by June Portnoy
Today more and more community hospitals in the Delaware Valley are partnering with children’s hospitals to offer care and services to kids.
This arrangement means if you don’t live near a children’s hospital, you still can obtain specailized pediatric services close to home.
Their number is shrinking, but a few community hospitals and systems offer pediatric care without formal alliances with a children’s hospital. Even those hospitals have transportation and other arrangements with children’s hospitals to provide specialized care when needed.
“At this point in time, we don’t consider it imperative for Kennedy to have a formal partnership with a children’s hospital,” says David Gibbons, assistant VP of operations at Kennedy Memorial HospitalUniversity Medical Center in Washington Township, NJ. “We have a very strong, viable pediatrics program.”
The Lower Bucks Hospital in Bristol, PA, maintains a four-bed pediatric unit as well as pediatric emergency and intensive care services. “We see a lot of children,” says Bob Harris, the hospital’s vice president for public relations.
Lower Bucks has transportation agreements with CHOP, Temple Children’s, St. Christopher’s and Thomas Jefferson, a duPont Hospital partner. In non-emergency situations, these relationships allow a child’s primary care doctor to recommend a hospital or arrange specialized care.
Kennedy’s Women’s & Children’s Services, including pediatric care, are based at its 197-bed Washington Township hospital. Kennedy also has hospitals in Cherry Hill and Stratford, NJ.
Gibbons notes that Kennedy’s strong team of pediatricians treats acute illnesses such as asthma and gastrointestinal problems. The Wash-ington Township hospital also offers 24-hour pediatric coverage in its emergency department. If pediatric patients need an intensive care unit, they are transferred to a children’s hospital.
“Most of our pediatric patients are admitted through our emergency department and require basic pediatric care, not specialists,” says Gibbons. “In addition to our specialty-trained pediatric doctors and nurses, we also have pharmacists, radiologists and staff who support pediatric care. We also work with Philadelphia providers like CHOP to provide specialty pediatric services.”
Providers such as CHOP also provide cardiology services and consultations at the hospital. “We feel the level of care we offer as a community hospital is extraordinary,” Gibbons says.
At hospitals with pediatric partnerships, kids can be examined by specialists from one of the Delaware Valley’s four children’s hospitals: Alfred I. duPont Hospital for Children in Wilmington and Children’s Hospital of Philadelphia (CHOP), St. Christopher’s Hospital for Children and Temple University Children’s Medical Center in Philadelphia.
The children’s hospitals are also offering their own outpatient services and specialists in the community.
Why a Partnership?
In the view of Trude Haecker, MD, chief medical officer, ambulatory services at Children’s Hospital of Philadelphia, “It is virtually impossible to have a pediatric unit at a community hospital these days without some kind of partnership with a children’s hospital because without that partnership, it’s hard to maintain the high standards for children.”
“The way you treat a two year old is very different than the way you treat a 15 year old, so you need a partnership to offer the specialization necessary for every age range,” says Dr. Haecker.
“Running a pediatric unit at an academic medical center or a community hospital without a partnership limits who we can care for,” says Jay Greenspan, MD, interim chairperson of pediatrics at Thomas Jefferson University Hospital in Philadelphia and its pediatric partner, duPont Hospital.
“DuPont enables us to offer specialists to our patients instead of forcing them to go elsewhere for specialists. This arrangement helps to enhance our quality of care, qual-ity initiatives, funding and training,” he says.
Benefits to Children
“The main advantages are that these community hospitals are close to home and in a familiar setting to the family,” says Anne J. Wright, senior director of business development for duPont Hospital. “By staying local, parents don’t have to take their child out of school to travel back and forth to a children’s hospital that might be an hour or more away.”
“Association with a specialty hospital that has all levels of children’s care contributes to the confidence that parents have in local hospitals,” says Barbara Wilson, program director for the partnership between duPont and Main Line Health System’s Bryn Mawr Hospital.
“Another advantage is that kids are receiving state-of-the-art care from an academic and children’s hospital, and that physicians are using appropriate treatment with appropriate medication dosages for kids instead of trying to adapt adult care to children,” says Andrea McCoy, interim chief officer of Temple University’s Children’s Medical Center.
Partnerships enable specialists, students and residents to see a broader range of patients, says McCoy. “It also allows us to market our presence to the broader community so they can see the services we provide.”
