There’s no question that Johns Hopkins Bayview Medical Center has a rich history in pediatric medicine. In 1936, Harold Harrison, the first pediatrician-in-chief of the then Baltimore City Hospitals, began a lifelong collaboration with his wife, Helen Harrison, in the research of mineral metabolism, vitamin D metabolism, the treatment of rickets and the introduction of oral rehydration therapy in children. The hospital started one of the first neonatal intensive care units (NICU) in the region, and in 1975 became the birthplace of the first Neonatal Transport team in the state of Maryland. In July 2007, neonatology merged with Johns Hopkins Department of Pediatrics, which strengthened the faculty, resources and focus of pediatrics at Johns Hopkins Bayview.

This spring Bayview Medical Center took another significant step in advancing care for children in the region with the opening of its new, state-of-the-art Pediatric Center. Featuring a dedicated pediatric ED—a first for Bayview—and a co-located inpatient unit with single all-private rooms, a pediatric play room and Child Life coordinator on site, the Center is designed to provide Hopkins level pediatric care in a family-friendly environment.

“The need for a dedicated space for pediatric patients and their families in the emergency department has been longstanding,” says Director of General Pediatrics Tina Cheng. “It is wonderful to see this become a reality.”

“The new pediatric center will improve the level of comfort and care we are able to offer our youngest patients,” says Pediatric Hospitalist Program Director Bob Dudas. “By having a combined emergency department and inpatient unit, our doctors and nurses are able to deliver innovative, family-centered pediatric care.”

The combined unit, in the North Pavilion building on the Bayview campus, was designed with efficiency in mind, too. In the ED, following a “segmentation model,” patients bypass the traditional “waiting room” and move quickly from the front desk to the examination room. Front-line staff outfitted with portable registration equipment can register patients at the bedside without impeding the flow of care. The goal under this new model is for patients to be seen within half an hour. During that brief time, pediatric patients find them in a child-friendly environment unlike that of the adult ED.

“For kids, waiting to be seen in an adult can be a scary situation,” says Dudas. “Now they are processed in child-friendly space and insulated from the trials and tribulations of the adult ED waiting area.”

As pediatric emergency visits represent nearly 20 percent of the total ED visits, Dudas adds, the new dedicated space will not only benefit the youngest and most vulnerable patients but also free up space and personnel to provide care for the growing adult ED population. The combined unit is staffed by a dedicated team of clinicians, including 24/7 pediatric hospitalist coverage, nurses, physician assistants and other team members.

The inpatient unit features nine single rooms, which is more in line with current expectations of patients and families, say Cheng and Dudas. Separating the inpatient unit and the ED is a shared work station for physicians and nurses, resulting in centralization of resources and more efficient allocation of staffing, as well as enhancing patient care communication.

The new combined unit, featuring child-friendly themed artwork with whimsical animals, will engender confidence in patients and parents, adds Dudas, which will influence patient satisfaction as well. Noting that Bayview Medical Center is already recognized as a provider of high-quality care for children, ranking above the 90th percentile in Press Ganey patient-satisfaction surveys, Dudas says, “We’re quite optimistic that our patient satisfaction will greatly improve even more.”

The pediatric center makes good business sense, too. Community hospitals that have designed such state-of-the-art centers for pediatric care have seen their ED and inpatient volumes, as well as patient satisfaction scores, soar as well.

“The ED is the community’s front door to the hospital,” says Dudas. “If families are pleased with their care in that setting, they are more likely to use the same hospital for other services such as primary care and specialty care.”

The concept of a combined inpatient unit, emergency department and observation area, proven to be successful at other community hospitals, originated at Howard County General Hospital, a member hospital of Johns Hopkins Medicine. Vulnerable to the same seasonal variations in patient volumes other community hospitals face, Bayview Medical Center leadership saw the model as a means to better manage these fluctuations while maintaining a high quality workforce.

“It’s a great model for community hospitals,” says Cheng, “a model that is spreading.”
For more information, visit the Pediatric Center’s website.

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