A growing portfolio of interventional studies aim to achieve the following outcomes: increase family engagement in care, improve clinical competency of trainees, decrease vaccine hesitancy, increase breast feeding rates and duration, prevent and decrease obesity, decrease externalizing behaviors, improve the coordination of care for children with medical and social complexity, improve the health of foster youth, reduce neighborhood preterm birth rates, increase reading proficiency, decrease food insecurity, reduce barriers to high-quality child care and reduce health disparities in the community. Interventions deploy a variety of innovative strategies, including virtual reality based education for clinicians and family members, group visits, web-based portal and mobile device applications to support chronic disease management, integration of behavioral health services with primary care practices and schools, new care management and payment models for children with medical complexity, identification of children from high risk neighborhoods using geospatial mapping software, and partnering with children, families, community and civic leaders, educators, social service providers, faith leaders, healthcare providers and others through the All Children Thrive collaborative learning network.
Across the division, our faculty published 83 manuscripts in peer-reviewed journals this year, attesting to the dissemination of research, clinical and education findings that are making a significant impact. John Hutton, MD, MS, authored our featured publication and whose research is having a significant impact in the fields of literacy and neuroscience. Through his neuroimaging studies, he shows alterations in brain structure in association with early exposure to reading. He also developed child-friendly instruments for measuring emerging literacy skills in preschoolers.
The hospital’s 2020 strategic plan for community health seeks to reduce excess inpatient admissions and ensure physical and behavioral health at age 5 among Cincinnati’s most vulnerable children. Robert Kahn, MD, MPH, provides leadership of the 2020 initiative with clinical leadership from Mona Mansour, MD, MS; John Morehous, MD; Zeina Samaan, MD; Mary Carol Burkhardt, MD, MHA; Andrew Beck, MD, MPH; Lisa Crosby, DNP, APRN, CNP; and Kristen Copeland, MD. These efforts recognized nationally through peer-reviewed publications, including those highlighted in the Annual Report. This past year, Beck also convened the Health Equity Collaborative to help team members from general pediatrics, adolescent medicine, trauma surgery, endocrinology and hematology achieve equitable outcomes for their patients. As COVID-19 emerged as a public health crisis, the Community Health team acted quickly to help coordinate our region’s response. The Anderson Center played a pivotal role in leading and supporting Community Health activities.
Innovations in Care Delivery
Closely aligned with our engagement with the Community Health Strategic Plan, the division redesigned care delivery to better meet the needs of our patients and families while working to ensure better health and wellness outcomes for our at risk patient populations. All of our general pediatric primary care sites and our Complex Care Center are active participants in the , under the leadership of Mansour. This program incentivizes practices that deliver high quality care while reducing the cost of care. Based on our performance in fiscal year 18, Cincinnati Children’s recently received half of the $14.4 million that Medicaid saved on our patients.
We launched telehealth visits in early 2020 to further enhance access to care, especially for our families who struggle with traditional office visits. As the COVID-19 pandemic evolved, our use of telehealth evolved to ensure continuous and quality access to care for patients. Preliminary data from the first 245 telehealth visits suggests that 19% of families would have sought care from urgent care or the emergency department if telehealth had not been available. In collaboration with patient services, Primary Care also started utilizing the Cincinnati Children's Mobile Care Center to provide access to patients where they are. The team is co-led by Nick DeBlasio, MD, and Anne Mescher, MSN, RN.
Innovations include those focused on promoting healthy social-emotional development and literacy. F. Joseph Real, MD, MEd, received a Procter Scholar Award to create a virtual reality training related to behavioral health anticipatory guidance. Copeland led a team to standardize our approach to engaging families when there are developmental concerns identified. Greg Szumlas, MD, and Tiana Henry led efforts to expand the impact of our literacy promotion programs. The PNC Bank Foundation made a large gift to build Grow Up Great Literacy Nooks at two of our primary care locations as well as support the Prescription for Reading Program which combines Reach Out and Read and Imagination Library. Moreover, Ohio’s First Lady, Fran DeWine, held a press conference at Cincinnati Children's in March to announce the Ohio Governor’s Imagination Library program which helps support expansion of our efforts to reach children throughout Hamilton County.
Integration of critical community partners in our clinics to address social determinants of health is a long-standing priority. Over the past years, Burkhardt, DeBlasio, Melissa Klein, MD, MEd, and Ms. Stephanie Coffey and Julie Kleiman, in collaboration with the FreeStore FoodBank, implemented the Food As Medicine Family Market to provide shelf stable food for food insecure families during their primary care visits at two of our practices. This program provided food to over 7800 individuals, including 4800 children in our communities. In addition, many of these families have connected with social work, Lisha Lungelow, MSW, who serves as our community resource liaison, Child HeLP (the Medical Legal Partnership) and psychology services to address and mitigate the underlying causes of food insecurity. Our Fairfield primary care location was also able to launch an in-clinic pantry in collaboration with Shared Harvest. Klein, Burkhardt and Beck mentored a pediatric resident who received a Cincinnati Children's Resident RISE Award to formally study the outcomes of the primary care pantries.
