AAP Section on Hospital Medicine/

Integrated SurgicalSurgical Care Subcommittee

(SCSC)

June 30, 2016

Tri-Chairs:Josh Abzug, David Rappaport & Becca Rosenberg

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 2016

6. Next meeting

In person: PAS, Baltimore MD: Sunday, May 1 @ 2-4pm, Hilton Baltimore Hotel: Hopkins Room

Late May/early June: Conference call

July: PHM, Chicago, IL Jul 27-30

Research

• Surgeon Survey on Comanagement

• Hospitalist Survey on Comanagement/Billing:

Submitted!

Survey:Surgeon Experience and Perceptions of Involving PH in Patient Care

Phase I:Pediatric

Distribution

N Phase II: General

Distribution

AAP Sectionon Surgery

Ben N Analyzingdata

290 ACS Ben N

AAP SONS/APNS

Doug/Eric

? TBD AANS Doug/Becca

POSNA/ AAP Ortho Section

Josh A Surveyclosed

415! AAOS Esurvey Not Possible

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) ??

PHM PRE-operative Workshop Agenda

July 29, 2016

• Rationale and evidence supporting pediatric preop clinics

20 min

• Structure and function of preop clinics– Anesthesiology perspective

20 min

• Small group cases– Medically complex adolescent s/p PSF– Toddler with OSA s/p T&A

• Discussion and Wrap-Up

30 min

5 min

PHM POST-operative Workshop Agenda

July 29, 2016

• 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

40 min

• Discussion and Wrap-Up5 min

Surgical Comanagement Best Practices in Pediatrics:AAP Policy Statement

Current WGPH: 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

Guiding Principles for Inpatient Comanagementof Primary Surgical patients (non-ICU)

Approach: Modified Delphi with nominal group technique

ROUND 1: Oct 15Survey to Experts:AAP• SCSC• Surgical Advisory

Panel *• SOHM Leadership• Section on

Surgical Care? Others

ROUND 2: Oct 15 In person @ NCE:Discuss results• SCSC WG

ROUND 3: Jan 2016Voting to:• SCSC WG• SAP• SOHM Leadership

3A: May 2016• Community

Hospitalist leaders

*Leaders of AAP Sections of Urology, Surgery, Orthopedics, Anesthesiology, Dentistry, Neurosurgery etc

LOI submitted to AAP

Draft in progress

22 very strong/strongly endorsed2 less so

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

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 comanagementPRACTICE MANAGEMENT: toolbox/business plans, templates

• Overall: more collaborative projects with clear ways to participate, focus on specific conditions

Extra

SAP NCE 2016 AgendaAs 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, 2016

4:00 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

Membership Roster/Regroup

PH

At least 15!

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

Overview-Delphi and Nominal Group Technique

Jones & Hunter: BMJ, 1995.