Bio

Clinical Focus


  • Pain and Symptom Management
  • Palliative Care
  • Acupuncture
  • General Pediatrics
  • Pediatrics

Academic Appointments


Administrative Appointments


  • Faculty Mentor, Hospital Wide Pain Management/Palliative Care Committee, Stanford Children's Health (2017 - Present)
  • Pharmacy and Therapeutics Committee, Stanford Children's Health (2015 - Present)
  • Pain Satisfaction Executive Committee, Lucile Packard Children's Hospital (2012 - 2015)
  • Co-Chair, Art and Anesthesia Committee, Stanford University Department of Anesthesiology, Perioperative and Pain Medicine (2011 - Present)
  • CVICU Comfort Task Force, Lucile Packard Children's Hospital (2006 - 2013)
  • Co-Chair Sedation Committee, Lucile Packard Children's Hospital (2001 - 2004)
  • Sedation Committee, Lucile Packard Children's Hospital (2001 - 2004)
  • Patient Safety Committee, Lucile Packard Children's Hospital (2000 - 2003)
  • Pain Management Committee, Lucile Packard Children's Hospital (2000 - 2002)
  • Ethics Committee, Lucile Packard Children's Hospital (1999 - Present)
  • Palliative Care Committee, Lucile Packard Children's Hospital (1998 - Present)

Boards, Advisory Committees, Professional Organizations


  • Treasurer, Children's Center of Stanford Community (2017 - Present)
  • Appointed Member, Quality Task Force, American Pain Society (2014 - Present)

Professional Education


  • Fellowship:Stanford University School of Medicine Registrar (2000) CA
  • Residency:Stanford University School of Medicine Registrar (1999) CA
  • Board Certification: Pediatrics, American Board of Pediatrics (1999)
  • Board Certification: Hospice and Palliative Medicine, American Board of Pediatrics (2008)
  • Board Certification, American Board of Pediatrics, Hospice and Palliative Medicine (2008)
  • DABMA, AAMA, Medical Acupuncture (2003)
  • MD, University of Minnesota, Medicine (1996)
  • Fellowship, Stanford University, Pediatric Pain Management (2000)
  • Residency, Stanford Hospital and Clinics, Pediatrics (1999)
  • Medical Education:University of Minnesota School of Medicine (1996) MN

Community and International Work


  • Board of Directors, Children's Center of Stanford Community, Stanford University

    Topic

    Center Leadership

    Location

    Bay Area

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    No

  • Exploring a Sense of Place, San Francisquito Creek Watershed

    Topic

    local bioregion, nature and self discovery

    Partnering Organization(s)

    Foundation for Global Community/Connextions

    Populations Served

    local citizens

    Location

    Bay Area

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • GirlVentures Risk Management Committee, San Francisco

    Topic

    girls self-esteem building organization, adventure experiences in the outdoors

    Populations Served

    middle/high school girls

    Location

    Bay Area

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

  • Papua New Guinea Medical Mission

    Topic

    health care/teaching

    Populations Served

    Sepik River People

    Location

    International

    Ongoing Project

    Yes

    Opportunities for Student Involvement

    Yes

Research & Scholarship

Current Research and Scholarly Interests


Julie's academic interests include pediatric palliative care, pain and symptom management for children with life-threatening illness, medical acupuncture, and meaning in medicine (the humanistic side of doctoring)

Teaching

2018-19 Courses


Graduate and Fellowship Programs


  • Developmental-Behavioral Pediatrics (Fellowship Program)
  • Hospice & Palliative Medicine (Fellowship Program)
  • Pain Management (Fellowship Program)
  • Pediatric Anesthesia (Fellowship Program)
  • Pediatric Cardiology (Fellowship Program)
  • Pediatric Critical Care Medicine (Fellowship Program)
  • Pediatric Hem/Onc (Fellowship Program)

Publications

All Publications


  • Improving Satisfaction with Pediatric Pain Management by Inviting the Conversation. Joint Commission journal on quality and patient safety Caruso, T. J., Kung, T. H., Good, J., Taylor, K., Ashland, M., Cunningham, C., Gonzalez, E., Wood, M., Sharek, P. 2018; 44 (4): 227–32

