Research Overview

Dr. McManus' work aims to identify, understand, and overcome access barriers to critical hospital services. He and colleagues use large datasets, simulation modeling, and systems research tools to solve complex problems in emergency departments, operating rooms, and intensive care units. His Robert Wood Johnson-funded research provided solutions for the ambulance diversion crisis in Massachusetts and subsequent studies of surgical scheduling improved access to intensive care units. Current work focuses on hospital capabilities, networks of care, and the differential impacts of health system change on children.

 

Research Background

Dr. McManus obtained his MD from Northwestern University and MPH in Health Policy and Management from the Harvard School of Public Health. He completed residencies in Pediatrics (Boston Children's Hospital) and Anesthesiology (Massachusetts General Hospital), followed by fellowship training in Pediatric Anesthesia and Critical Care (Boston Children's Hospital). He is currently a Senior Associate in Anesthesia and Critical Care at Boston Children's Hospital and Associate Professor at Harvard Medical School. Dr. McManus is past president of the Massachusetts Chapter of the AAP, member of the AAP Committee on State Government Affairs, and, during Massachusetts health care reform, served as the Governor’s pediatric representative on the Massachusetts Cost and Quality Council Advisory Committee.

 

Education

Medical School

Northwestern University Medical School
1986 Chicago IL

Internship

Boston Children's Hospital
1984 Boston MA

Residency

Pediatrics Boston Children's Hospital
1986 Boston MA

Residency

Anesthesia Boston Children's Hospital
1988 Boston MA

Residency

Anesthesiology Massachusetts General Hospital
1988 Boston MA

Fellowship

Pediatric Anesthesia Critical Care Boston Children's Hospital
1989 Boston MA

Graduate School

MPH Harvard School of Public Health
2001 Boston MA

Publications

  1. US Pediatric Inpatient Care Loss Before and During the COVID-19 Pandemic. JAMA Netw Open. 2024 Nov 04; 7(11):e2446025. View Abstract
  2. Pediatric Respiratory Syncytial Virus Hospitalizations and Respiratory Support After the COVID-19 Pandemic. JAMA Netw Open. 2024 Jun 03; 7(6):e2416852. View Abstract
  3. A National Survey of Pediatric Post-Acute Care Facilities. Pediatr Crit Care Med. 2024 Jun 01; 25(6):493-498. View Abstract
  4. Patterns in hospital admissions for adults with congenital heart disease for non-cardiac procedures. Open Heart. 2023 09; 10(2). View Abstract
  5. Hospital Access Patterns of Children With Technology Dependence. Pediatrics. 2023 03 20; 151(4). View Abstract
  6. Neighborhood Poverty and Distance to Pediatric Hospital Care. Acad Pediatr. 2023 08; 23(6):1276-1281. View Abstract
  7. Patients With Congenital Heart Disease Undergoing Noncardiac Procedures at Hospitals With and Without a Cardiac Surgical Program. J Am Heart Assoc. 2022 08 02; 11(15):e026267. View Abstract
  8. Impact of Allocation on Survival During Intermittent Chemotherapy Shortages: A Modeling Analysis. J Natl Compr Canc Netw. 2022 04; 20(4):335-341.e17. View Abstract
  9. Supraventricular Tachycardia in Infants With Congenital Diaphragmatic Hernia: Prevalence, Associations, and Outcomes. Pediatr Crit Care Med. 2022 07 01; 23(7):e329-e337. View Abstract
  10. Socioeconomic Disadvantage and Distance to Pediatric Critical Care. Pediatr Crit Care Med. 2021 12 01; 22(12):1033-1041. View Abstract
  11. Coagulations Studies Do Not Correlate With Each Other or With Hematologic Complications During Pediatric Extracorporeal Membrane Oxygenation. Pediatr Crit Care Med. 2021 06 01; 22(6):542-552. View Abstract
