Local Care Designed ‘For Families, By Families’
Just over three years after breaking ground on Nemours Children’s Hospital, the facility will open its doors to its first patient on Oct. 22, 2012 in what is known as Lake Nona Medical City. The historic achievement will grant Central Florida families and statewide residents alike access to long awaited, much demanded pediatric specialty care. With just 50 freestanding pediatric hospitals in the nation, Nemours Children’s Hospital will be the region’s only entity solely offering exceptional pediatric medicine including emergency treatment, prevention programs, and most importantly, a wide range of medical services, including specialties that are not currently available in Central Florida, which will provide intensive and acute inpatient care, in addition to outpatient services covering more than 40 disciplines.
Since the conception of the Nemours Foundation in 1936, this large pediatric health system has operated with a “for families, by families” mission. Today, the Nemours health system directly impacts care for 250,000 children annually through personalized treatment plans offered throughout 28 clinic and hospital facilities located in Delaware, Florida, New Jersey, and Pennsylvania. Nemours will have great influence in advancing pediatric medicine and research, in addition to economic stimulus, in Orlando. In fact, thus far, Nemours Children’s Hospital has hired more than 750 associates comprised of more than 200 trained nurses, 50 skilled physicians and surgeons, an experienced visionary administration team, and hundreds of other accomplished clinical and organizational staff positions.
“This hospital will represent how the Nemours Foundation believes care ought to be given to children in the 21st century,” stated David Bailey, MD, MBA, president and chief executive officer of The Nemours Foundation. “It’s all about providing care and support to children and the entire family unit, while effectively allowing health care professionals to implement superior, quality care.” That goal has remained a driving force during the formation process, and will finally take effect on a grand scale next month. Parents also will continue to have access to Nemours Children’s Clinics located throughout the state including Destin, Jacksonville, Lake Mary, Orange Park, downtown Orlando, Pensacola, and Viera.
Decision Making is a Family Affair
Barbara Meeks, RN, MSN, MBA, chief nurse executive for Nemours Children’s Hospital, explains that pediatric medicine is a personal family affair, and therefore, Nemours Children’s Hospital embodies a patient-family centered model of care. “When you are taking care of a sick child, you’re truly taking care of the whole family. It’s definitely not exclusive to one or the other – it’s both.” Meeks, who offers 35 years of pediatric health care experience, explains that though Nemours physicians may spearhead treatment plans, parents know their child best and thus, their knowledge and insight must count. “Parents, and of course our children, are the end-users of what we do. Their direction for our new facility and service lines has been essential in establishing the best quality of care that fits their treatments needs.”
To deliver this collaborative approach, Nemours Children’s Hospital established a Family Advisory Council to learn precisely what families desired for Orlando’s new pediatric medical facility. The council is made up of members of the community, many of whom have children with health issues. Under the executive ambassadorship of Meeks, roughly 25 local families, who have accessed the Nemours health system, were called to offer their consultative ‘expertise’ aimed to achieve a unique vision: “for families, by families.” Many of the passionate members are parents of children who have varying diagnoses and alignments, reflective of potential patient populations. Their personal feedback has guided aspects of facility and services development including planning, designing and building phases. “Sometimes children and their families spend days, weeks, or even longer in the hospital setting. Their comfort level – both physically and emotionally – is a key content to our healing environment. We gauged their hopes, wants and treatment frustrations,” adds Meeks.
The Family Advisory Council offered the direct perspective of parents like Lori Paul, an Orlando full-time mother to 8-year-old Max who received a diagnosis of cystic fibrosis at 13 months of age. Paul credits a Nemours physician with identifying her son’s rare symptoms that had previously been overlooked. “The caring team at Nemours has always felt like a family to us, truly invested in Max’s well-being. To be offered the chance to participate in the Family Advisory Council is simply the ultimate display of Nemours’ desire to foster genuine patient-family care. It’s unheard of in medicine and amazing!”
Paul and the other members have participated in monthly Family Advisory Council discussion and planning sessions, plus focused subcommittees. Results are integrated throughout the hospital, including details like the surface over patient beds. When one parent realized the reflective surface could scare a child to see himself with tubes in the arms and nose, the Family Advisory Council had the surface be made non-reflective. “As ‘frequent-users’ of healthcare and medical facilities, we know what our kids need and want more than hospital ‘traditional builders’.
For example, while most might expect food services to only provide ‘healthy’ meal plans, my son actually requires a higher caloric intake including high fat, high sodium foods because his body’s ability to absorb and process nutrients is different,” Paul explains. She adds that the diversity among the Family Advisory Council members (referring specifically to the variety of medical conditions) is what will make the unique qualities of Nemours Children’s Hospital best set to serve the needs of all families. “A fellow member utilizes a large motorized wheelchair for her daughter and was able to communicate her concern of space, such as handicap parking lot accessibility and size to room functionality.” Paul says that parents also were ‘testers’ for furniture such as desks, beds, couches, electronic capabilities, and other items that parents will utilize in private patient rooms and/or waiting lounges.
This patient-family centered influence stems back to Nemours Children’s Hospital’s objective to simply offer parents more choices. “It’s more than just physical design input. We’re expanding upon parent choices from comfortable, 24-hour access to be with your child to the ability to be present when the anesthesiologist puts your child to sleep before a procedure. We are listening to our parents and they see that in turn, the Nemours team is doing whatever we can to save the life of their child,” said Meeks.
