2023 Annual Report
Orlando Health Arnold Palmer Hospital for Children has provided experienced, compassionate care to the children, teenagers and young adults of Central Florida for more than 30 years. Led by world-renowned doctors and together with dedicated specialists and caregivers, Orlando Health Arnold Palmer offers a wide range of advanced pediatric services in an environment built just for kids. 2
Table of Contents A Message from the President......................... 4 A Look at Our Numbers....................................... 5 Our Accolades........................................................ 7 Our Locations.......................................................... 10 Our Specialties ....................................................... 12 Featured Services Cardiology......................................................... 14 Craniomaxillofacial Surgery ....................... 16 Emergency and Trauma............................... 18 Gastroenterology ........................................... 20 Genetic Testing and Counseling.............. 22 Hematology and Oncology ....................... 24 Neonatology and Perinatal Medicine.... 26 Nephrology........................................................ 28 Neurosciences.................................................. 30 Orthopedics...................................................... 34 Physical Medicine and Rehabilitation .... 36 Radiology........................................................... 38 Healing Beyond Our Walls................................. 40 Research/Clinical Trials....................................... 46 Pediatric Residency and Fellowship.............. 48 Caring for the Whole Family ............................. 50 Pet Therapy.............................................................. 52 Philanthropy............................................................. 54 3
A Message From the President Greetings, I am pleased to present the Orlando Health Arnold Palmer Hospital for Children Annual Report for 2023. We remain steadfast in our commitment to provide the highest quality pediatric care, while expanding access to specialty services throughout the Central Florida region. This year, we celebrated the opening of a new pediatric colorectal program for children diagnosed with colon function issues, the first of its kind in Florida. We also opened a pediatric specialty clinic on the campus of Orlando Health South Lake Hospital that offers care in gastroenterology, rheumatology, neurology and urology, another first of its kind for the area. During 2023, we earned some of the highest quality honors in healthcare. U.S. News and World Report named Orlando Health Arnold Palmer Hospital one of the nation’s best children’s hospitals for the 14th consecutive year. For the third time, Orlando Health Arnold Palmer Hospital for Children and Orlando Health Winnie Palmer Hospital for Women and Babies have achieved the prestigious Magnet designation from the American Nurses Credentialing Center (ANCC), the highest distinction a healthcare organization can earn for nursing practice and quality patient care. And we continue to be one of only two pediatric hospitals in the state – and the only one in Central Florida – to hold both Level 1 trauma and surgery verifications from the American College of Surgeons. Looking to the future, the Orlando Health Children’s Pavilion is now under construction. A six-story, 189,000 SF pediatric outpatient care facility that will house more than 30 pediatric specialty practices, offering truly coordinated multidisciplinary care to the children of Central Florida and beyond. I am deeply thankful for our dedicated physicians and team members, who continuously demonstrate their commitment to excellence and passion for offering hope and healing to the children and families we serve. Respectfully yours, Justin Williams President, Orlando Health Arnold Palmer Hospital for Children Senior Vice President, Orlando Health 4
A Look at Our Numbers Total Beds 298 Visits Discharges+ 9,502 Average length of stay 3.8 days Total ER visits 117,679 • Orlando Health Arnold Palmer 57,091 • Affiliated hospitals 60,588 Level 1 trauma alerts 418 Outpatient visits 310,478 Surgeries 6,068 Team Members+ 2,000 Providers+ 287 • Physicians+ 200 • Advanced practice providers+ 87 Residents* 42 Fellows* 25 Nurses+ 818 Volunteers 202 Primary care pediatricians in CIN 197 Payer Mix Medicaid 62% Managed care/commercial 35% Self-pay 1% Other 2% Locations Pediatric emergency departments 1 Community emergency locations 17 Satellite practice locations 12 *Academic year is from July 1 – June 30. Data reflects 2022/2023. + Includes neonatal intensive care unit (NICU) at Orlando Health Winnie Palmer Hospital for Women and Babies. 5
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Our Accolades U.S. News & World Report – Ranked in Four Specialties The year 2023 marked the 14th year in a row that Orlando Health Arnold Palmer has been ranked as a “Best Children’s Hospital” by U.S. News & World Report, a global authority in hospital rankings and consumer advice. With designations in pediatric diabetes and endocrinology, pediatric orthopedics, pediatric pulmonology and lung surgery, and neonatology, Orlando Health Arnold Palmer is the most recognized children’s hospital in Central Florida. American College of Surgeons Surgical/Trauma Verification Recognized for the highest level of pediatric surgical care, Orlando Health Arnold Palmer also has achieved Level 1 Children’s Surgical Verification and Level 1 Trauma Verification by the American College of Surgeons (ACS). We are one of just 20 facilities nationwide – and the only facility in Florida – to achieve this level of excellence. Magnet Recognition Meeting the gold standard in nursing excellence, Orlando Health Arnold Palmer is among fewer than 650 out of a potential 6,000+ U.S. healthcare organizations to earn Magnet Recognition from the American Nurses Credentialing Center’s (ANCC) Magnet Recognition Program. We’re proud to have earned our third designation. Intersocietal Accreditation Commission – Echocardiography Accreditation In 2023, Orlando Health Arnold Palmer reached a Bronze Milestone Recognition, marking 20 years of IAC Echocardiography accreditation. The accreditation signifies that Orlando Health Arnold Palmer has demonstrated expert care and better outcomes for patients through a review of critical operational and technical standards. The Orlando Health Arnold Palmer Hospital Pediatric Epilepsy Center is accredited by the NAEC as a level 4 epilepsy center. Level 4 epilepsy centers have the professional expertise and facilities to provide the highest level medical and surgical evaluation and treatment for patients with complex epilepsy. 7
Orlando Health Children’s Pavilion – Coming 2026 The region’s first and only advanced facility to provide comprehensive, coordinated and compassionate specialized care tailored to the needs of children and families. This six-story marvel will revolutionize outpatient pediatric care, uniting over 30 pediatric specialties and services in one location. Fostering seamless collaboration among specialists and ensuring a smoother experience for all, this monumental project promises to elevate the standard of outpatient pediatric care. Join us in creating a haven where children’s health and well-being are the top priority. If you would like to learn more or donate to this project, please scan this QR code. 8
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Our Locations Pediatric Emergency Room • Orlando Health Arnold Palmer Hospital for Children Bert Martin’s Champions for Children Emergency Department and Trauma Center Specialty Practice Locations • Downtown Orlando • Celebration • Clermont • Lake Mary • Lake Nona • Maitland • Melbourne • MetroWest • Osceola • Spring Lake – Dr. Phillips • Summerport – Winter Garden • Titusville • Winter Springs Hospitals and Emergency Rooms All Orlando Health emergency rooms (ER) are trained in pediatric emergency medicine by board-certified physicians from Orlando Health Arnold Palmer. • Orlando Health Orlando Regional Medical Center • Orlando Health Arnold Palmer Hospital for Children • Orlando Health Winnie Palmer Hospital for Women and Babies • Orlando Health Dr. P. Phillips Hospital • Orlando Health — Health Central Hospital • Orlando Health Horizon West Hospital • Orlando Health South Lake Hospital • Orlando Health South Seminole Hospital • Orlando Health St. Cloud Hospital • Orlando Health Advanced Rehabilitation Institute • Orlando Health Bayfront Hospital • Doctors’ Center Hospital Orlando Health – Bayamón • Doctors’ Center Hospital Orlando Health – Dorado • Doctors’ Center Hospital Orlando Health – Manatí • Doctors’ Center Hospital Orlando Health – San Fernando de la Carolina • Doctors’ Center Hospital Orlando Health – San Juan • Orlando Health Emergency Room – Randal Park • Orlando Health Emergency Room – Reunion Village • Orlando Health Emergency Room – Lake Mary • Orlando Health Emergency Room – Osceola • Orlando Health South Lake Hospital Emergency Room – Blue Cedar • Orlando Health South Lake Hospital Joe H. and Loretta Scott Emergency Room – Four Corners • Orlando Health Emergency Room – Crossroads • Orlando Health Emergency Room – Pinellas Park • Doctors’ Center Hospital Orlando Health Emergency Center – Arecibo • Doctors’ Center Hospital Orlando Health Emergency Center – Barrazas 10
