Pfizer Animal Health And American Humane Association Partner To Conduct Research On The Power Of The Human-Animal Bond In Pediatric Cancer Patients. - Veterinary Week

Pfizer Animal Health and American Humane Association announced a partnership to conduct a study on the impact of animal-assisted therapy on pediatric oncology patients, as well as on their parents, caregivers, siblings, and other close family members.

The partnership - which includes a $282,000 grant from Pfizer and the Pfizer Foundation - exemplifies the strategic goal of both organizations to better quantify in clinical terms what many in health care already realize as the extraordinary power of the human-animal bond.

'This important research will measure the impact of animal-assisted therapy on pediatric oncology patients and their families, thus furthering the fields of research on human-animal interaction and integrated therapies for conditions such as cancer in children,' said J. Michael McFarland, DVM, Diplomate ABVP and Group Director of Veterinary Medical Services & Corporate Citizenship for Pfizer Animal Health. 'We are proud to be part of the work that American Humane Association is doing - showing the far-reaching benefits of pets to our society.'

This partnership with American Humane Association's Child Protection Research Center and Animal-Assisted Therapy Program is an example of the Pfizer Animal Health Commitment to Veterinarians platform - which addresses the many challenges facing the veterinary profession through training and education, research and development, investing in the future, philanthropic efforts and the development of understanding around the human-animal bond.

Over the next three years, American Humane Association and Pfizer Animal Health will work with a total of 150 children at up to five hospitals or clinical settings throughout the United States that treat children with cancer. Researchers will examine the medical, behavioral and mental health benefits of animal-assisted therapy to quantify the effect on the family as a whole.

'Anyone who has ever seen a child turn to her pet for solace during a difficult time knows that a beneficial interaction is taking place there,' said Robin R. Ganzert, Ph.D., president and chief executive officer of American Humane Association. 'Our goal is to fully understand, from a scientific perspective, what is happening in these types of interactions with children undergoing cancer treatment. The question we are looking to answer is: In what ways can animal-assisted therapy improve the health and well-being of children - and their families - in their fight against cancer?'

Pfizer Animal Health also has recently become a Founding Partner in HABRI (Human Animal Bond Research Initiative) Foundation, which will deliver data, a central hub of research, awareness and evidence-based education about the impact of the human-animal bond. And, in 2009, Pfizer Animal Health funded a study to be completed this year that will formally measure clinical outcomes from therapy dog interactions with adult patients in inpatient oncology treatment and outpatient chemotherapy infusion settings. The study is being led by the Good Dog Foundation at the Continuum Cancer Centers of New York at Beth Israel Medical Center. Pfizer Inc.: Working together for a healthier world™ At Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. Our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world's best-known consumer products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world's leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, Pfizer has worked to make a difference for all who rely on us. To learn more about our commitments to animal health, please visit us at www.pfizerAH.com. About American Humane Association Since 1877, the historic American Humane Association has been at the forefront of virtually every major advancement in protecting children, pets and farm animals from cruelty, abuse and neglect. Today we're also leading the way in understanding human-animal interaction and its role in society. As the nation's voice for the protection of children and animals, American Humane Association reaches millions of people every day through groundbreaking research, education, training and services that span a wide network of organizations, agencies and businesses. You can help make a difference, too. Visit American Humane Association at www.americanhumane.org today.

Photos/Multimedia Gallery Available: http://www.businesswire.com/cgi-bin/mmg.cgi?eid=6719252&lang=en

Keywords: Oncology, Pediatric Cancers, Pediatric Carcinomas, Pediatrics, Pfizer Inc., Veterinary Research.

PFIZER ANIMAL HEALTH AND AMERICAN HUMANE ASSOCIATION PARTNER TO CONDUCT RESEARCH ON THE POWER OF THE HUMAN-ANIMAL BOND IN PEDIATRIC CANCER PATIENTS. - States News Service

MADISON, N.J. -- The following information was released by the American Humane Association:

Pfizer Animal Health and American Humane Association today announced a partnership to conduct a study on the impact of animal-assisted therapy on pediatric oncology patients, as well as on their parents, caregivers, siblings, and other close family members.

