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Growing Stronger Together is a podcast for people who care about children.
Growing Stronger Together was developed by faculty at East Tennessee State University, including members of the ETSU Health Department of Pediatrics, the ETSU Center for Early Childhood Learning and Development, and the ETSU Child and Family Health Institute.
East Tennessee State University is located in the beautiful Appalachian Highlands. We appreciate the financial support provided through a Community Health Improvement Site Investment from Ballad Health’s Department of Population Health.
Dr. Karen Schetzina (00:04)
Growing Stronger Together is a podcast developed by faculty at East Tennessee State University for people who care about children and families. We appreciate the support provided for the podcast from Ballot Health's Department of Population Health and Tennessee Department of Health's Maternal Mortality Prevention Program. I am host Karen Skatzina and I am thrilled to welcome our guests today. Emily Blanton, who is Assistant Vice President for Child Health Programs with Ballot Health and Niswonger Children's Network. Emily, welcome to the show.
Emily Blanton (00:44)
Thank you so much for having me, Dr. Schetzina.
Dr. Karen Schetzina (00:46)
To start, could you share a little more about your current role and your career path?
Emily Blanton (00:53)
Absolutely. So first of all, I am excited to be here today as a proud ETSU alumna. My undergraduate degree was in public health and I also completed my master's in healthcare administration through the College of Public Health. So I've been with Ballad Health for almost nine years. I actually joined prior to the merger whenever we were Mountain States Health Alliance. And my first job was in the marketing department at Niswonger Children's Hospital. So I've always had a passion for kids and had kind of advancing roles through the marketing and communications department. Marketing was my minor. And so I was with the marketing team for about eight years. And then whenever my current role became available last year, I just celebrated one year in this role. And so whenever that role became available, I took that leap.
⁓ I always knew I wanted to be ultimately on the operational side of things and so it just seemed like a perfect fit for me. ⁓ Really my current role is kind of a dual role with the population health team and the Children's Hospital. So I oversee our pediatric programs that includes the Child Life Department, the Children's Resource Centers. We have one in Johnson City at the Children's Hospital and one in Abingdon at Johnston Memorial Hospital.
our Strong Starts program, which I know you've chatted with Megan before, who's our wonderful program director. And then today, we'll talk about our pediatric care navigation program.
Dr. Karen Schetzina (02:22)
Well, you know, I've really enjoyed working with you, Emily, over the years in your various positions. And we also work together with the Pediatric Care Navigation Program team. So I'm very much looking forward to having this conversation today.
Emily Blanton (02:41)
Yes, it's such a wonderful team. We'll say PCN for short. We use that acronym quite frequently, but the PCN team has just kind of grown and evolved really, since I joined the team. And I know you have a lot of history with this team as well.
Dr. Karen Schetzina (02:57)
So tell us, Emily, what is the PCN program and why was it created?
Emily Blanton (03:02)
Yeah, so the Pediatric Care Navigation Program is based out of our pediatric subspecialty clinic. So there's a medical office building that is connected to the Children's Hospital. So very easy to be able to go back there for subspecialty appointments and then those providers also serve the
inpatient side as well. But the Pediatric Care Navigation Program was created to support families and children with complex medical needs.
So we really want to reduce barriers and improve access for kids within our 29 county region. We had noticed a specific patient population was showing difficulties in certain things like appointment adherence and readmission rates. So we really wanted to dig into why that was happening and how we could help these families navigate those unique challenges that they face with medical complexities. So we'd found a lot of the times hospital readmissions and ED visits might be unnecessary for this specific patient population. And ⁓ they may, you know, just show up for those certain medication issues, DME equipment malfunctions over the weekends, and they really just weren't sure where to turn and they didn't have a resource necessarily, especially on weekends whenever their providers from the subspecialty clinic may be out of the office.
So now with the Pediatric Care Navigation Program, we do have our team of navigators that families can always reach out to and follow up with. To qualify for the program, patients must be under 18 years old and see at least two of those pediatric subspecialty offices, so either with ETSU or our BHMA, Ballad Health Medical Associates, pediatric providers, or they can have one single system disorder such as type 1 diabetes. And then most recently, we have also opened the program to families who are struggling with severe social needs such as homelessness. So while we do have that defined criteria, we are always willing to consider referrals from providers, pediatricians, resources within the community as well. I know we'll talk more about that later.
But we encourage people not to shy away from making a referral because we are always willing to look at those on a case-by-case basis.
