2024 Children's of Alabama/UAB Annual Report

2024 Annual Report

02 Welcome Letter 04 Department Leadership 05 Anniversaries, Awards and Recognition 10 Community Events and Observances 16 Education and Nursing 24 Growth and Technology 31 New programs 40 Patient Care Quality and Safety 47 Philanthropy 52 Research 59 Surgery

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Welcome

Dear Friends and Colleagues,

Our shared passion for pediatric care unites Children’s of Alabama, the University of Alabama at Birmingham (UAB) Department of Pediatrics and the UAB Sections of Pediatric Surgical Subspecialties together to form the cornerstone for children’s health care in Alabama and the region. Our collective mission is to deliver exceptional care for children with an unwavering focus on research, innovation, education and clinical care. Each story in our 2024 Annual Report reflects these pillars and our dedication to this mission. Our collaboration is the key ingredient of our success. Pooling our resources and expertise, we offer the latest technology and provide leading-edge personalized care. Our research not only enhances what we do but also sets a benchmark for other pediatric enterprises. Moreover, our focus on education fosters the growth and development of talented, passionate and knowledgeable physicians ready to serve their patients effectively. As we deliver this report, we thank Mitch Cohen, M.D., who departed last year after serving as Chair of the UAB Department of Pediatrics for more than a decade. His visionary leadership led us to make positive strides on each of our pillars, and we deeply appreciate his contributions to pediatric healthcare. Looking ahead to 2025 and the years to come, we are committed to building on our successes and continuing to provide the best, most advanced care for children and adolescents. Our leadership, talented and compassionate physicians, surgeons, nurses, allied health professionals and staff each will play a crucial role in shaping our future success. It is through this remarkable collaboration that we will continue to give world-class care for every child who comes through our doors.

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We are proud to present this Annual Report as a testament of our collaboration and our commitment to be here for children and families for many years to come.

Tom Shufflebarger President and CEO Children’s of Alabama

Yung Lau, M.D. Interim Chair of Pediatrics Thomas N. Carruthers Jr. Endowed Chair of Pediatric Cardiology University of Alabama at Birmingham

Mike Chen, M.D., MBA Joseph M. Farley Chair in Pediatric Surgery University of Alabama at Birmingham Chief of Pediatric Surgery and Surgeon-in-Chief Children’s of Alabama

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Department Leadership

Yung Lau, M.D. Interim Chair, Department of Pediatrics

Smita Bhatia, M.D., MPH Vice Chair for Outcomes

Jeffrey Lebensburger, D.O. Vice Chair for Faculty Development

Erin Shaughnessy, M.D., MSHCM Vice Chair for Clinical Affairs

Tamera Coyne-Beasley, M.D., MPH Vice Chair for Community Engagement

Michele H. Nichols, M.D. Vice Chair for Education

Chrystal Rutledge, M.D. Vice Chair for Access and Engagement

David Kimberlin, M.D. Vice Chair for Clinical and Translational Research

Lauren Nassetta, M.D. Chief Wellness Officer

Richard J. Whitley, M.D. Vice Chair for Research

Division Directors

Terry Wall, M.D....................................................................Academic General Pediatrics Tamera Coyne-Beasley, M.D., MPH...............................Adolescent Medicine Prescott Atkinson, M.D., Ph.D. ........................................Allergy & Immunology Mark Law, M.D....................................................................Cardiology Michael Taylor, M.D...........................................................Child Abuse Pediatrics Nancy Tofil, M.D., M.Ed.....................................................Critical Care Laura McGuinn, M.D..........................................................Developmental & Behavioral Pediatrics Kathy Monroe, M.D............................................................Emergency Medicine Ambika Ashraf, M.D...........................................................Endocrinology and Diabetes Sandeep Gupta, M.D.........................................................Gastroenterology, Hepatology and Nutrition Girish Dhall, M.D.................................................................Hematology/Oncology Erin Shaughnessy, M.D......................................................Hospital Medicine Richard J. Whitley, M.D. David Kimberlin, M.D.........................................................Infectious Diseases Waldemar A. Carlo, M.D. Namasivayam Ambalavanan, M.D..................................Neonatology Daniel Feig, M.D., Ph.D......................................................Nephrology Leon S. Dure, M.D..............................................................Neurology Hector Gutierrez, M.D.......................................................Pulmonology and Sleep Medicine Drew Davis, M.D.................................................................Rehabilitation Medicine Randy Cron, M.D., Ph.D....................................................Rheumatology

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Anniversaries, Awards and Recognition

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Awards, Honors & Recognitions

Children’s Receives NRC Excellence Award

Children’s of Alabama was honored by NRC Health with the 2024 Excellence in Patient Experience—Pediatric Award, recognizing the top-performing hospitals and health systems in the nation for their excellence in delivering outstanding patient experiences across the continuum of care. “The outstanding dedication Children’s of Alabama has shown in understanding patient needs and elevating their experience truly reflects NRC Health’s mission to infuse human understanding into healthcare,” said Helen Hrdy, chief customer officer at NRC Health. “This significant achievement is the result of a collective team effort.”

