Letter from Shelly Voet, MD - Executive Community Physician Leader
Dear fellow community PCPs,
Happy holidays to all of you! THANK YOU for all you and your teams do for kids during this incredibly busy season!
Hospital Medicine Meeting: This month we hosted our second annual Joint Hospital Medicine/PCP virtual meeting. The event included an update on the new AAP Hyperbilirubinemia guidelines as well as updates on new HM services and studies. I am grateful to Michelle Parker, MD (Michelle.Parker@cchmc.org) Director of Community Integration in the HM Division, for organizing the evening. Please note the following updates from HM:
Diagnosis specific guidance on direct admission requests for bronchiolitis and hyperbilirubinemia can be found HERE. Hospital Medicine is using the new 2022 nomogram for treatment thresholds. You can find decision support using the new thresholds at BiliTool™ and (2022) Hyperbilirubinemia management guidelines (peditools.org). Contact Michelle Parker or Katie.Meier@cchmc.org with questions on these criteria.
A contact information slide for the various hyperbilirubinemia treatment options via CCHMC Home Care, Hospital Medicine, Neonatology, and birth hospitals through NCA.
An algorithm for the management of positive blood cultures developed as a part of a QI project to decrease overtreatment and unnecessary evaluation of contaminants. Contact Anna.Ipsaro@cchmc.org with questions.
Information about current HM studies involving the community are HERE. Contact Katherine.Auger@cchmc.org and Patrick.Brady@cchmc.org.
Infectious Diseases: This has been the theme of the last 2 months. As of mid-December, the “tridemic” looks like this regionally: RSV has peaked, Influenza A may be beginning to level off (but we know Flu B typically follows), and COVID-19 positivity rates have increased this week in all groups except for those under 20 years. We are also reminded of the importance of tracking our well care in our own practice populations as the measles outbreak in central Ohio continues, mainly among unvaccinated children. Meanwhile, treating secondary complications like OM has been difficult due to antibiotic shortages. As of this week, CCHMC pharmacy has reported amoxicillin supplies have improved but Amox/clauv shortages have become more of an issue.
ED: ED, Urgent Care and Virtual Urgent Care volumes at CCHMC remain high. You may hear from families about visits from CCHMC leaders to provide support during longer wait times. I am grateful to Elena Duma MD and ED faculty for our first collaboration with them on a Clinical Practice Support Tool (CPST) on their management of Gastroenteritis which is attached to this issue. CPSTs are conveniently available on a new app - see the CPST article for more information.
Opioid Use Clinic: CCHMC has launched an Opioid Use Treatment Clinic (OUT Clinic) within the Division of Adolescent Medicine. Please see the article in this issue for more information. The clinic cannot treat patients using any other substances at this time.
CPAC: Recently you should have received an email (sent by your Physician Liaison) from your Community Practice Advisory Council physician representative. While your physician outreach liaison is always your primary contact regarding any technical or patient-specific concerns, our CPAC physicians hope to represent the more global picture of what is working well (or not as well) between CCHMC and other pediatric health systems. Please do not hesitate to reach out to your physician representative!
Community Survey: Thanks to all who completed the Community Provider Survey. Your input regarding access has been shared with the Ambulatory Service team at CCHMC. We look forward to discussing the rest of the survey results in our Community Practice Advisory Council meetings.
Community Kudos: CPAC has established a new recognition at CCHMC called “Community Kudos”. This recognition is for individuals or teams from CCHMC that go above and beyond in helping PCPs and our patients in the interface with CCHMC. Last month, we presented this award to Roger Sloan, a recently retired IS specialist whose team helped make Epic Link a reality for us. In December, we will present this recognition to Roni Braggs in PPL and Ryan Jennings in PIRC. Thanks to Roger, Roni, and Ryan for all you have done for us. Any PCP can nominate a CCHMC employee or staff member for this recognition and join us for the meeting for presenting it. Please send nominations (or congrats for any of those recognized) to me at shelly.voet@cchmc.org. Thanks to Dr. Jim Davis for the idea. And no, the recipient’s first name does not have to start with R.
Finally, I wanted to thank Paul Bunch MD of Springdale Mason Pediatrics for his years of service on the Medical Executive Committee as the Community Associate Medical Staff representative. It has been a privilege to work with Paul. Paul will continue to serve on the Communications Committee and as a contributor to Pediatric Consults podcast (check out Paul’s conversation with Jeff Anderson on Syncope which was very informative). We welcome Abby Stein MD of Tri-Health to Med Exec in January.
Thanks again to all PCPs and team members for the commitment you provide every day for our region’s kids and their families. While every day has presented new challenges, each team member at each practice and facility is vital for the entire pediatric healthcare system to work. I hope you all enjoy some well-deserved R&R this month, and we look forward to working together in 2023 😊.
Shelly
Shelly F. Voet MD
Pediatric Associates PSC
CCHMC Executive Community Physician Leader