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Medical Specialties Annual Report 2019 Table of contents Leadership Team Welcome to Riley Children’s Health Ryan D. Nagy, MD Welcome to Riley Children’s Health ...... 1 Interim President As one of the nation’s leading pediatric health systems, Riley Children’s Health Elaine G. Cox, MD About Riley Children’s Health ...... 2 is committed to delivering evidence-based, patient-centered care to children and Chief Medical Officer Helping to build strong, healthy communities ...... 4 families. We are pleased to share this overview of Riley’s 25 medical specialties,* Paul Haut, MD Maternity Tower at Riley Hospital for Children at IU Health ...... 6 highlighting our expertise in pediatric healthcare from primary care to the most Chief Operating Officer Medical Specialties serious and complex medical conditions. Megan Isley, DNP, MBA, RN Chief Nursing Officer Adolescent Medicine ...... 8 Our care teams are honored to be part of a children’s hospital that is consistently Frank Runion Allergy and Immunology...... 10 ranked among the best in the nation by U.S. News & World Report. This year, Riley Chief Financial Officer Cardiology ...... 12 Hospital for Children at Indiana University Health—Indiana’s only nationally ranked D. Wade Clapp, MD Child Development and Developmental Pediatrics ...... 14 children’s hospital—is one of only 24 hospitals to be ranked in all 10 pediatric Chairman, Department of Pediatrics Child Protection Program ...... 16 specialties cited by U.S. News. Our urology and cardiology and heart surgery Frederick J. Rescorla, MD Critical Care programs are ranked second and fifth, respectively, with three other programs Surgeon-in-Chief Nationally out Pediatric earning placement in the top 15. Cardiac Critical Care ...... 18 Ranked in 10 of 10 Specialties Pediatric Critical Care ...... 20 With quality and safety among our highest priorities, Riley is a partner in the Children’s Hospitals’ Solutions for Patient Dermatology ...... 22 Safety Network, a group of hospitals that shares best practices for delivering preeminent care. As a leader in harms Diabetes and Endocrinology ...... 24 Cancer reduction and quality improvement, Riley has exceeded, as of November 2020, 483 days without a serious safety event. Emergency Medicine ...... 26 We’ve also received best-in-class recognition for our Level I Pediatric Trauma Center, congenital heart surgery program and Cardiology & 5th extracorporeal membrane oxygenation program, among others. Gastroenterology, Hepatology and Nutrition ...... 28 IN THE Heart Surgery NATION General Pediatrics and Primary Care ...... 30 While this is a 2019 report, we would be remiss if we didn’t address the COVID-19 crisis that has gripped our state, nation Hematology/Oncology ...... 32 Diabetes & and world. Months before the pandemic and in step with other IU Health system hospitals, Riley prepared for what we knew Hospital Medicine ...... 34 Endocrinology to be unprecedented circumstances. Making significant modifications to safely deliver care under challenging conditions, our Infectious Diseases ...... 36 response to COVID-19 has been swift, far-reaching and impactful. Medical and Molecular Genetics ...... 38 Gastroenterology & GI Surgery Neonatology ...... 40 ■ Riley is the only Indiana children’s hospital—and one of the few regionally—to voluntarily contribute data to the Nephrology ...... 42 TOP Virtual PICU System, a dashboard launched to track pediatric COVID-19 cases across North America and used to Neonatology 15 Neurology ...... 44 inform best practices for treatment. TOP Palliative Care ...... 46 Nephrology & Kidney Diseases 15 ■ For seriously ill children with heart and kidney conditions, we transitioned within 36 hours to virtual care to Physical Medicine and Rehabilitation ...... 48 ensure crucial monitoring and oversight continued without interruption. Neurology & Neurosurgery Psychiatry and Psychology ...... 50 ■ Our specialists have initiated COVID-19 research studies and developed clinical guidelines to treat children with Pulmonology and Sleep Medicine ...... 52 Orthopedics multisystem inflammatory syndrome (MIS-C). Radiology ...... 54 TOP ■ Through virtual town halls, Riley physicians are sharing the latest information and guidance with pediatric Rheumatology ...... 56 Pulmonology & Lung Surgery 15 providers across the state. Riley Medical Specialties Team Member Directory ...... 59 2nd Urology IN THE Refer a patient ...... 65 NATION These are just a few examples of our leadership in battling COVID-19. Through this pandemic and beyond, Riley is driven by our enduring commitment to deliver the unmatched clinical care and ambitious research that make healthier lives possible On the cover Inspiring patients, for children in Indiana and around the world. From the comfort of his Riley red wagon, Phoenix Spejewski, age world-class care: 3, likes playing with toy trucks and dinosaurs while recovering from open-heart surgery. An expert stories of Riley kids team of cardiologists and a Elaine G. Cox, MD Brian E. Wagers, MD unique integrated care model Physicians and care teams at Chief Medical Officer Physician Director of help ensure heart patients like Riley Children’s Health treat Pediatric and Maternal Quality and Patient Safety Phoenix receive the highest thousands of children each year. level of pediatric subspecialty care. The Riley Heart Center, Read some of their stories on consistently recognized for pages 3, 58, 63 and 64. exceptional patient outcomes, * The surgical specialties of Riley Children’s Health are highlighted in a is ranked fifth in the nation by separate annual report. Visit rileychildrens.org/surgeryannualreport or U.S. News & World Report. request print copies from [email protected]. This annual report is also available online at rileychildrens.org/medicalannualreport.
