovators, startups and BARDA portfolio companies. Dr. Eskandanian said that innovators have ideas for devices, but they often could benefit from wrap-around support to accelerate their development through technical guidance, business and commercialization expertise, and resources. The network will facilitate the rapid development, evaluation, validation and commercialization of medical countermeasures.

“One of the critical challenges we face in safeguarding our children during public health emergencies is the limited medical countermeasures specifically approved for pediatric use,” Dr. Eskandanian said. “This creates significant ethical, legal and operational dilemmas when considering whether to use untested or off-label options for our youngest and most vulnerable populations.”

Children’s National has in-depth experience leading nonprofit accelerator programs to spur innovation in healthcare. It is currently serving its 11th year as leader of one of five pediatric consortia funded by the U.S. Food and Drug Administration, the Alliance for Pediatric Device Innovation, which focuses on bringing patients medical devices specifically evaluated and labeled for use in pediatrics.

Children’s National is also one of two leading hospital sites for the Pediatric Pandemic Network (PPN), which aims to empower healthcare systems and communities to provide high-quality, equitable care to children every day and in crises. The Health Resources and Services Administration, a part of HHS, funds the PPN.

Sara Johnson, Ph.D., Desiree de la Torre, M.B.A., M.P.H., and Arethusa Kirk, M.D.

Children’s National summit unites 200+ to bridge health and education

Keynote speaker, Maya Martin Cadogan, executive director, Parents Amplifying Voices in Education (PAVE).

Keynote speaker, Maya Martin Cadogan, executive director, Parents Amplifying Voices in Education (PAVE).

More than 200 attendees from 35 organizations took part in the Children’s National Hospital’s School Health Summit to build strong academic foundations and help launch students into careers. The event, held at the Children’s National Research & Innovation Campus, showcased the Children’s National school-friendly health system framework, school health initiatives and partnerships across the Washington, D.C., area and fostered networking and new relationships between the health and education sectors. Over 80 school nurses from Children’s School Services in the District of Columbia attended the event as part of their summer professional development programming.

Summit highlights

Tonya Vidal Kinlow, M.P.A., vice president of Community Engagement, Advocacy & Government Affairs at Children’s National, delivered opening and closing remarks.

“We believe that addressing school attendance and offering career training programs can powerfully impact students’ academic success and build the foundation for healthy, successful lives,” Kinlow said.

The keynote speaker, Maya Martin Cadogan, executive director of Parents Amplifying Voices in Education (PAVE), shared valuable insight on the important role that parents and caregivers have in advocating for their children’s health through collaborations with health and educational systems.

“Our parent leaders are policy experts, fierce advocates and community connectors. We work with schools, elected officials, policymakers and other leaders, including our partners at Children’s National, to advance a parent-led agenda for systems change in our nation’s capital,” said Cadogan.

A panel of experts who provide school-based services around the region discussed challenges and potential solutions for improving healthcare and education in under-resourced communities. A panel on youth engagement and voices in healthcare also discussed strategies to engage youth in healthcare career opportunities.

Sara Johnson, Ph.D., Desiree de la Torre, M.B.A., M.P.H., and Arethusa Kirk, M.D.

Sara Johnson, Ph.D., professor of pediatrics, Johns Hopkins University School of Medicine; Desiree de la Torre, M.B.A., M.P.H., executive director, Community and Government Affairs, Children’s National and Arethusa Kirk, M.D., pediatrician and vice president, Population Health & Clinical Strategy, United Healthcare.

Panel topics and participants

  • Panel 1 – Innovations addressing chronic absenteeism and increasing access to care
    Moderator:  Arethusa Kirk, M.D., vice president of Population Health & Clinical Strategy at United Healthcare
    Panelists:

    • Andrea Boudreaux, Psy.D., M.P.H., M.A., F.A.C.H.E., executive director at Children’s School Services
    • Desiree de la Torre, M.B.A., M.P.H., executive director of Community and Government Affairs at Children’s National
    • Sara Johnson, Ph.D., pediatrics professor at the Johns Hopkins University School of Medicine
    • Hope Rhodes, M.D., M.P.H., F.A.A.P., medical director of THEARC at Children’s Nationa
  • Panel 2: Youth engagement across the region
    Moderator: Reneé Roberts-Turner, D.H.A., M.S.N, R.N., N.E.-B.C, C.P.H.Q., executive director of nursing excellence for Child and Family Services at Children’s National
    Panelists:  