Opening 2026 Opening 2026 Opening 2024 Opening 2025 Opening 2025 Opening 2025 Lake Nona St. Cloud Kissimmee Davenport Lakeland Plant City Zephyrhills Tampa Celebration Dr. Phillips Horizon West Four Corners Clermont Winter Garden Ocoee Turnpike Avalon Park Winter Park Oviedo Winter Springs Lake Mary Daytona Beach Apopka Mt. Dora Leesburg The Villages Ocala Turnpike Altamonte Springs Orlando Melbourne St. Petersburg Wesley Chapel Lutz Waterford Lakes 22 10 52 30 53 3 Ponce San Juan Carolina Barrazas Caguas Bayamón Manatí Arecibo Humacao Fajardo Puerto Rico Dorado San Juan Humacao Arecibo 4 75 95 75 275 Orlando Health Hospitals ERs & Pediatric ERs Pediatric Specialty Practices 11
Our Specialties Pediatric Services • Adolescent Medicine • Adult Congenital Heart Disease • Anesthesiology • Audiology • Behavioral and Developmental Pediatrics • Bone Marrow Transplant • Cardiac Critical Care Medicine • Cardiology and Cardiac Surgery • Cardiovascular Anesthesia • Child Abuse • Complex Care and Transition • Craniomaxillofacial Surgery • Critical Care Medicine • Emergency Medicine and Trauma Care • Endocrinology and Diabetes • Gastroenterology • Genetics • Hematology and Oncology • Infectious Diseases and Immunology • Interventional Radiology • Neonatology • Nephrology/Dialysis • Neurology • Neuropsychology • Neurosurgery • Orthopedic Surgery • Otolaryngology (ENT) • Palliative Care • Pathology • Pediatric and Adolescent Gynecology • Pediatric Hospital Medicine • Pediatric Residency Education • Physical Medicine and Rehabilitation • Psychology • Pulmonology and Sleep Medicine • Radiology • Rheumatology • Sports Medicine • Surgery • Urology Our Multidisciplinary Clinics • Aerodigestive Center • Amplified Musculoskeletal Pain Syndrome Clinic • Bleeding Disorders Clinic • Brachial Plexus Clinic • Burn Clinic • Central Nervous System Tumor Comprehensive Clinic • Cleft Lip and Cleft Palate Clinic • Congenital Chest Disorders Clinic • Craniosynostosis Program • Cystic Fibrosis Center • Feeding Difficulties Center • Fetal Care Center • Fetal GI Anomalies Clinic • Healthy Lifestyles Program • Liver Disorders Clinic • Neurofibromatosis Clinic • NICU Development Clinic • Plagiocephaly Clinic • Pulmonary Hypertension Clinic • Spasticity Program • Spina Bifida Program • Velopharyngeal Dysfunction Clinic • Voiding Dysfunction Clinic • Wheelchair Clinic 12
Featured Services 13
Cardiology and Cardiovascular Surgery With more than 20 years of expertise in pediatric cardiology, Orlando Health Arnold Palmer offers families an unmatched level of trust and confidence in knowing their child is receiving the best care. The Heart Center at Orlando Health Arnold Palmer brings together leading-edge cardiologists and cardiac specialists with expertise in the diagnosis and treatment of infants, children and adults with congenital heart disease. With our close relationship with Orlando Health Winnie Palmer Hospital for Women and Babies, many patients treated in The Heart Center are diagnosed before or at birth and are able to receive immediate care. From routine checkups to complex heart surgery, families from Central Florida and beyond depend on Orlando Health Arnold Palmer for a wide range of pediatric heart services. Highlights • Top ranked pediatric cardiology and heart surgery program in Orlando • The largest team of pediatric cardiac care physician specialists in Orlando • Performing the highest volume of complex cardiac procedures in Central Florida, with a cardiac survival rate exceeding 97%, according the Society of Thoracic Surgeons 3,365 New 8 Patients Locations 345 Cath Lab Cases Heart Surgeries 183 57 Team Members 5,171 Patient Visits 14
Program Spotlights Introduction of the Adult Congenital Heart Disease (ACHD) Program Under the leadership of David Briston, MD, this is the only dedicated clinic with ACHD board-certified cardiologists in the Orlando area. The program offers quality care for ACHD patients, with a team of specialized practice providers, nurses, MAs and social work professionals. 3D Printing for Surgical Planning The Heart Center collaborates with Digital Anatomy Simulations for Healthcare (DASH) in 3D printing. Through advanced techniques, our team can 3D print a partial or complete pediatric heart, offering better insight for surgical planning and determining the feasibility of surgical options based on the anatomy of the patient. This technology can help enhance outcomes and serve as an educational tool for the patient and the patient’s family. Advanced Options for Severe Pulmonary Valve Regurgitation Our Catheterization Lab specialists offer both the Harmony Transcatheter Pulmonary Valve (TPV) system and the SAPIEN 3 Valve with Alterra Adaptive Present system for patients with severe pulmonary valve regurgitation. The Harmony is the first FDA-approved nonsurgical heart valve developed for congenital heart defect patients with a native or surgically repaired right ventricular outflow tract (RVOT). A Growing Team Our staff continues to grow, recently adding a pediatric cardiologist specializing in advanced echocardiography, a pediatric cardiac interventionalist, three nurse practitioners, a full-time social worker, a PA and a dedicated ACHD nurse coordinator. Cardiac Research We are currently a top enrolling center in the PIVOTAL trial, the first trial of its kind to examine the role of closure of the ductus arteriosus in the pre-term baby. In addition, we are one of a handful of programs in the nation to develop transcatheter closure of the patent ductus in the neonate at the bedside rather than having to transport the baby from the NICU to the Catheterization Lab. Stella Stella’s family learned early in pregnancy that baby Stella had the chromosomal condition that causes Down syndrome, along with a heart condition that often accompanies Down syndrome. Stella was diagnosed with ventricular septal defect (VSD), a condition in which a hole forms between the lower chambers of the heart. Stella’s parents took early action, meeting with specialists at Orlando Health Arnold Palmer before she was even born – when her tiny heart was no bigger than a cherry. Stella required heart surgery in the first year of her life. “We would have gone to the ends of the earth,” said Stella’s dad, founding member of the musical supergroup Creed. “It turned out, you have the best doctor you could ask for right here at Orlando Health,” he said. Just four days after surgery, Stella went home with her family and continues to thrive. “She was so well taken care of here.” – Stella’s parents, Mark and Victoria 15
Craniomaxillofacial Surgery Craniomaxillofacial Surgery at Orlando Health Arnold Palmer is a unique specialty practice led by board-certified and fellowshiptrained pediatric craniomaxillofacial surgeons providing comprehensive diagnosis, treatment and follow-up care for infants, children and adolescents with a variety of congenital and acquired cranial and facial conditions. The surgical team offers prenatal counseling for expectant parents who have received a diagnosis of cleft lip, cleft palate or head shape abnormality for their unborn baby. In addition to the clinical practice, the surgical team is actively involved in ongoing facial reconstructive surgery research and in the education of fellows, residents, medical students and dental students. Highlights • The practice introduced Dr. Tyler Holley, MD, DDS, a board certified oral and maxillofacial surgeon fellowship trained in pediatric craniomaxillofacial surgery. • Orlando Health Arnold Palmer was approved as a Cleft and Craniofacial Team by the American Cleft Palate – Craniofacial Association for another five years, remaining the most longstanding ACPAapproved team in Central Florida. • The practice offers evaluation and treatment by two in-house speech and language therapists to deliver timely and coordinated care. • New in-office technology for nasendoscopic evaluation of speech disorders provides prompt and accurate diagnoses for children with palatal speech disorders. • Orlando Health Arnold Palmer is one of just nine facilities nationwide to offer a pediatric craniomaxillofacial fellowship program for advanced training. Established in 2009 and co-sponsored by Pediatric Neurosurgery, the fellowship program has graduated 14 fellows. • Expanding technology translates 3D scanning of facial and dental structures to print 3D models of the skull and dentition to aid in surgical planning. 400 New Patients 2 Locations 4 Specialty Clinics 2,000 Patient Visits 16 Team Members Surgeries 375 16
