Pediatric Resource Group is led by pediatricians who’ve decided to use their years of experience operationalizing safe and efficient pediatric care to help other organizations optimize their system for emergency and hospital care.
PRG is solely focused on pediatrics and our team has decades of experience working in academic medical centers, community hospitals, freestanding children’s hospitals, hospitals within larger health systems, and pediatric units within adult hospitals.
When needed, PRG will also partner with other coding & CDI experts, utilization management & ED RN leaders, general ED physicians, physician advisors, project managers, and data scientists to provide a comprehensive service for your organization. Depending on the specific needs of your hospital, PRG will deploy the team best suited for your organizational goals.
Since we don’t just consult on it, but also live it, we can leverage that credibility for a more meaningful and sustained impact on your physicians and staff.
Founder & CEO
Ara Balkian, MD, MBA
Ara Balkian, MD, MBA, is the founder and CEO of Pediatric Resource Group (PRG). He was the first hospitalist at Children’s Hospital Los Angeles (CHLA) and was the Associate Head of the Division of Hospital Medicine and the Associate Chair for the Department of Pediatrics until he took on his current role of Chief Medical Director of Inpatient Operations.
In that role, he has leadership over the Inpatient Access & Transfer Center, which is responsible for the handling of almost 18,000 admissions a year. He also leads the hospital's utilization management (UM) program and chairs the UM committee. He is the medical director for inpatient care coordination and leads CHLA’s throughput management efforts and led the organization through a major change in 2013 (with a significant reduction in length-of-stay) when California’s Medicaid program moved to the APR-DRG reimbursement model. He helped develop and leads the Clinical Documentation Improvement (CDI) program with a 100% physician response rate since program inception. He developed and leads the Physician Advisor program and the Denials Management program. He has worked closely with the emergency department on performance improvement efforts, particularly as it relates to collaborative and seamless care between the ED and other departments/divisions in the hospital.
He has lectured nationally on topics related to hospital reimbursement, CDI, denials management, and pediatric physician advisor program development. He continues to see patients and teach trainees as a pediatric hospitalist and his research interests are focused on the efficient delivery of inpatient pediatric care. He also holds a faculty position at the Keck School of Medicine at the University of Southern California as an Associate Professor of Clinical Pediatrics.
The driving force for starting PRG is his desire to leverage his experience and team of experts to positively affect pediatric organizations around the country with the ultimate goal of expanding and improving the care provided to children.
Wendy Arafiles, MD
Dr. Wendy Arafiles has been a practicing pediatric hospitalist at Phoenix Children’s for over 15 years with a specific interest in children with medical complexity and technology dependence.
She has also filled the role of medical director of the Clinical Documentation Integrity (CDI) program since 2018. In her dual roles, she is intertwining skills in medical education, innovations in quality improvement for children with medical complexity, and foundational understanding of hospital finance.
Her goals are to optimize the institution’s ability to describe the complexity of the patient population and develop high-value programs in patient and family service. Dr. Arafiles has presented on both CDI and Medical Complexity topics at several national conferences, and she is an active member of the Pediatric Documentation Research Collaborative, a research group that focuses on documentation-related issues in pediatric hospitals.
Matthew Baker, MD
Matthew Baker, MD, is a critical care physician at Children’s Hospital Colorado. He received his medical degree from George Washington School of Medicine in Washington DC, and then completed pediatric residency training and a chief resident year at Children’s Hospital Los Angeles.
Dr. Baker is actively involved in medical education to medical students, interns, residents, and fellows. He has lectured extensively on a variety of pediatric topics involving outpatient and inpatient pediatrics.
He has been involved in several quality improvement initiatives including targeting overuse of oseltamivir in the emergency department setting and preventing delirium in the pediatric critical care unit.
His current research interests involve hospital resource utilization and optimization, specifically how resource strain caused by shifts in patient volumes and acuity impact healthcare outcomes. These projects and others have been presented at conferences across the country including Pediatric Academic Societies and American Academy of Pediatrics and have also been published in Peds in Review and other peer-reviewed publications.
As for his administrative pursuits, he hopes to expand pediatric critical care resource availability to rural communities across the country through the use of real-time telemedicine consultation and offshoot ICU development.
Sheldon Berkowitz, MD, FAAP
Sheldon Berkowitz, MD, FAAP has recently retired after a 38-year career as a Pediatrician (having done both Primary Care and Hospitalist work) and an 8-year career as Medical Director (Physician Advisor) for Case Management, Utilization Management, and Clinical Documentation Improvement (CDI) at Children’s Minnesota, which is a free-standing, tertiary children’s hospital serving the upper Midwest. He had worked at Children’s since 2001 and in July 2014 was asked to be Children’s first Physician Advisor and to help develop the program.
