Scott Webb (Host): Welcome to BayCare HealthChat. I'm Scott Webb. And today we're going to learn about the differences between pediatric and adult surgery and how BayCare St. Joseph's Children's Hospital became a level I children’s surgical center from a pediatric surgeon, Dr. Sarah Sapienza.

Doctor, it's so nice to have you here today. I have a couple of kids. They're a little bit older, 18 and 23. I know you treat kids at birth to 18, if you will. And today we're going to talk about a level one children's surgery center and what that means exactly. And I guess I want to kind of get started here by just finding out what makes a pediatric surgeon different from a surgeon who only sees adults. What's the difference between the two?

Dr. Sarah Jones Sapienza: Yes, Scott. First, thank you for having me. A pediatric surgeon is a general surgeon who has then completed additional training in what we call a pediatric surgical fellowship. So that we have additional training to address the specific surgical concerns and issues that arise from patients from basically birth to about 18 years of age.

Scott Webb: Yeah. And it's interesting. I've often wondered with pediatricians or in this case a pediatric surgeon, what's the experience for you, the difference between dealing with adults and then dealing with kids? Yes, you'll also probably have to work with their parents as well, but is there a big difference, do you think?

Dr. Sarah Jones Sapienza: There is a big difference. And yes, when we're taking care of a child, we're aware that we're actually taking care of the whole family because the parents also have concerns that we need to be able to address and manage. But children, in general, are the best patients to take care of because when they don't feel well, they let you know it.

And then when they're better, they are up and around and impossible to keep down, as opposed to adults who maybe will lay around a bit longer. But children want to get back at it and back at life as quickly as possible. And so, they're really wonderful to take care of.

Scott Webb: Sure. Yeah, it's one sure way to know that they're feeling better when they're running around again, right?

Dr. Sarah Jones Sapienza: Yes, absolutely.

Scott Webb: For sure. So then let's talk about, Doctor, some of the new standards in pediatric surgery.

Dr. Sarah Jones Sapienza: The American College of Surgeons, it's the surgeons' professional organization, and it's dedicated to really providing education to surgeons and patients, advocacy and quality improvement for surgical care.  

And so, the American College of Surgeons has set standards for what a children's surgical center, so a center that operates on children, that takes care of children, certain standards that they should meet, which really includes services, processes, supplies, and really the quality that goes into taking care of children.

Scott Webb: Yeah. And my son had a titanium screw put in his elbow from a baseball injury, Doctor. And we weren't so much trying to choose the right place per se, but the right doctor, the right surgeon. So, I've been through this a little bit, a little bit of understanding at least of how to sort of interview the doctors, interview the surgeons, find out if it was the right person, and we felt like it was, and it went well.  

But in general, for parents, because you say it's like treating the whole family essentially, but the parents are involved in the decision making. How do we choose the right place or the right doctor or whatever it might be?

Dr. Sarah Jones Sapienza: Yes. That is a fantastic question, and it can be very challenging. Often the first resource that everyone turns to is the internet. Some of the basic things to look for in a facility would be if that facility has been verified, received accreditation from the American College of Surgeons, which would imply that they've met all the standards to be a center of excellence for care for children. That's one.

And then often it's really meeting the surgeon, talking to them, seeing if they are listening to your concerns, if you feel comfortable in that short interaction. We only have 15 minutes at most sometimes to meet a family, meet a patient, make an assessment, and develop a plan as well as build a bond with that family.

And so, if in that short period of time you feel that you've accomplished that with your surgeon, then full steam ahead. You can feel comfortable that you've picked the right person in the right place.

Scott Webb: Right. Yeah, that's great advice. I want to talk to you a little bit about BayCare St. Joseph's Children's Hospital. I know that it's a level I children's surgery center, so what does that mean exactly, and what criteria were met to get that designation.

Dr. Sarah Jones Sapienza: The Children's Surgical Verification was a project that really began several years ago with significant drive in developing quality processes to show that at every touchpoint within the organization that the surgical care of infants and children has been addressed.

And so, we began a systematic evaluation of every program in BayCare St. Joseph’s Children’s Hospital, which really sounds like a large undertaking. They look at everything from the process by which a patient is evaluated and cared for to really be able to deliver the best clinical outcomes for the patient. The Children's Surgical Verification Program improves access for patients.

These centers really show lower complications because they have paid attention to really the standards that have been set across the nation for what is the best quality of care. It also results in lower cost of care for the families with less redundancy in testing, and the best tests are chosen for the patients.

And all of that really leads to better outcomes for the patients.

Scott Webb: Yeah, as a parent myself, I was sort of nodding my head saying, "Yeah, that all sounds right." As a parent, I like it, love it, great. Of course, we're talking here about a level I children's surgery center and how great that is and great outcomes and great for patients and families and all of that.

But I'm sure the team still has goals. What are the next goals for the surgery team? Maybe it's a trauma verification. Tell us about that.

Dr. Sarah Jones Sapienza: Yes. So those are the magic words. The next steps, although it's a separate accreditation from the Children's Surgical Verification, which I should actually also include that it's not just the surgical processes. It really involves our pediatric anesthesiologists as well as our pediatricians to develop these standards in a consensus.

So, we also then are pursuing our American College of Surgeons Trauma Verification, which would mean that in addition to the surgical verification, now the American College of Surgeons has come in and said that we meet the highest level of standards available to be able to provide the optimum care of injured patients in the region, which is also really a very heavy lift.

There are many layers of care and processes and policies and procedures that go into making sure that our trauma care is at the standard of the American College of Surgeons. In Florida, we are already considered a pediatric trauma center according to Florida standards.

And so, we're seeking additional verification. It's another kind of gold star badge to say that we're providing the highest level of care to the patients in our community.

Scott Webb: Well, as a parent and the parents who are listening, of course, we never want our kids to have to go to a trauma center, or a children's surgery center. But the reality is that's going to happen for many parents and kiddos. And knowing that BayCare St. Joseph's Children's Hospital is a level I children's surgical center, that trauma verification sounds like it's not far behind in terms of that highest standard, the gold star.

It all sounds like it’s important to pick the right surgeon at the right place to care of your child. I appreciate your time and your expertise. Thanks so much.

Dr. Sarah Jones Sapienza: It's my pleasure. I always say it's good to know a surgeon, but never good to need one. But we're here ever at the ready. Hopefully our paths will never cross.

Scott Webb: That's perfect. Thanks again.

Dr. Sarah Jones Sapienza: Thank you.

Scott Webb: And that wraps up this episode of BayCare HealthChat. Head on over to our website at BayCare.org for more information and to get connected with one of our providers. Always remember to subscribe, rate and review this podcast and all of the other BayCare podcasts, so we can share the wealth of information from our experts together. I'm Scott Webb. Stay well.