  12. Availability of Inpatient Pediatric Surgery in the United States. Anesthesiology. 2021 06 01; 134(6):852-861. View Abstract
  13. Opportunities for Restructuring Hospital Transfer Networks for Pediatric Asthma. Acad Pediatr. 2022 Jan-Feb; 22(1):29-36. View Abstract
  14. Trends in the Use of Noninvasive and Invasive Ventilation for Severe Asthma. Pediatrics. 2020 10; 146(4). View Abstract
  15. An Approach to Consolidating Pediatric Hospital Beds During the COVID-19 Surge. Pediatrics. 2020 08; 146(2). View Abstract
  16. Assessment of Acute Hospital Use and Transfers for Management of Pediatric Seizures. JAMA Netw Open. 2020 04 01; 3(4):e203148. View Abstract
  17. Inadequate oxygen delivery index dose is associated with cardiac arrest risk in neonates following cardiopulmonary bypass surgery. Resuscitation. 2019 09; 142:74-80. View Abstract
  18. Visualizing Patterns in Pediatric and Adult Hospital Care. Hosp Pediatr. 2019 05; 9(5):398-401. View Abstract
  19. Pre-Nusinersen Hospitalization Costs of Children With Spinal Muscular Atrophy. Pediatr Neurol. 2019 03; 92:3-5. View Abstract
  20. Outcomes of Hospital Transfers for Pediatric Abdominal Pain and Appendicitis. JAMA Netw Open. 2018 10 05; 1(6):e183249. View Abstract
  21. Pediatric Specialty Care Model for Management of Chronic Respiratory Failure: Cost and Savings Implications and Misalignment With Payment Models. Pediatr Crit Care Med. 2018 05; 19(5):412-420. View Abstract
  22. Frequency, trends, and antecedents of severe maternal depression after three million U.S. births. PLoS One. 2018; 13(2):e0192854. View Abstract
  23. Trends in Regionalization of Hospital Care for Common Pediatric Conditions. Pediatrics. 2018 01; 141(1). View Abstract
  24. Availability of Definitive Hospital Care for Children. JAMA Pediatr. 2017 09 05; 171(9):e171096. View Abstract
  25. Feasibility and utility of an integrated medical imaging and informatics smartphone system for management of acute stroke. Int J Stroke. 2017 12; 12(9):953-960. View Abstract
  26. Transfer Frequency as a Measure of Hospital Capability and Regionalization. Health Serv Res. 2017 12; 52(6):2237-2255. View Abstract
  27. Medical Versus Nonmedical Immunization Exemptions for Child Care and School Attendance. Pediatrics. 2016 09; 138(3). View Abstract
  28. Chronic respiratory failure: Utilization of a pediatric specialty integrated care program. Healthc (Amst). 2017 Mar; 5(1-2):23-28. View Abstract
  29. Shifting Goals in Operating Room Management. A A Case Rep. 2016 Mar 15; 6(6):181-2. View Abstract
  30. The Growing Burden of Neonatal Opiate Exposure on Children and Family Services in Massachusetts. Child Maltreat. 2016 Feb; 21(1):80-4. View Abstract
  31. The nature and sources of variability in pediatric surgical case duration. Paediatr Anaesth. 2015 Oct; 25(10):999-1006. View Abstract
  32. Trial of telemedicine for patients on home ventilator support: feasibility, confidence in clinical management and use in medical decision-making. J Telemed Telecare. 2014 Dec; 20(8):441-9. View Abstract
  33. Pediatric neurocritical care: a neurology consultation model and implication for education and training. Pediatr Neurol. 2013 Mar; 48(3):206-11. View Abstract
  34. Eastern equine encephalitis in children, Massachusetts and New Hampshire,USA, 1970-2010. Emerg Infect Dis. 2013 Feb; 19(2):194-201; quiz 352. View Abstract
  35. Parameters of care for craniosynostosis. Cleft Palate Craniofac J. 2012 Jan; 49 Suppl:1S-24S. View Abstract
  36. Neuropathology of a fatal case of posterior reversible encephalopathy syndrome. Pediatr Dev Pathol. 2010 Sep-Oct; 13(5):397-403. View Abstract
