Natalie Ronshaugen, M.D., Part of Task Force to Help Prevent Youth Sports Injuries

Natalie Ronshaugen, M.D., Children’s Sports Medicine, was part of a task force of doctors and youth sports organization leaders in the Lincoln area that compiled a half-hour training course and tips on preventing the most common youth sports injuries: concussions, overuse injuries and dehydration. Dr. Ronshaugen says that athletic trainers are readily available to high school and college players, but youth sports have fewer resources. Free, videotaped training sessions are available on the group’s website safekidslincoln.org, as well as tips for preventing, treating and assessing each of the injuries.

See the Sports Injury Prevention Task Force website

Read more on 10/11 Now

Read the Lincoln Journal Star article

Watch the KLKN news report

Crash Carts Now Have LED Laryngoscope Handles

All crash carts in Hubbard Center, Wiebe Tower and Specialty Pediatric Center have new LED laryngoscope handles. What’s new:

  • The laryngoscope handles have been moved to the bottom drawer of the crash cart with the blades.
  • The new handles use 2 “C” alkaline batteries (large handle) or 2 “AA” batteries (small handle) so are not being kept on a charging station on top of the crash cart.
  • Technology has evolved. This light is 3x brighter than the former halogen handles.
  • In the event a handle light does not work, replace the 2 “C” or “AA” batteries.
  • Two “C” batteries and 2 “AA” batteries have been added to the bottom drawer of each crash cart.
  • Old halogen handles and charging bases were removed from the top of all crash carts.

Please contact Sara Tremel, resuscitation program coordinator, or call 402-955 4564, with questions

Milk and Molasses Enemas Being Removed from Children’s

Milk and molasses enemas have potential adverse effects and are being removed from Children’s formulary and order sets. Other enema types are as effective without the same adverse effect potential, including dairy allergies. Milk and molasses enemas have been used historically as therapy for acute management for fecal impaction. There are mixed reports in the literature regarding the safety and efficacy of milk and molasses enemas. Some cases of severe clinical decompensation have been reported resulting in PICU admission and even death.

A clinical pathway for acute management of constipation is being developed for use in the Emergency Department and inpatient settings, with an ambulatory clinic pathway to follow.  Contact David Freestone, D.O., Pediatric Gastroenterology, with questions, or if you are interested in participating in pathway development.

Read more & see references

CARE ERG Presents Program on Disability Diversity and Inclusion on Oct. 20

On Wednesday, Oct. 20, Children’s Compassion, Access and Respect for Everyone of all Abilities (C.A.R.E.) employee resource group is hosting a session, entitled “Why Should Businesses be Talking about Disability as Part of Diversity and Inclusion?” Meaghan Walls, from Assistology, will present the what, why and a little how, regarding increasing disability inclusion in the workplace. This session takes place from noon to 1 p.m. Children’s staff can register through Cornerstone. For more information, email CARE@childrensomaha.org.

See the flier

Children’s Honors Pediatric Legends

In more than 70 years, Children’s has known some of the finest and most beloved physicians, innovators and pioneers who have served Children’s pediatric patients. Some of these individuals hold a special place in the lives of the patients for whom they cared, as well as with their peers. They are thought of as pediatric legends. Children’s has been recognizing these pediatric legends since 2003.

See the list of past Pediatric Legends

Pediatric Legends are considered based on their:

  • Significant contribution to pediatric health care in the community
  • Service in a leadership role
  • Contribution as an innovator, champion or pioneer in medicine or pediatric health care, and/or
  • Excellence in teaching or research

This past year, Children’s paid tribute to five Pediatric Legends who have dedicated their lives to delivering the very best health care to children. The five who were recognized for a lifelong commitment to improving the lives of children through medical innovation, research and advances in treatment included: Kimberly Hansen, M.D.; James Wax, M.D.; Carl Gumbiner, M.D.; Joseph Ellison, M.D., and Bruce Buehler, M.D., who was honored posthumously.

There was no recognition dinner due to the pandemic. Honorees were presented with their awards at their homes.

Bruce A. Buehler, M.D., Genetics

Bruce Buehler, M.D.