The partnership -- which includes a $282,000 grant from Pfizer and the Pfizer Foundation -- exemplifies the strategic goal of both organizations to better quantify in clinical terms what many in health care already realize as the extraordinary power of the human-animal bond.

'This important research will measure the impact of animal-assisted therapy on pediatric oncology patients and their families, thus furthering the fields of research on human-animal interaction and integrated therapies for conditions such as cancer in children,' said J. Michael McFarland, DVM, Diplomate ABVP and Group Director of Veterinary Medical Services and Corporate Citizenship for Pfizer Animal Health. 'We are proud to be part of the work that American Humane Association is doing -- showing the far-reaching benefits of pets to our society.'

This partnership with American Humane Association's Child Protection Research Center and Animal-Assisted Therapy Program is an example of the Pfizer Animal Health Commitment to Veterinarians platform -- which addresses the many challenges facing the veterinary profession through training and education, research and development, investing in the future, philanthropic efforts and the development of understanding around the human-animal bond.

Over the next three years, American Humane Association and Pfizer Animal Health will work with a total of 150 children at up to five hospitals or clinical settings throughout the United States that treat children with cancer. Researchers will examine the medical, behavioral and mental health benefits of animal-assisted therapy to quantify the effect on the family as a whole.

'Anyone who has ever seen a child turn to her pet for solace during a difficult time knows that a beneficial interaction is taking place there,' said Robin R. Ganzert, Ph.D., president and chief executive officer of American Humane Association. 'Our goal is to fully understand, from a scientific perspective, what is happening in these types of interactions with children undergoing cancer treatment. The question we are looking to answer is: In what ways can animal-assisted therapy improve the health and well-being of children -- and their families -- in their fight against cancer?'

Pfizer Animal Health also has recently become a Founding Partner in HABRI (Human Animal Bond Research Initiative) Foundation, which will deliver data, a central hub of research, awareness and evidence-based education about the impact of the human-animal bond. And, in 2009, Pfizer Animal Health funded a study to be completed this year that will formally measure clinical outcomes from therapy dog interactions with adult patients in inpatient oncology treatment and outpatient chemotherapy infusion settings. The study is being led by the Good Dog Foundation at the Continuum Cancer Centers of New York at Beth Israel Medical Center.

Pfizer Inc.: Working together for a healthier world(TM)

At Pfizer, we apply science and our global resources to improve health and well-being at every stage of life. We strive to set the standard for quality, safety and value in the discovery, development and manufacturing of medicines for people and animals. Our diversified global health care portfolio includes human and animal biologic and small molecule medicines and vaccines, as well as nutritional products and many of the world's best-known consumer products. Every day, Pfizer colleagues work across developed and emerging markets to advance wellness, prevention, treatments and cures that challenge the most feared diseases of our time. Consistent with our responsibility as the world's leading biopharmaceutical company, we also collaborate with health care providers, governments and local communities to support and expand access to reliable, affordable health care around the world. For more than 150 years, Pfizer has worked to make a difference for all who rely on us. To learn more about our commitments to animal health, please visit us at www.pfizerAH.com.

About American Humane Association

Since 1877, the historic American Humane Association has been at the forefront of virtually every major advance in protecting children, pets and farm animals from cruelty, abuse and neglect. Today we're also leading the way in understanding human-animal interaction and its role in society. As the nation's voice for the protection of children and animals, American Humane Association reaches millions of people every day through groundbreaking research, education, training and services that span a wide network of organizations, agencies and businesses. You can help make a difference, too. Visit American Humane Association at www.americanhumane.org today.

Research from University of Calgary, Department of Community Health Sciences yields new data on pediatric in children. - Health & Medicine Week

Investigators publish new data in the report 'A community-based physical activity program for adolescents with cancer (project TREK): program feasibility and preliminary findings.' According to recent research from Calgary, Canada, 'As the number of pediatric survivors continues to grow, a greater emphasis is being placed on identifying long-term health risk/protecting behaviors. The primary purpose of this pilot study was to examine the feasibility of a theoretically-based physical activity (PA) intervention in adolescents with cancer.'

