PEDIATRIC CARDIOLOGY Division Highlights. March 19, 2013 Elman Frantz, MD Division Chief

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1 PEDIATRIC CARDIOLOGY Division Highlights March 19, 2013 Elman Frantz, MD Division Chief

2 Mission The Division s mission is to provide comprehensive state-of-theart cardiac care to all of the state s children regardless of geographic or financial circumstances: including patients with known or suspected heart disease from prenatal to young adult life facilitated by convenient access through a network of community-based subspecialty practices in regional population centers providing seamless access to the North Carolina Children s Heart Center, the Children s Hospital, and its full scope of multi-disciplinary services while educating the next generation of caregivers

3 Who are we? Scott Buck, MD Electrophysiology Medical Director, CICC Co-investigator, Project TICKER Greensboro, Cary, UNC John Cotton, MD Director, Pediatric Echocardiography Lab - ICAEL-certification, digital conversion Fetal Echocardiography Greensboro, Fayetteville, Wilmington, Burlington, UNC

4 Who are we? Elman Frantz, MD Division Chief Director, Pediatric Cardiac Catheterization Raleigh, Cary, Fayetteville, UNC Jim Loehr, MD Full-time Wilmington-based Pediatric Exercise Testing Fayetteville

5 Who are we? Blair Robinson, MD Cardiac catheterization/interventions Director, Pediatric Cardiac Transplantation Education Coordinator Raleigh, Cary, UNC Jennifer Whitham, MD Clinical pediatric cardiology Echocardiography, fetal echocardiography Pediatric exercise testing Raleigh, Cary, UNC

6 Who are we? Pediatric, fetal, and adult congenital diagnostic cardiac sonographers all pediatric-registered all with 7+ years tenure 98 years peds-specific experience Patti Zeiders, RDCS Noreen Kirwan, RDCS Jeff Jewell, RDCS ~ 8,000 studies/year ~ 5,000 studies off-site Ruben Centeno, RDCS Gary Stupp, RDCS Silvia Baker, RDCS

7 Who are we? A multi-disciplinary team Cardiothoracic Surgery Pediatric Cardiac Anesthesia Michael Mill, MD Bob Valley, MD Jennifer Nelson, MD Peggy McNaull, MD Karla Brown, RN, PNP Sara Pittenger, MD Ruben Bocanegra, PA Specialized Nursing Staff Diane Schroeher, RN Susan Simon, RN Mary Clay Federspiel, PNP CICC nursing staff Pediatric Critical Care Tina Willis, MD Keith Kocis, MD Jenny Boyd, MD Katherine Clement, MD Cherissa Hanson, MD Umesh Joashi, MD Benny Joyner, MD Afsaneh Pirzadeh, MD

8 Who are we? Administrative & Clinic Staff UNC Office Britt Mann, Administrator Jen Banich Nanette Coulon Tina Oxendine Vanessa Simmons Philip Young WakeMed Clinic Judy Taylor M Lissa Ellis Cary Clinic Dulce Vidal Carrie Miles Burlington Clinic (ARMC) Christie Gulledge Debby Harris Greensboro Clinic Christie Gulledge Debby Harris Wilmington Clinic Missy O Connor Erica Maid Fayetteville AHEC Clinic Janet Lockwood Jaime Anderson

9 Clinical Programs Guiding principles: Easy access: - for patients, community-based office practices - for referring physicians, direct access pager - for hospitalists/neonatologists, on site availability - just say yes, no voice mail, referrals managed in Division Rapid feedback: - office notes FAXed in hours - inpatient echo results phoned to ordering MD Specialty Clinics

10 Clinical Programs 1680 ½ day clinic sessions Specialty Clinics 8800 Annual Visits - UNC ~ Other sites ~ 7, echocardiograms

11 Clinical Programs Specialty Clinics WakeMed Heart Center 4 days/week 384 ½ day sessions/year 2,000 annual visits 1350 echocardiograms Cary office 3 days/week 288 ½ day sessions/year 1,500 annual visits 950 echocardiograms

12 Clinical Programs Specialty Clinics Greensboro office 3 days/week 288 ½ day sessions/year 1300 annual visits 760 echocardiograms Wilmington office 3 days/week 288 ½ day sessions/year 1600 annual visits 825 echocardiograms

13 External Collaborators WakeMed Children s Hospital WakeMed Cary Hospital (echo) Rex Hospital New Hanover Regional Medical Center Moses Cone/Women s Hospital of Greensboro (echo) Moore Regional Hospital Fayetteville AHEC Betsy Johnson Memorial Hospital Clinton Medical Center

14 Clinical Programs Summary by the numbers, annually: ~ 1400 Inpt Days, ~ 8800 OPVs ~ 8000 echos performed, ~400 fetal; interpreted ~ 200 cardiac surgeries and ~ 200 cardiac caths Continuous quality assessment (STS, TICKER, ICAEL, IMPACT) Specialty Clinics Fetal echocardiography (Greensboro, Wilmington, Raleigh/Cary, UNC) Pacemaker follow-up (Greensboro, Cary, UNC) Adult Congenital Heart Disease (Meadowmont)

15 Education Teach medical students on inpatient service and outpatient sites (UNC, Wake, and Cone rotations); 4 th year elective Teach housestaff on rounds in CICC and PICU, noon Core lecture series, outpatient sites; elective month No fellowship program currently Ten graduating residents in past 4 years have placed in excellent fellowships (Nationwide, U of Michigan (2), U of Colorado (2), Duke, Emory, Stanford, Cincinnati)

16 Primary Areas of Research No ongoing funded research participation in multi-center trials Project TICKER (AHCRQ-funded): Buck, Willis Pediatric Heart Transplant Study Group: Robinson Amplatzer muscular VSD post-market trial: Frantz IMPACT cath lab outcomes registry: Frantz, Robinson Wellstone Muscular Dystrophy Cooperative Research Center: Cotton Hunter Outcome Survey Cardiac Working Group: Loehr

17 Where are we going? Clinical Education Research Expand electrophysiology program (new recruitment) Develop adult congenital program with UNC Heart and Vascular Expand fetal cardiology outreach Expand Wake Co. presence at Rex clinic + exercise testing Explore further opportunities in Fayetteville Consider fellowship program (faculty expansion first) Consider participation in Pediatric Heart Network