Outline
- Introduction
- A short description of the healthcare facility
- The roles of the health facility
- Offers care in various specialties such as cardiology, surgery, pulmonology, orthopedics, care for high-risk newborns, and neurology.
- Provides regular primary care
- Follow-up care
- Services offered by the health facility
- Pediatric inpatient units
- Offers walk-in options and appointments
- Size of department
- In total the organization receives at least 25,000 patients yearly in different departments
- Cardiology division department
- Offers modern diagnostic services such as ECG interpretation, exercise testing, both inpatient and outpatient consultation for cardiology, holter monitoring on a 24-hour basis
- Receives around 200 patients on a weekly basis and 4, 000 patients on a yearly basis
- There are a total of 20 staff members with each offering cardiology services
- Pediatric cardiology department
- This is the largest department receives around 2000 children on a yearly basis
- There are two full-time pediatric cardiologists who alternative working
- There are four staff members
- There is one care coordinator
- pediatric emergency department
- This is a separate unit
- The department handles about 12, 000 emergencies on a yearly basis
- Staff members
- 5 specialist providers with pediatric emergency medical training
- 3 specialist nurses in pediatric emergency care,
- 4 physicians
- Follow-up services for premature
- Cares for 700 children of whom are admitted to the hospital’s Neonatal Intensive Care Unit (NICU) yearly
- over 3,300 babies are admitted to the new born nursery on a yearly basis
Staff Members
- 10 board certified pediatric nurse practitioners
- 25 pediatric gastroenterologists who offer care
- 10 Pediatric radiologists,
- 5 surgeons
- 12 pathologists,
- 20 nutritionists
- 9 speech therapists,
- 2 specialist adult gastroenterologists
- Number of Beds
- There are a total of 5, 000 beds in the organization
- Organizational Leaders/Managers
- Robyn Rosenblum, MD, FAAP, the Director of the center
- Gopi Desai, MD,
- Laurie Gordon, MD, the attending and director of the Pediatric Inpatient Unit
- Sara Kopple, MD, FAAP, an instructor in Clinical Pediatrics from the Weill Cornell Medical College,
- Rachel Sharret, MD, Magdy Mohammed,MD, Andrew Sinesi, M.D., as well as Tiffany Sanchez, CPNP-attending physicians (New York Presbyterian Queens, n.d).
- Training of the staff members
The staff members are trained on simulation curriculum such as
- Video recording
- Scenario construction
- Designing simulation center
- Scenario construction
- Programming
- Simulation technician training
- Customized services
Procedure Training
- Vaginal Delivery
- Chest Tube Insertion
- Ultrasound Guided Central Line Placement
- Abdominal paracentesis
- Transcutaneous Pacing
- Non-Ultrasound Guided Central Line Placement
- Defibrillation/Cardioversion
- Ventilator Management
- Peripheral IV Placement
- Pericardiocentesis
- Thoracentesis
- Paracentesis
Team Training
This involves training of staff on team basis and they comprise of
- MI Team
- Cardiac Arrest Team
- Rapid Response Team
- Stroke Team and
- Trauma Team
Simulation Services
The organization also trained its medical professional staff different services such as
- Pre-hospital EMS education workshops
- Corporate first-aid
- Mass casualty
- Military trauma and
- Movies
- Conclusion
- A summary of the main points
- References
The Theresa Lang Children’s Ambulatory Center, located in Queens, New York, is a state of the art healthcare facility whose primary focus is the provision of specialty pediatric care. The healthcare facility offers care in various specialties such as cardiology, surgery, pulmonology, orthopedics, care for high-risk newborns, and neurology. In addition, the center also provides regular primary care, as well as follow-up care. The center is also a member of the Fit Kids Queens, which is a healthy lifestyle program for both overweight and obese children (New York Presbyterian Queens, n.d). The center’s staffing draws from an extensive range of pediatric specialists who are responsible for providing comprehensive medical care from birth through to the age of 21 years. However, the center’s primary target population is children. Its core mission is the provision of healthcare to this population.
As an ambulatory center, the Theresa Lang Children’s Ambulatory Center does not offer inpatient services to its patients. However, the center has access to pediatric inpatient units throughout the Queens area with teams of highly dedicated pediatric providers at hand to ensure that its patients receive the best care. The center appreciates the extensive diversity of the Queens area, and commits itself to respecting the cultural practices and beliefs of everyone who walks through its doors. The center is committed to ensuring that patients and their families whether hailing from Queens, other areas within the city or state, or anywhere else in the nation or around the globe, feel at ease. To ensure this, the center offers real-time translation services for at least 100 languages and dialects, such as, among others, Russian, Cantonese, Mandarin, Korean, Hindi, and Spanish (New York Presbyterian Queens, n.d). This enhances communication between care providers and patients and their families, further enhancing the quality of care provided.
