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Health Policy and Management

She for She: Supporting Women in Orthopaedics
 She for She: Supporting Women in Orthopaedics 1024 575 Julie Samora, MD, PhD
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Julie Balch Samora, MD, PhD, MPH, an orthopaedic surgeon at Nationwide Children’s Hospital and the hospital’s associate medical director for quality, is the 2021 President of the Ruth Jackson Orthopaedic Society – the leading international organization championing women in orthopaedics. This column was adapted from her presidential address.   Shalane Flanagan is an American long-distance…

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One Year Reflection: Behavioral Health Pavilion Adds to Industry-Leading Model of Care During Pandemic
 One Year Reflection: Behavioral Health Pavilion Adds to Industry-Leading Model of Care During Pandemic 1024 538 Kaitlin Hall
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The full impact of COVID-19 on children’s mental health likely won’t be known for some time. But even before the pandemic, pediatric mental health was in a national crisis, with one in five children living with a mental illness, and suicide the second leading cause of death for children 10 and older. That means the…

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Study Shows That When Housing Quality is Poor, Children Suffer
 Study Shows That When Housing Quality is Poor, Children Suffer 1024 575 Jeb Phillips
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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…

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Pediatric Kidney Care: A Complex Issue for Low-Resource Nations
 Pediatric Kidney Care: A Complex Issue for Low-Resource Nations 1024 575 Eric Butterman
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Children are dying from kidney disease at alarming rates in low-resource nations. And some procedures that could reduce this high mortality would be considered simple and low-cost for many countries, says William Smoyer, MD, vice president and director of the Center for Clinical and Translational Research in the Abigail Wexner Research Institute (AWRI) at Nationwide Children’s Hospital. Dr.…

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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
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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…

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When the Neighborhood Improves, Does Pediatric Health Care Utilization Decrease?
 When the Neighborhood Improves, Does Pediatric Health Care Utilization Decrease? 1024 683 Jeb Phillips
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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%.…

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Racism Revisited
 Racism Revisited 1024 683 Deena Chisolm, PhD
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Deena Chisolm, PhD, shares why it is essential for the research community to take action against systemic racism. Five years after the publication of this post on racism, the topic is as relevant as ever. In the wake of racial disparities in the COVID-19 pandemic, continuing incidents of police brutality costing the lives of unarmed Black people,…

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A Decade of Healthy Homes
 A Decade of Healthy Homes 1024 683 Kelly Kelleher, MD, MPH
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Dr. Kelleher and Rev. John Edgar, executive director and pastor emeritus, Church and Community for All People, discuss the first decade of a collaboration aimed to take on housing issues in the South Side of Columbus as a way to improve health outcomes and answer the question: What’s on the horizon? The last decade has…

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How Does a Children’s Hospital Excel in the Discovery and Development of New Therapies?
 How Does a Children’s Hospital Excel in the Discovery and Development of New Therapies? 1024 575 Abbie Roth
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conceptual art of DNA

A conversation with Dennis Durbin, MD, MSCE chief scientific officer, Abigail Wexner Research Institute, Nationwide Children’s Hospital Nationwide Children’s has become an epicenter for gene therapy discovery and development. The discovery in 2009 that adeno-associated virus (AAV) could cross the blood-brain barrier was a milestone in the development of dozens of gene therapy products for neuromuscular…

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Tackling Physician Burnout and Moral Injury
 Tackling Physician Burnout and Moral Injury 150 150 Katie Brind'Amour, PhD, MS, CHES
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Across the United States, burnout and suicide rates for physicians have reached record highs, claiming the life of a doctor a day. What can be done to protect and improve the wellbeing of the people who care for everyone else? Most doctors enter their profession knowing that it is demanding, but believing that it is…

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Does Newborn Screening Lead to Life-Span Benefits?
 Does Newborn Screening Lead to Life-Span Benefits? 1024 678 Kevin Mayhood
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To find the answer, researchers suggest data systems to track long-term care and outcomes are needed. Newborns in the United States are screened for a list of diseases, a practice that saves or improves 13,000 lives annually, the Centers for Disease Control and Prevention estimates. But, a group of health experts who helped build the…

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Meet Oluyinka Olutoye, MD, PhD
 Meet Oluyinka Olutoye, MD, PhD 1024 575 Abbie Roth
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In August 2019, Nationwide Children’s welcomed Oluyinka Olutoye, MD, PhD, as surgeon-in-chief. In a Q&A, the internationally renowned fetal surgeon shares his thoughts about the past, present and future of fetal surgery and the challenges and opportunities facing pediatric surgeons today.   Q: What brought you to Nationwide Children’s Hospital? I was initially attracted to…