    • Andrea Zimmermann, director of the Advanced Technical Center at the D.C. Office of the State Superintendent of Education
    • Darcel Jackson, C.P.X.P., L.S.S.G.B., manager of Patient Experience and Patient and Family Engagement at Children’s National
    • Iana Clarence, M.P.H., former Children’s National intern and public health analyst at the Office of Population Health for the U.S. Department of Health and Human Services

As a School-Friendly Health System, Children’s National ensures all children reach optimal health and achieve their full academic potential. Children’s National is committed to addressing school attendance and career training, which can powerfully impact students’ academic success and build the foundation for healthy, successful lives. The health and education sectors must build trusted partnerships and share decision-making with families and schools.

This event was sponsored by the United Health Foundation and Children’s National Child Health Advocacy Institute through the leadership of Kinlow and Nathaniel Beers, M.D., M.P.H., F.A.A.P.

American Diabetes Association 84th Scientific Sessions logo

Children’s National at ADA 84th Scientific Sessions

American Diabetes Association 84th Scientific Sessions logoThe American Diabetes Association 84th Scientific Sessions were held in Orlando, Florida. The meeting presented an opportunity for researchers and health care professionals to exchange knowledge on the latest scientific advances and breakthroughs in diabetes. Participants included:

Oral Presentations:

Poster Presentations:

Dr. Craig Sable in Uganda

Around the world

Our Global Health Initiative launched in 2016 with the goal of eliminating pediatric health disparities around the world. We aim to address the most pressing pediatric health issues through better care for medically underserved populations. This leadership helps us achieve our mission of caring for all children. A broad range of education and research projects improves health outcomes. They also offer enriching opportunities for experienced faculty and emerging leaders to advance clinical excellence.

Healing hearts in Uganda

Dr. Craig Sable in Uganda

Dr. Craig Sable and team train partners in Uganda.

Craig Sable, M.D., interim chief of Cardiology, improves care for young people with rheumatic heart disease (RHD) in Uganda. Donors, including the Karp Family Foundation, Huron Philanthropies, Zachary Blumenfeld Fund and the Wood family, make this possible. RHD affects 50 million people, mostly children, worldwide. It claims 400,000 lives each year.

Dr. Sable and Ugandan partners completed important research showing that early RHD detection, coupled with monthly penicillin treatment, can protect the heart. They are working on practical solutions, such as a new portable device with artificial intelligence (AI) that can easily screen for RHD.

In 2023, Dr. Sable led two missions in Uganda where he and his team did surgeries and special tests for 18 children with RHD. They also taught local doctors new skills to help more kids on their own.

Plastic surgery and reconstructive care in Kenya and Nepal

Each year our Craniofacial & Pediatric Plastic Surgery team, under the leadership of Johnston Family Professor of Pediatric Plastic Surgery and Chief of Pediatric Plastic Surgery Gary Rogers, M.D., J.D., LL.M., M.B.A., M.P.H., provides opportunities for fellows to participate in surgical missions.

In 2024, Perry Bradford, M.D., traveled to the Moi Teaching Hospital in Eldoret, Kenya where she provided patients with burn, pressure wound and cleft reconstruction. She built community connections with the local plastic surgeons and educated registrars and medical students. “This gave me firsthand experience working in a community with limited resources and forced me to be more creative,” Dr. Bradford says. “The experience inspired me to examine what it means to have consistent access to advanced tools and equipment.”

In 2022, a group traveled to Nepal to provide care. Some patients arrived after days of travel by yak or buffalo. One child with a burn injury recovered use of her hand. The team educated local providers to deliver life-changing treatments unavailable in Nepal.

Dr. Tesfaye Zelleke in Ethiopia

Dr. Tesfaye Zelleke, left, and team in Ethopia.

Elevating epilepsy care in Ethiopia

Neurologist Tesfaye Zelleke, M.D., and partners in Ethiopia are seeking to improve the lives of children with epilepsy. The BAND Foundation provides support. Ethiopia has a population of about 120 million yet only a handful of pediatric neurologists.

Dr. Zelleke’s team trained nonspecialist providers to diagnose and treat children in the primary care setting. They also launched a mobile epilepsy clinic to provide community care and build the capacity of local clinicians. In collaboration with advocacy groups, the team educates the public about epilepsy with a goal of reducing stigma.

