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Healthcare Delivery Science

Nemours’ Center for Healthcare Delivery Science (CHDS) studies the many influences that can affect the outcomes, quality, cost, safety and value of children’s health care. Our goal is to build a strong base of scientific evidence about how health care can best be delivered so that children get exactly the care they need, right when they need it — and families feel that they have had an active role in that care.

We can achieve real gains in children’s health by learning exactly how existing or new treatments can be selected and delivered efficiently to improve access, children’s outcomes and family satisfaction.

What We're Doing

Researchers with the Center for Healthcare Delivery Science have been awarded research grants for a range of studies:

 
Cross-Cultural Psychosocial Risk Screening in Pediatric Cancer
American Cancer Society, RSG-13-015

The Psychosocial Assessment Tool (PAT) is a parent report screener of psychosocial risk for families in pediatric health care. This project studies English and Spanish versions of the PAT in pediatric cancer to describe changes over time in risk, particularly for Spanish-speaking families, in an effort to identify factors related to health disparities in this population. The study is being conducted at Nemours/Alfred I. duPont Hospital for Children, The Children’s Hospital of Philadelphia (CHOP) and MD Anderson Cancer Center.

Principal Investigator:

Anne E. Kazak, PhD, ABPP

 
Psychological Intervention Research in Pediatric Oncology
National Cancer Institute, K05CA128805

This is a senior scientist mentor award that provides for mentorship of multidisciplinary cancer researchers working on projects related to psychological intervention research.

Principal Investigator:

Anne E. Kazak, PhD, ABPP

 
Use of Continuous Glucose Sensors in Adolescents With Inadequate Diabetic Control
National Institutes of Health #R01-DK080831; Jan. 10, 2009 through Nov. 30, 2014

This study is testing a behavioral intervention to help adolescents with type 1 diabetes get more benefit from using continuous glucose monitors. These new devices could help greatly with blood sugar control, especially as other studies show that teens don’t benefit as much from the devices as do adults.

Principal Investigator:

Tim Wysocki, PhD

 
Shared Medical Decision Making in Pediatrics
Shared Medical Decision Making in Pediatrics: Pilot and Feasibility Study

A patient-centered approach to making difficult treatment decisions called shared medical decision making (SDM) has been used extensively in adult health care, but not in pediatrics. This pilot and feasibility study evaluated an SDM intervention based on physician-parent-child communication about two quite different pediatric treatment decisions: allergy shots (decision aid) and spinal fusion surgery for children with scoliosis (curved spine) as a result of severe neuromuscular conditions (decision aid). The results showed that use of carefully prepared decision aids resulted in increased knowledge, excellent satisfaction and better decision quality for both types of decisions and better appointment keeping for children who started allergy shots. The results support the feasibility, acceptance and effectiveness of SDM in pediatrics.

Principal Investigator:

Tim Wysocki, PhD

Shared Medical Decision Making in Pediatric Diabetes (Patient-Centered Outcomes Research Institute)

Studies show that teens with diabetes benefit less than adults from new technologies such as insulin pumps and continuous glucose monitors. In this study, we will be developing and testing web-delivered resources that are designed to help parents and teens with diabetes make better decisions about whether to add these devices to their care.

Principal Investigator:

Tim Wysocki, PhD

 
Maintenance of Health Care Providers’ Clinical Proficiency: Transdisciplinary Analysis, Modeling and Intervention
Pending research contract from the Department of Defense – Telemedicine and Advanced Technology Research Center

This project will plan and test automated feedback supports as part of the electronic medical record system to help doctors make the best decisions about children’s care.

Principal Investigator:

Tim Wysocki, PhD

 
Promotion of Primary Care Provider (PCP) Screening for Adolescent Depression, Suicidality and Suicide Risk Factors Through Specialized PCP Training
Subcontract to Substance Abuse and Mental Health Services Administration grant awarded to University of Florida; PI: J. Goldhagen. August 2012 through July 2013

Data collection has just been completed for this study that evaluates the effects of a training program for community primary care pediatricians on their practices in screening adolescents for depression and suicide risks.

Principal Investigator:

Elise Fallucco, MD

 
PedsNet Clinical Data Research Network
Patient-Centered Outcomes Research Institute: January 2014 through June 2015

Nemours is one of eight major pediatric care organizations comprising PedsNet that together were selected by the Patient-Centered Outcomes Research Institute (PCORI) as one of its 11 Clinical Data Research Networks. Nemours’ partners in PedsNet include Children’s Hospital of Philadelphia (the lead institution), Cincinnati Children’s Hospital and Medical Center, Boston Children’s Hospital, St. Louis Children’s Hospital, Nationwide Children’s Hospital, Children’s Hospital of Colorado and Seattle Children’s Hospital. PedsNet will combine de-identified electronic medical record data from all eight organizations to create an exceptionally valuable resource for comparative effectiveness research on children’s health conditions.