Program Spotlight Craniomaxillofacial Program The Orlando Health Arnold Palmer Craniomaxillofacial Program has cared for over 500 patients with cleft lip, cleft palate, Robin sequence, 22q deletion, craniofacial microsomia, Treacher Collins and syndromic craniosynostosis, and other craniomaxillofacial conditions. The interdisciplinary clinic brings together a team, including specialists in pediatric craniomaxillofacial surgery, speech and language pathology, pediatric genetics, pediatric otolaryngology, audiology, orthodontics and social work – combining expertise into one clinic visit and one episode of care. In addition, experts in pediatric neurosurgery, pediatric gastroenterology, pediatric pulmonology, pediatric ophthalmology and pediatric neuropsychology are committed to participating in this multidisciplinary care from their own clinics when needed. The program also participates in the Allied Cleft and Craniofacial Quality-Improvement and Research Network (ACCQUIREnet), a collaborative network of multidisciplinary teams from the United States and around the world, dedicated to standardizing assessments in cleft care. ACCQUIREnet fosters interinstitutional benchmarking, promotes knowledge exchange and facilitates implementation of proven quality-improvement programs and best practices. In Memory of Ramon L. Ruiz, DMD, MD Pediatric Craniomaxillofacial Surgeon Throughout his career, Dr. Ramon L. Ruiz was a champion for the children and families cared for at Orlando Health Arnold Palmer Hospital for Children. He leaves an incredible, lasting legacy of compassion, excellence and dedication that will forever be cherished by those who had the privilege of knowing him. Dr. Ruiz possessed a rare blend of surgical and clinical expertise, empathy, and a deep understanding of the unique physical and emotional challenges faced by children in need of craniomaxillofacial treatment and support and their families. In addition to being an innovative surgeon, a highly respected leader and an expert within his field of specialty, Dr. Ruiz will be remembered for his unwavering commitment as a devoted spouse, a loving father, and a genuine and loyal friend to countless individuals. 17
Emergency and Trauma The Bert Martin’s Champions for Children Emergency Department and Trauma Center is the first and only facility in Central Florida to provide emergency trauma care exclusively to children. As part of the Orlando Health Orlando Regional Medical Center Level One Trauma Center, Orlando Health Arnold Palmer Hospital for Children provides the highest level of trauma care for the most critically ill or injured children. 2,882 Orlando Health Arnold Palmer Transports 135 NICU Transports 55,000 ER Visits Annually Specialty Pediatric 5 Ambulances 59 Air Flights 18
Highlights • Orlando Health Arnold Palmer is the only Level One Trauma Center facility in Central Florida providing dedicated pediatric trauma care. • Orthopedic surgeons, neurosurgeons and general surgeons specializing in pediatric care are available 24/7 for trauma cases. • Pediatric radiologists review all images for specialized child-specific care. • We support all Orlando Health ERs 24/7 with access to immediate consult with our pediatric specialists or emergency transport to Orlando Health Arnold Palmer. • The Orlando Health Arnold Palmer ER handles 55,000 visits per year. • The pediatric emergency readiness team developed standardized pediatric emergency response protocols and procedures for all Orlando Health ERs. • Using a patient simulator, our trauma team has trained first responders in counties across Central Florida, including those in Orange, Osceola, Seminole, Brevard and Volusia counties, to better care for pediatric patients while being transported to our facility. Elias At 8 months old, Elias was the light of his parent’s lives. One night when he awoke for a bottle, something was wrong as Elias was gagging and letting out short, sharp cries before becoming lethargic and unresponsive. Mom immediately called 911 and began CPR. EMS brough Elias to the ER at Orlando Health Arnold Palmer at Orlando Health Dr. P. Phillips Hospital where teams quickly diagnosed Elias with a critical neurological issue before airlifting him to the ER at Orlando Health Arnold Palmer. Elias had emergency brain surgery to save his life. Thanks to quick thinking by his parents, early intervention at the Orlando Health ER and seamless transition to Orlando Health Arnold Palmer specialty care, Elias continues to be a joy to his parents and others. Designed specifically for the care of children, our trauma center is led by board-certified and fellowship-trained physicians and surgeons supported by an experienced team of skilled pediatric emergency nurses, respiratory therapists and anesthesiologists. The center features state-of-the-art trauma/resuscitation areas and a heliport for quick access to critical care for children transported by the Orlando Health Air Care Team emergency helicopter service. 19
Gastroenterology The Center for Digestive Health and Nutrition at Orlando Health Arnold Palmer follows a multidisciplinary approach to care with highly trained specialists collaborating for the most effective results. The entire team of physicians is board certified in pediatric gastroenterology and nutrition, working together with pediatric nurse practitioners, dietitians, developmental psychologists, nurse coordinators and surgeons to provide the best possible care. Along with offering excellence in clinical care, the center is also committed to teaching and research. A complete team of physician scientists committed to the creation of new knowledge in the discipline of gastroenterology works to provide comprehensive, coordinated care for each child. Highlights • Largest Pediatric Inflammatory Bowel Disease Center of Excellence in Central Florida, with an active involvement in ImproveCareNow collaborative community committed to the wellbeing of kids with Crohn’s disease and ulcerative colitis • Largest neuromotility center in the Southeast • The state’s largest feeding aversion center and the only one in Orlando • Aerodigestive Multidisciplinary Clinic • Healthy Lifestyles program for children and families at risk for obesity • Defecation Disorders Clinic • Eosinophilic Esophagitis/Eosinophilic Disorders Clinic • Cystic Fibrosis Multidisciplinary Clinic • Spina Bifida Multidisciplinary Clinic (only active program in Orlando) • NICU Follow-Up Multidisciplinary Clinic • Bone Health Multidisciplinary Clinic • Celiac Disease Clinic • Multidisciplinary Anorectal Malformation Clinic, introduced in 2023, in partnership with Pediatric Surgery • A growing team of 10 physicians, three Nurse Practitioners, four Registered Dietitians, six clinical nurse coordinators, two research nurses, a fulltime case manager and social worker • Dedicated hospital endoscopy staff and suite • Outpatient hospital-based infusion center • State-of-the-art diagnostic and therapeutic services for rapid and accurate support, including Video Capsule Endoscopy (VCE) for precise visualization, pH/impedance, Bravo, Breath Hydrogen, Endoscopic Ultrasound, Endo FLIP/Eso Flip, intestinal permeability testing, among others 20
13 Locations 3,724 Procedures 298 Participants in Healthy Lifestyles Program 690 Participants in Feeding Difficulties Center 14 Multidisciplinary Specialty Centers and Clinics 16 Pediatric GI Subspecialty Programs New Patients 2,647 40,884 Patient Visits 55 Team Members Looking to the Future We are currently working to enhance services with: • Pediatric endoscopic retrograde cholangiopancreatography (ERCP) to treat problems of the bile and pancreatic ducts. • Development and growth of a fully functioning clinical and Gastrointestinal Translational Lab • Further development of clinically relevant diagnostic tests, including disaccharidase activity, pancreatic enzyme activity, aspiration marker panel, eosinophil derived neurotoxin, small intestine microbial overgrowth brushing, sucrase-isomaltose gene testing and intestinal permeability/leaky gut test • Continued bench to bedside research, bringing the latest tested findings to our patients • Enrolled in ImproveCareNow (ICN) inflammatory bowel disease (IBD), Power (Obesity) collaboratives, supported by National Institutes of Health grants, including IKanEat (feeding difficulty), INSPPIRE (Pancreatic diseases), PROCEED (Adult Chronic Pancreatitis) • Leading Orlando Health-University of Central Florida (UCF) research and education program • Pediatric Gastrointestinal Fellowship is currently training two GI and nutrition fellows annually and developing a fourth-year nutrition fellowship • Organized the 2023 Central Florida Feeding Disorders Symposium for general pediatricians • A commitment to academics has inspired more than 70 peer reviewed publications since 2013 21
Genetic Testing and Counseling The Orlando Health Arnold Palmer Hospital for Children Division of Genetics is the largest and most comprehensive pediatric medical genetics center in Central Florida. Established in 1992, our specialty practice offers comprehensive medical management for children and young adults with a concern regarding a genetic or metabolic condition. Our multidisciplinary team includes board-certified pediatric geneticists, an advanced registered nurse practitioner, board-certified genetic counselors, registered dietitian, certified pediatric registered nurse and other professionals dedicated to providing personalized and compassionate care to our patients and their families. We provide genetic counseling and education to help families understand and manage their child’s genetic condition. Services are provided both at our outpatient clinic and through inpatient consultations at Orlando Health Arnold Palmer and at Orlando Health Winnie Palmer. We offer: • Coordination of genetic and metabolic testing • Enzyme therapy and diet management of metabolic genetic disorders, as appropriate • Follow-up care and referral to community resources • Multidisciplinary clinics with other specialties and community resource groups Examples of common disorders we manage include Down Syndrome, PKU, chromosome abnormalities, neurofibromatosis and Fragile X syndrome. 22
