Episoder
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Sharing data transparently, whether at a local or a national level, is a foundational contributor to healthcare quality. Atul Gawande wrote about this in his 2004 essay labeled āThe Bell Curveā. Over the last several decades, we have seen many pediatric specialties organize and collaborate around data collection at a national scale to improve care. Weāve seen firsthand how our hospitalās participation in a national cardiac critical care registry has driven quality improvement, better measurable outcomes and improved cardiac arrest rates for patients. Getting the data collection right is the first challenge. In between that first step and actually seeing improvements is a tremendous amount of work. In this episode, we explore the value of data sharing and transparency to improve outcomes for kids.
Our experts for this episode are Carly Scahill, DO, and Kelly OāNeil. Dr. Scahill specializes in pediatric cardiology as a pediatric cardiac intensivist. She is also the Fellowship Director for pediatric cardiology and the cardiac intensive care unit (CICU), as well as an associate professor of pediatrics at the University of Colorado School of Medicine. Kelly OāNeil is a registered nurse and the Manager of the Heart Institute Data Registries and Outcomes. Before her current role, she was a CICU nurse for over ten years.
Some highlights from this episode include:
The purpose and use of clinical registries How data collection improves measurable outcomes The future of data collection in healthcare How to get more entities involvedFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Over the last few decades, the roles of nurse practitioners (NPs) and physician assistants (PAs), also known as advanced practice providers (APPs), have greatly expanded to touch even more patient-family lives. They are an essential part of the care we provide, and their roles have evolved over time. In this episode, we explore the crucial part they play in our medical system and how that might continue to evolve in the future.
For this episode, we are joined by two University of Colorado leaders who continue to help keep our APP programs among the top ranked in the country. Jonathan Bowser is the Child Health Associate and Physician Assistant Program Director at the University of Colorado School of Medicine. He is also the Associate Dean of Physician Assistant Studies, the Section Head of Pediatrics, and an associate professor. Jill Marks, NP, is the Specialty Director of the Acute Care Pediatric Nurse Practitioner Program at the University of Colorado College of Nursing. She is also an inpatient nurse practitioner for the section of pediatric neurology at the University of Colorado School of Medicine.
Some highlights from this episode include:
Background on the creation of NPs and PAs The ways these roles have changed over time The impact APPs make on patient care The role APPs will play in healthcare in the futureFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Manglende episoder?
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Our medical community is committed to providing excellent patient care, and itās also our duty for that care to extend to our planet. Climate change is an increasingly important global health issue where children are the most vulnerable to adverse health outcomes. One major contributing factor to climate change in medicine is the use of nitrous oxide in spaces like the operating room and outpatient clinics. Efforts are underway in hospitals across the country to decrease our environmental impact, including at Childrenās Hospital Colorado.
To explore the exciting new project happening at Childrenās Colorado and to discuss the environmental impacts on a global scale, we are joined by two experts. Tom Majcher, DO, is the Chief of Anesthesiology at Childrenās Colorado, as well as a professor of pediatrics and clinical practice for anesthesiology at the University of Colorado School of Medicine. Diane Gordon, MD, specializes in anesthesiology at Childrenās Colorado and is an associate professor of pediatric anesthesiology at the University of Colorado School of Medicine.
Some highlights from this episode include:
How nitrous oxide is currently used in medical settings The damage it does on the environment What efforts are underway to reduce its impact How to keep the same standard of care with new alternatives The importance of this transition in the operating roomFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Over the last few decades, there have been many incredible medical advances in newborn care. At Childrenās Hospital Colorado, weāre launching an exciting new initiative to take another step forward in care for our tiniest patients.
For newborns who need to be hospitalized, getting home as soon as possible is critical for their successful development. A common barrier for discharge that can keep babies in the neonatal intensive care unit (NICU) for additional days or weeks is the need for a nasogastric (NG) tube. Ensuring an infant is receiving proper nutrition is essential to securing a safe discharge. What if we could deliver NG tube feeds at home and provide all the necessary support? Thatās the game changing idea we explore in this episode with our neonatology experts.
