171 Ashley Ave.
Charleston, SC 29425
843-792-1414
800-424-MUSC
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January 2005
This edition:
Letter from the Chair
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L. Lyndon Key, MD
Professor and Chairman
Department of Pediatrics |
Our Children's Hospital recently ranked 23rd among the best children's hospitals in the U.S. by Child magazine. Additionally,
our neonatology services were rated as one of the Top 10 in the country. We are proud of our national recognition.
However, even with our accomplishments we should always work together towards continuous improvement.
The new Charles P. Darby Children's Research Institute will allow our organization to expand our research initiatives and develop a
larger research component for our Children's Hospital. As we continue to grow with the upcoming opening of the
Institute, let us continue to evaluate our current services and determine how we can do better.
I am very excited about the new initiatives that are being put in place by our administration
to develop advisory boards representing community physicians and our patients.
These boards will provide us with new information and insight. However, instead of waiting to receive recommendations from others,
let us begin today by setting goals and make resolutions to ensure that 2005 proves to be better than the past.
My resolutions for the hospital and the department of pediatrics are:
We need to embrace change:
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Education
We recently heard from Tom Dewitt, MD, a primary care consultant from Cincinnati, Ohio,
about many programs that are becoming part of medical education.
I resolve to try to move our residency-training program toward an evidence-based
medicine curriculum. This is not something that can be done alone; so, I hope that
our faculty affiliates will come to hear about this
new program as we present some open forums and planning sessions during the new year.
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Clinical
Dr. Ector's report was sent to all division directors and provided
us with much to think about.
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Communication:
We should all strive to have our letters and reports back to our
referring physicians as soon as possible. These reports should include a
clear treatment plan and a contact number. Whenever possible, we should contact
the physicians and inform them about our patient care, diagnosis and treatment.
We should also let them know how this will affect their care.
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Timely appointments
We need to get patients into our system when the referring physicians need
them to be seen. Timely appointments are crucial. This wil mean more clinic slots and
a new outlook for our scheduling services.
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Recruitments:
In some areas, we need to recruit new physicians: gastroenterology,
neurosurgery, pediatric dermatology. These recruitments will
depend on all of our efforts. Many recruitments must be cross-departmental initiatives.
We all depend on a team effort.
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Teamwork:
We still have a number of areas where the different groups
making up the clinical staff are not a part of a cohesive team. The
outpatient clinics are one such area. The physicians answer to the department.
The nursing staff is still largely under the
supervision of the UMA outpatient administration. The scheduling,
registration, billing, coding, and collections are a separate division. These
systems need to be coordinated, all working toward the optima operation of their clinic.
To develop a team, there must be a shared goal. This will be a major effort this year
as it will require the development of cohesive teams.
I am extremely proud of the wonderful people who work with the patients and families at
MUSC Children's Hospital. Everyone cites our high quality of service. Being the 23rd best children's hospital out of 140 surveyed by Child magazine is quite good, but we can and will do better.
We need everyone to feel empowered to contribute to bettering our programs. Together we can achieve our goals.
We must however address the delays in getting appointments to see us, the delay in communication,
and the need for additional services. My resolution is to work with you to improve education, research, and clinical care.
I hope your resolution will be to support change, to express constructive opinions,
and to address the issues raised by our patients and their families.
Happy New Year,
L. Lyndon Key, MD
Chair, Department of Pediatrics
Feature Story: Exciting New Developments in Pediatric Training
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Debbie Blevins
Executive Director
Resident and Academic Manager |
Now, more than ever before, MUSC Children's Hospital is a dynamic and rewarding place
for pediatric residency training!
The residency program has made several exciting changes. First, the noon teaching
conference has been re-named to "Food for Thought" and revitalized into a combination
conference consisting of an unknown case with discussion, followed by lunch and a didactic
session with the faculty. In addition, much of the residency curriculum is now available
through the MUSC pediatric Web site, providing 24 hour access for independent learning.
