Pediatric Oncology Care Southern Nevada Ala n Ike d a MD CMO, - - PowerPoint PPT Presentation

Pediatric Oncology Care Southern Nevada

Ala n Ike d a MD CMO, Cure 4 T he K id s F

• und a tio n

Inte rim Cha ir o f Pe d ia tric s, Summe rlin Ho spita l Me d ic a l Ce nte r 16 SE P 2019

Objectives

• Pro vide a b e tte r unde rsta nding o f pe dia tric c a nc e r

se rvic e s c urre ntly a va ila b le in So uthe rn Ne va da

• Pro vide a b e tte r unde rsta nding o f spe c ific fa c to rs

tha t mig ht dic ta te re fe rra ls o utside the sta te .

• Pro vide a b e tte r unde rsta nding o f a dva nc e s

a va ila b le to pro vide tre a tme nt lo c a lly

Cure 4 The Kids Foundation

• No n-pro fit o rg a niza tio n who se missio n a nd visio n in

sho rt: is to a dva nc e c ure s a nd pro vide a c c e ss to q ua lity me dic a l c a re fo r pa tie nts with c o mple x dise a se s with a fo c us o n pe dia tric he ma to lo g y a nd

• nc o lo g y
• At o ur fa c ility, we pro vide o utpa tie nt c a re . We

c o lla b o ra te with ho spita ls to dire c t inpa tie nt c a re fo r pa tie nts with o nc o lo g ic diso rde rs, a s we ll a s he ma to lo g y a nd rhe uma to lo g y

• Summe rlin a nd Sunrise Ho spita l
• T

he re is no lo ng e r c o mpre he nsive Pe dia tric He ma to lo g y/ Onc o lo g y se rvic e s a t St. Ro se Sie na no r Unive rsity Me dic a l Ce nte r (UMC)

Cure 4 The Kids Staff and Services

• Appro xima te ly 90 e mplo ye e s
• No n-o nc o lo g ic se rvic e s inc lude b o ne ma rro w fa ilure

syndro me s, c o ng e nita l c yto pe nia s, he mo philia , thro mb o philia , me ta b o lic g e ne tic dia g no stic s a nd infusio ns, rhe uma to lo g y, sic kle c e ll dise a se , e tc .

• Co mpre he nsive Multidisc iplina ry Se rvic e s
• L
• ng -T

e rm F

• llo w-Up, Sic kle Ce ll, Ble e ding a nd Clo tting

Diso rde rs

• Me d ic a l, Nursing , So c ia l Wo rk, E

d uc a tio n, Physic a l T he ra py, Be ha vio ra l He a lth

• T

umo r Bo a rd

• On-site : Onc o lo g y, Ra d -Onc , Pe d s Surg , Pe d s Pa th, UCL

A Pe d s Nsg (re mo te )

• Re mo te : UCL

A Muskulo ske le ta l T umo r Bo a rd

Behavioral Health

• Bo a rd-Ce rtifie d Pe dia tric Ne uro psyc ho lo g y
• Ne uro psyc h te sting
• Psyc ho lo g y, Re g iste re d Pla y T

he ra pist

• Anxie ty, fa milia l stre ss
• Child L

ife Spe c ia list

• De c re a se stre ss a t a ppo intme nts, a t first me e ting / sha ring o f

dia g no sis/ prio r to sta rting the ra py

• MSW
• Assist with fina nc ia l to xic itie s tha t is o fte n a so urc e o f stre ss

Physicians and NP’s

• Ab dul-Ra shid, Nik M.D.
• Co mple te d F

e llo wship a t Mo nte fio re , Alb e rt E inste in Co lle g e o f Me d ic ine NY

• Pra c tic ing in So uthe rn Ne va d a o ve r 10 ye a rs, Jo ine d us 2014
• Dire c to r o f Sic kle Ce ll Dise a se Pro g ra m
• Pa rt o f the Pa c ific Sic kle Ce ll Re g io na l Co lla b o ra tive
• Alhushki, Wa se e m M.D.
• Co mple te d F

e llo wship a t CHL A

• Jo ine d us 2013
• L

e a d Clinic ia n fo r L T F U

• Ayya na r, K

a nya la kshmi M.D.

