Dr. Martin

Dr. Brian Martin, Vice President of Medical Affairs, UPMC Children’s Hospital of Pittsburgh discusses Children’s national ranking and the extensive steps underway to keep families safe when they come in for care.

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– This podcast is for informational and educational purposes only. It is not medical care or advice. Clinicians should rely on their own medical judgments when advising their patients. Patients in need of medical care should consult their personal care provider. UPMC Children’s Hospital is once again being honored as one of the top children’s hospitals in the nation. Welcome to the UPMC HealthBeat Podcast. I’m Tonia Caruso, and joining us right now is Dr. Brian Martin. He’s the vice president of Medical Affairs for UPMC Children’s Hospital. Doctor, thanks so much for joining us.

– Thank you, Tonia. Pleasure being here.

– And let’s start off with congratulations. This is another great honor.

– Thank you. Once again, UPMC Children’s Hospital of Pittsburgh is proud to be ranked in the top 10 of U.S. News & World Report’s best pediatric hospitals in the United States.

– And this means so much, and so many specialties were called out as making the list. And let’s tell folks about that.

– We are really proud and very excited to share this year that all of our specialties ranked within the top 20 within their respective categories within the U.S. News survey. Four in particular were actually within the top 10 in the nation. The first I’m excited to share is our cardiology and cardiac surgery program, actually ranked No. 2 in the United States. Our diabetes and endocrinology ranked No. 7. Gastroenterology, or GI services, ranked No. 9, and finally, pulmonology, or lung services, ranked No. 10. All fantastic, fantastic performance by those respective divisions.

– And this means so much to the Pittsburgh community, obviously for care of patients, but talk about the staff and the role of the staff in all of this success.

– Really important to note that we are fond of saying that our care within UPMC Children’s Hospital of Pittsburgh is truly a team sport. We are honored by the ranking of U.S. News and acknowledgement of the excellent care and services that we provide. It’s a great external validation of care that I think that viewers and listeners here know well if they were to bring one of their children for services that we would render. I also think it’s really important to note that this care involves everyone who surrounds the child. Care in a children’s hospital involves everything from, for example, the parking attendants that greet you when you’re first walking in the door to our registration staff, all the way through the nurses, patient care techs, lab techs, child life, and other support services, which really make a children’s hospital a unique environment. And then, obviously, also the physicians and subspecialists and others involved in the patient’s care that really end in an ideal outcome.

– Right. And so, obviously in this day and age, COVID-19 has been on everybody’s mind and certainly has impacted all of our communities and health care. Can you talk about the impact of COVID at Children’s Hospital and sort of the steps that folks at Children’s took to begin to deal with COVID and still provide the best care possible?

– I’m really, really proud of the work that UPMC Children’s and UPMC in general has undertaken as a result of the COVID pandemic. I think it’s really important to remember if each of us is to rewind where we were really at the beginning of March, every health care institution was facing really an unprecedented situation, something really that hasn’t happened in the United States in approximately 100 years, and that is a global pandemic. Our work at UPMC Children’s quickly arrived in the establishment of our command center, which dialogued very closely and really was guided and supported by our UPMC command center, in regards to our initial response, largely, which would involve things like screening, developing appropriate testing protocols, readying our facilities in a safe way for ongoing care, and also a lot of preparation, particularly early on in the pandemic, because we didn’t know exactly how this disease, how COVID-19, was going to affect the pediatric population, maybe a little bit differently than the adult population, and how we were going to sort of ready ourselves for a potential surge of patients.

– So what have you seen, or what are you seeing now in terms of the number of patients and children with COVID-19?

– Overall, we’ve been fortunate. We’ve been fortunate in many ways. Pittsburgh and our greater Pittsburgh region has overall had a lower disease incidence. There has been a surge recently, which many of us are aware of, but particularly early in the pandemic, we learned several important things about this virus. First of all, it seems to affect children less severely than it does adults. So that is a circumstance that as the pandemic grew and as our body of knowledge and experience grew with this virus, we’re fortunate to note that most kids, if they were going to get COVID-19, would have relatively benign courses of disease. In fact, if you look at the total number of patients that we’ve had at UPMC Children’s to date, this being in early July, we’ve had 12 inpatient cases. That is less in our region than some other regions of the country. Certain other children’s hospitals have had a greater number of inpatients. But it’s important to note that every one of those inpatients that we’ve had at UPMC Children’s has had a relatively low length of stay, or it’s a relatively short length of stay, and relatively benign courses. And all of them were actually discharged, as of this date, were discharged back to home for continued recovery.

– And so safety precautions in place across the board. And let’s tell folks about those and what people can expect if they come to the hospital.

– I think it’s really important for our listeners and viewers to understand just how seriously we take the preparation prior to your visit in terms of creating a safe environment. This really begins with the dialogue that our schedulers have with you as a patient or family in regards to asking some screening questions about potential exposure to COVID. We want to help you and help educate you and your family understand that that is a really key part of us getting the pieces in place for you to have a safe visit here at UPMC Children’s. After that screening process, obviously you’ll come onto our campus for some visits. And if you do, you’ll notice that we have appropriate social distancing guidelines and a robust screening process at the front door of our hospital that screens for temperature and a few basic questions that we ask regarding potential COVID exposure. We have everybody then perform some hand hygiene, which is a great way to help prevent disease, both COVID and non-COVID. We’re strong advocates of hand hygiene at UPMC Children’s. And then you’ll be routed appropriately to either your ambulatory or outpatient or potentially an inpatient or emergency department visit. Another key aspect of your care at UPMC Children’s is our continuous cleaning process. Our EVS, who are critical members of our health care team, have really said about a continuous cleaning process for high-touch surfaces. Those might be elevator buttons, for example, or maybe a stair guard on a stairwell, or a door handle. We’ve enacted really robust continuous cleaning in places we know we’re going to get a lot of high touch and could put patients at risk. So we’ve taken the steps necessary to go ahead and ensure that that’s a safe environment.

