Children's Hospitals Today - Summer 2017 - 22

FEATURE / INNOVATION

two-thirds of them-children's hospitals have placed an emphasis on organizing health care services across multiple providers to maximize resources
and create the best possible outcomes.
To inform sustainable change
in health care delivery through
new payment models supporting
better care, smarter spending and
healthier children, 10 children's hospitals, in partnership with Children's
Hospital Association, were awarded
a three-year, $23 million Health Care
Innovation Award from the Center for
Medicare and Medicaid Innovation.
The CARE Award study will test coordinating resources effectively for
children with medical complexity.
While the work happening within
the CARE Award will help identify best
practices and spread those ideas to the
larger community of children's hospitals, some hospitals are looking to their
peers to help them build or improve on
their coordinated care programs. "We
have taken quite a few models from
other organizations and adapted them,"
says Marla Silliman, senior executive
officer of Florida Hospital for Children

CHILDREN'S HOSPITAL S TODAY Summer 2017

and Florida Hospital for Women,
and chief operating officer of Florida
Hospital Orlando. "We don't have time
to reinvent an idea, so we learn from
and tweak what other children's hospitals have successfully implemented."
For Florida Hospital for Children,
this strategy evolved into its
Coordinated Care for Kids program,
a medical home to about 200 medically complex children. Patients are
assigned a care coordinator who manages all aspects of their care plan. The
program includes a day hospital where
patients have access to their medical
team on short notice, helping them
avoid trips to the emergency room. The
program also houses a complex care
clinic, a pediatric palliative care team
and multidisciplinary clinics. These
multidisciplinary clinics treat hundreds of children per year.

Collaborating to transition care
When Bruce Barnett began working
with cystic fibrosis (CF) patients more
than 30 years ago, there wasn't much
need for a transitional program to
adult care. "When I started in CF, the

average patient only lived to be about
10 years old," says Barnett, M.D., vice
president, medical affairs of ProMedica
Toledo Children's Hospital, a part of
the ProMedica health system in Ohio.
"Now, the average life expectancy is
42 years, and we see it going up every
year. We've seen incredible breakthroughs in care for this population."
Medical breakthroughs prompted
the Cystic Fibrosis Foundation to adopt
new standards of care for its maturing
patient population. ProMedica Toledo
Children's Hospital's Cystic Fibrosis
Center of Northwest Ohio was among
the first in the nation to participate in
a pilot transitional program sponsored
by the CF Foundation. The objective
of the program, launched in 2015, is to
prepare pediatric CF patients to become self-sufficient partners in their
care as they enter adulthood.
Patients enter the transition program when they turn 18, and they receive a checklist of 18 goals they must
accomplish before they "graduate" at
age 21. The checklist includes mastering skills and concepts essential
to their ongoing care, from ordering

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