About the Pediatric Liver Care Team
The strong reputation of the Liver Transplant Program at Cincinnati Children's Hospital Medical Center rests largely on the combined efforts of experts from many disciplines. Our pediatric surgeons and gastroenterologists have worked together since 1986 caring for children with liver disease.
Pediatric Liver Care team members are highly regarded by other physicians nationally and internationally for their successes in treating the full spectrum of pediatric liver problems, leading-edge research and education. This reputation has attracted referrals from physicians around the world who are looking for the best care available for their patients.
At your child's pre-transplant evaluation, you meet the entire Pediatric Liver Care Center team, which consists of liver transplant surgeons, liver transplant physicians, transplant nurse coordinators, gastroenterology nurse coordinators, service coordinators, a dietitian, a psychologist, a chaplain, a social worker, home care resource personnel, a child life specialist, a transplant financial specialist, a transplant administrator and other team members.
Pediatric Liver Care Team Member Roles
The child life specialist has many responsibilities regarding your child's developmental health. He or she helps your family access ongoing schooling for your child and assists with appropriate developmental activities for your child.
Child life specialists focus on the emotional well-being and continuing overall development of patients based on their individual needs, abilities and interests. This is done in collaboration with the patient and their family.
Child life specialists aim to:
- Decrease fear / anxiety of patients and families through providing information, preparation, activities and emotional support based on daily assessments
- Help patients develop and use coping strategies during procedures through education and medical procedural support
- Empower patients and their families to participate in treatment decisions
- Provide developmentally appropriate activities which promote family-centered care, thus strengthening the connection between patients and families
- Provide guidance and support to parents regarding sibling support; prepare and support siblings during visitations as medically appropriate
- Ensure access to ongoing education through our hospital school program for children during extended stays. With family permission, send patient and sibling school letters to facilitate communication and support.
- Provide ongoing opportunities for patients to use medical play, discussion or reenactment of medical experiences to facilitate a sense of mastery and to assess patient's understanding; clarify misconceptions
- Assist patients in having safe and appropriate choices through play, activities that divert the child's attention, and participation in their daily care
- Assist patients and families in preparing both psychologically and socially for the transition to home
- Be an ongoing resource to patients and families once they are discharged, and provide ideas and strategies to manage questions and behavioral concerns that may arise
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Dietitian
The dietitian is an integral part of the liver transplant team. The dietitian works with the medical team to improve your child's nutritional status and helps you and your family understand how many of the liver functions are related to nutrition and growth. The dietitian provides support through all phases of the transplant process from pre-evaluation through transplantation to your discharge from the hospital to home.
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Gastroenterology (GI) Nurse Coordinator
The GI Nurse Coordinator is the person you will communicate with most before your child has his or her transplant. The coordinator provides assistance with medical issues in the pre-transplant phase of care. He or she also works in collaboration with your referring physician and the Pediatric Liver Care Center medical team to meet the health care needs of your child.
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Transplant Nurse Coordinator
The nurse coordinator is your case manager and your main contact person before and after transplantation. When your child is in the hospital, the coordinator helps your family with the education needed to care for your child after the transplant, obtains medications and oversees discharge planning. The coordinator arranges home health care following discharge and sees your child for follow-up visits and yearly visits with the physician. The coordinator also communicates your child's lab test results and any medication changes the doctor has prescribed.
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Transplant Physician
The transplant physician is the pediatric gastroenterologist (liver doctor) who, together with the transplant surgeon, directs your child's medical care after transplantation, while your child is both in and out of the hospital. Throughout all phases of care, beginning with listing for transplantation, the goal of the transplant physician is to ensure the best function of your child's liver and to help your child reach the best quality of life possible. The transplant physician will review your child's health-related concerns and make assessment and treatment plans with you after physical, laboratory and imaging assessment of your child.
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Transplant Surgeon
The transplant surgeon is the physician who transplants your child's liver. This physician operates on your child and directs all of your child's care immediately after the transplant, when your child is in the intensive care and stepdown units. The surgeon also performs any additional operations your child may need and will stay active in your child's care as long as your child is followed at Cincinnati Children's.
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Pediatric Psychologist
The psychologist is a specially trained doctor in pediatric health psychology. This doctor provides assistance to patients and families who are struggling with acute and chronic illness. The time before, during and after transplant can be extremely stressful. The psychologist can assist with intervention and / or treatment for our patients and their families.
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Psychosocial Team
The psychosocial team consists of the chaplain, the social worker and the child life specialist. Families facing a transplant may experience anxiety, stress and a variety of other concerns. We are here to be a support to you and your family and to assist with providing resources throughout this entire process. When we meet with you, our goal is to learn about you as a family and determine what support would be helpful for you.
