By Lauren Francis, occupational therapist at CHOC Children’s
Occupational therapy is turning 100! The specialty’s roots formed in 1917 as “reconstruction aides” who helped rehabilitate wounded soldiers returning from battle in World War I. Today, occupational therapists apply a holistic approach to help children and adults engage in meaningful activities.
CHOC’s occupational therapists (OTs) are highly skilled and trained to help children of all ages who have unique needs. Some key components of OT are:
CHOC’s occupational therapists help treat a wide range of feeding issues, including babies who have trouble with breast and bottle-feeding, children who have oral motor or sensory difficulties and cannot manage textures of food, and teenagers who may have had an injury or procedure that affected their ability to eat. OTs at CHOC are also highly skilled in specialty therapies such as feeding tube weaning and swallowing therapy.
Sensory & Developmental Specialists
CHOC’s occupational therapists have advanced expertise and techniques to offer children and families with an assortment of developmental challenges as well. From supporting a child to stay strong and active through chemotherapy to helping a child recover from a neurological disorder or brain injury, occupational therapy can be a crucial part of a multidisciplinary care team. Children who have difficulty with sensory processing, learning delays, challenges with self-care, visual motor or visual perceptual deficits, difficulty coordinating their arms and hands, or who aren’t meeting developmental milestones, can all be excellent candidates for occupational therapy intervention.
Perhaps one of the greatest roles occupational therapists play is working with the parents and families of the children we serve. Parent education and involvement in therapy is an essential component to ensuring a child meets his or her goals. Through CHOC’s commitment to patient- and family-centered care, our OTs closely partner with parents to create individualized treatment plans, offer customized home programs unique to each child’s needs, and engage them in all aspects of care.
CHOC OTs work tirelessly as part of an advanced team to screen children who may be at risk for developmental delays. They apply years of clinical experience and expertise along with standardized testing to assess a child’s movement, mobility, hand use, interaction with the environment, and feeding skills. For children who require a long hospital stay, OTs help provide developmentally appropriate stimulation to help each child continue to grow and develop during their hospital stay.
In addition to providing high-quality medical care, physicians and staff at the Julia and George Argyros Emergency Department at CHOC Children’s Hospital strive to make the experience less stressful for children and families. One physician, in particular, has a few tricks to ease his patients’ fear and anxiety. Dr. Seth Brindis, a board-certified pediatric emergency medicine specialist and medical director of informatics, performs magic for his patients.
“For me, magic makes my job easier, instantly transforming what can be a scary experience for children to something fun. I incorporate magic into my physical exam as it makes the exam easier and more reliable when patients are comfortable with me and distracted. I tend to use coin tricks because they appeal to a wider range of ages, with the added benefit that the coins can be disinfected between patient contacts.”
Luckily, it doesn’t have to be an emergency in order to see Dr. Brindis’ magic. With help from child life, he occasionally puts on impromptu magic shows in the CHOC theater for inpatients, their siblings and parents.
Dabbling in magic since childhood, Dr. Brindis’ interest in magic was revitalized while in residency at Harbor-UCLA Medical Center, where he realized that simple tricks with cards and coins could help make connections with patients and staff. Since then, he has continued to study magic, even taking courses tailored for magic in medicine. Seeing thousands of patients each year, Dr. Brindis gets ample time to try out new tricks and help patients and their families leave with positive experiences and smiles on their faces.
Exclusively dedicated to the treatment of pediatric patients, CHOC’s ED features 31 exam rooms, including two trauma bays, and three triage suites. The ED is staffed with doctors who are board-certified in emergency medicine and specially trained nurses who provide the very best patient- and family-centered care. Child life specialists work with patients to help them feel safe and secure, and make the process a lot less stressful for the entire family.
“The ED is often the gateway for many families who are coming to our organization for the first time. We’re working together to deliver the best care to those who need it most. My job is to understand what is distressing to a parent in the middle of the night and either educate and reassure the family or intervene when called for.”
As the only trauma center in Orange County dedicated exclusively for kids, CHOC is ready to treat injuries 24 hours a day. The trauma team is trained to care for children and their unique physiological, anatomical and emotional needs, and CHOC’s protocols and equipment are specially designed for pediatrics.
The ED saw over 49,000 patients in the first year it opened. This year, it’s on pace to see more than 85,000 patients – an incredible rate of growth, which Dr. Brindis credits to the coordination and cooperation between the ED physicians, EMSOC leadership, and nursing, as well as CHOC administration.