Benefits to Partners
Initially, duPont’s partnership with Jefferson Medical College was exclusively academic. The faculty at duPont taught pediatrics to medical students and residents. In return, duPont brought its practitioners to Philadelphia. Today, the academic partnership continues so that a doctor working at duPont Hospital can have a faculty appointment at Jefferson. Conversely, Jefferson has access to training by duPont’s respected group of pediatricians and pediatric sub-specialists.
“We formed a partnership with duPont to better meet the community’s healthcare needs,” says Terry Ricca, vice president of ambulatory services and women’s and children’s programs at South Jersey’s Virtua Health system. “We brought together and leveraged existing strengths from both organizations to enhance our services and produce a full-service pediatrics program so that children with more complex medical conditions can be treated closer to home.”
“A partnership gives (a local hospital) the ability to maintain a high level of care in the community because kids are sicker these days when they come to a hospital and units are smaller,” says McCoy.
Wright notes that few community hospitals have the volume of pediatric patients to support staff subspecialties. “Partnering enables community hospitals to have a rich level of services for kids.”
“There are times when clinical needs exceed the capabilities of our host centers,” says Wright. In urgent situations, all children’s hospitals offer transport services via ambulance or helicopter to their facilities.
“If your child is very sick, you must take your child to the closest ER,” says Dr. Haecker. “Talk to your pediatrician ahead of time about where you should go after-hours if your child is sick.”
Thanks to the spread of children’s hospital partnerships, you probably won’t need to drive far to get top-flight hospital care for your child. The nearest hospital might well offer you the same level of care you would get at a children’s hospital.
June Portnoy is a contributing writer to MetroKids.
Children’s Hospitals and Partners
CHILDREN'S HOSPITAL of PHILADELPHIA (CHOP)
Children’s Hospital of Philadelphia, repeatedly named best children’s hospital in America by Child magazine, calls its partnerships with community hospitals CHOP Connections. Partners include Abington Memorial Hospital, Abington, PA; Grand View Hospital, Sellersville, PA; Shore Memorial Hospital, Somers Point, NJ; and The Chester County Hospital, West Chester, PA .
At these hospitals, pediatricians employed by CHOP provide in-patient services for kids who have conditions that can be managed closer to home than CHOP’s West Philadelphia location. “A partnership between CHOP and local hospitals extends our experience into the community,” says Trude Haecker, MD, CHOP’s chief of ambulatory services.
CHOP provides round-the-clock coverage at these community hospitals, freeing local pediatricians from the responsibility of monitoring their hospital patients. Some community hospital partners participate in CHOP’s neonatal (newborn) services, while others utilize its services throughout their pediatric units.
Kids First, another CHOP program, employs more than 100 pediatricians in a network of 28 community primary care practices. “We staff these local offices to ensure that the best possible care is offered for children in a place that is convenient for their parents,” says Dr. Haecker. “They provide comprehensive care for kids from birth to 18. They’re your child’s pediatrician in your community, all CHOP-employed.” Kids First doctors provide well care visits and screenings, as well as sickness care.
A related after-hours program allows parents to call at any hour to speak to a CHOP nurse. These nurses use CHOP’s electronic health record system to access a child’s records after hours. If needed, they can consult with a CHOP pediatrician.
CHOP pediatric specialists staff Specialty Care Centers in Chalfont, Exton, King of Prussia and Springfield, PA and in Mays Landing, New Brunswick, Princeton and Voorhees, NJ. These centers are for children with more complicated disorders. If needed, children can receive diagnostic services such as blood tests and x-rays, and at one site, CAT scans and MRIs.
Three of the centers have a day surgery unit and two provide oncology services. Other services include physical therapy, speech therapy, occupational therapy, audiology, neurology and treatment for developmental delays.
ALFRED I. DUPONT HOSPITAL FOR CHILDREN
Bryn Mawr Hospital, Thomas Jefferson University Hospital, Virtua Health and Atlantic City Medical Center have formed pediatric partnerships with the Alfred I. duPont Hos-pital for Children in Wilmington, DE.
DuPont also has a partnership with the Christiana Care Health System in Newark and Wilmington, DE. Christiana’s two hospitals offer a “Trauma Center Without Walls.” Once a child is admitted into a Christiana intensive care unit, a duPont specialist will provide a consultation.
“We have no staff permanently stationed (at the Christiana hospitals), but we do share our pediatric expertise in the areas of general surgery, trauma, critical care and anesthesia,” says Anne J. Wright, duPont’s senior director of business development.