'A group PA intervention was administered to participants over 16 weeks. Program attendance/adherence, total PA, physical fitness, and quality of life (QOL) were assessed at 5 different intervals over the 1-year study duration. Over a period of 6 weeks, 11 adolescents responded to recruitment efforts. Ten ultimately enrolled and completed the 1-year study. Overall, the program was well received with attendance over the 16-week intervention averaging 81.5%. Although improvements in total PA, physical fitness, and QOL were noted across the intervention, follow-up data revealed that participants failed to maintain their postintervention PA levels at both the 3 and 12-month follow-up assessments. Adolescents with a history of cancer are undoubtedly susceptible to the same maladaptive health habits as are their healthy peers. Innovative interventions aimed at improving their adherence to positive behavioral interventions, such as PA are warranted,' wrote M.R. Keats and colleagues, University of Calgary, Department of Community Health Sciences (see also Life Sciences).

The researchers concluded: 'Although not without limitations, this study provides preliminary data in support of a university-sponsored PA intervention.'

Keats and colleagues published their study in the Journal of Pediatric Hematology (A community-based physical activity program for adolescents with cancer (project TREK): program feasibility and preliminary findings. Journal of Pediatric Hematology, 2008;30(4):272-80).

For additional information, contact M.R. Keats, University of Calgary, University of Calgary, Dept. of Community Health Sciences, Calgary, Canada.

Publisher contact information for the Journal of Pediatric Hematology is: Lippincott Williams & Wilkins, 530 Walnut St., Philadelphia, PA 19106-3621, USA.

Keywords: Canada, Calgary, Life Sciences, Pediatric Hematology, Cancer, Oncology, Quality of Life, Exercise, Physical Fitness, Community Health, Behavior.

Level-of-care guidelines: interview with Lollie Dubiel, director of Behavioral Health, Mickesson Health Solutions. (Cover Story). - Behavioral Health Management

Level-of-care guidelines--prompting clinicians in making admisision and referral decisions up and down the healthcare continuum--are not new. The American Society of Addiction Medicine has been publishing them for years. What's more, a private firm--McKesson Corporation, a large pharmaceutical management and information technology company--has issued practice guidelines under the InterQual brand for a quarter century. It has only been in the last two years, though, that McKesson has made such algorithms available for behavioral healthcare. It introduced in 2000 criteria marketed under the InterQual brand for guiding adult mental health and substance abuse management decisions. Since then, McKesson Health Solutions has added instruments for managing adolescent and pediatric care. Geriatric and residential adolescent offerings are in development, with the former set to be released this fall. Recently Lollie Dubiel, director of behavioral health for the company's medical management group, discussed with Behavioral Health Management Editorial Director Richard L. Peck the concept of automated decision support and how it works.

Peck: Would you describe the InterQual Behavioral Health Criteria tool?

Dubiel: It is a decision-support tool using evidence-based, level-of-care criteria derived from the literature, nationwide clinical expertise and feedback from clients.

Peck: What does 'evidence-based' mean in this context?

Dubiel: Every year our staff submits to a national panel of experts-psychiatrists, psychiatric nurses, psychologists, pediatricians, teachers and social workers--proposed criteria revisions based on a literature review. Based on the panel's feedback and recommendations, the basic decision-support algorithms for the particular behavioral health criteria set are revised.

Peck: How do these algorithms work?

Dubiel: They are designed to guide the clinician in decision making from the initial assessment, to referral to appropriate level of care, to review of the appropriateness of continuing at that level, to referring the client up or down the continuum, to discharge. They do this with a series of linked questions and recommendations branching from the answers. For example, upon initial contact with a patient complaining of mental health symptoms, the decision tree raises the question of whether this patient is at immediate or potential safety risk. Based on the user's input, the algorithm might identify the patient as being at immediate risk and recommend hospitalization. If the algorithm identifies the patient as being potentially at risk, a series of prompts guides the clinician toward appropriate placement. In a case in which a patient presents with chemical dependency, an initial question would be whether the user is at severe, moderate or no risk of withdrawal. Again, the algorithm would recommend the most appropriate level of care.

Peck: For which caregivers and in what format are these programs available?

Dubiel: The hands-on users of these guidelines are typically care managers in a managed care organization (MCO). However, hospitals have used them for team clinical review meetings or in their clinical assessment centers. The criteria are available in a browser-based version under the name CareEnhance Review Manager, which is HIPAA-enabled to protect privacy, or in book form.

