KCH and Cincinnati Children's Joint Pediatric Heart Care Program
Dr. Carl Backer, Chief of Pediatric Cardiothoracic Surgery with UK Health, discusses the joint pediatric heart care program from Kentucky Children’s Hospital and Cincinnati Children’s.
Featured Speaker:
Learn more about Carl Backer, MD
Carl Backer, MD
Carl Backer, MD is the Chief of Pediatric Cardiothoracic Surgery.Learn more about Carl Backer, MD
Transcription:
KCH and Cincinnati Children's Joint Pediatric Heart Care Program
Melanie Cole (Host): Welcome to UK HealthCast with the University of Kentucky Healthcare. I’m Melanie Cole and today, we’re talking about Kentucky Children’s Hospital and Cincinnati Children’s Joint Pediatric Heartcare Program. Joining me is Dr. Carl Backer. He’s the Chief of Pediatric Cardiothoracic Surgery at UK Healthcare. Dr. Backer, it’s a pleasure to have you join us today. As I said in the intro, Kentucky Children’s Hospital and Cincinnati Children’s have partnered in this joint Pediatric Heart Program to provide the best possible care to Kentucky’s kids closer to home. Explain this partnership and how it came about.
Carl Backer, MD (Guest): Well it goes back a few years. Our motto is One Program, Two Sites. One of my major interests has been the regionalization of care for children with congenital heart disease and one of the problems that we have solved with One Program, Two Sites is that there are programs that are not quite large enough to handle the full scale complexity of what’s needed for children with congenital heart disease. But they are geographically remote enough that there are a number of children that if they didn’t have a program, these children would have to travel great distances for their care. So, I think that’s an example of what’s happened here at UK is that Lexington and the surrounding area doesn’t have the population base to support a pediatric congenital heart surgery program that does the full range of heart transplants, ventricular assist, taking care of the very most complex neonates whereas Cincinnati Children’s which does have a large population base and has a very well renowned Children’s Hospital does have all of those capabilities. So, the idea is to have a joint program between the two sites where we care for probably 80 to 90% of the children in eastern Kentucky and the Lexington area that need congenital heart surgery and then 10 to 20% of those patients we refer up to Cincinnati for more complex surgery or if they need heart transplants or ventricular assist or complex transcatheter treatment.
One of the things that’s made this program I think so successful is the use of audiovisual and Zoom technology. So, we have joint conferences with Cincinnati three times a week, Monday, Wednesday, Friday. All patients are discussed at both sites by surgeons and cardiologists and cardiac intensivists with a lot of experience from both centers and we do come to a consensus as to what the best thing is for each individual patient. There are many different treatment paradigms within that framework but again, we are able to care for so many children down here in Lexington and eastern and southern Kentucky that then don’t have to travel all the way to Cincinnati. But those patients that need that very high level, almost quaternary type care can get up to Cincinnati and we are in communication with them regarding their care and getting there in a timely fashion.
So, it’s kind of a long answer to your question. But that’s where we are. And this program has been going on now for about four years.
Host: Well that’s amazing. And the joint program was recently Dr. Backer, ranked 14th in the nation by US News and World Report. Tell us why that is and what your team does to go above and beyond because you are dealing with very terrified parents and as you say, little kids with cardio problems. So, tell us a little bit about your team, the multidisciplinary care and why you were ranked so high. What makes you so special?
Dr. Backer: One of the primary drivers of the Us News and World Report ranking is the outcomes and the outcomes are reported through a national database that’s run by the Society of Thoracic Surgeons. And the outcomes of our joint program have been excellent. They also look at some of the processes and the structure that we employ and many of those metrics, we are at the top of the nation for, those processes that we employ. Part of the success is that we start with a careful evaluation of each patient by a very dedicated and motivated group of surgeons and cardiologists, so we do the right operation at the right time for the right patient. That’s where it’s starts and then both at Cincinnati and at Kentucky Children’s Hospital, we have great teams taking care of the patients. Here at Kentucky Children’s, we have dedicated cardiac intensivists, we have dedicated pediatric cardiac perfusionists to run the heart lung machine. We have dedicated pediatric cardiac anesthesia. We have two full time pediatric cardiac surgeons. We have two surgical physician’s assistants. And then we have a dedicated pediatric cardiac intensive care unit. All of that is also present in Cincinnati and they probably have three to four times the manpower and womanpower that we have as far as the number of perfusionists, anesthesiologists, intensivists, et cetera. But both centers have excellent programs to take care of these patients with congenital heart disease.