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Hematology-Oncology The Haley Center for Children’s Cancer and Blood Disorders at Orlando Health Arnold Palmer is the largest and most comprehensive pediatric oncology and hematology program in Central Florida. We are part of the first national effort of pediatric hospitals collaborating on groundbreaking cancer research, including understanding the genetic makeup of tumors to develop targeted therapies. We are expanding the reach of these lifesaving treatments by creating the largest pediatric clinical cancer research center in Florida. As a designated member of the Children’s Oncology Group (COG), we’re able to offer advanced treatment options through clinical research trials. 915 New Patients 4 Locations 11,731 Patient Visits Team 111 Members Specialty Clinics 4 24
Alesis Diana noticed a lump under her daughter’s arm that made her pause. Alesis was soon diagnosed with Stage III non-Hodgkin Burkitt lymphoma (a rare and aggressive form of cancer) and started chemotherapy. Watching Alesis struggle with sores in her mouth, losing her hair and nausea that kept her from eating broke her parents’ hearts. Six months later, Alesis “rang the bell” to signal the end of treatment. Today, she is healthy, happy and a star student looking forward to becoming a teenager. “Having a child with cancer is, to me, the hardest thing a parent can go through. To the staff that took care of Alesis – you will always be in our hearts.” - Alesis’ mom, Diana Bleeding and Clotting Disorder Program Patient Care Offering Central Florida’s only federally designated Hemophilia Treatment Center specially trained and dedicated multidisciplinary team of clinical, nursing, social work, physical therapy and research staff. The team encourages patient advocacy and disease education by various educational and community events held by the program throughout the year. Research The Bleeding and Clotting Disorder Program participates in statewide, national and international research. We are an affiliate of the American Thrombosis and Hemostasis Network (ATHN), an organization comprised of the leading treatment centers in the United States. We are additionally involved in national and international registry and pharmaceutical studies. Transition The Bleeding and Clotting Disorder Program Pediatric to Adult Transition consists of individualized education, transition planning, specialty transition clinics and educational events. Carrier Clinic Offering a Hemophilia Carrier Clinic that provides support, education and consultation to mothers and sisters of patients who are affected with hemophilia. Girls and Women with Bleeding or Blood Disorders Offering the only multidisciplinary clinic devoted specifically to females with blood disorders—recognized as clinic of excellence by the Foundation for Women & Girls with Bleeding Disorders. Physical Therapy Offering dedicated physical therapy including services such as one-on-one outpatient sessions, in-patient services, personalized home exercise recommendations, and clinical support and education regarding safety during sports, community activities and general development. The program assesses joint health, identify joint changes, and assess functional mobility skills and physiological movement impairments. 25
26 days Average Length of Stay Neonatology and Perinatal Medicine With a Level IV designation, the Neonatal Intensive Care Unit (NICU) at Orlando Health Winnie Palmer Hospital for Women and Babies offers the highest available level of care for newborns and premature infants, not only in our state but in the country. Because our NICU is connected to Orlando Health Arnold Palmer Hospital for Children by an enclosed walkway, the pediatric medical and surgical specialists can seamlessly partner with our Neonatologists to provide coordinated, comprehensive care for NICU babies with virtually any medical condition. These are the same pediatric specialty teams that will provide ongoing care for our NICU graduates once they head home. In addition to the expert care babies receive from our neonatologists, approximately 40% of NICU babies require the additional services of another pediatric specialty – such as surgery, cardiac, ENT, gastroenterology, neurosurgery, pulmonology, palliative care and more. This additional care is immediately provided by physicians at Orlando Health Arnold Palmer Hospital. Coming alongside our amazing physicians is a multidisciplinary team of clinical experts, who care exclusively for babies in the NICU. Dedicated registered nurses, respiratory therapists, registered dietitians, physical therapists, occupational therapists, speech therapists, licensed clinical social workers, spiritual care professionals and more clinical disciplines create the complete team that cares for babies in the NICU every day. 1,650 Discharges 325 Babies Admitted with a birthweight of under 4 pounds 15% Percentage of Multiples 120 Transports in the Orlando Health Winnie Palmer Hospital for Women and Babies Mobile NICU 142 Beds Babies Requiring Specialty Care in addition to care by neonatologists 40% 450 Team Members 26
DJ Due to complications from eclampsia, Precious delivered her son, DJ, at just 28 weeks. He weighed just 2 pounds 7 ounces. He was admitted to the Alexander Center for Neonatology at Orlando Health Winnie Palmer. During his 71-day-stay, DJ learned to eat, gained weight and thrived through a bilateral hernia surgery. Because Precious had to return to work, she appreciated receiving updates and photos of DJ on the EASE app, allowing her to feel connected to her son even during her work day. Today DJ is meeting milestones and prefers running to walking. “I knew DJ was getting the best care possible. It takes a special person to go in every day and look after the tiniest of people.” – DJ’s mom, Precious We foster innovative programs, such as: The Tiny Baby Collaborative Program which is achieving some of the best possible outcomes in the United States for infants at the limits of viability Point of Care Ultrasound Program to provide rapid diagnostic and therapeutic results at bedside for the tiniest babies Florida’s First Neonatal Hemodynamics Program Launches for Vulnerable Newborns At Orlando Health Winnie Palmer, the new neonatal program features a dedicated echo machine and neonatal hemodynamic specialist with advanced structured echocardiography training. This program is only one of only two such programs in the Southeast. Looking to the Future The Neonatal-Perinatal Fellowship Program at Orlando Health Winnie Palmer Hospital is the first Accreditation Council for Graduate Medical Education (ACGME) approved community-based fellowship program in the United States. The three-year program is currently approved for two fellows per year and is funded through a partnership between Orlando Health and Pediatrix Medical Group of Florida. The fellowship program strives to develop fellows as clinicians, teachers and researchers capable of transforming the future of neonatal care. We provide broad educational, clinical and research experiences with a strong focus on clinical care, while providing opportunities for pursuing a master’s degree and research and QI projects in a tertiary care setting, meeting ACGME requirements for scholarly activity. The high volume and exceptional patient diversity in the NICU result in an extensive clinical experience. Highlights • Largest Level IV NICU in Florida • Named, a “Best Children’s Hospital” in Neonatology by U.S. News & World Report • Extracorporeal Membrane Oxygenation (ECMO) Center of Excellence, one of only four in Florida • Recognized with consecutive Beacon Awards for excellence in bedside care by the American Association of CriticalCare Nurses • Magnet designated facility – the gold standard for nursing excellence – from the American Nurses Credentialing Center • First hospital in Florida to earn the Advanced Certification in Perinatal Care Accreditation from The Joint Commission • Neonatal ICU transport team – 2 ambulances and dedicated clinicians supporting hospitals across Central Florida providing essential support to a baby through a fully operational mobile NICU • Nation’s first and only community-based Graduate Medical Education Fellowship program for Neonatal-Perinatal Medicine • Partnership with the Orlando Health Women’s Institute Center for Fetal Care, providing comprehensive services for patients receiving fetal therapies, interventions, and surgeries 27
