Childrens Hospital And Health System Inc

INTEGRATED AND COORDINATED HEALTH SERVICES NETWORK FOR INFANTS, CHILDREN AND ADOLESCENTS.

CHHS IS THE PARENT ORGANIZATION OF AN INTEGRATED SYSTEM OF ENTITIES PROVIDING COMPREHENSIVE MEDICAL CARE AND SOCIAL SERVICES TO CHILDREN FROM WISCONSIN AND THROUGHOUT THE COUNTRY. THE SYSTEM INCLUDES WISCONSIN'S ONLY FREESTANDING HOSPITAL DEDICATED SOLELY TO THE CARE AND TREATMENT OF CHILDREN, AS WELL AS VARIOUS OTHER FACILITIES PROVIDING INPATIENT AND OUTPATIENT CARE FOR CHILDREN WITH ALL TYPES OF ILLNESSES, INJURIES, BIRTH DEFECTS AND OTHER DISORDERS. THE SYSTEM ALSO INCLUDES EXTENSIVE RESEARCH, EDUCATION AND COMMUNITY OUTREACH PROGRAMS. ON AN AGGREGATE BASIS, THE ENTITIES WITHIN THE SYSTEM PROVIDED COMMUNITY BENEFITS OF NEARLY $151 MILLION.CHHS OVERSEES AND COORDINATES THE ACTIVITIES OF THE VARIOUS OPERATING ENTITIES WITHIN THE INTEGRATED SYSTEM, THROUGH THE PROVISION OF SUPPORTIVE AND ADMINISTRATIVE SERVICES ON A CONSOLIDATED, CENTRALIZED BASIS.

CHILDREN'S RESEARCH INSTITUTE ("CRI") IS A PROGRAM OF CHHS THAT ADVANCES PEDIATRIC MEDICAL RESEARCH IN WISCONSIN AND BEYOND. WITH A FOCUS ON TRANSLATIONAL RESEARCH, CRI IS TAKING DISCOVERIES FROM THE LABORATORY AND CONVERTING THEM TO NEW THERAPIES, DIAGNOSTICS, AND WAYS TO IMPROVE CARE AT PATIENTS' BEDSIDES. CHILDREN'S PROVIDES INSTITUTIONAL SUPPORT OF RESEARCH THROUGH INFRASTRUCTURE SUPPORT SUCH AS LABORATORY SPACE, SHARED EQUIPMENT, AND SHARED SERVICES (INCLUDING BIOSTATISTICIANS, GRANT WRITERS, AND CLINICAL RESEARCH NURSES) AS WELL AS PROGRAMMATIC SUPPORT FOR RESEARCHERS. A FEW EXAMPLES OF ONGOING RESEARCH PROJECTS ARE DESCRIBED BELOW.CHILDREN'S HAS SIGNIFICANT EFFORTS IN CHILDHOOD CANCER RESEARCH, INCLUDING IMPROVING SURVIVORSHIP AND QUALITY OF LIFE FOR CHILDREN BATTLING SOME OF THE TOUGHEST FORMS OF THE DISEASE. ONGOING LABORATORY RESEARCH EFFORTS INCLUDE CANCER IMMUNOTHERAPY PROJECTS, WHERE OUR LABS ENGINEER NOVEL ANTIBODIES AND INCORPORATE THEM INTO ANTIBODY-BASED PRODUCTS FOR THERAPY SUCH AS BISPECIFIC ANTIBODIES AND CHIMERIC ANTIGEN RECEPTORS THAT FUNCTION TO REDIRECT POTENT IMMUNE EFFECTOR CELLS TOWARD ELIMINATION OF TUMOR CELLS. IN ADDITION, OUR RESEARCHERS ARE ACTIVE WITH THE THERAPEUTIC ADVANCES IN CHILDHOOD LEUKEMIA & LYMPHOMA (TACL) CONSORTIUM. THIS NATIONAL CONSORTIUM WAS ESTABLISHED TO DEVELOP AND CONDUCT PHASE I /II CLINICAL TRIALS OF NEW DRUGS AND NOVEL DRUG COMBINATIONS FOR RECURRENT CHILDHOOD LEUKEMIA OR LYMPHOMA. OUR RESEARCHERS ALSO CONTINUE TO