Leadership Circle is proud to announce our six 2017 Grant Proposal Finalists! These proposals include research initiatives, cutting-edge technology and clinical programs and services. The competition for funding is greater than ever before with the Requested Amount increased to $150,000! Leadership Circle members will collectively vote and rank these proposals for funding at the annual luncheon on April 19, 2017, held at the Arizona Country Club.
Applicant: Mary Callaway, NICU Clinical Educator
Division: Clinical Education & Professional Development
Project: Let’s Go Home Program
Amount Requested: $60,200
We request support to implement a “Let’s Go Home” program geared towards preparing families to care for their medically fragile children at home. Phoenix Children’s Hospital takes care of the most complex patients in the state. Our families live and learn with us how best to care for their child. The time children spend with healthcare providers is a mere fraction compared to the time receiving care at home. Currently nurses at the bedside provide this education between caring for several patients on the floor.
Our project will have impact on the delivery of complex care for children in their home. In addition, the program will enhance parent comfort in providing care for their medically fragile children. A structured program will allow us to ensure consistent education, track the impact of the interventions on readmission rates, length of stay and patient outcomes. One criterion for success will be no delays in discharge due to need for parents to learn complex care. Another short term goal will be a decrease in readmission rates of less than 2 weeks. Long term changes will be the ability to provide education which will be fiscally responsible in the new healthcare arena while enhancing the patient experience. Evaluations will guide our continued efforts in preparing patients and families for discharge as well as determining future needs for a growing number of medically complex children in our community. In addition, we will utilize findings to develop interventions which will decrease the number of ED visits and readmissions.
Patient falls are the number one cause of further medical complications and/or death. The Vector Gait and Balance System will minimize risk of patient falls, as well as risk of injury for both patient and clinician. Use of the system will promote faster recovery, reduce patient length of stay and also minimize risk. The Vector Gait and Balance System is an over-ground, gait, balance and dynamic body weight support training system. The system will allow Phoenix Children’s Rehabilitation Department to provide the highest level of evidence-based care when treating all movement disorders; neurological and orthopedic in nature. The Vector System will enable therapists to treat all patients with mobility deficits over ground which is key to driving functional gains. Patients of all diagnoses can practice mobility safely, without fear nor risk of falling. Additionally, the risk of staff injury will be significantly decreased if not removed with the use of the Vector System.
In addition to all the benefits the system provides to the mobility training during a treatment session, objective outcome measures can be administered from the Vector system. The system will track patient outcomes with mobility throughout the patient plan of care. These objective measures can easily be translated into objective documentation by the therapist, be provided to the family to demonstrate therapy goals and progress, as well as shared with other healthcare providers involved in the patient’s healthcare management.
The Bereavement Program at Phoenix Children’s Hospital requests support for current services and expansion of the program. Expansion of the program would allow for increased availability of bedside support at end of life as well as the development of a peer support program. This program expansion would increase the availability and continuity of support services provided to a family prior to the death of a child (anticipatory grief), as well as following the loss (bereavement support).
This funding opportunity would allow the program’s bereavement coordinator to increase from 60% to a full time role. The availability of full time bereavement staff will increase bedside support for families, face to face follow-up, and allow for the development of a peer support/mentor program. Results will be used to make program improvements as well as impact how the program is involved in supporting families prior to and after the death of a child. The use of screening tools will allow for data that may be published or presented in conferences. Our program will have a direct impact on the patient and family experience by facilitating hope and healing in PCH families who have lost a child, including surviving siblings. Offering support to parents and children following the death of a child can make the difference between healing and prolonged silent suffering. Although there are some community resources that exist to support the loss of a child, many families continue to look to PCH for support even after the death of their child.
Applicants: Andrea Polach, Manager, Professional Practice; Katie Barchi, Quality Consultant; Jennifer Matchey, MD, CVICU; Zeb Timmons, MD, Emergency Department
Division: Quality Department
Project: WATCHER: Identification of Patient’s at Risk for Clinical Deterioration
Requested Amount: $122,700
We are seeking support to develop a real-time inpatient monitoring system to improve early detection of patients at risk for serious clinical deterioration and death at Phoenix Children’s Hospital. The WATCHER score is an innovative, automated, electronically-generated risk score which PCH has internally developed using EMR data to help clinicians identify early subtle signs of physiologic decline, guide clinical interventions, and prevent high-risk “code events” outside of the intensive care unit (ICU). In code events, a child’s heart and breathing stops and the clinical team must respond in minutes in order to prevent permanent organ damage. Heroic efforts and invasive procedures must be performed to rescue the child. Given the serious consequences of these code events, all efforts should be made to identify subtle signs of pending clinical deterioration and intervene pre-emptively. Recognition of early deterioration is important to reduce code events which occur outside of the ICU, an event associated with a 50% to 67% mortality. Several studies have demonstrated early recognition of clinical decline can decrease codes outside the ICU and hospital-wide mortality.