    Abstract

    Patient satisfaction with pain management is associated with improved patient adherence to medical management and efficient service utilization. Pediatric pain control is challenging, given the inability to elicit reliable histories, particularly in younger patients. Several studies have suggested that communication surrounding pain management can improve satisfaction, although there are limited data describing structured interventions with measurable outcomes. A quality improvement project was conducted to determine if reliably asking families about pain management was associated with improved patient satisfaction with pain management.In an academic pediatric hospital, nurse manager rounds were used to invite a conversation about pain management. The question, "Pain management is very important to us. Has your child's pain been well controlled?" was added to the established standard questions asked during nurse manager rounds. Effectiveness was measured using the preexisting Press Ganey survey question, "How well was your child's pain controlled?" Responses were compared between those patients who were and were not exposed to the rounding question.Data for 1,032 patients were used to establish baseline satisfaction with pain management scores. In the intervention period, 328 patients received nurse manager rounds and 121 did not. The median of the weighted mean patient survey satisfaction scores were baseline, 91.5%; receiving intervention, 94.2%; and not receiving intervention, 90.0%. Patients who received the intervention reported higher satisfaction with pain management than those who did not (p <0.0001).Hospitals seeking to improve satisfaction with pain management should encourage health care providers to reliably discuss pain control with pediatric patients.

    View details for DOI 10.1016/j.jcjq.2017.10.003

    View details for PubMedID 29579448

  • Training Pediatric Fellows in Palliative Care: A Pilot Comparison of Simulation Training and Didactic Education. Journal of palliative medicine Brock, K. E., Cohen, H. J., Sourkes, B. M., Good, J. J., Halamek, L. P. 2017

    Abstract

    Pediatric fellows receive little palliative care (PC) education and have few opportunities to practice communication skills.In this pilot study, we assessed (1) the relative effectiveness of simulation-based versus didactic education, (2) communication skill retention, and (3) effect on PC consultation rates.Thirty-five pediatric fellows in cardiology, critical care, hematology/oncology, and neonatology at two institutions enrolled: 17 in the intervention (simulation-based) group (single institution) and 18 in the control (didactic education) group (second institution). Intervention group participants participated in a two-day program over three months (three simulations and videotaped PC panel). Control group participants received written education designed to be similar in content and time.(1) Self-assessment questionnaires were completed at baseline, post-intervention and three months; mean between-group differences for each outcome measure were assessed. (2) External reviewers rated simulation-group encounters on nine communication domains. Within-group changes over time were assessed. (3) The simulation-based site's PC consultations were compared in the six months pre- and post-intervention.Compared to the control group, participants in the intervention group improved in self-efficacy (p = 0.003) and perceived adequacy of medical education (p < 0.001), but not knowledge (p = 0.20). Reviewers noted nonsustained improvement in four domains: relationship building (p = 0.01), opening discussion (p = 0.03), gathering information (p = 0.01), and communicating accurate information (p = 0.04). PC consultation rate increased 64%, an improvement when normalized to average daily census (p = 0.04).This simulation-based curriculum is an effective method for improving PC comfort, education, and consults. More frequent practice is likely needed to lead to sustained improvements in communication competence.

    View details for DOI 10.1089/jpm.2016.0556

    View details for PubMedID 28436742

  • Pain care for patients with epidermolysis bullosa: best care practice guidelines BMC MEDICINE Goldschneider, K. R., Good, J., Harrop, E., Liossi, C., Lynch-Jordan, A., Martinez, A. E., Maxwell, L. G., Stanko-Lopp, D. 2014; 12
  • The Stanford Arts and Anesthesia Soiree: Performing to create community and understand anesthesiology Creative Arts in Humane Medicine Ed. McLean CL Chen, C., Hasan, N., Good, J., Shafer, A. Brush Education Inc.. 2014: pp. 76–81
  • Pain care for patients with epidermolysis bullosa: best care practice guidelines. BMC medicine Goldschneider, K. R., Good, J., Harrop, E., Liossi, C., Lynch-Jordan, A., Martinez, A. E., Maxwell, L. G., Stanko-Lopp, D. 2014; 12: 178-?

    Abstract

    Inherited epidermolysis bullosa (EB) comprises a group of rare disorders that have multi-system effects and patients present with a number of both acute and chronic pain care needs. Effects on quality of life are substantial. Pain and itching are burdensome daily problems. Experience with, and knowledge of, the best pain and itch care for these patients is minimal. Evidence-based best care practice guidelines are needed to establish a base of knowledge and practice for practitioners of many disciplines to improve the quality of life for both adult and pediatric patients with EB.The process was begun at the request of Dystrophic Epidermolysis Bullosa Research Association International (DEBRA International), an organization dedicated to improvement of care, research and dissemination of knowledge for EB patients worldwide. An international panel of experts in pain and palliative care who have extensive experience caring for patients with EB was assembled. Literature was reviewed and systematically evaluated. For areas of care without direct evidence, clinically relevant literature was assessed, and rounds of consensus building were conducted. The process involved a face-to-face consensus meeting that involved a family representative and methodologist, as well as the panel of clinical experts. During development, EB family input was obtained and the document was reviewed by a wide variety of experts representing several disciplines related to the care of patients with EB.The first evidence-based care guidelines for the care of pain in EB were produced. The guidelines are clinically relevant for care of patients of all subtypes and ages, and apply to practitioners of all disciplines involved in the care of patients with EB. When the evidence suggests that the diagnosis or treatment of painful conditions differs between adults and children, it will be so noted.Evidence-based care guidelines are a means of standardizing optimal care for EB patients, whose disease is often times horrific in its effects on quality of life, and whose care is resource-intensive and difficult. The guideline development process also highlighted areas for research in order to improve further the evidence base for future care.

