2020 Research Recognition Awards Recipients

Professional Research Recognition Award

Reducing Anesthesia Use for Pediatric Magnetic Resonance Imaging: The Effects of a Patient- and Family-Centered Intervention on Image Quality, Health-Care Costs and Operational Efficiency

Journal of Radiology Nursing
Volume 38, Issue 1, March 2019, 21-27

Mastro, K.A., Flynn, L., Millar, T.F., DiMartino, T.M., Ryan, S. M., & Stein, M.H. 

Abstract: Children with complex medical problems who require anesthesia are known to be at risk for acute adverse physiologic events related to anesthesia. The risks of anesthesia include short- and long-term psychological and neurobehavioral issues. Magnetic resonance imaging (MRI) has emerged as the standard of care for diagnosis and follow-up of many conditions, and more children are being subjected to anesthesia to ensure acceptable motion-free image quality of the MRI scans. The aim of this study was to evaluate the effectiveness of an anesthesia-free patient- and family-centered intervention through an analysis of MRI quality, health-care costs, and operational efficiency as compared with other approaches. This study retrospectively reviewed patient data extracted from electronic medical records of children aged 3-17 years, who underwent outpatient MRI at an urban academic medical center from 2015 to 2016. A total matched sample size of 500 children, 125 per group, was used to investigate the outcome variables including the quality of magnetic resonance image, health-care cost, and procedural time. The groups included are as follows: (1) intervention group, patient- and family-centered preparation of the child, and no anesthesia given (PFC/NA); (2) comparison group, no structured preparation, and no anesthesia given (SC/NA); (3) comparison group, certified child life specialist preparation, and anesthesia given (CCLS/A); (4) comparison group, no structured preparation, anesthesia given (SC/A). The PFC/NA intervention group was found to have significantly lower costs (p < .0001) and shorter procedure times (p < .0001), and 96.8% of the MRI images were of acceptable or better quality than those of the SC/A and CCLS/A groups. The PFC approach provides a way for children to undergo outpatient diagnostic MRI without the need for anesthesia, thus reducing risk, costs, and procedure time.

Access the full article here.

Toni Millar, MS, CCLS

Department of Patient Centered Care, New York-Presbyterian/Columbia University Medical Center, New York, New York

Toni Millar

Toni started her professional career as an elementary school teacher, and after discovering Child Life, switched careers and became a CCLS in 1995, graduating with her Master of Child Life and Family Studies degree from Wheelock College. She immediately accepted a position at Mt. Sinai Hospital in Cleveland, Ohio as a child life specialist in the ambulatory surgery unit and the pediatric unit. After a call from Mary Barkey, she then went on to an ambulatory surgery child life position at University Hospitals Rainbow Babies and Children’s Hospital, and shortly afterwards, was asked to step into the Child Life Director position. The child life department expanded for the next 10 years during Toni’s leadership, adding child life, art therapy and music therapy positions.

NewYork-Presbyterian Morgan Stanley Children’s Hospital in New York City then called, and Toni became the Director of Child Life and Patient and Family-Centered Care. Within 8 years, the program expanded adding child life specialists, art and music therapists, a Family Resource Center and Health Librarian, and a Patient and Family Liaison position. A child life position was also created in the Radiology department specifically with this research project in mind. It was an amazing, collaborative project that solidified what child life specialists have anecdotally known- that preparation for MRI’s could reduce the need for sedation, resulting in improved efficiency while reducing recovery time and procedural costs without compromising the quality of the scan.

Toni’s next professional step at NewYork-Presbyterian was to become the hospital system’s first Vice President of Patient and Family-Centered Care, where she focused on improving the patient experience, mostly in adult units, and the resulting metrics of success across the multiple-hospital medical system.

An organizational restructuring let her follow her professional passion back to pediatrics and the ability to use her child life skills. Toni knew Project Sunshine throughout her time as the Child Life Director at Morgan Stanley Children’s Hospital, and she shared their mission- to provide play opportunities for pediatric patients and their families facing medical challenges. She accepted Project Sunshine’s newly created position, the Director of Program Innovation, where she assesses, creates and implements developmentally appropriate, evidence-based programs for child life specialists to use with their patients and families.

Toni and her husband have been married for 36 years and are the parents of 2 adult children and grandparents to their 2-year-old granddaughter. They live in New York City.

Student Research Recognition Award

Child Life Practices: Hand Molds as an End-of-Life Legacy Building Intervention

Kristin Horrillo, MA
Thesis (Spring 2019)
Mills College

Abstract: Surrounding the death of a child, child life specialists often offer and create hand molds with or for families in hopes of providing a sense of connection and comfort. To further professionalize the field of child life, it is vital to explore the ways in which professionals perceive hand mold offering and creation. Based on previous research, this study utilizes survey and interview responses to examine what factors child life specialists recognize as important when assessing if and how hand mold interventions should be implemented. Certified Child Life Specialists were asked to reflect on their experiences supporting families through the death of a child when they have chosen to utilize or not utilize hand molds as a legacy building intervention. Common themes related to challenges faced by child life specialists, the importance of family involvement in legacy building interventions, and the influence of intention of hand mold interventions on meaningfulness for families were analyzed and discussed. These findings may be utilized to create a standard of care that will inform practices that value individualized therapeutic hand hold making interventions for families surrounding the death of pediatric patients. 

Access the article here.

Kristin Horrillo, MA, CCLS

Kristin Horrillo (MA, CCLS) is a bay area native and currently works in Palo Alto at Lucile Packard Children's Hospital in the Stanford Emergency Department. After completing her undergraduate degree at UCLA, she did her graduate work at Mills College. During her time in graduate school she completed a Child Life practicum at UCSF Benioff Children's Hospital Oakland as well as an internship at Seattle Children's Hospital. She quickly started working per diem at California Pacific Medical Center where she was instrumental in spreading child life resources to children of adult patients. Following a short time as per diem at LPCH, she became full time in the emergency department where she continues to provide support. This published research is her Masters' thesis work. As a certified specialist, she continues to feel passionate about exploring the means through which we as Child Life Specialists serve families during challenging times of trauma and bereavement. In her free time Kristin enjoys spending time at the beach, traveling with friends and family, and snacking on desserts in the break room.