Riley Children’s Health Medical Specialties Annual Report 2019 | 1 About Riley Children’s Health
Riley Children’s Health, Indiana’s largest and most Riley Children’s Health Statewide Reach skilled pediatric system, provides care in more Story of Riley siblings: South Bend than 50 locations in communities across Indiana. Crown Point Samantha Brown, age 7 Miles Brown, age 3 Fort Wayne More than 300,000 Brother and sister West Lafayette PATIENTS TREATED ANNUALLY Lafayette beat cancer together.
Muncie
Fishers Carmel PRIMARY SPECIALTY Richmond Jeff and Melissa Brown are watching and laughing as their Indianapolis CARE CARE 7-year-old daughter flips her little body into cartwheels and 200 + 400 Avon headstands around their Westfield home. The laughter feels Greensburg good after nine months of unrelenting worry. It’s a long way physicians across 40 specialties Terre Haute Columbus from where they were last summer, when the couple were Bloomington knocked flat by the news that their first-born, Samantha, had kidney cancer. Two pediatric hospital Just about the time they approached the finish line of her locations in central Indiana: treatment at Riley at IU Health came another devastating blow almost too cruel to believe. Their 2-year-old son, Evansville/Newburgh Miles, was diagnosed with Burkitt’s leukemia, an ■ Riley Hospital for Children at IU Health – Indianapolis aggressive cancer. After learning that Miles had multiple tumors on his kidneys and his liver, Jeff immediately sent an email to Riley “I don’t know that we have processed it,” Melissa said ■ Riley Hospital for Children at IU Health oncologist Michael J. Ferguson, MD, who was overseeing during an interview earlier this year. “You don’t really have a North Hospital – Carmel Samantha’s care. The email was marked urgent, but this Riley Hospital for Children choice but just to keep moving forward.” time it was about Samantha’s little brother. at IU Health is a Magnet® It started in August 2019 when Samantha was diagnosed hospital, recognized for Dr. Ferguson got on the phone with the couple and the with Wilms’ tumor, a rare form of kidney cancer. She AFFILIATED WITH nursing excellence and high- Chicago urologist to discuss Miles’ care and create a game underwent surgery to remove the tumor, then began a five- quality clinical outcomes. plan for treatment. The family got in their car and drove month course of chemotherapy as an outpatient at Riley. back to Indianapolis the next day. In December, when Samantha was just a month away Once at Riley, a CT scan confirmed the diagnosis of Burkitt’s. from completing chemo and her scans were looking Miles was admitted to Riley and was hospitalized for 54 days. good, the family took a trip to Chicago, where they had ■ One of the largest medical schools in the U.S. Leader in research previously lived. While there, Miles, who was born in Riley oncology team members helped carry them through ■ One of the busiest locations for pediatric and innovation Chicago, had an appointment with a pediatric urologist who the worst of it, Melissa and Jeff said. There were nurses research funded by the National Institutes of had been watching a condition he was born with called who became an extension of their family because they Health and other sponsors ■ Indiana’s only pediatric hydronephrosis, a cared for their son like he was one of their own. And there research hospital was Dr. Ferguson, who told the couple to reach out anytime Riley Children’s Health and IU School of Medicine swelling of the kidney with questions. are committed to providing excellent healthcare due to a build-up of ■ Sixth-ranked children’s hospital urine. Now 3, Miles is regaining the strength he lost during for children through prominence in education, for National Institutes of Health funding training and research. Jeff will never forget treatment. ■ Home to the Herman B Wells Center what he saw during The Browns don’t know why both of their children were for Pediatric Research, Miles’ testing. afflicted with cancer, but they hope they are through the COMPREHENSIVE CHILDREN’S HOSPITAL AND HEALTH SYSTEM OF the Children’s Clinical “I was watching the worst of it. Research Center and ultrasound and I could “I will always be on edge with this,” Jeff said. “Whether the Center for Children’s see stuff lighting up in it’s a temperature or a bruise or whatever, anytime they’re Health Services Research there, and I’m asking, not feeling well, I’m probably going to communicate with ‘What is that?’” Dr. Ferguson.”
