Johns Hopkins Children’s Center was one of the first hospitals in the country to create a hospitalist program in pediatrics, mainly to provide medical consultations to surgical services about their patients. Starting last July, however, pediatric hospital medicine became a stand-alone division at Johns Hopkins, with seven hospitalists and one nurse practitioner.
“As inpatient and outpatient health care has changed, hospital medicine has become the fastest growing medical specialty and is now an accredited subspecialty,” says Children’s Center co-director Tina Cheng. “It was time to recognize and build hospital medicine as a separate division in the Children’s Center and to continue to lead in clinical care, education and research in this growing field.”
“This raises the profile of hospital medicine at the children’s hospital,” adds Eric Biondi, division director. “And it allows us to really take the lead on standardizing care for children with general medical illnesses and ensuring high-quality, inpatient general medical treatment.”
Hospitalists care for children hospitalized with general medical illnesses, including conditions “that are so complex that one subspecialty really can’t manage them,” Biondi says. “We work with residents and medical students to take care of these patients, and we communicate and coordinate with other specialties anything that the kids need.”
The hospitalists, who also continue to be available for medical consultation for surgical patients, serve as medical directors on the floors and participate in hospital committees, says Biondi: “Hospitalists are kind of like water on pavement—they fill every crack that is needed in a hospital.”
Biondi came to Johns Hopkins last fall from the University of Rochester, where he completed a pediatrics residency and became a hospitalist at the university’s medical center. “I started doing clinical outcomes research but found myself more attracted to answering questions right away rather than long term, so I moved into quality improvement,” says Biondi, who earned a Master of Business Administration degree with a focus on health care management. “I really wanted to understand how costs in the health care system play into quality improvement.”
From there, he built an inpatient complex care service staffed by nurse practitioners for the management of children with extremely complex medical illnesses, and became director of performance improvement for the university’s children’s hospital.
Pediatric hospital medicine, which just became a board-certified subspecialty, “is a young, vibrant, energetic field nationally and I really enjoy being part of that,” Biondi says. “It’s a group of people who are really fun to be around, and everybody has that same vision of trying to make things better for kids but in a very collaborative way.”
Biondi has a number of ideas for the division, such as working closely with nurses, social workers and child life specialists, building relationships with specialties, and teaching residents and medical students, as well as developing a fellowship program. Noting that he would also like to integrate with other pediatric inpatient units affiliated with Johns Hopkins, he concludes, “Our group should be seen as the quarterback for children hospitalized with medical illnesses.”