Children’s Hospital Central California serves a 45,000 square-mile area that covers the heart of the state. In fact, the other 111,000 square miles in California are covered by no fewer than seven other children’s hospitals. To put it in perspective, our service area is larger than Ireland – the country and the island.
Children’s sees more pediatric patients than any other hospital in Fresno and Madera counties, and the majority of pediatric patients who leave Merced, Stanislaus, Tulare, Kern, Mariposa and Kings counties for care. We treat 14 percent of the same types of patients from the Central Coast, a segment that grows every year. Our high-level of expertise is very rare for a primarily rural region this large, giving us a great deal of responsibility for serving not just the region’s children, but the medical professionals who care for them.
We honor this duty by providing accredited medical education for doctors, nurses, and healthcare professionals. This takes the form of partnerships with educational institutions like UCSF-Fresno, UC Merced, CSU Fresno and dozens more, as well as pediatric symposiums that our subspecialists offer existing practitioners throughout the state. All practicing doctors must complete a certain amount of accredited medical education every year, and for many physicians, the pediatric elements of this are provided by Children’s Hospital Central California.
There are also specialty courses for nurses, pharmacists, respiratory care professionals and more. Looking at the big picture, Children’s partners with nearly 60 schools offering training in 17 disciplines.
In addition to education programs, the Hospital leverages expertise in the area of child advocacy. We have programs aimed at child safety, literacy, water safety, and the prevention of child abuse. Business partnerships with companies like Walgreens Pharmacies helps us take our specialized knowledge into neighborhoods, sharing vital information on pediatric medication throughout their entire chain. Nurses at Children’s have also been key members of regional associations that advance the practice of nursing, and our pediatric subspecialist physicians are actively involved in ensuring that the Valley’s kids are well cared for.
If there is any place in Central California where children’s health is being discussed, taught or promoted, Children’s Hospital is most likely involved.
Sharing our knowledge base.
Children’s Hospital Central California is not part of a university-based system, but don’t let that fool you. We have strong, accredited academic programs, many affiliated with the region’s top learning institutions. With so many pediatric experts under one roof, Children’s is able to offer education to clinicians and students from throughout our region and beyond.
Children’s offers postgraduate medical education to physicians through its affiliation with the UCSF Fresno Pediatric Residency Program. Medical school graduates focusing on pediatrics come from throughout the country to this three-year, fully accredited post-graduate training program that encompasses all aspects of pediatric medicine. Children’s trains about 30 new doctors every year.
Children’s also offers a one-year, postgraduate residency program in pharmacy practice with an emphasis in pediatrics. Throughout the year, residents provide patient-specific clinical pharmacology in both inpatient and outpatient areas, providing drug education to medical residents and nurses, and precepting pharmacy students.
Children’s Hospital participates in several academic programs in partnership with schools from throughout the region, state and nation. We are part of nursing programs from California State University schools including CSU Fresno, CSU Bakersfield, CSU Dominguez Hills, and CSU Stanislaus, as well as UCSF. We work with community college RN programs that include Fresno, Reedley, West Hills, Pacific Union, College of the Sequoias and San Joaquin Valley College. Our pharmacy programs include University of the Pacific, UC San Diego and others. All in all, we offer clinical rotations in 17 disciplines, providing a pediatric training ground for our region’s future pediatric caregivers.
Central California’s practicing physicians fulfill their continuing medical education (CME) requirements by attending Children’s pediatric clinical symposiums. The Hospital hosts several symposiums every year in locations throughout the region including Madera, Modesto, San Luis Obispo and Bakersfield. Children’s subspecialists conduct the half-day events offering credits in a variety of pediatric health topics. These continuing medical education programs are taught in accordance with the standards of the Institute for Medical Quality (IMQ), the Accreditation Council for Continuing Medical Education (ACCME) and the Children’s Hospital CME Mission Statement.
New in 2009 was the University of California Merced lecture series. The monthly series at UC Merced pairs local practitioners and students with Children’s pediatric subspecialists for hour-long sessions in pediatrics.
Pediatric Cardiology Medical Associates of Central California, composed of Children’s cardiology physicians, hosted the 2009 meeting of the Western Society of Pediatric Cardiology at Yosemite National Park’s historic Tenaya Lodge. The group meets annually for a scientific session featuring courses on a large number of topics.
Other disciplines also offer outreach education. Our Neonatal Intensive Care Unit, or NICU, offers a full course catalog for nurses and other neonatal clinicians. This advanced program, offered by the only Level III Regional NICU in Central California, became the only area program in 2009 with the SimNewB, a high-fidelity newborn simulator.
Respiratory Care Practitioners at Children’s hosted quarterly pulmonary conferences open to all patient care providers, respiratory care students and nursing students in the region. The conference draws about 80 participants to each session. Children’s also hosts an annual Palliative Care Conference that brings together the Hospital’s staff with palliative care professionals from throughout the state. About 100 hospice care providers, representatives of groups like Exceptional Parents Unlimited, pediatricians and nurses from as far away as the Bay Area come to Madera for this unique gathering.