2 | Riley Children’s Health Medical Specialties Annual Report 2019 | 3 As Indiana’s largest and Sharing expertise with Virtual visits most comprehensive colleagues statewide To help ensure uninterrupted care during the pandemic, healthcare system for COVID-19 town halls Riley specialists increased ■ Virtual events for children, Riley Children’s and in some cases initiated community-based Health is committed to using medical providers the use of virtual visits and telehealth to meet the health our expertise and resources ■ Latest guidance and needs of pediatric patients in to serve our community. treatment of MIS-C Indiana. Several Riley surgical We offer advanced, nationally ■ Back-to-school series with specialties use virtual care ranked care in more than practical health tips for for initial assessments and a safe restart during the follow-up visits, and the Riley 15 communities across pandemic Emergency department is Indiana. Riley is also a leader ■ COVID-19 research by evaluating how telehealth in promoting preventive Riley specialists can be used to provide care and in sharing our emergent care. Project ECHO specialized expertise with (Extension for Community medical providers and Healthcare Outcomes) Supporting civic involvement and stakeholders to improve Riley physicians participate in Project ECHO, an initiative healthcare advocacy the health and well-being connecting local primary care Riley emergency medicine of children and families. providers with specialists physicians volunteered to improve treatment for to participate in VotER, a complex and chronic health nationwide nonpartisan concerns. In 2019, our initiative aimed at helping physicians shared knowledge people register to vote. and best practices for sepsis Founded by an emergency prevention. medicine resident at Harvard, Helping to build strong, VotER mobilizes healthcare organizations to provide healthy communities Promoting prevention information and resources and improving access to patients who express to care an interest in voting or Flu vaccinations using their voice to change and COVID-19 healthcare policy. Physicians In a year when flu at Riley and IU Health Meeting patients where they are: vaccinations are even more Methodist Hospital—wearing Riley Children’s Health at important to public health, “Ready to Vote?” lanyards— IU Health North Riley provided hundreds of helped 85 patients ■ Riley inpatient care at IU Health North free flu shots to children register to vote in Hospital with pediatric intensive care and families during two the weeks before unit and 24/7 coverage flu vaccination events at Indiana’s voter ■ Surgery and procedures in The Children’s Museum registration gastroenterology, urology, pulmonology, of Indianapolis. deadline. otolaryngology, orthopedics and sports medicine, and general surgery
■ On-site pediatric emergency medicine physicians
■ Outpatient care in more than two dozen pediatric specialties
4 | Riley Children’s Health Medical Specialties Annual Report 2019 | 5 New maternity tower to feature unique, fully integrated care model
The Maternity Tower at Riley Hospital for Children at IU Health is scheduled to open in 2021. The facility centralizes all of Riley’s obstetric and neonatal care across the Riley Hospital for Children and IU Health Methodist Hospital campuses. The maternity tower features a new coordinated care model anchored by the long- standing reputation of Riley at IU Health for delivering expert care for complicated pregnancies and at-risk newborns. Riley, alongside our partners at IU Health, offers comprehensive, multidisciplinary services and exceptional medical support to patients experiencing low- to high-risk pregnancies. In March 2020, Riley Maternal Fetal Medicine relocated to the Riley Outpatient Center, expanding its footprint with additional private exam rooms and ultrasound suites. The Riley Fetal Center is housed in the same area and includes a “nesting room” for patients to relax between appointments and testing.
