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Posts By :

Jeb Phillips

New National “Vital Signs” to Measure Population-wide Pediatric Health
 New National “Vital Signs” to Measure Population-wide Pediatric Health 1024 683 Jeb Phillips
By: Jeb Phillips

In 2017, an opinion piece in JAMA Pediatrics started this way: “We call for a national effort to develop a parsimonious set of quality and outcome measures for (all) children.” And now, for perhaps the first time in American pediatrics, that “parsimonious set: has been laid out to guide communities and health systems across the United…

Whole Child, Whole Family Care
 Whole Child, Whole Family Care 150 150 Jeb Phillips
By: Abbie Miller and Jeb Phillips

Meeting the needs of children and caregivers with evidence-based programming and intentional support for access. Parenting a young child can be tough in the best circumstances. But when you overlay poverty, inequity, and concerns about employment and education on top of it, parenting a young child can feel overwhelming. Whitney Raglin Bignall, PhD, has dedicated…

Caring for Incarcerated Children
 Caring for Incarcerated Children 1024 537 Jeb Phillips
By: Jeb Phillips

Young people in juvenile detention centers need health care. In fact, decades of studies show they most often need it more urgently than their peers who are not involved in the justice system – nearly 70% of “confined youth” have an unmet health care need (2010 study). So it makes some sense that “urgent care”…

Improving Racial Diversity and Equity in Clinical Trials
 Improving Racial Diversity and Equity in Clinical Trials 1024 511 Jeb Phillips
By: Jeb Phillips

There is now broad consensus across medicine that clinical trials must be more representative of minority populations. How can that be achieved? Last year, a group of Nationwide Children’s Hospital neonatologists published an unusually pointed critique of racial and ethnic representation in neonatal clinical trials in the Journal of Perinatology. They wrote that the lack…

Reconsidering Screening in Primary Care
 Reconsidering Screening in Primary Care 1024 683 Jeb Phillips
By: Jeb Phillips
2021 Bright Futures/AAP Recommendations for Preventive Pediatric Health Care (Periodicity Schedule) in color showing all of the screenings recommended across 34 patient visits through a patient's twenty-second birthday

Screenings are an important part of preventive care, but the growing list of recommendations is daunting. How do we prioritize the limited time we have with patients and families? There are 32 well-child primary care visits recommended by the American Academy of Pediatrics in its Bright Futures “Periodicity Schedule.” The first is prenatal, the last…

An Alarming Connection Between Justice System Involvement and Child Health
 An Alarming Connection Between Justice System Involvement and Child Health 1024 575 Jeb Phillips
By: Jeb Phillips

A first-of-its kind study finds that while only 2% of patients at a large children’s hospital are identified with likely personal or family involvement in the justice system, they account for large proportions of some troubling diagnoses. Research over the last decade has shown that young people who have been incarcerated can have poorer physical…

“Left Behind Again:” Rural Children Enrolled in Medicaid Use Home Health Services Far Less Than Urban Children
 “Left Behind Again:” Rural Children Enrolled in Medicaid Use Home Health Services Far Less Than Urban Children 1024 575 Jeb Phillips
By: Jeb Phillips

Data from a pediatric accountable care organization is allowing physicians and researchers to explore the rural-urban health care gap. While it’s long been clear that children in rural areas have reduced access to some kinds of health care services compared to their urban peers, understanding the specifics of the care gap has proven difficult, because…

How Can We Make Child Health Equitable?
 How Can We Make Child Health Equitable? 550 350 Jeb Phillips
By: Jeb Phillips, Abbie Miller and Natalie Wilson

Researchers in the Center for Child Health Equity and Outcomes Research at Nationwide Children’s Hospital are tackling this question by identifying health disparities and uncovering exactly how social drivers of health impact outcomes. “Health equity means that everyone has a fair and just opportunity to be as healthy as possible.” That’s how the Robert Wood…

A New Kind of Rectal Diversion in Classic Bladder Exstrophy
 A New Kind of Rectal Diversion in Classic Bladder Exstrophy 1024 754 Jeb Phillips
By: Jeb Phillips

  This article appeared in the Spring/Summer 2021 print issue. Download the full issue.   Medical illustrations by Mandy Root-Thompson for Nationwide Children’s Hospital Source: V. Rama Jayanthi, chief of Urology at Nationwide Children’s Hospital To learn more about the procedure and it’s applications, read A Surprising Approach to Classic Bladder Exstrophy.

