New Jersey hospitals provide groundbreaking pediatric care to the state’s most precious resource: our children.
By Jennifer Lesser, Contributing Writer on August 10, 2021
In New Jersey hospitals, the most remarkable technological advances and advanced techniques are aimed at our state’s youngest residents. The state’s pioneering treatments and technologies for pediatric care cover a wide variety of health conditions that affect infants, toddlers and adolescents, whether from a chronic condition or traumatic injury.
Of course, when we talk about pediatric care, the state’s neonatal care services are at the top of the list of improvements. Camden-based Cooper University Hospital’s state-of-the-art services for its youngest patients include high-frequency ventilation and therapeutic hypothermia, while the pediatric intensive care unit is equipped with the latest technologies to treat the sickest and most seriously injured children with a team of both pediatric and adult trauma specialists. For complex medical or surgical needs, the Cooper Regional Children’s Hospital employs experts in 27 pediatric subspecialties.
“We do offer the most up-to-date treatments and technology, but I think one of the most advanced aspects of Cooper is that we live and breathe, compassionate, patient- and family-centered care that may not be groundbreaking. edge, but in many ways it’s really cutting edge,” said Dr. Michael Goodman, chief and chair of pediatrics at Children’s Regional Hospital at Cooper University Hospital. “Such an environment between caregivers, doctors, nurses and patients helps create a compassionate connection and leads to better outcomes and patient satisfaction scores…and we believe that the old-fashioned way of medicine – really caring about your patient – is the new way of medicine, especially in pediatrics.”
At Saint Peter’s University Hospital in New Brunswick, two of the latest advances in pediatric care include antisense oligonucleotide (AON) and gene therapies. AON therapies target specific RNA sequences and induce targeted protein reduction or repair; AON therapies currently approved in the US include treatments for spinal muscular atrophy, Duchenne muscular dystrophy, and acute liver porphyria. Virus-based gene therapy products are registered for ADA-Severe Combined Immunodeficiency (SCID), beta-thalassemia, Leber’s congenital amaurosis, and type I spinal muscular atrophy.
“The goal of gene therapy is to introduce a therapeutic or working gene copy at a level sufficient to improve or cure disease symptoms with minimal side effects,” explains Dr. Debra-Lynn Day-Salvatore, chair of the division of medical genetics and genomics. medicine at the University Hospital Sint-Pieters. She notes that there are currently hundreds of cell and gene therapy programs in clinical development. “DNA or gene editing techniques are currently at an early experimental stage, but they will open up new possibilities for personalized gene therapy by modifying specific, unique nucleotide sequences. Earlier diagnosis and treatment of genetic disorders reduces morbidity and mortality and improves quality of life and longevity.”
Of course, treating children is not without its challenges, especially those with progressive genetic disorders. “The first challenge is the ability to identify them early enough to prevent irreversible complications,” Day-Salvatore says. “Newborn screening has had a huge impact on infants with a certain subset of inborn errors of metabolism, and will undoubtedly expand in the future as viable therapies are approved.”
Infants and children also present several unique challenges in clinical trial design, including the need to always limit the number of procedures requiring sedation and radiation exposure. “Neuro-developmental assessments are also extremely important to evaluate treatment effectiveness in infants and children who are unable to answer questions or complete quality-of-life surveys,” adds Day-Salvatore.
But involvement in clinical trials is not the only challenge. Many of the state’s healthcare facilities are grappling with the same issues they face when treating adult patients, and how to make changes within their pediatric departments to improve both the quality of care and outcomes, and improve patient experience and satisfaction. improve the patient. “Children with medical complexity deserve and need more investment in direct care, time, and care coordination,” said Dr. Matthew B. McDonald, III, president and CEO of Children’s Specialized Hospital (CSH) in New Brunswick. That’s why he notes that the hospital is striving to shift its care delivery model from traditional fee for service to value- and outcome-driven payment. “Alternative payment models will enable our healthcare systems to deliver better care and a better experience to our patients,” he adds.
Children’s Specialized Hospital, an RWJBarnabas Health facility, provides rehabilitation and specialty care to nearly 40,000 children and youth at 14 locations in New Jersey each year, utilizing the latest and most advanced technologies available to its patients. “In our inpatient rehabilitation units, we leverage innovative ventilation and respiratory support technologies, advanced nutritional strategies, and create new, adaptive equipment to help our patients reach their full potential,” says McDonald. CSH also regularly participates in research aimed at creating adaptive technology for children and trials related to new treatments for autism, ADHD and cerebral palsy.
At CSH, advances in genetics have also had a significant impact on the patient population. For example, the early detection of genetic diseases allows doctors to tailor care to patients earlier in life. “There is a growing number of children with special care needs and a marked increase in demand for behavioral health services as the incidence of anxiety and depression increases,” he adds. “As the needs of our pediatric patients change, CSH will be there to meet their unmet needs so that each patient can reach their full potential.”
When it comes to pediatric care, collaboration is arguably one of the most important tools used by healthcare providers. A recent case — where spinal fusion surgery was performed at K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center in Neptune on a baby just a few days old — demonstrated the value of contacting experts to consistently develop new approaches. devise to meet the needs of each individual patient.
“We had a baby with a complicated fracture and dislocation of the cervical vertebrae, and when dealing with this type of injury, nobody has that much experience in how to deal with it because it’s such a rare injury,” says Dr. Lawrence Daniels, a neurosurgeon with Hackensack University Medical Center. It was the youngest case documented with this injury. In these types of pediatric cases, he explains, the first step is to assemble a team from plastic surgeons, adult spine surgeons to neurosurgeons to help determine the best way to care for each patient’s unique needs.
“We do a lot of spinal surgeries in the US, but they’re mostly performed on adults with degenerative diseases,” he adds. “We often come across situations where we have to be creative and use techniques that have been tested and shown to be effective in adult patients – using tools and devices and instruments and grafts that are also primarily for adults – and make it work in a certain way to do something very unique and sometimes in a one-off situation for pediatric patients.”
In pediatrics, having the latest technology at your fingertips is not always the solution, as is often the case in the treatment of adults. That’s why pediatric care specialists in the state’s top hospitals and care networks are constantly abreast of new approaches and techniques to treat the complex needs of children, whether micropreemie born before 26 weeks. pregnancy, a traumatic injury from an accident or after-school sports, or a chronic condition or illness such as cerebral palsy.
“We have all these technologies in medicine, such as computers and monitoring tools to, for example, protect the spinal cord during surgery, but if your patient is only a week old, those things are often not always useful. Daniel’s decision. “We need to constantly innovate in the way we work with a child’s anatomy and encourage our youngest patients to grow in a way that doesn’t hinder them in the future, yet gives them the opportunity to grow into healthy, thriving adults.” .”
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