In addition, the health center is both friendly and accessible, offering both appointments and walk-in options for those in need of urgent care. Accessibility is a central goal of healthcare centers. This is because access to comprehensive and quality healthcare is critical to the attainment of quality of life for affected populations. The Theresa Lang Children’s Ambulatory Center enhances access to healthcare for individuals aged 21 years and below (New York Presbyterian Queens, n.d). The center ensures access to health service by providing timely personal health services to guarantee the attainment of best health outcomes. Principally, accessibility to healthcare concerns the capacity to enter the healthcare system, access healthcare locations that provide needed services, and finding providers of healthcare with whom patients can communicate and build trust relationships.
The benefits of access to healthcare include, among others, deterrence of disability, disease, and preventable death, diagnosis and treatment of conditions and illnesses, enhancement of life expectancy, and overall quality of life, including overall mental, social, and physical health(New York Presbyterian Queens, n.d). Limited access to healthcare has significant negative effects, including undermining the capacity of individuals to attain their full potential, as well as negatively impacting their quality of life. This is primarily because limited access to health services results in unfulfilled health needs, delays in the receipt of necessary care, incapacity to attain preventive services, and hospitalizations, or even deaths that are essentially preventable. By ensuring accessibility of primary and critical healthcare services, the Theresa Lang Children’s Ambulatory Center deters the incident of these deleterious events, ultimately ensuring a quality of life for its target population.
Every year, the center receives at least 25,000 patients. Given that the largest proportion of the center’s patients is children, the center encompasses a child-friendly décor that offers children a relaxed and happy setting. In the year 2012, Splashes of Hope, a non-profit public charity whose aim is to transform the environments of hospitals, social service facilities, and healthcare centers, created new murals throughout the Theresa Lang Children’s Ambulatory Center, effectively brightening the center’s space (New York Presbyterian Queens, n.d). For young patients, trips to the healthcare center can be uncomfortable, or even frightening. Going to the hospital can be especially traumatizing to pediatric patients who in addition to the issue that prompts their visit, which is probably stressful on its own, are introduced to environments with unusual sounds and sights. As such, depending on the patients’ ages, they may develop unpleasant memories of hospital visits. Administering healthcare services to anxious patients, especially pediatric patients can prove quite difficult. The center attempts to prevent this situation by providing its patients with a bright, colorful, and relaxed environment. Without a doubt, the murals found throughout the healthcare center add a degree of warmth to the place, thereby making the experiences of pediatric patients and their families, as pleasant as possible.
In addition, the center’s staff members constantly strive to ensure that waiting times are as short as possible. The center’s initiative to undermine waiting times borrows from the established evidence that patients who do not have to deal with long waiting hours have better outcomes compared to those faced with lengthy waiting durations. In some instances, especially when dealing with serious health conditions, such as cardiac problems, each second is critical to the survival and recovery of the patient. To ensure that its waiting times are as short as possible, the Theresa Lang Children’s Ambulatory Center made undermining wait times a central element of its organizational culture (New York Presbyterian Queens, n.d).
The center made wait times a priority by implementing specific policies, including staffing policies whose mission is to address issues that can cause increased wait times. The center constantly evaluates its workflow and invests in innovative solutions to guarantee speedy delivery of care, such as automated systems that streamline scheduling in all the organization’s divisions. In addition, by offering both walk-in, and appointment options, the center integrates patient preferences into its scheduling strategy (New York Presbyterian Queens, n.d). Effective scheduling strategies focus on patients rather than providers. Therefore, by giving its patient access to a system that allows them to make their own appointments for minimally critical issues, the center effectively ensures that patients have minimal wait times. Furthermore, the healthcare center’s front-line scheduling approach ensures that non-life-threatening procedures and surgeries take into account aspects of supply and demand. This means that the center schedules patients for such procedures on days when the center is less likely to experience explosions in patient volumes.
