ADVOCACY/PUBLIC
POLICY
Saturday, May 4, 2002
8:30am-11:30am
Workshop
4001
Pediatricians Summoning Action for Children
Pediatricians have
traditionally been natural and effective advocates for
children and youth. Increasingly, pediatricians find
themselves in advocacy roles, such as helping families
navigate managed care systems, persuading administrators
to increase funding for pediatric health care and
research, or advising community programs on how best to
meet the needs of youth. However, there is a lack of
consensus on what is (and is not) advocacy, and how
pediatricians can be effective advocates for their
patients, families, and communities. This workshop is
designed to create a forum to discuss these issues.
Advocacy will be defined in the context of pediatric and
community health. A framework for "the doing"
of advocacy will be examined through case examples of
advocacy projects designed and carried out by residents
from six pediatric programs funded by The Anne E. Dyson
Community Pediatrics Training Initiative. Sample
projects will include advocacy at the individual, local
community, and state and national government levels, and
will focus on projects that take an idea and create a
plan of action after a thorough assessment of the
perceived problem and the target community. These cases
highlight the importance of community partnership and
evaluation. Through this process, participants will gain
a broadened understanding of the pediatrician’s role
as advocate and skills that serve this role.
J. Pletcher, A. Amzel, S. Cohen, C. Derauf, J. Goepp,
P. Hametz, K. Hendricks, W. Kessel, F. LeFlore, D.
Schwarz, J. Skelton, H. Taras, and K. Zieselman, The
Anne E. Dyson Community Pediatrics Training Initiative
Advocacy Group
10:00am-12:00pm
Educational Seminars
ES02
Bioethical Dilemmas: Making Decisions for the Not Yet
Competent
This seminar will be a
provocative interactive session on Bioethics. Through
the use of cases and excerpts from literary works,
participants will be encouraged to view decision-making
from the perspective of parents and health care
providers. The Principles of Bioethics will be
presented, as well as the contextual considerations that
force us all to wrestle with principles and theory, if
we choose to do so. The goal is to raise the
consciousness about the range of issues involved in
making the best decision for the pediatric patient. In
the end, choices must be made, and all those involved
must live with these choices.
Susan Albersheim, British Columbia's Children's
Hospital, Vancouver, BC, Canada
ES02
Bioethical Dilemmas: Making Decisions for the Not Yet
Competent
This seminar will be a
provocative interactive session on Bioethics. Through
the use of cases and excerpts from literary works,
participants will be encouraged to view decision-making
from the perspective of parents and health care
providers. The Principles of Bioethics will be
presented, as well as the contextual considerations that
force us all to wrestle with principles and theory, if
we choose to do so. The goal is to raise the
consciousness about the range of issues involved in
making the best decision for the pediatric patient. In
the end, choices must be made, and all those involved
must live with these choices.
John D. Lantos, University of Chicago, Chicago, IL
12:00pm-3:00pm
Mini Course
4105
Update on Injury Control
Chair: Gary A. Smith,
Children's Hospital, Columbus, OH
The field of injury control
continues to evolve. Over the past decade new sources of
injuries have arisen, new information on old or
overlooked causes has been obtained, and new techniques
for preventing and minimizing the impact of certain
injuries have been developed and evaluated. This session
will review these advances and outline pertinent next
steps for health policy, research and clinical care.
Overview
Gary A. Smith, Columbus Children's Hospital,
Columbus, OH
Firearm Injuries: Just the Facts
M. Denise Dowd, Children's Mercy Hospital,
University of Missouri, Kansas City, MO
Update on Product-Related Injuries
Gary A. Smith, Columbus Children's Hospital,
Columbus, OH
Break
Prevention of Motor Vehicle-Related Injuries
Phyllis F. Agran, Pediatric Injury Prevention
Research Group, Health Policy and Research, University
of California, Irvine, CA
Current Federal Agency Priorities in Childhood Injury
Prevention Research
Richard A. Schieber, Centers for Disease Control and
Prevention, Atlanta, GA
12:00pm-3:00pm
Special Interest Group
4109
Advocacy Training
Resident CATCH Grants at a
Tool for Teaching Advocacy: The AAP CATCH (Community
Access to Child Health) program offers small planning
grants to residents to develop collaborative projects in
their communities. CATCH personnel will discuss the
CATCH planning grant process and discuss ways in which
the process can be used to teach community advocacy
skills.
