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