To dive into this topic, we are joined by three neonatologists practicing at Childrenās Colorado. Stephanie Bourque, MD, Kathleen Hannan, MD, and Danielle Smith, MD, tell us about a new at-home NG tube feed program that the team at Childrenās Colorado is currently developing. Dr. Smith is the Medical Director of the NICU, Dr. Bourque is the Associate Medical Director of the NICU, and all three of our guests are faculty at the University of Colorado School of Medicine.
Some highlights from this episode include:
What the need has been historically for NG tubes Model for this at-home program Whatās required to make this at-home model a reality The role of the primary care provider in this partnership The impact a change like this could have on patient outcomes and family satisfactionFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Join us for another insightful season of Charting Pediatrics! The same hosts you know and love will continue to bring the latest and greatest information about pediatric medicine to your ears. Joined by renowned experts, we will explore prominent topics while being moved by their personal stories. This is a season you won't want to miss!
For more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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We all know what it feels like to have a headache, but each person can experience that intensity for dozens of different reasons. Globally, headache disorders affect approximately 40% of the population, which is about 3.1 billion people. Headaches are also among the three most common neurological conditions for most age groups starting at age 5.
As such a ubiquitous issue, itās important for providers to understand, diagnose and treat headaches. What are the most common reasons for headaches in children? How should pediatricians know when a headache is more than surface-level discomfort?
To learn about the latest in pediatric headaches, we are joined by two headache experts, Marcy Yonker, MD, and Angelina Koehler, NP. Dr. Yonker is the Director of the Headache Program at Childrenās Colorado and the Dale, Cindy and Kristin Francescon Endowed Chair for Headache Treatment with the University of Colorado Department of Pediatrics. Angelina Koehler is a certified pediatric nurse practitioner in the Neuroscience Institute at Childrenās Colorado.
Some highlights from this episode include:āÆ
What PCPs should take into account about migraines How to approach headache treatment options What to consider with hesitation around certain medications When to look for signs of a more serious illnessFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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For almost 50 years, Dr. Fritz Karrer has been wearing a surgeonās cap, growing as a surgeon alongside the evolution of his specialty. For 40 of those 50 years, heās been at Childrenās Hospital Colorado, making an everlasting impact on kids and their families. On the brink of retirement, we look at his exemplary career and discuss how heās watched firsthand the progression of pediatric surgery. His half century of perspective makes him the perfect expert to dive into the growth of pediatric surgery.
Dr. Karrer specializes in pediatric surgery and surgical critical care at Childrenās Colorado and is a Professor of Pediatric Surgery at the University of Colorado School of Medicine. Heās also a colonel in the U.S. Army Reserve, he was recognized as a top doctor in 2023 by 5280 Magazine and heās been awarded the James Strain Award and the Military Medical Merit from the U.S. Army.
Some highlights from this episode include:āÆāÆ
The incredible journey of Dr. Karrerās career The ways pediatric surgery has evolved over the last 50 years The influence of technology on pediatric surgery Advice for young doctors wanting to follow a similar path āÆFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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More than 50% of rural counties in the United States do not have a pediatrician, and more than 80% of counties lack access to healthcare services that are simply needed to maintain the health of their population. The medical experts in those areas are lifelines to their communities. They are providing essential care, approaching resource and access challenges with creativity and innovation, and connecting kids to specialists when needed. Area codes can determine as much about health and life expectancy as issues like genetic predisposition and lifestyle.
Our two guests are doing this work in rural communities every day. Kelly Miller, MD, is a general pediatrician with Pediatric Partners of the Southwest in Durango, CO. Anna Mack, DNP, FNP, is a family nurse practitioner with Peak Vista Community Health Centers in Colorado Springs. She is also faculty at a post-graduate training advanced practice registered nurse fellowship program.
Some highlights from this episode include:āÆāÆ
What are the primary challenges for providers in rural pediatrics How experts are overcoming rural mental health hurdles for kids Ways providers are using innovative solutions for issues they face in rural areas How more urban and rural organizations can work toward stronger partnershipsFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Running is an increasingly popular sport, with high school track and field programs seeing booming participation rates. With rising interest comes more cases of injury, however, incredible sports medicine advancements and programs are helping young runners manage and prevent injuries.
