New program increases specialty health care access for Montana’s children

It is estimated that thousands of children are forced to leave the state for medical care annually. Currently, the distance from Kalispell to the nearest dedicated children’s health care facilities (Spokane, Seattle, Salt Lake City and Denver) is 200 to 1,000 miles, depending on the medical specialty needed. Traveling such a distance for children’s medical services creates several disadvantages:

• Health care fragmentation and disruption of a patient’s continuum of care
• Upheaval of family dynamics – siblings are separated from their parents and brother(s)/sister(s), or forced to miss school, parents miss work, and households are estranged from their support systems, including friends, extended family, church and social circles
• Financial burden for families – costly out-of-state medical bills for families as well as out-of-pocket expenses for lodging and travel
• Economic impacts to local Montana communities – loss of revenue when families leave the state

Over the past 18 months, Kalispell Regional Healthcare (KRH) has begun to address these issues by becoming the center of a growing collection of pediatric services. With more than 30 pediatric providers, a neonatal intensive care unit, a pediatric intensive care unit and many other specialized children’s health care services, KRH has made a significant investment in the state’s children by bringing skilled specialists and pediatric services to the Flathead Valley. Since pediatric specialty services began at KRH in 2015, pediatric subspecialists in anesthesiology, cardiology, endocrinology, gastroenterology, oncology/hematology, neurology, ophthalmology, pathology, psychiatry and surgery have been added to the KRH medical staff, and more than 5,000 Montana children have received specialty care locally, rather than traveling elsewhere.

With the arrival of Kelly Schmidt, MD, this past July, the most recent addition to the list of pediatric subspecialties at KRH is neurosurgery.

Dr. Schmidt earned her medical degree at the George Washington University School of Medicine in Washington, D.C., and subsequently completed her neurological surgery residency and pediatric neurological surgery fellowship trainings at the University of Texas Southwestern Medical Center in Dallas, Texas. She will be a leader in developing the pediatric neurosurgery services program.

Having a pediatric neurosurgeon on staff is an excellent example of why it’s important to provide local access to subspecialists. According to Dr. Schmidt, many pediatric neurosurgical conditions are congenital – patients are born with these conditions, which become lifelong issues. These children require regular neurosurgical follow-up. Without having pediatric neurosurgery in Montana, these children would have to go out of state to obtain this routine follow-up care. What tends to happen is that parents who feel their child is doing well often don’t go to the expense of keeping those routine follow-up appointments. Inevitably a surgical emergency can arise as the child gets older, which could have been prevented by having regular follow-up care closer to home. In the case of trauma, which can’t be predicted, time is brain. If a child who needs emergent lifesaving surgery can have a procedure after a short ambulance ride to a local hospital, rather than a three-hour transport to an out-of-state facility, his or her chances for a better neurologic outcome are greater.

“Pediatric neurosurgery is important and different than adult neurosurgery because a child’s nervous system is still growing and developing until the mid-teen years. Surgical intervention for brain trauma, brain tumors and congenital malformations allow a pediatric brain to continue to develop normally and repair itself much better than an adult brain can,” said Dr. Schmidt. “Children can make miraculous recoveries, and this is one of the most appealing aspects of the specialty for me.”

Children require extra time, monitoring, specialized medications and specially trained health care providers who are compassionate and understand kids of all ages. While all of Kalispell Regional Healthcare’s pediatric clinicians practice according to these tenants, pediatric services at Kalispell Regional Healthcare currently operate within a facility designed for adults.

In August 2016, Kalispell Regional Healthcare broke ground on a 190,000-square-foot facility dedicated to children’s health. Called Montana Children’s, the three-story building will house the majority of pediatric services. It is slated to be completed in the spring of 2019.

“Consolidating children’s services under one roof offers many advantages to patients, families and clinicians. Pediatric medicine is not simply a miniaturized version of adult care,” said Federico Seifarth, MD, medical director for Montana Children’s. “Children’s facilities are designed with children in mind. Kids deserve health care focused on their unique needs – family-centered care in healing environments.”

In addition to a 12-bed pediatric unit, a six-bed pediatric intensive care unit and a 12-bed neonatal intensive care unit, Montana Children’s will include:

• Patient rooms and family areas conducive to children and families
• An architectural and interior design with which children can identify through color and pattern
• Dedicated spaces for family caregivers
• Customizable spaces to allow children to bring items from home, to make their environment familiar
• Specialized equipment on site
• Acuity adaptive rooms that are flexible to minimize movement/disruption to the continuum of patient care
• Lighting that emphasizes daylight and connects the indoors and outdoors
• Design details that engage a child’s imagination from the moment he/she arrives
• Ample space for expanded services, including shelled space for the future expansion of inpatient beds and other services as needed

Montana Children’s will be the core of Kalispell Regional Healthcare’s pediatric program, which also includes primary care, specialty care, inpatient acute care, emergency care and transport, patient and family support services, recreation and wellness programs, and school-based programs.

“Bringing together the pediatric staff specifically trained in the medical, emotional and developmental needs of children, specialized equipment, supporting services and a treatment environment designed for pediatrics is critical to the future care of Montana’s children,” said Jason Spring, KRH chief strategic officer, who provides executive leadership to the program. “The Flathead Valley and other communities in Montana need a dedicated children’s health care facility that is focused on high-quality, family-centered care that invites parent participation and decision-making in the care of their children. Montana Children’s will be those things and much more.”

Pediatric health care available locally

Pediatric Primary Care

Pediatric Specialty Care:

• Pediatric Anesthesia
• Pediatric Cardiology
• Pediatric Critical Care
• Pediatric Dentistry
• Pediatric Endocrinology and Diabetes
• Pediatric Gastroenterology
• Pediatric Hematology/Oncology
• Pediatric Neurology
• Pediatric Neurosurgery
• Pediatric Ophthalmology
• Pediatric Pathology
• Pediatric Psychiatry
• Pediatric Radiology
• Pediatric Surgery
• Perinatology
• Neonatology
• Montana Children’s Specialists Outreach clinics, satellite offices and telemedicine

Pediatric Inpatient Care:

• Neonatal Intensive Care Unit
• Pediatric Acute Care
• Pediatric Intensive Care Unit
• Pediatric Emergency Care and Pediatric Patient Transport

Pediatric Support Services:

• Pediatric Pharmacists
• Pediatric Respiratory Therapists
• Pediatric Clinical Social Workers
• Pediatric Dietitians
• Pediatric Physical and Speech Therapy
• Home Health
• School-based Behavioral Health and Turtle Bay

Resources for Patients and Families:

• Psychosocial Support
• Spiritual Care
• Educational Support
• Support Groups and Educational Classes
• Financial Counseling

Recreation and Wellness:

• The Summit Medical Fitness Center

School-Based Programs

Learn more about pediatric services at Kalispell Regional Healthcare.

First published in 406 Woman magazine, October/November 2017