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Bias: Do You See What Influences You?
 Bias: Do You See What Influences You? 1024 575 Abbie Roth
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In the United States, children of color have worse clinical outcomes than white children. Racial disparities have been documented in nearly every pediatric specialty. Among the most studied and most widely perpetuated disparities are those between black and white children. For example: The infant mortality rate, while declining overall, is nearly three times higher for…

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How and When Do Children Become Aware of the Construct of “Race”?
 How and When Do Children Become Aware of the Construct of “Race”? 1024 737 Abbie Roth
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Researchers have shown that babies of color are just as likely to experience bias as adults of color. But very young children don’t interpret that experience in the same way as older children. “Children become aware of differences in physical characteristics of human beings when they are 3 years old. They notice differences in sex…

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Pharmacists: The ‘Next Big Thing’ in Population Health Management
 Pharmacists: The ‘Next Big Thing’ in Population Health Management 1020 304 Katie Brind'Amour, PhD, MS, CHES
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Nationwide Children's style illustration showing a row of houses with a prescription in front of it

One of the nation’s largest pediatric accountable care organizations has expanded pharmacists’ role in quality improvement efforts, which could substantially impact prescribing patterns and patient management. Partners For Kids (PFK), one of the country’s oldest and largest pediatric accountable care organizations, is a provider-based organization dedicated to population health management with three key aims: improved…

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Medicaid Patients With Common “Buckle” Fractures Have Less Access to Primary Care Physicians
 Medicaid Patients With Common “Buckle” Fractures Have Less Access to Primary Care Physicians 150 150 Katie Brind'Amour, PhD, MS, CHES
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Moving From Child Health Care to Child Health
 Moving From Child Health Care to Child Health 1024 575 Kelly Kelleher, MD, MPH
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As pediatricians, we want children to be healthier, even the ones who never come through our doors. At Nationwide Children’s Hospital, the board and leadership have aimed to do just that by setting the highest bar yet for our organization – we want central Ohio children to be the healthiest in the United States. But…

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Four Reasons Hospitals Fail to Prioritize Drug Abuse in Communities Plagued by Opioids
 Four Reasons Hospitals Fail to Prioritize Drug Abuse in Communities Plagued by Opioids 150 150 Kevin Mayhood
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Lack of money and expertise, risk and stigma appear to forestall community benefit programming. Communities in Appalachian Ohio are among the hardest hit in America’s opioid crisis, but a study of hospitals in the region shows that under half make substance abuse a priority in their community benefit programs. “These hospitals are comfortable addressing diabetes,…

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Bouncing Back: Overcoming Physician Burnout With Resilience
 Bouncing Back: Overcoming Physician Burnout With Resilience 1024 575 Suzanne Reed, MD and John Mahan, MD
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Physician burnout is becoming increasingly recognized as an extensive and debilitating reality. Present in specialties across the spectrum of medicine, most disciplines report burnout rates of 50 to 60 percent or more, and these rates have been increasing over the last several years. Pediatrics alone demonstrated a more than 16 percent increase in burnout, up…

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Intervention for Medically Complex Children Improves Health, Saves Money
 Intervention for Medically Complex Children Improves Health, Saves Money 800 533 Kevin Mayhood
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The population-based program features coordinated care, education and feeding tube management. A population-based intervention for children with medical complexity in central and southeast Ohio led to fewer admissions, shorter hospital stays and a reduction of inpatient charges of nearly $11.8 million over 30 months, all while making children healthier. Nationwide Children’s Hospital and its affiliated…

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Can You Ration Health Care in a Just Society?
 Can You Ration Health Care in a Just Society? 150 150 Pedro Weisleder, MD, PhD
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How the Clinical Effectiveness Model enables the provision of uncompromised, yet fiscally responsible, medical care Health care costs in the United States are an unsustainable expense. In 2014, the United States’ gross domestic product (GDP) was about $17 trillion, and of that, close to $2.7 trillion was spent on health care. Per capita, we spend…

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Racism in Our Hospitals and Communities: Everyone Matters
 Racism in Our Hospitals and Communities: Everyone Matters 150 150 Kelly Kelleher, MD, MPH
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Let’s touch all families by erasing racism from children’s hospitals. Here at Nationwide Children’s Hospital, we are engaged in an important new initiative: Everyone Matters. The idea is simple — we each have effects that ripple far beyond us through our everyday actions and attitudes toward each other, our patients and our community. Those effects can be…

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What Do DALYs Mean for Pediatrics?
 What Do DALYs Mean for Pediatrics? 150 150 Dave Ghose
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An emerging, innovative metric could radically change childhood health policy. A new way of looking at illness is beginning to change how public health officials view life and death. The concept — called DALYs — offers a fuller view of disease that could have a big impact on pediatrics if embraced. Unlike death tolls —…

