From Rounds to Downloads

As doctors, curiosity can be the driving factor to a long, successful, and fulfilling career. It can be the difference between daily repetition and years of practicing evolved education. For Barton Schmitt, MD, curiosity has been a transformative force for over 50 years, influencing his approach to teaching residents, patient encounters and career development. Otherwise known as a true icon of pediatrics, Dr. Schmitt’s humble, down-to-earth nature helped create one of the most prestigious pediatric guidelines in our industry. “Feedback from a variety of sources is really the life blood of all of this. At least 100 to 150 of the protocols are updated every year,” Dr. Schmitt says.   For more than five decades, Dr. Schmitt has elevated the Children’s Hospital Colorado name while creating an honorable legacy of his own. Many of you know him as the author of the ‘Pediatric Telephone Triage Guidelines’ used in our Pediatric Call Center. Those decision-support tools are now used worldwide and have been translated into multiple languages. Throughout his career he’s had numerous other titles such as the Faculty Attending for the Child Health Clinic and the medical director of the Child Protection Team. Now on the brink of his next chapter, we reflect on his incredible legacy and find out what’s next.  “I’m hoping to retire when I’m 90. I’ve got to because I have other things I want to do, including some books I want to write about teaching residents,” Dr. Schmitt says.  Some highlights from this episode include:  Details about the creation and expansion of the Pediatric Telephone Triage Guidelines  The impact that curiosity has had on his career  His hopes for the future  Advice for doctors, nurses and medical professionals  “Continual quality improvement is a team sport," Dr. Schmitt says. Dr. Schmitt wants to thank the many health care professionals who help him keep the pediatric telehealth guidelines, parent handouts and symptom checker up-to-date. Most of all, his dedicated pediatric editorial team: Medical editors: Sam Wang, MD, and Julia Bruckner, MD. Nurse editors: Kelli Massaro, RN and Lisa Swerczek, RN. Specialists at Children’s Colorado, who provide expert reviews of new topics. The many triage nurses who have worked in the Children's Colorado call center since 1988 and made observations that led to change. David Thompson, MD FACEP and the Adult Editorial Team The nurse leadership at over 40 other U.S. and Canadian call centers who provide the annual user feedback that keep the guidelines reality-based and evolving. For more information on Children’s Colorado, visit: childrenscolorado.org

5 Mars 202440min

Digital content is at the center of our society and its prevalence continues to grow. Storytelling on digital platforms allows the medical community to showcase groundbreaking research and connect with audiences, who otherwise may not be privy to this information. Experts like Joshua Williams, MD, are at the forefront of some of this innovation. In October 2023, he received the Advancement in Research Award at the American Academy of Pediatrics National Conference.  Dr. Williams is an assistant professor of pediatrics at the University of Colorado School of Medicine, as well as a practicing primary care pediatrician with Denver Health. He is the principal investigator on a National Institutes of Health grant to examine the impact of digital storytelling on influenza vaccination equity. In addition, he is a co-investigator at the Denver Health for the Centers for Disease Control and Prevention Vaccine Safety DataLink Project. “And what I hope comes from it is improvement in equity, improvement in the rate of influenza vaccination uptake in groups that historically haven’t had high uptake,” says Dr. Williams  Some highlights from the episode include:  The larger goals of these data- and digital-based projects  How to merge medicine and storytelling  Advice for young doctors and medical professionals  Finding success from rejection  Dr. Williams will be presenting on this very topic at the PAS 2024 meeting in Toronto, Canda.  For more information on Children’s Colorado, visit: childrenscolorado.org

27 Feb 202436min

Pediatricians, families, and pharmacists are faced with increasing drug costs and a vast array of complex biologic therapies. Up-to-date knowledge on prescribing practice is constantly a need, specifically regarding generics and the availability of biosimilar and interchangeable biosimilar agents. According to a report from the Association for Accessible Medicines, the U.S. healthcare system saved $408 billion from using generic and biosimilar drugs in 2022, a huge jump from the $195 billion in savings accumulated in 2013. In today’s episode, we have a rare opportunity to learn critical knowledge about this topic from renowned experts in the field.  We are joined by John Routt Reigart, MD, and Dr. Siu. Dr. Reigart is professor emeritus at the Medical University of South Carolina as well as the chairperson for the American Academy of Pediatrics’ (AAP) Committee on Drugs. “I have been recognized in my state, and to some extent nationally, as being an advocate for improved health for children. I feel that it’s very important that pediatricians be advocates for effective regulations for their patients,” Dr. Reigart says.  Dr. Siu is a clinical professor, the vice chair for teaching and learning, and the director of faculty mentoring at the Ernest Mario School of Pharmacy at Rutgers University. She is a pediatric pharmacy clinical coordinator and practices at the K. Hovnanian Children’s Hospital and Jersey Shore University Medical Center. She has also been appointed to the board of directors of the Board of Pharmacy Specialties and the Pediatric Pharmacy Association liaison for the AAP Section on Clinical Pharmacology and Therapeutics executive committee. “We want to make sure that medications are easily accessible to families and we also want to make sure that they are also cost effective,” Anita Sui, PharmD, says.  This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:  The difference between biologics and generics  What the orange and purple books are and their roles in the industry  What an interchangeable product is  Patents and exclusivity  What savings could look like with an uptick of biologics and generics    For more information on Children’s Colorado, visit: childrenscolorado.org