According to his nomination, Dr. Buehler was one of the rare “triple threat” physicians, in that he was a respected clinician, a well-known national and international researcher and he also led the Department of Pediatrics at UNMC School of Medicine.  Jay Snow, M.D., wrote, “Along with the late Steve Chartrand, M.D., Dr. Buehler developed the first, and by far, most successful joint Pediatric Residency in the country.”

Dr. Buehler is known as a giant in the field of pediatrics among many Nebraska medical professionals. He was born in Ohio, grew up in Chicago and studied medicine and genetics at the University of Florida. He was a veteran of the U.S. Air Force. In 1981, he moved to Omaha and began a career that transformed pediatrics across Nebraska. His visionary leadership and support extended from the Munroe-Meyer Institute, where he served as director, to the chairman of the University of Nebraska Medical Center’s pediatric department, impacting numerous areas of medicine and hundreds of colleagues. He was a champion for children and his mentorship and education of young professionals on genetics and medicine have created a chain reaction of revolutionary, outstanding care. Dr. Bruce Buehler’s immense contributions and care for children are paramount to his posthumous honor as a Pediatric Legend.

Joe Ellison, M.D., Pediatrics

Joe Ellison, M.D.

Dr. Ellison was born and raised in Long Island, New York. His first job at a drug store led him to become a pharmacist. His service in the U.S. Army inspired him to become a doctor, and his first child inspired him further to become a pediatrician. He earned his medical degree from Creighton University School of Medicine and completed his residency at Children’s. He helped more than a thousand patients over the 46 years he was a pediatrician in Omaha, known for his ability to build relationships with families. His calm and caring bedside manner touched many lives.

“I think Dr. Ellison is an excellent example of what a general pediatrician should be. Knowing everything about your patient all the time, both personally and from the medical standpoint,” remarked Paul Esposito, M.D. “He was consistent, caring and a major part of our community. I feel he is very deserving of this honor.”

Dr. Ellison cannot run errands in Omaha without a former patient or family approaching him. He has six children and thirteen grandchildren. His impact spans generations, even in his family. His youngest son, Scott, is a surgeon and his granddaughter, Hannah, is in medical school. He is a Pediatric Legend in practice, personality and connections across the community.

“When I saw him with kids, I was taken aback. I knew he picked the right profession the minute I realized what his profession was, and it wasn’t just being a doctor. It was being a counselor to kids and parents. Of course, it was being a doctor, but also being a father and grandfather to them,” Dr. Ellison’s daughter, Jeannie Powers, shared. “I had the privilege of seeing him in all of those roles. And he filled each one beyond any expectation I could have imagined. I’d say, ‘Dad, you done good.’”

Carl H. Gumbiner, M.D., Pediatric Cardiology

Carl Gumbiner, M.D.

Dr. Gumbiner served Children’s for three decades, and as chief medical officer for nearly 10 years. He was the first pediatric cardiologist at Children’s, as well as the first to be board-certified in Pediatric Critical Care. Dr. Gumbiner decided to become a doctor at an early age, following in the footsteps of his father, who was a physician. Originally from Chicago, he went to Northwestern Medical School. After serving in the U.S. Army as a general pediatrician, he trained in the subspecialty of Pediatric Cardiology at Texas Children’s Hospital. Dr. Gumbiner came to Children’s Hospital & Medical Center in 1983 as director of Pediatric Cardiology and Intensive Care. Back then, there were only seven ICU beds.

Dr. Gumbiner has a knack for relating to children and families to ease their fears and provide explanations. He would even juggle as a way to keep their minds off their medical situation. In 2010, he was named Children’s chief medical officer and senior vice president of Medical Affairs. Dr. Gumbiner still treated patients and always kept a physician’s perspective in mind as a leader. As Children’s has expanded, Dr. Gumbiner has been one of the visionaries behind the scenes, building meaningful programs, as well as culture. He is a cornerstone of Pediatric Cardiology and culture at Children’s and is honored as a Pediatric Legend.

