Category Archives: News

Surgery before birth saves lives of preemie twins

Amina (left) and Rahia Abdi were born Feb. 11, 2014, at 25 weeks. The twin sisters were diagnosed with twin-to-twin transfusion syndrome while in the womb. (Jimmy Bellamy / Children's Hospitals and Clinics of Minnesota)

We continue our focus on fetal care this month by honoring Siman Abdi and her twin daughters, Amina and Rahia, who were born Feb. 11 at 25 weeks.

Earlier in Siman’s pregnancy, the sisters were diagnosed with twin-to-twin transfusion syndrome (TTTS), which is a rare condition that occurs when one twin donates blood to the other while in the womb and, if left untreated, potentially can be fatal for both babies.

Thanks to the work of the Midwest Fetal Care Center, a collaboration between Abbott Northwestern Hospital and Children’s, Siman’s daughters are recovering at Children’s and continue to grow stronger each day.

Learn more about twin-to-twin transfusion syndrome:

Twin-to-Twin Transfusion Syndrome from The Mother Baby Center on Vimeo.

Honoring patient- and family-centered care

If there is a Children’s staff member who has made a difference to your family, nominate him or her for the Excellence in Patient- and Family-Centered Care Award.

When Deb’s daughter was born prematurely at 28 weeks, Kathy Wharton, RN, in Children’s neonatal intensive care unit, was there to comfort her, teach her and laugh with her.

“Kathy was calming, funny and professional,” Deb said. “She was our decoder for this confusing, unplanned madness we got thrown into. I can’t imagine getting through the first few weeks without her kind words, explanations and hugs.”

Deb honored Kathy by nominating her for the Excellence in Patient- and Family-Centered Care Award, which is organized by Children’s Family Advisory Council. The award, which is given out twice a year, gives families an opportunity to recognize and honor care providers who demonstrate an outstanding commitment to patient- and family-centered care.

For Kathy, the award was a touching reminder of why she comes to work every day.

“I have spent over 30 years in nursing and have done it all – from bedside nursing to supervising, from hospital to clinic, NICU to dialysis and back to bedside NICU,” Kathy said. “This award reminded me why I came back to bedside nursing. It renewed my spirit and reminded me that I can make a difference.”

If there is a Children’s staff member who has made a difference to your family, nominate him or her for the Excellence in Patient- and Family-Centered Care Award. Families can nominate any Children’s staff member from whom they have received services in the past 12 months. The next awards will be presented in May and October.

Questions? Please email familyadvisorycouncil@childrensmn.org.

Minneapolis among 10 best U.S. cities for health care

Minneapolis was named one of the 10 best U.S. cities for health care, according to Becker’s Hospital Review and a release from iVantage Health Analytics and its Hospital Strength INDEX, a rating system analyzing publicly available data to measure hospitals across 10 pillars of performance and 66 metrics.

Minneapolis was named one of the 10 best U.S. cities for health care. (2014 file / Children's Hospitals and Clinics of Minnesota)

List of cities in top 10 (in alphabetical order):

  • Atlanta
  • Boston
  • Charlotte, N.C.
  • Chicago
  • Minneapolis
  • New York
  • Philadelphia
  • Portland, Ore.
  • St. Louis
  • Washington, D.C.

The 10 cities serve approximately 60 million people, 19 percent of the U.S. population, according to the report.

Sources: Becker’s Hospital Review and iVantage Health Analytics

Study: Concussion recovery time doubles when injury is sustained during school year

A patient visits the concussion clinic at Children's — St Paul on March 11, 2014. (Photo by Scott Streble)

A patient visits the Concussion Clinic at Children's — St Paul on March 11, 2014. (Photo by Scott Streble)

Concussions and the treatment after one is sustained have been at the forefront of media coverage in recent years. What once was viewed by some as brag-worthy or a badge of honor now is being taken seriously for its potential immediate and long-term effects.

While progress has been made in how the seriousness of a concussion is perceived, it’s still relatively unknown when it’s acceptable for individuals, including children, to return to normal cognitive and physical activity after suffering one.

According to a study by the Concussion Clinic at Children’s Hospitals and Clinics of Minnesota, a child who sustains a concussion during the school year takes significantly more time to recover than one who suffers a similar injury during the summer.

“We were surprised at the magnitude of the differences,” Robert Doss, PsyD, co-director of the Pediatric Concussion Program and one of the study’s researchers, said. “We weren’t surprised that it was in that direction; just simply that the magnitude was what it was.”

Researchers took patients seen in the Concussion Clinic at Children’s from 2011-12 — 43 children who suffered concussions during the school year and 44 injured in the summer — and monitored their progress. For the children who sustained a concussion in the summer, the average number of days to recover was 35. Recovery time more than doubled (72 days) when the injury was sustained during the school year.

