October 30, 2014

Health Care: Partnerships

A Healthy Alliance - Johns Hopkins & All Children's

From its residency program to clinical studies, Johns Hopkins' acquisition of All Children's in St. Petersburg is starting to pay dividends.

Amy Keller | 12/11/2013

Power in numbers

Dr. Neil Goldenberg, who is building the Clinical and Translational Research Organization at All Children’s, says collaboration between the Baltimore and St. Petersburg campuses will give research efforts a large enough group of patients to produce more statistically robust results — without having to replicate a smaller study’s findings with a second effort.

Goldenberg and his colleagues, for example, recently launched a study of deep vein thrombosis — extensive blood clotting — that began with a 15-year-old Tarpon Springs girl treated at All Children’s for a clot that extended from her ankle to above her kidneys. The study will track how she and other children with the same condition respond to treatment and attempt to identify the factors that produce better outcomes.

Investigators are also looking at a variety of other diseases and childhood health conditions, including more common ailments, such as appendicitis, which can be difficult to diagnose because children have trouble identifying where their pain originates, says Goldenberg. “We hope that we’ll be able to discover some new markers in the blood or perhaps in other body fluids” that lead to earlier diagnosis.

Central Decision-Making

To help facilitate bi-campus research collaborations, All Children’s has integrated its Institutional Review Board, which provides oversight of all research involving human subjects, into Johns Hopkins’ review board system. The move essentially allows for simultaneous approval of a study on both campuses.

The hospital’s research and grants administration has also been integrated into Hopkins’ Office of Research Administration and study coordinators, once scattered throughout the hospital, have been brought under one roof, where they’re receiving standardized training and ongoing professional development.

The newly created Clinical and Translational Research Organization has also employed in-house teams of experts to help clinician researchers with everything from study design and analysis — which includes epidemiological and biostatistical support — to data collection and database design.

Other personnel, meanwhile, have been hired to operate the new biorepository, which contains specialized equipment designed for storing and processing biospecimens and extracting DNA and RNA.

 

Future pediatricians

Meanwhile, other hospital leaders are focused on the launch next year of a pediatric residency program that they say will be unlike any other in the country. The program, which creates up to 12 new slots, also aims to help ease Florida’s shortage of primary and specialty pediatric physicians.

The American Council for Graduate Medical Education has recognized that many residency programs don’t address major elements in how medicine is evolving — the Affordable Care Act, cultural competency, continuous quality improvement and safety, and changes in the business of medicine, says Dr. Chad Brands, director of the Office of Medical Education at All Children’s Johns Hopkins Medicine.

Brands and Dr. Raquel Hernandez, associate director of the Office of Medical Education, are designing a program that will incorporate those kinds of subject areas, including genomics, which have created new hurdles for physicians. Today, whole genome and exome sequencing of a patient’s DNA is readily available for between $5,000 and $10,000, but integrating that information into clinical practice effectively is a challenge.

“Any patient can have their data available and used for a variety of different reasons,” says Hernandez. “The communication behind that, the ethics behind that data, how counseling families is relevant in those discussions, needs to be taught.”

While residents often serve as work horses in many teaching hospitals, All Children’s Johns Hopkins says it wants to focus its residents more on learning than just providing care. “Since we have 300-plus admitting privilege physicians, we don’t need residents just to provide services,” says Brands.

The University of South Florida, meanwhile, will continue to operate its own, separate pediatric residency program at the hospital.

Ellen says all the pieces are in place for the hospital to become a top five children’s institution. “We advocate on behalf of children; we provide the greatest clinical care; we’re going to have the best training program for residents; and we’re going to discover new ways to deliver care and new cures for different ailments.” That, he says, “makes for a particular unique kind of children’s hospital that can then become a leader, rather than just a place where you can get care for your child.”

Tags: Healthcare

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