cub chat Best Children s Hospital in 5 U.S. News Specialties National Leader in Pediatric Heart Surgery

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1 cub chat A Publication of Penn State Hershey Children s Hospital Winter 2014 Best Children s Hospital in 5 U.S. News Specialties National Leader in Pediatric Heart Surgery Partnering with Moses Taylor to Treat Kids in Northeastern PA

2 News from Children s Hospital Penn State Hershey Quality by Patti Hart, M.S.N., R.N., C.P.N., NE-BC, Director of Nursing Penn State Hershey Children s Hospital takes an active approach to continual process improvement. We have agreed to participate in a national program to compare ourselves with other children s hospitals across the nation. This program, Ohio Children s Hospital Solutions for Patient Safety, is by invitation only and is assisting Penn State Hershey Children s Hospital to coordinate best practice and standardize processes to achieve the highest quality outcomes for our children. This program allows us to learn from our peers who have achieved positive patient outcomes. We have been very pleased with the collaboration with other children s hospitals in sharing data, information, and assistance. Hospital Capacity More children are admitted to the hospital each winter because of illnesses. We have added additional beds to accommodate that need. We will expand our beds when capacity exceeds that of our new building by using the updated space at our prior children s hospital. This patient care unit will have the same nurses and physicians working with our children and will provide the same great care regardless of the location. Pediatric Progressive Care Unit (PPCU) Opens on 7th Floor In November, the Pediatric Progressive Care Unit opened in the old Pediatric Intermediate Care Unit space on the seventh floor of the Medical Center building. The patient logistics team, in collaboration with the pediatric charge nurses and triage officer, determines if and when the unit needs to open and when to close, based on patient needs and the number of pediatric patients coming through the institution. The unit is used for pediatric patients who would typically be placed on the pediatric acute care unit in Children s Hospital, when bed availability is limited. The patients are screened for appropriate placement before being directly admitted to this unit. This affords Children s Hospital the opportunity to admit additional pediatric patients during particularly busy times of year, when the institution sees an increase in pediatric patients. Mark Dias, M.D., pediatric neurosurgeon, is the medical director for this new unit. Beth Bradley and Brian Albrecht manage this unit. Mark Dias, M.D. Pediatric Neurosurgeon Expanded Room for Our Smallest Patients and Their Families After an Extreme Makeover: Pediatric Edition, the Continuing Care Nursery (CCN) opened its doors in June 2013, expanding the total bed space of the neonatal unit from 32 to 42 beds. The 10 new bed spaces in the CCN are more spacious and have improved the comfort for families. The majority of newborns in the CCN are affectionately referred to as feeders and growers, but some may still require additional support (including an incubator, supplemental oxygen, or IV therapies). Because of this, the new unit is less crowded than the original Neonatal Intensive Care Unit (NICU), with fewer beeps and alarms. This helps these families as they transition to more independent care, and it is more conducive for breastfeeding and infant bonding. Families have had a favorable response to the movement of their infants to the CCN, a step closer to home. The enhanced space and privacy also allow more parents to room-in with their babies and become comfortable with their care before being discharged from the neonatal unit. Since opening the CCN, the NICU has increased the average daily census and there have been no referred neonates turned away due to lack of bed space. 2 Penn State Hershey Children s Hospital, pennstatehershey.org/childrens

