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Healthy Futures Working together for Healthy Futures A MAGAZINE FOR REFERRING PHYSICIANs FALL 2013 A new team for kids with GI and nutrition challenges 3 4 PLUS Developmental Screening 3 Pediatric Gastroenterology 4 Pediatric Psychiatry 6 6 The principal pediatric teaching hospital for Tufts University School of Medicine A LETTER FROM JOHN SCHREIBER, MD Dear Physicians, Typically I use this space in Healthy Futures to talk about why I think Floating Hospital for Children at Tufts Medical Center is an incredibly special place worthy of your referrals. But this time I’d like to allow some of our patients and their parents speak for themselves. Below are some comments from our families posted on Floating Hospital’s Facebook page. By the way, if you’d like to keep up with what’s happening at Floating Hospital, “liking” our Facebook page is a great way to connect. And you can always get in touch with me at jschreiber@ tuftsmedicalcenter.org or 617-636-8031. All the best, John Schreiber, MD, MPH Pediatrician-in-Chief, Chief Administrative Officer Floating Hospital for Children at Tufts Medical Center Chairman, Department of Pediatrics Tufts University School of Medicine My 6 month old is preparing for his second surgery at Floating Hospital. Both are minor surgeries, but I would absolutely recommend Floating for any procedure. We travel from Taunton to Floating for almost everything with our twins. Well worth the drive. Everyone has been wonderful & SO supportive!” Our 7 year old son has had 6 surgeries at the Floating I’m a new patient at Floating, but I just love them. Hospital. I must say we have had nothing but excellent Got home on Tuesday from a one night stay on Floating 7. outcomes and experiences each time. The anesthesiolo- Have never been happier with the care I have received. gists, the doctors, the ER and Recovery nurses, and other Thank you so much Floating for all you do.” essential staff at the Floating have always made our son feel like the Floating is his “home away from home”. When- I’ve loved this hospital since 1996 when they ever asked our opinion, we highly recommend the Float- first saved my son’s life. As I sit here in the PICU ing Hospital to our friends and family. There is no other now while he recovers from another surgery, hospital that we would chose to care for our boy other I still love this place. As far as I’m concerned this than you. Thank you Floating Hospital for all you’ve done is the best hospital on earth! Thank you for and continue to do for our son and our family!” taking such amazing care of my son!!” We love Tufts MC Nurses! The day my daughter was born and rushed to Tufts MC was so traumatic however the nurses not only helped my daughter but helped my husband and I in ways I will never forget! My daughter would not be here if it wasn’t for them! We have been admitted a few more times and the PICU and floor 7 nurses, Thank you! Thank you and we are forever grateful for them and Dr. Scott!” A New Developmental Behavioral Screening Tool Tufts MC researchers create a screening instrument and analyzed in one screening instru- that’s easier to use ment. Tested in over 500 children so far, the SWYC appears to be at least Identifying children with developmen- options,” explains Perrin. So in 2008, as accurate as the other screening tal and behavioral issues is one of the Perrin and Sheldrick set out to develop instruments that are in routine use in many challenges a busy pediatrics an improved questionnaire to accurately pediatrics. Massachusetts Medicaid practice faces. But finding delays or identify developmental and behavioral is expected to approve the use of the abnormalities as early as possible is issues in young children, without the SWYC soon to fulfill the requirement for crucial. “The earlier these problems drawbacks of the mainstream tools. pediatricians to administer a behavioral screening instrument to all children on are identified,” says Ellen C. Perrin, MD, The final result was the Survey of Medicaid. Director of Research for the Division of Wellbeing of Young Children (SWYC), Developmental-Behavioral Pediatrics a screening tool that is quick to complete NIH grant funds comparative at Floating Hospital, “the more effec- (an average of 15 minutes), with clear, effectiveness trial tive the treatment and services will be.” easy-to-answer questions. Designed for The next step for Perrin and Sheldrick It was this common sense conclusion children five years old and younger, the is to perform a head-to-head compari- that led Perrin and her colleague R. SWYC is completely free, easily adminis- son of the SWYC with current surveys. Christopher Sheldrick, PhD, Research tered and available in Spanish; questions In August 2011, Perrin and Sheldrick Psychologist, on a research course that are short, self-explanatory and can be applied for an NIH grant to support a would ultimately secure them five years