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How Research Reinforces the Collaborative Culture of a Children’s Hospital

April 19, 2019
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As he retires, the CEO of Nationwide Children's Hospital reflects on the less-obvious effects of scientific discovery.

Nationwide Children’s Hospital has undergone a dramatic transformation in the last two decades, from an important regional resource into a nationally preeminent medical system. One of the clearest signs of our growth, and one that we’re particularly proud of, is the expansion of our research program.

Like many of our academic medical peers, we are involved in the discovery of new knowledge, and our work is helping shape the future of health care. From my vantage point as CEO for the last 13 years, I have seen what may seem like a surprising effect of this research growth on Nationwide Children’s itself: a powerful reinforcement of our collaborative hospital culture.

Children’s hospitals across the country emphasize their institutional cultures and the effects on patients. Seattle Children’s Hospital calls its operating principals “ART” for Accountability, Respect and Teamwork. Colorado Children’s Hospital asks its staff to abide by a “Standards of Behavior Promise.”

At Nationwide Children’s, we have “One Team Values.” Our values say that our primary goal is providing optimal care for children, and we can best achieve the goal by collaborating, supporting each other and holding each other accountable. We recruit employees and faculty who will uphold these values, and we train new hires to call out managers and senior leaders who act counter to them.

So what does an increase in the number of principal investigators in our research institute from 111 to 195 since 2006, or a rise in National Institutes of Health research funding from $23.9 million to nearly $49 million, have to do with these internal values?

We have found that our increasing work to discover new knowledge, and the push to create new treatments and better outcomes, has actually driven collaboration, accountability and innovation, both at Nationwide Children’s and far outside our walls. A growing research program:

  • Allows us to make broader use of our personalized clinical work. The treatment provided to individual children at Nationwide Children’s, in combination with knowledge about outcomes, can be used to better inform treatment practices here and elsewhere.
  • Enables us to break through the fragmentation and regionalization of pediatric medicine. Pediatrics is often bound by geography and tradition – we do something because that’s the way we’ve always done it. Through our membership in scores of national and international research consortia and associations, we see in real time the successes and challenges of our peers, and they see ours. We all improve together.
  • Motivates us to know what is new, and what is coming in the future. Because we are pushing the field of medicine forward, we must keep up with the ways others are pushing. We stay aware of the newest and best, and we change practice based on what we learn.
  • Encourages greater cross-pollination between the bench and the bedside. Our clinicians increasingly turn to their research colleagues for help solving difficult problems, while our researchers increasingly focus on the translational aspects of their lab work. We also have more faculty members who identify as a “clinician-researcher” than ever before.
  • Creates opportunities for technology commercialization, ultimately benefiting patients. A total of 13 startup companies are now based on the research of Nationwide Children’s staff. The companies can often take treatments to market more efficiently than we can, while we reinvest financial gains from our licensing efforts into our clinical and scientific endeavors.
  • Continues to facilitate basic scientific discovery. An institution’s level of intellectual curiosity is raised when people push the boundaries of knowledge – when they learn something no one else knows about fundamental biologic mechanisms. This information forms the building blocks for others to pursue inquiries into disease.

There are countless examples in just the last two years of projects that have proven all of these points. Nathalie Maitre, MD, PhD, a neonatologist and principal investigator in our Center for Perinatal Research, and Garey Noritz, MD, chief of our Section of Complex Care, helped develop new guidelines for early diagnosis and intervention in cerebral palsy as members of a multinational collaborative – then led Nationwide Children’s to be the first hospital in the world to fully implement them.

A child is typically diagnosed with cerebral palsy at 2 years of age or older; now, with the guidelines and as the coordinating site for the Cerebral Palsy Foundation’s Early Detection and Intervention for Cerebral Palsy network, our average age of diagnosis is 10.5 months. An earlier diagnosis allows for earlier interventions, and potentially better outcomes. Meanwhile, Dr. Maitre is using cutting-edge neural processing measurement technology to study how infants born preterm respond to stimuli in order to improve their neurodevelopment.

Lauren Bakaletz, PhD, director of our Center for Microbial Pathogenesis, and her colleagues are creating a vaccine for common otitis media, or middle ear infection, which can be delivered through a bandage on the skin. Some of the underlying basic research, though, has helped show how many bacteria survive typical treatments by forming resistant biofilms, and how those biofilms can be eradicated. This knowledge has implications for researchers everywhere who study bacterial infection.

Perhaps most prominent is the work of Jerry Mendell, MD, a neurologist and principal investigator in our Center for Gene Therapy. Decades of basic science and clinical research led in 2017 to a publication in the New England Journal of Medicine, showing a gene therapy developed at Nationwide Children’s was extending the survival of patients with spinal muscular atrophy type 1. The disease is caused by a mutation in a single gene and nearly always leads to death by 2 years of age.

Dr. Mendell and his collaborators have been able to insert a healthy gene into a modified virus, infuse the therapy into very young children and are seeing astonishing results. Children with SMA1 are typically never even able to achieve head control, but after this gene therapy, children have been able to walk. The technology has been licensed to a company now working to bring it to market.

This is not the only benefit of this line of inquiry, however. To support gene therapy and other cell-based work, Nationwide Children’s has built a Clinical Manufacturing Facility to produce pharmaceutical-grade biologics, such as the modified virus vector Dr. Mendell uses. We are now able to help other institutions with their own cell-based therapies as a result.

We have invested in these and many other projects for the good of children. That is Nationwide Children’s Hospital’s mission. But these projects have also proven important for our One Team culture, which helps us achieve our mission. They have deepened staff members’ connections with each other. They have opened up lines of communication inside this institution that did not exist before. They have resulted in new infrastructure that will aid our discovery efforts for years to come.

In the end, our research growth has helped us remember that when it comes to better outcomes for children – whether here at Nationwide Children’s or around the world – we’re all on the same side. We’re all One Team.

Photo credit: Nationwide Children’s