Each year since Valley Children’s Hospital opened in 1952 it has grown in size, services provided, technology, and staff. Many of the changes have resulted in a better experience for patients and their families, something documented in the 30 The Fresno Bee’s Kids Day special editions.
“Its a whole different place in terms of our capacity to take care of kids. Years ago we would have to admit a patient for a time and now they can leave after surgery the same day,” says Beverly Hayden-Pugh, senior vice president of clinical operations and chief nursing officer, who has witnessed her share of change since starting her career with the hospital in 1983 as a staff RN in the pediatric/oncology unit.
Hayden-Pugh’s passion for the hospital started long before she began working there. She was admitted into the hospital when she was 10 yeas old for gastrointestinal problems. Even though she was scared about being in the hospital, she felt the nurses would keep her safe.
As she looks back, one change in particular stands out: the hospital’s move from Fresno to Madera in 1998. She says it was like going from “a one-room house to a palace.”
Growth has been necessary.
Since the first Kids Day special edition rolled off the presses in 1988, the hospital has gone from dealing with just over 6,000 patients a year to last year’s total of almost 13,000. The staff in that time nearly tripled from 1,092 to 3,178. The hospital has expanded its reach to 11 counties and has become one of the most highly regarded hospitals in the country.
The growth has meant being on the cutting edge of medical technology and working to improve, even down to the simple tubing used to care for patients. Here is a closer look at two of the hospital’s advancements.
Less invasive surgery
Thirty years ago, any discussion of surgery meant cutting open a patient, whether it be to work on a knee or to do heart surgery. Advancements in surgery techniques and technology in the last three decades have dramatically decreased potential health problems.
New methods make it safer for patients and reduce recovery time, often from days to hours. It also means that more procedures can be done in a day at the hospital.
Many issues are now handled by a pediatric interventional radiologist rather than a surgeon. Instead of a large incision, a variety of procedures can be done with only a minor cut and equipment guided through the body using sonograms and CT scans.
Delhi’s Lisa Trafolla was a beneficiary of advancements earlier this year. The 16-year-old discovered a lump on her left side that didn’t feel right. An examination showed that she had a cyst on her kidney as large as an oversized softball. Eliminating the mass didn’t require a major incision; pediatric interventional radiologist Trevor Davis only had to make a minor cut.
“Surgery is the key word here,” Davis explains.” We are not necessarily surgeons. We are in the operating room in sterile conditions, but I am not really cutting people open. These are all minimal invasive procedures. … by using ultrasound, we just guide a needle in to drain the cyst.”
After the cyst is drained, Davis injects a liquid to make sure there is no place where the fluid would pass into the girl’s body or kidney, which would be harmful. A quick scan shows there are no leaks, so he injects the medicine that will collapse the cyst. The procedure moves quickly and Lisa is sent back to her room.
The procedure will have to be done at lest one more time. But it’s still an improvement. Thirty years ago, Lisa would have been required to stay in the hospital because of an open incision.
Today, Davis can do a procedure and send the patient home until he or she comes back for the next round. In general terms, recovery time goes from days or weeks to hours.
“That is especially great for kids,” Davis says. “Another advantage is you can often get away without having to use general anesthesia. You don’t have to put the child completely asleep but just make him a little drowsy.”
In the past, dealing with patient safety was more about risk management, which meant dealing with a situation after it happened.
Since 2014, when Valley Children’s became part of a collaborative of 110 children’s hospitals called Solutions for Patients Safety, the hospital has adopted a more aggressive way of identifying potential problems and taking steps to eliminate them.
One of the biggest safety changes affects almost every part of patient care. No matter whether a procedure is minimally invasive or major surgery, there is one common factor with patients: They have some sort of tubing, whether it is for feeding a child too small to eat or giving medicine through an intravenous injection line.
The problem all hospitals faced for decades was that the clear plastic tubing all looks the same.
Valley Children’s Hospital is one of the first hospitals to implement a plan where plastic tubing is color coded. The goal is to reduce errors when dealing with young patients.
C. Leanne Kozbub, an RN and manager of patient safety and risk management at Valley Children’s, says the changes with the tubing are a very big change from the past.
“When you are in the hospital, you have tubes everywhere,” Kozbub says. “Different manufacturers didn’t pay attention to how this IV tubing has the the same connector as this NG tubing. There have been instances, fortunately not here, where they have put an IV tube to a lumbar catheter.”
Following a mandate by the state of California, the manufacturers were directed that tubing can only fit like tubing. Combined with a new color coding system for the tubes, the changes have made it easier for the staff to use all the correct equipment.
Hayden-Pugh points out that despite all the changes, one thing has remained constant: “The culture and focus of getting kids and their families better is the same. That has been the legacy that has gone through all the changes.”
How to help
Make a donation to Kid’s Day at www.valleychildrens.org/kidsday.