Nephrology Caring for Central Florida children since 2011, the Hewell Kids’ Kidney Center is the only hospital-based pediatric nephrology center in our region, with about 5,000 children visiting the center annually. Our skilled and compassionate team specializes in helping children with end-stage kidney disease, metabolic bone disease, obesity-related kidney disorders, systemic lupus nephritis, kidney transplantation preparation and post-transplant care, as well as acute kidney failure in newborns and more. Highlights • Since opening, the Hewell Kids’ Kidney Center has performed over 7,216 hemodialysis treatments and over 4,015 days of peritoneal dialysis. • More than 155 children on dialysis have visited the center from across the U.S. • More than 50 of our patients have undergone transplantation. • We have maintained top 10% in the U.S. for performance in significant patient dialysis treatment metrics. • The center is a participant in the National Children’s Hospital Association’s Standardized Care to Improve Outcomes in Pediatric End-Stage Kidney Disease (SCOPE) collaborative, focused on identifying and sharing effective interventions to prevent infections in children and adolescents on peritoneal dialysis and hemodialysis and was instrumental in creating the Transition project. • Our Hewell Kids’ Kidney Center team has created a support group for children and families, now recognized as an important component of the model dedicated to the treatment and care of this patient population. • The center has received recognition from the Centers for Disease Control and Prevention for 1,000-plus days without a CLABSI (central line-associated bloodstream infection). • Our team had six abstract “posters” presented and published in internationally recognized journals and conferences. 761 New Patients 4 Locations 4 Specialty Clinics 4,903 Patient Visits Team 18 Members 28
Program Spotlight Outpatient Pheresis Treatment Options After establishing a dedicated dialysis team and outpatient hemodialysis unit, the Hewell Kids’ Kidney Center is now able to offer pheresis treatment options, such as red blood cell (RBC) exchanges and plasmapheresis, as outpatient procedures. Providing these treatments in an outpatient setting offers convenience and ease of access, which is very helpful to our patients due to the chronic nature of their disease. Another benefit is the rapport patients may establish with our team as they receive one-on-one care with the convenience of returning home right after treatment. 29
Neurosciences The Leon Pediatric Neuroscience Center of Excellence at Orlando Health Arnold Palmer is one of the most comprehensive pediatric neuroscience programs in Central Florida, offering expertise in all subspecialty areas of pediatric neurosciences. Orlando Health Arnold Palmer is ranked a “Best Children’s Hospital” in Neurology and Neurosurgery for 2022-23 by U.S. News & World Report. We offer the most comprehensive pediatric neuroscience program in Central Florida, including expertise in fetal neurosurgery and the most advanced microsurgical options for complex neurosurgical cases. Our multidisciplinary team includes world-renowned experts utilizing state-of-the-art evaluations and procedures specialized for young people. This combination of expertise and technology gives these children the best opportunity to develop to their full potential. Our pediatric specialties include: Program Spotlights Fetal Spina Bifida Surgery In collaboration with the Leon Pediatric Neuroscience Center of Excellence, the Fetal Care Center at Orlando Health Winnie Palmer is dedicated to helping families when prenatal conditions are diagnosed. Our experienced neurosurgeons and maternal-fetal specialists perform innovative procedures that include repairing the most severe form of spina bifida. Only a few hospitals in the U.S. can perform this type of open fetal surgery – we were the first and remain the only one in the state of Florida. Our team’s expertise and experience have produced consistent, positive outcomes for babies with spina bifida, and our program continues to flourish, with 42 surgeries completed since the program’s inception in 2018. We have recently added innovative 3D printing technology to help surgeons prepare for surgery on unborn babies. Created based on ultrasound and MRI imaging, incredibly lifelike 3D-printed models enable the surgeon to see a model of the fetus that truly represents the actual condition of the baby. With the ability to predict any challenges or complications beforehand, this new technology helps to ensure a safe and effective surgery. 3,493 New Patients 13 Locations 10 Specialty Clinics Patient Visits 12,152 50 Team Members • Behavioral and Developmental Pediatrics • Neurology • Neuro-Oncology • Neurosurgery • Neuropsychology • Psychology • Physical Medicine and Rehabilitation Surgeries 274 4,969 Hospital Consults 30
Delaney At the age of two, Delaney began crying at night and refusing to nap. With two older children, her parents were familiar with the “terrible twos,” but this was different. Then the first seizure occurred. The seizures increased until Delaney needed the specialized care of Orlando Health Arnold Palmer neurologists. Doctors discovered a brain lesion and began a surgery plan for Delaney. In the days leading up to surgery, even in a medically-induced coma, Delaney had nearly 300 additional seizures. During the surgery, Delaney showed non-stop brain activity, which allowed her surgeons to pinpoint the lesion and remove it. Today, Delaney is thriving, continuing with follow-up care as she achieves milestones at an incredible pace. “We honestly can’t thank Orlando Health enough for what they gave us. We got a second chance with Delaney because of the doctors and nurses who never gave up on us.” – Delaney’s Mom, Michelle Epilepsy Monitoring Unit The Leon Pediatric Neuroscience Center of Excellence at Orlando Health Arnold Palmer Hospital includes state-of-the-art technology and innovation across a range of specialties and neurological conditions, including epilepsy. Each year, Orlando Health Arnold Palmer cares for more than 2,000 children who are being monitored for epilepsy. Our epilepsy program is designated as a Level 4 Epilepsy Center by the National Association of Epilepsy Centers, which means patients have access to the most advanced technology and solutions available to care for all conditions on the epilepsy spectrum, including epilepsy surgery. With philanthropic support, Orlando Health Arnold Palmer has been able to advance our Epilepsy Monitoring Unit (EMU) with upgraded equipment and the most advanced technology available. A second phase of upgrades was recently completed, significantly enhancing the patient experience, enhancing outcomes as it adds convenience and accessibility to life-changing care. A Robotic Surgical Assistant in Epilepsy Surgery The Leon Pediatric Neuroscience Center of Excellence provides advanced epilepsy surgical procedures using leading-edge technology that involves an array of depth electrodes. The Robotic Surgical Assistant (ROSA™) was used for the first time during an epilepsy surgery in April 2021 at Orlando Health Orlando Regional Medical Center (ORMC). This surgery was very successful as the child is now seizure-free. ROSA helps to place the electrodes that are inserted into specific targets using stereotactic placement. This allows for results that are less invasive while helping to cover a larger portion of the brain tissue. The use of ROSA has shown many proven advantages in epilepsy surgery, including more precise localization of the electrodes to identify the source of the seizures, resulting in superior outcomes and reduced complications. 31
Reuniting In-Utero Surgery Patients for 5-Year Celebration Orlando Health celebrated a remarkable five-year milestone of performing successful fetal in-utero surgery to correct spina bifida before birth. To date, the hospital system has carried out 42 cases involving expectant mothers and their unborn babies. Patients from various parts of Florida, Puerto Rico, Alabama and Hawaii have benefited from the hospital’s expertise in this field. “We’re thrilled to celebrate five incredible years of our fetal surgery program and reunite with many of the mothers and babies we’ve had the privilege to care for,” said Dr. Samer Elbabaa, board-certified pediatric neurosurgeon and chief of pediatric neurosurgery at Orlando Health Arnold Palmer, and co-director of fetal surgery at Orlando Health Winnie Palmer. Orlando Health Winnie Palmer was the first and remains the only hospital in the state of Florida to offer this unique and life-changing procedure. While fetal surgery is not a cure for spina bifida, studies show that it can significantly reduce the need for a spinal shunt at birth and can improve the child’s mobility and leg function. 32
A Step Forward to Cure Tuberous Sclerosis Complex The Tuberous Sclerosis Complex (TSC) Walk - Orlando brought together patients and families from all around the Central Florida region to spread awareness about this rare disease. Many families attended this inaugural walk, supported by friends and family members, raising funds to support TSC Alliance research to find a cure. A lifelong disease, TSC patients need continuous monitoring to prevent complications The walk was possible with help and support from Orlando Health Arnold Palmer and other sponsoring organizations. Participants enjoyed a Kona Ice truck and energetic DJ. Thanks to all the volunteers from Orlando Health and the families, this first-in-Florida TSC Walk was very successful and will continue to be an annual event, providing an opportunity for interaction between families struggling with this rare disease 33