• Co mple te d F

e llo wship a t Mo nte fio re , Alb e rt E inste in Co lle g e o f Me d ic ine NY.

• Jo ine d us in 2015
• F
• rme r Dire c to r o f Pe d ia tric Ne uro -Onc o lo g y a t the Unive rsity o f L
• uisville , K

Y. Dire c to r o f Onc o lo g y

Physicians and NP’s

• Jo se ph L

a sky I I I

• Co mple te d F

e llo wship a t UCL A

• Jo ine d us in 2017
• F
• rme r Dire c to r o f Pe dia tric Ne uro -Onc o lo g y a t UCL

A a nd Chie f o f Ha rb o r-UCL A Divisio n o f Pe dia tric He ma to lo g y Onc o lo g y. Dire c to r o f Ble e ding a nd Clo tting Diso rde rs Co mpre he nsive Clinic

• Be rg , Ang e la DNP, APRN, CPNP
• Ac hie ve d DNP fro m Unive rsity o f Uta h
• Dire c to r o f Spe c ia lty Se rvic e s a nd Pe dia tric Pa llia tive Ca re Pro g ra m
• Buitra g o , Je nnife r APRN
• Ac hie ve d APRN fro m UCL

A

• I

nte rim Chie f Nursing Offic e r

Patients

• Appro xima te ly 35,000 pa tie nt visits pe r ye a r
• Almo st 4,000 ne w pa tie nts se e n pe r ye a r
• 100-120 ne w o nc o lo g y pa tie nts se e n pe r ye a r
• L

e uke mia & L ympho ma , Bra in T umo rs, So lid T umo rs (no n-b ra in)

• L
• sing so me a b ility to e nume ra te d ue to Pe d ia tric Ne uro surg e ry
• Pa tie nt a nd pro g ra mma tic suppo rt:
• Ca nd le lig hte rs Child ho o d Ca nc e r F
• und a tio n o f Ne va d a , Ag a ssi F
• und a tio n,

Ama nd a Ho pe Ra inb o w Ang e ls, Ame ric a n Ca nc e r So c ie ty, And y Be ld y’ s E le c tric Stud io , Chris Ang e l, Cla rk Co unty Sc ho o l Distric t, Critic a l Ca re Co mic s, Do msky Gla ss, Gwe n Ste fa ni, Hyund a i Ho pe o n Whe e ls, Justin Avila , K e lly F e rtitta , K ya ’ s Smile s, Ma ke A Wish F

• und a tio n, NCCF

, Summe rlin Ho spita l Me d ic a l Ce nte r, T yle r Ro b inso n F

• und a tio n, ve g a s Wish, a nd ma ny o the rs
• Ove r ha lf-millio n do lla rs pe r ye a r thro ug h o ur Cha rity

Ca re Pro g ra m a nd write -o ffs

• De spite b e ing no n-fo r-pro fit, le ss tha n 2% o f Cure 4 T

he K id s F

• und a tio n

fina nc ia l e xpe nd iture s a re thro ug h phila nthro py

Cure 4 The Kids

• T

he Jo int Co mmissio n a c c re dite d

• Almo st 40,000 sq ft
• Dire c t pa tie nt a c tivity o n to p flo o r
• 15 pa tie nt ro o ms
• 18 I

nfusio n re c line rs with a t le a st o ne c ha ir fo r a c c o mpa nying fa mily me mb e r

