Communicating for Better Care

PCCH offers full-time pediatric hospitalists and daily multidisciplinary rounds


By Kathy Lou Reynolds, MD, and Gina Randall, RN


“The good physician treats the disease; the great physician treats the patient who has the disease.” 

Dr. William Osler 1849-1919


Effective communication is the gold standard in disseminating patient care information.  In 2006, the Joint Commission added the following to its national patient safety goals: “Improve the effectiveness of communication among care providers.” Cottage Children’s Hospital (CCH) takes pride not only in being on the cutting edge of medical information and technology, but also in improving delivery of care and medical services to the children of the Central Coast.  Full-time pediatric hospitalists and daily multidisciplinary rounds are just two of the means by which we are enhancing the effectiveness of communication among providers of care to children.

Kathy Lou Reynolds, MD, and Gina Randall, RN


Cottage Children’s Hospital offers the services of four full-time pediatric hospitalists, each of whom is an experienced, board-certified pediatrician paneled by California Children’s Services (CCS).  The CCH pediatric hospitalists manage pediatric medical patients and consult on pediatric trauma and surgical patients.  They work closely with other pediatric subspecialists locally, as well as throughout the region, to provide quality continuity of care to pediatric patients.  The pediatric hospitalists assure communication with the child’s primary care doctor at both admission and discharge, typically via a telephone call and a summary of the hospital course.  The hospitalists also provide acute consultation to physicians in the community, including emergency department physicians and primary care providers.


Under the leadership of Liz Lundquist, RN, Director of Children’s Services for CCH, daily multidisciplinary rounds were instituted over four years ago. The CCH multidisciplinary team consists of a remarkable group of professionals, all with specialty pediatric training in their field of expertise.  The team includes a pediatric clinical nurse specialist; social workers; child life, speech, occupational and physical therapists; respiratory therapists; pediatric case managers; dietitians; a pediatric sedation nurse and a pediatric pharmacist, in addition to the direct care nurse, nurse manager and pediatric hospitalist or pediatric intensivist.  Other pediatric subspecialists and pediatric surgeons often join the rounds, as do residents, medical students and students in other specialties, as part of their education.


Every morning, in both the Pediatric Intensive Care Unit (PICU) and then in Acute Pediatrics, the multidisciplinary team gathers to discuss each child in the hospital. By congregating the entire team each day and discussing the needs of each patient, we are able to provide a highly individualized hospital experience for every child and family.  Starting the morning with multidisciplinary rounds ensures that each team member knows exactly the role he or she will be playing in the child’s care. 


The discussion of each patient begins with a pediatric hospitalist presenting the reason for admission, followed by the direct care nurse reviewing events from the last 24 hours. From this discussion, a multidisciplinary plan for the day is formulated. By enhancing communication, this unified team approach has improved the delivery, safety and organization of patient care at Cottage Children’s Hospital, leading to an enhanced experience for pediatric patients and their families.



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