“It has been my privilege to serve alongside Carl and observe his leadership firsthand,” said Rob Spicer, M.D., Pediatric Cardiology. “I’ve witnessed how deeply he cares for his patients, their families and his colleagues. I’ve appreciated his knowledge and skill as a fellow cardiologist—and benefited from his experience and expertise. Whether interacting with a patient, colleague or a medical student, Carl brings people together and brings out the best in them. He was a legendary teacher for students and residents — a friend to all, loved by many and respected by everyone,” said Dr. Spicer.

Kimberly A. Hanson, M.D., Ph.D., Pediatric Anesthesiology

Kimberly Hanson, M.D., Ph.D.

Dr. Hanson has been a cardiac anesthesiologist at Children’s since 2000. She has served on countless committees and started the Pediatric Anesthesia fellowship. She was a founding member of the Cardiac Anesthesia team and has provided countless anesthetics and care to many children in need.

According to nominator, Shannon Hoy, APRN, Pediatric Anesthesiology, Dr. Hanson trained and mentored many students, residents and staff throughout the years. “Without her, the Cardiac Anesthesia service line would not be what it is today,” said Shannon. “Kim has consistently placed a high priority on being an active and productive member of the team. She has traveled extensively around the world on mission trips with teams from Children’s, in addition to honoring her commitment to the children in the Omaha community. She will be greatly missed by our department and hospital as well as by the families she has taken care of over the years, who consistently ask for her to care for their children again and again.”

Her interest in science and medicine goes back as far as Dr. Hanson can remember. Born in California and raised in Omaha, Dr. Hanson’s diagnosis of the very rare Freeman-Sheldon syndrome meant numerous surgeries and extended time in the hospital as a child. However, her health never slowed down her drive and helped her relate with patients and families as a pediatric anesthesiologist. Throughout her long career in medicine, Dr. Hanson participated in groundbreaking research, comforted countless patients before and after surgery, made a difference in other countries on several mission trips and mentored colleagues—leading with kindness and empathy every step of the way. It is for these reasons and more that Dr. Hanson has been honored as a Pediatric Legend. 

James Wax, M.D., Pediatrics

James Wax, M.D.

Dr. Waxearned his medical degree in the same place he grew up—Wisconsin. He came to Omaha for his residency in pediatrics intending to return to the Packer state. A job offer to practice here led to Omaha being his home for the entirety of his career. Dr. Wax estimates he’s treated hundreds of patients over the years, but his colleagues say it was more like thousands. He is a great philanthropist, giving back whenever and wherever possible. He is a mentor—reminding younger doctors to keep compassion for families in mind. He regularly attends grand rounds, and colleagues admire his caring, engaging nature.

“From the time Dr. Wax arrived in Omaha in the late 1960s, he was an instructor. He felt that it was part of his mission to continue education and not just run the business of being a pediatrician,” said colleague, Jay Snow, M.D. “He gave his time, talent and treasure to the community in so many ways. When you take all of the components that he was, you can’t think of anything other than being a legend.”

His legacy as a Pediatric Legend includes his dedication to caring for children and families, as well as his enduring commitment to the community, colleagues and the profession.

“Dr. Wax was of the generation when pediatrics was first becoming a specialty. At that point, Omaha was a growing community, not a metropolis like it is now. The people that grew this hospital and this community are the people who were part of the original Children’s Hospital & Medical Center,” said Paul Esposito, M.D. “I think his legacy is his attitude, care for the community and care for people that he worked with. Children’s was a big part of his life. And he was a big part of Children’s life, too.”

Plan to Attend Physician/Provider Town Hall Oct. 13-15

Mark your calendars for this opportunity for physicians and providers to engage with physician executive leaders and hear what is happening at Children’s. See the Physician/Provider Town Hall schedule below. The sessions will all contain the same content.  All sessions are available via Zoom.

Wednesday, October 13
6 – 6:30 p.m.

Thursday, October 14
Noon – 12:30 p.m.

Friday, October 15
6 – 6:30 a.m.

Questions are encouraged and will be addressed at the meetings. Please email your questions to ThePulse@ChildrensOmaha.org by Oct. 11, with “Physician Town Hall” in the subject line.