New hope in Norway

In 2023, our Division of Colorectal & Pelvic Reconstruction shared its expertise with clinicians at Oslo University Hospital, Rikshospitalet, in Norway. This effort was a key first step in Oslo becoming the first dedicated colorectal center in Scandinavia.

Marc Levitt, M.D., and team members performed complex surgeries otherwise unavailable for waiting patients. They led an academic conference. They held clinics to educate nurses, reviewed patient records and made care recommendations. Specialized care enabled a young patient with significant bowel difficulties to recover function and lead a normal life.

The team will travel to South Africa, the Czech Republic and Spain in 2024. Donors, including The Dune Road Foundation and Deanna and Howard Bayless, make this work possible.

Improving outcomes for babies in the Congo

AI can be a valuable tool for diagnosing genetic conditions. It detects unique facial patterns that clinicians without genetics training can miss. However, existing facial analysis software struggles in nonwhite populations.

A team led by Marius George Linguraru, D.Phil., M.A., M.Sc., the Connor Family Professor of Research and Innovation and principal investigator in the Sheikh Zayed Institute for Pediatric Surgical Innovation, is working to improve the newborn diagnosis rate worldwide. They are testing smartphone software in the Democratic Republic of Congo. Diverse newborn data improves AI’s ability to detect a variety of genetic conditions in more children. Early detection, diagnosis and informed care lead to better health outcomes.

Nephrology care for kids in Jamaica

Dr. Moxey-Mims and team in Jamaica

Jennifer Carver and Dr. Marva Moxey-Mims, center, with staff at Bustamante Children’s Hospital.

Marva Moxey-Mims, M.D., chief of Nephrology, is bringing care to children with kidney disease in Jamaica, with a goal of improving health equity. An International Pediatric Nephrology Association grant helped make it possible.

On a recent trip, Dr. Moxey-Mims and a small team — including Jennifer Carver, RN, CNN, lead peritoneal dialysis nurse at Children’s National, and three pediatric nephrologists from Jamaica — trained nearly 30 nurses from Jamaican hospitals. Nurses received hands-on dialysis education to improve their clinical skills. The team also worked to educate the community in disease awareness and prevention.

Read more stories like this one in the latest issue of Believe magazine.

Drs. Donnelly and Goyal

Inspired to make a change

Drs. Donnelly and Goyal

Drs. Donnelly and Goyal lead our efforts to support survivors of violence with a focus on prevention.

Children’s National Hospital created the Youth Violence Intervention Program in 2022 to build connections with patients and prevent future violence through follow-up support for them and their families.

The team works under the leadership of Katie Donnelly, M.D., M.P.H., the program’s medical director who is an emergency medicine physician. They care for children who are survivors of community violence, including gunshot wounds, stabbings or assaults. The program has cared for about 250 youth to date.

Dr. Donnelly and Monika Goyal, M.D., MSCE, associate division chief of Emergency Medicine and Trauma Services, lead our efforts to support survivors of violence with a focus on prevention. Dr. Goyal leads the Safer through Advocacy, Firearm Education and Research (SAFER) group. It works on a local and national level to reduce firearm injuries and deaths among children.

We spoke Drs. Donnelly and Goyal about their goals and the impact of this work.

The interview is edited for brevity.

What inspired you to launch the youth violence intervention program and SAFER?

Dr. Donnelly: Injury is a part of life, and it is something I can never fully protect any child from. But for me, the toughest cases are those caused by violence, particularly gun violence. We are seeing more kids come in with their second or third injury. Violence is a chronic disease that runs much deeper than a single injury. I wanted to do more to break the cycle and address its root causes, such as disconnection from school, unaddressed emotional trauma and poverty. I researched other hospital-based violence intervention programs and learned about the D.C. Office of Victim Services and Justice Grants. We established the program with funding from that entity.

Dr. Goyal: As we started to hear more about gun violence impacting youth, I felt like I needed to do something. Every time I care for a child in our trauma bay who suffered a gunshot wound, it just takes a piece of me. I co-founded SAFER in 2016 to make our communities safer for children so they can live healthy and fulfilling lives. It began with four physicians and has grown into a multidisciplinary team of more than 40 Children’s National experts who volunteer their time in addition to their regular duties.