“I love being a part of this team. I feel like we provide exemplary care to every person who enters our doors. Often, I feel like the conductor of an orchestra of care. There is no way I could do my job without the incredible people I work with. It really is impressive to watch our team working in concert to stabilize a really sick child.”
Dr. Brindis received his medical degree from Vanderbilt University. He completed his pediatric residency and pediatric emergency medicine (PEM) fellowship training at Harbor-UCLA Medical Center. In addition to caring for patients in the ED, he is actively involved with the training and teaching of pediatric and emergency medicine residents as well as the PEM fellows.
In his spare time, Dr. Brindis enjoys spending time with his wife, son and daughter. He also enjoys cooking, painting and, of course, working on his magic.
CHOC Children’s wants its referring physicians to get to know its specialists. Today, meet Dr. Christine Bixby, a neonatologist. She completed a fellowship in neonatology, as well as her residency and an internship in pediatrics at Harbor UCLA Medical Center. She attended medical school at University of California, Davis. Dr. Bixby is the president of the Orange County Breastfeeding Coalition. Currently the medical director of lactation services at CHOC, she has been on staff at CHOC for ten years.
Q: What are your special clinical interests?
A: Newborn and premature care, and breastfeeding and breast milk use in extremely low birth weight infants.
Q: What are some new programs or developments within your specialty?
A: Through CHOC’s NICU initiative, the increased number of private rooms will help further facilitate family involvement in infants’ care and allow for a better transition to the family for breastfeeding. It will allow them to be as close to their baby as possible.
Q: What are your most common diagnoses? A: Prematurity and respiratory distress in newborn.
Q: What inspires you most about the care being delivered at CHOC? A: We’re trying to continually push the envelope of providing better and better care from both a technical standpoint and also from a supporting families standpoint.
Q: Why did you decide to become a doctor? A: My father experienced a serious injury at age two, and only survived it because of the great medical care he received. Once I was older I got the chance to see what medicine was really about, and I realized it’s about using critical thinking skills to get people through a challenging time, both medically and emotionally.
Q: If you weren’t a physician, what would you be and why?
A: I’d be a park ranger because my father was a park ranger. I love being outside and spending quiet time in nature.
Q: What are your hobbies/interests outside of work?
A: I love spending time with my children and family, crocheting, inline skating, hiking and camping.
Q: What have you learned from your patients?
A: I’ve the learned the incredible strength of babies. We underestimate them as a society, but a sick baby is often stronger than a sick adult. I’m continually impressed by my patients’ families and the way they handle challenging diagnoses. They are put into a difficult position, but they process the information and move forward and are wonderful advocates for their children.
Genomics of sudden cardiac arrest; athletes with implantable cardioverter defibrilators (ICDs); and ECG screening and automated external defibrilators (AED) in schools — the role of the primary care physician, are just some of the topics that will be featured at an upcoming CHOC conference, featuring the country’s top cardiac experts.
The Sports Cardiology & Sudden Cardiac Arrest in the Young Conference will be held on Jan. 20-21, 2017, at Disney’s Grand Californian Hotel, in Anaheim. The anticipated biennial event will create an opportunity for those involved in the care of athletes and young individuals, to gain the latest education related to athletic training and the diagnosis and management of inherited cardiac diseases, in the hope of preventing tragic young sudden deaths in the future.
CHOC designates this live activity for a maximum of 12.0 CME hours of AMA PRA Category 1 Credits™.
I would like to wish you a very happy and healthy new year. As we leap into 2017, I’d like to take a few moments to reflect on just a few of the milestones that were achieved at CHOC Children’s in 2016. Each year we raise the bar in providing the best care possible to the children and families that we serve, and 2016 was no exception. We added faculty and staff, launched several programs and services, broke ground on two new inpatient units, and made great strides in clinical research.
Many of you are aware that CHOC was once again named a “Top Children’s Hospital” by the Leapfrog Group for providing the safest and highest quality services to our patients. This is a highly prestigious designation, as CHOC is one of only nine children’s hospitals in the nation and the only children’s hospital on the West Coast to receive this honor.
This distinction helps us to recruit the best and the brightest to CHOC, and in 2016, we welcomed nearly 40 new medical staff members representing 22 specialties. While this allows us to better serve Orange County families, we continue to treat patients traveling to CHOC from other counties, states and even countries, seeking our expertise through specialized programs such as our world class feeding, epilepsy/neurosciences, and orthopedic surgery programs, just to highlight a few. The Pediatric Subspecialty Faculty (PSF) and CHOC Children’s Specialists (CS) alone is now comprised of over 150 medical and surgical specialists.