A Surprising Approach to Classic Bladder Exstrophy
 A Surprising Approach to Classic Bladder Exstrophy 1024 754 Jeb Phillips
By: Jeb Phillips

A procedure developed at Nationwide Children’s Hospital comes with possible risks but can have a huge impact on quality of life. It’s become clearer over the last two years that a “good outcome” for children born with classic bladder exstrophy is in the eye of the beholder. One of the best outcomes, nearly everyone would…

Study Shows That When Housing Quality is Poor, Children Suffer
 Study Shows That When Housing Quality is Poor, Children Suffer 1024 575 Jeb Phillips
By: Jeb Phillips
two houses: one in poor repair, one in good repair

Holes in floors, cracks in walls, plumbing issues and/or problems with pests are linked with overall poorer pediatric health and higher health care use in a nationally representative study. Housing instability and homelessness are widely understood to have an impact on health, and certain housing problems have been linked to specific childhood health conditions, such…

Paying for Telehealth After COVID-19
 Paying for Telehealth After COVID-19 1024 535 Jeb Phillips
By: Jeb Phillips
Collage of health technology tools

Telehealth has become an essential part of health care delivery during the COVID-19 pandemic, but its future depends on reimbursement and other financial questions. Just weeks into the COVID-19 pandemic in the United States, health care stakeholders across the country were talking about the expansion of telehealth as a silver lining, and how it seemed…

Pediatric Vital Signs: Measuring and Improving the Health of a Population
 Pediatric Vital Signs: Measuring and Improving the Health of a Population 150 150 Jeb Phillips
By: Jeb Phillips

Nationwide Children’s Hospital and its community partners have begun an “audacious” project to help every child in their region. Despite the best efforts of primary care providers and children’s hospitals, some children do not receive the care they need. Patients can only spend a limited amount of time in a medical office; some who would…

When the Neighborhood Improves, Does Pediatric Health Care Utilization Decrease?
 When the Neighborhood Improves, Does Pediatric Health Care Utilization Decrease? 1024 683 Jeb Phillips
By: Jeb Phillips

A new study finds decreased rates of high-cost care after a community development initiative, which may exceed decreases in similar neighborhoods. More than a decade into the community development initiative called Healthy Neighborhoods Healthy Families, the 30-block Southern Orchards neighborhood on Columbus’ South Side had clear, notable improvement. Home vacancy fell from 30% to under 6%.…

Accountable Care and Quality Improvement: How an ACO Helps Community Practices Provide the “Right Care” Through QI
 Accountable Care and Quality Improvement: How an ACO Helps Community Practices Provide the “Right Care” Through QI 1024 575 Jeb Phillips
By: Jeb Phillips

An accountable care organization (ACO) should deliver “the right care at the right time,” according to the Centers for Medicare & Medicaid Services. Early, high-quality primary care helps people stay well, while coordinated specialty care can help people with chronic or complex conditions spend less time in a hospital. ACOs are usually considered the province…

Study Shows Three-Day Intensive Crisis Intervention is Associated with Reduced Suicidality in Adolescents
 Study Shows Three-Day Intensive Crisis Intervention is Associated with Reduced Suicidality in Adolescents 150 150 Jeb Phillips
By: Jeb Phillips

When an adolescent is acutely suicidal and cannot safely remain in the community, inpatient psychiatric hospitalization is the traditional intervention. But a lack of appropriate facilities across the United States, combined with an increasing demand for inpatient psychiatric services, means many young people who are at critical risk often cannot get the help they need.…

Addressing Childhood Obsessive-Compulsive Disorder in Primary Care
 Addressing Childhood Obsessive-Compulsive Disorder in Primary Care 150 150 Jeb Phillips
By: Jeb Phillips

Primary care providers play an important role in recognizing the disorder and in providing a bridge to mental health care providers.

Worth It: Why Wrestling Through the Logistical Challenges of a Multidisciplinary Colorectal Center Matters
 Worth It: Why Wrestling Through the Logistical Challenges of a Multidisciplinary Colorectal Center Matters 150 150 Jeb Phillips
By: Jeb Phillips

Consider the complex case of a girl born with rectal, vaginal and urinary tracts fused into a common channel – a cloacal malformation. The child needs reconstructive procedures across three different organ systems and three different surgical specialties. It could take months or years to manage the surgeries needed for the colorectal portion, then the…

Toward a Cell-based Therapy for Cystic Fibrosis Lung Disease
 Toward a Cell-based Therapy for Cystic Fibrosis Lung Disease 150 150 Jeb Phillips
By: Jeb Phillips

