Latest / Becker’s Healthcare -- Pediatric Leadership Podcast / Dr. Nick Holekamp, Chief Medical Officer at Ranken Jordan Pediatric Bridge Hospital

Transcript

Dr. Nick Holekamp, Chief Medical Officer at Ranken Jordan Pediatric Bridge Hospital · Becker’s Healthcare -- Pediatric Leadership Podcast

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  This is Chris Olson with the Becker Healthcare
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  care podcast.
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  And thrilled to be joined by doctor Nick
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  H cam, Chief Medical Officer Rank and jordan
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  Pdp at Bridge Hospital. He joins us today
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  to discuss a among of other topics, where
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  I can join model focused on using Play
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  as el. Doctor Whole camp, thank you for
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  joining us today.
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  Thank you very much for having me.
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  Yes. Of course. Would you please introduce yourself
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  and tell us a bit about your background?
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  Yeah. Well,
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  The Chief Medical officer at Rank in Jordan
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  and have been for about 24 years.
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  I did a general pediatric residency here in
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  Saint Louis and finished to 19 90, but
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  joined Rank Jordan in 2000
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  and
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  really proud of the fact that over that
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  time we've really
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  built and enhanced the model of care for
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  a specific population of patients who,
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  I think
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  otherwise sort of under unattended to under addressed
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  in healthcare community and have established ourselves
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  an expert in the field of pediatric complex
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  care,
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  especially that part
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  that involves the transition of these children from
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  the complex care, the, acute care settings,
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  Pediatric hospitals and ideally home where we you
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  want all kids to be eventually.
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  Thank you for that, doctor.
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  You are on this program today to discuss
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  a certain program in particular. But before we
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  get into that, I'd like you to just
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  expo a little bit on the health issues
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  your monitoring most closely in 20 24.
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  Well, my focus has always been on children
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  with not complexity
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  and in that realm, these days, the issues
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  are that more and more of these children
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  are coming out of hospitals
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  because we're doing on the acute care and
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  of care,
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  such a better job of saving the lives
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  of severely premature incidents of severely injured and
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  children and children who spend long periods of
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  time in the hospital after
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  serious illnesses
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  in the
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  intensive care
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  neonatal intensive care unit So the fact that
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  the need for this kind of transitional care
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  is growing. And at the same time the
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  health care system
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  hasn't really,
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  I... In my opinion figured out how best
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  to manage these kids who...
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  When I trained, I finished
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  training more than 30 years ago,
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  we didn't really have to worry about a
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  lot of these kids because they just didn't
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  survive. So that's my focus these days is
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  how to do a better job caring for
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  this population that has come online just in
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  my
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  professional lifetime.
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  Understood. Thank you again, doctor. So on that
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  note,
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  if you could please let us know how
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  the care beyond the bedside program involved at
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  Rank in Jordan, and what are few metrics?
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  Well, the the care beyond the bedside model
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  is really
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  a a model of care that evolved from
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  rank in Jordan sounding in 19 41 by
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  Mary Rank in Jordan. And her goal was
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  to give children a more
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  child friendly, child normal experience,
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  even though they had to be
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  in anti hospital or hospital life setting, requiring
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  lots of medical care.
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  She discern that
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  hospitals really no place for children to grow
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  up. So created the space
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  not home, but more like home, the kids
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  could go to continue their recovery and she
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  had,
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  you know, Rose garden the she get the
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  kids out too. She have birthday parties and
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  celebrate life events as if they were home
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  in a way that's just not tactical
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  then or certainly now in conventional acute care
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  hospitals.
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  So it's really about getting kids back to
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  childhood meaning getting them up and out of
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  bed and out of their room and into
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  places where they can play and interact or
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  socialize
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  with
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  caregivers, staff members even other patients, which again
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  is almost unheard of in conventional hospitals.
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  We feel like that's essential to their
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  emotional
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  cognitive
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  developmental
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  physical progress in recovery in a way that
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  is missing
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  for these kids have to spend long periods
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  of time in hospitals due to their medical
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  complexity.
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  And so the key metrics of that are
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  well how good of a job do we
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  do getting kids up and out of bed.
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  And
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  we are proud of doing that, we think
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  better than just about anywhere else. But when
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  we actually went to measure it, which I
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  might add
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  was a study that we couldn't find any
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  evidence of ever having been done before actually
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  measuring where patients were and what they were
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  doing while hospitalized in the pediatric setting.
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  So we measured we followed kids around and
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  measured
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  pay attention took very
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  detailed
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  observations about where they were, who they were
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  with, what they were doing, What was going
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  on in their environment. To get a sense
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  of or how is how might their environment
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  be affecting their
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  progress development recovery? And just to a measure.
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  Well, how much time are they spending out