Another study, “Returning to Learning Following a Concussion,” published in October in Pediatrics, the official journal of the American Academy of Pediatrics (AAP), explains the difficulties children experience in a school setting after suffering a concussion. Post-concussive symptoms often can linger or increase in severity without proper adjustments to a child’s environment or academic routine. Research suggests that academic demands and school environment may be a barrier to recovery.

Because each concussion and child is different, the AAP study recommends creating a multidisciplinary team to facilitate a student’s recovery and help him or her return to normal activities. Those four teams are: 

  • Family (student, parents, guardians, grandparents, peers, teammates and family friends)
  • Medical (emergency department, primary care provider, concussion specialist, clinical psychologist, neuropsychologist, team and/or school physician)
  • School academic (teacher, school counselor, school psychologist, social worker, school nurse, school administrator, school physician)
  • School physical activity (school nurse, athletic trainer, coach, physical education teacher, playground supervisor, school physician).

“It’s important to understand the individual child,” Doss said. “It seems like our practitioners are noticing more responsiveness by the schools to put forth accommodations for these kids. Some schools are more accommodating than others. Some seem to have a grasp of concussions.

“Overall, I think our perception is that schools are more receptive and thinking about it more actively. They’re instituting programs on their own, so they’re prepared for what comes next.”

Subjects were evaluated and treated in the Concussion Clinic after presenting with symptoms consistent with mild head trauma.

Researchers identified two groups based upon whether they recovered from their concussions during the school year or summer months and were ages 7 and older. The school year was defined as September through May. The school group was matched to the summer group by age and gender.

The average age of the children in the study at the time of injury was 14 years old.

Date of recovery was defined as the final visit date in the Concussion Clinic.

Doss also cautions parents and kids that they aren’t out of the woods once recovery is complete.

“It seems pretty clear in some of the guidelines that prior history of a concussion puts you at a higher risk for subsequent concussions,” he said.

However, according to the Children’s study, there’s little empirical support for the amount or duration of cognitive and physical rest after a concussion and the time frame for children to safely return to normal daily activities without experiencing ongoing cognitive or physical deficits.

According to the “Returning to Learning” study, cognitive rest refers to avoiding potential cognitive stressors, such as texting, video games, TV exposure and schoolwork. However, to date, there is no research documenting the benefits or harm of these methods in either the prolongation of symptoms or the ultimate outcome for the student following a concussion.

“Should the kids not be on Xbox versus playing a little bit of Xbox?” Doss said. What may be best during recovery depends on the case. “How much schoolwork is appropriate?”

Doss said the perceptions families and academic institutions have about concussions are evolving.

“Schools across the U.S. did not seem to be prepared. You bump up against the usual: The kids look fine. They’re not limping. They have an injury that’s not visible,” he said. “The general population is dealing with this heightened awareness of concussions.”

Variables collected for analysis included school grade, prior concussion history, loss of consciousness with presenting injury, first clinic visit ImPACT computerized cognitive testing raw scores — verbal memory composite, visual memory composite, visual motor speed composite, reaction time — ImPACT post-concussive symptom  scores, and history of depression and anxiety, migraine, other neurological problems, learning disability or ADHD.

The study was conducted by Robert Doss, PsyD, Neuroscience Center of Children’s Hospitals and Clinics of Minnesota, and Minnesota Epilepsy Group, P.A.; Kara Seaton, MD, Emergency Department of Children’s Hospitals and Clinics of Minnesota; and Mary Dentz, RN, CNP; Joseph Petronio, MD; Julie Mills, RN, CNP; Jane Allen, RN, CNP; and Meysam Kebriaei, MD, of the Neuroscience Center of Children’s Hospitals and Clinics of Minnesota.

Girl Scout Day at Children’s – Minneapolis

Children's is hosting Girl Scout Day on March 29.

Are you the parent of a Girl Scout or the leader of a troop? If so, mark your calendar for Girl Scout Day at Children’s – Minneapolis 10 a.m. to noon Saturday, March 29.

We’re excited to be hosting our second Girl Scout Day at Children’s to bring troops together and honor their generosity and hard work for Children’s patients and their families. An exciting day of celebration will include Children’s speakers, a tour of the hospital’s public spaces, a few fun activity stations and a photo booth with Children’s mascot, Twinkle!

To learn more about Girl Scout Day, register your troop or learn about ways your troop can make a difference, contact Maggie Overman at Maggie.Overman@childrensmn.org.

NOTE: Space for this event is limited and registrations are taken on a first-come, first-serve basis, so sign up today.

Children’s Youth Advisory Council celebrates 10 years

They conceive new, innovative music carts, design teen lounges and visit the state Legislature to advocate on behalf of other kids in Minnesota.

They’re the Youth Advisory Council and for the 10th year running, this group of patients and patient siblings have dedicated their time to making Children’s a better place.