Another exciting change has been the formal inclusion of evidence-based medicine into the
curriculum. Dr. Suresh, neonatology division, heads the pediatric evidence-based journal club each month, providing the
pediatric residents with valuable hands-on experience. The residents can systematically review journal
articles and incorporate critical thinking strategies into their clinical practice.
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Valerie Panzarino, MD
Assistant Professor in the
Division of Pediatric Nephrology |
Also, starting in July 2005, the Children's Medical Associates pediatrics office has
agreed to have our first and third year residents rotate through their office. This rotation
will provide a valuable private practice experience, complementing the ambulatory
pediatrics training taught in the continuity clinic in Rutledge Tower. Other changes
slated to begin in July 2005 include adjustments in the neonatal intensive care and
level 2 nursery resident rotations. Such changes are designed to facilitate
continuity of care during those rotations and incorporate more delivery room
and procedural experience.
As always, the faculty and staff remain committed to providing the framework
for an outstanding pediatric education at MUSC Children's Hospital. We look
forward to 2005 as a banner academic year for our residency program.
Message from the Medical Director
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J. Philip Saul, MD
Medical Director
Director, Pediatric Cardiology |
In my job as medical director of the Children's Hospital, I must first and foremost
focus on issues that affect the quality of our patient care. However, in preparing for the
grand opening next month of the Children's Research Institute, we are reminded
of the importance of education and research in our overall institutional mission.
In fact, it can be argued effectively that the only way to deliver truly state-of-the-art
clinical care is through the voluntary inclusion of our patients in clinical research
trials. Most physicians agree that patients often get better care when
included in an investigational trial because of the intense focus placed on
every aspect of their disease management. Finally, we are fortunate that the
directors of our new research institute, Drs. Maria and Singh, are keenly aware
of and focused on the importance of translational research to our mission.
As we look to the future, it is this type of research that promises to most
quickly move concepts and therapies from the laboratory to the bedside, bringing
us back full circle to the priority on patient care. I offer kudos to all
who have been involved in this exciting venture.
Update from the Administrator
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John Sanders, MHA
Administrator
MUSC Children's Hospital |
High Marks For MUSC Children's Hospital
To echo Dr. Key's letter, we are proud to announce that Child magazine recently
ranked MUSC Children's Hospital as one of the best children's hospitals in the country. We were selected among more than
140 children's hospitals from across the U.S. We are very proud of this
accomplishment and recognition. This recognizes the wonderful care and compassion
that our staff and physicians provide to our children and their families everyday.
The care that is provided to our patients is driven by research performed
across the world. Many advancements in the care of children have come from our organization.
Now, we are in a position to take that activity to another level with the
opening of the Children's Research Institute. The CRI only strengthens our presence
nationally and internationally for the care of children. This is an exciting time for
our hospital, as we continue to strive to provide the best possible care for
the children of South Carolina.
Click here to read the Catalyst article.
Children's Research Institute News Brief
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Bernard L. Maria, MD, MBA
Executive Director
Children's Research Institute |
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Inderjit Singh, PhD
Scientific Director
Children's Research Institute |
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On February 10, 2005 MUSC will host the dedication and opening of the Charles P. Darby Children's Research Institute.
Several exciting activities are planned for this memorable event including a speech given by
David G. Nathan, MD, president emeritus and distinguished professor of pediatrics at Harvard Medical
School. Dr. Nathan's talk entitled, Careers in Clinical Research, will commence at 11 a.m.
The opening will also include a ribbon-cutting ceremony, followed by guided tours of
the Institute and its labs. A reception will be given at the Wickliffe House, immediately
following the tours.
On February 17, 2005, one week following the dedication ceremony, the Institute's investigators
and colleagues will convene in the Basic Science Building in room 502 at 8 a.m. for a
mini-symposium to present new exciting data and recent findings that will supply other
investigators with an understanding of the research being conducted in different labs
within the Institute. For more details on how the Institute is moving the 'bench' closer to
the 'bedside', click here to read the MUSC Update (pdf).