To break down the most common running-related injuries in youth and discuss comprehensive approaches to prevention and recovery, we are joined by three Childrenās Hospital Colorado experts. Aubrey Armento, MD is a sports medicine physician, Medical Director of the Runners Clinic for Young Athletes, and an assistant professor of Orthopedics at the University of Colorado School of Medicine. Amanda McCarthy is a program coordinator of sports nutrition and a registered sports dietician. Cameron (Cody) Yeaman, DPT, is a sports physical therapist and a certified specialist in orthopedic sports and strength and conditioning.
Some highlights from this episode include:āÆāÆ
What to know about new diagnoses in young runners What there is to be learned from dissecting a case study How patients and families benefit from a variety of specialists at the Runners Clinic How pediatricians can understand and tap into an athlete mentality to gain buy-in from their patients. āÆFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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For some, COVID-19 may seem like a thing of the past, but for medical professionals, the data regarding post-acute sequalae of COVID infection is only just emerging. Four years ago, the start of the pandemic left doctors puzzled by certain symptoms. Today, we are learning more about the long-term impacts of SARS-CoV-2 in children, often called long COVID or PASC. As the population continues to struggle with persistent and debilitating after-effects and symptoms, we are looking for answers.
To provide insight into this important diagnosis, we are joined by Suchitra Rao, MD. She is an infectious disease specialist at Childrenās Hospital Colorado, as well as the Associate Medical Director of Infection Prevention and Control. She is also an associate professor of Pediatrics within the sections of Infectious Diseases, Epidemiology, and Hospital Medicine at the University of Colorado School of Medicine.
Some highlights from this episode include:āÆāÆ
The epidemiology of long COVID in kids The difference between the data in adults and children A discussion of how to diagnose asymptomatic patients A closer look at Dr. Raoās groundbreaking researchFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Inflammatory bowel disease, otherwise known as IBD, is an illness pediatric providers need to consider when they see kids with abdominal pain, diarrhea or weight loss. IBD can present in a fairly straightforward way, or it can be incredibly challenging to diagnose. Weāve seen improvements in IBD diagnosis and care recently, including new screening tools and medications, as well as future treatments currently under investigation. Getting these medications to kids can be a challenge since pharmaceutical companies focus on adult indications and pediatric clinical research can sometimes lag. That delays access to some of the best therapies.
One of our experts in IBD at Childrenās Hospital Colorado is our guest for this episode, Edwin De Zoeten, MD. He is the director of the Pediatric Inflammatory Bowel Disease Center, and is the Hoover Family Endowed Chair for Digestive Health and Nutrition. He is a professor of Pediatrics at the University of Colorado school of Medicine and has a basic science research lab focused on better understanding the pathophysiology of IBD and looking at new treatment opportunities.
Some highlights from this episode include:āÆāÆ
Understanding what symptoms look like and how early they can begin Looking at the underlying pathophysiology that triggers IBD Sharing tools pediatricians can use for diagnosing and treating IBD Discussing the durability of treatments and benefits over time āÆFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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In simple terms, bioethics is the study of ethical, social and legal issues that arise in biomedicine and biomedical research. It provides guidelines for clinical decision-making and is vital to policy change. Despite standards set by medical entities, significant gaps and variabilities exist within bioethics education for pediatric residents. Every resident will face ethical challenges in their career, so it's important that programs prepare learners to navigate these dilemmas. To address these inconsistencies, a chief resident at the University of Colorado School of Medicine has created a new curriculum that could significantly improve our bioethics education.
Joining us for this episode is Ella Sorscher, MD, Brian Jackson, MD, and Brady Slater. Dr. Sorscher is a pediatrics chief resident at the University of Colorado School of Medicine and is one of the brains behind this new bioethics curriculum. Dr. Jackson is the Medical Director of Clinical Ethics and specializes in critical care as a pediatric intensivist at Childrenās Hospital Colorado. He is also an associate professor at the University of Colorado School of Medicine. Dr. Slater is a pediatrics and medical genetics resident at the CU School of Medicine.