Resident Advocacy Poster Session: We will solicit
abstracts from Residency programs, including recipients
of past Resident CATCH Planning Grants. We will select
up to12 abstracts for poster presentation at the SIG.
Core Competencies: We will solicit input from the SIG
into the formulation of guidelines for advocacy training
in residency training.
Cochairs: David Keller, KellerD@ummhc.org,
and Rosland Vaz, rvaz@lifespan.org
3:15pm-5:15pm
Topic Symposium
4200
Cloning and Embryonic Stem Cells
Chair: Judith Hall,
University of British Columbia, Vancouver, Canada
There is enormous public
interest in cloning and embryonic stem cells. This
symposium will update the pediatric community on recent
developments and raises a variety of policy and ethical
issues.
Overview
Judith G. Hall, University of British Columbia,
Vancouver, Canada
Imprinting and Reprogramming
Arthur L. Beaudet, Baylor College of Medicine,
Houston, TX
Cloning
Brigid Hogan, Vanderbilt University Medical Center
and the Howard Hughes Medical Institute, Nashville, TN
Embryonic Stem Cells
Janet Rossant, Samuel Lunenfeld Research Institute,
Mount Sinai Hospital ON, Canada
3:15pm-5:15pm
Platform Session
4252
Health Services Research: Quality of Care
Chairs: Glenn Flores and
Richard C. "Mort" Wasserman
3:15pm-5:15pm
APA Committee
4302
APA Public Policy/Advocacy Committee
5:15pm-7:15pm
Poster Session
– Education
Sunday, May 5, 2002
8:00am-10:00am
Topic Symposium
5001
Measuring and Improving Quality in Academic Medical
Centers
Chair: Michael Apkon, Yale
University School of Medicine, New Haven, CT
Applying scientific approaches
to quality management presents an important leadership
challenge for Academic Medical Centers to enhance health
care delivery. This symposium will review new paradigms
with which to examine opportunities for measuring and
improving the process of care delivery. The symposium
will also consider areas of congruence as well as areas
of opposition between the educational and care-delivery
missions of Academic Medical Centers where
often-competing interests of research, clinical care,
and education create a particularly challenging
environment for quality management.
The Case for Quality
Michael Apkon, Yale University School of Medicine,
New Haven, CT
Measuring the Quality of Care
Rita Mangione-Smith, University of California, Los
Angeles, CA
Comparing Quality Across Institutions
Murray M. Pollack, Children's National Medical
Center, George Washington University School of Medicine,
Washington, DC
Pediatric Outcomes Measurement in Academic Medical
Centers
Jeffrey H. Silber, The Children's Hospital of
Philadelphia and the University of Pennsylvania School
of Medicine, Philadelphia, PA
Aligning the Missions of Providing Care and Educating
Physicians
Martha Radford, Yale University School of Medicine,
Yale New Haven Health System, New Haven, CT
Discussion
1:45pm-2:30pm
State of the Art Plenary
5590
Children as Victims of Bioterrorism: Protecting the
Fragile Host
Chairs: Phyllis Dennery,
Stanford University School of Medicine, Palo Alto, CA
and Tina Lee Cheng, Johns Hopkins University School of
Medicine, Baltimore, MD
With the recent world events
and new threats of biowarfare, what should pediatricians
know? Due to their size and physiology, children are at
higher risk of injury from bioterrorism. This session
will address the biology, clinical manifestations, and
possible preventive strategies for likely biowarfare
agents. The unique vulnerability of the child will be
addressed.
Overview
Phyllis A. Dennery, Stanford University School of
Medicine, Palo Alto, CA
Children as Victims of Bioterrorism: Protecting the
Fragile Host
Ralph D. Feigin, Baylor College of Medicine,
Houston, TX
Discussion
2:00pm-4:00pm
State of the Art Plenary
5701
Children as Research Subjects: Ethical and Regulatory
Issues
Chair: Myron Genel, Yale
University School of Medicine, New Haven, CT
A number of highly publicized
adverse events, including the death of two volunteers
participating in non-therapeutic research, and the
federal shutdown of research at many well-recognized
academic institutions because of inadequate compliance
with regulatory requirements have intensified scrutiny
of the protection afforded to human subjects
participating in research, including children.
