All posts by CHOC Children's

CHOC Clinical Nutrition and Lactation Services Director and Registered Dietician Contribute to Infant and Pediatric Feedings Book

We are proud of our clinical nutrition and lactation services team for continuing to advance best practices. Caroline Steele, the department’s director, co-authored Infant and Pediatric Feedings: Guidelines for Preparation of Human Milk and Formula in Health Care Facilities (third edition), with CHOC RD Katherine Bennett contributing a chapter. And we’ve just learned more than 2,000 copies of this authoritative guide have been sold in just a couple of months!

This edition of the book addresses the most up-to-date information on human milk and formula storage, handling, and preparation techniques. Five new chapters have been added. Further updates and additions include: both infant and pediatric feeding preparation; guidelines for facilities seeking to implement centralized infant and pediatric feeding preparation for the first time or expand scope of operations; and information on donor human milk along with guidelines for human milk products. The book discusses lactoengineering techniques and current research. There is a chapter on use of blenderized (real food) tube feedings within the hospital setting. In addition, the book contains expanded information on modular components and other additives.

To order a copy, visit

In the Spotlight: Robert B. Kelly, M.D.

A board-certified physician in pediatrics and critical care with clinical interests in pulmonary hypertension, ECMO, pediatric transport, global health, outreach and business has joined CHOC Children’s.

Dr. Robert Kelly is medical director of the cardiovascular intensive care unit (CVICU) and associate division chief and director of research and academics for the division of critical care at CHOC.

In his role, Dr. Kelly enjoys working in the pediatric intensive care unit (PICU) and CVICU, as well as supporting one of CHOC’s goals in guiding research and educational opportunities for physicians and trainees.

“What makes our division special is our incredible diversity,” Dr. Kelly says. “Our group has an excellent mix of new and seasoned physicians from various training programs and prior experiences. From special interest and experience in CVICU and palliative care, to community PICU care and hospital administration, we are a varied group.”

Dr. Kelly attended medical school at Georgetown University School of Medicine, in Washington, D.C. He completed his pediatric residency at Penn State Milton S. Hershey Medical Center, in Hershey, Penn.; and completed his pediatric critical care fellowship at UCLA Mattel Children’s Hospital.

This dedicated physician has been fascinated with science and biology since he can remember, but he found his passion for pediatrics while in medical school.

“Taking care of children is the most rewarding aspect of my job because the challenges of dealing with patients who often cannot communicate their symptoms pushes me to constantly think, question and re-evaluate,” Dr. Kelly says. “I cannot think of anything more satisfying than being able to form a therapeutic relationship with a family, have a direct hand in the progression of their child’s recovery and then see so many of our patients return to visit the unit after discharge.”

One of Dr. Kelly’s goals is to help expand the capacity and capabilities of the CVICU to handle more complex surgical cases. The team recently added an expert CVICU nurse practitioner with excellent leadership and educational experience. Additionally, the team is working on protocolizing sedation and analgesia practices.

“I’m really excited about one of our latest projects, where we will be revamping daily bedside rounding to begin with nurse-led presentations,” Dr. Kelly says. “We believe this practice will make our care even more family-centered, while also empowering nurses to take a larger role in the care of their patients.”

Through the David Geffen School of Medicine at UCLA, Dr. Kelly has participated in several global health missions, including a recent trip to a tertiary academic PICU in Maputo, Mozambique, which he has been working with for many years to bring pediatric resuscitation training to its physicians, nurses and students.

“On the latest trip, I traveled to two referring hospitals to begin instruction on building a local pediatric transport system,” he says. “We plan on future trips to begin analyzing the demographics of pediatric transport among those three hospitals in order to measure the success of our interventions.”

Dr. Kelly is a fellow of the American Academy of Pediatrics and a member of the Society of Critical Care Medicine.

In his spare time, Dr. Kelly likes to spend time with his wife and daughter. He enjoys playing golf and taking vacations with his family to Hawaii, as well as watching the New York Mets and New York Giants.

CHOC Children’s Hospital Achieves Magnet® Recognition Again

CHOC Children’s Hospital has again attained Magnet recognition, a testament to its continued dedication to high-quality nursing practice.

The American Nurses Credentialing Center’s Magnet Recognition Program® distinguishes healthcare organizations that meet rigorous standards for nursing excellence. This credential is the highest national honor for professional nursing practice.

Receiving Magnet recognition for the third time marks a significant achievement for CHOC Orange as it continues to proudly belong to the global community of Magnet-recognized organizations. Currently, fewer than 500 U.S. healthcare organizations out of more than 6,300 U.S. hospitals have achieved Magnet recognition.

“Magnet recognition is a tremendous honor and reflects our commitment to delivering the highest quality of care to Orange County and beyond,” said Melanie Patterson, CHOC’s vice president of patient care services and chief nursing officer. “To earn Magnet recognition once was a great accomplishment and an incredible source of pride for our nurses, but our repeated achievement of this credential underscores the foundation of excellence and values that drive our entire staff to strive harder each day to meet the healthcare needs of the patients and families we serve.”