answered in a yes/no/maybe format. comparative effectiveness trial to ana- of support from the National Institutes The SWYC also is unique because it lyze the performance of three screening of Health (NIH). combines all critical aspects of child tools, including the SWYC. In January Most pediatric practices offer some development in one survey: cognitive, 2013, they received word that the grant early childhood screening for develop- motor, and language development, had been funded for more than $3.25 mental and behavioral problems. Unfor- social and emotional development, million over five years. “We think our tunately, the screening tools currently Autism Spectrum Disorder (ASD) and survey has advantages in ease of use, available are often costly and can take family risk factors (i.e. parental depres- convenience and cost-efficiency,” said too long to administer in a typical office sion, alcohol and drug abuse and Perrin, “but this study will allow us to visit. “There was room for a new kind of conflicts, and hunger). The SWYC is assess its accuracy directly compared survey, and we thought we could create the first survey in which all these impor- with two other prominent screening one that was better than the available tant aspects can be examined instruments. The results will help pedia- tricians choose the best screener for their patients.” The systematic comparison study to measure the SWYC against the other two screening tools is already under- way. The study is based in Boston and involves numerous pediatricians’ offices in Eastern and Central Massachusetts. More than 3000 children and their parents will participate in this research project. ❍ For more information on the Survey of Wellbeing of Young Children or to download the instrument, please visit www.TheSWYC.org. Healthy Futures 3 We have an intimate environment that “enhances collaboration — including with the referring physician.” Pediatric –JYOTI RAMAKRISHNA, MD Gastroenterology and Nutrition Floating Hospital’s pediatric GI team: (back row, left to right) Jeanne Plasse, PA, Gerrett Zella, MD; Khoa Tran, MD; (middle row, left to right) Melissa Quinn, RN, BSN; Marcella Radano, MD, Christianna Moran, RD; in front: Jyoti Ramakrishan, MD, Chief of Pediatric Gastro- enterology and Nutrition. 44 FloatingFloating Hospital Hospital for for Children Children at at Tufts Tufts Medical Medical Center Center We have an intimate environment that FLOating HOspitaL’S new Chief of Pediatric part of what we do, taking care of a range of patient needs enhances collaboration — including with Gastroenterology and Nutrition Jyoti Ramakrishna, MD is from answering parents concerns over the telephone, to pre- the referring physician.” energized to build on the hospital’s history of outstanding scription refills, running infliximab and other infusions care for children with GI problems. and educating parents about home care.” –JYOTI RAMAKRISHNA, MD “We’re in a huge growth phase, and there’s nothing but growth Pediatric Dietitian Christianna Moran, RD rounds out the ahead of us,” says Ramakrishna, who joins Floating from the division team. “She is wonderful in dealing with the spectrum faculty at Massachusetts General Hospital and was a fellow of nutritional issues our patients face, including celiac disease, in Floating Hospital’s pediatric GI program in the early 1990s. food allergies, tube feeding, or a child at home with IV nutrition,” Since arriving in March of this year, Ramakrishna has recruited Ramakrishna says. three additional physicians and a physicians’ assistant, provid- Most importantly, this array of Floating Hospital pediatric ing a breadth of expertise for kids throughout the region. gastroenterology expertise is available not only in Boston, but “We’re all broad-spectrum pediatric gastroenterologists, but also in many surrounding communities. Floating Hospital has each of us also has a niche,” she notes. “Together, we cover established Pediatric Specialty Centers — through affiliations all of the main GI issues that arise in children.” with respected local hospitals — in several communities to the Ramakrishna’s clinical focus is on acid reflux, food allergy north, west and south of the city. As a result, young patients can related GI manifestations and Pediatric inflammatory bowel be seen on an outpatient basis in a convenient, closer-to-home disease. Other new clinicians and their specialties include: setting — and busy parents don’t always have to take their child to Boston to see a subspecialist. ➢ Marcella Radano, MD has worked in the area of food allergies in children and is part of the pediatric Food Allergy Floating’s new pediatric gastroenterologists already have Center. She completed her pediatrics residency at Hasbro started seeing patients at satellite locations in Chelmsford, Children’s Hospital and her Pediatric Gastroenterology and Framingham, Woburn, Lawrence and Easton.
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