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What's Best for the Kids
Big things are happening for small patients. Families and health care providers across the region rely on the University of Maryland Hospital for Children to treat the most complex conditions in patients – from newborns to young adults. Regardless of the diagnosis, all of the patients get one important thing: a treatment plan based as much on a family-centered approach as on the best medical evidence. "We are building on our success as a world-class hospital that is already recognized for expertise in cardiology, gastroenterology, hematology/oncology, neonatology, pulmonology and surgery," says Steven J. Czinn, MD, head of the University of Maryland Hospital for Children and professor and chairman of the Department of Pediatrics at the University of Maryland School of Medicine. "As we continue to grow, we look at the needs of the community and concentrate on building services in those areas." In all the pediatric specialty areas of the Hospital for Children, the focus is on family-centered care. That approach means that the clinical staff, including physicians, communicates thoroughly with parents and patients. Whenever possible, patients are treated in the outpatient specialty clinic on the 5th floor of the Medical Center or at satellite clinics held in multiple counties. In cases where a child must be admitted to the hospital, every attempt is made to make it as normal an experience as possible. At every stage of diagnosis and treatment, the patient and the family's emotional and physical well-being are considered. 
Creating this family-centered approach involves the whole team of caregivers, including nurses, patient-care technicians, unit secretaries, respiratory therapists, physical therapists, occupational therapists and social workers. In anesthesia, radiology, the laboratories, pharmacy and other areas, staff members who are devoted to working with pediatric patients bring their highly specialized knowledge to the care team. Child life specialists provide developmental and psychosocial support to patients throughout their hospitalization. "Being a hospital-within-a-hospital allows the UM Hospital for Children care providers to share experiences and gain insight from colleagues that might not take place in other children's hospitals," says Kristin Feliciano, vice president for women's and children's services. "As I round in our patient care areas, I am continuously impressed by the level of attention given to patients and parents by all members of the team. From the security officers' reassurance to a collaborative team discussion between OT, nurses and parents, it is clear that the patient and family come first." More Than 100 Strong And Growing These caregivers, along with more than 100 full-time physicians in nearly three dozen specialty areas of pediatric medicine and surgery, make up the University of Maryland Hospital for Children. Just like a thriving child, the faculty continues to grow as Czinn recruits physicians in the areas of greatest need. Cardiac and Critical Care
This summer, Geoffrey Rosenthal, MD, PhD, left the Cleveland Clinic and joined the Hospital for Children as the new director of the Pediatric and Congenital Heart Program and professor of pediatrics at the School of Medicine. He brings experience in cardiac critical care, research, teaching and children's health care advocacy. Working with partners within and beyond the Medical Center, Rosenthal is leading the development of a comprehensive program to meet the needs of children in Maryland and the region. In addition to his clinical work, Rosenthal is on the Pediatric Advisory Committee of the US Food and Drug Administration to support the evaluation of medications for children. And Rosenthal also brings great enthusiasm to his work. Soon after arriving, he worked with the UMMS Foundation to recruit a team of about 30 runners from among the UMMC staff to be part of the Baltimore Running Festival in October, to raise awareness in the community about the Hospital for Children. Rosenthal was on the team, competing in the main event. He ran 26.2 miles, crossing the finish line proudly in a shirt with the UM Hospital for Children logo, with his son at his side. Neonatology Another impressive addition to the Hospital for Children was the successful recruitment of Cynthia Bearer, MD, PhD, as head of the division of neonatology and professor of pediatrics. Bearer came to UMMC one year ago from Rainbow Babies and Children's Hospital in Cleveland, Ohio. She is renowned for her expertise in fetal alcohol syndrome. The Neonatal Intensive Care Unit (NICU), with at least 40 babies at almost all times, is one of the largest in the state. The skilled clinicians on this level IIIC unit use advanced technology and the latest evidence-based medicine to save the tiniest and sickest babies. "We evaluate everything we do to care for these infants, making sure it is based on the best evidence, so that our care will give these infants the best chance to thrive," Bearer says. Sometimes, the techniques may be unfamiliar to parents, so communication is important in helping them know what's best for the baby. For example, the NICU staff has incorporated a protocol for inducing hypothermia – lowering the body temperature – for 72 hours in full-term infants who suffered decreased oxygen or blood flow as the result of a difficult birth. This period of hypothermia reduces the extent of injury that can happen as a result of the returned flow of oxygenated blood to the infant's brain. Although cooling a newborn may seem counterintuitive to parents, Bearer says randomized, controlled clinical trials have shown the infants have the best outcomes when this method is used. "It's just one example of looking at all of our practices, and asking which ones are based on the best evidence, and which are not," Bearer says.