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  of bed, how much time are they spending
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  out of the room, how much time are
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  they spending well other people
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  is really eye opening. These those results
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  to
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  modify enhance our approach and it led to
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  the development of
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  of really innovative new program, but looking forward
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  to telling you more about that.
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  Excellent. Thank you, Doctor. Yes. I'd love for
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  you to
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  expo a little bit more on where the
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  program is now and what might be next
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  for it.
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  Well, when we first did this study,
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  about 3 years ago, we
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  noted that
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  we we got kids up and out of
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  bed about 5 hours per day
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  that's a lot more than most hospitals. And
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  out of their room almost 2 hours a
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  day. The kids and these are kids with
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  significant
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  medical device support like tracheostomy,
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  ventilators,
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  central lines,
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  gas
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  tubes for artificial feeding.
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  And those kids and other hospitals do not
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  leave their room
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  hardly at all. So if to get them
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  out 2 hours a day was great, but
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  we also noted that about 5 5 hours
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  a day, they were in bed of loan
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  not being attended to, which again, in our
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  opinion just wasn't good enough. These are the
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  critical
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  developmental
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  months and years of a young child life
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  and we wanted to do better so developed
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  a program that
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  would offer kids
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  developmental appropriate and stimulating
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  opportunities with other hospitalized
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  children
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  structured
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  around
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  a curriculum,
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  not unlike preschool that just gives good opportunities
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  to learn
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  together and most importantly to play. So
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  we're really
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  proud of that
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  goal is to optimize the child's recovery. We
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  call that that space the
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  optimization zone. And so kids go to the
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  and enjoy play and
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  learning with other patients along with the medical
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  staff that keeps them
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  safe them well all the while.
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  Sounds like the programs making tremendous product sector.
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  And on that note, what advice would you
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  give leaders who are similar to yours who
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  might be looking to adopt your approach?
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  Well, I understand how challenging it is in
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  the conventional hospital setting.
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  But I would say that we haven't up
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  to this point paid enough attention to sort
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  of the whole child view of healthcare care.
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  We really focus on organ systems and body
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  parts.
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  For me,
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  the most important thing is a child's
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  development and and irr developmental
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  outcome and long term progress in recovery, and
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  we can start that in
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  the acute care setting if we pay attention
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  to those elements that kids or ordinarily don't
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  have opportunities to do when they're in
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  a high medical intent for the environment.
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  So more attention to the whole child and
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  to the families
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  ability to be there and interact with the
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  child
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  and finally play play in my opinion highly
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  underrated as
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  as of therapeutic benefit we think it's the
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  central therapeutic elements for these children
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  without play, you're not going to get the
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  best result for kids who are recovering from
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  whatever problem got them there in the first
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  place.
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  Thank you so much for detailing all of
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  that, Dr. H and that's very heartwarming what
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  Rank and Jordan is doing?
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  Find a question for you. What your in
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  healthcare care do you think deserves a brighter
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  spotlight at the moment?
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  I think
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  again,
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  I'm focused mostly on this small,
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  I call the small but mighty
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  population of pediatric patient 1 percent of patients
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  generally fall into this category called children with
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  medical complexity.
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  But they account for about a third of
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  pediatric healthcare resource use
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  and
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  some estimates
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  show more than half of all pediatric acute
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  care hospital days
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  are consumed so to speak by this 1
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  percent of patients.
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  So I think more retention needs to be
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  paid a to this population but also
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  while we invest so much in terms of
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  resources,
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  and
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  dollars and energy and attention into these kids
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  on the acute and once they are discharged
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  from hospital, all that responsibility falls on the
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  families
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  and
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  I'm confident that we're
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  not meeting all of the family's needs who
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  then take over the care of these very
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  challenging patients in many instances. So more attention
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  to what we're not currently doing to meet
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  the needs of families of these children and
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  the children themselves
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  is where I think healthcare care needs to
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  dev devote a little bit more time and
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  attention.
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  Okay. Thank you for being so generous with
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  your time and insights today. We absolutely cannot
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  wait to share them with our audience, and
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  we look forward to connecting with you soon.
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  Well, thank you very much again for, letting
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  me share a little bit about our work
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  here, and I happy where we can help
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  get the word out and hopefully
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  more progress will be made in the care
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  of these kids moving forward.