Every year, Phoenix Children’s has hundreds children who have abrupt clinical decline that require urgent intervention across the emergency department, intensive care units, and general medical inpatient units. Currently, clinicians on the general medical inpatient units assess patient risk using the Pediatric Early Warning System (PEWS). Given the complexity of our patient population, including patients with cardiac, neurologic, and complex surgical conditions, PEWS has proven unsuccessful in detecting deterioration. Our practitioners and nurses have yet to find a screening tool to assist them with timely identification of at-risk patients. To prevent poor outcomes including patient death, a more robust and reliable method is needed to increase early recognition of clinical deterioration and prompt treatment of patients which is vital. Based on the proven effectiveness of the process, PCH will consider licensing the technology to its EMR vendor as it has previously with several other similar initiatives. This has the potential to generate revenue and enhance PCH’s reputation as a national pediatric leader.
Applicant: Brigham C. Willis, MD
Division: CV Surgery / Critical Care / Cardiology
Project: Tissue Engineering of Bioinspired, Personalized Neonatal Cardiac Patches to Improve Outcomes in Pediatric Patients with Congenital Heart Disease
Requested Amount: $100,000
Cardiac disease is one of the most common causes of morbidity and mortality in infants and children. Just under one percent of infants, or approximately 40,000 children, are born each year with congenital heart disease (CHD), the most common cause of cardiac disease in this population. Only limited research has been done investigating the development of personalized therapies for pediatric cardiac diseases. In addition, all of the common therapies for pediatric cardiac dysfunction have been studied primarily in adults, making extrapolation of their use in pediatrics problematic. We believe that we can solve these critical shortcomings through development a bioinspired and patient-specific regenerative-based therapy for pediatric cardiac disease. Specifically, we propose a novel and interdisciplinary approach using natural hybrid biomaterials, conductive gold nanorods (GNRs), and patient derived primary cells to develop personalized and biomimetic neonatal cardiac tissues. We envision that bioinspired neonatal cardiac patches, proposed herein, will dramatically improve therapeutic outcomes for children with myocardial dysfunction.
One of the pillars of clinical care at PCH today is the Heart Center. Ranked as one of the top clinical care centers for CHD in the country by US News and World Report, PCH has the opportunity to continue to develop the Heart Center into one of the best in the country. Currently, the biggest area of opportunity to improve our center is in research. While various members of the Heart Center have been performing interesting and novel research, there is much room for growth. The funding of the research effort described herein would put PCH at the forefront of some of the most exciting and innovative research in any field. Development of bioinspired, biocompatible, patient-specific therapies would elevate PCH to the top of research endeavors in CHD nationally and internationally. This would directly support the mission of PCH to become a top-ten Children’s hospital. It would also have a profound effect on our patient population, leading to the development of cutting-edge lifesaving therapies.
Applicant: Benjamin Wright, MD
Division: Department of Medicine, Division of Pulmonology
Project: Imaging of Functionally Distinct Eosinophil Subtypes within Tissue Biopsies Using Gene Expression Profiling and a Multiple RNA Targeting
Requested Amount: $150,000
This proposal represents a synergistic/collaborative approach to adapt multiple-target in situ imaging technology under development at Arizona State University (ASU) and leukocyte gene expression profiling efforts at Mayo Clinic in Arizona (MCA) for clinical application in patient biopsy samples at Phoenix Children’s Hospital. Ultimately, this will allow us to characterize leukocyte subtypes in inflammatory disease states. Our long term goal is to develop gene expression-based biomarker approaches allowing physicians to image patient biopsies with these novel diagnostic strategies.
White blood cells are commonly recruited to sites of inflammation and contribute to activities that lead to associated symptoms. On-going studies have led to the unexpected conclusion that these cells are not all the same and that they are a collection of multiple and functionally distinct subtypes. This suggests that methods capable of imaging these distinct white blood cells may represent an underappreciated ability to diagnose patients and will be of value in the care of many patients suffering with inflammatory diseases. This project is in line with Phoenix Children’s strategic focus on interdisciplinary growth because it aligns clinical research efforts in the divisions of Allergy/Immunology and Pathology with existing basic science research infrastructure at Arizona State University and Mayo Clinic in Arizona. It is our goal through this expanded collaborative effort to solidify translational research partnerships between ASU, Mayo Clinic and PCH investigators to increase opportunities for additional scientific discoveries of clinical import. This award will help increase our collaborative efforts with ASU and Mayo Clinic Arizona and develop a technology that will accelerate to PCH Department of Pathology to the forefront of modern histopathology.