Issue link: https://beckershealthcare.uberflip.com/i/1541944
13 PATIENT & CAREGIVER EXPERIENCE Missouri systems perform nation's 8th domino pediatric heart transplant By Mariah Taylor T eams at St. Louis Children's Hospital and St. Louis- based WashU Medicine Heart Center performed its first living pediatric "domino" partial heart transplant. The achievement marks the eighth program in the U.S. to successfully complete a pediatric domino heart transplant, according to an Oct. 13 system news release. In the procedure, a first patient received a total heart transplant before having their aortic heart valve transplanted into another patient. The surgeries required the collaboration of more than 20 specialists in two operating rooms. In 2024, the program became the first in the nation to surpass 600 pediatric heart transplants. n meeting Sepsis-2 criteria. When certain clinical factors align, the BPA alerts the clinician and initiates the sepsis bundle process. We also use Epic's Sepsis Analytic Screening Tool, which runs in the background to predict who's at risk for developing sepsis. When a patient's score crosses a threshold, it alerts our rapid response team and bedside nurse to intervene before decline. One of the things I'm most proud of is our use of virtual care services in sepsis management. We employed tele-ICU physicians and nurses to follow up with bedside providers to ensure they are meeting bundle requirements when a BPA is triggered. Within three months of implementing that [in 2020], we saw a 30% improvement in bundle compliance. Our tele-ICU providers now touch over 5,300 patients a year across the system. Over the course of my career, I've seen as much as a 25% reduction in patients who would have gone to the ICU because we assisted, and were able to get them fluid and antibiotics as fast as possible. Q: Payers often rely on Sepsis-3 criteria, which can sometimes delay or deny coverage, while clinicians emphasize early intervention. How has Novant Health navigated these competing priorities? DF: As physicians, the last thing we need to worry about is the payer's definition of sepsis. Payers should rely on clinicians and medical literature. We need to cast a wide net, use Sepsis-2 criteria, and treat patients early and fast. Our clinicians and advanced practice providers feel very supported by Novant and our Center for Public Policy Solutions, which has issued a white paper outlining how legislation mandating standardized sepsis protocols in states like New York and Kentucky are saving lives. e organization has said, "What's best for patients is best for patients." ey trust our clinical know-how and have fully supported our decision to use Sepsis-2 as the best criteria for early identification and treatment. ere's been zero financial pressure from Novant — just trust in our ability to provide the best care. Q: What final thoughts would you like to share about advancing sepsis care in North Carolina and beyond? DF: North Carolina has high volumes of sepsis, and our outcomes could be better compared to other states, likely due to its rural nature and other economic disparities. We should recognize that North Carolinians are at a disadvantage because of that. North Carolina has an opportunity to do the first and most important step, which is mandating a single sepsis definition. Let's get rid of the concerns about payers and other people having a different definition. We really need to get to them early and fast, and we need governmental policy to help us along. n RWJBarnabas Health expands community health program systemwide By Paige Twenter R WJBarnabas Health, a 14-hospital system based in West Orange, N.J., said Oct. 9 it is widening its community health worker program across its enterprise. e program launched in 2023 to improve health outcomes while reducing barriers to care and hospital admissions. Since then, more than 100,000 patients have benefited from RWJBarnabas' community health worker program, according to an Oct. 9 news release. e system employs more than 70 community health workers — who are embedded in hospitals, federally qualified health centers, and homeless and community centers — to assist patients with health and social needs. RWJBarnabas has provided more than 116,000 rides for patients, the release said. Additionally, the system's community health workers have referred nearly 31,000 patients to community-based resources, scheduled more than 11,400 physician appointments and helped about 3,200 patients enroll in the Supplemental Nutrition Assistance Program. n