Cincinnati-Israel Partnership: Strengthening Care

While the Tel-Aviv Sourasky Medical Center in Israel may seem like a world away, Cincinnati Children’s is having a big impact on its patients. In 2007, the Israeli hospital wanted to open a pediatric bone marrow transplantation program, but needed to learn best practices. They searched the United States from the east to west coast for a model program on which they could base theirs, and they found it at Cincinnati Children’s.

Menachem Bitan, MD, PhD, left his home country of Israel to spend one year learning everything he could about the bone marrow transplantation (BMT) program at Cincinnati Children’s.

“I knew that when I returned to Israel I was going to open a bone marrow transplantation program,” Dr. Bitan says. “I thought that Cincinnati Children’s would be the best example to learn from, and that proved to be true.”

During his year at Cincinnati Children’s, Dr. Bitan shadowed all aspects of the BMT team.

“Opening a program is not just giving a certain regimen, or doing the transplant in a certain way, but all the processes around it,” Dr. Bitan says.

From physicians, to nurses, to care managers and clinical pharmacists, Dr. Bitan was able to learn the best practices already developed in Cincinnati and use that knowledge to begin the Pediatric Blood and Marrow Transplantation Program at Tel-Aviv Sourasky Medical Center.

One of the most beneficial educational experiences during his time in Cincinnati was seeing the large volume of patients that come to Cincinnati Children’s for its internationally-recognized care.

“In Israel, I could see 10 patients with a type of leukemia, but if I were at Cincinnati Children’s, that number would be 60,” he says. “That gives you a better chance to learn more about the process and pitfalls.”

Another enriching part of his experience was learning about the full spectrum of care found at Cincinnati Children’s.

“If someone comes in for a bone marrow transplantation, that’s not the beginning of treatment, that’s the end,” he says. “There’s six months of work and treatment to get to the point of the transplantation.”

And the steps he learned from Cincinnati Children’s have been invaluable to the start-up of his program. Since June 2010, the Tel-Aviv hospital has conducted 10 transplants. While the program is new, Dr. Bitan has high expectations for the impact it will have.

“We are able to offer something now that we couldn’t before,” he says. “This is a matter of not only quality of life, but life and death.”

Partnering to Save Children

Now fellows from Dr. Bitan’s division in Tel-Aviv will participate in month-long trainings at Cincinnati Children’s through the Israel Exchange Program (IEP). Established in 2009, the IEP connects leading pediatric clinical, academic and research institutions in Israel with Cincinnati Children’s to improve clinical care for children around the world, train pediatric providers and scientists, and make research advances to benefit children worldwide.

“The Israel Exchange Program is a model on which to base other international partnerships,” says Michelle Kohn, international regional manager in the Global Health Center at Cincinnati Children’s. “We have a great deal of expertise to contribute to Israeli hospitals and much to learn from our Israeli counterparts.”

One thing that Cincinnati Children’s does exceptionally well, Dr. Bitan says, is continuous quality improvement, which is reflected in regular meetings within divisions.

“Each month a division describes what happened in a certain situation they faced, what went wrong, what could have been done better. And everyone weighs in,” he says.

Currently his hospital does not have the same type of quality assurance system, but Dr. Bitan hopes to implement it in the future. He points out Israelis are already familiar with the concept of quality assurance through their military background, but it has not yet been implemented in other areas, such as health care.

Kohn points out the experience Israelis get in mandatory military service develops unique skills and knowledge that can be applied to health care here in the states.

“Their military training cultivates a culture of highly strategic, innovative and entrepreneurial thinking,” she says. “That culture is definitely something American health care professionals can benefit from when working in collaboration with Israeli counterparts.”

Improving Access to Care

In addition to collaborative learning opportunities for doctors, the IEP allows Israeli patients to receive treatments unavailable at their local hospitals. In the last year, Cincinnati Children’s has treated eight patients from Israel, and that number continues to grow. Many more have received care in their own country from doctors traveling from Cincinnati Children’s.

Shahar Avneri is one of those patients. She traveled with her parents, Iris and Ram, to Cincinnati Children’s for lifesaving surgery. A year later, the family still keeps in contact with Shahar’s surgeon, Marc Levitt, MD, associate director of the Colorectal Center for Children.

“While her care was too complex for her first surgery to occur in Israel, Dr. Levitt will be performing her second operation in Israel,” Iris and Ram write in a letter thanking the medical center for its service. “We have been personally impacted by the connections made between Cincinnati Children’s and Israel.”

For Dr. Bitan, he sees the partnership between Israel and Cincinnati as a valuable tool in training doctors and other professionals. He hopes as the IEP continues to grow and thrive that even more health care professionals are able to participate in exchanges between Tel-Aviv Sourasky Medical Center and Cincinnati Children’s.

“The sky is not the limit,” he says, noting that he would like for all members of his health care team to have the opportunity to visit and exchange knowledge with health care professionals at Cincinnati Children’s.

“I am really excited to see where this program can take us,” Kohn says. “With support from our community, we can continue to change the outcome for children in Cincinnati and across the world.”

To contribute to the IEP, contact Tracey Kastelic, tracey.kastelic@cchmc.org, 513-636-8758.

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