Learn More About This Initiative »
See Abstract »

During the 18-month Phase I of this grant support, which is in progress, each network is expected to meet a variety of technical and administrative milestones. The networks that achieve satisfactory progress will be eligible for more substantial Phase II funding that will enable completion of several research studies to demonstrate the network’s capabilities and to illustrate how other researchers can make use of this unique resource.

Nemours Principal Investigator:

David E. Milov, MD

PedsNet Principal Investigator: Christopher B. Forrest, MD, PhD, Children’s Hospital of Philadelphia

Center for Healthcare Delivery Science

Our Mission

The Center for Healthcare Delivery Science (CHDS) helps Nemours to be among the top 5 percent of all U.S. pediatric health care organizations by:

  • using Nemours’ advanced electronic health record system to show the quality and value of health care we deliver
  • teaching Nemours medical staff how findings from health care delivery science research can be applied in their practices
  • helping Nemours care teams identify research questions and design research that can improve the quality, cost and value of care
  • attracting skilled researchers to conduct health care delivery science at Nemours
  • obtaining more funding for CHDS research, including studies based at Nemours and multisite national investigations

Center for Pediatric Traumatic Stress (CPTS)

A number of studies are joint efforts with the Center for Pediatric Traumatic Stress (CPTS), founded in 2002 to address medical trauma in the lives of children and families. The center is co-located at duPont Hospital for Children and the Children’s Hospital of Philadelphia. CPTS is a Treatment and Services Adaptation Center within the National Child Traumatic Stress Network. The Center for Pediatric Traumatic Stress develops and disseminates educational resources to patients and families, as well as assessment and intervention materials and resources for medical traumatic stress for health care and mental health providers.

The primary goals of CPTS are to:
  • Increase awareness and recognition of medical traumatic stress by health care providers.
  • Develop and promote empirically based screening and intervention for children and families who have experienced traumatic stress due to pediatric illness and injury.
  • Provide training to medical and mental health providers about best practices in assessing and treating medical traumatic stress.
  • Develop and disseminate resources about coping with traumatic stress to ill and injured children and their families.

To address medical traumatic stress, the Center for Pediatric Traumatic Stress has developed the Health Care Toolbox website, a compendium of useful information resources and training tools for medical and mental health professionals treating children and families experiencing medical trauma. In addition, the center collaborates with partner health care institutions across the United States to implement the Psychosocial Assessment Tool (PAT), the DEF Worksheet for Trauma-Informed Care and the Surviving Cancer Competently Intervention Programs (SCCIP/SCCIP-ND).

The Center for Pediatric Traumatic Stress is co-directed by Nancy Kassam-Adams, PhD, at the Children’s Hospital of Philadelphia and Anne Kazak, PhD, ABPP, at Nemours.

The center’s Nemours-based staff in Wilmington includes:
  • Stephanie Schneider, MS, Program Manager
  • Stephen DiDonato, MS, Program Coordinator
  • W. Douglas Tynan, PhD

Co-Directors

 
Anne E. Kazak, PhD, ABPP

Dr. Kazak is a clinical psychologist (with board certification from the American Board of Professional Psychology) who joined Nemours in January 2013. She holds faculty positions at Thomas Jefferson University (pediatrics), the University of Delaware (psychology) and the University of Pennsylvania (pediatrics and psychology).

Dr. Kazak was previously at The Children’s Hospital of Philadelphia (CHOP), where she held various clinical and research leadership positions. Dr. Kazak has held national leadership roles including editor-in-chief at Health Psychology, president (2006) of the Society of Pediatric Psychology of the American Psychological Association (APA) and chair of the APA Taskforce on Evidence-Based Practice for Children and Adolescents.

She is currently the co-chair of the Patient-Centered Medical Home Taskforce for the APA. She has had federal research funding continuously since 1991 for her study of stress and coping in children and families with life-threatening illness. Dr. Kazak also is co-director of the Center for Pediatric Traumatic Stress (part of the National Child Traumatic Stress Network) She received the American Psychological Foundation (APF) Cummings PSYCHE Prize, in recognition of her work integrating behavioral and medical care.