Because cystic fibrosis (CF) is a genetic disease caused by mutations in the CFTR gene, the pulmonary disease could be reversed if CF airway epithelial cells were replaced with basal cells expressing CFTR without mutations. That is one of the ideas underpinning the Cystic Fibrosis Foundation’s Epithelial Stem Cell Consortium, but there are a number of…

A Simple Measure to Help Early Detection of Hemiplegic Cerebral Palsy in Infants
 A Simple Measure to Help Early Detection of Hemiplegic Cerebral Palsy in Infants 150 150 Jeb Phillips
By: Jeb Phillips

An easily derived Hammersmith Infant Neurological Examination asymmetry score, in combination with the total HINE score, differentiates typically developing infants from those with hemiplegic CP. While cerebral palsy can now be diagnosed at 6 months of age – allowing for earlier interventions and better potential outcomes than ever before – evaluation can be difficult in…

A High Risk of Urological Diagnosis in Anorectal Malformations
 A High Risk of Urological Diagnosis in Anorectal Malformations 150 150 Jeb Phillips
By: Jeb Phillips

Endocrinology Considerations in Duchenne Muscular Dystrophy
 Endocrinology Considerations in Duchenne Muscular Dystrophy 150 150 Jeb Phillips
By: Jeb Phillips

Concussion is Associated With a 2x Higher Risk of Suicide
 Concussion is Associated With a 2x Higher Risk of Suicide 150 150 Jeb Phillips
By: Jeb Phillips

Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed
 Prenatal Magnesium Sulfate May Not Reduce Cerebral Palsy Severity as Once Believed 1024 575 Jeb Phillips
By: Jeb Phillips

Improved neonatal care and earlier diagnosis and management may instead be reason for a decrease in cerebral palsy severity. A large randomized controlled trial showed in 2008 that when pregnant women at imminent risk of preterm delivery were given magnesium sulfate, their children had reduced rates of moderate or severe cerebral palsy. As a result…

How to Reduce Cast Complications in Orthopedics
 How to Reduce Cast Complications in Orthopedics 150 150 Jeb Phillips
By: Jeb Phillips

The Changing Medical and Legal Landscape for Cannabidiol
 The Changing Medical and Legal Landscape for Cannabidiol 150 150 Jeb Phillips
By: Jeb Phillips

Can Ultrasound or MRI Help Monitor Dysgenetic Gonads for Tumors?
 Can Ultrasound or MRI Help Monitor Dysgenetic Gonads for Tumors? 150 150 Jeb Phillips
By: Jeb Phillips

Dysplastic gonads that have neoplasms are often deemed “normal” in imaging studies. Patients with gonadal dysgenesis and a Y chromosome have a substantial risk of gonadal neoplasm, so providers have traditionally recommended bilateral gonadectomy for them. But relatively recent concerns about caring for children with differences of sex development (DSDs) have called that recommendation into…

Saving Constipation Treatment Costs With a Bowel Management Program
 Saving Constipation Treatment Costs With a Bowel Management Program 1024 575 Jeb Phillips
By: Jeb Phillips
Simple illustrated diagram of the GI track with organs colorized and body outline and background in blue

A protocolized approach significantly reduced ED visits and hospital admissions for children with chronic constipation – and became a driver for surgical referrals. If hospitals are willing to foot the bill for staffing and start-up costs, a structured bowel management program for children with chronic severe constipation likely saves both individual and institutional health care…

Race, Insurance, and ED Visits for Pediatric Crohn’s Disease
 Race, Insurance, and ED Visits for Pediatric Crohn’s Disease 1024 680 Jeb Phillips
By: Jeb Phillips
Close up color photo of little boy holding hands on his belly

Black children and children insured by Medicaid make more repeat emergency department visits for Crohn’s disease than their white and privately insured peers. In what appears to be the first nationally representative study evaluating the impact of race and insurance status on emergency department treatment for Crohn’s disease, a team of physicians and researchers at…

Guidance on Counseling Children at Risk for Fertility and Sexual Function Issues
 Guidance on Counseling Children at Risk for Fertility and Sexual Function Issues 150 150 Jeb Phillips
By: Jeb Phillips

Many childhood medical conditions and treatments can affect reproductive health. A new report from the American Academy of Pediatrics explains when and how doctors should address those concerns. While fertility and sexual function are most often considered adult issues, even very young children may have conditions that will have an impact on reproductive health later…

