This is Chris Olson with the Becker Healthcare care podcast. And thrilled to be joined by doctor Nick H cam, Chief Medical Officer Rank and jordan Pdp at Bridge Hospital. He joins us today to discuss a among of other topics, where I can join model focused on using Play as el. Doctor Whole camp, thank you for joining us today. Thank you very much for having me. Yes. Of course. Would you please introduce yourself and tell us a bit about your background? Yeah. Well, The Chief Medical officer at Rank in Jordan and have been for about 24 years. I did a general pediatric residency here in Saint Louis and finished to 19 90, but joined Rank Jordan in 2000 and really proud of the fact that over that time we've really built and enhanced the model of care for a specific population of patients who, I think otherwise sort of under unattended to under addressed in healthcare community and have established ourselves an expert in the field of pediatric complex care, especially that part that involves the transition of these children from the complex care, the, acute care settings, Pediatric hospitals and ideally home where we you want all kids to be eventually. Thank you for that, doctor. You are on this program today to discuss a certain program in particular. But before we get into that, I'd like you to just expo a little bit on the health issues your monitoring most closely in 20 24. Well, my focus has always been on children with not complexity and in that realm, these days, the issues are that more and more of these children are coming out of hospitals because we're doing on the acute care and of care, such a better job of saving the lives of severely premature incidents of severely injured and children and children who spend long periods of time in the hospital after serious illnesses in the intensive care neonatal intensive care unit So the fact that the need for this kind of transitional care is growing. And at the same time the health care system hasn't really, I... In my opinion figured out how best to manage these kids who... When I trained, I finished training more than 30 years ago, we didn't really have to worry about a lot of these kids because they just didn't survive. So that's my focus these days is how to do a better job caring for this population that has come online just in my professional lifetime. Understood. Thank you again, doctor. So on that note, if you could please let us know how the care beyond the bedside program involved at Rank in Jordan, and what are few metrics? Well, the the care beyond the bedside model is really a a model of care that evolved from rank in Jordan sounding in 19 41 by Mary Rank in Jordan. And her goal was to give children a more child friendly, child normal experience, even though they had to be in anti hospital or hospital life setting, requiring lots of medical care. She discern that hospitals really no place for children to grow up. So created the space not home, but more like home, the kids could go to continue their recovery and she had, you know, Rose garden the she get the kids out too. She have birthday parties and celebrate life events as if they were home in a way that's just not tactical then or certainly now in conventional acute care hospitals. So it's really about getting kids back to childhood meaning getting them up and out of bed and out of their room and into places where they can play and interact or socialize with caregivers, staff members even other patients, which again is almost unheard of in conventional hospitals. We feel like that's essential to their emotional cognitive developmental physical progress in recovery in a way that is missing for these kids have to spend long periods of time in hospitals due to their medical complexity. And so the key metrics of that are well how good of a job do we do getting kids up and out of bed. And we are proud of doing that, we think better than just about anywhere else. But when we actually went to measure it, which I might add was a study that we couldn't find any evidence of ever having been done before actually measuring where patients were and what they were doing while hospitalized in the pediatric setting. So we measured we followed kids around and measured pay attention took very detailed observations about where they were, who they were with, what they were doing, What was going on in their environment. To get a sense of or how is how might their environment be affecting their progress development recovery? And just to a measure. Well, how much time are they spending out of bed, how much time are they spending out of the room, how much time are they spending well other people is really eye opening. These those results to modify enhance our approach and it led to the development of of really innovative new program, but looking forward to telling you more about that. Excellent. Thank you, Doctor. Yes. I'd love for you to expo a little bit more on where the program is now and what might be next for it. Well, when we first did this study, about 3 years ago, we noted that we we got kids up and out of bed about 5 hours per day that's a lot more than most hospitals. And out of their room almost 2 hours a day. The kids and these are kids with significant medical device support like tracheostomy, ventilators, central lines, gas tubes for artificial feeding. And those kids and other hospitals do not leave their room hardly at all. So if to get them out 2 hours a day was great, but we also noted that about 5 5 hours a day, they were in bed of loan not being attended to, which again, in our opinion just wasn't good enough. These are the critical developmental months and years of a young child life and we wanted to do better so developed a program that would offer kids developmental appropriate and stimulating opportunities with other hospitalized children structured around a curriculum, not unlike preschool that just gives good opportunities to learn together and most importantly to play. So we're really proud of that goal is to optimize the child's recovery. We call that that space the optimization zone. And so kids go to the and enjoy play and learning with other patients along with the medical staff that keeps them safe them well all the while. Sounds like the programs making tremendous product sector. And on that note, what advice would you give leaders who are similar to yours who might be looking to adopt your approach? Well, I understand how challenging it is in the conventional hospital setting. But I would say that we haven't up to this point paid enough attention to sort of the whole child view of healthcare care. We really focus on organ systems and body parts. For me, the most important thing is a child's development and and irr developmental outcome and long term progress in recovery, and we can start that in the acute care setting if we pay attention to those elements that kids or ordinarily don't have opportunities to do when they're in a high medical intent for the environment. So more attention to the whole child and to the families ability to be there and interact with the child and finally play play in my opinion highly underrated as as of therapeutic benefit we think it's the central therapeutic elements for these children without play, you're not going to get the best result for kids who are recovering from whatever problem got them there in the first place. Thank you so much for detailing all of that, Dr. H and that's very heartwarming what Rank and Jordan is doing? Find a question for you. What your in healthcare care do you think deserves a brighter spotlight at the moment? I think again, I'm focused mostly on this small, I call the small but mighty population of pediatric patient 1 percent of patients generally fall into this category called children with medical complexity. But they account for about a third of pediatric healthcare resource use and some estimates show more than half of all pediatric acute care hospital days are consumed so to speak by this 1 percent of patients. So I think more retention needs to be paid a to this population but also while we invest so much in terms of resources, and dollars and energy and attention into these kids on the acute and once they are discharged from hospital, all that responsibility falls on the families and I'm confident that we're not meeting all of the family's needs who then take over the care of these very challenging patients in many instances. So more attention to what we're not currently doing to meet the needs of families of these children and the children themselves is where I think healthcare care needs to dev devote a little bit more time and attention. Okay. Thank you for being so generous with your time and insights today. We absolutely cannot wait to share them with our audience, and we look forward to connecting with you soon. Well, thank you very much again for, letting me share a little bit about our work here, and I happy where we can help get the word out and hopefully more progress will be made in the care of these kids moving forward.