One of the healthcare center’s primary focuses is pediatric cardiology. The center boasts of an amazing team of health professionals in this area. The center’s pediatric cardiology division is comprised of two full-time pediatric cardiologists who are board certified, as well as two pediatric echocardiography technicians who are also certified (New York Presbyterian Queens, n.d). The primary focus of the cardiologists is to provide healthcare for a wide array of conditions that affect newborns, infants, children, adolescents, as well as young adults. Professionals working at the pediatric cardiology division include Maria T. Thanjan, M.D, F.A.A.P, F.A.C.C,who is the director of pediatric cardiology, Ajay J Mirani, MD, FAAP, FACC, the attending, and pediatric echocardiographers Laura Lorito, R. D.C. S, R.D.M.S., and Nicole D’Alto, R.C.C.S (New York Presbyterian Queens, n.d). Some of the conditions, which the cardiologists treat, and which affect newborns, infants, children, adolescents, and young adults include fetal cardiac defects, sports clearance, chest pain, and congenital heart defects such as cyanotic and acyanotic defects. In addition, the cardiologists also deal with fainting, clearance of usage of ADHD medications, arrhythmias and palpitations, heart murmurs, cardiomyopathy, obesity, hyperlipidemia, obesity, genetic syndromes with associated heart disease, and acquired heart diseases such as rheumatic fever, Kawasaki disease, and myocarditis.
The center’s state of the art cardiology division offers modern diagnostic services such as ECG interpretation, exercise testing, both inpatient and outpatient consultation for cardiology, holter monitoring on a 24-hour basis, fetal echocardiography, pediatric echocardiography, and pediatric cardiac catheterization and surgery coverage, which are offered by physicians at health centers within the larger New York Presbyterian system (New York Presbyterian Queens, n.d). The center offers these urgent care and monitoring clinical services for walk-in patients as well as those brought to the specialized pediatric emergency unit with cardiac symptoms.
The healthcare institution prides itself on being a patient-centered healthcare facility. The center operates between 8 am and 8 pm on weekdays, and between 8 am and 12.30 pm on Saturdays. In a statement to its patients and their parents, the healthcare center considers a patient-centered healthcare institution as a care team whose leadership consists mainly of primary care physicians and whose primary focus is the individual needs of each patient’s health goals. The center further considers patient-centeredness as the coordination of patient care throughout every setting. In July 2014, the Theresa Lang Children’s Ambulatory Center attained Level III certification as a patient-centered medical home (PCMH) (New York Presbyterian Queens, n.d). To attain this objective, the center instituted an array of changes, such as introducing an Electronic Medical Record system, as well as the employment of additional personnel. Perhaps one of the most critical levels added to the center’s personnel is that of a care coordinator who is responsible for assisting patients with regard to coordinating care both within and without the center’s practice.
In addition, the center is presently in the process of advancing its certification from its current PCMH standards. The rationale for this is the continued provision of best care coordination for both the center’s patients and their families. Given this, the center is presently encouraging patients and their families to share their thoughts through a suggestion box located at the front desk. In addition, to evaluate its practices, the center presents its patients and their families with the capacity to take part in monthly quality improvement surveys located on the bulletin board near the intake room. Furthermore, to ensure the delivery of best care to its patients, the Theresa Lang Children’s Ambulatory Center commits to close checking and follow-up of critical preventative care, chronic care conditions, and mental health conditions (New York Presbyterian Queens, n.d). As a consequence, the center often dispatches letters or makes phone calls to inform its patients of crucial follow-ups, missed appointments, or irregular tests.
In addition, to maintain its attention on clinical care, the center’s policies do not allow patients and their families to refill prescriptions or forms during walk in hours. Instead, the center’s policy on prescription and form refills, following the prescription of primary care physicians, requires patients and their families to make requests through fax, mail, phone, or in person. Moreover, in its mission of comprehensive and quality healthcare provision, the center requires that infants below the age of 6 months to be seen every 2 months for check-up, those between 6 to 18 months to be seen every 3 month for check-up, those between 18 months to 4 years to be seen every 6 months for check-up, and those above 4 years to be seen by a care provider every year for checkup (New York Presbyterian Queens, n.d).
The Theresa Lang Children’s Ambulatory Center is also keen to follow laws affecting the healthcare system, including patient privacy and confidentiality of patient information. In keeping with this, the center maintains strict policies regarding the filing and storage of patient files and records. For instance, the center requires patients and their families to address medical records to the office staff, and allows patients to use the services of the care coordinator to obtain such records when faced with challenges. However, the center only approves such assistance once the care coordinator obtains a duly completed record transfer form (New York Presbyterian Queens, n.d). This policy aims at maintaining the confidentiality of patient medical records, in keeping with both state and federal laws.
Overall, the leadership of the Theresa Lang Children’s Ambulatory Center consists of highly competent healthcare professionals, including Robyn Rosenblum, MD, FAAP, the Director of the center, Gopi Desai, MD, Laurie Gordon, MD, the attending and director of the Pediatric Inpatient Unit, Sara Kopple, MD, FAAP, an instructor in Clinical Pediatrics from the Weill Cornell Medical College, attending physicians Rachel Sharret, MD, Magdy Mohammed,MD, and Andrew Sinesi, M.D., as well as Tiffany Sanchez, CPNP (New York Presbyterian Queens, n.d). These professionals make up an extraordinary team as their special interests range from medical education, hospital medicine, breastfeeding, mental health, development, immunization, child safety, to antibiotic use, infectious disease, and adolescent medicine. These interests provide for a comprehensive range of competencies that ensure that the center provides its patients with comprehensive and quality healthcare services. In addition to providing comprehensive and quality healthcare to its target population, the Theresa Lang Children’s Ambulatory Center also functions as a teaching site for residents and medical assistant students from Weill Cornell Medical College.