Host: Well tell us how it works Dr. Backer for parents that may have a child with a cardiac condition. How does it all sort of work for them? When they are making their first appointment, they’ve got their referral from their pediatrician or it’s something that was found in utero. How does it work when you are working together with another hospital as far as referral and helping parents and communication with referring physicians? How does it all come together?
Dr. Backer: Well one of the things actually that we have here at Kentucky Children’s Hospital is a specific patient coordinator and her soul job is to communicate with families and coordinate all of those questions that you just raised. But to answer your question, the initial contact would be with one of our pediatric cardiologists presuming it’s not an emergent situation and the pediatric cardiologist would, in most cases, perform an examination and then additional studies often including an echocardiogram which would then give a basic diagnosis. Once that’s been done, then the child would be discussed at our joint conference and again, we have conference Monday, Wednesday, Friday. So, there’s no delay in discussing a patient’s clinical diagnosis with the entire group.
And at that time, an assessment is made as to what the next steps should be for that child, whether it be urgent intervention or watchful waiting or in some cases, nothing is required but that starts the whole process in motion for next steps whether that be more diagnostic studies, surgery, transcatheter intervention, medical therapy. There’s a whole range of potential treatment options for many of these patients.
Host: What a great partnership and it’s got to be so good for the community in Lexington and the surrounding areas. Dr. Backer, wrap it up for us, what would you like listeners to takeaway from this about this very important partnership between Cincinnati Children’s and Kentucky Children’s Hospital for pediatric cardiac care?
Dr. Backer: Well I would like them to take away the – remember that Cincinnati Children’s has been ranked number three in the United States as a pediatric hospital nine years in a row and the fact that Kentucky Children’s Hospital can take advantage of that amazing expertise and then transfer those same expert care to huge majority of patients that we see down here in Lexington is one of the things that makes this whole thing work so very well. We just reviewed our results and we’ve now operated on over 200 patients here at Kentucky Children’s Hospital and have essentially no major morbidity or mortality in that group of patients. So, I think the outcomes speak for themselves. The outcomes are excellent and again it’s that joint program system that’s working extremely well.
Host: Thank you so much Dr. Backer for coming on and sharing this partnership with us and it’s so important to help people in the community. Thank you again. Please visit our website for more information at www.ukhealthcare.uky.edu/kentuckychildrenshospital for more information about the success of this partnership. And that concludes another episode of UK HealthCast with the University of Kentucky Healthcare. Please remember to subscribe, rate, and review this podcast and all the other UK Healthcare podcasts. I’m Melanie Cole.
KCH and Cincinnati Children's Joint Pediatric Heart Care Program
Melanie Cole (Host): Welcome to UK HealthCast with the University of Kentucky Healthcare. I’m Melanie Cole and today, we’re talking about Kentucky Children’s Hospital and Cincinnati Children’s Joint Pediatric Heartcare Program. Joining me is Dr. Carl Backer. He’s the Chief of Pediatric Cardiothoracic Surgery at UK Healthcare. Dr. Backer, it’s a pleasure to have you join us today. As I said in the intro, Kentucky Children’s Hospital and Cincinnati Children’s have partnered in this joint Pediatric Heart Program to provide the best possible care to Kentucky’s kids closer to home. Explain this partnership and how it came about.
Carl Backer, MD (Guest): Well it goes back a few years. Our motto is One Program, Two Sites. One of my major interests has been the regionalization of care for children with congenital heart disease and one of the problems that we have solved with One Program, Two Sites is that there are programs that are not quite large enough to handle the full scale complexity of what’s needed for children with congenital heart disease. But they are geographically remote enough that there are a number of children that if they didn’t have a program, these children would have to travel great distances for their care. So, I think that’s an example of what’s happened here at UK is that Lexington and the surrounding area doesn’t have the population base to support a pediatric congenital heart surgery program that does the full range of heart transplants, ventricular assist, taking care of the very most complex neonates whereas Cincinnati Children’s which does have a large population base and has a very well renowned Children’s Hospital does have all of those capabilities. So, the idea is to have a joint program between the two sites where we care for probably 80 to 90% of the children in eastern Kentucky and the Lexington area that need congenital heart surgery and then 10 to 20% of those patients we refer up to Cincinnati for more complex surgery or if they need heart transplants or ventricular assist or complex transcatheter treatment.