What keeps you going when challenges feel insurmountable?

Dr. Donnelly: I try to focus on the kids’ successes. Last year we had several teens in the program enroll in D.C.’s Mayor Marion S. Barry Summer Youth Employment Program. They were so proud to show off the debit cards they received to process their earnings. I also think about the kids that our team has helped get back into school who are doing well. These successes are things you can’t always measure with graphs or reports. But I hold them close to my heart, and they are all inspiring.

Dr. Goyal: Gun violence has a ripple effect. Even if a child has not personally experienced gun violence, it may still touch their lives. They may have family members, neighbors or friends who are victims. Their neighborhoods may have experienced gun violence, so it impacts a child’s ability to feel safe. It is devastating. Our work through SAFER keeps me going. We are doing this by sharing evidence-based interventions, advocating for policies that protect kids, and educating families about safe firearm storage and use, among other efforts.

What do these efforts mean to you?

Dr. Donnelly: The work we do gets us a seat at the table to impact larger change, and that is gratifying. Children’s National has become the expert on pediatric firearm injuries in the D.C. region, and we work with local governments on gun violence prevention legislation. I also appreciate opportunities to share our knowledge with the community. I recently spoke at a Teach for America conference about how young teachers can talk about gun violence and safety in their classrooms.

Dr. Goyal: There have been so many feelings of helplessness, and we know we can’t make a difference in every child’s or family’s life. But we are committed to tackling this crisis and trying to prevent tragedies from happening again. It is humbling to be part of this work.

How can philanthropy support these programs?

Dr. Donnelly: External support is essential to sustaining the Youth Violence Intervention Program. We are thankful for the government funding to keep this work going, but D.C. has faced budget cuts, so it’s not always guaranteed. Also, most of the critical psychosocial support we provide is not reimbursed by insurance. This includes things like food and housing resources and transportation costs for kids to get to school or medical appointments safely. Philanthropic support would ensure that we can continue this work and expand the program. We need more Violence Intervention specialists and a trauma-focused mental healthcare provider so our patients don’t have to wait for services. There is much more we can do to ensure that families have what they need to thrive.

Dr. Goyal: I agree, there are so many opportunities for growth. We were grateful to receive a generous gift from the Honorable Ann Brown (former commissioner of the U.S. Consumer Product Safety Commission) to support some of our prevention efforts. These include expanding screenings in the E.D., developing trainings to help youth de-escalate conflict and advancing research to increase awareness of gun safety. Additional support would allow us to scale and grow our programs so we can make an even bigger impact.

Read more stories like this one in the latest issue of Believe magazine.

abstract illustration of a head and brain

Funding opportunity for medical devices addressing youth substance misuse, addiction

Pediatric medical device grant announcementThe Alliance for Pediatric Device Innovation (APDI), a nonprofit consortium led by Children’s National Hospital and funded through the Food and Drug Administration (FDA), today announced a grant opportunity for pediatric medical devices that improve the monitoring, diagnosis or treatment of youth suffering from substance use disorder and addiction. Grants up to $50,000 each are available for pediatric-specific solutions selected by a panel of experts from submitted proposals. Up to $150,000 in grant funds are available for distribution through this program.

The National Institutes of Health (NIH) reports that over 3.6 million U.S. youth, ages 12 to 17, used illicit drugs in 2022. In that same period, an average of 22 youth, ages 12 to 18, died weekly from an overdose. Often, these adolescents did not show the expected warning signs before an overdose, such as problems with alcohol, drugs or prior substance use treatment. Of the teens and tweens who fatally overdosed, only 1 in 10 had a history of treatment for a substance use problem, and only 1 in 7 had ever experienced a prior nonfatal overdose.

“Tragically, drug overdose is now the third leading cause of death among adolescents and, to improve outcomes, we need medical technologies that are specifically designed for the youth,” says Kolaleh Eskandanian, Ph.D., M.B.A., vice president and chief innovation officer at Children’s National and APDI principal investigator and program director. “Teens and tweens are such enthusiastic users of technology. We believe that the time is right for new health technology solutions that can save lives and improve the health of our young people.”

