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Peds Paper

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It is often said, “Necessity is the mother of invention”. The necessity may arise from world events, legislation, economic circumstances, and sometimes a combination of all these things. The “inventions” that stem from these necessities do not end once the original need is met. They continue to gain momentum and often change the world, as we know it. The entities that make up the Vanderbilt Hospital system are examples of this necessity driven innovation.
In 1928, the first Pediatrics wing was created at Vanderbilt hospital. At the apex of the Second World War, the South was a more agrarian culture that relied on the harvesting of crops to provide food for their families. Due to the amount of nitrates provided in the fertilizer used to assist in crop growth, a disorder known as Methemoglobinemia or Blue Baby Syndrome developed in children. According to Zieve, (2014), “Methemoglobinemia is a blood disorder in which abnormal amounts of methemoglobin—a form of hemoglobin—is produced.” This disorder caused the babies' skin to have a blue pallor caused by the lack of bonded oxygenated blood in their circulation. This condition was treatable by administering supplemental oxygen and methylene blue. This was not the only Blue Baby Syndrome that had occurred in the South. Dr. Helen Taussig, who was appointed head of the Children’s Heart Clinic at John Hopkins Hospital's pediatric unit in 1930, had also encountered a case of “blue baby” syndrome during this same time (“Changing the Face,” 1993). Different than the current syndrome, this was a congenital disorder called Tetralogy of Fallot. The Mayo Clinic (2015), defines this as “a rare condition caused by a combination of four heart defects that are present at birth.” This is where the surgical research of Dr. Alfred Blalock and Vivian Thomas of Vanderbilt University came into play. According to Thomas’ autobiography (1985), “Blalock and Thomas began experimental work in vascular and cardiac surgery”; defying medical taboos against operating upon the heart. It was this work that laid the foundation for the revolutionary, lifesaving surgeries they were to perform at John Hopkins a decade later. After this success and the end of the war, many other branches of pediatric care began to stem from the Pediatrics and Obstetrics wards at Vanderbilt. A Neonatal Intensive Care Unit (NICU) was introduced in 1961 to treat sick newborns and infants. This lead to the eventual creation of the Monroe Carell Jr. Children’s Hospital at Vanderbilt. This hospital received worldwide recognition through Dr. Amos U. Christie, chair of pediatrics and his team's pioneering work in histoplasmosis (Wood, 2016). Once Vanderbilt met the initial need by improving pediatric care in their hospital, they decided to address the needs of the community.
The Monroe Carell Jr. Children’s Hospital at Vanderbilt has always had a vision to strive for excellence in the area of pediatric care. Vanderbilt has a mission that includes delivering the highest quality care to children. This has been accomplished in many ways beginning with the inception of the hospital and it continues to present day. One of the most current forerunners for the education and improvement of the children’s hospital is The Red Wagon Project that was established in 1971. “The Red Wagon Project is a collaborative effort between teens in the community and Monroe Carell Jr. Children’s Hospital at Vanderbilt to provide extra support items for Children’s Hospital patients and their families during their hospital stay” (“The Red Wagon,” 2015). The Red Wagon Project allows their “ambassadors”, usually student’s grades 7-12, to create their own donation drive and work with the organization. Sometimes the end result of these donation drives is money that can be used towards patient bills or books for children with extended hospital stays. In addition to the success of the donation drives, the primary mission of the Red Wagon Project is the education to the public for wellness tips and awareness of childhood diseases and immunization care of the childhood community.
According to the Vanderbilt University Medical Center (VUMC) main calendar of events (2016), there are also many internal programs Monroe Carell Jr. Children’s Hospital at Vanderbilt at that are designed to help achieve this goal. Trainings such as Clean Hands Save Lives and hands-on clinical safety classes are for the internal education of their staff. A monthly Know Your Numbers class invites community members to attend and learn basic wellness trackers such as BPM, heart rate, BMI, and activity logs. Community interaction is only one way that VUMC continues to innovate, this time in the area of medical research
Another way that Vanderbilt is improving the future is in the area of healthcare informatics and technology. Vanderbilt Hospital was the creation of The Center for Research and Innovation in System Safety (CRISS).
The Center for Research (2015) reports CRISS as being: highly interdisciplinary and collaborative with projects spanning numerous clinical domains (from the Medical Home to the operating room) and disciplines (medicine, nursing, and pharmacy). Using a range of human factors and systems engineering, cognitive psychology, biomedical informatics, and implementation science techniques, CRISS studies performance during patient care and in realistic simulations to better understand how and why care deviates from optimal. (p.1)
CRISS is used for the evaluation and study of the effects of new technologies that are used to help with electronic care of patients. This can be anything from the recording of their chart to the type of postoperative care and education a patient should receive upon the departure of the medical facility. CRISS helps with the communication aspect of the medical facility. Currently, Dr. Slagle and Weinger are co-investigators in an NLM- funded trial to evaluate how mode of clinical documentation affects the patients experience as well as the quality of the resulting note. (“Center for Research,” 2015) Vanderbilt continues to lead the charge in the adoption of emerging technologies. One way Vanderbilt uses emerging technology to improve patient care is in the area of communication and patient education has been through their Residency iPad Program. Through this program all resident physicians would be issued their own company iPad that has up-to-date information on patient illnesses, education, and services provided by the facility (Department of Medicine,” 2016). Another way that Vanderbilt uses technology to educate patients and staff through their Clean Hands Saves Lives initiative is with the creation of a mobile app for Apple products. This app was created by the IT professionals of The Hand Hygiene Committee at Vanderbilt. Users of the app can enter data of individuals that are not compliant with hand hygiene regulations. This data is recorded electronically and sent in real-time and used on individuals as a teaching guide and education purposes ( Clendening, 2012). With the influx of technology VUMC has proven itself a fierce competitor in the healthcare industry. This coupled with their rapid response teams and quality improvement techniques makes them a force to be reckoned with.
Everything can be followed back in time to a singular moment. A moment in time can shape the way we can see our future. The Monroe Carell Jr. Children’s Hospital at Vanderbilt has had a multitude of moments that has made them great. From the pioneering of open-heart surgery from a somewhat familiar disorder to the construction of a children’s hospital that has for many years been spearheading the campaign for children and their healthcare needs. They achieved this not only through their own technological ingenuity, but also through safe practices in their hallways and education through their city. The Monroe Carell Jr. Children’s Hospital at Vanderbilt will continue making it’s footprints in the medical world through improvement initiatives and procedures, one child at a time. Spanning many years of ingenuity and