Mental Health Resource News Brief
The Need for Efficient Mental and Developmental Screening
What is a source of morbidity and mortality, common to any pediatric practice for 15 to 20 percent
of the time? Pediatric behavioral, developmental and mental health issues are more common
than childhood cancers, cardiac and renal problems combined. However, research has repeatedly
shown that primary care clinicians recognize less than 30 percent of children with substantial
dysfunction. This lack of recognition is due to the necessary brevity of pediatric appointments, stigma associated
with mental health concerns and the resultant hesitancy to bring up subject areas
where there is no "quick fix".
Children who have major difficulties in one area of
functioning often demonstrate symptoms and difficulties in other areas of daily functioning.
For example, if they are having school difficulties secondary to attention-deficit/hyperactivity
disorder (ADHD), symptoms such as motoric activity or impulsivity will be evident at home and
may interfere with other activities. Even less overt disorders such as learning disabilities
or difficulties in peer relationships will often manifest as depressed mood at home,
tension with siblings, or low self-esteem.
Most kids have at least one visit per year with their primary care provider and most
behavioral, developmental and mental health problems are first discussed in that setting.
It makes perfect sense to look to primary care as an access point for developmental and
behavioral health care. However, this can be a challenge as primary care culture
focuses on acute care, while mental health and developmental disorders in children and
adolescents tend to be chronic and relapsing. Busy primary care physicians feel they
do not have time, nevertheless, they do understand the importance of screening for these types of problems.
As mentioned last month, probably the most efficient way for pediatricians and other
health professionals to improve the recognition and treatment of psychosocial problems
in children is by use of the free 35-item Pediatric Symptom Checklist, which can be completed
in the waiting room by a parent in four minutes and scored in one minute. The PSC consists of 35-items
that are rated as never, sometimes, or often present and scored 0, 1, and 2, respectively.
Item scores are summed and the total score is recoded into a dichotomous variable indicating
psychosocial impairment. For children aged six through sixteen, the cut-off score is 28 or
higher. For four and five year-old children, the PSC cut-off is 24 or higher. A positive score
on the PSC suggests the need for further evaluation.
Please visit psc.partners.org for the Spanish and
English child and teen versions of this screening instrument, or contact us for a copy. If there is time for only
a few questions, consider asking question #17 "Seems to be having less fun", as this is a
screening question indicating possible depression. Screening enables clinicians to recognize
problems quickly and to provide help, preferably at an early and effective point.
Our Promoting Happy and Healthy Youth discussion group of health care professionals that meets
on the third Tuesday of each month in room 377 - Rutledge Tower at 8 a.m.. As sources, we will use
Bright Futures: Mental Health, evidence based literature and pertinent Web sites for
discussion. This Collaborative Office Rounds group is funded by a small grant from the
Maternal and Child Health Bureau and provides an ideal way to disseminate mental health
and behavioral information. Such an informal setting can be customized to the needs/questions
of participants. Moderators are Drs. Eve Spratt and Michelle Macias, and
co-moderators are Drs. Angela LaRosa and Roxane Scott. Any interested MUSC or
private practice pediatric health care provider is welcome to attend. A
bonus is that breakfast and CME's will be provided in the near future.
For more information, please call Dr. Spratt or Cristol Duke at (843) 876-0504 or e-mail spratte@musc.edu.
A special thanks to the following individuals for their efforts in putting together Kids Connection each month.
Managing Editor: Bernard L. Maria, MD, MBA
Assistant Editor: Mary Jacobs
Publisher: Jessica Munday (Trio Solutions Inc.)
Web design: Jennifer Cherock (Trio Solutions Inc.) and Brian Dadin (MUSC IT Lab)
Contributing Writers: Lyndon Key, MD; Phil Saul, MD; Bernard Maria, MD; Valerie Panzarino, MD, John Sanders and Debbie Blevins
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