AAP Section on Hospital Medicine/ Integrated Surgical Surgical Care Subcommittee (SCSC)

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1 AAP Section on Hospital Medicine/ Integrated Surgical Surgical Care Subcommittee (SCSC) June 30, 2016 Tri-Chairs: Josh Abzug, David Rappaport & Becca Rosenberg

2 Agenda 1. Intros/Attendance 2. Research: 3. Education: PHM Workshops; Clinical Guidelines; Website; July SOHM Webinar 4. Guidelines/Policy: DP and Becca update on process/results 5. Dialogue: Connie, SAP Panel, speakers confirmed for AAP NCE Next meeting In person: PAS, Baltimore MD: Sunday, May 2-4pm, Hilton Baltimore Hotel: Hopkins Room Late May/early June: Conference call July: PHM, Chicago, IL Jul 27-30

3 Research Surgeon Survey on Comanagement Hospitalist Survey on Comanagement/Billing: Submitted!

4 Survey: Surgeon Experience and Perceptions of Involving PH in Patient Care Phase I: Pediatric Distributio n N Phase II: General Distribution AAP Section on Surgery Ben N Analyzing data 290 ACS Ben N AAP SONS/APNS Doug/ Eric? TBD AANS Doug/Becca POSNA/ AAP Ortho Section Josh A Survey closed 415! AAOS Esurvey Not Possible

5 Education Target: Pediatrics On Surgical Comanagement Surgical Care Module (for PH/Peds) CCMC Now available on MedEd Portal July 2016: SOHM Webinar/Comanagement? Ped Hosp Medicine Conference (AAP/APA/SHM) workshops (July 2016, Chicago) Preoperative Management/Models-Practice Management-Clinical Postoperative Management/Clinical Target: Surgeons Pediatric Module (for surgeons)??

6 PHM PRE-operative Workshop Agenda Rationale and evidence supporting pediatric preop clinics 20 min Structure and function of preop clinics Anesthesiology perspective Small group cases Medically complex adolescent s/p PSF Toddler with OSA s/p T&A Discussion and Wrap-Up 20 min 30 min 5 min July 29, 2016

7 PHM POST-operative Workshop Agenda Review post-operative care models and surgical comanagement 10 min Interactive Evidence Review 20 min Small group cases Medically complex adolescent s/p PSF Toddler with OSA s/p T&A Discussion and Wrap-Up 40 min 5 min July 29, 2016

8 Surgical Comanagement Best Practices in Pediatrics: AAP Policy Statement Current WG PH: David Pressel, Moises Aron, Becca Rosenberg, David Rappaport, Yeng Yang, Anjna Melwani, Sonaly McClymont, Sybil Klaus Surgeons: Josh Abzug MD (Ped Orthopedics) Ellen Raney (Ortho), Mark Mazziotti (Gen Surg), Tom McPartland (Gen Surg), NS? 9/20/2015

9 Guiding Principles for Inpatient Comanagement of Primary Surgical patients (non-icu) Approach: Modified Delphi with nominal group technique ROUND 1: Oct 15 Survey to Experts: AAP SCSC Surgical Advisory Panel * SOHM Leadership Section on Surgical Care? Others ROUND 2: Oct 15 In NCE: Discuss results SCSC WG ROUND 3: Jan 2016 Voting to: SCSC WG SAP SOHM Leadership 3A: May 2016 Community Hospitalist leaders LOI submitted to AAP Draft in progress 22 very strong/stron gly endorsed 2 less so *Leaders of AAP Sections of Urology, Surgery, Orthopedics, Anesthesiology, Dentistry, Neurosurgery etc

10 National Dialogue Symposia/Discussion 2016 NCE: Symposia Surgical Advisory Panel (n=300) Connie Agenda to include PH and Surgical Reps including panel on models of care at end

11 SCSC: Future Directions From your Feedback Survey results (Thank you!) 20 respondents (14 hospitalists/anesthesiologists, 6 surgeons) CLINICAL: Guidelines most often requested RESEARCH: multicenter trials on variation in care, effect of comanagement PRACTICE MANAGEMENT: toolbox/business plans, templates Overall: more collaborative projects with clear ways to participate, focus on specific conditions

12 Extra

13 SAP NCE 2016 Agenda As the number of children with complex medical needs increases and more children are cared for in medical facilities with limited surgical personnel, collaborative practice models involving non-surgeons in perioperative care are becoming more common. This session will provide an introduction to the concept of pediatric hospitalist-surgeon co-management, outline models of collaborative surgical care, and describe the successes, challenges and opportunities for this type of combined perioperative care. Saturday, October 22, :00 pm 5:30 pm Joint Subspecialist Program Co-management of surgical patients: Who, what, when, where, why and how? 4:00 pm Welcome and Introduction Constance S. Houck, MD, FAAP Chair, Surgical Advisory Panel 4:10 pm What and why? Introduction to hospitalist-surgical co-management David Rappaport, MD, FAAP & Rebecca Rosenberg, MD, MPH, FAAP 4:25 pm Where and when and who? Models of surgical co-management Mark Mazziotti, MD, FACS, FAAP 4:40 pm How co-management impacts care: Successes, Challenges and Opportunities Lisa McLeod, MD, FAAP 4:55 pm Panel Discussion: Speakers + Carl-Christian Jackson, MD, FACS, FAAP & Joshua Abzug, MD, FAAOS, FAAP 5:30 pm Pediatric Subspecialists Reception

14 Membership Roster/Regroup At least 15! PH Surgeons Ortho Josh Abzug, UMMC Wade Shrader, UMC Peter Sturm, CCMC Ellen Raney, OHSU Tom McPartland, RWJ Gen Surg Marybeth Browne, Lehigh Valley Mark Mazziotti, Texas Children s Carl-Christian Jackson, Tufts Neurosurg Doug Brockmeyer, Utah (AAP) Eric Jackson, JHH

15 Jones & Hunter: BMJ, Overview- Delphi and Nominal Group Technique

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