PARTICIPATE IN THE COG (CHILDREN'S ONCOLOGY GROUP) CONSORTIUM FOR CLINICAL TRIALS OF NOVEL PEDIATRIC CANCER THERAPIES.RESEARCH IN IMPROVING NURSING CARE IS ALSO PART OF OUR RESEARCH PORTFOLIO, INCLUDING ONE PROJECT STUDYING WAYS TO ASSIST FAMILIES IN MANAGING COMPLEX CARE ISSUES AFTER THEY LEAVE THE HOSPITAL, POTENTIALLY IMPROVING ACCESS TO CARE AND POST DISCHARGE OUTCOMES FOR TRANSPLANT PATIENTS. THIS STUDY IS EVALUATING A NOVEL FAMILY CENTERED SELF-MANAGEMENT INTERVENTION THAT INCORPORATES AN INDIVIDUALIZED DAILY POST-DISCHARGE INTERACTIVE COMMUNICATION BETWEEN FAMILIES AND TRANSPLANT NURSES VIA MOBILE TECHNOLOGY. THE TOOL TRACKS DAILY FAMILY COPING, FAMILY SELF-MANAGEMENT BEHAVIORS OF COMPLEX CARE AT HOME, AND PARENT MANAGEMENT OF CHILDREN'S TRANSPLANT SYMPTOMS. THE TOOL MAY RESULT IN A PRE-IDENTIFIED TRIGGER AND ACTIVATE IMMEDIATE NOTIFICATION TO THE TRANSPLANT NURSE. THE ULTIMATE GOAL OF THE PROJECT IS TO IMPROVE ACCESS TO CARE.RESEARCHERS IN THE NEONATAL INTENSIVE CARE UNIT CONTINUE TO IMPROVE UNDERSTANDING OF PERSISTENT PULMONARY HYPERTENSION OF THE NEWBORN (PPHN), A LIFE-THREATENING CONDITION WHICH RESULTS FROM FAILURE OF PULMONARY VASCULAR RESISTANCE TO DECREASE AT BIRTH. IMPAIRED ANGIOGENESIS IN THE LUNG IS A KEY CONTRIBUTOR TO THE FAILED ADAPTATION. ENDOTHELIAL NITRIC OXIDE SYNTHASE (ENOS) PLAYS A CENTRAL ROLE IN THE REGULATION OF ANGIOGENESIS AND PULMONARY VASODILATION AT BIRTH. ONGOING STUDIES ARE INVESTIGATING THE CONTRIBUTION OF ENOS DYSFUNCTION TO IMPAIRED MITOCHONDRIAL BIOGENESIS AND EPIGENETIC ALTERATIONS IN ENOS GENE EXPRESSION IN PPHN, POTENTIALLY LEADING TO NOVEL THERAPY DEVELOPMENT TO RESTORE MITOCHONDRIAL BIOGENESIS AND ANGIOGENESIS IN INFANTS WITH PPHN.RESEARCHERS AT CRI ARE INVESTIGATING WAYS TO IMPROVE CARE FOR HEART TRANSPLANT PATIENTS, INCLUDING THE DEVELOPMENT OF A NEW METHOD TO MONITOR PEDIATRIC HEART TRANSPLANT RECIPIENTS AND IDENTIFY EARLY SIGNS OF TRANSPLANT REJECTION. TYPICALLY, HEART TRANSPLANT PATIENTS MUST UNDERGO A SERIES OF EIGHT TO TWELVE BIOPSIES PER YEAR TO MONITOR FOR TRANSPLANT REJECTION. THIS INVASIVE APPROACH POSES CERTAIN RISKS, AND CAN BE DIFFICULT FOR CHILDREN WHO HAVE ALREADY SPENT A CONSIDERABLE AMOUNT OF TIME HOSPITALIZED. THE RESEARCHERS HAVE DESIGNED A NONINVASIVE APPROACH THAT INVOLVES A SIMPLE BLOOD DRAW. THE LEVEL OF DONOR DNA IN THE BLOOD SERVES AS A BAROMETER OF HEART HEALTH; MORE THAN ONE-PERCENT OF DONOR DNA IN THE BLOOD INDICATES REJECTION. IN A PILOT STUDY, THIS METHOD SHOWED 100% SENSITIVITY.

