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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.