The University of Florida Clinical and Translational Science Institute (CTSI) Translational Workforce Development Program’s KL2 Training Grant provides junior faculty with financial support and research training to develop the skills necessary to build a well-funded, collaborative career in clinical and translational research. Meet two KL2 Scholars, emergency-medicine assistant professors Jennifer Fishe, MD, and Henry Young, MD, and learn about their research.
Jennifer Fishe, MD
Treating asthma attacks before children arrive in the emergency room
Jennifer Fishe, MD, an assistant professor in the department of emergency medicine and associate medical director for the UF Health Jacksonville Pediatric Emergency Department, recently became the CTSI’s second KL2 scholar from UF Health Jacksonville.
“Asthma is the most common chronic disease of childhood, and a frequent reason for emergency department visits, but not much is known about prehospital, or emergency medical services care of pediatric asthma,” Fishe said. “I want to see what can be done before children arrive in the emergency department to improve their chances of being discharged home, as opposed to being admitted to the hospital.”
Fishe’s KL2 research project seeks to further the understanding of how children are treated for asthma before they arrive at the hospital. Administering systemic corticosteroids (such as Prednisone) before children arrive in the hospital could improve clinical outcomes, but most protocols that first responders follow only authorize the IV form of the medication, which requires time and skill for IV placement. However, the medication is also available orally. Later, in the emergency room, children may receive systemic corticosteroids orally or through an IV.
This would be the first large study to examine how systemic corticosteroids are used, and how they are associated with hospital admission rates and length of stay in the emergency department. Fishe’s study is analyzing a statewide and national emergency-medical-services database, using CTSI resources and collaborating with the UF GeoPlan center’s experts in Geographic Information Systems to uncover the influence of time to emergency department arrival. The results will inform a prospective clinical trial to determine the most efficacious and practical method of systemic corticosteroid administration for pediatric prehospital asthma patients.
Prior to the KL2 training grant, Fishe was the principal investigator on a retrospective study of pediatric prehospital and inter-facility transport patterns in Maryland, funded by The Falck Foundation. She is a co-investigator on a HRSA Targeted Issues Grant to develop a novel pediatric direct transport protocol (H34MC30232).
Her research interests include pediatric prehospital care and quality improvement.
She received her Lean Six Sigma Green Belt in healthcare quality improvement in 2017, and previously was the lead physician on a quality improvement project reducing pediatric ED patient consult times. Fishe received her undergraduate degree in Biology from the Massachusetts Institute of Technology, and her medical degree from the University of Miami. She completed her residency in general pediatrics at the Children’s Hospital of Philadelphia, and her pediatric emergency medicine fellowship at the Johns Hopkins University.
Henry Young, MD
Alternatives to opioids in the emergency department
Henry Young, MD, an assistant professor in the UF College of Medicine’s department of emergency medicine and assistant residency director with UF Health, was recently appointed a KL2 Scholar by the CTSI.
Young’s KL2 research project assesses the willingness of patients with acute pain to accept alternatives to opioids in the emergency department.
“In the emergency department, pain is the most commonly treated symptom and opioids are often prescribed to treat that pain,” Young said. “Unfortunately, four out of five individuals addicted to heroin reported that their first opioid was a prescription drug. With this project, I hope to provide data to inform the use of safer therapeutic options for the management of pain. If we are able to reduce the amount of opioids prescribed, we may be able to prevent exposing susceptible people to a treatment that may lead to addiction.”
His study will explore the implementation of a patient-centered approach to treating pain, that emphasizes evidence-based alternatives to opioids in the emergency department and assessing if individuals at increased risk to abuse opioids are willing to accept these safer alternatives. His study will also explore barriers and facilitators to the implementation of this approach from both healthcare providers and patients. The goal of the study is to reduce the overall prescription of opioids while continuing to effectively manage pain with safer, less addictive treatment options.
Born in the small town of Cordele, Georgia, Young became interested in a career in medicine after watching his father serve his community as a family physician for several years. He majored in Biology at Georgia Southern University, graduated from the Medical College of Georgia and completed an emergency medicine residency program at UF, serving as chief resident in his final year, followed by a National Institute on Drug Abuse T32 Post-Doctoral Fellowship.
During his NIDA fellowship, Young served as lead researcher on a study that found few emergency-medicine providers in Florida used a statewide database designed to encourage safer prescribing and to reduce opiate abuse and diversion. The state had declared the opioid epidemic a public health emergency, tapping more than $27 million of federal grant money for treatment, prevention and recovery services.