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Talking to Adolescent Patients About Marijuana
 Talking to Adolescent Patients About Marijuana 150 150 Katie Brind'Amour, PhD, MS, CHES
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With legalization spreading across the United States, it’s hard to know what to say to teens curious about marijuana. Legal in 23 states and the District of Columbia. Renowned in pop culture. Affectionately called everything from “wacky tobaccy” to “hippie lettuce.” Marijuana isn’t going away. Despite its popularity and availability, many youths — and clinicians…

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Do You Believe in Integrated Health Care?
 Do You Believe in Integrated Health Care? 150 150 Miguel Saps, MD
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Patients are more than a segregated set of organ systems. Treating them as whole beings requires the practice of integrated medicine. I believe in an integrated approach to health care. The care of patients is often envisioned as fractionated, with different specialists taking care of different organs or organ systems — a model that I…

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Crohn’s Disease Not Exempt From Racial Disparities
 Crohn’s Disease Not Exempt From Racial Disparities 150 150 Gina Bericchia
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Disparities exist among pediatric Crohn’s patients of different races for a number of health care metrics. A study published in the journal Inflammatory Bowel Diseases found significant differences in hospital readmissions, medication usage and both medical and surgical complications of children with Crohn’s disease related to race. In the study, black children had a 1.5 times higher frequency…

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Orphan Disease Seeks Parents, Funding
 Orphan Disease Seeks Parents, Funding 1024 575 Kevin Mayhood
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Color photo, family portrait of Reagan, a young girl with an orphan disease, her parents, and their dog

Research on rare pediatric diseases often remains underfunded and obscure until motivated families give scientists — and their own children — a much-needed shot at potential therapies worthy of federal funding. Reagan McGee’s pediatrician couldn’t figure out why she had cold after cold. Her parents, Karin and Peter McGee, took her to an ear, nose and…

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Patients Without Borders
 Patients Without Borders 150 150 Dave Ghose
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Immigrant children represent the fastest growing segment of the U.S. population. What can pediatricians do to help these vulnerable patients? James Duffee, MD, MPH, watched the immigrant population change dramatically during his 15 years as a community health pediatrician and child psychiatrist in Springfield, Ohio. When he founded the Rocking Horse Community Health Center in 1999,…

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Ebola in Children Creates Ethical Quandary
 Ebola in Children Creates Ethical Quandary 150 150 Kevin Mayhood
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Do you keep a parent in the room while the virus rages inside a child? The Ebola outbreak in Guinea, Liberia and Sierra Leone has challenged emergency preparedness at Children’s Hospitals and Clinics of Minnesota like nothing before — even more than the early days of AIDS and outbreaks of measles and H1N1 flu, says Infection Prevention…

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A Shift in the Antibiotic Prophylaxis Debate?
 A Shift in the Antibiotic Prophylaxis Debate? 150 150 Katie Brind'Amour, PhD, MS, CHES
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The RIVUR trial laid to rest certain questions surrounding antimicrobial prophylaxis in children with vesicoureteral reflux. But it also launched a new debate. The Randomized Intervention for Children with Vesicoureteral Reflux (RIVUR) trialwas supposed to provide clear direction for pediatric urologists. To date, it is the largest double-blind, placebo-controlled, randomized, multicenter study examining urinary tract infection…

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Conflicting Directions for BPD Treatment
 Conflicting Directions for BPD Treatment 150 150 Katie Brind'Amour, PhD, MS, CHES
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Treatment of bronchopulmonary dysplasia differs dramatically among institutions. But why does variation matter? Recent studies report extreme variation among hospitals ordering three common medications for chronic lung disease, or bronchopulmonary dysplasia, calling into question the appropriateness of their use and the reason for their prescription. “In the use of diuretics, inhaled bronchodilators and inhaled corticosteroids,…

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Beyond the Basics: Enrolling Children in Research
 Beyond the Basics: Enrolling Children in Research 150 150 Katie Brind'Amour, PhD, MS, CHES
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The ethics of pediatric research include far more than the concepts of autonomy and assent. Consent and assent. Competence and autonomy. Physicians are familiar with the catchphrases of ethical research, but the deeper researchers dig, the more they find that the field’s current understanding of the dimensions involved in pediatric investigations is still shallow. Numerous…

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Disparities in Care: Beyond Insurance
 Disparities in Care: Beyond Insurance 150 150 Dave Ghose
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A Minnesota study suggests the ACA’s Medicaid expansion won’t be enough to reduce persistent health care disparities among minority groups. The health care gap isn’t just about insurance. A variety of barriers — including transportation, inconvenient office hours, cultural biases and confusing information — prevent minorities from accessing health care. In a paper published in the August issue…

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