More than a dozen members of the Family Advisory Council are trained to interview finalists for positions at Nemours, including involvement in the hiring of top executive level positions. “The opinions of our Family Advisory Council truly were deciding factors in determining our leadership roles. For example, these members took part in the interview and hiring process of Randall W. Hartley who was ultimately hired as Chief Administrative Officer (CAO) for Nemours Children’s Hospital,” says Meeks.
The nursing team of the system’s other children’s hospital, the Nemours/Alfred I. duPont Hospital for Children in Delaware was equally as vital in contributing design direction for functionality of private patient rooms. With an understanding that the nursing staff likely navigates patient rooms most frequently, their experience offered knowledge surrounding flow of care and space requirements affecting the ease of equipment’s mobility. Ultimately, such insightful planning on the front end for Nemours Children’s Hospital will allow staff to work more efficiently, resulting in cost savings. Nemours nurses, who follow perinatal guidelines for a low nurse to patient ratio (1:4 pediatrics and 1:3 intensive care unit), will also take a collaborative approach to leadership. “We’ve established a physician-nurse partnership to oversee the emergency department. It’s a joint responsibility for all aspects including financials, quality of care, patient satisfaction, staffing and so on. This strategy will ultimately eliminate silos among roles and create uniformity,” describes Meeks.
Lori Paul says she is especially looking forward to the ‘one-stop shop’ quality care experience that Nemours Children’s Hospital will provide to her son Max. The 60-acre, fully integrated health campus is split into two complimentary halves. One side of the facility is clinic-based, housing specialty pediatric practices; while the other is an advanced 95-bed hospital inclusive of a pediatric emergency department. “We won’t have to shuffle around town (or even to another city) to different doctor’s offices because all of Max’s specialty physicians – pulmonologist, nutritionist, gastroenterologist, social worker and other providers – will be here at one centralized location,” says Paul.
Unique features generated with the support of the Family Advisory Council are prevalent throughout all hospital floors. Embracing the power of nature, natural light fills the hospital. Outpatient surgery and surgical clinics are housed on the second floor, under the third floor neonatal and pediatric intensive care units. The fourth floor houses infusion departments and pediatric specialists, with the rehabilitation and neuro units comprising the fifth floor.
Specializing in Pediatric Specialties
The Nemours health system utilizes HIMSS Analytics™ Database, an electronic records system which grades progress in effectively completing eight stages (0-7) of electronic technology. In 2011, Nemours achieved Stage 7, this top level has only been accomplished by 5 percent of hospitals nationwide. With a comprehensive environment embodying numerous specialties, this high standard of metric tracking ensures patient safety and quality of care. “Medical personnel can easily access up-to-date medical records at the bedside of a patient,” explains Terri Finkel, MD, PHD, chair of pediatrics and chief scientific officer for Nemours Children’s Hospital.
Dr. Finkel is charged with establishing cutting-edge pediatric research programs. She says Lake Nona Medical City offers research synergy through collaborations and partnerships from the Sanford-Burnham Research Institute, University of Central Florida, University of Florida (Pharmacy), the Orlando VA Medical Center and even Holmes Regional Medical Center. Dr. Finkel, is also an example of one of the rare specialists recruited by Nemours. She is one of just 250 pediatric rheumatologists practicing in the nation and earned a top distinction by U.S. News & World Report. Prior to her arrival in Orlando, no one with this specialty was based in Orlando. “The U.S. Department of Health and Human Services estimates that the specialty field of pediatric rheumatology actually requires at least 700 more trained physicians throughout the country. Our community is delivering that demand for care. This unique specialty will impact many families who previously had no choice but to travel at least 50 miles outside of the area for rheumatic diseases such as childhood arthritis or autoimmune diseases,” says Dr. Finkel.
Dr. Finkel says that while ‘Dr. House’ may be the fictional lead character on the FOX network’s hit television program, sometimes children’s health symptoms often do require ‘detective’ medicine. In addition to pediatric rheumatology, Dr. Finkel says Nemours Children’s Hospital will offer other specialties new to the Central Florida area and advancements to other specialties already present. Some new disciplines include, among other areas, chronic pain, pediatric rehabilitation, gastroenterology, behavioral health, fetal surgery, interventional radiology and muscular dystrophy – a specialty area for her husband and fellow researcher, Richard Finkel, MD. “Like many aligned with Nemours Children’s Hospital, we’re looking for cures, not just methods of treatments.”
Dr. Finkel’s research is still needed to answer very basic questions stumping medical scientists: Why is this specific condition developing? How does the condition occur (in children)? What is the genetic makeup? She is now working to find solutions in her laboratory, located at the Sanford-Burnham Institute, regarding pediatric immune system diseases. Dr. Finkel says it’s important for parents to know that physicians at Nemours Children’s Hospital are leading the charge with pediatric research. “Patients will gain a sense of security and hope knowing their physician is a researcher. Research physicians are accustomed to asking questions and digging down for a precise, accurate conclusion. Therefore, we’re not going to accept the obvious and possibly flawed medical diagnosis and treatment approach when caring for pediatric patients. We can do better…we can save lives. That’s why our motto remains Your Child. Our Promise.”
Article by Nancy Devault, Staff Writer
Photos courtesy of Preston Mack and Nemours