CHHS PROVIDES VARIOUS OUTPATIENT HEALTH CARE SERVICES. IN 2021, THERE WERE 54,464 VISITS TO THE ORGANIZATION'S URGENT CARE CLINICS, AND 4,528 OUTPATIENT SURGICAL CASES PERFORMED AT THE ORGANIZATION'S AMBULATORY SURGICAL CENTER, THE SURGICENTER OF GREATER MILWAUKEE, LLC (A DISREGARDED ENTITY FOR FEDERAL TAX PURPOSES).

CHHS OFFERS FREE AND INEXPENSIVE HEALTH EDUCATION PROGRAMS AND RESOURCES AT NO CHARGE TO TEACHERS, CHILDREN AND PARENTS. IN ADDITION, CHHS PROVIDES INJURY PREVENTION PROGRAMS WHICH FOCUS ON CAR SEAT AND BIKE HELMET FITTINGS, TO KEEP CHILDREN SAFE AND HEALTHY. CHILDREN'S SCHOOL NURSE PROGRAM PROVIDES FULL-TIME REGISTERED NURSES FOR HEALTH CARE SERVICES IN 11 K-5 AND K-8 MILWAUKEE PUBLIC SCHOOLS AT NO COST TO MPS OR TO STUDENTS AND FAMILIES, SERVING OVER 4,000 STUDENTS ANNUALLY WHO MIGHT OTHERWISE NOT HAVE ACCESS TO HEALTH CARE. THE NURSES ADVOCATE FOR A COLLABORATIVE AND HOLISTIC APPROACH TO ADDRESS THE PHYSICAL, MENTAL, AND SOCIAL-EMOTIONAL WELLBEING NEEDS OF STUDENTS. THE SCHOOL NURSES ADDRESS THE SOCIAL DETERMINANTS OF HEALTH HELP BY FAMILIES' ACCESS COMMUNITY RESOURCES THROUGH COORDINATION WITH THE COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS. THEY BRING TOGETHER PARENTS/CAREGIVERS, SCHOOL SUPPORT STAFF, PRIMARY AND SPECIALTY CARE PROVIDERS, AND MENTAL HEALTH PROVIDERS TO ADDRESS AND IMPROVE THE HEALTH AND WELLNESS OF THE STUDENTS THEY CARE FOR. THE SCHOOL NURSES EDUCATE STUDENTS AND FAMILIES ON THE IMPORTANCE OF PREVENTIVE CARE AND CONDUCT SCREENING SERVICES INCLUDING BEHAVIORAL HEALTH ASSESSMENTS. THEY ASSIST WITH ESTABLISHING MEDICAL AND DENTAL HOMES, CARRY OUT DISEASE SURVEILLANCE AND REPORTING, PROVIDE CHRONIC DISEASE MANAGEMENT, ASSESS AND DEVELOP SCHOOL SAFETY AND EMERGENCY PREPAREDNESS PLANS, PROVIDE DAILY CARE INCLUDING MEDICATION ADMINISTRATION, G-TUBE FEEDINGS AND OTHER COMPLEX HEALTH PROCEDURES ONLY A HEALTH CARE PROVIDER CAN ADMINISTER IN THE SCHOOL SETTING. AS THE HEALTH EXPERT IN THE SCHOOL, THE NURSES ALSO OFFER CLASSROOM EDUCATION ON TOPICS SUCH AS MINDFULNESS, HYGIENE, AND NUTRITION.THE NURSES ADVOCATE FOR A COLLABORATIVE AND HOLISTIC APPROACH TO ADDRESS THE PHYSICAL, MENTAL, AND SOCIAL-EMOTIONAL WELLBEING NEEDS OF STUDENTS. THE SCHOOL NURSES ALSO WORK CLOSELY WITH THE COMMUNITY HEALTH NAVIGATORS AND COMMUNITY CONNECTORS ON POPULATION-BASED CARE, OUTREACH, AND ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH. THEY BRING PROVIDERS, FAMILIES, AND SCHOOL SUPPORT STAFF