In addition to pediatric cardiology, the center also offers other subspecialty care; including services such as primary pediatric care, and acute care for established walk-in patients. In addition, the center also has access to a pediatric emergency department, a separate unit, which is dedicated to providing pediatric care in 16 semi-private areas used for patient assessments (New York Presbyterian Queens, n.d). The emergency division consists of specialist providers with pediatric emergency medical training that allows them to deal with trauma management, resuscitation, and routine pediatric conditions such as ear infections and fever. The center works in liaison with the larger New York Presbyterian network, thus is able to access easily specialists when none are available on site. The center’s pediatric emergency department consists of specialist nurses in pediatric emergency care, physicians, as well as associate providers with extensive experience in pediatric emergency medicine and pediatrics, and radiology services such as ultrasound, and CAT scan. As a network center of the New York Presbyterian Enterprise, the center can easily access a wide range of healthcare services, including transfers to other hospitals within the New York Presbyterian network, when needed.
In addition, the center provides follow-up services for high-risk newborns. As a central component of the New York Presbyterian hospital in Queens, the Theresa Lang Children’s Ambulatory Center plays a key role in ensuring the provision of quality care for vulnerable infants. A special clinic in the center provides follow-up services for premature, as well as high-risk infants following discharge from the hospital. At the center, these high-risk patients receive specialist care, including outpatient hearing screening, as well as access to specially trained neonatologists (New York Presbyterian Queens, n.d). Each year, the New York Presbyterian hospital maternity unit delivers at least 4,000 babies, approximately 700 of whom are admitted to the hospital’s Neonatal Intensive Care Unit (NICU) while over 3,300 babies are admitted to the newborn nursery. Upon discharge, all of these vulnerable patients require extensive care and follow-up, which is offered at the Theresa Lang Children’s Ambulatory Center, making the center a central player in the New York, Queens’ pediatric care.
Moreover, the center offers follow-up and outpatient care in pediatric endocrinology, as well as pediatric gastroenterology and nutrition. The pediatric gastroenterology and nutrition division offers appointments for non-urgent cases and emergency care for acute and urgent cases. The division comprises of board certified pediatric nurse practitioners and pediatric gastroenterologists who offer care for a range of nutritional and gastrointestinal problems such as abdominal pain, constipation, celiac disease, gastrostomy tubes and enteral nutrition, gastroesophageal reflux. The team is also specialized in handling feeding difficulties, food allergies, failure to thrive, obesity, complete parenteral nutrition, fatty liver disease, high cholesterol, and inflammatory bowel disease, which is managed by a team of multi-disciplinary practitioners (New York Presbyterian Queens, n.d). The division specializes in the provision of coordinated patient care through collaboration with pediatric radiologists, surgeons, pathologists, nutritionists, and speech therapists, as well as pediatric subspecialists and general pediatricians. Additionally, the pediatric gastroenterology and nutrition division works collaboratively with specialist adult gastroenterologists in cases that require advanced diagnostic or therapeutic procedures. The center also offers other services such as pediatric hematology, pediatric nephrology, pediatric neurology, and pediatric surgery.
In summation, the Theresa Lang Children’s Ambulatory Center is a care institution that offers general, as well as subspecialty pediatric care from birth to the age of 21 years (New York Presbyterian Queens, n.d). The center maintains flexibility by offering primary care through appointments, walk-in for established patients, and same-day visits. The center comprises of expert staff who are dedicate to assisting children and parents meet their health needs. The center assigns every child to an attending pediatrician with extensive knowledge and experience in pediatrics. The institution’s nursing, clerical, and medical staff is a fully dedicated team of professionals who work collaboratively to ensure that patients receive the best care. With the introduction of a care coordinator, the center is able to manage its scheduling and referrals with ease. Furthermore, the center has a pediatric social worker on hand to assist patients and their families. Ultimately, the expert personnel and warm setting make the Theresa Lang Children’s Ambulatory Center an exceptional center for access to quality and comprehensive pediatric care.
References
New York Presbyterian Queens. (n.d). Theresa Lang Children’s Ambulatory Center. Retrieved from http://www.nyhq.org/Theresa_Lang_Children_s_Ambulatory_Center