Furthermore a Maryland court has recently decreed that
children cannot participate in research without the
potential for direct benefit. As a consequence there has
been increasing media attention and Congressional
concern regarding the adequacy of institutional
oversight and investigator attentiveness to established
standards and regulations. In addition, new regulations
issued under the Health Insurance Portability and
Accountability Act of l996(HIPAA) threaten the capacity
to conduct health services and outcomes research. These
issues will be addressed in the 9th annual Public Policy
Plenary Symposium in an interactive format intended to
stimulate dialogue among the members of the panel and
with the audience.
Overview
Myron Genel, Yale University School of Medicine, New
Haven, CT
Overseeing Research in Children: New Concerns and New
Regulations
Alan R. Fleischman, The New York Academy of
Medicine, New York, NY
International Health Research: Where Bioethics,
Politics and Economics Converge
Eric M. Meslin, Indiana University Center for
Bioethics, Indianapolis, IN
Compliance: What You and Your Institution Need to
Know (and Do)
Pearl O'Rourke, Partners HealthCare System, Inc.,
Boston, MA
HIPAA, Privacy & Confidentiality and Research In
Children?
Brian Kamoie, The George Washington University,
Washington, DC
Discussion
Sponsored jointly with the Public Policy Council
of the APS, AMSPDC, SPR and the Public Policy Committee
of the APA
Partially supported by an educational grant from
Columbus Children's Hospital
2:00pm-5:00pm
Workshops
5600
A Curriculum for Disclosing Medical Errors: Responding
to the Joint Commission Imperative
Release of the Institute of
Medicine Report (1999) has increased public awareness of
the existence of errors in the practice of medicine. The
Joint Commission on Accreditation of Healthcare
Organizations (JCAHO) has issued a directive that
medical errors be disclosed to patients and families.
Healthcare organizations need strategies to ensure
compliance, yet many questions remain: What represents a
disclosable medical error? Is there a means of reaching
consensus among professionals and how does one share
with families in the most constructive ways possible?
This workshop will focus on a program developed at
Vanderbilt designed to help medical groups reach
consensus concerning what represents an error and
understand existing literature concerning the
consequences of disclosure. Using a case-based approach
participants will be afforded an opportunity to share
such sensitive information through role-play and
"audience lifeline" techniques. The program
will emphasize that there is no single correct approach
given the complexity of medicine and differences in
families and physicians. Participants will be encouraged
to use a "balance beam approach" in which
physicians (pediatricians) consider all possible
disclosure strategies ranging from limited to full
disclosure with assignment of responsibility and the
relative advantages and disadvantages of each approach.
Participants should be better equipped to share highly
sensitive information with families and adapt course
concepts into their own institutions.
G. B. Hickson, J. W. Pichert, J. Gigante, Vanderbilt
Children’s Hospital, Nashville, TN
5603
Developing Faculty To Teach Child Advocacy
The Pediatric RRC now requires
that residents be prepared "for the role of
advocate for the health of children within the
community." Programs have addressed this
requirement through community block rotations,
longitudinal experiences, lectures, workshops and
service-learning experiences. A common problem, voiced
in the APA Advocacy Training SIG meetings, is lack of
preceptors to teach and model child advocacy within
their programs to reinforce the message that child
advocacy is part of good pediatric practice.
This workshop will allow participants to learn how to
promote the teaching of child advocacy by academic and
community preceptors in pediatric residency.
Participants will: 1) participate in an interactive
discussion of child advocacy to develop a working
definition that fits their clinical setting, 2) identify
faculty at their institutions who could serve as models
and mentors for advocacy training, 3) discuss training
methods used at our institutions (scavenger hunt/ photo
essay, community connections and case-based advocacy
projects) to promote teaching and learning about
community involvement and child advocacy and 4) work in
small groups to adapt these methods to each participant’s
home institutions and present the results to the
workshop. The participants will be enrolled in a
post-workshop LISTSERVE to share experiences over the
ensuing year.
