Regional Clinics and Care Alliances Keep Kids Closer to Home

When it’s hard for kids to come to Children’s Hospital Colorado, expert providers go to them

The sun has begun to set as Dr. Christopher Rausch heads to the Durango-La Plata County Airport to hop on the small commuter jet that will shuttle him home to Denver. The pediatric cardiologist just wrapped up two full days of seeing patients inside a local pediatric primary care office as part of a Children Hospital Colorado regional outreach clinic he runs in Durango, Colo.

After the 90-minute flight lands, Dr. Rausch will likely go straight home and sink into his bed. He wants to be well-rested for the next day’s packed schedule seeing patients at his regular clinic in the Heart Institute at Children’s Colorado in Aurora.

Easing the burden for families

The Durango clinic eliminates the need for pediatric heart patients in the southwestern corner of the state to make the grueling seven-hour drive to the Anschutz Medical Campus for a specialist appointment.

Dr. Rausch sets up shop in Durango every other month to care for young patients with a range of conditions, spanning from abnormal heart rhythms to complex congenital heart disease. A trained pediatric sonographer always accompanies him in case there is a need for on-the-spot imaging. 

As medical director of Pediatric Cardiology Network of Care and Outreach at Children’s Colorado, Dr. Rausch has been regularly traveling to outreach clinics in four locations across the region since 2008. And while he admits there’s a lot of effort and travel involved, he says the tradeoff for the families he serves is well worth it.

“It’s a really important service to the community. We want kids to stay healthy, and we recognize the importance of ensuring they can access the specialty care they may not otherwise get,” he says. “Sometimes families can’t afford to take time off work to get to our main medical campus, or they don’t have reliable transportation. If we can bring care to these patients and make it easier on their families, we should.”

Children’s Colorado is the only dedicated pediatric health system within a seven-state region, and Durango is just one clinic location out of Children’s Colorado’s 34 regional outreach sites that provides care across three dozen pediatric specialties. The clinic sites are in far-flung locations across a 1,000-mile-radius that comprises Colorado, Montana, Wyoming and New Mexico. In 2019, Children’s Colorado’s regional outreach clinics accounted for more than 5,000 patient visits and 625 full-day clinics in total.

For some families, the Children’s Colorado clinics are the only access point to specialized pediatric care in their area, like in sparsely populated Wyoming, where there are only a handful of pediatric specialists in the entire state.

The clinics are typically held anywhere from once a month to quarterly, depending on the local community’s needs. Patients may need to be referred for further testing or procedures, but many children can remain in their local communities and receive the same state-of-the-art care that is delivered at Children’s Colorado’s physical medical campuses.

For those who do require an in-person visit, parents can have peace of mind knowing that their child will be cared for at a top-ranked pediatric hospital that boasts some of the best health outcomes nationwide. Last year alone, Children’s Colorado served patients from 49 different states and 22 countries. 

Removing geographic barriers

In addition to the clinics, Children’s Colorado has 10 ongoing care alliances with health care organizations across four states to ensure that a family’s geographic location is never a barrier to receiving expert pediatric care.

“Many providers in surrounding regions may not be specifically trained in pediatrics, but they’re the ones providing care to kids when kids are admitted,” says Jennifer Knotts, director of Partnerships and Outreach at Children’s Colorado. “Though a care alliance, there’s a formalized hospital-to-hospital agreement to collaborate on optimizing care for kids in the community where they live. We’re giving the competency and comfort level to be able to do what they are currently doing in the best way possible.”

Organizations in the alliance receive support from Children’s Colorado including access to up-to-date clinical care pathways, protocols and evidence-based medicine that can be customized to fit the needs of their community.

Medical providers can also tap into Children’s Colorado’s educational resources and training, including training videos and on-site simulation training at their location, or the chance to travel to a Children’s Colorado hospital campus for in-person training.

Local providers who seek training through the alliance have grown exponentially, from 50 learners in 2017 to more than 1,100 in 2020, Knotts says.

Complementing, not competing

Beyond the care alliances, Children’s Colorado has formed partnerships with five healthcare systems to place Children’s Colorado-employed neonatal nurse practitioners or University of Colorado School of Medicine pediatric hospitalists in other hospitals to deliver specialized inpatient care. The alliances provide the opportunity for local health systems to tap into the resources and expertise of a top 10 children’s hospital when it’s needed.

“We want to complement — not compete — with care available locally and support that care however we can. If a patient needs to be transferred to Children’s Colorado for more complex care, to the extent we can hand them off to be followed and managed in their community, we want to do that,” Knotts says. 

Dr. Rausch says he’s been welcomed with open arms at all the locations he visits — not only by patients and their families but by other providers, too.

“We’ve built strong relationships going to these clinics,” he says. “The pediatricians and family practitioners all seem very happy we come. They use us as a resource for their questions and we chat with them pretty regularly.”

He adds, “Parents are so appreciative to be able to get specialized care for their child close to where they work and live. Some of the kids, I’ve been taking care of my entire career. It’s wonderful to watch them grow up and get little glimpses into their lives and to see how their life unfolds.”