Orthopedics The Orlando Health Arnold Palmer Hospital Center for Orthopedics includes board-certified and fellowship-trained orthopedic surgeons as well as a team of skilled specialists offering a variety of inpatient, outpatient, diagnostic and rehabilitation services to ensure every condition – big or small – is treated with the most advanced care possible. Our specialty practice is home to the EOS Imaging System, Central Florida’s first and only ultra-low radiation dose, 3D, full-body imaging technology for pediatric patients. Children with scoliosis or hip dysplasia who require frequent imaging can especially benefit from this system, which performs a full 3D body image with only a fraction of the radiation traditionally used in X-rays and in less than four minutes. Areas of specialized care include: • Clubfoot • Congenital disorders • Hand surgery • Hip disorders • Limb deformities • Musculoskeletal injuries • Scoliosis and spinal injuries • Sports injuries • Trauma 7,896 New Patients 4 Locations 1,130 Orthopedic Surgeries 4 Specialty Clinics 31 Team Members 16,689 Patient Visits 34
Highlights • Our Center for Orthopedics developed a multimodal pain management strategy for spinal fusion patients that demonstrated an overall decrease in the use of postoperative narcotics. • Our program is pioneering the development of novel fixation techniques in the management of bladder exstrophy by combining surgical procedures with urology. Novel fixation techniques are the use of subcutaneous internal fixation (INFIX) versus external fixation (EXFIX) for pelvic stabilization. Because there are no external pins, there is a reduced risk of infection and pin-site irritation, which also makes sitting easier. • Our program has made advancements in the Hip Preservation Program by combining arthroscopic management and joint preservation osteotomies into one procedure rather than two separate surgeries with different surgeons. • Our program participates in multiple international study groups, including the International Hip Dysplasia Research Group, Pediatric Cervical Spine Study Group and The Children’s Spine Foundation, which allows us to combine data with other institutions around the world involving low-event diseases to better understand pathology and best procedures. Program Spotlight Brachial Plexus Multidisciplinary Clinic Expands Services Pediatric Orthopedics at Orlando Health Arnold Palmer continues to expand services at the Brachial Plexus Multidisciplinary Clinic with office visits that incorporate Pediatric Orthopedic Surgery, Hand Surgery, Pediatric Neurosurgery, Physical Medicine and Rehabilitation and Occupational Therapy with single-event multidisciplinary surgeries. These complex surgeries are not performed anywhere else in the state, providing a referral source for the entire Southeast region. 35
Physical Medicine and Rehabilitation Central Florida’s leader in pediatric rehabilitative care, the Pediatric Rehabilitation Program at Orlando Health Arnold Palmer offers a child-friendly environment for a full range of pediatric rehabilitation services guided by compassionate and skilled occupational, physical and speech therapists. Our therapists work with children through both our acute care and outpatient therapy programs, providing them with the tools needed to improve function and maximize potential. Highlights • Our rehab team is involved in 24 multidisciplinary clinics led by our specialty physicians. • We have increased the interaction of our speech therapists with our craniofacial specialty physicians to offer consultation and education for babies with cleft palate and tongue ties. • Our new Complex Tics Clinic and Chronic Headache Clinic provide multidisciplinary resources to offer children relief and improved outcomes. • As part of a rehab continuum, we are seeing more adults with diagnoses that fit the expertise of our pediatric therapists, such as spina bifida and cerebral palsy, often requiring lifelong wheelchair and adaptive-equipment needs. We are able to support these patients with wheelchair seating and positioning and other services to promote long-term success. • The addition of a Physical Medicine and Rehabilitation department offers treatments to help relieve spasticity, 2 sialorrhea and migraines. Locations Patient 7,440 Referrals 228 Therapy Sessions per day 57,568 Patient Visits 39 Team Members 36
Program Spotlight Amplified Musculoskeletal Pain Syndrome (AMPS) This innovative new program provides intensive outpatient treatment to help children and teens overcome pain that has not responded to traditional therapy, medical management and invasive procedures. Using a research-based approach and patient-first philosophy, we work to bring hope and healing to children and their families. Our multidisciplinary team focuses on helping to increase function, strength and endurance so that patients can look forward to participating in daily activities including school, sports, leisure activities and socializing with family and friends. 37
Radiology Whether for diagnostic or interventional purposes, undergoing an MRI or ultrasound can be especially stressful for a child. At Orlando Health Arnold Palmer, we understand and offer a delicate approach that only an experienced pediatric team can provide. We offer comprehensive, state-of-the-art radiology and imaging services in a warm, caring and familyfriendly environment that caters to the unique needs of children. To help children feel comfortable, our amenities include interactive game stations, art activities assisted by volunteers and a catalog of movies to view during MRI exams. Our staff also includes a Child Life specialist to help young patients relax for more extensive diagnostic procedures. Our completely digital imaging system allows a child’s physician to access imaging results from their home or office. And all test results are interpreted by board-certified radiologists to help ensure that the unique physical conditions of childhood are considered. We offer the following services: • Computed Tomography (CT) scan • Fluoroscopy procedure • General radiography (X-rays) • Magnetic Resonance Imaging (MRI) • Nuclear medicine and SPECT imaging • Radiation dose reduction software • Ultrasound Interventional Radiology Our specialized pediatric interventional radiology procedures include: • Abscess/Fluid Drainage • Arteriography/Embolization/Trauma • Arthrogram/Joint Injection • Biopsy • Vascular Access • Gastrointestinal • Genitourinary • Tumor Thermal Ablation • Vascular Intervention, with special interest in Vascular Malformations and Sclerotherapy • Venography 38
Innovation In 2023, our team created a specialized functional NICU procedural table, allowing bedside fluoroscopic interventional work in the Neonatal ICU. We also expanded our malformation sclerotherapy services to include aneurysmal bone cyst treatments and more robust treatment of venous and arteriovenous malformations as well as thrombolysis treatments for acute and chronically occluded venous structures. Neuroradiology In 2023, our neuroradiology team distinguished itself in the following ways: • Provided advanced preoperative functional neuroimaging of critical anatomic tracts to plan safe maximal resection of tumors in highly functional areas of the brain and spine • Dr. William O’Brien was named president-elect of the American Society • Dr. William O’Brien, Pediatric Radiologist, authored a textbook on pediatric head and neck imaging (Pediatric Head and Neck Imaging, An Issue of Neuroimaging Clinics of North America) published by Elsevier • Authored five peer-reviewed publications • Chaired the annual scientific program for the American Osteopathic College of Radiology (AOCR) - Top Three Differentials in Radiology • Served as invited faculty for five national and international scientific meetings. 39
Healing Beyond Our Walls Our role in the community extends beyond our hospital walls. As part of the Orlando Health family of care, Orlando Health Arnold Palmer is committed to making health and wellness accessible to the broader Orlando and Central Florida community. Throughout Central Florida, we strive to improve the lives of the individuals and communities we serve. Our community outreach efforts are designed to meet identified health needs, particularly among vulnerable and underserved communities. These outreach efforts include events, such as health screenings, health fairs, support groups, wellness activities and sponsorship of other community events. 40