20 Feb 202436min

For the second time in Charting Pediatrics history, we brought a live audience together to watch the taping of an episode with a guest who has made an everlasting impression on our hospital system. This time, the show was for our colleagues here at Children’s Hospital Colorado.  Our guest is one of the top healthcare executives within pediatric hospitals in North America. Don’t just take our word for it; she was recently selected to be the chair of the board of trustees for the entire Children’s Hospital Association. Under her leadership, Children’s Colorado has been routinely identified as one of the country’s top 10 pediatric healthcare systems. In recent years, her advocacy for greater pediatric behavioral healthcare is a notable example of her dedication to research and innovation.  In today’s episode, we welcome Jena Hausmann, the CEO and president of Children’s Colorado. “I think leaders really should be authentic and should role model, always, their true leadership self and impact. I do think it is important for any of us to see ourselves reflected in whether it’s gender or race or ethnicity or age or you name it,” says Hausmann.  Some highlights from this episode include:   Jena’s career evolution and how she landed in her current role How to make an impression in healthcare administration The role that mentors play in career growth  The example she aims to set for women in leadership How Jena’s authenticity and vulnerability enhance her leadership The trends in U.S. healthcare that will impact how we care for kids For more information on Children’s Colorado, visit: childrenscolorado.org

13 Feb 202437min

Every day, we see patients whose medical hurdles land them at hospitals like Children’s Hospital Colorado. There are many answers our providers and specialists can provide when giving patient families a medical diagnosis, but many of those same children are facing gaps and inequities socially. Often, they fall into different minority groups facing disparities in healthcare equality. Medical insurance may cover labs and procedures, but it doesn’t cover the need for food or housing. Those are just two examples of social barriers that greatly affect one’s health. While many questions remain on best practices for social care programs and how we bring them to fruition, experts, like our guests today, are working hard to use them effectively. “We can’t meet family’s needs if we don’t know what they are. So, the first step is assessing what those needs are,” says Lisa DeCamp, MD.   In today’s episode we are joined by Lisa DeCamp, MD, a practicing general pediatrician at Children’s Colorado and an associate professor at the University of Colorado School of Medicine. Her research focuses on increasing healthcare engagement of Spanish -speaking Latino families and reducing disparities in healthcare equality and safety for patients and families with limited English proficiency. Julie Beaubian is an operations manager here at Children’s Colorado within the community health department. She manages community benefits for the hospital. “So we’re constantly trying to balance what is reasonable, what does the family need and how can we continue to support that family,” Beaubian says.  Read the paper mentioned in this episode.  Some highlights from this episode include:  Outlining this Children’s Colorado social care program  How this program can influence other communities and hospitals  Social barriers and how that impacts healthcare  How we can bridge gaps for communities facing inequities For more information on Children’s Colorado, visit: childrenscolorado.org

6 Feb 202429min

While considerable progress has been made in reducing cigarette smoking among our nation’s youth, the tobacco product landscape continues to evolve. It includes a variety of tobacco products, including smokeless and electronic products such as e-cigarettes. E-cigarettes entered the U.S. marketplace around 2007, and since 2014 they have been the most used tobacco product among youth. E-cigarette use, among middle and high school students, remains unacceptably high and sets youth up for lifelong nicotine addiction and the effects of toxin exposure.   In today’s episode, we are joined by Brian Williams, MD, a pediatric and adult hospitalist. He is an assistant professor of pediatrics and internal medicine at the University of Wisconsin School of Medicine and Public Health. Dr. Williams has a research interest in how we promote vaping cessation in young people. “As a resident at UC San Diego, I grew sort of tired and frustrated by seeing patients suffering complications from secondhand smoke exposure,” Dr. Williams says.  In San Diego, he founded a program that trained nurses to screen for tobacco exposure among the parents of pediatric patients. It worked, increasing screenings from 66% to nearly 100%. “The popularity of e-cigarettes is concerning, and we are seeing rising rates in both middle schoolers and high schoolers,” says Williams. This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:   Why are e-cigarettes so appealing to youth Harmful ingredients in e-cigarettes Potential impacts on brain development How advertising impacts behavior For more information on Children’s Colorado, visit: childrenscolorado.org