In April, we opened our Adolescent and Young Adult (AYA) Cancer Unit within the Hyundai Cancer Institute. Our new AYA Unit provides an inpatient treatment setting designed to meet the needs of our adolescent and young adult patients. CHOC recently added oncologists specializing in the unique needs of adolescent and young adult patients.
In September, we formally broke ground on the CHOC Children’s Mental Health Inpatient Center. This will be an 18-bed mental health unit with outdoor recreation space, serving children from ages 3 through 18 years old. When this unit opens in early 2018, it will be the only inpatient program in Orange County serving children under the age of 12.
In 2016, we also began the build out of our state-of-the-art, expanded Neonatal Intensive Care Unit (NICU). Scheduled to open in the summer of 2017 on the fourth floor of the Bill Holmes Tower, the NICU will offer 37 rooms, of which 36 will be private, designed to allow parents to comfortably remain at the bedside while we care for their critically ill newborns. The new unit will also contain our recently expanded neurocritical services, offering increased capacity for whole body cooling and long-term video EEG monitoring for prevention and early detection of seizure activity in newborns.
We also expanded our outpatient adolescent/teen program, now located in the Centrum North Building. By adding services, offered by both male and female physicians specializing in adolescent medicine, CHOC is able to better meet the unique needs of our teenage patients.
In 2016, CHOC clinicians published more than 330 manuscripts and delivered more than 200 lectures. The CHOC Research Institute had 369 active IRB-approved clinical research studies across multiple specialties. A prime example of our emphasis in research is the recruitment of Dr. Jeff Huang, a PhD scientist, who is partnering with Dr. Raymond Wang, a physician scientist. Together, they hope to advance the understanding of Pompe Disease. Through our partnership with UC Irvine and the Institute for Clinical and Translational Science, we awarded five promising pilot research grants. And the Hoag Foundation awarded CHOC Principal Investigator Phil Schwartz, PhD with a three-year $1,048,168 grant to advance pediatric stem cell research with the goal of filing a “Pre-Investigational New Drug” application with the FDA.
The Sharon Disney Lund Medical Intelligence and Innovation Institute (MI3) at CHOC continues to grow, advancing the culture of innovation and supporting thought leaders from around the world to join together in pursuit of innovative approaches to improve the lives of children. This year, MI3 launched the first innovation education/training program at CHOC, which included an innovation challenge. The first place challenge winners were invited to present at the International Peds2040 Conference in Miami this month. Institute director, Anthony Chang, MD, leads with the philosophy that “The best and fastest way to innovate, is to collaborate.” The result of this philosophy was the creation of The International Society for Pediatric Leadership (iSPI), now comprised of 33 children’s hospital members (and growing). Last summer, nearly 100 future healthcare innovators participated in MI3’s Intern Program. Also in 2016, Dr. Chang became the president of the OC/SD Chapter of the Society of Physician Entrepreneurs (SoPE). To close a successful year, MI3 hosted the AIMed Conference in December, with over 400 participants.
And finally, this year CHOC launched our refreshed 2020 Strategic Plan, which will serve to guide us in 2017 and beyond as we continue to reach new goals in expansion and enhancement of patient care. One of the major initiatives in the strategic plan is our population health strategy. With the creation of the CHOC Children’s Network, we are taking transformative steps toward seamless integration of specialty and primary care providers, with primary care as an increasingly important part of the continuum of care. As one of only 29 healthcare recipients nationwide and the only pediatric institution, CHOC received a four-year Center for Medicare and Medicaid Innovation (CMMI) Transforming Clinical Practice Initiative Grant totaling $17.8 million. Working in partnership with Rady Children’s Hospital, we are launching new care model designs across the care continuum for enhanced coordination of inpatient, primary, emergency, urgent care and specialty care services.
While I wish that I could list all of our accomplishments from calendar year 2016, it is simply not possible, as there are far too many to mention here. Suffice it to say, we should all be very proud. With everything else going on in the world around us, we can say that we continue to focus on the health and well-being of the children and families that we serve, providing expanded, higher quality care, setting the stage for a great 2017. I would like to congratulate you all on a job well done. The future at CHOC is bright!