Family-centered care is at the heart of the NICU: parents can be present any time of the day or night, as much as they want, whether to nurse the infants or gain skills in preparation for taking them home when they grow strong enough. Future plans are to expand the NICU by adding rooms that allow one infant and his or her family to occupy a room together, called "single-family rooms" or "rooming-in." This will help all infants, but it will especially help support the nursing mother and infant by allowing the mother to sleep in the same room with the baby. Pulmonology In December, Trip Browning, MD, will be the newest addition to the Hospital for Children medical staff as head of the Division of Pediatric Pulmonology and Allergy. Most recently, he was at Texas A&M Health Science Center College of Medicine. Baltimore has an exceptionally high number of children with asthma. Since this chronic condition continues to be the number-one reason children miss school, the pediatric pulmnologist's role is vital in helping children to stay in school and breathe easily.
Bold Decision, Thriving Network 
In 1984, when the staff of what was then called University Hospital learned that it was to be converted from a state institution to a private, non-profit health care system with a greater ability to grow, the big question was: "Will the things that I love about my job change?" For Marie Jews, BSN, RN, things only got better.
Jews had just graduated from the University of Maryland School of Nursing one year earlier, but she had been a student nurse at the hospital since 1980. She has worked here ever since, turning down opportunities to go elsewhere because of the professional growth available at the Medical Center. She is now a case manager for acute care at UMMC, the flagship hospital of the University of Maryland Medical System, which has since grown to include 10 more hospitals throughout Maryland. "When the transition took place, many of my colleagues expressed concerns about how this change would impact their nursing careers," Jews says. "Over time, many of those same individuals remained at UMMC and have been active in the many professional changes that have taken place. "On a daily basis, we experience growth while providing excellent care to seriously ill individuals in the state of Maryland," Jews says. "We are proud to say, ‘We do the tough jobs.' " "The solid foundation that was made possible by privatization has permitted the Medical Center to plan a bold future," says Jeffrey A. Rivest, president and chief executive officer of the University of Maryland Medical Center. "We can provide great hope for the advancement of medical technologies and therapies that will make a distinct difference for our patients." The University of Maryland Medical System (UMMS) is celebrating the 25th anniversary of its transformation from an aging, state-run hospital to a successful private, non-profit network of 11 academic, community and specialty hospitals throughout Maryland with more than 15,000 employees and almost $2.5 billion in annual revenue. "The transformation and growth of our medical system is an amazing success story," says Robert A. Chrencik, president and chief executive officer of the University of Maryland Medical System. "The privatization gave us the flexibility to be innovative and reinvest cash flow from hospital operations into clinical programs. We gained access to additional sources of funding, such as the bond market, to revitalize our facilities and technology, and consistently achieved an ‘A' rating from bond rating agencies." Chrencik, who has been with the medical system during its entire 25-year history, adds, "Today, we have some of the most sophisticated hospital facilities and advanced technology in the region and we have been able to build a world-class workforce, including some of the finest physicians anywhere, due to our strong partnership with the University of Maryland School of Medicine." The transformation took place when the Maryland General Assembly and then-Gov. Harry Hughes enacted a law enabling the change in governance from the state to a private, non-profit corporation led by a board of directors that included business, legislative and community leaders. At that time, the hospital faced constant financial challenges and struggled to keep up with innovations in patient care. Still, this was a bold idea; only one other teaching hospital, Shands Hospital in Florida, had ever made the switch to a privately run entity. Morton I. Rapoport, MD, the first president of UMMS, led the organization until 2003. Rapoport says, "The fundamental challenge in the early days was to change the culture of the hospital into an enterprising, competitive and innovative institution and to have enthusiastic physicians, nurses and staff who would support and become committed to that vision. I believe that vision was achieved and I am thankful to have been able to witness the tremendous growth and success of the Medical System over its 25-year history." "The University of Maryland Medical System is a treasured resource for the state, providing excellent health care and generating $3.5 billion in economic activity. We are very proud of the organization's accomplishments and dedication to the health of our citizens," says Maryland Gov. Martin O'Malley. Chrencik says he expects the Medical System to continue to grow statewide to ultimately be recognized as one of the top academic hospital systems in the United States. "I want to thank all the people who have really made a difference in getting us to where we are today—our board, our employees, our patients, the community and the physicians who provide the outstanding care at all of our hospitals. They are the people who deserve credit for our success and will be central to our continued success moving forward."