Scott Callahan MD, medical director for the Complex Care Center, led efforts to launch telehealth visits for the extremely vulnerable population served by the center. The Cincinnati Children's telehealth team received a large grant from the Federal Communications Commission which will enable our Complex Care Clinic to remotely monitor their patients using state of the art technology in the near future. He also collaborates with Patrick Brady, MD, MSc, from the Division of Hospital Medicine, on a research study entitled, “Improving Hospital to Home Transitions for Children with Medical Complexity” with funding from the Place Outcomes Research award.
Sheela Geraghty, MD, MSc, IBCLC, medical director for the Breastfeeding Medicine Clinic, worked to have uniform breastfeeding-related equipment, supplies, educational materials, and trained staff all of our primary care practices with the goal on increase the number of infants fed breast milk. In addition, Julie Ware MD, MPH, IBCLC, continues to lead mom-to-mom support groups in neighborhoods with low breastfeeding rates. The program, entitled All Moms Empowered to Nurse (AMEN) is now on its third cycle of funding from a variety of sources (CCTST, AAP CATCH, and Ohio Dept of Medicaid). These efforts received recognition in 2019 with the CCTST Community Academic Partnership Award.
Nicholas Newman DO, MS, medical director for the Environmental Health and Lead Clinic, received the Michael Shannon Research Award from the Academic Pediatric Association (APA) for his abstract entitled, “Environmental Justice Screen Lead Index and Blood Lead Concentrations in Hamilton County, Ohio.” Newman is widely recognized for his technical and research expertise through membership on a World Trade Center Health Program advisory committee, membership on the Ohio Governor’s Lead Advisory Committee, holding vice chair of the Ohio Lead Advisory Committee and representation of Cincinnati Children's on the Lead Safe Cincinnati Committee.
Mary Greiner MD, MS, medical director of the CHECK (Comprehensive Health Evaluations for Cincinnati’s Kids) Foster Care Center, continues to receive recognition for innovative efforts like the Integrated Data Environment to eNhance ouTcomes in cusTody Youth (IDENTITY) data-sharing platform for children in protective custody (i.e. foster care) in Hamilton County, Ohio. IDENTITY supports access to integrated records for more than 600 child welfare and healthcare providers to improve healthcare delivery for more than 2200 children in Hamilton County Job and Family Services (HCJFS) custody. There is intense interest in expanding this platform to serve additional communities.
Recognition for Excellence in Medical Education
The Division of General and Community Pediatrics has a strong history of leadership and innovation in medical education. Our primary care sites serve as the continuity clinic for over 120 pediatric residents and as the third year outpatient clerkship site for 125 medical students annually.
Klein, in collaboration with Daniel Schumacher, MD, PhD, MEd, (co-principal investigator from the Division of Emergency Medicine), received an Academic and Research Committee (ARC) Award to build the Cincinnati Education Research Unit. The Education Scholars Research Program graduated their first cohort of Scholars: Matthew Zackoff MD, MED, from the Division of Critical Care, and Benjamin Kinnear, MD, MED, from the Division of Hospital Medicine. Through the training and mentorship provided, the faculty (including Real) and scholar team achieved success in funding through a Cincinnati Children's Proctor Award and PLACE Outcomes Award as well as a R21 from the NIH and a Macy Scholar Faculty Award. In addition, this team published 45 peer reviewed publications.
Several faculty members received recognition with institutional and national leadership roles and awards for their achievements in education.
Copeland and Yolton continue to lead the General Pediatrics Research Fellowship which received funding from a National Research Service Award (NRSA T32) from the Health Resources Service Administration since 1998. Current fellows were quite successful, with two receiving APA Young Investigator Awards: Keith J. Martin, DO, MS, "Qualitative Study of Immigration-Related Trauma and Resilience among Latinx Children and Parents", and Clare Crosh, DO, “Parental Beliefs and Motivations Towards Shared Reading in the First 6 Months of Life.”
Burkhardt won the Junior Clinical Achievement Award, and Yolton won the Senior Research Achievement Award, and Klein received the Senior Advocacy Achievement Award at the Annual Cincinnati Children’s Faculty Awards.
Klein received the University of Cincinnati Leonard Tow Humanism in Medicine Award, presented by the Arnold P. Gold Foundation. She also continues to serve as the director of the APA’s Educational Scholars Program.
Emily Cooperstein, MD, won the Ray Baker Teaching Award from the Cincinnati Pediatrics Society.