Peck: What kind of outcomes can you cite from the use of these instruments?

Dubiel: One example is of an MCO with 2.2 million covered lives that began using the Adult Psychiatric guidelines when they were introduced in 2000. The MCO reported about a 5% reduction in overall utilization in the first six months.

Peck: What kind of return on investment (ROI) might the user expect from this approach to level-of-care decision making?

Dubiel: In assessing ROI, there are three issues that the typical MCO looks at: First, there is usually significant variation among its clinicians with regard to clinical decision making. Many have different patient care philosophies and worldviews. Particularly on the mental health side, various caregiving professionals are involved with decision making-physicians, nurses, social workers, psychologists, each group with its own particular take on the situation. Use of decision-support criteria can help standardize the decision making while still providing a patient-specific approach based on the individual's presentation.

Second, if variations continue between clinicians' decision making and the established criteria, this might show that network expansion or other quality initiatives are in order. Or, it could demonstrate the cost savings that could be achieved by using the criteria appropriately.

Third, many plans experience a savings of clinical reviewer resources because of the increased efficiency of the review process itself.

In general, level-of-care criteria offer a way to break away from lockstep reauthorization of fixed amounts of days of care, such as renewals of seven-day inpatient stays. Clinicians now have guidelines for deciding whether the more appropriate referral might be partial hospitalization, or an intensive outpatient or outpatient setting, according to evidence-based clinical criteria.

Peck: Are there specific advantages to an automated format?

Dubiel: Having the criteria in an interactive, browser-based application enables organizations to gather data and produce useful management reports to identify any areas where they can improve care management processes. Well-designed software allows for flexible use of data and daily, monthly, quarterly and yearend reporting. Another major advantage of automation is its impact on workflow. Our program, for example, prompts staff on days when patient follow-up should occur and finds the necessary clinical review data for that patient to expedite the evaluation. Also, well-designed software should have a security function built in to help with HIPAA compliance.

Recent Findings from Oregon Health & Science University Highlight Research in Pediatric Research. - Pediatrics Week

Fresh data on Pediatric Research are presented in the report 'Apolipoprotein E4 and sex affect neurobehavioral performance in primary school children.' 'Apolipoprotein E4 (apoE4) and female sex are risk factors for developing Alzheimer's disease. It is unclear whether apoE4 contributes to behavioral function at younger ages,' investigators in the United States report.

'Standard neuropsychological assessments [intelligence quotient (IQ), attention, and executive function] and a test developed in this laboratory (Memory Island test of spatial learning and memory) were used to determine whether E4 and sex affect neuropsychological performance in healthy primary school children (age 7-10). A medical history was also obtained from the mother to determine whether negative birth outcomes were associated with apoE4. Mothers of apoE4+ children were more likely to report that their newborn was placed in an intensive care unit. A sex difference in birth weight was noted among apoE4-(males >females), but not apoE4+, offspring. Conversely, among apoE4+, but not apoE4-children, there was a sex difference in the Wechsler Abbreviated Scale of Intelligence (WASI) vocabulary score favoring boys. ApoE4-girls had better visual recall than apoE4+ girls or apoE4-boys on the Family Pictures test. Finally, apoE4+, unlike apoE4-, children did not show spatial memory retention during the Memory Island probe trial,' wrote S.F. Acevedo and colleagues, Oregon Health & Science University.

The researchers concluded: 'Thus, apoE4 may affect neurobehavioral performance, particularly spatial memory, and antenatal health decades before any clinical expression of neurodegenerative processes.'

Acevedo and colleagues published their study in Pediatric Research (Apolipoprotein E4 and sex affect neurobehavioral performance in primary school children. Pediatric Research, 2010;67(3):293-9).

For additional information, contact S.F. Acevedo, Oregon Health & Science University, Dept. of Behavioral Neuroscience, Portland Oregon 97239 USA.

Keywords: State:Portland, Country:United States, Apolipoproteins, Apoproteins, Lipoproteins, Pediatric Research, Pediatrics.

