National Recognition of the Shands Hospital for Children at UF

Last week, U.S. News released rankings of the top children’s hospitals in the United States. The Shands Hospital for Children at UF was ranked in the top 50 in seven of nine specialties evaluated. These results represent a marked improvement: In 2009 we were not listed by U.S. News in any specialty; in 2010, we were listed in one, and in 2011 six.

Clearly, steady progress is evident in the number of specialties for which we are recognized. Equally encouraging, however, is our ranking among the 14 children’s hospitals in Florida: We have the highest standing in three specialties — Cardiology and Heart Surgery, Diabetes and Endocrinology, and Gastroenterology — and the second-highest in Neonatology, and Nephrology.

As our pediatricians often say, “children aren’t small adults.” Those of you who are parents will no doubt endorse that statement from the standpoint of general behavior and development. From a medical standpoint as well, children are indeed quite different. They are more vulnerable to certain diseases than adults, and respond differently to treatment. Healing requires not only specialized technical skills adapted to tiny anatomical structures and small volumes of distribution, but also a sophisticated understanding of psychological development, family dynamics and family communication.

U.S. News uses a sophisticated methodology to assess three components of quality — patient outcomes (e.g., infection rates, survival from cancer, efficacy of treatment of chronic diseases such as asthma), process of care (which includes a reputation measure based on a survey of specialists), and a mix of 38 measures of care such as surgical volume, nurse-patient ratio and condition-specific clinics and programs. We can all be very proud of our pediatric faculty and children’s hospital administrators and staff for being recognized for their excellence by specialists in the field as well as by objective measures of patient care processes and outcomes.

Our progress in pediatric specialties reflects a partnership between the Department of Pediatrics in the College of Medicine and the administration and staff of the Shands Hospital for Children at UF. Their collaboration has embodied the ampersand in UF&Shands. Here is a listing of the seven specialties at the Shands Hospital for Children that have been recognized nationally for their excellence, along with their division directors:

Scott Rivkees, MD, professor and chair of the Department of Pediatrics and physician-in-chief of the Shands Hospital for Children at UF, provides the following perspective on the U.S. News results: “The recognition of so many of our pediatric programs as among the best in the United States, and the best in Florida, reflects the greatness of our department and children’s hospital. Realizing that the U.S. News ranking system favors large hospitals, it is especially gratifying to know that our programs as a group were the highest ranked among moderate-sized children’s hospitals in the entire country. The children and families who come here expect to receive the best treatment available anywhere, and our goal is to provide that level of care to each and every child.”

In our Strategic Plan for UF&Shands, we emphasize that we not only must invest in the bricks and mortar of our faculty practice offices and hospital facilities to create an appropriate environment for patient care, education and research, but we also must make parallel programmatic investments in the faculty and staff who create synergies among our missions. The Department of Pediatrics and the Shands Hospital for Children at UF embody this alignment between investment in space and people. On the facilities side, we are implementing our plan to create a contiguous 165-bed children’s hospital on the first four floors of the East wing of Shands, having created a new inpatient and outpatient oncology unit in 2010 and a new Pediatric Emergency Room in 2011. And we are now planning for a new hospital entry and lobby, with construction to begin this year. Regarding people, Dr. Rivkees, who arrived as department chair in 2011, is now actively recruiting clinical and research faculty and creating new paradigms in our clinical, research and education programs.

Here are some of the things we are implementing through the work of Dr. Rivkees and his faculty and staff, who no doubt will continue to advance all our missions in pediatrics:

1. In education, we have developed a novel curriculum for pediatric residents that distinguishes UF from all other programs in the U.S. Most residency programs provide the same training platform for house officers, irrespective of the trainees’ career goals. At UF, our new curriculum considers residents’ career aspirations and the changing landscape of medicine and biomedical research in the U.S. UF pediatric residents can now focus their education in key areas via the creation of four new tracks: Primary Care, Global Health, Public Health and Research. This differentiated curriculum is unique in the U.S. and builds on UF’s many strengths, and will allow us to help train the next generation of pediatric leaders.
2. Our pediatric fellowship programs have benefited from a new curriculum that focuses on the development of the intellectual and practical skills needed to be an academician. Fellows are matched with leading experts during their research and clinical training. Reflecting the success of our training programs, several pediatric residents and fellows have won prestigious awards and research grants during the past year.
3. In research and discovery, we are growing. Reflecting the strength of our pediatric research programs, the Department of Pediatrics has more than $37 million in grant funding, of which a sizable amount is from the National Institutes of Health. Our gene therapy program is one of the leading programs in the world, as is the research program in pediatric endocrinology. We are expanding in these areas and in all other subspecialty areas, with the addition of 10 new research faculty to our department in the past few months alone.
4. The department is developing a new discovery effort called the University of Florida Pediatrics Innovation Program, which will lead to novel approaches for the treatment of childhood diseases. This program encompasses gene therapy, stem cell therapy, and the discovery of new drugs and therapeutics for children. This will be a unique and transformational program.
5. We are adding vitality and programmatic changes to clinical care. We are modernizing our facilities to match our faculty strengths. On the heels of our renovation of the Pediatric E.R., we are renovating Shands Medical Plaza, where we see more than 30,000 children each year who have conditions that require the care of subspecialists. We also will soon be building a new gateway to Shands Hospital for Children at UF that will create a stand-alone children’s hospital image.
6. We are changing our clinical operations and will be implementing an open access policy, so children can be seen quickly when referrals are made. As we expand our outreach and ties with pediatricians throughout northern Florida, we will soon expand our circle of care to different areas in this region. Whereas patients have typically come to Gainesville for their care, we will now go to where the children live.
7. We are developing special programs or clinical centers of excellence. These multidisciplinary programs will bring together the expertise of different physicians to provide unparalleled care. Programs of excellence are being developed in several areas, including asthma, neuromuscular diseases, autism, rheumatology, epilepsy, chronic renal failure and childhood cancer. Through this new model of pediatric care, we will be better able to take care of children in Florida. These programs will also provide care for boys and girls across the United States, who require specialized services that only team-based care can provide.

Philanthropy has been extremely important in achieving these programmatic goals, along with progress towards phased completion of our children’s hospital. We are indebted to the Sebastian Ferrero Foundation, Stop Children’s Cancer, Climb for Cancer, the Children’s Miracle Network (including Dance Marathon), and many individual gifts from faculty and friends of the Shands Hospital for Children at UF. Collectively, the recent initiatives in education, research and clinical care that Dr. Rivkees and his faculty have initiated are already being recognized nationally. As these new programs take hold, we are becoming an even stronger pediatric department and hospital for children. Both are taking their place at the forefront of national leadership and innovation.

Forward Together,

David S. Guzick, M.D., Ph.D. Senior Vice President, Health Affairs President, UF&Shands Health System