In his role as Medical Director (name change in 2016 to reflect the broader responsibilities in the job), he supported the hospital’s inpatient case managers in assessing admission status as well as assisting in discharge planning when barriers were encountered. In addition, he handled all insurance denials for inpatient status or lack of medical necessity and was successful in getting the majority of those overturned. He also supported the CDI department in getting clinicians to answer documentation queries as well as helping to develop documentation guidelines (e.g. Acute Respiratory Failure and Malnutrition). Finally, he co-chaired the Utilization Management Committee as it oversaw all issues of utilization.
Dr. Berkowitz has lectured nationally on various topics dealing with case management and CDI. He is also a Clinical Assistant Professor of Pediatrics at the University of Minnesota.
Dr. Berkowitz has a long-standing interest in Bioethics and was a member of the hospital’s Ethics committee for over 34 years and has written and lectured on various Ethics topics both locally and nationally. Dr. Berkowitz is the Past President of the Minnesota Chapter of the American Academy of Pediatrics.
Douglas Carlson, MD
Douglas Carlson, MD is the Chair and Professor of Pediatrics at Southern Illinois University School of Medicine and the Medical Director of HSHS St. John’s Children’s Hospital. He is board-certified in Pediatric Hospital Medicine and Pediatric Emergency Medicine. Dr. Carlson has established and improved pediatric hospital medicine programs in a large children’s hospital, in community hospitals and currently in a children’s hospital within a large general hospital. He has worked in both academic and nonacademic environments. He was previously the Associate CMO for Patient Safety and Clinical Quality at St. Louis Children’s Hospital.
Dr. Carlson has extensive experience in developing care delivery systems. His experience as both a pediatric emergency physician and pediatric hospitalist helps develop an insight on delivering effective, safe, equitable, efficient, timely and family centered care from an ED visit or direct admission through discharge planning. Dr. Carlson has provided consultative services in many types of delivery systems, including newborn care.
Dr. Carlson is recognized internationally for his work in developing pediatric sedation programs. He is a founding member of the International Committee for the Advancement of Procedural Sedation. Dr. Carlson has worked with many types of hospitals in developing pediatric sedation programs including skill development, maintenance of skills and credentialing of providers.
Daxa Clarke, MD
Dr. Daxa Clarke is the Chief Medical Information Officer and a Pediatric Hospitalist at Phoenix Children’s Hospital. As the CMIO, she is involved in projects that leverage IT resources to affect change in physician workflows, clinical documentation, utilization management, patient safety, and quality.
Previously, she was the Medical Director for Clinical Documentation Improvement/Utilization Management (CDI/UM) at Phoenix Children’s Hospital. As Medical Director of CDI, Dr. Clarke has provided education to medical staff and house officers on CDI, DRGs, CC/MCCs, SOI changes, audits, and denial management. She led the hospital’s efforts for continuous monitoring for CDI queries using programming logic. She developed several documentation guidelines, leading change in the hospital’s diagnosis capture rates. In these endeavors, she has engaged the medical staff in transforming clinical documentation and developed recognition programs to reinforce positive change.
As Medical Director of UM, Dr. Clarke has been involved in medical necessity assignments, peer-to-peer discussions and appeals, and overall length of stay management and utilization review. She chaired the Utilization Management Review Committee for the hospital. She has been involved in all levels of denial management related to level of care assignments and DRG assignments, including active involvement in contract discussions. She has been involved in the redesign of the hospital’s Call Center, helping to create workflows for the acceptance of patients from outlying clinics and EDs, admissions from PCP offices, transfers from outside hospitals needing higher level of care, and admissions internally from the hospital’s ED.
Dr. Clarke is an Associate Professor of Pediatrics at the University of Arizona College of Medicine—Phoenix and continues to practice as a pediatric hospitalist. She has previously served as the Clerkship Director for Pediatrics for the medical school. She also developed, and previously led, the Fellowship Program for Pediatric Hospital Medicine at Phoenix Children’s Hospital. She is board certified in Pediatrics, Pediatric Hospital Medicine, and Clinical Informatics.
Denise Goodman, MD
Denise M. Goodman, MD, MS, FCCM is a board-certified pediatric intensivist, Senior Physician Advisor, and Co-Chair, Utilization Review at Ann & Robert H. Lurie Children’s Hospital of Chicago. In that role she has oversight of utilization management, denials management, and multiple operational initiatives including discharge efficiency, throughput, status determination, observation management, out-of-network processes, and prior authorization among others. She now leads a team of 4 other physician advisors focused on enterprise-wide process improvement aimed at providing effective, equitable, safe, family-centered care.