One of the things that’s made this program I think so successful is the use of audiovisual and Zoom technology. So, we have joint conferences with Cincinnati three times a week, Monday, Wednesday, Friday. All patients are discussed at both sites by surgeons and cardiologists and cardiac intensivists with a lot of experience from both centers and we do come to a consensus as to what the best thing is for each individual patient. There are many different treatment paradigms within that framework but again, we are able to care for so many children down here in Lexington and eastern and southern Kentucky that then don’t have to travel all the way to Cincinnati. But those patients that need that very high level, almost quaternary type care can get up to Cincinnati and we are in communication with them regarding their care and getting there in a timely fashion.
So, it’s kind of a long answer to your question. But that’s where we are. And this program has been going on now for about four years.
Host: Well that’s amazing. And the joint program was recently Dr. Backer, ranked 14th in the nation by US News and World Report. Tell us why that is and what your team does to go above and beyond because you are dealing with very terrified parents and as you say, little kids with cardio problems. So, tell us a little bit about your team, the multidisciplinary care and why you were ranked so high. What makes you so special?
Dr. Backer: One of the primary drivers of the Us News and World Report ranking is the outcomes and the outcomes are reported through a national database that’s run by the Society of Thoracic Surgeons. And the outcomes of our joint program have been excellent. They also look at some of the processes and the structure that we employ and many of those metrics, we are at the top of the nation for, those processes that we employ. Part of the success is that we start with a careful evaluation of each patient by a very dedicated and motivated group of surgeons and cardiologists, so we do the right operation at the right time for the right patient. That’s where it’s starts and then both at Cincinnati and at Kentucky Children’s Hospital, we have great teams taking care of the patients. Here at Kentucky Children’s, we have dedicated cardiac intensivists, we have dedicated pediatric cardiac perfusionists to run the heart lung machine. We have dedicated pediatric cardiac anesthesia. We have two full time pediatric cardiac surgeons. We have two surgical physician’s assistants. And then we have a dedicated pediatric cardiac intensive care unit. All of that is also present in Cincinnati and they probably have three to four times the manpower and womanpower that we have as far as the number of perfusionists, anesthesiologists, intensivists, et cetera. But both centers have excellent programs to take care of these patients with congenital heart disease.
Host: Well tell us how it works Dr. Backer for parents that may have a child with a cardiac condition. How does it all sort of work for them? When they are making their first appointment, they’ve got their referral from their pediatrician or it’s something that was found in utero. How does it work when you are working together with another hospital as far as referral and helping parents and communication with referring physicians? How does it all come together?
Dr. Backer: Well one of the things actually that we have here at Kentucky Children’s Hospital is a specific patient coordinator and her soul job is to communicate with families and coordinate all of those questions that you just raised. But to answer your question, the initial contact would be with one of our pediatric cardiologists presuming it’s not an emergent situation and the pediatric cardiologist would, in most cases, perform an examination and then additional studies often including an echocardiogram which would then give a basic diagnosis. Once that’s been done, then the child would be discussed at our joint conference and again, we have conference Monday, Wednesday, Friday. So, there’s no delay in discussing a patient’s clinical diagnosis with the entire group.
And at that time, an assessment is made as to what the next steps should be for that child, whether it be urgent intervention or watchful waiting or in some cases, nothing is required but that starts the whole process in motion for next steps whether that be more diagnostic studies, surgery, transcatheter intervention, medical therapy. There’s a whole range of potential treatment options for many of these patients.
Host: What a great partnership and it’s got to be so good for the community in Lexington and the surrounding areas. Dr. Backer, wrap it up for us, what would you like listeners to takeaway from this about this very important partnership between Cincinnati Children’s and Kentucky Children’s Hospital for pediatric cardiac care?
Dr. Backer: Well I would like them to take away the – remember that Cincinnati Children’s has been ranked number three in the United States as a pediatric hospital nine years in a row and the fact that Kentucky Children’s Hospital can take advantage of that amazing expertise and then transfer those same expert care to huge majority of patients that we see down here in Lexington is one of the things that makes this whole thing work so very well. We just reviewed our results and we’ve now operated on over 200 patients here at Kentucky Children’s Hospital and have essentially no major morbidity or mortality in that group of patients. So, I think the outcomes speak for themselves. The outcomes are excellent and again it’s that joint program system that’s working extremely well.
Host: Thank you so much Dr. Backer for coming on and sharing this partnership with us and it’s so important to help people in the community. Thank you again. Please visit our website for more information at www.ukhealthcare.uky.edu/kentuckychildrenshospital for more information about the success of this partnership. And that concludes another episode of UK HealthCast with the University of Kentucky Healthcare. Please remember to subscribe, rate, and review this podcast and all the other UK Healthcare podcasts. I’m Melanie Cole.