Connecting the Docs: Creating a Network Department

August 26, 2024 by Janet Essman Franz

Two adults smiling and looking at a child who is playing with a toy, with red and blue furniture in the background

Pediatric pulmonologist Keith Robinson, M.D., (left) and pediatric primary care physician Stan Weinberger, M.D., collaborate to share screening tools and track patient information across the network. (photo: David Seaver)

Many people note that a silver lining of the COVID-19 pandemic is that it forced people to collaborate remotely, accelerating innovations in teamwork and problem-solving. This is evident within the UVM Children’s Hospital and the pediatrics department at the Larner College of Medicine.

In 2020, pediatrics personnel at each of the six UVM Health Network hospital sites and five outpatient pediatrics primary care sites across Vermont and New York quickly came together, remotely, to stay abreast of COVID information for the patients served at these network sites. Collaborations soon expanded to other topics, including workflow, care quality, and social drivers of health. In 2023, pediatric care and nursery services blossomed into a cohesive academic network where providers connect regularly to learn from each other, share best practices, and solve problems in patient care and population health.

“We were collaborating previously, but we had separate practices,” says Keith Robinson, M.D., associate professor of pediatrics and vice chair of quality improvement and population health at UVM Children’s Hospital. “Now we are looking at processes and health outcomes centrally with site leaders from all the health care partners to improve pediatric outcomes across the network. It’s clearer that we’re all part of the same network department with the same academic pursuit and mission.”

Pediatric primary care providers throughout the network now meet monthly to share ideas. “Each site is unique and does things in different ways, and we’ve been able to share what we do and take things from each other’s sites to implement across all our sites,” says Stan Weinberger, M.D., associate professor of pediatrics, pediatric primary care division chief, and site director for pediatric primary care in Burlington and Williston, Vermont. “It’s been interesting and rewarding to work with our network colleagues in a more cohesive way.”

Asthma care, for example, has greatly improved through collaboration across the network, says Weinberger. “Asthma is one of the most common chronic illnesses that we see and the cause of many preventable emergency room visits. As much as we try to help families maximize control of asthma symptoms, it’s hard,” Weinberger says. “Central Vermont Medical Center was doing a nice job with triage nurses doing standardized check-ins with families and tracking information in a way that we had not yet figured out. It was nice to see this working, they piloted it, and we were able to bring that method to other primary care sites.”

side view of a person's face turned toward a laptop computer screen; the screen shows a person with a stethoscope around their neck and an infant in a perambulator in a hospital room, with medical equipment all around them.

Neonatologists use telehealth to provide specialized care across the region.

Another area of innovation has been in screenings for food insecurity and mental health during primary care and specialty care visits. All sites now use the same screening tools and processes to include screenings in the workflow, document and share the information, and follow up with patients and families, which leads to improved care and better outcomes.

As examples, when a screening identifies a patient who is experiencing mental health challenges or whose family struggles to buy food, that information becomes part of the patient’s electronic health record so that all providers who work with that patient have the same facts and can implement appropriate follow-up plans as a result

Inpatient care also benefits from more robust collaboration. Neonatologists at UVM Children’s Hospital frequently engage in telehealth visits with partners at other network hospitals for babies needing specialized care, and children with serious health issues receive the same high-quality care regardless of their medical home location.

Education and research have expanded through greater network connectivity. “We spread educational opportunities for residents, medical students and other learners across all the sites, along with opportunities for educational leadership,” says Weinberger. “A pediatrician or nurse practitioner at Central Vermont or Porter can take on leadership roles around education.”

Staying connected generates ongoing improvements in patient safety and care quality, says Robinson. Each month, representatives from pediatric inpatient, outpatient, specialty care, emergency care, family medicine, and family advisors gather online to share concerns and ideas.

Additionally, Robinson leads a quality and safety team that includes UVMCH Director of Patient Safety Caroline Hesko, M.D., M.P.H., Senior Quality Improvement Partner Kathleen Browne, LICSW, and Pediatric Patient Safety Coordinator Andrea Aldrich, M.S.N., RN CPPS, who meet weekly to review reports regarding patient safety and engineer solutions across the network.

Four people posing for a photo in front of a window in a corridor at the UVM Children's Hospital

Keith Robinson, Stan Weinberger, and UVM Children's Hospital and Pediatrics Department Quality and Safety Program team members Kathleen Browne, LICSW, and Caroline Hesko, M.D., in the Children's Specialty Center. (photo: David Seaver)

“Each site is unique and does things in different ways, and we’ve been able to share what we do and take things from each other’s sites to implement across all our sites. It’s been interesting and rewarding to work with our network colleagues in a more cohesive way.” 

— Stan Weinberger, M.D., associate professor of pediatrics, pediatric primary care division chief, and site director for pediatric primary care in Burlington and Williston, Vt.