April, 2012

“I want this to be an opportunity for you to learn about our plans and what we have here – because it is pretty remarkable.”

Supporters of Los Angeles Orthopaedic Hospital (LAOH) recently gathered at the new state-of-the-art Santa Monica-UCLA Medical Center and Orthopaedic Hospital to hear LAOH’s President and CEO deliver a special presentation regarding the state of children’s orthopaedic care in Los Angeles, including LAOH’s role in meeting our community’s need for accessibility and excellence. Taking place in the facility’s technologically advanced auditorium, which is also utilized for medical education conferencing, the presentation touched upon recent developments at the institution, surveyed current programming and individual success stories, and shared leadership’s vision for the future.

On the challenges to the families:

Dr. Scaduto opened his presentation with the optimistic reminder that LAOH exists to secure kids’ quality of life – and, where needed, to go beyond that to extend the lifespan by treating conditions and disorders that directly threaten children’s lives either immediately or in their progression as children grow. Noting LAOH’s leading role in the Los Angeles community in pediatric orthopaedic trauma care, he described the challenges families face today in finding appropriate, high-quality care for their children regardless of whether they have public or private insurance:

“Getting kids care is a challenge all families face today. Getting the initial assessment and treatment done quickly and correctly is key. Fracture care is time-intensive, so we’ve focused a lot of our efforts and clinical research around ways we can we optimize a child’s care – so there are fewer visits, and the casts we use don’t have to be changed as frequently or worn as long.

“We have a setting where definitive treatment can be provided. The cast can be put on, the bone can be realigned; and it can be done with conscious sedation. That doesn’t happen in many emergency rooms. In many places, kids would have to go through the operating room to get that cast.”

On the challenges to the community:

The surging need for pediatric orthopaedic care, both locally and nationally, is unfortunately countered by diminishing availability – a fact confirmed by the findings of a recent regional study published in The Journal of Pediatrics. Dr. Scaduto explained:

“One reason it’s harder for kids today to get treatment is that training has changed. People have subspecialized more. They treat only shoulders or only hands, for example, so that the concept of treating a child for a condition they don’t often treat becomes daunting. Kids get turned away not only because of their insurance, but because no one feels comfortable doing their surgery.”

“More and more, we have become the site – the center – for both basic pediatric orthopaedics and subspecialized care.”

How LAOH meets these challenges:

“Our guiding principles are access, for which we’ve always been known, and excellence.”

The extent of LAOH’s charity care program, integral to the mission, often leads to the question of whether LAOH is a safety net organization or the program of choice. Dr. Scaduto pointed out that these two positions are not mutually exclusive.

”We are excellent and we provide care that would be very difficult for families to get elsewhere. We treat unique bone conditions and trauma that can lead to significant deformity, conduct interventions that will allow a child to lead a completely different life. These are things that can only be done at institutions that are dedicated to pediatric orthopaedics.”

As an example of an LAOH program that functions superbly to bring excellence in care to the safety net, Dr. Scaduto referred to the Urgent Care, which has become a model program under Medical Director Mauricio Silva, M.D. Dr. Scaduto shared that multiple preeminent local programs including the emergency room and family medicine programs at UCLA, and programs at Kaiser and White Memorial, have arranged or plan to send their residents to LAOH to train. And that LAOH’s sphere of influence continues to grow.

“Last week I got a call from my mentor at Texas Scottish Rite, which I consider one of the best pediatric orthopaedic programs anywhere. They said, “We want to know how you’re doing it, because we want to do the same thing.”

Advances in clinical practice:

In describing the impact resulting from the growth at the downtown campus and the expansion to the Westside, Dr. Scaduto affirmed that opportunities to improve children’s lives are being created institution-wide and extended to a broader community.

“We have a brand-new hospital, a wonderful clinic tied to it, additional medical offices, research facilities, and teaching environments. LAOH is not interested in simply maintaining the status quo. Quality and performance are key.”

He confirmed that the organization will continue to develop programs of excellence in treatment areas from the very and the somewhat common, such as pediatric trauma, cerebral palsy and spinal deformity, to the rare, including pediatric tumors, limb deficiencies, and skeletal dysplasias. While overseeing these program expansions, LAOH will also look to bring its expertise to additional geographic areas. As always, teaching and research are integral elements of the support brought to the community.

“Research is becoming increasingly child-focused, and the future may hold such inventions as a smart cast that has the ability to respond to circumstances, tightening or loosening as a child needs.”

“It really starts with the kids. We get to improve kids’ quality of life – and that’s a lifelong impact.”