– And so in hearing all of these steps, we’re hoping that parents especially are reassured that the hospital is a safe place to bring their children for checkups, or for emergencies, or any kind of procedure. What do you want to say about the importance of returning to care? And talk about some of the areas and cases that you may have been worried about if they’re not seeking out treatment.

– Tonia, that’s a great question. We did share particularly early in the pandemic significant concerns about patients and families that were so fearful of the environments that they weren’t engaging us with care. And some patients — for example, patients with chronic health conditions or conditions that might get worse if they didn’t seek care — we had concerns that deferral of this could actually lead to greater morbidity, or a negative outcome, or a greater disease burden. All of these concerns really were at the heart of our physicians and our professional staff in terms of asking us, OK, how can we engage patients and families? And really, what we did was we went to the front lines. We had our schedulers and we had our physicians and our APPs engaging families, particularly if patients with chronic care or conditions that would be sensitive to timing of care and engaging them in a variety of different ways. Some of those patients we brought back to the campus, and we had them do face-to-face visits and had some appropriate discussions with patients’ families. Some of those visits actually pivoted and moved over to telemedicine platforms. Particularly in April, we saw tremendous increase in a number of our televisits. And we recognize that this is a component of care that actually we have significant depth and expertise with. We learned a lot during that time frame. All of our service lines really developed a capacity, and if they had existing capacity, they strengthened it. If they needed to develop new capacity, they developed it and ramped it up quickly and appropriately. And we know now that this is an option that for certain patients, for certain categories of patients and certain types of visits, for example, like a behavioral health visit, like a telecounseling visit, it’s a fantastic opportunity for patients and families to continue to engage with us with care. So I would say at the beginning, we started conversations. We also provided other options, i.e. telemedicine. And right now, what we’re seeing is a really strong mix of outpatients that are coming back to see us. The majority of those are actually face-to-face visits, but we still also have a significant percentage of them that are continuing to engage us, and appropriately so, with telemedicine visits.

– And what’s so important is it’s individualized care. So it’s really a conversation for a parent to pick up the phone and have a conversation with the doctor’s office about the best way to proceed.

– That’s exactly right. It’s highly individualized, just like any individual’s care plan really is. I think that one of the things that in general, if we’re speaking about COVID-19, we have a real duty to our patients to make sure that we’re giving them the most up-to-date and accurate information regarding the context of their child’s treatment plan as it lays or sort of sits within the COVID-19 pandemic. And really, that comes down to access, and it comes down to patient engagement, and that comes down to continue to encourage patients and families that if they’re anxious about something, if they have a question, their child’s UPMC Children’s provider or UPMC Children’s-affiliated provider, is really the best source of information for what’s best for their child’s care.

– And this really stretches from immediate doctor care to even care on the dental end of things, correct?

– A favorite pet subject of mine. So I’m a pediatric dentist. I was the chief of dentistry for over 15 years at UPMC Children’s before I segued over into a hospital administration role. And if someone asks me about oral health care — fundamentally, what makes oral health care important? — I bring it back to one basic thing is that oral health care cannot really be separated from your general health. If you have an individual who thinks they have great general health but they’re walking around with a toothache all the time, or if you have a child who might have some broken teeth, for example, and is changing their eating patterns or the way that they eat as a result of infected or broken teeth, they’re not really healthy. So oral health care is fully integrated, just like eye care, ear care, any other aspect of care into total habilitation or total care for a child.

– And really you can look at a child’s mouth, and teeth can be an indicator of certain kinds of diseases and conditions, correct?

– It can be somewhat of a proxy for general sort of care. I mean, we want to make sure that when we’re engaging patients and families in regards to oral health, cavities, it’s important to note like dental care and cavities really don’t know… they don’t discriminate. So we know that certain patient populations might be a little bit more at risk for oral diseases, particularly cavities or caries, but really and truly we go over the basics of anticipatory guidance, which is prevention. Really, pediatric dentistry’s hallmark is really predicated on a foundation of prevention. And that type of information that we share with patients’ families, in addition to the physical care that they provide, what we’re really looking to do is create great dental experiences for children so that we can set them up for a lifetime of great oral health care and great engagement with the oral health environment. We want to create kids that enjoy coming to the dentist and also enjoy a great oral health as a byproduct of that relationship.

– So doctor, as we close, what’s your final message? What do you want to say to parents about the importance of continuing their child’s care?

– The message I would like to relay is this. Our community at UPMC Children’s Hospital of Pittsburgh is here for you throughout the COVID-19 pandemic. We want to ensure the continued health, well-being, and success of your child. To that end, please don’t hesitate to engage us. Reach out to your provider, either through our patient portal, through our phone number, or, if you need to, through our Emergency Department or other avenues. Also, let’s not forget that your patient’s primary care physicians are really key partners in all of this as well. So I would say that we have done a tremendous amount of effort in making sure that our environment is sanitized, safe, and protected, and also that we’re your partners to see your child’s care throughout this COVID-19 pandemic. And together, we’ll go ahead and get through this.

– And if someone is listening or watching this, what is a phone number that they can call?

– 692-KIDS.

– Dr. Brian Martin, thank you so much for coming in and spending some time with us today. We certainly do appreciate it.

– Thank you.

– I’m Tonia Caruso. Thank you for joining us. This is UPMC HealthBeat.

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.