For most partners, duPont provides pediatricians trained in up to 12 different sub-specialties. These specialists have regular office hours in addition to their hospital duties. Most duPont partners also receive pediatric surgical services. However, if the surgery is complex, it is done at duPont Hospital.
For Bryn Mawr, Jefferson and Atlantic City Medical Center, duPont provides neonatal specialists (who care for newborn babies experiencing problems) as well as hospitalists (physicians who specialize in hospital care) for children admitted to the hospitals’ pediatric inpatient units.
“Gone are the days when a PCP (primary care physician) had the time to make hospital rounds,” says Wright. “Today, these pediatricians work longer hours, including nights and weekends at multiple offices. Therefore, they depend on hospitalists to provide excellent care for their patients.” These doctors stay in communication with each patient’s pediatrician.
“Many community hospitals could not support these specialists full-time,” says Wright. “Our specialists rotate from center to center, whereas our surgeons and hospitalists are more anchored at a specific partnering facility.”
ST. CHRISTOPHER'S HOSPITAL FOR CHILDREN
St. Christopher’s sends pediatric specialists to its affiliated hospitals, depending on each hospital’s needs. It most often provides orthopedic surgeons, cardiologists, neurologists and general surgeons to these hospitals. Affiliates include Capital Health System in Hamilton and Mercer, NJ and St. Luke’s Hospital in Bethlehem, PA.
Doctors on staff at St. Christopher’s have medical staff privileges at its affiliated hospitals. At Capital Health System, St. Christopher’s pediatric hospitalists oversee treatment and care for the inpatient pediatric unit. A pediatric unit is also being developed at St. Luke’s Hospital.
Emergency room pediatricians at Capital Health also have access to St. Christopher’s specialists. “We help a hospital’s traditional pediatric unit to ensure they get a higher level of care,” says Jeffrey Snyder, Chief Operating Officer at St. Christopher’s Hospital.
In addition to St. Christopher’s affiliates, Albert Einstein Medical Center in Philadelphia, which maintains round-the-clock pediatric emergency room services, stabilizes and transports pediatric patients to St. Christopher’s.
Holy Redeemer Hospital in Huntingdon Valley, PA, which has a 13-bed pediatric unit and pediatric emergency room services, also transports to St. Christopher’s as needed. St. Christopher’s pediatricians and pediatric sub-specialists provide consultations to Holy Redeemer patients.
St. Christopher’s has a well-known neonatology group that it makes available to its sister hospital, Hahnemann University Hospital in Philadelphia. Physicians in this group are on staff round-the-clock at Hahnemann and at St. Christopher’s. “By coming to Hahnemann, patients are getting the highest possible level of care from our neonatologists,” says Snyder.
In addition, St. Christopher’s has Specialty Care Centers at its affiliated hospitals and other community locations. At these satellite locations, specialists rotate office hours. “Access-ibility to pediatric sub-specialists in a community setting is key,” says Snyder. “We want our affiliate hospital patients to be seen and treated whenever possible in the communities where they reside.” Specialists have regular established hours at St. Christopher’s and at the satellite
TEMPLE UNIVERSITY CHILDREN'S MEDICAL CENTER
Temple University Children’s Medical Center is the only hospital in Temple’s health system with a pediatric unit. The Children’s Medical Center provides Temple University Health System hospitals with telephone consultations and specialized pediatric transportation to its hospital when needed, such as when a Temple health system hospital cannot accommodate a child in its emergency department or well baby nursery.
Hospitals in the Temple system include Jeanes, Northeastern, Temple University Hospital and the Temple UniversityEpiscopal Campus, all in Philadelphia. Temple Children’s also provides pediatricians in the neonatal, well baby nursery and emergency room at Montgomery Hospital in Norristown, PA.
Temple Children’s Center supports next-door-neighbor Shriners Hospital for Children’s surgical, anesthesia and intensive care services. Shriners uses its own surgeons for orthopedics, but Temple often furnishes pediatric specialties to assist with surgery and intensive care cases. Some Temple’s physicians are on staff at both hospitals. Some Shriners surgeons use Temple’s operating room. Temple supports Shriners Hospital with lab and radiology services.
Temple Children’s Center also has affiliations with physicians in various communities, some of whom are private practitioners and others who are members of the Temple School of Medicine. For example, a Temple pediatric gastroenterologist practices in Willow Grove, PA. Temple also has pediatric surgeons with a practice at Abington Memorial Hospital and ear, nose and throat specialists with a practice in Rydal, PA who utilize Abington Memorial Hospital.