Research demonstrates that Magnet recognition provides specific benefits to healthcare organizations and their communities, such as:

◾higher patient satisfaction with nurse communication, availability of help, and receipt of discharge information;

◾lower risk of 30-day mortality and lower failure to rescue rates;

◾higher job satisfaction among nurses; and

◾lower nurse reports of intentions to leave their positions.

Magnet recognition is the gold standard for nursing excellence and is a factor when the public judges health care organizations. U.S. News & World Report’s annual showcase of “America’s Best Hospitals” includes Magnet recognition in its ranking criteria for quality of inpatient care.

The Magnet Model provides a framework for nursing practice, research, and measurement of outcomes. Through this framework, ANCC evaluates applicants across several components and dimensions to gauge an organization’s nursing excellence.

The foundation of this model comprises various elements deemed essential to delivering superior patient care. These include the quality of nursing leadership and coordination and collaboration across specialties, as well as processes for measuring and improving the quality and delivery of care.

To achieve initial Magnet recognition, organizations must pass a rigorous and lengthy process that demands widespread participation from leadership and staff. This process includes an electronic application, written patient care documentation, an on-site visit, and a review by the Commission on Magnet Recognition.

Healthcare organizations must reapply for Magnet recognition every four years based on adherence to Magnet concepts and demonstrated improvements in patient care and quality. An organization reapplying for Magnet recognition must provide documented evidence to demonstrate how staff members sustained and improved Magnet concepts, performance and quality over the four-year period since the organization received its most recent recognition.

“We’re a better organization today because of the Magnet recognition,” Patterson said. “Magnet recognition raised the bar for patient care and inspired every member of our team to achieve excellence every day. It is this commitment to providing our community with high-quality care that helped us become a Magnet-recognized organization, and it’s why we continue to pursue and maintain Magnet recognition.”

Using Imagination to Help Heal Through Guided Imagery – Helpful Tips for your Patients

Guided imagery, a therapeutic technique that has been used for centuries, involves creating images in the mind which can help reduce pain, stress, and other symptoms associated with a patient’s condition. Further, the technique includes envisioning a certain goal to help cope with health problems or the task or skill a child is trying to learn or master.

Guided imagery is offered at CHOC Children’s as part of our integrative health services. The experts at CHOC teach patients to imagine sights, sounds, smells, tastes or other sensations to create a kind of daydream that “removes” them from or gives them control over their present situation.

Your patients can practice the technique with these six useful tips:

  1. Close your eyes.
  2. Take 3-5 deep belly breaths.
  3. It’s time to imagine you are going to your special place. Where would you like to go? If you could be anywhere in the world at this moment, where would you be?
  4. When you have picked out a place, picture yourself there. Through your mind, you can be at this place as if this were really happening.
  5. Use your daydreaming skills and think about every little thing that makes this place and experience just as you like it. What do you see, taste, touch, hear and smell?
  6. Be aware of how comfortable your body feels when you imagine yourself in this place. You may notice your breathing slow down and your muscles feel looser as your whole body starts to relax.

Click here for more tips, including audio clips from CHOC’s pediatric psychologists that help guide patients through scenarios to help them feel better.


CHOC Children’s CHIO Recognized for Leadership in Health Information Technology

Dr. William Feaster, CHOC Children’s chief health information officer, has been recognized nationally for his leadership in utilizing health information technology to increase positive outcomes for patients.

Dr. William Feaster, chief health information officer at CHOC

Already recognized as an international leader in population health technology and analytics, Dr. Feaster was one of five physicians to receive a Physician All-Star award from Cerner, a leading worldwide provider of health information technology solutions, services, devices and hardware, at its recent annual conference.

“This award further validates the important work underway at CHOC Children’s to use data to save children’s lives,” Dr. Feaster says. “Advancing technology will continue to dramatically enhance how we practice medicine, and I am proud to stand with CHOC on the forefront of a dramatic shift that will ultimately lead to more children having happier and healthier childhoods.”

As CHOC’s chief health information officer, Dr. Feaster leads the implementation and adoption of technologies that support clinical care and data analysis across the healthcare community. His work promotes the application of data science tools on healthcare data for predictive analytics, data mining, and related technologies to support new informatics initiatives.

Dr. Feaster’s work supports CHOC’s population health efforts; innovation and performance excellence initiatives; and clinical and translational research informatics.

At CHOC since 2012, Dr. Feaster has been involved in advancing information technology throughout nearly 40 years of clinical practice in pediatric critical care and anesthesia. He has held several medical administrative positions in hospitals, health systems and universities, and is board-certified in pediatrics, anesthesia and clinical informatics.

The annual Cerner Health Conference, held mid-October in Kansas City, Mo., drew nearly 14,000 healthcare industry leaders, practitioners and employees to discuss the latest innovations for health information technology.