Dr. Howell’s clinical, administrative, teaching, and research activities align around the care of critically ill and injured patient, and those with incipient critical illness. He is the Director of Critical Care Quality and the Associate Director of Medical Critical Care at the Beth Israel Deaconess Medical Center and the Silverman Institute for Health Care Quality and Safety. The Critical Care Quality division helps align and implement quality and safety priorities across all of the nine adult intensive care units and five physician specialties that provide critical care at the BIDMC. He also serves on the Patient Safety Core Faculty at BIDMC.

Before entering medicine, Dr. Howell consulted in materials purchasing workflow analysis and automation for the company which built most of the space shuttle. This longstanding interest in putting the right person in the right place at the right time flowed naturally into his current research focus on how standardized identification and treatments for time-sensitive and error-prone diseases affect patient care, with a particular interest in protocols which rapidly alter provider staffing. Supported by the Robert Wood Johnson Foundation, particular areas of current focus include (1) understanding whether current safety metrics may be misleading because of a mathematical problem in the metric construction; (2) developing a clinical decision rule to predict which patients will need rapid response team care; and (3) pharmacoepidemiologic risk factors for hospital-acquired infections. Over the past year, this work has been published or is in press in journals such as JAMA and Archives of Internal Medicine.

As a result of this work, Dr. Howell has been selected for several national/international consensus groups and panels. He has served on a consensus conference on the afferent limb of rapid response teams, the 2007 guidelines revision committee for international sepsis guidelines, the National Patient Safety Foundation/Lucian Leape Institute’s Roundtable on improving medical education, and the American Heart Association’s Consensus Conference on Outcomes for Resuscitation Science. At BIDMC, he has been selected as a member of the Patient Safety Core Faculty and has also won several named awards, including the sixth annual Robert M. Melzer Leadership Award, awarded to only two physicians in the entire organization in 2007. In 2008, he was one of 40 providers, attorneys, health plan leaders, and lawmakers selected statewide for the Massachusetts Medical Law Report’s inaugural Rx for Excellence Award, which honors best practices in medicine in the Commonwealth. Currently, he serves as the chair of the task force in charge of revising the Society of Critical Care Medicine’s ICU Resource, Evaluation, and Patient Outcomes Reporting Tool, and also chairs the Society’s major quality improvement implementation committee, Paragon Critical Care.