30 Jan 202427min

In a busy outpatient practice, timely access to up-to-date clinical resources is crucial to delivering evidence-based care. In the olden days, books and journal articles were the go-to method. Today, technology creates a more user-friendly method of receiving the most recent information. Say goodbye to having to order the latest edition of a book and hello to automatic updates. Our Children’s Hospital Colorado antimicrobial stewardship team, clinical effectiveness and pathways teams, along with other local and state partners have partnered with Firstline, a health technology company, to design a mobile version of our infectious disease guidance. “It is another way to bring clinical decision support directly into somebody’s hand if they are not sitting at a computer, which a lot of times you are not,” Leigh Anne Bakel, MD, says. A technology like this can change the future of treating patients. With new information comes new treatment choices, and this app is a way to put all of that content in the palm of a provider’s hand. “It’s really about judicious use, so using the right antibiotic for the right length of time but also only in the right patient and then the right dose; I think we understand overtime that antibiotics have a lot more side effects than we previously appreciated,” Sarah Parker, MD, says. Joining us to talk about this innovative technology are Drs. Sarah Parker and Leigh Anne Bakel. Dr. Parker is the Medical Director of the Antimicrobial Stewardship Program here at Children’s Colorado, as well as a professor of pediatrics in the Division of Infectious Diseases at the University of Colorado School of Medicine. Dr. Bakel is the Medical Director of Clinical Effectiveness here at Children’s Colorado, as well as a practicing pediatric hospitalist. She is also an associate professor of pediatrics. Some highlights from this episode include:   How the Firstline app works Why Firstline is beneficial for providers everywhere How Firstline will enhance rural healthcare The future of technology for treating patients  For more information on how to download the app visit https://firstline.org/colorado/. Drs. Parker and Bakel would like to acknowledge the brains behind this operation.   With Children’s Colorado:  Sarah Parker, MD Leigh Anne Bakel, MD, MSc Michael J Bozzella, DO, MS Joana Dimo, DO Matthew Weber, Research Assistant, MPH Christine MacBrayne, PharmD, MSCS Matt Miller, PharmD With Denver Health:  Tim Jenkins, MD Katie Shihadeh, PharmD Maggie Cooper, PharmD With CDPHE:  Chris Czaja, MD, DrPH Lauren Biehle, PharmD Rachel Schaefer, MPH Other:  Local and regional providers, infection preventionists and pharmacists who gave feedback Firstline Pfizer Global Bridges Grant Daniel Dodson, MD, MS For more information on Children’s Colorado, visit: childrenscolorado.org

23 Jan 202425min

In today’s fast-paced work environment, it can be easy to feel overwhelmed. Due to that intense pace, it’s important for employees and employers alike, to promote healthy working behaviors and surroundings. Healthy employees are more productive, have fewer absences, are less prone to work-related injury and are less likely to burn out. “Leading others is how you support them when they show up to work. Showing thanks, giving appreciation, valuing your staff,” Jennifer Shaer, MD, says. A 2021 survey tells us that 79% of employees believe their company’s wellbeing programs help them be productive employees, but a lot of work still needs to be done. In today’s episode, Jennifer Shaer, MD, joins us to discuss wellness in the workplace and how to nurture a positive culture. Dr. Shaer is the Chief Wellness Officer of Allied Physicians Group in Melville, New York, as well as a board-certified pediatrician, an International Board-Certified Lactation Consultant and a certified executive and life coach. “Sometimes you just need a change in your working environment, physically. Sometimes you need a change in your internal world. I’ve worked with lots of people who have been able to change their mindset around their work and suddenly enjoy their work and extend their working years,” Dr. Shaer says. Dr. Shaer has her own podcast called ‘Reinventing the White Coat’ which you can find here. This episode was recorded at the 2023 American Academy of Pediatrics National Conference and Exhibition. Some highlights from this episode include:   How to nurture a positive workplace culture  Implementing discipline appropriately Identifying a toxic situation How to advocate for yourself This episode is underwritten by Aegon Transamerica Foundation, a proud supporter of Charting Pediatrics and Children's Hospital Colorado. The Aegon Transamerica Foundation helps build a better world by committing to the improvement of wellness throughout their communities. Their partnership with Children's Colorado addresses the youth mental health crisis to help create a better mental health future for children. Thank you to Aegon Transamerica Foundation for investing in Children's Colorado.     For more information on Children’s Colorado, visit: childrenscolorado.org

16 Jan 202431min