I have been in clinical practice since completing my Pediatrics training in 1996 and my Pediatric Emergency Medicine training in 1999. Since 1999, I have cared for patients and taught trainees in the emergency department (ED) at the Children’s Hospital Colorado, the tertiary referral center and pediatric trauma center for a 7-state region, serving 75,000 children each year. I also work in Children’s Colorado’s Network of Care, which treats an additional 75,000 patients annually.

While caring for patients, I provide bedside teaching for fellows and residents from pediatrics, emergency medicine, family medicine and dentistry.

In my research, I have conducted grant-funded research in ED crowding, the quality of care provided to children, and healthcare delivery system characteristics that optimize care to patients with chronic conditions. Mentoring trainees and faculty in research is one of the things I love most about my job.

My research has focused on using electronic health data methods to define and model systems- and patient-level factors associated with process and outcome measures of health care quality. This work has assessed variation in quality of care for various conditions, and has demonstrated the importance of rigorous methods in selecting and implementing quality metrics. These publications have highlighted the importance of the following in quality measurement: (1) selecting process measures only when they have demonstrated association with outcomes of value; (2) using risk-adjustment that extends beyond adjustment for the severity of the acute condition to encompass chronic medical complexity and social determinants of health; and (3) incorporating adjustment for structural measures of quality, including crowding and occupancy measures.