Recipients join an elite group of winners

who have demonstrated an exceptional commitment to improving the care experience, earning top satisfaction ratings from patients and their families. Children’s was selected for its first place ranking in Excellence in Patient Experience among Pediatric Hospitals. Winners are annually selected based on receipt of exceptional real time patient and family feedback. “We are honored by NRC Health’s recognition of Children’s of Alabama with this award,” said Beth Rocker, associate vice president of customer service at Children’s. “Our dedicated

care teams and employees work together to provide exceptional family-centered care for our patients and their families, ensuring they have the best experience possible. We are humbled by the trust our patients and their families have in us, and we’re grateful for their invaluable feedback that helps us continue improving the care we provide.”

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COA Sustainability Leadership Award

“ “We have always been at the forefront of innovation, and we look forward to continuing our work with Johnson Controls on ways to enhance energy efficiency on our campus.”

Johnson Controls honored Children’s of Alabama as an OpenBlue Pioneer. The award is presented to businesses advancing a more sustainable, safe and healthy world supported by Johnson Controls technology and expertise.

– Tom Shufflebarger

“We are delighted to accept this award, marking an incredible achievement for Children’s of Alabama,” said

Tom Shufflebarger, Children’s president and CEO. “In our 113-year history, we have always been at the forefront of innovation, and we look forward to continuing our work with Johnson Controls on ways to enhance energy efficiency on our campus.” Johnson Controls launched the Blueprint of the Future Award in 2022. Previous winners include Colorado State University, Museum of the Future in Dubai and Microsoft Beijing West Campus in China. Children’s was recognized in December 2023 as a pioneer in sustainability alongside global leaders at COP28 in Dubai.

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Awards, Honors & Recognitions

Critical Care Transport flight nurse Mark Rogers reached the 5,000 transport milestone, becoming the first member of the Children’s team to do so. Rogers has completed an average of 200 ground, jet or helicopter transports annually and has impacted the lives of more than 4,000 patients since he joined the team several years ago. Rogers Reaches Critical Care Transport Milestone

“I have a passion for what I do—to be able to help children and take the level of care from Children’s to every corner of the state and help those families get back here for definitive care,” Rogers said.

“He has a true passion for caring for children and their families,” said Jason Peterson, director of the Critical Care Transport team. “Seeing him reach this milestone warms my heart to think of the direct impact as well as the extended family impact he has made on so many patients. I look forward to continuing to serve the children of Alabama with Mark.”

Pediatric Practice Anniversaries

50 YEARS

30 YEARS

25 YEARS

25 YEARS

Greenvale Pediatrics

Greenvale Pediatrics Brookhighland

Midtown Pediatrics

North Alabama Children’s Specialists

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Children’s Receives IDSA Antimicrobial Stewardship Center of Excellence Designation

The Infectious Diseases Society of America (IDSA) designated Children’s of Alabama as an Antimicrobial Stewardship Center of Excellence. This designation indicates that Children’s has continued to make antibiotic stewardship a priority commitment with full leadership support. Children’s is part of an esteemed group of designated institutions that help raise standards of excellence in practicing and implementing stewardship. Shannon Ross, M.D., the medical director of the Children’s of Alabama Antimicrobial Stewardship Program, was instrumental in helping the hospital achieve this designation, which is valid for two years from July 1, 2024, to June 30, 2026.

The Children’s of Alabama Sleep Disorders Center has maintained accreditation from the American Academy of Sleep Medicine (AASM) for 15 consecutive years, demonstrating its commitment to providing high-quality care for people with sleep problems. AASM-accredited sleep centers provide diagnostic and therapeutic care for people who Sleep Disorders Center Reaches 15-year Accreditation Milestone

have problems related to sleep and alertness. To receive and maintain accreditation for a five year period, a sleep center must meet or exceed all standards for professional health care as designated by the AASM. These standards address core areas such as personnel, facility and equipment, policies and procedures, data acquisition, patient care and quality assurance. Additionally, the sleep center’s goals must be clearly stated and include plans for positively affecting the quality of medical care in the community it serves. The Children’s Sleep Disorders Center is directed by Robert B. Troxler, M.D.