TOGETHER TO ADDRESS AND IMPROVE THE HEALTH AND WELLNESS OF THE STUDENTS THEY CARE FOR ON A DAILY BASIS. THE SCHOOL NURSES ROLE ENCOMPASSES DELIVERING PREVENTIVE AND SCREENING SERVICES; ESTABLISHING MEDICAL AND DENTAL HOMES; BEHAVIORAL ASSESSMENT; DISEASE SURVEILLANCE AND REPORTING; CHRONIC DISEASE MANAGEMENT; SCHOOL SAFETY AND EMERGENCY PREPAREDNESS; PROVIDING HEALTH EDUCATION; AND DAILY CARE COORDINATION INCLUDING MEDICATION ADMINISTRATION, G-TUBE FEEDINGS AND OTHER COMPLEX HEALTH PROCEDURES ONLY A HEALTH CARE PROVIDER CAN ADMINISTER.AN INCREASING NUMBER OF STUDENTS ARE ENTERING SCHOOLS EACH YEAR WITH SPECIAL NEEDS AND COMPLEX HEALTH CONDITIONS (ATTENTION-DEFICIT/ HYPERACTIVITY DISORDER, DIABETES, LIFE-THREATENING ALLERGIES, ASTHMA, AND SEIZURES) THAT REQUIRE EXTENSIVE INTERVENTION AND COORDINATION THROUGHOUT THE SCHOOL DAY TO KEEP KIDS HEALTHY AND IN THE CLASSROOM LEARNING. AS THE ONLY HEALTH CARE EXPERT IN THE SCHOOLS, THE SCHOOL NURSES PLAY A VITAL ROLE ON THE SPECIAL EDUCATION TEAMS TO ADVISE AND ADVOCATE FOR SPECIAL EDUCATION SERVICES NECESSARY FOR STUDENTS WITH MEDICAL CONCERNS TO ACCESS A FAIR AND EQUAL EDUCATION. FOR CHRONIC ILLNESSES SUCH AS ASTHMA, DIABETES, SEIZURES OR SICKLE CELL ANEMIA, THE SCHOOL NURSES WORK WITH PARENTS AND FAMILIES TO CREATE CARE PLANS HELPING GUIDE THE STUDENTS TO SELF-MANAGEMENT BY THE TIME THEY REACH HIGH SCHOOL, WITH A GOAL OF DECREASED URGENT CARE AND EMERGENCY DEPARTMENT VISITS AND INCREASED UTILIZATION OF PRIMARY CARE PROVIDERS. DURING THE 2020-21 SCHOOL YEAR THE SCHOOL NURSES WERE ACTIVE TEAM MEMBERS ON DEVELOPING 13 BEHAVIOR PLANS, 48 INDIVIDUAL EDUCATION PROGRAMS AND 4 504 PLANS FOR STUDENTS WITH DISABILITIES. FOR THE 2020-21 SCHOOL YEAR, STUDENTS AND NURSES WERE VIRTUAL FOR MUCH OF THE TIME. IN APRIL APPROXIMATELY 35% OF STUDENTS RETURNED TO IN PERSON LEARNING, WHILE THE REMAINING STUDENTS REMAINED VIRTUAL UNTIL THE END OF THE SCHOOL YEAR. DURING THIS TIME, THE NURSES FOUND INNOVATIVE WAYS TO SUPPORT STUDENTS IN BOTH LEARNING ENVIRONMENTS. CHILDREN'S SCHOOL NURSES WERE ABLE TO IDENTIFY WHAT CHALLENGES STUDENTS FACED, AND HELPED PROVIDE THEM WITH THE TOOLS NECESSARY TO ACHIEVE SUCCESS. EQUITY, COLLABORATION AND ADVOCACY WERE CRITICAL DURING THIS SCHOOL YEAR, AND THE TEAM WORKED TO ENSURE STUDENTS AND FAMILIES HAD WHAT THEY NEEDED TO BE HEALTHY, SAFE AND READY TO LEARN.CHILDREN'S NURSES COMPLETED 970 IN-PERSON STUDENT ENCOUNTERS AND 1,601 STUDENT/FAMILY OUTREACH CONNECTIONS, KEEPING