3 Children s Hospital Ranks Among Best Children s Hospitals in 5 Specialties As another calendar year begins, we are reminded of the recognition Penn State Hershey Children s Hospital has once again received from U.S. News & World Report s Best Children s Hospitals, published in Children s Hospital ranked in cancer, urology, orthopedics, neurology and neurosurgery, and cardiology and heart surgery two more specialties than the previous year. Children s Hospital first made the Best Children s Hospitals list in The Best Children s Hospital rankings are the first to be released since Penn State Hershey opened its new 263,000-square-foot Children s Hospital building last February. The rankings highlight the top 50 U.S. hospitals in each of these pediatric specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology, and urology. U.S. News introduced the Best Children s Hospitals rankings in 2007 to help families of sick children find the best medical care available. The rankings offer families an exclusive look at qualityrelated information at the individual hospital level. Each hospital s reputation among doctors is part of what U.S. News factors into its rankings. Three-quarters of each hospital s score is determined through an analysis of patient outcomes and data on the structural resources each hospital has for pediatric care. To gather data, U.S. News uses two surveys: a clinical questionnaire sent to 179 pediatric hospitals and, for the reputational assessment, a survey of 150 pediatric specialists and subspecialists in each specialty. The 1,500 physicians were asked where they would send the sickest children in their specialty, setting aside location and expense. A video of thanks and congratulations to Penn State Hershey faculty and staff, students, friends, and supporters is available on the Penn State Hershey YouTube channel (see box below). Recognition banners are now proudly displayed in the lobby of the Children s Hospital, proclaiming these rankings, as are recognition signs in outpatient clinics where these specialties are practiced. While Children s Hospital is very proud of the exceptional performance of providers and staff and reminded of this on a continued basis from our patients and their families, it is gratifying to be recognized by an external benchmark that cites these specific specialties. To see our videos, visit our YouTube channel at youtube.com/user/pennstatehershey and click on the Children s Hospital playlist. Penn State Hershey Children s Hospital, pennstatehershey.org/childrens 3

4 Breastfeeding and Breast Cancer Breast cancer is the most common cancer and the second leading cause of death in women in the U.S. In fact, approximately one in every eight women in the United States will develop breast cancer at one point in her lifetime. Sadly, everyone knows someone who has been affected by this disease. Although there is still much to be learned about what causes breast cancer, there are significant patterns that have emerged that allow us to better predict a woman s risk for developing this devastating disease. For example, does breastfeeding your infant decrease your risk for developing breast cancer? This question has been investigated for some time now, and although we still don t know for certain, there is increasing evidence to suggest that this may be the case. Studies have shown that, in general, women who breastfeed have a decreased risk of developing breast cancer, and that the longer they breastfeed during their lifetime, the more their risk is reduced. There is also some evidence that breastfeeding may be beneficial by specifically protecting against the more aggressive types of breast cancers. Breastfeeding may be particularly protective for specific populations, including women with a family history of breast cancer and African- American women. 4 Penn State Hershey Children s Hospital, pennstatehershey.org/childrens

5 by Shannon Kelleher, Ph.D., Associate Professor, Departments of Nutritional Sciences, Surgery, and Cell & Molecular Physiology; Director, Graduate Program in Nutritional Sciences, and Nick McCormick, Ph.D. Candidate, Department of Nutritional Sciences But how does breastfeeding exert these effects? Most likely, it has to do with the balance of hormones that are produced during the breastfeeding process. Certain cancer-related hormones, such as estrogen, are low during lactation, and therefore the risk of breast cancer is reduced. Also, at the end of lactation, the body gets rid of many breast cells. Some of these cells may contain damaged DNA, which is known to cause cancer. By getting rid of these cells, the risk of developing breast cancer may be lowered. Obviously, deciphering the relationship between breastfeeding and breast cancer is a complicated one, and there are still many questions that need to be answered. For example, is it total length of time spent breastfeeding during a woman s lifetime that matters? Or is there a minimal amount of time each infant should be breastfed that matters? Do women who mix breastfeeding and bottle feeding also have a reduced risk for breast cancer, or must breastfeeding be exclusive, meaning no formula, foods, or drinks? Does pumping milk, perhaps while at work, and then breastfeeding when at home make a difference when it comes to breast cancer risk? While many questions still remain, it is certain that breastfeeding has many other health benefits for both the mother and infant. The World Health Organization currently recommends six months of exclusive breastfeeding followed by continued breastfeeding with appropriate complementary foods up to 2 years of age. Penn State Hershey Breast Center Cares for Women Throughout Central Pennsylvania With locations on both the East Shore and West Shore for mammography and surgical consults, Penn State Hershey Breast Center allows patients to be cared for closer to their own communities. The Breast Center provides breast health support, education, and coordination of services for women of all ages and their families, offering a truly multidisciplinary team of providers to care for women at various stages of their lives. Call anytime, day or night, to schedule your screening mammography: To schedule a diagnostic mammography or clinical appointment, or to transfer previous mammograms, please contact us at For breast surgery appointments, call (Hershey) or (Mechanicsburg Oakwood). For more information, visit us online at pennstatehershey.org/breast. Penn State Hershey Children s Hospital, pennstatehershey.org/childrens 5