Studies in the area of pediatric in children reported from National Institute of Child Health and Human Development. - Diabetes Week

Current study results from the report, 'A multisite trial of a clinic-integrated intervention for promoting family management of pediatric type 1 diabetes: feasibility and design,' have been published. 'The feasibility of a family-based clinic-integrated behavioral intervention to improve family management of type 1 diabetes was evaluated. In each of four clinical sites, 30-32 families (a total of 122) were randomized to intervention or usual care comparison groups,' researchers in the United States report (see also Life Sciences).

'The WE*CAN intervention, based on family problem-solving methods, was delivered during three routine clinic visits by trained 'Health Advisors'. Of eligible families across the four sites, 83% agreed to participate, of whom 96% completed the baseline, mid-term, and postintervention assessments. Families participated in an average of 2.85 intervention sessions over an 8-month period. The intervention was integrated into the clinic setting without impairing clinic flow and was implemented with fidelity and consistency across sites by trained non-professionals. The findings provide evidence of the feasibility of conducting a multisite trial to evaluate the effects of a clinic-integrated problem-solving intervention to improve family management,' wrote T.R. Nansel and colleagues, National Institute of Child Health and Human Development.

The researchers concluded: 'Many lessons were learned that provide guidance for recruitment, measurement, and intervention for the larger clinical trial.'

Nansel and colleagues published their study in Pediatric Diabetes (A multisite trial of a clinic-integrated intervention for promoting family management of pediatric type 1 diabetes: feasibility and design. Pediatric Diabetes, 2009;10(2):105-15).

For additional information, contact T.R. Nansel, National Institutes of Health, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, DHHS, Bethesda, MD USA..

Publisher contact information for the journal Pediatric Diabetes is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA.

Keywords: United States, Bethesda, Life Sciences, Pediatric Diabetes, Type 1 Diabetes, Insulin Dependent Diabetes Mellitus, Child Health, Behavior.

Orlev slams government for failing to reform mental-health services. National Council of the Child head Dr. Yitzhak Kadman decries 'shocking' pediatric psychiatric treatment, 'collapsing' facilities - Jerusalem Post

JUDY SIEGEL
Jerusalem Post
01-12-2011
Orlev slams government for failing to reform mental-health services. National Council of the Child head Dr. Yitzhak Kadman decries 'shocking' pediatric psychiatric treatment, 'collapsing' facilities
Byline: JUDY SIEGEL
Edition: Daily
Section: News
Type: News

The Health Ministry conceded on Wednesday that there is a serious shortage of medical manpower in the public psychiatric service it runs, especially in the treatment of children and teenagers. The charge was made in Tuesday's meeting of the Knesset Committee for Children's Rights by chairman MK Zevulun Orlev (Habayit Hayehudi) as well as others attending the session.

'The Treasury has not learned its lesson from the Carmel Forest fire tragedy,' Orlev said. 'There, the development and reform of the Fire Service was held back. The Treasury regards the mental-health service as a hostage until reform begins.'
A 40 percent decrease in beds for minors in psychiatric hospitals has occurred during the last 15 years, according to data provided by the Knesset research and information department. Dr. Igor Barash, the deputy head of the Health Ministry's mental-health services said that when National Health Insurance began in 1995, structural reform was carried out and 200 hospital beds were eliminated in the hope that patients would be treated in the community. He added that the government thought more community facilities would be constructed, replacing many of the inpatient facilities. But solutions were not found, especially for children and teenagers.

Dr. Michal Rappaport of the Child Psychiatry Society, said that there are 170 pediatric psychiatrists in the country.

'When a child comes for treatment in a clinic, I allocate a year's care for him. Priority is given for serious cases, and 'light' cases such as parents' divorce or criminality have to wait long months while the problems get more serious,' she said.

'Children discharged from psychiatric hospitals are given drugs that stabilize them, but they need continued treatment, and in many cases, the health funds do not approve the recommended medications.'

The health insurers approve psychiatric drugs only for those with psychosis or schizophrenia, and not those with behavioral problems, she said.

Orlev said that the committee will make a surprise visit to facilities that treat children and have another committee session on the matter in six months. The committee criticized the Treasury's approach of holding back reform because of a 15-year dispute over the status of these services. It also discovered problems of coordination between the Health Ministry and the Welfare and Social Services Ministry, Orlev said.