Children’s Clinical Education Department will be expanding outreach education in 2010. Working with the staff that developed the NICU course catalog, as well as physicians and nurses from throughout the facility, the department will use this program as a model for education in other disciplines.
New clinical partnerships.
Children’s Hospital Central California began an exciting partnership with Sierra Vista Regional Medical Center in San Luis Obispo in 2009, opening The San Luis Obispo Pediatric Subspecialty Center at Sierra Vista. Providing children and families access to some of the world’s finest pediatric subspecialists in an environment that is close to home, the San Luis Obispo Pediatric Subspecialty Center serves patients from San Luis Obispo County and the Central Coast. The Center is a partnership between Sierra Vista Regional Medical Center and Specialty Medical Group (SMG), in affiliation with Children’s Hospital Central California. Supspecialists from Children’s currently provide clinical services in cardiology, endocrinology and pulmonology. These three subspecialties were selected based on results from Sierra Vista’s own survey of community pediatricians who identified these as the greatest needs.
The San Luis Obispo Pediatric Subspecialty Center becomes the third practice in SMG’s and Children’s network, joining the Merced and Modesto Pediatric Subspecialty Centers to bring care to kids where they need it most – close to home.
The Hospital also entered into a relationship with Walgreens Pharmacies in 2009. Children’s has traditionally operated two kinds of pharmaceutical businesses. The first is within the Hospital itself. These are the pharmacists and technicians who provide direct care to our inpatient, Emergency Department and outpatient center populations. The second was our retail pharmacy, a place where families could get their prescriptions filled, confident that the pharmacists on hand understood children’s unique needs. As Children’s Hospital examined business operations in 2008, we looked for ways to improve our retail pharmacy business. The method for improvement eventually presented itself to us - Walgreens wanted to buy Children’s retail pharmacy.
This sale made sense in many ways, but Hospital leaders were concerned about continuing to provide specific pediatric-based service. Children’s and Walgreens came up with a solution. Not only would Walgreens keep members of the existing staff and focus on kid’s needs, they would take this newly-acquired pediatric expertise and spread it throughout the region. There are many pediatric drug compounds that, in the past, you could only get at Children’s. With Walgreens using our pharmacy as a launching pad, the expertise and knowledge required to serve pediatric patients is making its way into Walgreens stores throughout the Valley.
The Community Benefits program at Children’s Hospital Central California contributed to programs and services designed to meet the needs of Central Valley children and families.
In keeping with its Mission, Children’s Hospital accepts all patients, regardless of their ability to pay. As part of that commitment, the Hospital provided $13 million in charity care to patients who met certain criteria under the Hospital’s charity care policy. In order to assist families with ongoing care needs, Children’s Hospital requires patient families to apply for appropriate government funding in conjunction with applying for financial assistance (charity care). As a result, many families qualify for government programs and do not ultimately require charity care.
Given the large number of Medi-Cal patients treated at the Hospital and the historically low Medi-Cal reimbursement we receive for providing those services, the Hospital also absorbs a significant amount of uncompensated care annually. Uncompensated care represents the difference between what we get paid for providing services, and the cost of providing those services.
We partner with a variety of community-based organizations to help prevent or treat childhood illness in our region. For instance, Children’s Hospital founded the Childhood Obesity Prevention Task Force, a consortium of public and private agencies in Fresno and Madera counties committed to reducing the incidence of childhood obesity through networking, coordination, and development of best practices. Activities supported by the Task Force included the development of community consensus on the indicators used to measure obesity and increased coordination among existing programs and services.
Another important service is The Guilds Child Abuse Prevention and Treatment Center. In partnership with a number of private and public agencies, the Center provided education, leadership, and direct services for children who were victims of abuse and to parents and community based organizations to help prevent abuse. The Program provides education and training to over 17,000 individuals annually in the areas of child maltreatment, pediatric trauma, water safety, wheeled sports safety, childpassenger safety, the choking game, Munchausen by Proxy syndrome, and shaken baby syndrome.
We also help treat and prevent childhood developmental disabilities through our work with Exceptional Parents Unlimited, March of Dimes, and local First 5 agencies. And with advances in technology, more and more children with complex medical conditions are able to attend school full time. To help ensure they continue to receive medically appropriate care, Children’s Hospital provided education and training to school nurses on a variety of clinical procedures, including care of gastrostomy tubes and tracheostomy tubes, and use of insulin pumps.
The Hospital also provides assistance to our patients’ families so that they can effectively participate in their child’s care. These services include transportation services, meal assistance and a family assistance fund that helps families obtain items needed when they return home.
Central to California.
You’ve heard it before - Children’s Hospital provides services and resources from Modesto to Bakersfield, the Sierra Nevada Mountains to the Pacific Ocean. Direct patient care, outreach centers, medical and community education are all a part of our important impact on the region. We are Central California’s pediatric experts, and we are so intricately tied into children’s lives that it would be almost impossible to imagine the heart of the state without us. As years go by, we continue to find new ways to help both children and those who care for them, and we take our responsibilities very seriously. Central California is our home, and all of the people we reach out to are our family.