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Services Coordinator / Staff Assistant
The services coordinator is an integral part of the liver transplant team and is the person who you will probably talk to most often (other than the transplant coordinator). The services coordinator provides support for the team members, schedules all new patient evaluations, and assists with obtaining lab results, tests and procedures.
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The social worker and the chaplain work closely together. Their goal is to learn about you and your family and offer support. They collaborate with the liver transplant nurse coordinators in ensuring that your child's psychosocial needs are met. They may assist your child in adjusting to hospitalization, offer supportive counseling for family members, and help obtain resources at the time of discharge.
Social Worker
The primary role of the transplant social worker is to provide support to the patient and family and to act as a resource for the transplant team. The amount and type of involvement by the social worker varies widely depending upon the needs of each family situation. In many cases assistance begins with the transplant evaluation to help you and your family prepare for your family's unique requirements and to reduce obstacles prior to transplant.
The social worker may:
- Assist you and your child to adjust to hospitalization and transplant
- Offer supportive counseling for family members
- Help to obtain resources during your hospital stay
- Link you to ongoing resources at discharge
- Act as an advocate to ensure services or to clarify your particular needs and views
Considerable effort is made to work with you in determining what ways and resources might best be of assistance and continue in that relationship in the weeks and months ahead. Like other members of the transplant team, the social worker works collaboratively with team members to help provide continuity and quality care for your child. Questions are always welcome as together we pursue excellent care.
Chaplain
Being here at Cincinnati Children's often means being separated from the emotional and spiritual supports that we use to cope with stressful circumstances. Even being at home can be stressful, as family and friends are often unaware of the complex issues involved on the path to transplant.
The chaplain on the team is here for support and to attend to the spiritual needs you may have along the way. Some of the ways the chaplain might be available to you are:
- Visiting and prayer
- Making connections to clergy of various faiths according to your specific needs
- Offering communion, baptism and anointing of the sick
- Reflecting with you on your upcoming decisions
- Discussing concerns or fears about future procedures
- Offering encouragement and comfort
- Reading scripture or other important texts with you
- Working with you in communicating with the team over concerns you have expressed
The chaplain is usually present during the transplant surgery and works with the team to support you and keep you informed. Chaplains also are available to you during any stays in the hospital as well as when you might be in for a clinic visit. In addition, they are available to you while you are at home through phone, email and regular mail.
While there is a chaplain available to you through the transplant team, there are also other chaplains at Cincinnati Children's with whom you may have contact. There are other staff chaplains, chaplain residents and an on-call support staff. The Department of Pastoral Care at Cincinnati Children's offers 24-hour / 7-day in-hospital availability to all patients, families and staff.
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Transplant Financial Specialist
The financial specialist is responsible for assisting you in evaluating the financial issues related to the transplant and hospital care your child receives. The cost of treatment may be one of your biggest concerns, next to the health of your child. Our transplant financial specialist addresses many of your concerns before the transplant and assists your insurance company with coverage issues.
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Other Health Care Team Members
In addition to the Pediatric Liver Care Center team members, you will meet other health-care providers from throughout Cincinnati Children's who participate with the team in taking care of your child.
| Team Member | Services Offered |
|---|
| Attending Intensive Care Physicians |
Specially trained doctors who direct the medical care while your child is in the intersive care unit. These doctors work in collaboration with the liver transplant physicians in helping make medical decisions ofor your child. |
| Audiologist |
Specially trained member of the health care team who works with children to evaluate and monitor your child's hearing. |
| Chaplains |
Chaplains from many demoninations are available to you and your child for spiritual support. |
| Health Unit Coordinators (HUC) |
Health unit coordinators greet you as you enter the unit. They can be a resource to answer many of your questions. |
| Gastroenterology Fellows |
Gastroenterology fellows are physicians who have completed their residency in pediatrics and are completing further training to specialize in the care of patients with gastrointestinal and liver diseases. |
| Occupational / Physical Therapists (OT / PT) |
OTs / PTs are stecially trained staff who help your child work on strengthening muscles needed for feeding and development. |
| Patient Representative |
An individual who serves as a link between you and your child and the hospital staff. The patient representative can inform you about patient rights and responsibilities, hospital procedures, policies, resources and services. |
| Pediatric Nurses |
Registered Nurses (RNs) who are prepared to give you and your child the specialized care you need. These nurses will be assigned to your child to coordinatre his or her care with the health care team and to help meet your needs as parents. |
| Pharmacists |
Pharmacists are specially trained and licensed to prepare medications for your child. |
| Resident Physicians |
Physicians who come to Cincinnati Children's to receive training in the care of children. They work closely with the attending physician to care for your child. |
| Research Coordinator |
Specially trained nurse or other health care professional who may talk to you about special research studies at Cincinnati Children's that your child may be eligible for. |
| Respiratory Therapists (RT) |
Specially trained members of the health care team who work with children to prevent complications and to help children who are having trouble breathing. |
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