  37. Design and implementation of a portable physiologic data acquisition system. Pediatr Crit Care Med. 2007 Nov; 8(6):563-9. View Abstract
  38. Total phenytoin concentrations do not accurately predict free phenytoin concentrations in critically ill children. Pediatr Crit Care Med. 2006 Sep; 7(5):434-9; quiz 440. View Abstract
  39. Managing unnecessary variability in patient demand to reduce nursing stress and improve patient safety. Jt Comm J Qual Patient Saf. 2005 Jun; 31(6):330-8. View Abstract
  40. Basilar meningitis associated with ethmoid and sphenoid cephaloceles. Pediatr Neurol. 2005 Jul; 33(1):57-60. View Abstract
  41. Perioperative management of diabetes insipidus in children. J Neurosurg Anesthesiol. 2004 Jul; 16(3):220-5. View Abstract
  42. Queuing theory accurately models the need for critical care resources. Anesthesiology. 2004 May; 100(5):1271-6. View Abstract
  43. Perioperative management of diabetes insipidus in children [corrected]. J Neurosurg Anesthesiol. 2004 Jan; 16(1):14-9. View Abstract
  44. Variability in surgical caseload and access to intensive care services. Anesthesiology. 2003 Jun; 98(6):1491-6. View Abstract
  45. Root Cause Analysis of Emergency Department Crowding and Ambulance Diversion in Massachusetts. A report submitted by the Boston University Program for the Management of Variability in Health Care Delivery under a grant from the Massachusetts Department of Public Health. 2002. View Abstract
  46. Emergency department diversion: causes and solutions. Acad Emerg Med. 2001 Nov; 8(11):1108-10. View Abstract
  47. Emergency department overcrowding in Massachusetts: making room in our hospitals. Issue Brief (Mass Health Policy Forum). 2001 Jun 07; (12):1-38. View Abstract
  48. Rebound swelling of astroglial cells exposed to hypertonic mannitol. Anesthesiology. 1998 Jun; 88(6):1586-91. View Abstract
  49. Intracellular electrolytes regulate the volume set point of the organic osmolyte/anion channel VSOAC. Am J Physiol. 1997 Jun; 272(6 Pt 1):C1766-75. View Abstract
  50. Cerebral blood flow velocity after mannitol infusion in children. Can J Anaesth. 1996 May; 43(5 Pt 1):461-6. View Abstract
  51. Regulation of cell volume in health and disease. N Engl J Med. 1995 Nov 09; 333(19):1260-6. View Abstract
  52. Coagulation factor deficiencies during initiation of extracorporeal membrane oxygenation. J Pediatr. 1995 Jun; 126(6):900-4. View Abstract
  53. Intensive blood and plasma exchange for treatment of coagulopathy in meningococcemia. J Clin Apher. 1995; 10(4):171-7. View Abstract
  54. Doppler sensor placement during neurosurgical procedures for children in the prone position. J Neurosurg Anesthesiol. 1994 Jul; 6(3):153-5. View Abstract
  55. Ketoconazole blocks organic osmolyte efflux independently of its effect on arachidonic acid conversion. Am J Physiol. 1994 Jul; 267(1 Pt 1):C266-71. View Abstract
  56. Laser light-scattering system for studying cell volume regulation and membrane transport processes. Am J Physiol. 1993 Aug; 265(2 Pt 1):C562-70. View Abstract
  57. Acute volume regulation of brain cells in response to hypertonic challenge. Anesthesiology. 1993 Jun; 78(6):1132-7. View Abstract
  58. Coagulopathy as a predictor of outcome in meningococcal sepsis and the systemic inflammatory response syndrome with purpura. Crit Care Med. 1993 May; 21(5):706-11. View Abstract
  59. Osmoregulation of Na(+)-inositol cotransporter activity and mRNA levels in brain glial cells. Am J Physiol. 1992 Dec; 263(6 Pt 1):C1282-8. View Abstract
  60. Use of topically applied nitroglycerin in the treatment of purpura fulminans. J Pediatr. 1990 Dec; 117(6):993-5. View Abstract

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