Elizabeth "Betsy" Hunt, MD, MPH, PhD, Associate Professor, Pediatric Anesthesia; Drs. David S. and Marilyn M. Zamierowski Director, Johns Hopkins Medicine Simulation Center

Associate Professor
Drs. David S. and Marilyn M. Zamierowski Director,
Johns Hopkins Medicine Simulation Center
ehunt@jhmi.edu

Betsy Hunt joined the PICU faculty at Johns Hopkins as a pediatric intensivist in 2003. She works predominantly with cardiac patients and has a passion for improving outcomes from cardiac arrest. She would like to be able to intervene early enough to prevent cardiac arrests, but for now focuses on providing the best treatment possible as early as possible to optimize a child’s chances of surviving with little to no neurologic damage.

In 2003, Dr. Hunt started a Pediatric CPR Advisory Committee for the hospital, which meets monthly to make decisions regarding such matters as the teams, defibrillators, drugs, and policies. For example, the institution used to have a “code team,” which was called if a child’s heart stopped beating. Instead, it now has a rapid response team that is called earlier, when clinicians become concerned that a child’s heart might stop beating. This earlier response enables the team to potentially prevent a cardiac arrest and move the child to the PICU where more tools are available in case he/she does enter cardiac arrest. Implementation of the rapid response team has significantly reduced the number of children who require intubation or chest compressions on the general wards.

In January of 2013, Dr. Hunt started a program called “Code Busters,” which meets weekly to discuss any cardiac arrest that occurred in the Children’s Center during the previous week. There, they review all of the data from the event and discuss lessons learned in order to improve both CPR quality and teamwork. A new defibrillator pad has a sensor in it that measures depth and rate of compressions. This feedback can be used to determine whether American Heart Association guidelines were met and help clinicians to improve their performance. Attendees at the meeting discuss these data and data from other monitors, as well as individual experiences and observations. Dr. Hunt has found that survival rates from cardiac arrest have improved substantially since the start of this program.

In addition to her role in the PICU, Dr. Hunt is the director of the simulation center for the hospital and School of Medicine. Therefore, she is able to orchestrate an intense, 60-hour simulation training program for new PICU fellows, as well as monthly multidisciplinary simulation sessions in which all PICU faculty and staff can engage in refresher training. In addition, these sessions can be used diagnostically to discover flaws and improve the system. Dr. Hunt loves her job because she is very curious about how systems work how to improve them. The simulation center provides an opportunity to continually try new methods until she find one that works better than the current standard. In her research she is developing new methods of simulation to improve resuscitation performance. For examples she has developed RCDP (rapid cycle deliberate practice), which entails repeating a simulation multiple times with brief discussions of performance in between. She is also using data-driven debriefing to improve performance. Finally, she is developing innovations to improve the way that resuscitation is taught. For example she has redesigned the interface between the defibrillator and the simulation mannequin to enable trainees to use the defibrillator realistically. She hopes that her education efforts will enable teams to be confident that they can give the best care possible. Now she travels nationally and internationally to spread her success beyond Johns Hopkins and help other hospitals to improve their programs. She is also a senior co-chair of INSPIRE (International Network of Simulation-based Pediatric Innovations, Research, and Education), which enables members to easily conduct multicenter trials of new teaching and teamwork methods. This group of more than 450 members in 50 countries is helping to improve resuscitation practice throughout the world.

Education
After graduating from Villanova University, Dr. Hunt attended medical school at Albany Medical College and spent 6 months at Oxford in England. She then did her residence in internal medicine and pediatrics at Duke, from 1995 to 1999, and an additional year as Pediatric Chief Resident from 1999 to 2000. After residency, Dr. Hunt came to Johns Hopkins, where she undertook a pediatric critical care fellowship from 2000 to 20003 and a 6-month research fellowship. Additionally, she earned an MPH in 2002 and a PhD in clinical epidemiology in 2008, both from the Johns Hopkins Bloomberg School of Public Health.

Selected Publications

  1. Hunt EA, Heine M, Hohenhaus SM, Luo X, Frush KS. Simulated pediatric trauma team management: assessment of an educational intervention. Pediatr Emerg Care 23(11):796–804, 2007.
  2. Shilkofski NA, Nelson KL, Vera K, Hunt EA. Recognition and treatment of unstablesupraventricular tachycardia by pediatric residents in a simulation scenario. Simul Healthc 3(1):4–9, 2008.
  3. McCabe ME, Hunt EA, Serwint JR. Pediatric residents’ clinical and educational experiences with end-of-life care. Pediatrics 121(4):e731–7, 2008.
  4. Nelson KL, Shilkofski NA, Haggerty J, Hunt EA. The use of cognitive aids during simulated pediatric cardiopulmonary arrests. Simul Healthc 3(3):138–45, 2008.
  5. Hunt EA, Patel S, Vera K, Shaffner DH, Pronovost PJ. Survey of pediatric resident experiences with resuscitation training and attendance at actual cardiopulmonary arrests. Pediatr Crit Care Med 10(1):96–105, 2008.

Honors

  • Helen B. Taussig Young Investigator Award, Johns Hopkins University School of Medicine (2004).
  • Letter of Commendation from the British Medical Journal in recognition for being among the Top 10 percent of Peer Reviewers.
  • Best Scientific Abstract by a Trainee, (Mentor), 7th Annual International Meeting on Simulation in Healthcare, Orlando, FL.