Riley Fetal Center Maternity Tower at Riley Hospital for Children Learn more about our approach to The Riley Fetal Center provides preeminent Expertise and services management of a broad range of complex maternity and newborn health ■ Most comprehensive obstetrics and maternal fetal medicine and high-risk conditions, while supporting program in the state Collaboration between obstetrics and neonatology exists in most health families with coordinated care specific to the ■ High-risk pregnancy consultation and services for women with centers, but the Riley care model is integrated both operationally and needs of the patient. medical and obstetrical issues physically in our children’s hospital. This allows our specialists to deliver services in a seamless manner from initial consultation and maternal ■ Advanced fetal imaging, including ■ On-site Level III and Level IV NICUs and fetal assessment to delivery planning—and finally, to management echocardiography, extensive – Riley’s combined Level III and Level IV NICU is the largest NICU of labor and delivery. For babies needing immediate, high-level care, ultrasonography and the state’s only in Indiana and among the largest in the country fetal MRI our pediatric subspecialists are available on site, with no need for ■ Specialty maternal fetal medicine programs: transport, resulting in consistently better patient outcomes. ■ Personalized, multidisciplinary and family- – Mood Disorders Program (collaboration with IU Health Psychiatry) centered care consultations with families Comprehensive services for high-risk and support team members – Maternal Recovery Program (women recovering from substance abuse disorders) and low-risk pregnancies ■ Multidisciplinary fetal care conferences, Being equipped to manage the highest risk cases means Riley is bringing together more than 40 Riley – Centering Pregnancy Program (group prenatal care) more than prepared to take care of mothers experiencing normal specialists, to discuss best practices – Programs for pregnant women with medical conditions such pregnancies. Complications during labor and delivery are unpredictable and management plans for complex as diabetes and cardiac disease and occur even in pregnancies that are considered low risk. Our fetal diagnoses ■ General pregnancy care, including experienced obstetricians expertise in managing complex pregnancies makes Riley the safest and midwifery program place even for low-risk patients because of our ability to skillfully respond at the highest level to unexpected complications that Maternity tower These images are renderings only. The final product may differ slightly. can happen. In addition, the new midwifery program at Riley offers an alternative for women who want a more natural labor and delivery experience but also desire the security of a hospital setting. Our certified nurse midwives provide patient-centered care for women through pregnancy, birth, postpartum and beyond.
24/7 adult care for mothers While our maternity services are in a children’s hospital, our program The tower includes: is closely aligned with IU Health adult services to provide high-quality, ■ 45-bed Level III NICU ■ Labor/delivery birthing suites safe care for all mothers delivering at Riley. Our obstetrics intensive (private rooms) ■ 68 private postpartum rooms care unit will be covered 24/7 by an adult intensive care physician, and ■ Obstetrics intensive care unit for mother and baby both adult and pediatric experts from throughout the IU Health Adult With 105 total NICU beds (new Level III NICU plus existing 60-bed Academic Health Center will be on call day and night for consultations Level IV NICU), Riley at IU Health houses the largest NICU in the state. at Riley, if needed.