“Children’s is very fortunate to have one of the first, and I think one of the best, Youth Advisory Council’s in the country. Our YAC members take their job very seriously, and work hard to make the hospital experience better for all children,” said Alan L. Goldbloom, MD, CEO of Children’s. “I think the ideas and suggestions that have come from our YAC have made us a better children’s hospital, and I appreciate all of their work.”

The mission of YAC is three-fold: to help Children’s staff, leaders, doctors and parents understand what is important during hospital stays, clinic visits and emergency care; discuss and give feedback on issues that are important to kids and teens having to do with their health care; and develop a group that has a voice and active participation in thinking about health care services for pediatric and young adult patients.

“They really want to bring Children’s from good to great,” said Christi Dady, a child life specialist and one of the group facilitators.

There are currently 17 members on the council, and they meet on the second Saturday of each month during the school year. There are approximately 20 councils like this one at pediatric hospitals throughout the country, said Sheila Palm, who oversees child life and YAC at Children’s.

“Being in YAC helps members learn about health care delivery and services and gain a new perspective on taking responsibility for their health,” Palm said. “We encourage them to let their voice be heard and advocate for themselves and others.”

Members are encouraged to articulate their thoughts and be active, thoughtful and respectful listener to others ideas.

“Even though most of these kids have some sort of chronic condition, they are very active in their community. A lot of them are student athletes. They all have busy lives, but they still give to Children’s,” Palm said. “I think for the most part they’re altruistic, and they want to help other children. They really are looking at it as service to others.”

MNsure: What you need to know

Family with health professionalOct. 1 marks the much anticipated launch of MNsure, the state’s new health insurance exchange. You may have recently seen ads and billboards featuring Paul Bunyon and Babe the Blue Ox talking about MNsure and encouraging Minnesotans to sign up for health insurance. That’s because under the Affordable Care Act (ACA), everyone is required to have healthcare insurance starting in 2014. Beginning Oct. 1, Minnesotans will have a new way to shop for health insurance coverage using MNsure, our state’s health insurance exchange.

So, what is MNsure? It’s an on online marketplace that you can use to compare plans and costs, enroll in public programs and purchase your own health insurance.

Who can use MNsure to buy policies? Individuals who don’t have health insurance, Medicaid recipients and small businesses with 50 or fewer employees can use MNsure.

How does this affect Children’s patient families?

  • If you currently have health insurance, you will likely see no change.
  • If you are enrolled in Medicaid already, you will be automatically transferred into the exchange for the first year. You will need to re-enroll for Medicaid through the exchange the second year.
  • If you do not have access to affordable coverage you can sign up for coverage through the exchange.
  • Enrollment begins Oct. 1, 2013 for coverage that takes effect on Jan. 1, 2014.
  • Low-cost plans, financial assistance and tax credits are available for those who qualify.
  • If you do not purchase health insurance you will be subject to a tax penalty.

Things to consider when picking your plan

  • Costs (premiums and out-of-pocket): MNsure users will be able to choose from a number of different plans: bronze, silver, gold or platinum. The various levels are based on the percentage of costs that the plans will cover. Be sure to pick a plan that works best for you and your family.
  • Access to health professionals: You will be able to look up your current pediatrician or provider on the MNsure website to ensure they participate in the plan you choose.

Children’s is here to help! Our financial counselors are being trained to help patients and families apply and enroll in health insurance through the exchange. They may also refer families to the MNsure Customer Service Center. Patient families can contact our financial counselors at the phone numbers listed below:

  • Minneapolis: 612-813-6432
  • St. Paul: 651-220-6367

The MNsure Customer Service Center: Customer contact specialists will be available to answer any questions online or through a toll-free number: 1-855-3-MNSURE (1-855-366-7873)

  • Monday – Friday: 7:30 a.m. – 8 p.m.
  • Saturday: 9 a.m. – 4:30 p.m.

Assistance will be available in English, Spanish, Hmong and Somali. Additional interpreter services are offered in more than 140 languages.

MNsure.org

You can also download and print a factsheet with this information.

Recap: Our discussion with Emily Bazelon on bullying

Emily Bazelon takes on the topic of bullying.

We read and hear about bullying in the news daily. But, what is bullying, exactly? Is it conflict? Picking on someone?

Emily Bazelon, a New York Times best-selling author of “Sticks and Stones: Defeating the Culture of Bullying and Rediscovering the Power of Character and Empathy” and Slate contributor, defines it as verbal or physical aggression that is repeated over time and involves a power imbalance.

Bazelon addressed approximately 130 health professionals, lawmakers, researchers and educators at the Minnesota Children’s Museum on Sept. 11. The event built upon work Children’s Hospitals and Clinics of Minnesota has done around bullying, including a report released earlier this summer: “Understanding the threat of bullying.”

