Reaching Out: Packard outpatient center brings pediatric specialists to South Bay families

By Ruth Schechter
Friday, October 1, 2010

Seated together on a couch, three youngsters stare intently at the Disney cartoon playing silently on a flat-screen TV. At a low table nearby, other children rifle through a box loaded with well-worn books and magazines. In a periwinkle-blue room whose walls are dotted with colorful framed photographs, parents and older kids wait patiently for their names to be called, glancing up as new arrivals register at the front desk.                     

It’s a busy afternoon at the South Bay Specialty Center in Los Gatos, a satellite outpatient service run by Lucile Packard Children’s Hospital at Stanford. Down the hallway from the waiting area are 12 exam rooms, where children and their parents meet with Packard pediatric subspecialists for diagnosis, consultation, and follow-up care. The rooms are designed with young patients in mind, offering colorful décor, toys, posters, and child-sized exam tables and chairs.

For families who live in San Jose, Santa Cruz, Monterey, and farther afield, the South Bay Center allows them access to Packard’s specialized care and expertise, close to their own back yard. Each month, Packard physicians see about 1,000 patients at the Center, caring for kids with heart defects, vision problems, diabetes, abdominal pain, and asthma, as well as providing surgical consultations, nutrition advice, and hearing tests.

“Parents like that it’s a new facility, with a family-friendly atmosphere,” says Jodi Kazemini, the Center’s practice manager. “And, because we are a Packard service, we offer the highest standards of care.

For a full year before the South Bay Center opened three years ago, Elizabeth Salcido of Marina had to drive to Packard Children’s three times a week for her son’s allergy shots. Francisco, now 15 years old, developed a severe reaction to dust mites when he was 4, which caused him to rub his eyes so much that Salcido worried he could damage his vision. The trips to Palo Alto from her home in the Monterey area took 90 minutes each way.

“I didn’t know about the clinic until a doctor at the hospital told me about it,” says Salcido, who also brings her 14-month daughter to the Center for treatment of a congenital kidney disorder. “It’s a relief to not have to drive all the way up there. Plus they know me and my family.”

Community Connections

The idea behind the South Bay Center was to create a satellite facility for a population that could not easily bring their children to Packard Children’s, explains Gary Hartman, MD, a pediatric surgeon and chief of Regional Clinical Program Development for Packard. “The Center is an important part of Packard’s commitment to serving the community. We saw a real need to reach out to this area because so many of our patients live down here.”

Gary Hartman, MD, and the Packard team will care for more than 12,000 children at the South Bay Specailty Center this year.

He adds that many parents seem pleased by the Center’s easy access—it’s located right off Highway 85—and by its friendly, low-key environment.

“A hospital can be a scary, busy place, especially when dealing with a sick child. The Center is smaller and less hectic so it’s easier to maneuver—not to mention there’s free parking,” he says. “But the real benefit is that people don’t have to drive as far to receive the same high standards of care and specialty services they would receive at the main Packard Children’s. We are an accessible, neighborhood service.”

It’s that sentiment that appeals most to Jim Buckley of Morgan Hill, whose 11-year-old grandson Clint Mandarich has been treated for type I diabetes at the South Bay Center for nearly a year.

Clint Mandarich comes from Morgan Hill.

“I can’t say enough about how pleased I am with the care Clint is getting,” says Buckley. “The level of care is extraordinary. Their reassurance and professionalism takes a lot of the stress out of coming to the doctor. They are available and open, and I don’t believe we would receive the same level of patience and deference at another institution.”

Filling a Need

The original outreach clinic was established a short distance from its current location by Bruce Buckingham, MD, professor of pediatric endocrinology, in collaboration with Packard’s pediatric surgery service. Demand was obvious, and in a short time the small, stand-alone facility began offering endocrinology, urology, pulmonary, and general surgery clinics several days a week.

“I was seeing 12 to 15 children a day,” says Buckingham, who specializes in treating children with diabetes. “It got so busy, so quickly. I would go to people’s homes in the evening to teach them how to do shots since there was no time during clinic hours.”

The pace didn’t let up: Buckingham estimates he followed about 300 to 500 children at first. The Endocrine clinic now sees about twice that number—about 70 percent of whom have diabetes.

Because the Center is small, he adds, specialists can consult on each other’s patients and arrange cross-referrals, streamlining visits for busy parents.

Between 10 and 15 physicians work at the South Bay Center, with most clinics offered one or two days per week (audiology is available each weekday). The greatest demand is in endocrinology, urology, otolaryngology, and ophthalmology, and Center staff are looking at ways to minimize the wait for an appointment.

“Packard’s mission is to provide care to any child in need,” Buckingham says. “We come to where the children are, and there is a high density of families in this region. Many of them might fall through the cracks of the health care system if we did not make it easy for them to see a doctor.”

A Network of Care

Families learn about the South Bay Center through physician referrals and positive word of mouth. A dedicated physician liaison works with local practitioners to identify their areas of need and to simplify the transfer of care.         

“We are a complement and an auxiliary service to the area physicians,” says Fouzel Abbas, director of physician partner relations. “We let them know we’re here for them. It’s an opportunity for Packard Children’s to serve their patients and the general South Bay community.”

Abbas and her team work a two-way street, getting the word out about the Center by hosting educational events and visiting South Bay general practices, and identifying new needs based on the concerns of community providers. Since it opened, the Center has added an audiology clinic, ultrasound, and blood draw in response to feedback from the area’s referring physicians.

“We keep the lines of communication open,” Abbas explains. “We’re still relatively new, so we work to help local clinicians learn about what we can offer their patients. We understand the challenges they face in caring for their patients and their families, and we consider ourselves both a partner and resource.”                        

Referring physicians and follow-up patients call a central number to set up an appointment. With demand for specialty services so high, physicians sometimes face long waits before their patients can be seen; the South Bay Center helps to alleviate some of the waits at the Hospital, Abbas says, allowing more immediate access to Packard expertise.

Bryan Drucker, MD, a partner in a San Jose private practice for the past 15 years, estimates that he refers a patient a week to the Center. “I feel fortunate to have the services of these subspecialists available close to my practice,” he says. “Families do not have to travel as far to be seen, and it enhances the care these children receive.”

Growing Pains   

Last year, close to 12,000 patients came to the South Bay Center, and this year’s numbers are on pace to eclipse that total. At 7,000 square feet, the Center is already outgrowing its space, and staff is exploring possibilities for expansion. In the meantime, they have developed some creative solutions to the constraints: One check-in room does double-duty for blood draw, and new ultrasound and laser imaging equipment is rolled out of storage when it is needed. The conference room is also used for patient education sessions as well as for scanning records.

Practice Manager Kazemini works with referring physicians and families to keep waits to a minimum, but some specialties are backlogged and she hopes creative scheduling will continue to keep patients accommodated.

“The demand is higher than we can accommodate, and it’s a challenge to meet the needs of our referring physicians and patients,” says Hartman. “But Packard Children’s is committed to outreach and is dedicated to maintaining its services in the South Bay. We are filling an important niche in the community, and we are proud and happy with what we have to offer.”