6 Children s Hospital Pediatric Providers at Moses Taylor Hospital Partnership Offers Advanced Pediatric Care for the Children of Northeastern Pennsylvania Frequently Asked Questions What is a pediatric hospitalist? Hospitalists are doctors who spend all their time caring for patients in a hospital setting. Penn State Hershey pediatric hospitalists spend all their time in the hospital caring for inpatients they do not see patients in outpatient offices, nor do they replace primary care providers. Dedicated Inpatient Pediatric Care in Northeastern Pennsylvania Thanks to a partnership with Moses Taylor Hospital, Penn State Hershey Children s Hospital now provides inpatient pediatric services by a team of pediatric hospitalists at Moses Taylor Hospital in Scranton. Penn State Hershey pediatric hospitalists provide coverage anytime day or night for admission, treatment, and consultation for hospitalized children (infants through 17 years of age). Penn State Hershey is committed to communicating with primary care doctors (family doctor or pediatrician), and keeping parents and guardians informed of their child s progress and future plans. Services Provided to Pediatric Patients at Moses Taylor Hospital High-quality care for infants and children hospitalized for various medical conditions Consultations for hospitalized infants and children being cared for by other doctors Evaluation of children in the Emergency Department at the request of the child s doctor or the emergency doctor caring for the child Care coordination with specialists at Penn State Hershey Children s Hospital, when necessary Facilitation of transfers of extremely ill patients to Penn State Hershey Children s Hospital in Hershey Assistance in identifying a primary care doctor for patients who do not have one, to help with ongoing care Meet Our Team of Penn State Hershey Pediatric Hospitalists Mikhail Mirer, M.D., Lead Hospitalist Terry Gubitosi, M.D. Tanya Kumaria, M.D. Thomas Martin, M.D. Why are Penn State Hershey pediatric doctors at Moses Taylor Hospital? Both Penn State Hershey and Moses Taylor are committed to delivering high-quality pediatric services for families closer to their own homes. This opportunity brings the advanced care of Penn State Hershey to the children and families of northeastern Pennsylvania. Thanks to this partnership, doctors are available to care for children of northeastern Pennsylvania at Moses Taylor Hospital, closer to their own communities. If they would need specialty care, they now have access to the pediatric experts at Penn State Hershey Children s Hospital. How does the partnership work? When infants, children, and young adults (through age 17) are admitted as patients to Moses Taylor, they are then cared for by Penn State Hershey pediatric doctors throughout their stay. Will my child s primary care doctor be informed while my child is in the hospital? Absolutely! Penn State Hershey pediatric hospitalists are committed to communicating with you and your child s primary care doctor to provide the most up-to-date information on your child s plan of care and progress. Moses Taylor Hospital 700 Quincy Ave., Scranton, PA Penn State Hershey Children s Hospital, pennstatehershey.org/childrens