6 | Refer a patient: 317.944.7010 (Maternal Fetal Medicine | Riley Fetal Center) Riley Children’s Health Medical Specialties Annual Report 2019 | 7 Adolescent Medicine Riley Gender Health Program for children Riley Adolescent Medicine is dedicated to the care and treatment and adolescents of young people up to age 21. Our fellowship-trained physicians, This interdisciplinary experienced in caring for the special needs of teenagers and young program offers adults, treat a wide range of adolescent health concerns, including comprehensive support eating disorders, reproductive health and gender health. The to children, teens and adolescent medicine team routinely works with other Riley specialties, young adults who are including cardiology, hematology/oncology, child development, experiencing gender psychiatry, endocrinology, and obstetrics and gynecology. dysphoria and seek supportive and affirmative care. We address the medical, psychological, nutritional, family, social, legal and school- Expertise and specialized programs to treat related issues associated with diverse gender identities. Our team DIVISION CHIEF a variety of adolescent health concerns offers a variety of care and services, including: Rachel A. Katzenellenbogen, MD Adolescent Medicine Consultation Program ■ Gender-affirming hormone therapy Program leader since 2020 This program offers evaluation and treatment of any problem in an Associate Professor of Pediatrics, adolescent that persists or requires more specialized treatment than ■ Puberty-blocking medication IU School of Medicine For full team member list, see page 59. is usually available through primary care providers. The range of ■ Treatment for menstrual suppression services is broad and includes treatment for physical, emotional ■ Psychological counseling and support and behavioral concerns. Patients are seen in person at the Riley Program distinctions Pediatric Care Center or through a virtual visit. Common referrals ■ Surgery consultation and coordination include (but are not limited to): One of the largest divisions of its Charis Center for Eating Disorders kind in the nation with high- ■ Management of chronic illness The Charis Center offers the full array of medical, psychological volume clinical care, prolific ■ Evaluation for chronic symptoms without a diagnosis and family services for patients with eating disorders. The grant-funded research and a multidisciplinary program includes physicians, nurses, psychologists, robust training program ■ Mental health and behavioral issues, including anxiety, dietitians, art therapists, schoolteachers and psychiatrists who focus depression and disordered attention on the care of children, adolescents and adults with eating disorders. Home to the Charis Center, ■ Nutritional concerns, including eating disorders The Charis Center treats patients of all ages and provides three levels Indiana’s most comprehensive of care to match the needs of the patient and family. eating disorders treatment Adolescent gynecology and reproductive healthcare program Riley adolescent medicine specialists evaluate and treat a variety ■ Partial hospital program – Eleven-hour therapy, five days per week of gynecological conditions, including delayed puberty, dysfunctional ■ Intensive outpatient program – Three-hour therapy, three days The only comprehensive program uterine bleeding, polycystic ovary syndrome, chronic pelvic pain and per week; provides group therapy targeted for patients who need in the state targeted to meet the dysmenorrhea. Riley offers specialized gynecology and reproductive more focused treatment unique needs of gender-diverse healthcare, such as long-acting reversible contraceptive options. children and adolescents ■ Outpatient care -- More than 10,000 outpatient visits each year Our specialists have extensive experience consulting patients and families about fertility preservation for adolescents with complex illnesses, such as heart transplants and congenital heart conditions, sickle cell disease, cystic fibrosis, and childhood cancer.
Active in research Riley adolescent medicine specialists conduct research in a variety of areas, including human papillomavirus (HPV), HPV vaccines, sexually transmitted infections, healthcare access for youth, eating disorders, teen pregnancy prevention, gender health and the long-term effects of illness and recovery on youth. Our researchers are committed to translating research findings into improved patient care and healthcare policy.
8 | Refer a patient: 317.274.8812 Riley Children’s Health Medical Specialties Annual Report 2019 | 9 Allergy and Immunology With experience and Immunomodulator management and immunotherapy training in the unique Our specialists—all trained in the management of allergic rhinitis The board certified allergy and immunology specialists at Riley at IU Health and asthma—have improved the quality of life for hundreds of ways allergic reactions are extensively trained in the management and treatment of pediatric allergy, children with severe asthma by using immunomodulators (biologic asthma and immunology issues. Our skilled team, which includes two pediatric affect children, Riley medications that reduce inflammation). We also treat children with nurse practitioners, offers the latest diagnostic tools and treatments delivered allergy physicians immunotherapy—allergy injections that change the body’s immune in a safe and comfortable manner to children dealing with the challenges of response to pollens, molds, dust