Some highlights from this episode include:āÆāÆ
Details about this curriculum The significance of bioethics in a physicianās career Information on assessing learners and evaluating the curriculum Opportunities for other institutions to learn from this modelFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Earlier this year, new guidelines were released to improve the diagnosis of pediatric sepsis and septic shock. For the first time, the novel Phoenix Sepsis Criteria provides an objective and data-driven approach to aid in the identification of these life-threatening conditions, including prediction of mortality in children with suspected or confirmed infection. Sepsis is one of the leading causes of death among children worldwide, and these guidelines could be a major step in changing outcomes.
To help us understand these guidelines and apply them to your practice, we are joined by two experts who have been at the forefront of this new research. Tell Bennett, MD, specializes in pediatric critical care at Childrenās Hospital Colorado. He is the Vice Chair of Clinical Informatics, as well as a professor of biomedical informatics and pediatrics at the University of Colorado School of Medicine. Halden Scott, MD, is the Director of Research for the section of emergency medicine at Childrenās Colorado. She is also an associate professor of pediatrics at the University of Colorado School of Medicine.
Some highlights from this episode include:āÆāÆ
How to diagnosis sepsis under the new guidelines How these criteria can be applied to primary care practices What treatment options are and why time is of the essence āÆFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Newborn screening has expanded dramatically over the last decade as our detection methods improved and new treatments became available for rare diseases. One of those rare diseases is adrenoleukodystrophy, otherwise known as ALD. ALD is an example of a rare disease where, thanks to expansions in newborn screenings, we are now able to make a precise genetic diagnosis very early in life and offer therapies far in advance of the onset of symptoms. Early detection and treatment of this can potentially spare a family a lifetime of devastating health impacts. In December 2013, New York became the first state to require newborn screening for ALD. Currently, 43 states and Washington, D.C. are testing babies for ALD.
To help us understand the role of newborn screening, we are joined by Kevin Ess, MD. He is the Ponzio Family Chair of pediatric neurology and is the section head of neurology at Childrenās Hospital Colorado. He is also a professor of pediatrics at the University of Colorado School of Medicine.
Some highlights from this episode include:āÆāÆ
The pathophysiology of ALD. The clinical manifestations of ALD that make it the perfect model for newborn screening. The specifics of diagnosing and treating ALD. The long-term impact newborn screening can have for the lifetime of children with ALD. āÆFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Artificial intelligence (AI) has the potential to transform healthcare and disrupt the field of medicine in significant ways. We have already seen remarkable progress in areas such as diagnostics and data analysis, but what could broader use in patient care looks like? A little over a year ago, the arrival of ChatGPT got everyone talking about AI ā how realistic it is, how well it understands certain concepts and, specifically in medicine, how it can benefit our care systems. In this episode, we explore the overarching needs for AI in pediatrics and medical education, as well as where we stand in implementing it.
We are joined by two guests from Childrenās Hospital Colorado who are leading the way in understanding how AI could be incorporated into pediatric care. Jim Barry, MD, specializes in neonatal/perinatal medicine at Childrenās Colorado and is an associate professor of pediatric neonatology at the University of Colorado School of Medicine. He is also the Medical Director of the UC Health NICU. He co-founded NeoMIND-AI, a learning collaborative for neonatologists and data scientists interested in AI within neonatal and pediatric critical medicine. Sarah Milla, MD, specializes in pediatric radiology and is the John D. Strain Endowed Chair for Radiology, Chief of Pediatric Radiology and Vice Chair of Radiology at Childrenās Colorado and the University of Colorado School of Medicine. She is also a visiting professor.
Some highlights from this episode include:āÆāÆ
Examples of how AI is currently being used in medicine Ways providers can get started with AI Ideas on how we can advance care in the future with this toolFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Over the last decade, weāve watched childhood obesity emerge as a major health concern, taking over news stories and social media posts worldwide. The evaluation and treatment of children with obesity has evolved, and how we handle these diagnoses today is different than in years past. Whatās important to emphasize is that obesity is a chronic disease, and the medical community needs to treat it as such.
To learn more about this important topic and highlight an impressive woman in medicine, we are joined by Ihuoma Eneli, MD. She is the Section Head of Nutrition at Childrenās Hospital Colorado and a visiting professor of pediatrics at the University of Colorado School of Medicine. She is an internationally recognized expert on pediatric obesity and serves in leadership and advisory roles for many organizations.