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Community, Events & Observances

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Community, Events & Observances

INNS Conference

Children’s of Alabama partnered with UAB’s Division of Pediatric Nephrology to host the inaugural

International Neonatal Nephrology Symposium (INNS). The conference brought together experts, researchers and clinicians from across the globe to share knowledge, exchange ideas and collaborate on the latest advancements in neonatal kidney disease. It provided a unique platform for networking and fostered scientific dialogue that will contribute to improving outcomes in the youngest patients. The five-day conference welcomed 105 attendees from 21 states and 10 countries. Collectively, they represented more than 10 sub-specialties. INNS included 11 scientific programs, 25 speakers, 44 poster presentations, two pre-course events, 12 exhibitors, 16 sponsors, two educational grant funders and three patient family talks in support of neonatal kidney care.

105 Attendees from 21 states and over 10 countries representing 10 + subspecialties

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Community, Events & Observances

Major League Baseball Visits Children’s

Birmingham was center stage for Major League Baseball’s Tribute to the Negro Leagues game at Rickwood field in June, and it was a big event for Children’s of Alabama as well. MLB executives, former players and representatives from the St. Louis Cardinals and San Francisco Giants charitable organizations visited the hospital while in town. Some of the special guests—including mascots for both teams—played games and took photos with Children’s patients. Hall of Fame manager and four time World Series champion Joe Torre was among the visitors.

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Inside Out Movie Party

Disney, Pixar and Starlight Children’s Foundation visited Children’s for an Inside Out 2 Movie Party in a Box. Patients had the chance to watch the movie, interact with one of its characters and meet actor Tony Hale, a Samford alumnus who plays the voice of one of the characters. It was a special day for these patients, and the event was even mentioned on Good Morning America.

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Education & Nursing

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Empowering Rural Health Care Communities: The Impact of Dr. Chrystal Rutledge’s COACHES Program

By Holly Dunn

In 2015, Chrystal Rutledge, M.D., an associate professor in the Division of Pediatric Critical Care, pioneered the idea for the COACHES Program— an initiative that is now transforming pediatric care in Alabama through education and simulation training.

Chrystal Rutledge, M.D.

While completing her pediatric critical care medicine fellowship at UAB in 2014, Rutledge recognized a gap in access to specialized pediatric care in rural areas, sparking her to create long-term solutions. In 2016, she, along with Stacy Gaither, MSN, RN, and Kristen Waddell, CRNP, launched the COACHES Program, developed in collaboration with the organization IMPACTS (Improving Pediatric Acute Care Through Simulation). COACHES, which stands for Children’s of Alabama Community Healthcare Education Simulation, focuses on pediatric emergency readiness for healthcare providers in community hospitals across Alabama.

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Education & Nursing

“We really wanted to figure out how we could help our communities in caring for sick children, and that meant education,” Rutledge explained. “Transporting sick children from community hospitals can take hours. Our goal was to be able to say: Not only do hospitals have the supplies, the infrastructure, the policies, the education to understand how to manage these sick kids, but they are also able to provide appropriate ongoing management until we can get there.” The COACHES program adopts a multipronged approach to improve pediatric emergency care, with education serving as the foundational element. Rutledge emphasized the importance of approaching underserved hospitals

we provide them with feedback through a detailed report.” This feedback not only highlights successes but also uncovers areas for improvement, ensuring that hospitals are prepared for real-life critical situations. the COACHES program facilitates ongoing relationships between hospitals and specialists at Children’s of Alabama. “We want to be a resource for them, connecting them with others who can help with specific issues, like diabetes management,” Rutledge shared. This collaborative approach has led to successful studies, such as one focused on diabetic ketoacidosis, a critical condition that can arise from poorly controlled or undiagnosed diabetes. By providing education and formal feedback on how to manage this condition, the program has seen measurable improvements in care across multiple hospitals. In addition to improving emergency readiness,

“ “We want to be a resource for them, connecting them with others who can help with specific issues, like diabetes management.”