References:

Clendining, J. (2012, June 17). Vanderbilt University Medical Center - New iPhone “app” helps Vanderbilt University Medical Center monitor hand washing compliance. Retrieved April 16, 2016, from http://www.mc.vanderbilt.edu/news/releases.php?release=2459

DeBaun, M., Frei-Jones, M., & Vichinsky, E. (n.d.). Methemoglobinemia: MedlinePlus Medical Encyclopedia. Retrieved April 24, 2016, from http://www.nlm.nih.gov/medlineplus/ency/article/000562.htm

Mayo Foundation for Medical Education and Research. (2015, October 08). Tetralogy of Fallot. Retrieved April 16, 2016, from http://www.mayoclinic.org/diseases-conditions/tetralogy-of-fallot/basics/definition/con-20043262

National Library of Medicine. (1993, January 1). Changing the Face of Medicine | Dr. Helen Brooke Taussig. Retrieved April 24, 2016, from http://www.nlm.nih.gov/changingthefaceofmedicine/physicians/biography_316.html

Thomas, V. T. (1985). Pioneering research in surgical shock and cardiovascular surgery: Vivien Thomas and his work with Alfred Blalock: An autobiography. Philadelphia: University of Pennsylvania Press. Retrieved April 16, 2016.

Vanderbilt University Medical Center. (2015, December 4). The Red Wagon Project. Retrieved April 24, 2016, from http://childrenshospital.vanderbilt.org/guide.php?mid=10766

Vanderbilt University Medical Center. (2015). Center for Research and Innovation in Systems Safety. Retrieved April 24, 2016, from http://www.mc.vanderbilt.edu/criss/

Vanderbilt University Medical Center. (2016). Vanderbilt University Medical Center. Retrieved April 16, 2016, from http://www.mc.vanderbilt.edu/calendar/?xtags=vumc

Vanderbilt University Medical Center. (2015, December 04). Childrens Hospital Vanderbilt. Retrieved April 16, 2016, from http://www.childrenshospital.vanderbilt.org/guide.php?mid=10766

Vanderbilt University Medical Center. (2016). Department of Medicine. Retrieved April 16, 2016, from http://medicine.mc.vanderbilt.edu/residency-ipad-program

Wood, W., VUMC Reporter. (2016). History | Vanderbilt University School of Medicine. Retrieved April 16, 2016, from http://medschool.vanderbilt.edu/history…...

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