D. M. Keller, J. A. Andrake, S. Starr and E. Schulte,
UMass Medical School, Worcester, MA, SUNY Upstate
Medical University, Syracuse, NY, and Albany Medical
College, Albany, NY
2:00pm-5:00pm
Special Interest Group
5612
Environmental Health
All Pediatric Academic
Societies' (PAS) members and meeting attendees are
invited to join us at the annual Special Interest Group
Meeting to be held in Baltimore during the PAS annual
meetings. We continue to be an informal group committed
to the protection of children and environmental hazards
through our interest and/or our direct professional
activity.
Based on the highly successful format of our session
at the PAS meetings in May 2001, we again plan to
include in our meeting:
- Educational session – lecture/discussion on a
current Peds Environmental Health topic
- Discussion of current issues and progress on
medical and health professional education and
curriculum development
- Select research presentations of general relevance
- Issues of advocacy in Peds Environmental Health
pertinent to Ambulatory Peds Association and PAS
members and attendees
The specific program will be announced in the next
APA newsletter. We hope to see you there. Please feel
free to contact SIG cochairs for questions or comments.
Cochairs: Ben Gitterman, bgitterm@cnmc.org,
and Jimmy Roberts, robertsj@musc.edu
Monday, May 6, 2002
7:00am-8:00am
Topic Symposium
6000A
Public Policy 16th Annual Legislative Breakfast
Symposium
Privacy & Confidentiality
Regulations and Their Impact on Health Research and
Academic Medicine
Jennifer Kulynych, Director,
Division of Biomedical and Health Sciences Research,
Association of Medical Colleges, Washington, DC
Sponsored jointly with the Public Policy Council of
the APS, AMSPDC, SPR and the Public Policy Committee of
the APA
9:00am-12:00pm
Workshops
6102
Clinical Forensic Medicine: Bridging the Gap Between
Medicine and Law
Medical practitioners who work
in acute care settings are likely to encounter forensic
issues, such as child abuse, assault or unexpected
death. However, few training programs prepare physicians
to adequately manage these issues.
Objective: This workshop is designed to increase
participant awareness of their pediatric patients’
forensic medical needs, and to review techniques for the
acute evaluation of such patients.
Methods: Experts in the fields of Pediatric Emergency
Medicine, Child Abuse and Neglect, Toxicology and
Forensic Medicine will work directly with participants
to teach them how to evaluate pediatric patients from a
forensic perspective. Workshop participants will receive
hands-on instruction in the following skills: the
detection, collection and preservation of evidence,
documentation of injuries (including medical
photography), pattern injury recognition and
interpretation of injuries, preparation for court
testimony, and reporting requirements and regulations.
During one of the segments, participants will rotate
through stations where they will utilize these skills
using state-of-the-art equipment. All registrants will
also receive a comprehensive syllabus containing
relevant information and recent references related to
the practice of Clinical Forensic Medicine that is
designed to be used as a teaching aid.
K. Bechtel, K. Santucci, L. Arnold, C. Baum J. Klig
and M. D. Baker, Section of Pediatric Emergency
Medicine, Yale-New Haven Children’s Hospital, New
Haven, CT
6109
Program Evaluation for Advocacy Interventions in
Residency Programs
Many residency programs are
implementing interventions to expose residents to
advocacy activities, enhance residency training with
regard to advocacy, and better meet the needs of
families within the communities in which they live. As
part of these activities, programs face challenges
designing and implementing appropriate evaluations to
determine whether their objectives are being met. The
purpose of this workshop is to highlight local
evaluations being conducted at 6 pediatric residency
programs as part of the Anne E. Dyson Community
Pediatrics Training Initiative and engage participants
in considering multiple aspects of program evaluations.
Using interactive breakout groups, participants will
propose possible methods and challenges of evaluating
hypothetical advocacy interventions. The workshop will:
articulate the usefulness and constraints of evaluating
advocacy interventions; describe fundamental steps to
designing and implementing successful evaluations; and
highlight purposes and creative approaches for
conducting program evaluations. Funded by The Dyson
Foundation.
C. Minkovitz, Johns Hopkins University, Baltimore,
MD, M. Aten, University of Rochester, Rochester, NY, D.
Bragg, Medical College of Wisconsin, Milwaukee, WI, A.