Dr. Kazak received her doctorate from the University of Virginia and completed internship training at Yale University School of Medicine. Her undergraduate degree is from Smith College. She is licensed in Delaware and Pennsylvania.

Learn More About Dr. Kazak »
View Dr. Kazak's Curriculum Vitae (CV) »

 
Tim Wysocki, PhD, ABPP

Board certified by the American Board of Professional Psychology, Dr. Wysocki has been with Nemours since 1992 as a pediatric psychologist and researcher. His roles include chief of the Division of Psychology and Psychiatry (1997-2004), director of the Center for Pediatric Psychology Research (1992 to 2013) and chair of two Nemours Institutional Review Boards from 2000 to present. He is president-elect of the Society of Pediatric Psychology.

Dr. Wysocki also has received numerous external research grants for his studies, most of which focus on family coping with type 1 diabetes in children and adolescents. He has received national awards for this research and served on many editorial boards and research grant review panels on both the national and federal foundation levels. Dr. Wysocki did his undergraduate training at the University of Texas, his PhD at Western Michigan University and his post-doctoral fellowship at Johns Hopkins School of Medicine.

View Dr. Wysocki's Curriculum Vitae (CV) »


Center Staff

Wilmington - Nemours/Alfred I. duPont Hospital for Children:
  • Melissa A. Alderfer, PhD, Senior Research Scientist
  • Francisco Argueta Ortiz, MS, Clinical Research Coordinator
  • Julia Price, PhD, Research Associate
  • Mary McElwain, Administrative Assistant
Philadelphia/Nemours duPont Pediatrics, Thomas Jefferson University Hospital:
  • Rhae Ana Gamber, BS, Research Specialist
  • Ania Gosek, BS, Research Specialist
Florida:
  • Alex Taylor, MACP, Senior Research Coordinator
  • Amy Milkes, MA, Research Specialist
  • Robbin Seago, MA, Research Specialist
  • Shannon Henry, MA, Research Specialist
  • Carolina Bejarano, BA, Research Specialist
  • Melodie Gerry, BA, Administrative Assistant

Members of the Center’s Scientific Advisory Board

Laurie Duckworth, PhD, ARNP

Director of Nursing Research and Advanced Practice
Nemours Florida Operations

Richard Finkel, MD

Chief, Division of Neurology
Nemours Children’s Hospital, Orlando

James Franciosi, MD

Associate Chief, Division of Gastroenterology
Nemours Children’s Hospital, Orlando

Vicky Funanage, PhD (Advisory)

Director of Research
Nemours Foundation

Paul Garfinkel, MHS (Advisory)

Director, Nemours Office of Human Subjects Protection
Administrative Director, Clinical Research Operations

Samuel Gidding, MD (Advisory)

Chief, Division of Cardiology
Nemours/Alfred I. duPont Hospital for Children, Wilmington

Sandra Hassink, MD

Director, Nemours Obesity Initiative
Nemours/Alfred I. duPont Hospital for Children

Stephen Lawless, MD, MBA (Advisory)

Vice President for Quality and Safety
Nemours Foundation

David Milov, MD

Chief Medical Information Officer
Nemours Foundation

Paul Pitel, MD (Advisory)

Chair, Department of Pediatrics
Nemours Children’s Clinic, Jacksonville

Iman Sharif, MD

Chief of General Pediatrics
Nemours/Alfred I. duPont Hospital for Children, Wilmington

W. Doug Tynan, PhD

Director of Programs,
Nemours Health and Prevention Services (NHPS)

Lloyd Werk, MD

Chief, Division of General Pediatrics
Nemours Children’s Hospital, Orlando

What We Can Offer

If you are a researcher, the Center for Healthcare Delivery Science (CHDS) can offer you a wide range of assistance:

  • mentoring and career development toward a goal of earning external funding for your CHDS work
  • consultation in preparing and refining your CHDS grant applications so they meet the Methodology Standards of the Patient Centered Outcomes Research Institute 
  • locating sources of funding for your CHDS research
  • helping you plan for the collection of preliminary data that could strengthen your CHDS grant applications
  • developing statistical analysis plans for your CHDS studies
  • assisting with queries to the Nemours Data Warehouse, either for research or for determining feasibility of research ideas
  • helping you find databases and patient registries that may provide opportunities for CHDS research in your field of interest 
  • connecting you with experts at Nemours and elsewhere with research interests similar to yours
  • connecting CHDS researchers elsewhere with the right people at Nemours
  • consultation in writing journal articles that report the results of your research

Collaborate With Us

With active labs in the Delaware Valley and Florida, we’re always seeking new research partners to collaborate with. Join us.
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