Why Obese Women Have More Surgical Infections After Cesarean Delivery
 Why Obese Women Have More Surgical Infections After Cesarean Delivery 1024 575 Jeb Phillips
By: Jeb Phillips
Illustration showing the precise pattern of a biofilm - a perfect, 3D matrix

Even though all pregnant woman typically undergo a standardized antiseptic preparation before a cesarean delivery, obese women are twice as likely to develop a surgical site infection after the procedure as women with a normal body mass index. A new, first-of-its-kind study from The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital shows why — and…

Cannabis-Derived Treatment Can Significantly Reduce Seizures in Hard-To-Treat Childhood Epilepsy
 Cannabis-Derived Treatment Can Significantly Reduce Seizures in Hard-To-Treat Childhood Epilepsy 150 150 Jeb Phillips
By: Jeb Phillips

A new study shows that cannabidiol is effective in children with Lennox-Gastaut syndrome. Children with Lennox-Gastaut syndrome can have hundreds of brief seizures every day. This complex form of epilepsy often does not respond to conventional epilepsy medication, leaving children at serious risk of injury from their seizures, or confined to wheelchairs and beds. An international…

New Guidelines Offer Practical Tools to Treat GI Reflux
 New Guidelines Offer Practical Tools to Treat GI Reflux 150 150 Jeb Phillips
By: Jeb Phillips

An international committee’s new recommendations reflect shifting opinions about acid-suppressive medications and include an expanded diagnostic algorithm. While reflux-related complaints are heard often by pediatric gastroenterologists and primary care physicians, it can be difficult to tell when gastroesophageal reflux (GER) crosses the line into gastroesophageal reflux disease (GERD) — or how that disease should be…

The PDA Conundrum
 The PDA Conundrum 150 150 Jeb Phillips
By: Jeb Phillips

A patent ductus arteriosus is associated with increased morbidity and mortality, but common treatments are associated with poor outcomes as well. What is a neonatologist to do? Until the mid-2000s, most neonatologists were pretty sure they knew how to handle a patent ductus arteriosus (PDA) in an infant born preterm – it needed to be…

The National Mortality Rate for the Comprehensive Stage 2 Procedure
 The National Mortality Rate for the Comprehensive Stage 2 Procedure 1024 575 Jeb Phillips
By: Jeb Phillips

A substantial overall U.S. rate, in contrast to the low rates reported by a few single centers such as Nationwide Children’s, shows room for improvement in handling the hybrid approach for left ventricular physiology. Most published outcomes data on the pediatric Comprehensive Stage 2 procedure come from the few institutions routinely using the “hybrid approach”…

A Better Non-Invasive Method To Monitor Liver Disease in Short Bowel Syndrome?
 A Better Non-Invasive Method To Monitor Liver Disease in Short Bowel Syndrome? 150 150 Jeb Phillips
By: Jeb Phillips

A pilot study suggests that acoustic radiation force impulse elastography can help monitor liver disease in children with short bowel syndrome. Patients with intestinal failure (most frequently caused by short bowel syndrome) are at risk for developing liver disease due to multiple contributing factors, including the underlying cause of their intestinal failure, need for parenteral…

Can Spinal Replace General Anesthesia in Pediatric Urology Patients?
 Can Spinal Replace General Anesthesia in Pediatric Urology Patients? 150 150 Jeb Phillips
By: Jeb Phillips

Spinal anesthesia offers a viable low-risk alternative to general anesthesia for a wide range of pediatric procedures, particularly for urology patients. As research continues to illuminate the possibility of neurotoxic effects from general anesthesia in pediatric patients, surgeons and anesthesiologists at Nationwide Children’s Hospital have already sought out an alternative among children 2 years of…

Dopamine: A Rescue Therapy for Fontan Patients With Protein-Losing Enteropathy?
 Dopamine: A Rescue Therapy for Fontan Patients With Protein-Losing Enteropathy? 150 150 Jeb Phillips
By: Jeb Phillips

Patients with quickly worsening PLE saw serum albumin levels stabilize after dopamine treatment. Patients who have undergone the Fontan procedure for single ventricle congenital heart disease do not often develop protein-losing enteropathy (PLE) – but those who do are at substantial risk of mortality and morbidity. Only heart transplant has been shown to alleviate PLE…

How to Reduce Unnecessary Antibiotic Use for UTI in Urgent Cares
 How to Reduce Unnecessary Antibiotic Use for UTI in Urgent Cares 150 150 Jeb Phillips
By: Jeb Phillips