Duggan, H. Grason, Johns Hopkins University, Baltimore,
MD, V. LeBlanc, Columbia University, New York, NY, K.
Minot, Children’s Hospital of Philadelphia,
Philadelphia, PA, M. Zuniga de Nuncio, UCSD, San Diego,
CA
12:00pm-1:00pm
Alliance Club
6310A
Bioethics Interest Group
Chair: Susan Albersheim
Is It Quality Improvement
OR Is It Research?
Henry L. Halliday, Belfast, Ireland
Jon E. Tyson, Houston, TX
Barbara McGillivray
1:30pm-5:30pm
APA Presidential Plenary
6450
APA Presidential Plenary and Armstrong Lecture
Chair: Steve Ludwig
International Health Award:
Clinical Presentation, Immediate Outcome and Prognostic
Factors of Cerebral Malaria in Children Admitted to
Mulago Hospital
Richard Idro
Ray E. Helfer Award for Innovation in Pediatric
Education: Measuring Medical Knowledge Competencies
Using Web-Enhanced Instruction During a Pediatric
Resident Ambulatory Block Month
Larry C. Hurtubise
Carl E. Johnson
Distinguished Career Award
Barbara Starfield
The George Armstrong Lecture
Steven A. Schroeder
Tuesday, May 7, 2002
8:45am-11:45am
Workshop
7105
Medical–Legal Collaboration: Advocacy in the Clinical
Setting
Lawyers have become an
essential part of the multidisciplinary healthcare team
that low-income communities rely on to protect the
health of their children. No longer is a doctor’s
letter enough. Poor families navigating the bureaucratic
barriers to government benefits such as food stamps or
subsidized housing need both a doctor and a lawyer by
their side. The goal of this workshop is to underline
the importance of making local social resource networks
more accessible to the patient population, while
simultaneously teaching health care providers how to do
so. The workshop will:
• Teach pediatricians and other health care
providers about the basics of legal advocacy by
providing them with the necessary tools and resources to
proactively address the social issues that affect
children’s health and wellness.
• Introduce pediatricians to Advocacy Code Cards,
on which are listed reference numbers of social service
agencies in Boston, a sample letter a doctor could use
to advocate for a patient, as well as general advocacy
tips.
• Emphasize the unique ability of medical–legal
collaborations located within pediatric clinics to
comprehensively care for children’s health.
Participants will learn methods to establish liaisons
between legal services and pediatric offices. Case
examples will be used to demonstrate the usefulness of
medical and collaboration from an on-site legal service
program to provide families more holistic care.
B. Zuckerman, MD, M. Sandel, MD, E. Lawton, Esq., Eric
Fleegler, MD, Boston Medical Center, Boston, MA
1:45pm-3:45pm
Hot Topic
7702
Disaster Preparedness: Beyond 9/11
Chairs: Tina L. Cheng,
Johns Hopkins University School of Medicine, Baltimore,
MD; Danielle Laraque, Mount Sinai School of Medicine,
New York, NY; and Benard Dreyer, New York, NY
The impact of 9/11 and the
public health aftermath have affected us personally and
professionally. This session will address what the child
health professional needs to know regarding disaster
planning and preparedness. Speakers will review and
provide updates on national and regional systems for
emergency management and how those systems interact with
local public health agencies, the pediatrician's role in
the community's preparedness including what the school
system, the pediatric office and the patient should be
doing to prepare and respond, recognition and management
of chemical and biologic agents of terrorism, and the
psychological reactions to disaster and stress.
Disaster Planning and Preparedness for Child Health
Professionals
George L. Foltin, New York University School of
Medicine and Bellevue Hospital Center, New York, NY
Biologic Agents of Terrorism
Anne Fine, New York City Department of Health, New
York, NY
Chemical Agents of Terrorism
Fred Henretig, University of Pennsylvania School of
Medicine and Children's Hospital of Philadelphia,
Philadelphia, PA
Helping Children Cope with Terrorism and Disasters
David J. Schonfeld, Yale University School of
Medicine, New Haven, CT
Discussion
1:45pm-3:45pm
Platform Session
7803
Health Services Research
Chairs: Denise M. Dougherty
and Thomas B. Newman
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