APDI’s call for proposals coincides with the National Advisory Council on Drug Abuse (NACDA) approval last month of the concept “Promoting Medical Device Development for Youth Affected by Drug Addiction and Substance Misuse,” which describes potential funding opportunities. In anticipation of future federal funding from the National Institute on Drug Abuse (NIDA), APDI is providing early support by identifying potential innovations. Along with APDI grant funding, the consortium is providing awardees with support services across all phases of the medical device product lifecycle, including facilitating access to NIDA technical assistance.

Dr. Eskandanian described the kinds of pediatric-focused innovations the grant seeks to attract, which align with NACDA’s listed priorities. They include, but are not limited to, the following:

  • Artificial intelligence-based algorithms that collect, integrate, analyze and visualize various types of data related to the diagnosis or treatment of drug misuse and addiction in youth.
  • Stand-alone or add-on digital therapeutics focused on behavioral health interventions to diagnose, treat, prevent and mitigate drug misuse and addiction.
  • Wearables and connected digital therapeutics at a point-of-need intended to detect, diagnose and treat opioid-induced respiratory depression.
  • Therapeutic devices, such as neuromodulation, intended to improve SUD treatment outcomes and prevent recurrence.

As most medical devices are designed for adults, Dr. Eskandanian notes that this limits usability and acceptance by adolescents. She adds that existing algorithms supporting medical devices are often based on adult data and are not optimized for adolescents, limiting their usefulness.

“Our goal is to bring more effective pediatric medical devices to market to address the alarming rate of harm substance misuse and addiction is creating for young people and their families,” says Dr. Eskandanian. “Since this is an area of focus for NIDA, we see an opportunity to help create a pipeline of qualified companies that can apply for NIDA follow-on funding.”

Interested innovators can learn more and apply for the APDI funding opportunity online at innovate4kids.org. The application deadline is July 30, 2024.

APDI is one of five nonprofit consortia in the FDA’s Pediatric Device Consortia grant program that receives funding to provide a platform of services, expertise and grants to support pediatric innovators in bringing medical devices to the market that specifically address the needs of children. Along with Children’s National, APDI members include Johns Hopkins University, CIMIT at Mass General Brigham, Tufts Medical Center, MedStar Health Research Institute, MedTech Color and OrthoPediatrics Corp.

smoke coming from chimney stacks

Call for action on healthcare sustainability

smoke coming from chimney stacks

New research reveals the U.S. healthcare system’s contribution to greenhouse gas (GHG) emissions and climate change is disproportionately high and harms the public.

A recent review reveals the U.S. healthcare system’s contribution to greenhouse gas (GHG) emissions and climate change is disproportionately high and harms the public. The findings are part of a series of articles being co-published by Open Forum Infectious Diseases and the Journal of the Pediatric Infectious Diseases Society, which highlight the effect of climate change and air pollution on global health and infectious diseases.

Our current policies and practices on healthcare waste and emissions do not do justice to the health of the children we want to improve,” said Shreya Doshi, pediatric fellow at Children’s National. “The U.S. contributes to 27% of the global healthcare industry GHG emissions (greater than any other country). Infectious diseases professionals can use their background in antimicrobial stewardship and infection prevention and control to lead projects in healthcare sustainability and make a difference.”

Q: How will this work benefit patients?

A: Ultimately, when different specialties and organizations in healthcare make changes to their practices, we will have fewer GHG emissions and a healthier planet for our patients. There is also strong evidence that climate change affects vulnerable communities and countries disproportionately and we hope to change that. We want to provide safe healthcare to children from the current generation without taking away resources from the future generation.

Q: What’s been the hold up in the field?

A: Lack of awareness and time needed for change in practices and policies. For any organization leadership buy-in is needed when it comes to healthcare sustainability. Children’s National actually received a sustainability award two years ago for reducing anesthetic gases.

Q: What did you find that excites you? What are you hoping to discover?

A: There is so much yet to be explored at the intersection of infectious diseases and healthcare sustainability and that’s exciting! No matter what you do within the healthcare field — there is room for improvement and room for reduction in waste and GHG emissions. It is time to reassess and, rethink and innovate our practices. Having collaborators in other specialties who are passionate about the sustainability can help us move the needle faster. Lastly, it is important to know that work in healthcare sustainability has huge cost savings, so it’s a win for the financial health of the institution and for the planet!

You can read the full study, Healthcare Sustainability to Address Climate Change: Call for Action to the Infectious Diseases Community, in the Open Forum Infectious Diseases and the Journal of the Pediatric Infectious Diseases Society.