programs for children with complex chronic conditions at brenner childrens hospital savithri...
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![Page 1: Programs for Children with Complex Chronic Conditions at Brenner Childrens Hospital Savithri Nageswaran MD,MPH September 12 th 2012](https://reader035.vdocuments.site/reader035/viewer/2022070306/5519d03e5503468b0c8b47a2/html5/thumbnails/1.jpg)
Programs for Children with Complex Chronic Conditions at Brenner
Children’s HospitalSavithri Nageswaran MD,MPH
September 12th 2012
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PEDIATRIC ENHANCED CARE PROGRAM
• Pediatric Enhanced Care Team (PECT)• Community Pediatric Enhanced Care Team
(CPECT)• Community Pediatric Enhanced Care Team
(CPECT-Extend)• Collaborative Care Service
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Medical Neighborhood:Healthy Child
Child & Family
AHRQ White Paper: Medical Neighborhood
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Medical Neighborhood:Child with a Chronic Condition
Child & Family
AHRQ White Paper: Medical Neighborhood
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Medical Neighborhood:Child with Complex Chronic Condition
Child & Family
AHRQ White Paper: Medical Neighborhood
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Pediatric Enhanced Care Program• PECT: pediatric palliative care in the hospital for seriously ill children
– 1 FTE nurse & 0.3 FTE physician– Funding: Duke Endowment start-up funds; now Brenner Children’s
Hospital• CPECT: care coordination for children with CCC in Forsyth County
– 0.5 FTE nurse, 0.05 FTE project director, 0.1 research associate– Funding: Maternal & Child Health Bureau
• CPECT-Extend: Extension of CPECT to Yadkin, Surry, Stokes, Davie, Wilkes counties– 0.75 social worker, 0.05 project director & 0.1 research associate– Funding: Maternal & Child Health Bureau
• Collaborative Care Service (CCS): collaboration between multiple sub-specialists in the care of children with undiagnosed complex conditions– 0.5 FTE nurse & 0.15 physician– Funding: Brenner Children’s Hospital
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Children with CCC at Brenner Children’s Hospital(FY 2009 PECT Patient Statistics)
Medical Center Strategic Planning; January 2010
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Children with CCC at Brenner Children’s Hospital(FY 2009 PECT Patient Statistics)
Utilization PECT (%)*3-Day Readmission Rate 6.9 %
7-Day Readmission Rate 11.9 %
14- Day Readmission Rate 21.1 %
30- Day Readmission Rate35.6 %
ED Visits within 7-days of Discharge
1812%
*Medical Center Strategic Planning; January 2010
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Children Enrolled in CPECT & CPECT/E (n=56)
• All <18 (one now older than 18)• All chronic condition• Complexity upon enrollment– >5 subspecialists/services 46 yes, 4 no, 2 missing– >2 technology 29 yes, 19 no, 4 missing– >3 hospitalization/months 14 yes, 34 no, 4 missing– >30 days hospitalized/6 months 20 yes, 28 no, 4
missing
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Care Coordination Needs
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Child & Family
Medical Home
Specialist
Dentist
Pharmacy
Care Coordination Needs:Complexity
Child & Family
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Care Coordination Needs:Low Fragmentation
Child & Family
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Care Coordination Needs:High Fragmentation
Child & Family
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Care Coordination Needs: Family Capacity
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Care Coordinator's Contacts with Children with CCC & their Families
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Care Coordination of Children with CCC
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Gaps in Coordinated Care of Children with CCC
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Community Team to Coordinate Care of Children with CCC
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Community Team to Coordinate Care of Children with CCC
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Community Team to Coordinate Care of Children with CCC
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Community Team to Coordinate Care of Children with CCC
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Community Team to Coordinate Care of Children with CCC
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PEDIATRIC ENHANCED CARE PROGRAM
• Pediatric Enhanced Care Team (PECT)• Community Pediatric Enhanced Care Team
(CPECT)• Community Pediatric Enhanced Care Team
(CPECT-Extend)• Collaborative Care Service• New: Interdisciplinary clinic for children with
CCC