Some highlights from this episode include:
A discussion of the new AAP obesity guidelines Genetics and how clinicians can reframe their understanding of obesity Suggestions for motivational interviewing with patients and families Treatment options that are available to patient-families The stigma around fault versus genetics New drugs and their future impactFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Hirschsprung disease. Anorectal and colorectal malformations. These are some of the most challenging surgical problems encountered in young children. The precision of surgical technique required to achieve optimal outcomes takes many years, if not decades, to develop. Colorectal surgery has become a subspecialty in pediatric surgery, requiring close collaboration with other specialists. At Childrenās Hospital Colorado, we offer this care through our International Center for Colorectal and Urogenital Care, and our surgical team has some of the most experience in the world.
In this episode, we are joined by Andrea Bischoff, MD, and Luis De la Torre-Mondragon, MD. They both specialize in pediatric surgery at Childrenās Colorado and are associate professors of surgery and pediatrics with a specialty in colorectal surgery at the University of Colorado School of Medicine. Dr. Bischoff is also the Medical Director of the International Center for Colorectal and Urogenital Care here at Childrenās Colorado.
Some highlights from this episode include:āÆāÆ
The importance of pediatric colorectal programs. A discussion of when surgical intervention is necessary. A look at what procedures are offered at Childrenās Colorado and how they work. The role primary care providers can play as it pertains to identification, referral and care of patients who might need colorectal surgery.For more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Sleep problems can occur at any age, but when toddlers, children or young adults are the ones experiencing them, they can have a big impact on the entire family. Specifically, one to five percent of children, from newborns to teenagers, experience obstructive sleep apnea. While the effects may be significant, many children are not diagnosed or treated due to insufficient access to testing. A team at Childrenās Hospital Colorado has been preparing a recommendation on how and when to use home sleep apnea testing in kids.
To explore this topic, we are joined by Antoinette Burns, DO, who specializes in pediatrics and sleep medicine at Childrenās Colorado. She is also an associate professor of clinical practice, Department of Pediatrics-Pulmonary Medicine, at the University of Colorado School of Medicine.
Some highlights from this episode include:āÆāÆ
An explanation of obstructive sleep apnea. New modalities for sleep apnea testing. Barriers for accessing testing and how to combat them. Suggestions on what primary care providers should do when they think their patient might have obstructive sleep apnea.For more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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Knowing something is wrong with your child is terrifying for any parent, but the mystery becomes more frightening when the symptoms even puzzle the experts. In 2018, at a peak in cases of acute flaccid myelitis, also known as AFM, otherwise healthy kids experienced debilitating paralysis. Researchers of this perplexing illness braced for a surge in 2022 that never came, and now there is talk about a possible increase of AFM this year.
To break down the past and prepare for the future, we are joined by two experts. Kevin Messacar, MD, and Hai Nguyen-Tran, MD, both specialize in pediatric infectious disease at Childrenās Hospital Colorado. Dr. Messacar is an associate professor and Dr. Nguyen-Tran is an assistant professor at the University of Colorado School of Medicine.
Some highlights from this episode include:āÆāÆ
What the history of AFM tells the medical community Why itās so tricky to diagnose and identify How primary care providers can properly prepareFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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In just the United States, more than 15,000 children are diagnosed with cancer each year. Globally, that number is greater than 300,000. As difficult as those numbers may be, there is good news: Our cancer therapies continue to improve. In the 1960s, only about 5% of children survived leukemia. Today, that number is 90% or better. Many more pediatric oncology patients are now transitioning into survivors of childhood cancer and have the opportunity to achieve their hopes and dreams as adults. This means primary care providers are caring for these patients in increasing numbers. Whatās important to know about this group of kids? In this episode, we discuss how to best integrate survivorship care with pediatric care.
The Childrenās Hospital Colorado HOPE Cancer Survivorship Program is one of the longest running survivorship programs in the nation. Leading that charge is Jenna Demedis, MD, who specializes in pediatric hematology and oncology. Dr. Demedis completed her training at Childrenās Colorado and is currently an assistant professor at the University of Colorado School of Medicine.
When a patient can transition into survivorship How to keep patient families engaged in these programs How primary care providers can partner with survivorship programsFor more information on Childrenās Colorado, visit: childrenscolorado.org.āÆāÆāÆ
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