Paediatrics



On Collaboration
 

By Charles C. Roberts, MD & David Westbrook

When collaboration comes to medicine, good medicine comes to patients. Collaboration between providers, institutions and other countries is important for quality medical care, particularly for the complex, chronically-ill children. At Children’s Mercy Kansas City, we are dissolving silos in order to achieve true collaboration.

Collaborate as a team because none of us is as smart as all of us

Modern medicine is changing in major ways. Although the expert mind of the well-trained and experienced physician has been, is, and always will be paramount, the care of one patient often needs expertise from multiple specialties or disciplines. This need is seen every day in our Fetal Health Center. Here, healthy mothers diagnosed with an at-risk pregnancy are served by integrated teams of surgical and medical subspecialists, social workers, and others. Before the birth takes place, these teams come together to develop a diagnosis and treatment plan to share in detail with the family. When the birth comes, the entire team is there, ready not only to take care of the critically ill infant, but to remain connected to that child until conditions are stabilized and progress is achieved.

Collaborate internationally to bring collective wisdom to a case and improve quality and safety

We collaborate with colleagues around the world, particularly to evaluate treatment approaches for pediatric disease too uncommon to be fully tested at one center. Through our work with the Children’s Oncology Group, we are able to gain access to multi-center data and protocols, enabling us to compare our rare oncology cases with others throughout the nation, improving survival for pediatric cancer patients here and across the country.

Other such examples include our involvement with the Improve Care Now Network (pediatric IBD), the Pediatric Trials Network (drug therapy), the Neonatal Research Network, and our leadership in the development of international pediatric dialysis guidelines.

Collaborate to improve outcomes

The successes of pediatric medicine cause celebration, but bring challenge. The patients we treat today are far more complex than ever before. Those who come to us with chronic issues often bring comorbidities or complexities that require multiple subspecialists to treat the conditions expressed. A prime example of this collaboration is the Ward Family Heart Center. Our whole team, including cardiologists, CV surgeons, neonatologists, intensivists, psychologists, nurses, radiologists and anesthesiologists, are now organized to function as one coordinated unit. In order to assess and improve care, the team has developed a software tool used to track thousands of data points for all patients.

Another example is our approach to chronic pain. For years we have had multidisciplinary clinics for pain, headache and abdominal pain. New to Children’s Mercy is the Rehabilitation for Amplified Pain Syndrome Program (RAPS). The RAPS program is an intense, no-medication, collaborative program focused on returning adolescents who have failed traditional pain treatment to full function. The results are impressive.

Collaborate to nurture innovation

As an academic institution, we find ourselves rarely satisfied with the present. We seek always to find the better in the future. The multidisciplinary Center for Pediatric Genomic Medicine headed by Dr. Stephen Kingsmore collaborates internationally, nationally and locally. The center has developed a test (TaGSCAN) to look for 750 rare genetic disorders greatly reducing the cost and time to make a diagnosis. STATSeq, recognized by Time magazine as one of the top 10 medical breakthroughs in 2012, decodes and interprets a newborn’s genome in less than 50 hours. This gives clinicians the potential for early intervention in critically ill neonates.

Collaborate to deliver the best possible value into the future

We collaborate, of course, with physicians who refer their patients to us for special care. Our Quality Program professionals collaborate to measure and report on outcomes. As those outcomes produce evidence of progress, the standards will be promulgated to achieve clinical integration. For us at Children’s Mercy, collaboration is more than a popular word of the day. Collaboration is a practical protocol that delivers better care for patients and families and better value to those who pay for it.

Collaborate across borders

For more information on how you or your institution can collaborate with Children’s Mercy Kansas City to provide high quality pediatric care, contact International Services +1 816-701-4524 or send an email to international@cmh.edu

The Authors

Charles C. Roberts, MD, is Professor of Pediatrics at the University of Missouri - Kansas City School of Medicine and Executive Vice President/Executive Medical Director of Children’s Mercy Hospital, Kansas City, Missouri.

David Westbrook, is Senior Vice President of Strategy and Innovation, also at Children’s Mercy Hospital.
 

 Date of upload: 14th July 2014

 

                                  
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