– Chrystal Rutledge, M.D.

in a nonthreatening manner, saying, “What we really want to do is help you. Helping you helps the patients, and we want to improve patient outcomes and patient safety.” Through simulation-based training, the program assesses the current capabilities of health care providers and hospitals. “It’s a way for us to understand what’s going on in their hospital,” Rutledge noted. “We go through different scenarios that help us assess what supplies they have, and

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Offering Qualit

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Since the inception of COACHES, members of the team have conducted more than 150 visits to nearly 60 hospitals, engaging more than 2,000 participants. As the program has grown, both its team and scope have expanded to enhance its impact. Following Waddell’s transition out of her role, Carrie Norwood, MSHI, RN, joined Gaither as a program coordinator. Additionally, two faculty members from the Division of Pediatric Emergency Medicine have joined the leadership team. Sarah Bingham, M.D., now serves as assistant program director, while Lauren Robinson, M.D., has taken on the role of director of outpatient and school readiness. Bingham has collaborated with Shea Duerring, M.D., to expand educational opportunities for EMS providers, while Robinson is spearheading efforts to improve pediatric emergency readiness in outpatient clinics and schools. Overall, Rutledge’s vision for the COACHES Program is to create a sustainable network of support that empowers health care providers to deliver high-quality care to critically ill children, ultimately enhancing patient outcomes throughout Alabama. “This program is about bridging a gap and ensuring that we can provide equitable care for all the kids of Alabama,” Rutledge said, “so they don’t have to live close to Children’s to receive quality care.”

“ “This program is about bridging a gap and ensuring that we can provide equitable care for all the kids of Alabama, so they don’t have to live close to Children’s to receive quality care.”

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Education & Nursing

Shaundra Blakemore, M.D., and Brian Sims, M.D., Ph.D., were once students in the Birmingham City Schools system who had a passion for science. After college, they transformed their passions into a career by attending medical school at the University of Alabama at Birmingham. Fast forward, and they are returning to BCS classrooms to inspire the next generation of health care professionals. Launched in 2022 by the UAB Department of Pediatrics and administered through community engagement in the Division of Adolescent Medicine, the UAB Mini Medical School provides a series of virtual and in-person experiences to increase middle school students’ exposure to science, technology, engineering and math careers, with a particular focus on health care. UAB Partners With Birmingham City Schools to Expand Mini Medical School Program By Hannah Echols

Shaundra Blakemore, M.D.

After a successful first year with 25 students from across the Birmingham and Jefferson County areas, UAB partnered with Birmingham City Schools to expand the program for the 2023-2024 school year. They now have programming during the school day for 60 Birmingham City Schools students. Their partnership with the YMCA has continued to reach out to students beyond BCS during the after-school hours. “BCS helped pave our way to medical school and beyond,” said Sims, program co-director and professor of neonatology at UAB and Children’s of Alabama. “The partnership allows us to reach more students, and hopefully, what they learn here will help them stay ahead of the curve through the rest of their educations and their careers.” Brian Sims, M.D., Ph.D.

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“ “We have medical doctors who are products of our school district giving back by mentoring and teaching the next generation of medical professionals.”

Mark Sullivan, Ed.D., superintendent of Birmingham City Schools, says the Mini Medical School program shows success on several levels. “First of all, this is another successful partnership between BCS and UAB with a positive impact on our scholars and our community. At the same time, we have medical doctors who are products of our school district giving back by mentoring and teaching the next generation of medical professionals.”

– Mark Sullivan, Ed.D.Schools

Hands-on Approach Each session, students are immersed in a different area of the health care field. Professionals from each field help guide a hands-on lesson and answer questions about their educations and career journeys. Professionals including physicians, nurses, respiratory therapists, poison control experts and forensic scientists have volunteered with the program.

“We want to engage our local

students at a young age to the immense career possibilities in health care,” said Blakemore, co-director of the program and assistant professor in the Division of Pediatric Emergency Medicine at UAB and Children’s. “We also want the program to be an additional resource for students to learn valuable lessons and skills that they can integrate into their education and personal lives.” During sessions, the students take part in a variety of hands-on activities, including performing CPR and intubating lifelike manikins, obtaining vital signs such as heart rate and blood pressure, venipuncture using a lifelike model, learning the importance of healthy meals and making their own healthy snacks, and much more. Carlette Smith joined the first session of the 2023-24 school year to discuss the field of nursing. Smith, who graduated from the UAB School of Nursing, spent more than 26 years as a nurse manager at UAB Hospital. From her education journey to her mantra of “treating patients like I would want my mother to be treated” she provided insight and encouragement to students interested in pursuing nursing.