National Council of the Child head Dr. Yitzhak Kadman said that state treatment of mentally disturbed children and youths was 'shocking' and that facilities are 'collapsing.'

The Health Ministry said it is working to advance the reform in which the health funds would provide psychiatric services instead of the ministry, which has inadequate budgets for such an undertaking. Deputy Health Minister Ya'acov Litzman previously had opposed the reform, but he said he reluctantly agreed to it almost two years ago. But it has not yet been implemented due to Treasury opposition.

To provide more pediatric psychiatrists, the ministry said it added 34 more job slots in the last few years and recognized pediatric psychiatry as a 'specialty with inadequate manpower,' offering salary bonuses to doctors who specialize in it.(c) Copyright Jerusalem Post. All rights reserved.

(Copyright 2011 The Jerusalem Post)

Understanding Children with Special Health Care Needs: A National Pediatric Nursing Challenge.(Brief Article) - Pediatric Nursing

The technologies of medical care have greatly improved in the last decades to the extent that infants and children are surviving, and in some cases thriving over, conditions that were previously lethal. These children are not unique to North America. Children with complex medical conditions, chronic illnesses, or disabilities exist around the world. They grow and develop along with their 'normal' peers, presenting unique challenges to their respective health and educational systems due to their complex needs. Nurses around the world take care of them. No matter what country these children live in, particularly in the industrialized world where a comprehensive health care system is a source of great national pride, we know historically that they are an underserved population. Traditional systems of care fall short of reaching children with complex medical, developmental or behavioral problems adequately. Families struggle to find services for them.

In the United States, it is now estimated that up to 30% of children aged 18 or younger have a chronic condition (Newacheck & Halfon, 1998) and that approximately 20% of these children have more than one condition (Newacheck & Stoddard, 1994). Children with chronic disease and disability make up a large proportion of the hospitalized and community-based patients we serve. These conditions often impact on development or behaviors of the child, with many having serious influence on all aspects of daily life. Pediatric nurses from all nationalities are called upon to understand and meet the care requirements presented by these special children in a variety of settings, and it is always an additional challenge when the systems of care impose barriers.

Issue Focuses on Children with Special Health Care Needs

It is for these reasons that this issue of Pediatric Nursing tackles topics related to serving children with special health care needs, and offers articles that represent a variety of international perspectives. As our industrialized nation confronts its own sad track record of serving the most vulnerable of its citizens, we need to be cognizant of what nurses do in the rest of the world. It is important to periodically glimpse at the research and programs of care provided by nurses in other nations. With insights from countries different from our own we can be proud of some of our advances and humbled by some of our shortcomings.

In addition to the international CE Series in this issue on children with special health care needs, the launch of the Maternal and Child Health Bureau (MCHB) national 10-Year Action Plan, 'All Aboard the 2010 Express' is highlighted (see pages 429, 432) to remedy some of the barriers that exist in today's medical approach to care. In this country, as well as in many others, we recognize that children do best when they have access to comprehensive, family-centered, culturally competent, coordinated, and fully inclusive systems of service at the community level. This document, a companion to Healthy People 2010, and its associated educational activities scheduled for distribution in December 2001, promise to children with special health care needs a commitment of service by multiple professionals predicated on establishing a 'medical home.' The notion of a medical home is intended to be a broad, inclusive term, meaning a source of ongoing, comprehensive care by a primary care professional in the child's community. The needs of the child and the family are central to the medical home approach. Professionals who are part of the medical home ideally develop a trusting partnership with families, respecting their diversity, and recognizing that families are the constant in a child's life as well as their most important caretakers (Achieving Success for All Children and Youth with Special Health Care Needs: A 10-Year Action Plan to Accompany Healthy People 2010, 2001, p. 10).

Call to Action for Pediatric Nurses

These recommendations are consistent with what pediatric nurses in the U.S. and around the world do. In the pages of 'All Aboard the 2010 Express,' as the ideas of family-centered care are folded into the descriptions of a 'medical home,' it becomes clear that nurses need to be at the front of this train helping to set the action plan in place. In coordinating services with the child's identified 'medical home,' providers can ensure that children have continuity of care from visit-to-visit, from infancy through transition into adulthood, as an organized team with an accessible, comprehensive, central record that contains all pertinent information about the child in a way that assures confidentiality. Nurses can make this happen. In the coming months as this plan unfolds, beginning with the October 1st National Child Health Day established by Congress, nurses need to actively engage in state and community activities to educate all professionals, administrators and policy makers with these materials so that new systems of service can be developed.

