Name of Program: Cohen Children’s Medical Center, Northwell Health
Year Program Established: 2018
Program Leader: Arushi Dhar, MD
Key Staff and Specialties: Arushi Dhar, Elena Kwon (Pediatric Cardiology)
Victoria Chen, Nili Major (Developmental and behavioral pediatrics)
Jeanette Felix, Patti Hanson (Registered nurses)
Mindy Schmutter (Social Worker)
Melissa Mancuso, Kristen Laurino (PT/OT)
Age Range of Patients Served: We have expanded our patient selection to include all those who underwent surgical repair/palliation for congenital heart disease regardless of age. Each patient is risk stratified based their cardiac diagnosis as well as clinical/surgical course according to the American Heart Association Scientific Statement entitled “Neurodevelopmental Outcomes in Children with Congenital heart Disease Evaluation and Management” (2012). The above risk stratification is taken into account when determining the timing of the initial and follow-up assessments.
Description of Inpatient Program(s): A referral workflow has been established in the NICU and cardiac ICU. In the NICU a developmental assessment is performed and outpatient appointments are established prior to hospital discharge. Low risk cardiac patients are referred to the high risk NICU clinic then transitioned to the cardiac neurodevelopment (CND) clinic as determined by the development team. The high risk cardiac patients are directly referred to the CND clinic. In the cardiac ICU a referral is sent to the CND team and a follow up appointment is made, based on the above risk factors. A formal letter explaining the CND program is given to the families prior to hospital discharge.
Description of Outpatient Program(s): At each CND visit the patient undergoes a developmental/behavioral assessment as well as physical and occupational therapy evaluations. The recommended developmental screening tools, as well as the timeline of assessments based on the patient’s age, as established by the Cardiac Neurodevelopmental Outcomes Collaborative, are followed. The COVID-19 pandemic has had a significantly negative impact on our CND clinic due to changes in the referral process and transition to telehealth evaluations.
Description of research or QI projects in cardiac neurodevelopment – undergoing or accomplished: A QI project focused on improving referral compliance to the CND clinic in the inpatient and outpatient setting is currently underway. Our goal is to improve compliance with our CND enrollment and include >80% of new surgical patients.
Unique features and strengths of this program:
- Multidisciplinary approach
- We have expanded our patient selection to include all those who underwent surgical repair/palliation for congenital heart disease regardless of age