mites and animals. Children can offer the skills and allergic conditions. We collaborate with other medical disciplines at Riley to then reduce or even stop their medications for itchy eyes, runny nose, provide integrated, multidisciplinary care to children and families. expertise to manage the sneezing and similar chronic symptoms. We currently see patients most complex allergic in Indianapolis, Carmel and Bloomington, with plans to add more Comprehensive care for allergy and immunology conditions statewide locations. As clinicians, researchers and educators, our specialists are uniquely qualified to conditions in children. DIRECTOR diagnose and treat the full spectrum of pediatric allergic conditions: Girish V. Vitalpur, MD, FAAP, FAAAAI ■ Allergic rhinitis (hay fever) ■ Eosinophilic esophagitis ■ Immune deficiencies The allergy program is a vital part of the Riley Program leader since 2018 Associate Professor of Clinical Pediatrics, ■ Angioedema (swelling) ■ Food allergies/anaphylaxis ■ Insect sting reactions High-Risk Asthma Program, which brings IU School of Medicine For full team member list, see page 59. ■ Asthma ■ Food protein-induced enterocolitis ■ Oral allergy syndrome together allergists, pulmonologists and clinical syndrome asthma educators to address all aspects of ■ Drug allergies ■ Recurrent infections ■ Urticaria (hives) asthma management. Program distinctions ■ Eczema (atopic dermatitis) ■ Sinusitis A center of clinical excellence Fields of clinical excellence and specialized programs in food allergy—a certification Serving Indiana’s Food allergies. Riley at IU Health is recognized by Food Allergy Research & Education selectively awarded by Food as a center of excellence. We perform more than 200 food challenges annually, and Allergy Research & Education children our team has years of experience in food introduction at all ages. The Children’s Riley immunologists are Clinical Research Center at Riley provides designated, child-friendly rooms for families Home to a leading and responsible for reviewing participating in research protocols and food challenges. innovative High-Risk all positive results for Drug allergy management. Our allergy physicians perform several outpatient drug Asthma Program Indiana’s newborn screening challenges each year. Antibiotic challenges are the most common. In addition, we program for severe combined have collaborated with colleagues in infectious diseases and pharmacy to develop an Inpatient and outpatient immunodeficiency (SCID). algorithm based on history, testing and oral drug challenges that accurately labels or antibiotic allergy and Outcomes from SCID de-labels a child’s drug allergies. We have also advised pediatricians across Indiana on de-labeling programs treatment show that early how to implement these programs in their practices. identification and intervention Gastrointestinal Digestive Disease Program. Riley has the only multidisciplinary with hematopoietic stem program in Indiana dedicated to the treatment of children with eosinophilic digestive cell transplant provide the disorders. Riley allergists, gastroenterologists and dietitians consult with patients and best chance for survival. families at every visit to provide comprehensive care for eosinophilic esophagitis, Our specialists are leaders eosinophilic gastroenteritis and other complex immune-mediated digestive issues. in the state in treating Immunology SCID. Management for Dedicated to clinical and basic science research these children includes Our team provides inpatient and outpatient consultation for children with primary and prompt diagnosis, family secondary immune deficiencies. We guide the use of immunoglobulin replacement n Riley allergists participate in international clinical trials for peanut genetic counseling, inpatient and other immune modulators in working with children who have challenging allergy oral and patch immunotherapy. management and long-term cases. Our immunology program addresses the array of immune system disorders, n Our team collaborates with basic science researchers at the care after hospitalization. including DiGeorge syndrome, antibody deficiencies, chronic granulomatous disease Herman B Wells Center for Pediatric Research at Riley to study the and other complex conditions. In the past 20 years, we have performed stem cell initiation, pathogenesis and progression of allergic diseases to identify better transplants in more than 25 children with severe combined immunodeficiency (SCID) ways to treat or prevent allergic symptoms. and other immune deficiencies. Riley immunologists routinely participate in national ■ Other areas of research interest include: conferences to review complex cases with colleagues in hematology/oncology, rheumatology and infectious diseases. – Examining the regulation of genes important for the development of T cells involved in allergic inflammation Our allergy and immunology specialists collaborate with rheumatologists and other – Studying the biology of cytokines and other factors that promote specialists in the Riley Center for Immune Dysregulation. This multidisciplinary allergic disease program provides optimal care and research opportunities for patients with complex disorders of the immune system. The center is the first of its kind in Indiana and – Analyzing lung development and function and how changes contribute provides families with opportunities to participate in national trials. For more about to lung reactivity to allergens the center, refer to page 57.