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“It was important for me to volunteer with the program, not only to promote careers like nursing, but to emphasize the importance of education,” Smith said. “I want these students to be prepared to sustain themselves in life no matter the career path they choose.” Besides monthly in-person sessions, the UAB Mini Medical School holds monthly virtual sessions where students hear from health care professionals from around the country, including a pediatric surgeon, a dermatologist, family medicine, neonatologists, pediatricians and many more. All speakers had a relationship with UAB at some point in their careers, whether training or previous faculty. The UAB Mini Medical School partnered with the UAB summer program Center for Community Outreach and Development to encourage students to continue their science learning even when school is out via their summer camp offerings. During the 2023-24 program, students enjoyed a Saturday field trip to the UAB and Children’s Pediatric Simulation Center. This year, the simulation center came to the students to bring their lifelike skills stations to the students.

Looking Ahead Courtlynn Perkins, a seventh grader at Phillips Academy, loves all things sports. From football to baseball, he enjoys the thrill of being on the field and aspires to play professionally one day. He also has a passion for science.

But for Courtlynn, those two areas did not seem to coincide with one another. Then he enrolled in the UAB Mini Medical School, where he learned about emergency and sports medicine from Jeremy Towns, M.D., former UAB Emergency Medicine resident and NFL player. “It was the first time I realized I could have a career after sports that still kept me connected to the game,” Courtlynn said. “It was cool and exciting to learn about emergency medicine, physical therapy and sports medicine.” Courtlynn, who is in his second year of the program, enjoys the hands-on activities and the opportunity to meet people from different career fields as well as students from other schools. When he learned the program would be offered through BCS, he encouraged his friends to join as well. “I encouraged them to try it because we are still young and the program offers different career perspectives,” Courtlynn said. “Even if you don’t end up going into the medical field, you learn important life lessons and skills.” The UAB Mini Medical School hosts sessions once a month. BCS students have the option to attend sessions during the school day. The program also offers an after-school session that is open to all middle school students.

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Education & Nursing

Heart of Birmingham Nurses Block Party

Children’s of Alabama and UAB collaborated to celebrate the nursing teams from both organizations for the inaugural Heart of Birmingham Nurses Block Party. The event, held in October, included a photo booth, food trucks, games, music and the opportunity for the Children’s and UAB nursing teams to spend time together.

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Education & Nursing

Health Education and Safety Center Grants

The Children’s Health Education and Safety Center completed the first year of its Alabama Department of Economic and Community Affairs (ADECA) grant for pediatric vehicular heatstroke education. Among the educational programs the grant (worth $195,788.02) supported was Look and Lock, a safety event held on National Heatstroke Prevention Day (May 1). Children’s sponsored the event in conjunction with several other national and state organizations, including the National Highway Traffic Safety Administration and ADECA. At the event, Children’s and other sponsors provided parents and caregivers with valuable knowledge about hot car safety and prevention, along with the opportunity to win a free age-appropriate car seat and a consultation with certified child passenger safety technicians. Many of the other educational opportunities supported by this grant were targeted toward rural and underserved communities. The Health Education and Safety Center also promoted the message of safety through a comprehensive statewide media campaign for education on hot cars.

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Education & Nursing

Other Grants

$ 200,000 Alabama Department of Transportation (ALDOT) grant for transportation-related programming, including car seats, teen driving, bike helmets and other safety education

$ 64,000 State Farm grant for teen driving education

$ 50,000 Hyundai grant renewal for child passenger safety

$ 25,000 Honda USA Foundation grant supporting safety programs such as ThinkFirst Alabama and the Child Passenger Safety program

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Growth & Technology

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Growth & Technology

Children’s Begins Construction of Quarterbacking Children’s Health Pediatric Intensive Care Unit

Children’s of Alabama announced that the Quarterbacking Children’s Health Foundation committed $3 million to help relocate and expand the hospital’s pediatric intensive care unit (PICU).

Construction began in 2024 on the project, which involves building out the Benjamin Russell hospital building’s 12th floor— previously a shelled space—to serve as a 50-bed unit that will have the flexibility to meet the needs of both critical care patients and lower acuity patients. In recognition of the foundation’s gift, the unit will be named the Quarterbacking Children’s Health Pediatric Intensive Care Unit. As part of this project, Children’s also will be able to update intensive care rooms and bring in the latest technology designed to care for patients on the unit. Construction is expected to be completed in 2026.

