I am very proud to be entering the new academic year as the recently named CHOC Children’s senior vice president and physician-in-chief (PIC). Our President and Chief Executive Officer (CEO) Kim Cripe sees this as a natural progression from the pediatrician-in-chief position I have held over the past several years. My primary objective remains to further CHOC’s clinical and academic vision. In this newly expanded capacity, I will continue my focus on nurturing relationships, both internally and externally, clinically and academically. I look forward to working with you all to create a brighter future for our patients and their families.
I take great pride in the level of care we provide to our patients, and I am honored to have spent the vast majority of my career at CHOC. Even in my expanded role, I will not step entirely away from the privilege of caring for our patients and families. You will continue to see me in the PICU and CVICU on a fairly regular basis as I continue my research efforts, as well as on-going teaching and mentoring of our residents and fellows.
This will be another exciting academic year, as we enter a new chapter in the growth of world-class programs. We recently opened our new private-room NICU, and look forward to the 2018 opening of our mental health inpatient center. We will continue growing our fellowship programs, increasing our emphasis on collaborative relationships, and striving toward innovative population health management strategies. Within the next 30 days, the CHOC Children’s and Rady Children’s Institute for Genomic Medicine Research Collaborative will launch two exciting projects. We are also preparing to begin the recruitment of our first ever chief scientific officer (CSO). And finally, I am extremely encouraged by the growth in philanthropy here at CHOC, and look forward to participating in our Transformational Venture Funding and our numerous Innovation Institute initiatives.
While I can’t possibly list all the exciting projects and program advancements happening on our hospital campuses, I would like to again say how proud I am to be in a position to work with you as we continue our focus on excellence in clinical medicine, teaching, research and innovation at CHOC Children’s.
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!
Dr. Nick Anas, CHOC’s pediatrician-in-chief, sat down with Dr. Mitchell Katz, director of CHOC’s Multidisciplinary Feeding Program and pediatric GI lab services, to talk about CHOC’s Clinical Leadership Council (CLC), and how it has benefited programs like the feeding program.
CHOC’s Multidisciplinary Feeding Program is one of a few specialty feeding programs in the country to offer comprehensive outpatient consultation and inpatient programs. With the support and success of CLC’s process, the feeding program has grown tremendously and increased the number of patients it can treat.
Watch this brief video to learn more about CLC and the feeding program.
It is an exciting time to be at CHOC Children’s. Since the opening of the Holmes Tower in spring 2013, we have clearly adopted a campus-wide “can do” mentality. Our focus on innovation, the acceleration of new and expanded clinical programs, and our increasing academic emphasis are propelling us forward on the path to greatness, and I am very proud to be on this journey with you.
As the CHOC Clinical Leadership Council (CLC) enters its fourth year of the New and Expanded Clinical Program Process, I am encouraged by both the caliber of concept proposals that are developed each year, as well as the level of support and guidance that CHOC Executive Leadership continues to bring to this process. The result of this model of physician and administrative partnership is the advancement of our clinical vision at CHOC. On a parallel path, earlier this year, Kim Cripe, CHOC Children’s President and Chief Executive Officer, launched our Transformational Program Process, which has to date far exceeded our expectations. The level of enthusiasm has driven a collaborative process that has resulted in some truly transformational concept proposals. I have summarized details on both the New and Expanded Clinical Program and Transformational Processes below.
Again, I would like to share my appreciation along with my true sense of pride at being a part of this this legacy-creating time in CHOC’s history. I look forward to working with you on our continued clinical and academic advancements made on behalf of the children that we serve.
CHOC Clinical Leadership Council – New and Expanded Clinical Programs
FY17 New and Expanded Clinical Program Process
I am pleased to share with you that the CHOC Clinical Leadership Council (CLC) has recently launched our fourth year of the New and Expanded Clinical Program process. For fiscal year 2017 (FY17) projects, the CLC has received a number of exciting concept proposals. The physician and EMT proposal champions have been invited to formally present their concepts to the CLC on November 2nd. The concept proposal ranking provided by the CLC will result in recommendations to the CHOC Senior Leadership Team (SLT) to develop full business plans for the top ranked concept proposals. Our goal is to complete the business plans in time for inclusion in the FY17 budget, which means that they must be finalized by February of 2016 for final presentation to CLC and SLT for approval, allowing them to move onto “green light” implementation stage starting as early as July 2016.
Approved New and Expanded Clinical Programs
During the first three years of the New and Expanded Clinical Program process, CLC recommendations to SLT have resulted in several “green lighted” programs, which are now in various stages of implementation. To date, the CLC has received SLT approval for implementation of the following clinical programs:
Sleep Program expansion at CHOC, providing a third sleep station, along with introduction of a new Sleep Program at CHOC at Mission. In Mission we built an entirely new 3-bed sleep lab, and at CHOC we completed physical plant enhancements along with Children’s Specialists (CS) recruitment of Dr. Neal Nakra, board certified sleep and pulmonary specialist, allowing CHOC’s sleep labs to become accredited.
Gastroenterology Pill Cam was added as a new service at CHOC; implemented in 2014, the Pill Cam program is serving a growing number of GI patients.
Craniofacial Program expansion, including purchase of the Cone Beam CT Scanner (with the first cases completed in August 2015), addition of a physician assistant (to be hired), and expanded marketing and business development support, including robust web-content.
Vascular Anomalies Program expansion, including addition of Pulsed Dye V-Beam Laser services at CHOC. Our first three cases were performed on October 6th. The team also added Kim Hai, RN as the full-time nurse coordinator. The team is currently working with CHOC business development and marketing to launch enhanced web-content and print materials to promote the expanded program.
