Researcher | Research Overview
Since joining Boston Children’s Hospital (BCH) in 2008, Dr. Rangel’s research efforts have focused on characterizing variation in practice, resource utilization and outcomes for high-volume pediatric surgical conditions with an emphasis on pediatric appendicitis. Practical applications of this work have included the development of novel, value-based comparative performance benchmarks for the prioritization of quality improvement (QI) efforts at the level of individual hospitals, and as a means to set national priorities for collaborative QI efforts. These benchmarks were used to develop the first automated and risk-adjusted comparative performance report card for appendicitis, one of the most common and resource-intensive surgical emergencies in the pediatric age group. This work subsequently led to the development and implementation of the first disease-specific, comparative-performance module for the American College of Surgeon’s Pediatric National Quality Improvement Program (NSQIP-P). Data from the module is currently distributed to over 70 hospitals nationally, and provides a benchmarking framework for an ongoing multi-center QI collaborative dedicated to improving care and value for children with this disease. Dr. Rangel is the recipient of multiple sources of intra & extra-mural funding in support of his QI work, including funding from the Agency for Healthcare Research and Quality (AHRQ), the Children’s Hospital Association, and the Patient-Centered Outcomes Research Initiative (PCORI).
Researcher | Research Background
Dr. Rangel received his MD from the University of California, San Francisco school of medicine and completed his internship and residency in general surgery at Stanford University Medical Center. During his time at Stanford, he took three years off from his surgical residency to obtain graduate training in Clinical Epidemiology through Stanford's Department of Health, Research and Policy. Once he completed his general surgery training, Dr. Rangel went on to complete a pediatric surgery fellowship at Cincinnati Children's Hospital before joining the staff at Children's Hospital Boston.
In addition to his research efforts, Dr. Rangel had advocated for improved quality and safety in the surgical care of children through his many local and national administrative efforts. At BCH, Dr. Rangel currently serves as the Director of QI and Patient Safety for the Department of Pediatric Surgery, serves a member of BCH’s Executive Steering Committee for Patient Safety & Quality Research, and as the hospital’s Surgeon Champion for NSQIP-P. At the national level, Dr. Rangel currently serves as chair of the American Pediatric Surgical Association’s Committee on Patient Safety & Quality, chair of NSQIP-P’s Measurement & Evaluation Committee, vice-chair of NSQIP-P’s Executive Steering Committee, and recently served as the inaugural chair of the American Academy of Pediatrics Section on Surgery’s Committee for the Delivery of Surgical Care.
At the national level, Dr. Rangel has also lectured broadly on the methods and implications of comparative performance measurement for driving QI in surgery, including meetings of the American College of Surgeon’s National Surgical Quality Improvement Program, American Pediatric Surgical Association, American Academy of Pediatrics, and the Children’s Hospital Association, among others. Dr. Rangel currently serve as an ad-hoc reviewer for QI & safety-related surgical research for a multitude of peer-reviewed journals including The Lancet , Annals of Surgery, and JAMA-Pediatrics, among others, and was recently recruited as the first and only surgeon to be standing member of the JAMA-Pediatrics editorial board.