Overview

	Lawrence M Opas, MD Division Chief Phone (323) 226-3691

The Department of Pediatrics based at LAC+USC Medical Center is responsible for the provision of pediatric care at Women’s and Children’s Hospital (WCH) and Clinics, three Northeast Healthcare Network Comprehensive Health Centers (El Monte, Hudson, and Roybal), seventeen juvenile detention facilities located throughout Los Angeles County and MacLaren’s Children Center. These efforts are complimented by five nationally recognized clinical and research programs: Mobile Asthma Van “Breathmobile” Program; Comprehensive Maternal-Child and Adolescent Center for Infectious Disease, Virology and HIV Management and Research Program; Center for the Vulnerable Child; Sickle Cell Research Program; and the Neonatal Medicine and High Risk Follow-up Program.

The clinical efforts at WCH result in over 7,216 admissions, 55,000 outpatient visits and 40,000 emergency room/ urgent care visits. There were approximately 51,000 pediatric visits at the three comprehensive health centers and 18,000 admissions and 35,000 outpatient visits in the juvenile hall facilities.

The LAC+USC Medical Center Violence Intervention Program (VIP) and their Center for the Vulnerable Child (CVC) continues to provide 24 hour, 7 day per week multidisciplinary services to over 200 victims of child abuse and sexual assault each month. In addition to ongoing funding from State and local funding sources, CVC received over $200,000 in grant and gift funding to support the Community Mental Health Center and their individualized services for children and families impacted by family violence. The Nike Foundation© donated $25,000 for the creation of the Nike© play yard that opened in September.

In addition to an increasing number of children and adolescents impacted by child abuse and sexual assault the VIP has added extensive multidisciplinary services for victims of domestic violence, their children and has created the Adult Protection Team with interventions for the elderly and disabled.

Researchers in the VIP published the second edition of “The Evaluation of the Sexually Abused Child,” and three original research articles ranging from normal genital anatomy in the preadolescent to a large prospective study of healing genital injuries.

The Division of Allergy & Clinical Immunology has continued to expand based on the success of the Pediatric Asthma Disease Management Program (PADMAP). This year, PADMAP became the first disease specific care program in the United States to be credentialed by JCAHO. PADMAP is the result of a collaborative effort to build a comprehensive and integrated healthcare model for children with asthma. The Los Angeles County Department of Health Services (LAC DHS), Southern California Chapter of the Asthma & Allergy Foundation of America (AAFA), and local school districts have worked together since 1995 to establish a sustainable infrastructure for the long term preventive care of children with asthma. In 2001 the fourth Breathmobile, or mobile asthma clinic, was added to the program. The 4 Breathmobiles provide ongoing preventive care to children with asthma at 85 schools and three County Comprehensive Health Centers. The care delivered on the four Breathmobiles is coordinated at the Pediatric Asthma Disease Management Center at the LAC+USC Medical Center. Patient tracking and health information is supported by the AsthmaWatch health information system developed for the program. Demographic, clinical, and outcomes information from each of the Breathmobiles is integrated at the center where care coordinators contact families to facilitate participation in ongoing preventive care. In 2001, a school based screening process, developed as part of PADMAP, was validated providing an efficient method to help identify children with poorly controlled asthma. The healthcare process is supported by system wide readily available health information. Routine analysis of performance measures allow ongoing program evaluation and quality improvement. A thorough onsite review of the healthcare process, data collection, analysis, and performance improvement process led to the credentialing by JCAHO.

The division has continued to secure grant funding to develop and test various components of the PADMAP healthcare model. In collaboration with the Southern California Chapter of AAFA, more than $486,000 in grants was obtained in 2001 to start the fourth Breathmobile and to support data management and analysis. The division is actively pursing epidemiologic and outcomes research related to the program. The division is also actively collaborating in program development and research efforts with other medical centers around the country. Currently, the division has six faculty members and two residents in the Allergy & Immunology Residency training program.