Feeding Program expansion provided for dedicated, renovated, fully-equipped inpatient space including 3 beds and the addition of a third feeding team to support program growth. The inpatient unit and 3rd team went live earlier this year.
Adolescent and Young Adult (AYA) Program includes design plans that were recently completed, as the team is working toward a build-out and an implementation plan to create a uniquely adolescent space and program for adolescent and young adult patients.
Inpatient Telemedicine Program expansion plans include the hiring of our full-time manager, Michelle Jones. In partnership with Dr. Jason Knight, who received a formal Medical Director role, they are focused on increasing utilization, adding subspecialty participation, and bringing on new hospital partners to provide inpatient telemedicine services.
Visualase, which provides minimally invasive tumor ablation, will be added to the CHOC Neurosurgery service line as a one-year pilot project approved by Matt Gerlach, CHOC Executive Vice President and Chief Operating Officer. The team is finalizing steps to bring Visualase to CHOC by December of this year.
In addition to these program approvals, CLC received approval for purchase of a portable CT scanner now in use in the CHOC ICU’s, along with several other equipment purchases. Matt Gerlach, has actively engaged the CLC membership to assist in prioritization of requested clinical capital equipment as part of the annual budget process, and is providing additional support to the New and Expanded Clinical Program process through the newly created CHOC Project Management Office (PMO).
The CLC also has several programs in the business plan development stage for consideration. These business plans include expansion of the CHOC Pain Program, creation of an Aerodigestive Disorders Center, and the potential for a Neuro-Intensive Care NICU Program. CLC is also working toward completion of business plans evaluating expansion of the Inflammatory Bowel Disease (IBD) and Eosinophilic Esophagitis (EoE) Programs, as well as review of a plan to develop an Undiagnosed/Rare Diseases Center. As these plans move through the process for consideration, we will keep you posted on their status. While all proposed programs that come through the CLC process are not approved for implementation, the process provides a venue and dedicated resources to all ideas to be further developed, actively discussed, and formally evaluated.
CLC Review of Existing Clinical Programs
As the CLC is focused on advancing the clinical mission of CHOC, we not only support proposals for new and expanded clinical programs, but also focus on promoting the growth and development of programs including the CHOC Institutes, house-based programs including anesthesiology, emergency medicine, pathology, and radiology, along with other premier programs at CHOC. The CLC is the perfect venue for clinical program advancement, bringing together physician and administrative leadership into a cohesive council, working together to help raise CHOC to the next level, as we secure our position as a nationally recognized children’s hospital.
Transformational Program Process
I am so proud of the preliminary results of a very exciting CLC-led concept, The Transformational Program Process. In January 2015, Kim Cripe, CHOC President and Chief Executive Officer, invited CHOC clinical, scientific, and administrative leadership to “dream big.” She asked for ideas that would transform not only CHOC, but change aspects of pediatric healthcare nationally/internationally. This call for ideas resulted in thirty-four proposals, igniting unique and exciting collaborations; ultimately culminating into fourteen transformational concept proposals. Through a formal evaluation process, the CLC recommended that the ten top ranked proposals move forward for further development.
CHOC recently engaged Lori Baker Schena, a talented medical writer, to work with each of the ten groups to develop compelling case statement “briefs.” These case “briefs” will first be shared with CHOC Senior Leadership Team (SLT) for concept approval, and then ultimately with key mega-donors in a collaborative process to develop truly transformational programs at CHOC Children’s. With the case statement writing actively underway, we are excited to move to the next stage of the process.
The somewhat unanticipated early outcome of this Transformational Program Process has been the overall level of commitment and enthusiasm, the unique and dynamic collaborations that have resulted, and the overall sense of “we can do this.” We feel this is a result of the evolving culture of innovation and collaboration at CHOC as we work together to create our legacy for the future. I am so proud to be leading this effort with Jan Lansing, with the dedicated support of Debra Beauregard, along with the entire CLC membership. We will continue to share our progress with you as we continue the Transformational Program Process.
I wish you all my best as we enter the fall of 2015. Please feel free to contact me any time at firstname.lastname@example.org to discuss ideas, new or expanded clinical program concepts, or your thoughts regarding the CHOC clinical vision or strategic plan.
“Nick exemplifies all the attributes one would look for in selecting a ‘Pediatrician of the Year’: Outstanding Clinician, Educator, Advocate, Leader and Mentor. His enthusiasm and energy set the bar in all of these arenas,” said Dr. Paul Lubinsky, associate director, pediatric intensive care unit, CHOC Children’s and medical director, CHOC Children’s Specialists.
In addition to serving as pediatrician-in-chief – a position appointed to him in 2009, Dr. Anas leads CHOC’s critical care program as the medical director of the hospital’s pediatric intensive care unit. The unit is the first in the nation to earn the Pediatric Beacon Award for Critical Care Excellence. He leads his team with a steadfast commitment to the highest standards of patient care and safety. Dr. Anas is actively involved in clinical research, frequently contributing to medical journals and textbooks, and in education, training the next generation of leaders in the field of pediatric critical care medicine.
A graduate of West Virginia University, Dr. Anas completed his pediatric training at the Children’s Medical Center, Southwestern Medical School in Dallas and his fellowship training at the University of Rochester. He is board certified in pediatric critical care medicine and pediatric pulmonology.
“CHOC is very proud of Dr. Anas for his passionate dedication to the children and families in Orange County – and beyond. He’s an extraordinary leader, keeping his colleagues and CHOC on the forefront of critical care medicine. As an inspiring advocate, he’s tireless in his efforts to ensure all children have access to the finest facilities, equipment, treatment and care,” said Dr. Maria Minon, vice president, medical affairs and chief medical officer, CHOC Children’s.