References

Achieving Success for All Children and Youth with Special Health Care Needs: A 10-Year Action Plan to Accompany Healthy People 2010. (2001). Washington DC: Department of Health and Human Services, Maternal Child Health Bureau.

Newacheck, P.W., & Halfon, N. (1998). Prevalence and impact of disabling chronic conditions in childhood. American Journal of Public Health, 88, 610-617.

Georgia facility sets a new standard: Willowbrooke at Tanner presents a brand-new behavioral health hospital to meet the state's growing needs.(DESIGN FOCUS)(Report) - Behavioral Healthcare

The state of Georgia waited 20 years for a new behavioral health hospital, a wait that was rewarded with Willowbrooke at Tanner, a 52-bed facility serving pediatric, adult, and geriatric clients that opened in April 2009 and set a new standard for care.

As part of Tanner Health System, the 50,000-square-foot Willowbrooke at Tanner facility, located in Villa Rica, averages more than 650 behavioral health assessments per month. Yet, despite this client traffic, it functions efficiently in terms of cost and staffing thanks to well-planned design led by Wayne Senfeld, the facility's administrator, Paula Gresham, the facility's assistant director, and Willowbrooke at Tanner staff.

[FIGURE 1 OMITTED]

In the early stages of the facility's development, Tanner benchmarked peer facilities nationwide and identified best practices. Then, it trusted staff to make the major design decisions. 'The cornerstone of the decision was the depth, quality, and commitment level of the behavioral health staff,' says Tanner President and CEO Loy Howard. 'They were really the lead--Wayne and his team.'

From the start, the design team sought to create a serene, natural aesthetic, free from any 'institutional' feel. The aesthetic begins with a landscape design that combines the site's willow trees with colorful foliage, year 'round. 'There's always going to be some color out here,' says Senfeld, 'whether it's fall foliage or flowers in the spring.' Clients can enjoy the environment in the facility's outdoor dining areas and courtyards.

The natural aesthetic is carried directly into the lobby (figure 2), which was developed by Mark Camp and Kevin Sutton of Advantage Office Solutions' commercial interior design division. 'We brought in botanical and leaf motifs and things that were very natural feeling,' says Camp. 'We took our color cues from a palette of beiges, browns, greens, and blues and kept it very calming and serene--almost like a spa.'

[FIGURE 2 OMITTED]

The lobby also features a 20-foot glass waterfall, which is 'kept at a nice, neutral flow all the time,' says Senfeld. Framed by large windows, he adds that the lobby and waterfall 'create a soothing environment that I think is very helpful in terms of treatment.'

The layout of the nurses' station (figure 3) helps to maximize staff efficiency, functioning as the hub of Willowbrooke at Tanner's single-floor layout. From the station, the staff has a line of sight--directly or via security camera monitors--to every area of the facility. 'You can be in the nurses' station and still be monitoring what's going on in a group room, the cafeteria, or the gymnasium,' Senfeld explains. 'You're constantly aware of the feel and the security of the building.' Wall-mounted computers in the hallways support paperless charting and enable staff to stay closer to the clients.

[FIGURE 3 OMITTED]

In addition to line of sight monitoring, sensors in client beds and hallways, developed by KNINE TECHnologies of Douglasville, GA, notify staff if clients leave or fall from their beds, or if clients are walking the halls.

Staff worked with a mechanical engineering firm, Addison Smith Mechanical Contractor, Inc. of Carrolton, GA, to develop client rooms that seamlessly merge comfort with mandatory safety features, including:

* Window blinds located inside two layers of shatter-proof Lexan glass, which are operated by a button inside the room;

* Breakaway hangers and shower curtains that support maximum loads of 15 pounds;

* Artwork mounted on foam-core board instead of traditional wood/glass frames;

* Piano door hinges; and

* Covered heating and air vents.