Here are some noteworthy messages from the evening:

  • Social media is a vehicle for bullying. But if it’s happening online, it’s probably happening offline, too.
  • For the target of an online bully: The Internet makes it feel like bullying is happening 24/7. It’s permanent and visible, and it can potentially reach a bigger audience.
  • For the online bully: He or she doesn’t have to look the target in the eye, there’s no face-to-face feedback and it can be anonymous.
  • We spend little time talking about whether social media companies need to play a role. That needs to change.
  • We need to send the message to kids that bullying isn’t normal behavior, and it’s not something everyone does.
  • Bystanders who watch bullying often have the most power to stop it. Bystander kids intervene about 20 percent of time.
  • A message for kid bystanders: You don’t have to be a hero. A thoughtful or empathetic message like “Are you OK?” can be helpful.
  • What do we do about bullying? Bazelon emphasizes prevention and intervention, which can’t be done in a day. We need to help shape who kids are.

Read more about bullying and how one local family overcame it.

 

New payment model values quality over quantity

At Children’s Hospitals and Clinics of Minnesota, we pride ourselves in getting the best outcomes for our patients. That includes keeping patients healthy so they don’t require extra visits and expensive procedures.

We have a long-standing commitment to innovative care delivery, which triggered our willingness to partner with the Minnesota Department of Human Services to test a new delivery and payment model aimed at better health outcomes and lower costs for our state’s Medicaid program. The shift in approach is to tie payment to delivering higher quality outcomes rather than relying on the historic model of publicly-funded health care programs in Minnesota where health care providers were paid for the procedure.

By participating in this new payment model, our job at Children’s will be to manage the care of 14,000 patients. Rather than a system that creates an incentive for more visits and procedures, the total cost of the care model creates an incentive for us to advance methods that keep people healthy so they don’t have to use expensive services.

The cool news is that we’ve already been doing this for nearly a decade. Children’s established the state’s first Medical Home in 2004 and this care coordination model has resulted in reduced hospitalization and fewer readmissions, among other outcomes.

“With nearly a decade of experience to draw on, Children’s is pleased to partner with the state on an approach that financially rewards better health outcomes,” said Maria Christu, General Counsel and Vice President of Advoacy and Policy at Children’s. “We are confident we’ll deliver on the quality outcomes the state and, more importantly, our patients expect.”

Children’s joins five other major health care providers. They include Essentia Health, CentraCare Health System, North Memorial Health Care, Federally Qualified Health Center Urban Health Network (FUHN) and Northwest Metro Alliance (a partnership between Allina Health System and HealthPartners). In all, we’ll be responsible for 100,000 Minnesotans enrolled in publicly-funded programs.

Minnesota is the first state in the country to implement this new payment model. “This new payment system will deliver better health care at a better price. By changing the way we pay health care providers we can incentivize reform, help Minnesotans live healthier lives, and slow the rising cost of health care in our state,” Gov. Mark Dayton said in a statement.

This model is being implemented at the same time as Minnesota’s Medicaid population is expected to increase. Gov. Dayton’s budget proposal, which we wrote about last week, includes expanding Medical Assistance to 145,000 more Minnesotans, including 47,000 kids.

 

After rescue, Children’s nurse encourages water safety education

Leah Mickschl

At Children’s Hospitals and Clinics of Minnesota, we encounter life-and-death situations every day.

Earlier this summer, Leah Mickschl, a Children’s RN, experienced a crisis outside our walls. She was at a private neighborhood pool in Lakeville when a 4-year-old boy was discovered at the bottom of the pool.

She was in the right place at the right time.

Mickschl, who works at Midwest Children’s Resource Center, called upon her training and performed CPR on the boy. He had been under water for approximately two minutes, she said. But within seconds of having CPR performed on him, he sputtered water and regained consciousness. The boy recovered, and today, he’s active and healthy.

In July, the Lakeville City Council honored Mickschl for her life-saving efforts. She appreciates the honor and wants to use it as an opportunity to remind people of aquatic safety.

On the day of the boy’s near-drowning, the pool was filled with people – children and adults, she said. No one saw him go under; Mickschl’s own children were only a few feet away.

Leah Mickschl with her family

“Drowning is silent. It’s not like in the movies where you’re thrashing about and calling for help,” Mickschl said.

Unfortunately, drowning is the leading cause of accidental death among children ages 1 to 4, according to the Centers for Disease Control and Prevention. It remains the second leading cause of unintentional injury-related death behind motor vehicle crashes among children 1 to 14.

Mickschl encourages people to check out these water-safety tips from Children’s Dr. Manu Madhok before they head to the pool or lake. She also suggests getting CPR-certified.

“Prevention should always be the goal, but you never know when those skills might be needed,” she said.