• 2 Priva te suite s fo r lo ng infusio ns fo r iso la tio n

pa tie nts

• 3 pro c e dure ro o ms
• Se da tio n fo r BM a sp a nd b x, L

P, I T me ds, Jo int a sp, Skin b io psie s

Upcoming at Cure 4 the Kids

• F

urthe r b uilding o ur pa tie nt na vig a tio n pro g ra m

• Cla ssro o m a nd c urric ula
• F

ACT a c c re dita tio n fo r HSCT

• Auto ’ s, the n a llo ’ s
• T
• inc lude c e llula r the ra pie s, a s this will b e pa rt o f upfro nt the ra py in COG

tria l fo r HR B AL L

• Allo g e ne ic HSCT

L T F U Clinic

• Sub spe c ia lists in multidisc iplina ry c linic s

Cure 4 The Kids Foundation Clinic

Entry Way

Waiting Room

Waiting Room

Exam Rooms

Infusion Suite

Infusion Pod

Infusion Pod

View from Infusion Suite

Lab Space

Isolation Room

Procedure Room

Checkout

Summerlin Hospital Medical Center

• I

npa tie nt pa rtne r: Only ho spita l who wo uld b e lie ve in us

• Gre a t c o lla b o ra tio n to b uild wha t o ur c o mmunity ne e ds
• 17 b e d inpa tie nt unit iso la te d fo r Pe dia tric

He ma to lo g y/ Onc o lo g y

• E

ntire unit is HE PA filte re d

• I

npa tie nt c he mo the ra py, immune the ra py, COG studie s,

• utpa tie nt b lo o d pro duc t tra nsfusio ns, F

&N, e tc

• Hig h-Do se Che mo the ra py with Auto lo g o us Ste m Ce ll

Re sc ue (a ka . HD-c he mo w/ ASCR, a uto lo g o us tra nspla nt)

• So me insura nc e s se nd ing pa tie nts o ut-o f-sta te d e spite lo c a l se rvic e s
• T

he y a ppre c ia te the d iffe re nc e s b e twe e n a llo a nd a uto , b ut d o no t ma ke the d istinc tio n

• De ve lo p Pe d ia tric AYA Pro g ra m

Current Obstacles

• L

a c king Co mpre he nsive Onc o lo g ic Se rvic e s

• Pe dia tric Ne uro surg e ry
• Prima ry Child re n’ s Uta h Ne uro sc ie nc e s Pro g ra m will ha ve a Pe d ia tric

Ne uro surg e o n with suppo rt a t Sunrise Ho spita l

• Pe dia tric Ortho pe dic Onc o lo g y
• Gre a t c o lla b o ra tio n with UCL

A

• Ca n ha ve a pa tie nt sta rte d o n c he mo a s so o n a s o r fa ste r tha n a t the ir

c e nte r

• Outpa tie nt fo llo w-up c linic a t Cure 4 T

he K id s a fe w time s pe r ye a r

• Ac c e ss to the ir MSK

T umo r Bo a rd a nd spe c ia lists a s ne e d e d

• Pe dia tric HSCT

: Ce llula r the ra pie s, inc luding g e ne the ra py

• MI

BG T he ra py

• COG Pha se I

tria ls (ne a re st CHOC)

Other Inpatient Obstacles

• Pe dia tric Ne uro lo g y a t Summe rlin Ho spita l
• Awa iting c re de ntia ling
• Pe dia tric E

NT Onc o lo g y g a p a t Summe rlin a nd Sunrise Ho spita ls

• Ce rvic a l No de b io psie s ha ve no t b e e n a n issue

Other Obstacles

• Co lla b o ra tive e ffo rts with o utside ho spita ls
• We ha ve de ve lo pe d g re a t c o lla b o ra tive te a ms
• I

nsura nc e s o fte n c o ntra c t b a se d o n the ir c o sts

• Ma in issue ha s b e e n po o r c o mmunic a tio n
• I

nsura nc e s sho uld re vie w the ir c o sts a s so me pro g ra ms do no t tra nsfe r pa tie nts b a c k to o ur pro g ra m o r ma y b e ve ry de la ye d