Mariellen Synan, community outreach manager, started working at the hospital 26 years ago, just before the change to a private medical system. She organizes the Medical Center's presence at several health fairs and community events. "When I'm out in the community, I hear a lot of positive remarks," she says. "People say, ‘Your hospital saved my life.' They see us as the hospital to go to." 
A Kid-Friendly Space for Young Surgery Patients  Pediatric nurses know that surroundings can have a huge Impact on the way children feel – especially when they're feeling nervous about impending surgery. When Amber Lloyd, RN, BSN, CPN, came to work for the Pediatric Surgery Center of the University of Maryland Hospital for Children two years ago, she took one look at the waiting room for young surgery patients and decided it could use a few cosmetic procedures. "Our waiting room was not kid-friendly," says Lloyd, whose nursing duties include preparing children for surgery and caring for them in the post-anesthesia period. "The colors were a dark blue with flowered pictures on the wall and blue chairs." So Lloyd set about connecting with other departments in the Medical Center to get the resources to pay for the job and make sure it was carried out well. "I approached our nurse manager, and she helped connect me with the UMMS Foundation office," Lloyd says. The UMMS Foundation is the philanthropic arm for the Medical Center and other hospitals in the University of Maryland Medical System. Pamela A. Scott, RN, MS, the nursing manager whose areas include the Pediatric Surgery Center, thought of the UMMS Foundation because it had provided some small donations in the past that came from grateful former patients or other members of the community who wanted to support pediatric areas. Over the years, grateful families had given collective contributions specifically earmarked for improving the aesthetics of pediatric areas. From this money, Foundation staff were able to provide Lloyd with a budget of $10,000 to carry out her ideas. In order to use the money in the most efficient manner, Lloyd worked with the UMMC Facilities Department, including project managers Christina Riggs and Lois Savage. The Facilities staff learned of a mural company that could produce what Lloyd had envisioned – a magical "under-the-sea" feeling – using inexpensive murals. "Once we started really looking at the space, we realized that we could create a soothing atmosphere by providing murals and color, yet still allow a professional but comfortable space for anyone who came in," Riggs says. Lloyd says the end result feels like walking into an aquarium: chairs were recovered in fish patterns; two walls each have an under-the-sea mural; all of the walls were repainted in greens, blues and yellows; and a new bookcase holds the storybooks that help soothe or distract children who are waiting for surgery. Three new Playstation game consoles are also popular with the children. "What we have now is a huge improvement from the past," Lloyd says. "It is amazing now to watch the children come in and enjoy the murals on the walls and tell their parents what animals they see. We now have a few more ideas that would make the space even better – a few more pictures for the walls, and a design for the front door. We will be working with the UMMS Foundation to try to identify other sources of funding to make that possible."
UMMC Receives Second Consecutive AHA Fit-Friendly Designation The American Heart Association (AHA) has recognized the Medical Center as a Start! Fit-Friendly Company for the second year in a row – because of the Step Up to Good Health program, which Promotes health and fitness among employees.
"The Start! Fit-Friendly Company award is presented to those companies who make their employees' health and wellness a priority," says Melissa Frisch, MD, MPH, the medical director of employee health. "The Step Up to Good Health Program at UMMC is designed to help employees develop healthier lifestyles by offering a variety of programs that promote health and fitness and encourage employees to live longer, stronger, healthier lives. "Receiving this award for a second consecutive year is an honor and represents a real team effort," says Frisch. "We are proud to offer our employees these programs in the hopes of promoting physical activity, a wellness culture and good nutrition." The Step Up to Good Health program is a total health improvement program which includes these components:
The following Step Up to Good Health programs are available to all staff, regardless of which type of insurance they have.
C2X Needs You!
There are several ongoing opportunities to participate in C2X activities, such as volunteering at the Communication Forums, serving as an act with heart champion, serving as a C2X communication liaison for your unit and volunteering to support spontaneous celebrations such as when the hospital wins national accolades. Volunteering to become a C2X Champion does not require a large block of time and is just a few clicks away. Visit the C2X Intranet site and click on the "C2X Champion" link. Take a minute to review the criteria, fill out the form and fax it. Becoming a C2X Champion is a great way to take a more active role in helping to shape the culture of the Medical Center. Here's your chance to get involved. You may even be invited to join one of the five cultural excellence teams.
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The Medical Center's Commitment to
Excellence (C2X) has been in full
swing for three years now, but
sustaining a culture of service
excellence is a job that never ends.
So the C2X Cultural Excellence
Teams are looking for volunteers
to become C2X Champions.