Dr. Karen Schetzina (05:24)
So this program was developed to address a critical need in our region, and it's still a critical need. You know, Niswonger Children's Hospital and our pediatric subspecialty providers have continued to grow, and more care is now available for families in our region. But it can be confusing, you know, especially for this population of children.
with complex medical issues, their parents and caregivers, or those youth or teens themselves with health issues have a lot on their plate understanding where are my appointments, when are my appointments, what do I need to do at home? And so this really has helped to fill a gap. So.
Let's talk about the family's experience. What can families expect if they enroll in the PCN program?
Emily Blanton (06:27)
Yeah, absolutely. So just to talk a little bit about our pathways after we receive a referral, our team does an intake questionnaire, and this really helps us determine what the needs of the patients and families are. So our team is small but mighty. We do have two nurse navigators, and they really each kind of focus half and half on specific subspecialties. So our providers have developed great relationships with those nurses and they've really become kind of the subject matter experts in those subspecialties. So we have those two nurse navigators to assist with the medical needs. We do have our wonderful community health navigator, and she follows up on those health-related social needs. And then we also have a transitions coordinator, and her role is to focus on helping teens become more independent and take responsibility for their health as they get older, or also can help navigate next steps because we do have some kiddos enrolled in the program who will be dependent on a caregiver for the duration of their lives. So after that, our team really takes a tier-based approach to determining the cadence of communication needed with families. So the more needs, the more frequently we would contact them. We also create care plans for those enrolled families and help them kind of meet their goals, set goals together of milestones that they want to meet. And then we do our best to coordinate same day visits, especially you mentioned just the need for subspecialty providers between Roanoke and Oak and Knoxville, Niswonger Children's Hospital and our subspecialty clinic. see patients sometimes from North Carolina, Kentucky, absolutely Southwest Virginia and Northeast Tennessee. But in that 29 county service area, any child could qualify for this program. So we're very excited to be able to grow with our subspecialty clinics and to see those patients as they come. So after we kind of work on coordinating those appointments, our team also can serve as a friendly face. So whenever patients come in, whether they're admitted on the inpatient side or they are coming in for their subspecialty appointment, we are happy to meet them where they are. Just to go into a little bit more about the resources that we offer, we do our best to really meet any needs that families may have. And we're constantly looking to grow those resources through new partnerships throughout the community. And so we've provided support on everything from medications, medical equipment, transportation, food, housing resources, disability services at local colleges and universities for those teens that are expecting to graduate and continue on at their next phase of life. And then you alluded to this earlier, but absolutely health literacy. So I think, you know, a lot of times, you know, even for us personally working in the medical field, there's certain words and acronyms that can be overwhelming, but especially for families who, you know, their kiddos may have a genetic disorder, a very complex medication list, and just a lot of different barriers to navigate with those kiddos. And so anything that we can do to kind of help break that down to help those families understand that piece, we will absolutely be happy to do that as well. I did want to mention also that we do have a grant through the Healthy Tomorrow's Partnership for the Children Program, and that's through the Health Resources and Services or HRSA administration. So we were awarded this grant in 2003 and this really supports our transitions piece of the program. So once kids turn 14, then our transitions coordinator will start working with them again to build that independence piece or to help kind of prepare them for their next step.
Dr. Karen Schetzina (10:33)
Well, thank you for explaining everything that families could expect with the PCN program. I think it's really nice that a child or youth would be matched with one of the navigators who can help meet their unique needs and the family's unique needs. And that the team's navigators are right here, right? They're not on the phone. They're not in another... you know, part of the country, you do get that personal interaction when families visit the clinic or visit the hospital. So I think that's a really unique and valuable part of the program. And I also like that we tailor it to the age or developmental needs because we know that these kids one day will be adults and there will be a lot of things that are different, right? Whether or not they're continuing to be at home or going off out of the area to school or entering the workforce. I love that the team helps build their capacity for the youth or their family to continue to care for them so they can thrive as adults.
Emily Blanton (11:51)
Absolutely. I also do want to mention our Regional Advisory Council. So this is a group, a collaborative group that we have that meets monthly. And then once a quarter, we try to meet in person. But this is a group of folks, everybody that's invested in children and teens with medical complexities. So we really have put together a wonderful group of multidisciplinary professionals.
We would absolutely open that up to other professionals that would like to attend. But we do a presentation once a month on different resources that we found ⁓ or perhaps new resources that we wanted to learn about. I know we've had ETSU's disability services did a presentation, which was so wonderful and really just different areas that we can look out to support our kiddos. And so it's just a wonderful time of like-minded individuals and just continuing to build on the services and resources that we can offer our kids.
Dr. Karen Schetzina (12:54)
I am so glad you mentioned the Regional Advisory Council, Emily So for professionals in the service area who may be listening, we will have some contact information in the show notes for this episode. If they would like to get involved in the Regional Advisory Council, I attend those monthly meetings and it's been really helpful for better understanding the needs and the resources that we can connect families to in the region. What else should professionals know about the pediatric care navigation program?