The seamless design of such features reflects the design team's determination to provide inviting, dignified surroundings. So, too, does the design of areas suited to pediatric, adult, and geriatric clients. Rooms in the pediatric wing (figure 4) are decorated with 'kid-friendly patterns and colors to make it more of a fun area,' says Sutton. Large circles in the corridor flooring were 'pulled into the room to continue a circular motif,' adds Camp, representing the full circle of treatment. Adult and geriatric wings, meanwhile, feature solid, contemporary colors that offer depth and richness and better reflect more mature tastes.

[FIGURE 4 OMITTED]

Common areas (figure 5) reflect similar thinking. For example, Camp and Sutton chose recliners and glider rockers for the geriatric common room. 'These give a little more comfort to clients who are less likely to be up and mobile,' says Camp.

[FIGURE 5 OMITTED]

Senfeld points out another client-focused feature: two flat-screen television sets in each common area. 'It has really bothered me over my career to go into a common area and see the patients huddled around a 19-inch television on the floor. They all have to watch the same thing. It's dehumanizing in a lot of ways,' he says. Multiple TVs, with DVD players located in the nurses' station, offer clients a choice of what they would like to watch.

Camp and Sutton selected furniture and materials that were pleasing to the eye, but easy to maintain. They chose vinyl-covered, componentized chairs that enable repair or replacement of damaged parts, rather than the whole chair. 'We used chairs to create seating and conversational groups. All three [common] areas also have tables,' says Camp.

The facility's most important treatment area, the expressive therapy room (figure 6), continues the design team's balance of durability and physical appeal. 'When you're dealing with mental health and emotional disturbance, there is a tremendous amount of energy, and that energy is often released in group and expressive therapy,' Senfeld says. 'Expressive therapy rooms get a lot of use, so we incorporated elements that are easier to maintain.' Marlite--a rough, plastic like material--lines the lower walls to resist marks and dents and maintain the look of the room, where clients go to explore their feelings through drama, art, and music.

[FIGURE 6 OMITTED]

Another high-activity area is the gymnasium (figure 7), which includes a rock-climbing wall. 'Clients need some downtime to go run around or shoot a basketball. So having that gymnasium has been really helpful,' says Senfeld, who adds that local schools assisted in fundraising for the climbing wall by collecting $5,000 in nickels and dimes.

[FIGURE 7 OMITTED]

Clients aren't the only ones to benefit from Willowbrooke at Tanner's amenities. The site hosts continuing education courses for its 100 employees in the classroom (figure 8). Because it is 'nearly impossible' to afford sending so many staff' off-site for required licensure training, Senfeld explains that 'we offer about 50 hours per year of continuing education credits to our staff.' The room features a SMART board and refreshment area, along with chairs and tables that offer flexible seating arrangements. It's a win-win: a comfortable, convenient, and cost-saving educational resource for all.

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Though the facility just opened last year, Willowbrooke at Tanner is already looking to the future. 'We have designed it so that we can add another 20 beds to it,' says Tanner's Senior Vice President Larry Steed. He adds that Tanner will also be looking into incorporating other treatment modalities, such as brain mapping for people with PTSD, into the core services at Willowbrooke at Tanner.

Well received by staff and clients alike, Willowbrooke at Tanner has set a new standard for behavioral healthcare delivery for Tanner and for the state of Georgia. 'Willowbrooke's development has confirmed how critical it is to include staff in a leadership role in the architecture, design, and flow of the facility,' Howard says. 'If you truly stay committed to that approach, you end up with a better facility that is really geared toward taking care of patients.'

RELATED ARTICLE: Furnishing Willowbrooke at Tanner

Mark Camp and Kevin Sutton of Advantage Office Solutions turned to dozens of furnishing manufacturers in their efforts to supply Willowbrooke at Tanner with the finest resources for the brand-new facility. Some of the furnishings featured throughout the facility were manufactured by:

* GlobalCare: Patient lounges, group and consultation rooms, dining room

* Kl: Continuing education seating

* Legacy Furniture Group: Lobby

* Recover Care: Client beds

* Teknion: Staff offices and training area

* Landscape Forms: Exterior furnishings

* Shaw Contract: Carpet

* Armstrong: Floor tile