STUDENTS AND STAFF SAFE WHILE FOLLOWING STRICT COIVD PROTOCOLS AND MITIGATION STRATEGIES. WITH THE CONTINUING CONCERNS OF THE CORONAVIRUS PANDEMIC AND THE DISPROPORTIONAL IMPACT ON STUDENTS AND FAMILIES OF COLOR, OUR TEAM HAD TO REMAIN INNOVATIVE AND READY TO RESPOND TO THE ONGOING NEEDS OF VULNERABLE STUDENTS AND FAMILIES. THE NURSES CONTINUED TO BE AVAILABLE DURING THE SCHOOL DAY FOR FAMILIES OF STUDENTS PARTICIPATING IN VIRTUAL SCHOOL FOR PHONE CONSULTATIONS TO ANSWER BASIC HEALTH QUESTIONS SUCH AS GENERAL HEALTH AND WELLNESS CONCERNS, VACCINE QUESTIONS OR CONCERNS, MEDICATION MANAGEMENT, AND CORONAVIRUS INFORMATION. THE NURSES ALSO MAINTAINED THEIR GOOGLE CLASSROOMS TO CONNECT WITH THE STUDENTS ENSURING EQUITY IN PROVIDING EDUCATION, RESOURCES AND REASSURANCE. AS KNOWLEDGE OF THE PANDEMIC INCREASED AND VACCINES BECAME AVAILABLE, THE SCHOOL NURSES WERE VITAL IN COMMUNICATING, GUIDING AND EDUCATING FAMILIES ON THE CORONAVIRUS TO KEEP THEM SAFE, ESPECIALLY IN COMMUNITIES, SEEING HIGHER RATES OF INFECTIONS, HOSPITALIZATIONS, AND DEATH. THEY WERE ABLE TO ASSIST FAMILIES WHO WERE UNSURE OF HOW TO ACCESS COVID TESTING SITES AND EDUCATE OR ALLEVIATE FEARS ON COVID VACCINES. THE SCHOOL NURSES WERE INSTRUMENTAL IN COORDINATING FOUR SCHOOL-BASED FLU VACCINE CLINICS, MAKING 684 REFERRALS THROUGH OUTREACH, AND VACCINATING 415 STUDENTS AND COMMUNITY MEMBERS FOR INFLUENZA. WHEN SCHOOLS RESUMED IN-PERSON LEARNING, THE SCHOOL NURSES WERE THE LEADERS IN PROVIDING COVID EDUCATION AND CONSULTATION FOR MITIGATION POLICIES AND PROCEDURES, EDUCATING 1,025 STUDENTS AND 103 SCHOOL STAFF ON COVID SAFETY. SINCE 2014 CHHS PARTNERED WITH WISCONSIN'S DEPARTMENT OF HEALTH SERVICES AND THE DEPARTMENT OF CHILDREN AND FAMILIES AND ESTABLISHED A FOSTER CARE MEDICAL HOME PROGRAM CALLED CARE4KIDS TO ADMINISTER THE COORDINATION OF COMPREHENSIVE HEALTH CARE SERVICES INCLUSIVE OF MEDICAL, DENTAL AND BEHAVIORAL HEALTH CARE SERVICES FOR CHILDREN PLACED IN "OUT OF HOME CARE" (A.K.A. "FOSTER CARE") IN KENOSHA, MILWAUKEE, OZAUKEE, RACINE, WASHINGTON, AND WAUKESHA COUNTIES IN WISCONSIN. UPON ENROLLMENT INTO THE PROGRAM THESE FOSTER CARE CHILDREN HAVE ACCESS TO CHILDREN'S COMMUNITY HEALTH PLAN'S ("CCHP") PROVIDER NETWORK AS CCHP PROVIDES ADMINISTRATIVE AND UTILIZATION SERVICES FOR CARE4KIDS PROGRAMMING. THROUGH DECEMBER OF 2021, PROGRAM ENROLLMENT WAS 2,900 WHICH REPRESENTED APPROXIMATELY 40-45% OF THE TOTAL OUT OF HOME CARE POPULATION IN THE STATE OF WISCONSIN.