10 | Refer a patient: 317.948.7208 Riley Children’s Health Medical Specialties Annual Report 2019 | 11 Total Catheterization Volume: 2016 – 2019 Cardiology We are the only pediatric heart program in Indiana to perform transcatheter closure of patent ductus arteriosus (PDA) in tiny premature infants. The Riley Heart Center is one of the most highly RANKED 5th IN THE NATION respected programs for diagnosis and treatment 600 of congenital and acquired heart conditions in 500 526 500 479 children. With the latest technologies and world-class 427 400 facilities, expert cardiologists at Riley provide the full continuum of care from fetuses and premature 300 infants to adults with congenital heart disease. 200 51 PDAs 47 PDAs 78 PDAs 52 PDAs 100 (2 premature (7 premature (21 premature (24 premature Care from a highly skilled team infants) infants) infants) infants) 0 Heart care is managed by an experienced and highly 2016 2017 2018 2019 DIVISION CHIEF skilled team, including cardiologists, cardiovascular Larry W. Markham, MD surgeons, cardiovascular critical care specialists, cardiovascular anesthesiologists, neonatologists, cardiovascular geneticists Care for the most complex Program leader since 2018 and adult cardiologists specializing in congenital heart disease. We also have inpatient and outpatient nursing and advanced Phillip Murray Professor of Pediatric Cardiology, Cardiac catheterization practice providers who are specifically dedicated to the care of cardiac patients. IU School of Medicine Riley Heart Center specialists use the latest advancements in cardiac For full team member list, see page 59. Care for the most fragile catheterization, making it possible to diagnose and treat cardiac birth Fetal Cardiology Program defects without conventional surgery. We routinely perform leading- Our Fetal Cardiology Program, part of the comprehensive Riley Fetal Center, offers in-depth diagnostic imaging and counseling edge procedures, including atrial septal defect closure, ventricular Program distinctions septal defect closure, balloon valvuloplasty and transcatheter valve during pregnancy to enable thorough evaluation and development of a treatment plan. With nearly 1,700 evaluations Ranked among the top five replacement. In the past five years, our team has implanted 57 performed in 2019, patient volume has more than doubled since 2000. Fetal echocardiograms are performed statewide in pediatric heart programs by transcatheter pulmonary valves. South Bend, Fort Wayne, Bloomington, Evansville and at U.S. News & World Report five locations in Indianapolis. Cardiomyopathy Program Notable Home Monitoring Program outcomes Our program is approved by the Children’s Cardiomyopathy Foundation One of only seven programs Home Monitoring Program ■ 0% inter-stage mortality from 2016 to 2019; Centers of Care, which recognizes medical centers with expertise in worldwide to earn the highest Originally designed for babies with single ventricle 3.8% since 2009 pediatric cardiomyopathy. A center of care provides high-quality cardiac rating (three star) from the physiology, this program now includes any baby with Society of Thoracic Surgeons (STS) ■ 89% survival from birth to first birthday care and specialized disease management, including genetic evaluation, complex physiology. Implemented upon discharge after to children with cardiomyopathy. Riley cardiologists evaluated 110 new ■ Greater than 75% without growth failure by Integrated care model promotes initial intervention, the Riley Home Monitoring Program patients in 2019. Since 2016, we’ve assessed more than 500 children Stage 2 intervention high-level subspecialty care uses a unique web-based iPad component to assist for this heart condition. parents in tracking wellness and enable cardiologists ■ Less than 1% readmission rate for major or serious coordination and novel approaches to cardiac intensive to evaluate data in real time. Parents with questions adverse events through Stage 2 intervention Heart failure, transplant and mechanical support In 2019, Riley Heart Center: care, inpatient navigation and can contact an on-call provider 24/7. Our program What parents say ■ Provided support with a Berlin Heart to three patients awaiting home monitoring allows patients and families to go home sooner and ■ 89%: Program helped them feel more comfortable transplant has contributed to a median length of stay following leaving the hospital ■ Performed nine heart transplants: six pediatric patients and three Only children’s hospital in Indiana the Norwood procedure that is lower than the national ■ 86%: Home monitoring increases confidence in adult congenital patients to offer a home monitoring average (47.5 days versus 49.8 days).* providing care at home ■ 100% survival to date in patients receiving heart transplants in 2019 program for babies born with * Source: Society of Thoracic Surgeons (STS) July 2015 – June 2019. single ventricle or complex Most recent data available as of Nov. 15, 2020. ■ 83%: They feel more connected to the Riley care team Adult Congenital Heart Disease Program physiology because of the program Jointly led by adult congenital cardiologists from Riley and the Krannert Institute of Cardiology at IU Health Methodist Hospital, our program has Only formalized comprehensive experienced tremendous growth in recent years, with outpatient visits adult congenital heart disease South Bend increasing from 275 just seven years ago to almost 2,000 evaluations program in the state Statewide access in 2019. to nationally Fort Wayne 17,938 0 ranked heart care