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Evan S. Fieldston, MD, MBA, MSHP
Attending Physician
Dr. Fieldston focuses on evidence-based management aimed at delivering high-value care and the impact of operational issues on patient outcomes. His academic work included investigating associations between patient flow, care models, workload and occupancy levels, and resource utilization on the quality of healthcare delivered to children, particularly those in the hospital, as well as healthcare value and value education.
Bio
Dr. Fieldston's operational and academic work align with evidence-based management, which is the infrastructure in which evidence-based medicine is delivered. The common themes that distinguish and unify this work bring together three domains of scholarship: resource utilization and operational issues; socioeconomic determinants of workload and outcomes in pediatric healthcare; and, healthcare value and value education. Taken together, these foci align with the concepts of the learning health system, seeking to improve the care patients receive, notably by turning attention to the structures and processes in which it is delivered.
Dr. Fieldston has analyzed and published on topics including patient flow, resource utilization and impact of socioeconomic status, readmissions, as well as quality, cost and value educational programming. One example of this learning health system concept in action includes work to develop tools to help clinical and administrative leadership better track demand for hospital services, the strain it places on staff and facilities, and how that demand and strain impacts performance and clinical outcomes. Since workload can be viewed through many lenses, Dr. Fieldston has collaborated with others to consider it through resource utilization analyses with large datasets (such as the Pediatric Health Information System [PHIS]), local data from CHOP; direct observations of care and patient needs, with the input of human factors engineering experts; and from the perspective of quality, cost and value. This latter approach also brings in educational activities around cost and value, including research on the impact of such training on attitudes and knowledge about cost and value.
Dr. Fieldston was supported with research funding from the Society of Hospital Medicine (SHM) and the Agency for Healthcare Research and Quality (AHRQ). Recent publications include studies on resource utilization, readmissions, and healthcare finance and value. He is on the editorial board of Hospital Pediatrics and Academic Pediatrics.
Education and Training
AB, Princeton University (Public Policy), 1998
MD, University of Pennsylvania School of Medicine, 2003
MBA, Wharton School, University of Pennsylvania (Health Care Administration), 2003
MS, University of Pennsylvania (Health Policy Research), 2009
Titles and Academic Titles
Attending Physician
Associate Professor of Pediatrics
Associate Chief Medical Officer for University City
Professional Memberships
American Medical Association, 1999-
Alpha Omega Alpha Medical Honor Society, 2003-
Academic Pediatric Association, 2009-
Eastern Society for Pediatric Research, 2009-
Society for Hospital Medicine, 2009-
Society for Pediatric Research, 2011-
Professional Awards
Nancy Elizabeth Barnhart Award & Honorarium for Dedicated Efforts to Improve Health and Well Being of Children in the Community, Children's Hospital of Philadelphia, 2006
Outstanding Advocate Achievement Award, Children's Hospital of Philadelphia, 2006
Young Investigator's Travel Award, Pediatric Academic Societies, 2009
Junior Faculty Development Award, Society of Hospital Medicine, 2010
Pediatric Hospital Medicine Research Excellence Award, 2015
Physician Partnering Award, Children's Hospital of Philadelphia Department of Nursing, Respiratory, and Neurodiagnostics, 2018
Publication Highlights
Pubmed:
Jonas JA, Shah SS, Zaniletti I, Hall M, Colvin JD, Gottlieb LM, Sills MR, Bettenhausen J, Morse RB, Macy ML, Fieldston ES. Regional Variation in Standardized Costs of Care at Children's Hospitals. J Hosp Med. 2017 Oct; 12(10):818-825. PMID: 28991947
Fieldston ES, Zaniletti I, Hall M, Colvin JD, Gottlieb L, Macy ML, Alpern ER, Morse RB, Hain PD, Sills MR, Frank G, Shah SS. Community household income and resource utilization for common inpatient pediatric conditions. Pediatrics. 2013 Dec; 132(6):e1592-601. PMID: 24276839
Fieldston ES, Shah SS, Hall M, Hain PD, Alpern ER, Del Beccaro MA, Harding J, Macy ML. Resource utilization for observation-status stays at children's hospitals. Pediatrics. 2013 Jun; 131(6):1050-8. PMID: 23669520
Rock TA, Xiao R, Fieldston ES. General pediatric attending physicians' and residents' knowledge of inpatient hospital finances. Pediatrics. 2013 Jan; 131(6):1072-80. PMID: 23713110
Morse RB, Hall M, Fieldston ES, McGwire G, Anspacher M, Sills MR, Williams K, Oyemwense N, Mann KJ, Simon HK, Shah SS. Hospital-level compliance with asthma care quality measures at children's hospitals and subsequent asthma-related outcomes. JAMA. 2011 Oct; 306(13):1454-60. PMID: 21972307