Seattle Children's Hospital

Research Studies
Pediatric Neurosurgery

Pediatric Guideline Adherence and Outcomes (PEGASUS) Project

Principal Investigator: Monica S. Vavilala, MD, UW Associate Professor of Anesthesiology and Pediatrics
Co-Investigator: Richard Ellenbogen, MD
Funded By:

Monica S. Vavilala, UW associate professor of anesthesiology and pediatrics, has been awarded a $2.7 million grant to examine how to increase the adoption of the national pediatric guidelines to improve outcomes for children with traumatic brain injury.

The National Institute of Neurological Disorders and Stroke is funding the five-year Pediatric Guideline Adherence and Outcomes (PEGASUS) project. Vavilala is the project’s principal investigator.

In 2003, the “Guidelines for the Acute Medical Management of Severe Traumatic Brain Injury (TBI) in Infants, Children, and Adolescents" was released as the evidence-based care pathway to improve outcome for children with TBI. Although traumatic brain injury is the leading killer of children over one year of age, there are no data on how systems can best adopt the guidelines and improve patient outcomes.

The PEGASUS project will examine how to increase adherence and reduce barriers to adoption of the pediatric guidelines. Valvilala and colleagues will determine if adherence by innovators/early adopters of the guidelines is higher than among other adopter sites nationally. Using surveys, focus groups, and value stream mapping, investigators will also examine the sources of barriers to adoption of the pediatric guidelines across the full spectrum of hospital sites. The team will develop microsimulation models and, based on findings, will create a targeted blueprint that may not only improve the adoption of the 2003 pediatric guidelines, but may be important to increasing the adoption of other evidence-based guidelines for the care of acutely injured patients. The long-term goal is to examine the effect of the targeted blueprint on patient outcomes in children with TBI.

Co-investigators are Richard Ellenbogen, professor and chair of neurological surgery; Frederick Rivara, professor of pediatrics; Douglas Zatzick, associate professor of psychiatry and behavioral sciences; Pamela Mitchell, professor of biobehavioral nursing and health systems; Linda Boyle, associate professor of industrial and systems engineering; and Mary Kernic, research associate professor of epidemiology.