• We ’ re fine if c a re is pro vide d, b ut it is a ha rdship o n the pa tie nt a nd

the ir fa mily

• L
• c a l ho spita l with a dult ne uro surg e ry pe rfo rming

tumo r re se c tio ns o n c hildre n do wn to pre -sc ho o l a g e s

• I

nsura nc e a c tio ns

• Ofte n will pro vide a utho riza tio n, the n no t re imb urse . T

hus we ne e d to wa it fo r L OA’ s to b e c o mple te d b y a dministra tio n o f ho spita l a nd insura nc e

Education

• UNL

V pe dia tric re side nts

• Unsure ho w lo ng this will c o ntinue
• Summe rlin Ho spita l F

P re side nts

• T
• uro DO stude nts
• Ro se ma n Unive rsity
• Ong o ing RN stude nt ro ta tio n
• De ve lo p o nsite c linic a l de ntistry pro g ra m a nd te a c hing ro ta tio n. F

e a sib ility e va lua tio n is o ng o ing fo r c linic a l, a s we ll a s te a c hing pro g ra m

• De ve lo p Pha rma c ist tra ining ro ta tio n
• We will pa rtic ipa te in upc o ming Me dic a l Sc ho o l
• UNL

V pe dia tric de ntistry

• UNL

V pe dia tric psyc ho lo g y

• RN ne w g ra dua te pro g ra m
• I

nte rmitte nt e xte rna l me dic a l stude nt a nd re side nt ro ta tio ns

• Po ssib le c o lla b o ra tio n fo r g e ne ra l o nc o lo g y ro ta tio n fo r fe llo ws
• MA e xte rnship

Research

• Co o pe ra tive Gro up (b ulk), I

ndustry-I nitia te d, I nve stig a to r-I nitia te d

• Co -PI

fo r NCORP, NCI Co mmunity Onc o lo g y Re se a rc h Pro g ra m

• Ho use d a t So uthe rn Ne va d a Ca nc e r Re se a rc h F
• und a tio n
• One o f o rig ina l me mb e rs fro m 1983 CCOP pro g ra m
• One o f 46 g ra nts a wa rd e d in 23 sta te s
• Ope ra tio na l g ra nt to ha ve c a nc e r re se a rc h tria ls a va ila b le fo r o ur c o mmunity
• Allia nc e , CAL

GB, GOG, E COG, SWOG, a nd o f c o urse o ur b e lo ve d COG (Child re n’ s Onc o lo g y Gro up)

• Ove r 100 stud ie s o pe n
• Multiple site s in L

a s Ve g a s

• 1 site in K

ing ma n, Arizo na

• 1 site in Arro yo Gra nd e , Ca lifo rnia
• 2 site s in Wa shing to n. Be lle vue a nd Re nto n
• So me stud ie s o pe n a t Ca rso n T

a ho e , Re no wn, a nd St. Ma ry’ s

Research

• COG
• Sta nda rd o f c a re fo r Pe dia tric Onc o lo g y c a re in the US
• I

n So uthe rn Ne va da , the se a re Only a t Cure 4 T he K ids F

• unda tio n,

Summe rlin, a nd Sunrise

• So me studie s a re c lo sing a t UMC
• I

ndustry-I nitia te d tria ls fo r he mo philia , o nc o lo g y, pe dia tric thro mb o se s, ra re dise a se re g istrie s, sic kle c e ll dise a se

• I

nve stig a to r-I nitia te d tria ls in le uke mia , b e ha vio ra l he a lth re spo nse s to c a nc e r the ra py, ne e ds huma n re so urc e s

• Our Physic ia ns se rve o n UNL

V a nd Ro se ma n I RB’ s

In The End

• Busy Pe dia tric He ma to lo g y/ Onc o lo g y g ro up

pushing to impro ve me dic a l te c hno lo g y fo r the future , while c a ring fo r tho se o f the pre se nt

• We ne e d mo re ho urs in the da y a nd/ o r ma npo we r
• E

a g e r a nd e nthusia stic to c o lla b o ra te with o the rs, b ut b ring the e xpe rtise to o ur c o mmunitie s

T ha nk yo u Que stio ns o r Co mme nts?