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Community Engagement We’re proud to partner with organizations that share our mission of improving health and quality of life in the communities we serve, such as: Creative City Project’s Dragons and Fairies Orlando Health Arnold Palmer and Orlando Health Winnie Palmer co-sponsored the Creative City Project’s Dragon and Fairies experience at Harry P. Leu Gardens. Attendees had the opportunity to experience a moving story as live actors in costumes led participants on a walking journey. Large-scale lighting installations, animatronic dragons and other surprises delighted guests. The fairy performers also brought their magic to Orlando Health Arnold Palmer to visit and take photos with patients. Camp Boggy Creek’s Family Weekend Retreat Camp Each year Orlando Health Arnold Palmer supports Camp Boggy Creek’s Family Weekend Retreat Camp for those with diabetes. Camp Boggy Creek makes it possible for children with serious illnesses to enjoy a camp experience in a safe, medically-sound environment. This specific weekend offers a family retreat where parents and guardians can relax and find needed support among other families dealing with similar challenges. Siblings can participate in all of the fun. Junior Achievement’s 3DE Program Orlando Health Arnold Palmer supports Junior Achievement’s 3DE program annually. The 3DE program re-engineers high school education to be more relevant, experiential and authentically connected to the complexities of the real world in order to more fully prepare today’s students for the demands of tomorrow’s economy. The program is hosted at Ocoee, Oak Ridge and Osceola high schools. Team members serve as coaches and judges throughout the program. A Gift for Teaching’s Great Big Backpack Build Orlando Health Arnold Palmer supports A Gift for Teaching’s Great Big Backpack Build annually. The Great Big Backpack Build is an event where volunteers come together to build backpacks with core school supplies for students in Orange and Osceola counties. Each year, team members volunteer to help pack these backpacks. Between 2021-2023 roughly 50,000 backpacks have been put together and donated to students in need. 42
Community Partners • A Gift for Teaching • Autism Society of Greater Orlando • Camp Boggy Creek • Cannonball Kids’ Cancer Foundation • Children’s Safety Village • Creative City Project • Crohn’s & Colitis Foundation – Central & Northeastern Florida Chapter • Cystic Fibrosis Foundation – Central Florida Chapter • Down Syndrome Foundation of Florida • Early Learning Coalitions of Orange County • Florida Symphony Youth Orchestras • Harry P Leu Gardens • Hemophilia Foundation of Greater Florida • Juvenile Diabetes Research Foundation (JDRF) Northern Florida Chapter • Junior Achievement of Central Florida • Kids Conquering Sickle Cell Disease Foundation • Make-A-Wish Central and Northern Florida • Nathaniel’s Hope • OCA • Orange County Fire Rescue • Orlando Family Stage • Orlando Philharmonic Orchestra • Orlando Science Center • Ronald McDonald House Charities of Central Florida • Runway to Hope • Spina Bifida Association of Central Florida • St. Baldrick’s Foundation • TSC Alliance 43
Howard Phillips Center for Children and Families The Central Florida area is a vibrant, thriving set of communities. But children and families in our neighborhoods still face challenges, such as child abuse, sexual trauma, developmental disabilities and lack of access to medical care. The Howard Phillips Center helps combat these obstacles by delivering children and family services to support and advocate for those at risk. Programs include: • Central Florida Early Steps • Child Protection Team • Children’s Advocacy Center Healthy Families Healthy Families continues to maintain better than a 98% success rate in preventing child abuse and neglect. This nationally credentialed model promotes child and family well-being through weekly home visits and support services to overburdened families with newborn babies in targeted zip codes in Orange and Osceola counties. Expert economists continue to demonstrate every dollar invested in early prevention programs yields a 13.7% return year after year. Early Steps Central Florida Early Steps provided over 65,000 hours of early intervention services last year to 4,178 infants and toddlers and their families. Of these children, 99% demonstrated improvement in the outcomes related to socialemotional, cognitive and behavioral development, the foundational components for early learning and school readiness. Early Steps received the highest designation in quality from the Florida Department of Health, scoring 100% in 10 out of 11 indicators, and 94% on the remaining indicator. Teen Xpress Teen Xpress served nearly 800 middle and high school students and provided over 4,600 services last year in five middle schools, two high schools and several community sites in Orange County. Nationwide research indicates patients are losing their doctors and their trust in the primary care system. For Orlando Health Arnold Palmer, we are finding teens are not seeing pediatricians or healthcare providers for well care anymore, leading to the building of chronic issues including mental health concerns. Connecting with teens and families builds long-term relationships, leading to better health. • The Healing Tree • Healthy Families Orange & Osceola • Teen Xpress 44
Looking to the Future • Continued partnership with Swim Life This partnership assists in creating and distributing drowning prevention information, and Water Watcher Tags to promote safe swim practices. • Continued participation in community cycling safety event We support bicycle helmet fittings and safety education throughout Central Florida. • Continued partnership with Boys & Girls Club After School Zones Together with middle schools in Orange County, we work to provide education on topics such as proper helmet use, drowning prevention, burn prevention, pedestrian safety and proper seat belt use. • Continued partnership with Safe Kids Orange County Coalition Together we deliver education on safety strategies and injury prevention. This organization has recently applied to be part of the Good Neighbor Car Seat Safety Program through Safe Kids Worldwide and State Farm, which will allow increased access to education and resources to support a culture of safety for children and families. • Continued collaboration to increase car seat safety We work with certified child passenger safety technicians to support car seat installation assistance to Central Florida families through individual appointments at the hospital and at community events. We also partner with the Lake County Library System to facilitate car seat installation checkpoints. These checkpoints are hosted with certified child passenger safety technicians in the Lake County area. • Continued outreach to prevent traumatic injuries We use social media outreach to prevent traumatic injuries associated with seasonal activities, including education on water safety before summer break, firework safety before Independence Day and helmet safety before winter holidays. • Continued support for teen driving safety We partner with the Florida Teen Safe Driving Coalition to equip teenagers with the knowledge, skills, and resources to make informed decisions and develop responsible behaviors as new drivers. Preventing Child Abuse Orlando Health Arnold Palmer is committed to working to prevent child abuse. Almost 19,000 child abuse reports have been received yearly by the Florida Child Abuse Hotline for Orange and Osceola County since 2021. Last year, our Children’s Advocacy Center (CAC) program provided over 80 training opportunities on child abuse and neglect topics to professionals and community members to help expand the local safety net for children. Our elite Child Protection Team facilitated nearly 450 multidisciplinary case meetings, more than any other CPT in the state, and we have now hired a second child abuse pediatrician, enhancing our team expertise. Our Healing Tree therapeutic experts achieved outstanding scores on two in-depth audits and were identified by the Florida Department of Health as having one of the best trained Sexual Abuse Treatment Programs in the state. Injury Prevention Because most children’s injuries can be prevented, Orlando Health Arnold Palmer’s Injury Prevention Team is dedicated to reaching out to the community, parents, caregivers and children to provide safety education and resources to help prevent these injuries. In 2023, we served 6,020 children and families, providing education on a variety of injury prevention topics, including child passenger safety, helmet use, drowning prevention, bicycle and pedestrian safety and bleeding control, just to name a few. 45