To join from a PC, Mac, iPad, iPhone or Android device, please click this URL to join. https://childrensomaha.zoom.us/j/93418752183?pwd=bFkrNEpOajNvNTBZSGxQSzloS2FaZz09    Passcode: 089946

Nurses Featured, Honored in Pediatric Nurses Week Video Series

Children’s is sharing a series of nurse video profiles to help celebrate Pediatric Nurses Week and spotlight some of our highly skilled, caring nurses.

Click here to watch a story about Kerri Foulk, a nurse at Children’s Physicians, UNMC.

Click here to watch a story about Theresa Rhylander, a nurse in Children’s Pediatric Intensive Care Unit.

Click here to watch a story about Dani Bunger, one of Children’s private duty nurses.

Please offer your gratitude to our outstanding nursing staff this week (and year-round) and thank them for all the ways they improve the lives of children!

Children’s Earns 2021 CHIME Digital Health Most Wired Recognition

Children’s has earned the 2021 CHIME Digital Health Most Wired recognition from the College of Healthcare Information Management Executives (CHIME). Children’s achieved Level 8 designation in Ambulatory Care and Level 7 recognition in Acute Care.

The CHIME Digital Health Most Wired program conducts an annual survey to assess how effectively health care organizations apply core and advanced technologies into their clinical and business programs to improve health and care in their communities.

“These results are a testament to Children’s commitment to advance technology and innovation in support of providing the highest quality and safest care for the patients we serve,” says Jerry Vuchak, senior vice president & chief information officer. 

A total of 36,674 organizations were represented in the 2021 Digital Health Most Wired program, which includes four separate surveys: acute, ambulatory, long-term care and international acute. The surveys assessed the adoption, integration and impact of technologies in health care organizations at all stages of development, from early development to industry leading. For more information about the CHIME Digital Health Most Wired program, please go here. 

Technically Speaking: Sharing Resident Notes

Medical records belong to patients… or, in pediatrics, parents. At any time, a parent (or guardian) can walk into Health Information Management (HIM) and request a copy. But that’s a pretty big hurdle, so the government has been working to make accessing records easier for patients and families. In 2020, the ONC* Cures Act Final Rule (an information-blocking provision) went into effect. This stipulates, among other things, that health care organizations cannot block electronic access to most parts of a patient’s medical record; they must be shared freely. This includes (but is not limited to) clinical notes, lab and imaging results and medication and allergy lists.  You can read all about it here, but be prepared to spend several days digesting it. Fine. No big deal. We’ve actually been doing this for years.

But what about resident notes? Lots of us use those as a framework for our own notes.  Addend, make changes and sign. What happens to those? Well, up until now, the attendings had to click a button at the top of the note to share it. Otherwise it didn’t go anywhere. The reason behind this is that we didn’t want families to be confused by reading a resident note before an attending had a chance to review it and make corrections. Any inconsistencies could undermine trust in the team and/or hospital. So, because the note was created by a resident, it wasn’t shared by default. In cases when the attending forgot to click Share, we were out of compliance. Houston, we have a problem.

Fortunately, Epic came through with a fix. We are now able to separate sharing from releasing when it comes to notes. Sharing now simply means that a note is eligible to be released electronically. It’s not until it’s released that it actually gets pushed to patients and families.  And what magically releases these notes now? Voila—an attending signature! So going forward, all resident notes will be shared… it’s just that they won’t get released until they’re signed by a staff physician.

Parallel to all this, the Centers for Medicare and Medicaid Services (CMS) relaxed their restrictions on attendings utilizing student documentation for billing purposes. This led to student notes being addended and signed. Fortunately, the above also applies to student notes; they’re only released when signed.

Compliance achieved? Yep. Extra work required? Nope. Actually, this new behind-the-scenes workflow requires less work for us! That’s a win in my book!

If you have questions or concerns about this new process, please reach out! Thanks for all you do to keep our patients safe and our organization in compliance!

* Office of the National Coordinator for Health Information Technology

Stephen Dolter, M.D., CMIO

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