A quality improvement project shows children with negative urine cultures take antibiotics they don’t need. Even before a urine culture confirms the diagnosis, urgent care physicians often prescribe antibiotics when children present with symptoms of urinary tract infection (UTI). Early treatment is important for relief of symptoms and prevention of complications. But what if the…

Mapping the Journey to Optimal Health for NICU Graduates
 Mapping the Journey to Optimal Health for NICU Graduates 1024 683 Jeb Phillips
By: Jeb Phillips

Babies born preterm need ongoing, specialized care to help them thrive after discharge from the hospital. Innovative programs are being designed to ensure that they get that care. In the early 1980s, only 10 percent of infants born before 28 weeks of gestational age survived to be discharged from the hospital. By 2015, 65 percent…

Integrating Research Into the “Journeys”
 Integrating Research Into the “Journeys” 1024 683 Jeb Phillips
By: Jeb Phillips

Along with their work to build an innovative follow-up program, Nationwide Children’s faculty and staff members are international leaders in NICU follow-up research. A number of foundation and National Institutes of Health-funded follow-up studies are housed entirely or in part at the hospital, and The Research Institute at Nationwide Children’s is one of 17 member…

Sweat Chloride Should Be the First-Line CF Test, but Often Isn’t
 Sweat Chloride Should Be the First-Line CF Test, but Often Isn’t 150 150 Jeb Phillips
By: Jeb Phillips

A study finds that CFTR mutation analysis is being ordered before (or without) sweat chloride in some cases, potentially leading to missed diagnoses, increased patient anxiety and unnecessary costs. The Cystic Fibrosis Foundation is clear in its diagnostic guidelines: sweat chloride needs to be the first test ordered after a positive newborn screening for cystic…

Bracing for Buckle Fractures
 Bracing for Buckle Fractures 150 150 Jeb Phillips
By: Jeb Phillips

Shifting from casts to splints for distal radius buckle fractures has saved time and money for providers and families. The traditional treatment for distal radius buckle fractures involves immobilization in a short- or longarm cast. A 2015 multi-institutional study found that more than 70 percent of pediatric orthopedic specialists use this as their standard of…

In Sight: Three Procedures, One Surgery
 In Sight: Three Procedures, One Surgery 388 320 Jeb Phillips
By: Jeb Phillips

Colorectal Surgery, Urology and Gynecology coordinate to save tissue and time. A child with a complex colorectal and pelvic condition may require several surgeries over months or years before they are able to successfully manage their urine and stool. With advance planning and coordination it can be possible to treat many issues at once and…

How to Solve Feeding Disorders Without a G-Tube
 How to Solve Feeding Disorders Without a G-Tube 1024 575 Jeb Phillips
By: Jeb Phillips

Babies in a neonatal intensive care unit must have a safe way of receiving nutrition in order to go home. Full oral feeding is ideal, of course. But for those patients with persistent difficulty feeding by mouth, there were two primary options before 2002 to guarantee nutrients by the time of discharge. Both had their…

Best Practices in Severe BPD Treatment
 Best Practices in Severe BPD Treatment 150 150 Jeb Phillips
By: Jeb Phillips

To help standardize care, the Bronchopulmonary Dysplasia Collaborative has published a comprehensive review of evidence-based approaches for treatment of patients with severe forms of the disease. Infants with severe bronchopulmonary dysplasia (BPD) have high risks of late morbidities and mortality, but the best ways to manage these vulnerable patients are still debated. In fact, it’s…

How a QI Project Dramatically Increased Pediatric Survival After Cardiopulmonary Arrest
 How a QI Project Dramatically Increased Pediatric Survival After Cardiopulmonary Arrest 150 150 Jeb Phillips
By: Jeb Phillips

A survival rate of 37-48 percent among young heart surgery patients who experience code events is the norm. A multidisciplinary review process helped achieve an 81 percent rate at Nationwide Children’s Hospital. Survival rates have remained stubbornly low for young heart surgery patients who experience cardiopulmonary arrest; critical care literature reports that fewer than 50…

Evaluating and Treating Pediatric Lower Back Pain in the Primary Care Setting
 Evaluating and Treating Pediatric Lower Back Pain in the Primary Care Setting 150 150 Jeb Phillips
By: Jeb Phillips

While pediatric training often focuses on etiology, recent studies have found that most cases of lower back pain in school-aged children have no definitive diagnosis and are benign and self-limiting. Primary care pediatricians are often taught that lower back pain in school-aged children has a definitive cause. As a recent review published in JAMA Pediatrics highlights, studies conducted over…

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