Research/Clinical Trials As an organization dedicated to serving children and families, Orlando Health Arnold Palmer is committed to the future – the future of each child and the future of healthcare. Research is the foundation for medical advancement and plays a critical role in improving outcomes for children. The Corporate Office of Research Operations (CORO) is responsible for supporting investigators and administrators in research by managing research projects and clinical trials. CORO processes approximately 200 applications annually for Orlando Health. The goal of CORO is to create an outstanding climate of support for Orlando Health researchers, enabling exceptional research advances. The research environment of clinical trials involves faculty and collaboration across multiple departments at Orlando Health. Research activities include the design, conduct and analysis of clinical trials. Thanks to expanded research and advanced clinical trials, we are able to offer leading edge treatments for renewed hope and better outcomes. Orlando Health Arnold Palmer has numerous active clinical trial studies that allow our patients to gain access to new research treatments before they are widely available. While all clinical trials have participation guidelines, participants in clinical trials are allowed to play a more active role in their own healthcare and help others by contributing to medical research. In addition to clinical trials, we continue to collaborate with other professionals and organizations to advance options for our patients, improving outcomes as well as enhancing the patient and family experience. Highlights • Our Orthopedics Program participates in multiple international study groups, including the International Hip Dysplasia Research Group, Pediatric Cervical Spine Study Group and The Children’s Spine Foundation, which allows us to combine data with other institutions around the world involving low-event diseases to better understand pathology and best procedures. • Our Nephrology Center is a participant in the National Children’s Hospital Association’s Standardized Care to Improve Outcomes in Pediatric End-Stage Kidney Disease (SCOPE) collaborative, focused on identifying and sharing effective interventions to prevent infections in children and adolescents on peritoneal dialysis and hemodialysis and was instrumental in creating the Transition project. • Our Gastroenterology team is enrolled in ImproveCareNow (ICN) inflammatory bowel disease (IBD), Power (Obesity) collaboratives, supported by National Institutes of Health grants, including IKanEat (feeding difficulty), INSPPIRE (Pancreatic diseases), PROCEED (Adult Chronic Pancreatitis). • Our Gastroenterology team is leading Orlando HealthUniversity of Central Florida (UCF) research and education program and organized the 2023 Central Florida Feeding Disorders Symposium for general pediatricians. 46
• The Department of Pediatric Emergency Medicine at Orlando Health Arnold Palmer is conducting groundbreaking research on traumatic brain injury. Linda Papa, MD, an emergency physician and director of emergency medicine clinical research at Orlando Health, is the principal investigator of a multi-million-dollar National Institutes of Healthfunded research study that is developing a blood test for traumatic brain injury and concussion in children and youth. The blood test identifies substances released from the brain into the blood after injury. A simple blood test would revolutionize the care of children and youth with brain trauma by helping doctors to identify injuries earlier, recognize how serious a brain injury is and determine whether a CT scan or brain surgery is needed. It could also identify children needing specialized rehabilitation and allow researchers to test new treatments that could help children recover and have a better quality of life. • Developed at Orlando Health Arnold Palmer, the Electronic Access to Surgical Events (EASE) application is a HIPAA-compliant app that allows healthcare professionals to provide updates to friends and family of patients undergoing medical procedures. The EASE app is now being used successfully nationwide. • Our Endocrinology and Diabetes Research professionals have pioneered a growth hormone program that continues to be a national leader in the use of long-acting growth hormone analogues compared to traditional daily growth hormone therapy. Our dedicated Growth Hormone Team continues to serve as a model for other institutions across the country. Given the volume and resources, our site has been selected to participate in several new clinical trials and registries for long-acting growth hormone analogues to determine efficacy and safety for new indications. Dr. Joshua Yang serves as the principal investigator for these studies. • In addition, our Endocrinology Growth Hormone Team has completed several clinical trials in the fields of growth and puberty. In 2023, Dr. Joshua Yang has presented clinical trial data to the following groups: CHOP, Boston Children’s, UPMC, Nationwide Children’s, UCSD, University of Iowa, University of Oklahoma, Nicholas Children’s, and Nemours Jacksonville. 47
Pediatric Residency and Fellowship Medical Education at Orlando Health Arnold Palmer Our Pediatric Residency has been accredited by the Accreditation Council for Graduate Medical Education (ACGME) since 1976. We are the most wellestablished pediatric training program in Central Florida and one of the most longstanding in the state of Florida. We currently have 42 residents.Next year, we will grow to 48 residents. We have seven Pediatric Subspeciality Fellowships: Neonatology, Pediatric Critical Care, Pediatric Emergency Medicine, Pediatric Gastroenterology, Pediatric Orthopedic Surgery and Oral Maxilofacial Surgery. In total, we currently have 25 fellows. • We also teach medical students from the Florida State University College of Medicine, as well as other medical schools from around the country. • Our General Pediatrics Certifying Exam (the Boards) pass rate for first-time test takers is consistently above the national average. • All of our residents who applied to fellowships this past year were successful, matching in Pediatric Cardiology, Pediatric Endocrinology, Hospitalist Medicine, NICU, and PICU at the University of Wisconsin, University of Pittsburgh, Nicklaus Children’s Hospital, University of Florida, Orlando Health and Children’s Hospital of Orange County/ Los Angeles. • Our Pediatric Residency Diversity Council continues to sponsor events in our institution and in the local community. The mission of our Diversity Council is to promote a safe culture that celebrates diversity and inclusivity to benefit our residents, patients, institution, and the Central Florida community. • Our senior residents presented numerous research and quality improvement projects nationally and regionally, and also will present at our annual Orlando Health Arnold Palmer Hospital and Winnie Palmer Hospital Research Symposium in March 2024. • Our Pediatric Primary Care Residency Clinic was recognized by the National Commission for Quality Assurance as a patient centered medical home. 48
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Caring for the Whole Family Child Life Program Our Child Life Program helps children and teens learn stress management and coping skills needed to help them through their experience. Specially trained in psychosocial strategies and child development, our certified Child Life Specialists focus on helping to reduce the stress and uncertainties of a medical encounter by providing individualized care – including education, play and preparation – based on each child’s age, development, background, temperament and past medical experiences. Music Therapy As a research-based and complementary treatment option, music therapy can aid in promoting the general wellness and healing of hospitalized children. Our specially trained and board-certified music therapists use a variety of interventions throughout a child’s treatment and recovery, including instrumental play, music/lyric composition and music improvisation, to help in managing stress, alleviating pain, expressing feelings, enhancing memory and improving communication. Patient Academics To help reduce the added stress that extended or unplanned time away from school can create, Orlando Health Arnold Palmer offers academic support through a certified, on-site teacher who can assist families in understanding and navigating the various options for receiving hospital/homebound instruction through the public school system or with virtual schooling. Our goal is to help children and teens stay on track academically with educational enhancement opportunities throughout their medical journey. Spiritual Care Our chaplains are available 24/7 to assist with faith issues, decision making, rituals and prayers. We hold weekly Chapel services and visit in patient rooms. We can coordinate with a family’s own clergy or serve families who are from out of town, supporting families through the healing process. Recognizing that a child’s hospitalization and illness can present many challenges for the child and family that go beyond the physical illness, Orlando Health Arnold Palmer offers several programs that provide unique therapeutic and personal support to patients and their families. Special Events and Community Engagement Special events and activities are an important way to deliver experiences that every child and teen would potentially have if they were at home or at school. These events are recreated in the hospital setting so kids don’t miss out on important life experiences, like birthday and holiday celebrations, parties and engagement with our community partners for special visits. These engagements offer some excitement and normalization for families to enjoy together. 50