Dr. Goodman is also the inaugural chair of the Pediatric Committee of the American College of Physician Advisors, and is recognized as a leader in developing physician advisor programs in pediatrics.
Dr. Goodman is a Professor at Northwestern University Feinberg School of Medicine. Clinically, Dr. Goodman is Medical Director of the Pulmonary Habilitation Program, a large clinical program for children receiving invasive home mechanical ventilation via tracheostomy. She continues to publish widely in the areas of critical care practice and in the care of children with medical complexity. She has previously been a fellowship program director both for the Lurie program and national chair of pediatric critical care fellowships.
Howard Jeffries, MD, MPH, MBA
Howard E. Jeffries, MD, MBA, is a Pediatric Cardiac Intensivist and the Senior Medical Director of the Regional Network at Seattle Children’s Hospital. He has worked at Seattle Children’s since 2004 and has had multiple leadership roles that have spanned quality improvement, lean healthcare transformation, strategic planning, and the development of the Seattle Children’s Care Network. In his current role, he leads Seattle Children’s clinical efforts across the states of Washington, Montana, Alaska, and Idaho. This includes partnerships and affiliations with multiple hospital organizations across the region in which Seattle Children’s provides specialty care in neonatal intensive care units, pediatric hospital medicine wards as well as in ambulatory settings. Patients outside of the Seattle area represent more than half of the annual clinical volume and revenue for Seattle Children’s.
He is board-certified in pediatrics and pediatric critical care medicine. He has edited textbooks on lean transformation in healthcare and has lectured and published in the areas of quality improvement and clinical transformation, quality metrics, cardiac intensive care, informatics, and outcomes assessment.
He is the co-founder of BlueBin, a healthcare supply chain consultancy. BlueBin provides world-class supply chain solutions for healthcare institutions based on lean healthcare concepts. Since its founding in 2011, BlueBin’s solutions have been implemented at more than 50 hospitals across the United States and are currently deploying supply chain analytics at more than 120 hospitals.
Deborah Liu, MD
Deborah Liu, MD is currently Associate Division Director for the Division of Emergency Medicine at Children’s Hospital Los Angeles (CHLA). She is board certified in Pediatrics and Pediatric Emergency Medicine. Since joining CHLA in 2003, Dr. Liu has held multiple leadership roles, including Fellowship Director and Director of Process Improvement. In her current role, Dr. Liu oversees the clinical operations for the Emergency Department, which saw 85,000 visits in FY20.
Dr. Liu has collaborated with numerous groups throughout CHLA towards continuous process improvement efforts for the organization. Along with her colleagues and a large multidisciplinary group, Dr. Liu was the physician champion of the CHLA ED Redesign Initiative in 2016, which transformed ED throughput metrics, quality of care, and education for our resident physicians without adding any additional resources.
In addition, Dr. Liu has published numerous scholarly articles and textbook chapters on various topics in pediatric emergency medicine, has been elected to the Society for Pediatric Research, was an associate editor for a textbook, and has won several local, regional, and national awards. She also serves on the CHLA Medical Group Board of Directors, the CHLA Medical Executive Committee, and the Board of Directors of non-profit organizations.
Lauren Maskin, MD
Dr. Maskin is a board-certified pediatrician and board-eligible pediatric hospitalist who has been in practice at Children’s Hospital & Medical Center for 10 years. Since 2014, she has been the Medical Director of Inpatient Medical-Surgical Services and in that role has overseen clinical operations for 3 inpatient units.
Dr. Maskin has supported the leadership of the Division of Pediatric Hospital Medicine and served as the voice for this group on several hospital committees and institution-wide initiatives. She has also led development of an observation unit, redesigned use of inpatient space during COVID, adopted policies related to acute care, and helped to establish standards of care for numerous conditions and therapies.
Dr. Maskin played a key role during times of bed crisis in developing ways to improve throughout and optimize bed capacity. She has leadership and quality improvement training as well as extensive experience in leading multi-disciplinary teams.
Ameer Mody, MD, MPH
Ameer P. Mody, MD, MPH, is a pediatric emergency physician, Associate Division Director, and Director of ED Clinical Informatics at Children’s Hospital Los Angeles (CHLA). He is board-certified in Pediatrics and Pediatric Emergency Medicine. He also holds a faculty position in the Keck School of Medicine at the University of Southern California as an Associate Professor of Clinical Pediatrics.
In his roles, Dr. Mody has focused on utilizing data to create infrastructure for emergency department (ED) optimization. His projects have included the development of ideal staffing and scheduling models, integration of allied health providers into the ED care model, ED dashboard and KPI development, authoring and editing evidence-based protocols, and strategies to improve revenue capture. He most recently championed the integration of telehealth services into the workflow of the ED.