Emily Blanton (13:33)
Yeah, so I think just knowing that we're here as a resource, we really want to focus this year on outreach and to be able to let not only, our inpatient side of the hospital know, but our pediatrician groups as well. We always want to make sure that our patients have that true medical home. I know we talk about that a lot, but have that established provider within their pediatrician and before, you know, they graduate, so to speak, from our program, we want to make sure that they are also set up with an adult provider as well as, you know, seeing their adult subspecialist provider. really just that we're here and we're happy to help. We want to work alongside the medical teams and make things as seamless as possible for everyone. Again, we do take referrals on a case-by-case basis. So, I've mentioned our criteria as well, but we're, again, always willing to kind of look at any case to make sure that we can meet as many needs as we possibly can for those kiddos. So we have a new email address, actually. It's just PCN@balladhealth.org. And so if any providers or other professionals in the community have any questions or would like to join us for regional advisory council, we would welcome you to reach out to us.
Dr. Karen Schetzina (14:57)
That is easy to remember, but we will also have it in the show notes. I know our primary care providers at ETSU Health ⁓ in the Department of Pediatrics, we've really appreciated partnering
with the PCN program. And it's just been sort of an extension of our ability to provide that medical home and facilitate connection to subspecialty services and improve communication to make things easier for families. What else should families know?
Emily Blanton (15:31)
One other thing I do want to add is in terms of the professionals, we do have monthly, we call them M.A.R.K. meetings, and that stands for Monitoring At-Risk Kids. And so on the professional side of things, that's just another way that we can be as transparent as possible and make sure that we're on the same page as our providers. We meet quarterly with each different subspecialty group, as well as our ETSU providers as well.
And we really discuss our most medically complex kiddos. So our tier three, I mentioned that we kind of classify our patients by a tiered approach. And so, and that's just on our side for our purposes, but we'll discuss those most complex cases and most critical cases. And so we can all make sure that we're on the same page there if there's any concerns about patients and that we're serving them the best that we possibly can.
Dr. Karen Schetzina (16:25)
So I think that's also a really valuable aspect of the program for providers, but also for families. You know, sometimes when you're in that position as a patient or a family member of a patient, you wonder, are my different providers talking to each other? Are they working together? I'm glad you mentioned the MARC meetings, because that really is an opportunity for ⁓
improving communication among the team and making sure that everyone's on the same page and again, improve care for families.
Emily Blanton-1 (17:00)
Definitely.
And for families too, I would also say, you know, if there's anything that comes to mind or any question that you have regarding your child's health care, we may not be, you know, the most appropriate person to answer that question, but we'll find that answer for you. And so I know our team really is ⁓ just so dedicated to tracking down those answers and, you know, that's, we have such a mission driven team.
And that's what we're here to do. So anything that we can possibly help with, whether it's health related or again, the social needs related, we've seen that come up more frequently as needs that our team can help support. And so anything that comes to mind that we can help with, big or small, we're happy to do so.
Dr. Karen Schetzina (17:48)
Well that is wonderful. Emily, thank you for talking with me today. Is there anything else you'd like to share before we wrap up?
Emily Blanton (17:57)
Yes, actually. So we have recently begun a new process evaluating patients on the inpatient side. So I had mentioned currently our process really is to receive referrals from our subspecialty providers. Once patients come in for their first subspecialty appointment, then they might see that they have certain needs and they'll refer them to the PCN program. But with this new process, we are evaluating patients on the inpatient side.
So this is really a partnership between our case management team, our population health team, and our child health programs. And so how this works is each patient comes in and is screened for health-related social needs. And then we are able to pull a report of those positive screenings. And then we have a navigator who follows up on those positive screenings and can connect them to the PCN program if needed. They can connect them to behavioral health or strong starts, for example. So just a plethora of resources that we're very excited to be able to connect our families with because we have seen, you know, especially a lot of transportation barriers. And so where we've not really been enrolling patients in our program until they see that first subspecialty appointment, we're now able to get a little bit more proactive and we're very excited about that so we can round on the inpatient side as well and make sure that we can help support families before they even get to that first subspecialty appointment.
Dr. Karen Schetzina (19:35)
That's wonderful. So really meeting families where they are and absolutely where and when they need help. Well, thank you again for talking with me, Emily. And I really look forward to seeing how the Pediatric Care Navigation Program continues to grow and serve children and families in our region. Thank you.
Emily Blanton (19:40)
Absolutely.
Thank you, Dr. Schetzina