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LPCH Intensive Care Units
At Packard Hospital, residents participate in three excellent intensive care units. The Neonatal Intensive Care Unit (NICU), is part of the Johnson Center and is a Level 4, 40-bed unit dedicated to neonates. The unit is a major referral center for northern California. The NICU is adjacent to the high-risk delivery service at the Johnson Center and cares for patients with a wide variety of medical and surgical diseases. Residents spend between 2 and 3 months in the unit over the course of their 3 years of training.
The Pediatric Critical Care division includes a Pediatric ICU (PICU)
and a Cardiovascular
ICU (CVICU). Both currently have 12 beds, but plans are underway to increase to 20 beds for each ICU by July 2008. The PICU
handles trauma, medical referrals, transplantation and post-surgical
cases. The PICU is also equipped with ECMO for cardiovascular and multi-organ failure. The CVICU is primarily pre- and post-surgical CV patients, and
is a part of the nationally prominent LPCH Children’s Heart Center.
Resident time is weighted towards the PICU, with some exposure to the
CVICU to give breadth of training in cardiac care. For pediatric residents with an interest in Cardiology, electives can be arranged in the CVICU.
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Wards at LPCH include the Hematology-Oncology ward on the second floor, and the General Pediatric and Subspecialty wards on the third floor. The 20-bed Oncology ward includes bone marrow transplantation, new referrals, chemotherapy and acute admissions. Construction is underway to expand our capacity in order to enhance our bone marrow and stem cell transplantation service to national renown. All residents spend 1-2 months on the Oncology ward in their intern year, and some return for an additional month as a Senior supervisor. The oncology service also has a night float covering overnight shifts. This is typically a junior resident doing a 4 week rotation composed of 2 weeks night float and 2 weeks outpatient hematology.
The wards on the third floor are currently organized into three or four resident
teams, divided along sub-specialty lines.
The Blue Team is composed of one to two interns and a senior resident and cares for general pediatric, endocrine, neurology, pulmonary, and cardiology patients. At certain times of the year, an additional Yellow Team is established that cares for the cardiology and pulmonary patients. This team is comprised of one intern and one supervising resident. The Red Team is composed of one intern and one senior resident and cares for nephrology and rheumatology patients. The Green Team is composed of one intern and one junior resident and cares for our gastroenterology and liver patients.
Surgical patients are covered primarily by the surgical services. All
residents spend time on all teams at multiple points throughout their
three years. Overnight call on the LPCH wards is taken primarily by Night Float Teams. On the Wards a team of two interns and one senior resident care for patients at night from Sunday through Thursday. The oncology ward is covered by one junior resident at night. There is an evening report curriculum, led by the LPCH hospitalists, which serves as an educational component for the night teams.
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The Ambulatory Care Center has over 100,000 annual clinic visits and
provides primary and specialty care in a wide variety of medical, obstetrical
and surgical clinics. Our General Pediatric clinics (including the Acute
Care Clinic) provide ample well child assessments, sick visits, and continuity
clinic patients for our residents. Specialty clinics offer the entire
range of pediatric subspecialty care including Adolescent Medicine, Allergy/Immunology,
Bone Marrow Transplantation, Cardiac Transplantation, Cardiology, Dermatology,
Endocrinology, Diabetes, Center for Healthy Weight, Gastroenterology & Nutrition,
Genetics, Hematology/Oncology, Infant Development, Infectious Diseases,
Liver Transplantation, Nephrology, Neurology, Neurosurgery, Orthopedics,
Pediatric Surgery, Renal Transplantation, Rheumatology, and Urology.
Residents participate in many of these clinics during their selective
and elective blocks, as well as scheduled rotations. These clinics are located in the recently opened Mary Johnson Ambulatory Care Center.
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LPCH Family Centered Care
The entire staff of LPCH is dedicated to family centered care. This
commitment is reflected in the design of the facility and in the operations
of the hospital and clinics with its dedicated child-oriented support
services. We feature special facilities such as recreation therapy and
a school within the hospital walls. Our active Child Life department
includes the Forever
Young Zone with recreational facilities for children
of all ages. Parents participate actively in their children's care and
are encouraged to stay overnight in special in-room parent beds. Cooking,
laundry, shower, and lounge facilities are available for family use.
Social service professionals, chaplains, interpreters, and a special
sibling program are available to minimize the stress of a child's hospitalization.
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SCVMC Units and Clinics
In 1999, SCVMC opened a new state-of-the-art hospital in San Jose with comprehensive pediatric clinical services. The new facility features a 12-bed critical care unit, a 32-bed neonatal unit, and a 30-bed pediatrics unit. SCVMC offers special pediatric services including a burn treatment center and a special unit for rehabilitation and spinal cord injuries. Its active obstetrical service with over 6000 deliveries per year provides ample delivery room experience for our pediatric residents. SCVMC is also a Level I trauma center with an active trauma service. Residents spend time in the NICU and on the inpatient team, which is a combined ICU and ward experience. This experience is highly rated by residents for its diversity, autonomy and sense of camaraderie.
The SCVMC outpatient facility, the Valley Health Center, is located
across the street from the hospital and offers more than 60 primary care
and specialty clinics. During each training year, our residents work
in the SCVMC clinics as part of their ambulatory training curriculum.
Additionally, some residents choose SCVMC or one of its satellite clinics
for their continuity clinic experience. During subspecialty selectives,
residents participate in a variety of SCVMC clinics including Behavior
and Development, Cardiology, Endocrinology, Gastroenterology, Genetics,
Infectious Diseases, Nutrition, Nephrology, Neurology, Neuro-Development,
Orthopedics, Ophthalmology, and Pediatric Surgery.
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The pediatric service at Kaiser Santa Clara includes a 19-bed Pediatric
Ward and a 8-bed Intensive Care Unit. These intensive care units and the High Risk Pregnancy Program
serve as a referral center for other Kaiser Permanente Medical Centers
in Northern California. Residents spend a month during their Junior year
as the primary physician on the Kaiser Inpatient Service (the ward and
the PICU), with back-up and teaching from a staff of excellent Kaiser
physicians. Not only does the rotation provide exposure to a large staff-model
HMO setting, but it gives a manageable sense of independence and the
opportunity for exploration.
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Patient Population and Demographics
Our patient population at LPCH is very diverse, both in ethnicity and
socio-economic strata. In the primary care clinic, our patients are roughly
60% Hispanic, 12% Pacific Islander, 10% African American, 7% Asian, and
7% Caucasian. Most of our primary families are living at or below the
poverty level, and qualify for MediCal (Medicaid in California). Beyond
the clinics, LPCH is also the local hospital for a large network of community
primary care pediatricians, serving a broad patient population from the
surrounding affluent communities of the San Francisco peninsula and Silicon
Valley, adding common illnesses to the diversity of patients on our inpatient
units. As a referral center for specialized tertiary and quaternary care
clinical services, we attract patients from across the western United
States, Alaska, and Hawaii. We also have an international patient population
seeking our most highly specialized clinical services such as interventional
cardiology and cardiac surgery.
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