Dr. Mody has lectured extensively, authored numerous textbook chapters and scholarly articles on a variety of topics in pediatric emergency medicine. He serves on the Chapter 9 American Academy of Pediatrics Committee on Injury and Violence Prevention. He has been awarded the CHLA Resident Teaching Award, twice nominated for the CHLA Humanism Award, and received the American Academy of Pediatrics local chapter Young Pediatrician of the Year Award.
Natalia Paciorkowski, MD. PhD, FAAP
Dr. Paciorkowski is a pediatric hospitalist and the Medical Director of the Pediatric Hospital Service at Rochester General Hospital, in Rochester NY. She is also a member of the Pediatric Hospitalist Division of the University of Rochester Medical Center. Dr. Paciorkowski provides patient care as well as resident education at Rochester General and Golisano Children’s hospitals. She also leads the development of all clinical and operational pediatric policies and processes at Rochester General Hospital.
Since 2014 Dr. Paciorkowski has been serving as a physician advisor for Rochester General and affiliated hospitals. In her role as a pediatric physician advisor in a general hospital, Dr. Paciorkowski reviews pediatric and neonatal hospitalizations for level of care determination (inpatient vs. observation status) and medical necessity of the hospital stay. She provides support and education for utilization review nurses and the coding team on pediatric and neonatal cases. Dr. Paciorkowski also manages all pediatric and neonatal denials for the Rochester Regional Health System, including medical necessity, level of care, and DRG/diagnoses denials, where she does all the peer-to-peer reviews as well as all levels of appeals.
In addition to her pediatric physician advisor work, Dr. Paciorkowski also works as part of a large general physician advisor group, reviewing adult medical and surgical hospitalizations for appropriateness of inpatient vs. observation status and supporting the utilization review team.
Dr. Paciorkowski has presented nationally on various topics, including patient status determination, the role of pediatric physician advisor, and denial management. She has also been involved in multiple collaborative projects through the Section of Hospital Medicine of the AAP, leading her hospital efforts in pediatric research and quality improvement and presenting at national meetings.
Amy Sanderson, MD
Amy Sanderson, MD is a pediatric intensivist and has a faculty appointment at Harvard Medical School as an assistant professor in Anaesthesia. She is board certified in Pediatrics, Pediatric Critical Care and Internal Medicine.
Dr. Sanderson has been the Physician Advisor for the Clinical Documentation Integrity (CDI) Program at Boston Children’s Hospital since its inception in 2014. She is a resource to physicians regarding coding guidelines and diagnosis terminology in order to improve the accuracy of final code assignment. Dr. Sanderson has led the effort to develop a set of guidelines representing a glossary of underutilized diagnostic terms and has contributed to the creation of numerous CDI tips that are distributed to all prescribers in the hospital. In her role as Physician Advisor, she works collaboratively with various key individuals and departments throughout the hospital including hospital leadership, the health information department and case management.
Dr. Sanderson has presented at several national conferences and has published scholarly articles on a variety of topics including palliative care and documentation. She has been involved with the Association of Clinical Documentation Integrity Specialists (ACDIS) by giving clinical and research webinars, presenting clinical topics at ACDIS’ pediatric networking group meetings, contributing to the book Pediatric CDI: Building Blocks for Success, publishing articles in ACDIS’ CDI Journal and presenting at their national conference. In addition, Dr. Sanderson is a founding member of the Pediatric Documentation Research Collaborative, a research group that focuses on documentation-related issues in pediatric hospitals.
Christine White, MD
Christine White, MD, MAT, is Professor of Pediatrics in the Division of Hospital Medicine and the Chief Capacity, Flow and Access Officer at Cincinnati Children’s Hospital Medical Center.
Dr. White is a graduate of the University of Missouri-Columbia School of Medicine. She completed her pediatrics residency and chief residency at Cincinnati Children’s Hospital. Dr. White’s interests and research focus on quality improvement with an expertise in the application of quality improvement sciences to improve inpatient systems of care.
Dr. White has led efforts on patient safety, including initiatives to raise rates of medication reconciliation completion, to improve communication at night, and to improve discharge efficiency through standardization of discharge criteria. This last project, which significantly decreased length of stay without increasing readmission rates, earned the Children’s Hospital Association Pediatric Quality Award in 2013.
Since 2016, she has served on the Faculty for the Institute of Healthcare Improvement with a focus on patient flow. In 2020, she was recognized for her significant achievements in quality improvement and patient safety with the Pediatric Hospital Medicine Quality and Patient Safety Award.