7 Pediatric Heart Surgery at Children s Hospital in Top 15 in the Nation Penn State Hershey Notably Ranks Above National Standards Based on Outcome Data In a recent report from the Society of Thoracic Surgeons (STS) National Congenital Heart Surgery Database, Penn State Hershey Children s Hospital pediatric heart surgery program ranks among the top 15 in the country based on the outcomes of pediatric patients following pediatric heart operations! We proudly acknowledge the continued dedication of our multidisciplinary team of pediatric specialists who work with these heart patients, including cardiologists, heart surgeons, anesthesiologists, critical care physicians, neonatologists, nursing staff, and technologists in heart-lung bypass and respiratory care. For noted data reports, please visit pennstatehershey.org/childrens. Penn State Hershey Children s Hospital Heart Surgery Program Two pediatric and congenital heart surgeons, both board certified in cardiothoracic and congenital heart surgery, with a total of 35 years of experience Dedicated pediatric cardiac operating room and four pediatric cardiac anesthesiologists, intraoperative transesophageal echocardiography, and neuromonitoring for all cases Dedicated Pediatric Cardiac Care Unit (private rooms) staffed by pediatric critical care physicians, 24/7 (all rooms have facilities for a family member to stay with the child throughout his or her hospital stay.) 12 pediatric cardiologists caring for patients in 20 locations across Pennsylvania Penn State Hershey Children s Hospital, pennstatehershey.org/childrens 7

8 Eating Healthy During Winter Months by Ellie Hogentogler, Penn State Hershey PRO Wellness Center and respiratory problems, osteoarthritis, and dyslipidemia. 3 Hearty meals don t have to be unhealthy ones. Aside from being mindful of portion sizes, there are a few smart food choices you and your family can make to still eat nutritious and satisfying meals throughout the winter months. Here are a few tips for making your winter meals healthy. Eat Your Fruits and Vegetables. There are many winter vegetables like cabbage, carrots, cauliflower, and leeks that are in season during this time of year. These are a great addition to healthy soups and stews. Also don t discount frozen or canned produce. Stock your cupboard so that these ingredients are on hand for a quick and nutritious addition to your plate. The cold, dark winter months can prove challenging for families especially when trying to maintain healthy eating habits. Many of us are tempted to bypass lighter meals for warming comfort foods that unfortunately are higher in calories and fat. According to a recent study, 1 the average weight gain over the winter months is more than 1 pound. Another study 2 suggests that those who are already overweight gain 5 or more pounds. This may not sound like much. However, year after year, these pounds contribute to the gradual increase in weight that frequently occurs during adulthood. Making healthy meal choices over time can greatly benefit your long-term health. According to the Centers for Disease Control and Prevention (CDC), maintaining a healthy weight over time can reduce your risk for conditions like heart disease, type 2 diabetes, hypertension, cancers, stroke, sleep apnea Substitute Ingredients When You Can. There are many ingredient substitutions that can lighten up your family dishes. For instance: Add flavor without the fat by using different spices. Substitute mashed cauliflower for mashed potatoes. Replace higher fat dairy products with light or skim versions. When baking, try substituting applesauce for oil, butter, or sugar. Rethink Your Drink. Many warming winter drinks are also very high in empty calories. Choose low- to no-calorie drinks when you can. If your beverage of choice is made with milk, choose to make it skinny with 1 percent or fat-free milk. Also try to avoid whipped-cream and syrup toppings. These small choices can limit a lot of extra calories that lead to weight gain. Your diet isn t the only thing that can contribute to weight gain during winter. It s also important to not lose sight of exercise. Colder weather and shorter days shouldn t discourage you from getting active as a family. Contact your local recreation center to see whether it offers indoor swimming pools or tennis and badminton courts. There are many winter activities that can keep you moving. Consider taking a brisk walk, making a snowman, going sledding, or even switching your outdoor routine to one that can be done indoors ResultsPanel.Pubmed_RVDocSum 3 Cub Chat is a complimentary quarterly newsletter produced by Penn State Hershey Children s Hospital. For questions or additional copies, please call or visit us online at pennstatehershey.org/childrens. A. Craig Hillemeier, M.D., Medical Director and Chairman Articles in this newsletter are written by professional journalists or physicians who strive to present reliable, up-to-date information. But no publication can replace the care and advice of medical professionals, and readers are cautioned to seek such help for personal problems. All models used for illustrative purposes only. 6228