    View details for DOI 10.1186/s12916-014-0178-2

    View details for PubMedID 25603875

  • Psychiatric medications for the treatment of pruritus Conference on the Futute of Psychiatric Diagnosis - Refining the Research Agenda Shaw, R. J., Dayal, S., Good, J., Bruckner, A. L., Joshi, S. V. LIPPINCOTT WILLIAMS & WILKINS. 2007: 970–78

    Abstract

    To review the use of psychiatric medications in the treatment of pruritus.A literature review was conducted using the key words pruritus, psychiatric, and treatment.Three categories of pruritus are described: dermatologic, systemic, and psychogenic. Peripheral and central nervous system mechanisms of pruritus are reviewed. Conventional dermatologic treatments for pruritus are contrasted with some of the common psychopharmacologic treatment modalities that include anxiolytic, antidepressant, and antipsychotic agents. A treatment algorithm is offered to help guide the treatment of patients with pruritus.Psychiatric medications have been used successfully in the treatment of pruritus that is associated with both psychocutaneous and systemic disorders, which are resistant to conventional treatment.

    View details for DOI 10.1097/PSY.0b013e3181572799

    View details for Web of Science ID 000251204900024

    View details for PubMedID 17991825

  • Improved pain management in pediatric postoperative liver transplant patients using parental education and non-pharmacologic interventions PEDIATRIC TRANSPLANTATION Sharek, P. J., Wayman, K., Lin, E., Strichartz, D., Sentivany-Collins, S., Good, J., Esquivel, C., Brown, M., Cox, K. 2006; 10 (2): 172-177

    Abstract

    A pain management intervention, consisting of pretransplant parental education and support, pre- and postoperative behavioral pediatrics consultation, postoperative physical and occupational therapy consultation, and implementation of non-pharmacologic pain management strategies, was introduced to all pediatrics patients receiving liver transplants at Lucile Packard Children's Hospital beginning August 2001. Children receiving transplants pre-intervention (May, 2000 to February, 2001) and post-intervention (August, 2001 to March, 2002) were compared using pain scores, parent perception of pain ratings, length of stay, ventilator days, total cost, and opioid use. A total of 27 children were evaluated (13 historical control, 14 intervention). The two populations did not differ on age at transplant (mean age 53.8 vs. 63.6 months), sex (46.1% vs. 50% male), ethnicity (53.8% vs. 57.1% white, non-Hispanic) weight at transplant (17.5 vs. 24.7 kg), percent with biliary atresia as the primary reason for transplant (42.9% vs. 69.2%), percent with status 1 transplant listing score (38.5% vs. 50.0%), or public insurance status (30.8 vs. 57.2% with Medicaid). No differences were found in mean pediatric intensive care unit (PICU) postoperative length of stay (6.7 vs. 5.3 days), total postoperative length of stay (17.5 vs. 17.5 days), total inpatient length of stay (27.0 vs. 24.4 days), time to extubation (30 vs. 24.3 h), total cost (dollar 147,983 vs. dollar 157,882) or opioid use through postoperative day (POD) 6 (0.24 vs. 0.25 mg/kg/day morphine equivalent). A decrease in mean pain score between POD 0 and 6 (2.82 vs. 2.12; p = 0.047), a decrease in mean parental pain perception score (3.1 vs. 2.1; p = 0.001), and an increase in number of pain assessments per 12 h shift (3.43 vs. 6.79; p < 0.005) were seen. A comprehensive non-pharmacologic postoperative pain management program in children receiving a liver transplant was associated with decreased pain scores, improved parent perception of pain, and an increased number of pain assessments per 12 h shift. No increases in lengths of stay (PICU, postoperative, total), time to extubation, or total cost were found.

    View details for DOI 10.1111/j.1399-3046.2005.00438.x

    View details for Web of Science ID 000236026400011

    View details for PubMedID 16573603

  • Food, toys, and love: pediatric palliative care. Current problems in pediatric and adolescent health care Sourkes, B., Frankel, L., Brown, M., Contro, N., Benitz, W., Case, C., Good, J., Jones, L., Komejan, J., Modderman-Marshall, J., Reichard, W., Sentivany-Collins, S., Sunde, C. 2005; 35 (9): 350-386

    View details for PubMedID 16301200