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Peds West Moves to Hueytown

Children’s of Alabama opened a new pediatric practice, Pediatrics West Hueytown, in July. The practice houses five full-time, board-certified pediatricians. It is open six days a week and provides Saturday access by appointment for Pediatrics West McAdory and Hueytown patients. Patients can access onsite laboratory, sick and well visits, medication management and immunization administration, among other services. “We are thrilled to be able to provide excellent pediatric primary care in Hueytown and in this part of the state,” said Sandy Thurmond, vice president of Primary Care Services at Children’s. “The opening of this beautiful new facility will give families an excellent and convenient option for their children’s healthcare. We are honored to be a part of Hueytown’s legacy of growth.”

“ “The opening of this beautiful new facility will give families an excellent and convenient option for their children’s healthcare.”

– Sandy Thurmond

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Growth & Technology

Extended Reality Improves the Mental and Physical Health of Children with Disabilities: Here is How By Anna Jones

Researchers at the University of Alabama at Birmingham are using extended reality to help improve the mental and physical health of children with disabilities. Byron Lai, Ph.D., an assistant professor in the UAB Division of Pediatric Rehabilitation Medicine, and the division research team of Ashley Wright, Raven Young and Bailey Hutchinson, combine behavioral change theories, telemedicine and extended reality in their recent research as they work to improve the physical and mental health of children with disabilities.

Byron Lai, Ph.D.

Physical Benefits Children with disabilities are three times more likely to have cardiometabolic disease versus their peers with no disabilities, according to a study in the World Journal of Diabetes. Lai says there currently are very few options for children with mobility disabilities to perform health enhancing aerobic exercise. Extended reality provides an enjoyable and accessible form of aerobic exercise to children. Most importantly, extended reality allows them to exercise at a moderate intensity while using only their arms for movement. This helps children with mobility disabilities to get the amount of exercise they need to improve their cardiovascular health. Many of the children Lai works with had never participated in a serious exercise program until they joined one of the several extended reality studies provided by the division team at UAB and Children’s of Alabama.

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Extended reality provides an enjoyable and accessible form of aerobic

exercise to children, helping those with mobility disabilities get the amount of exercise they need.

“Extended reality games can provide a high level of immersiveness, and that is something the kids really enjoy,” Lai said. “This leads to high engagement and retention. Because they enjoy these games, they are more likely to stick to a therapy prescription that is built into extended reality.”

“ “Because they enjoy these games, they are more likely to stick to a therapy prescription that is built into extended reality.”

Mental Benefits Extended reality helps improve the mental health of children with disabilities as it helps combat social isolation, anxiety and depression.

“In addition to getting the children to exercise, we have found these games provide children with a sense of accomplishment as they are able to engage in games and activities they were unable to do up until this point,” Wright said. “This sense of accomplishment plays a role in improving the child’s mental health, specifically when it comes to coping with anxiety and depression.” Wright says extended reality allows children to pull themselves away from their reality, distract them from any pain they may be feeling, or virtually escape from their clinic or hospital rooms. This immersion provides them with an engaging activity that, combined with mindfulness and peer-socialization strategies, helps improve their mental health. “With extended reality, these kids just get to be kids and have fun and get away from all the noise in the world,” Wright said. “Everyone in these extended reality games has full mobility, and they are treated the same way. They are not judged based on their disability. They are just a kid hanging out with other kids.” – Byron Lai, Ph.D.

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Equipment Needed The best part about using extended reality to help improve the health of children with disabilities is that the tools used in Lai and Wright’s research are accessible in the market. With extended reality, children wear head-mounted displays and use controllers to participate in exercises that are adapted to their needs. There are adaptable controller hand and head straps for children who may have limited hand strength. The games used for these extended reality experiences can be found on the headset’s app store and modified to fit the child’s needs. Some of the gaming categories include fitness games, such as boxing or table tennis, rhythmic movement-to-music games, and mindfulness meditation games. The division’s research studies intentionally utilize off-the-shelf supplies so the program can be replicated in real-world settings. Parents just need to purchase a headset and accessories from their local retailers, purchase games from the headset’s store, and make game setting adjustments to best fit the child’s needs. Some of the settings parents can adjust include turning on “No Fail” mode, turning off “Obstacles,” adjusting height and making games playable with one hand. By adjusting these types of settings, parents can help enhance playability in a seated position. Safety Tips Extended reality headsets have embedded safety features that include requiring the user to set up a play space that allows plenty of room for movement. If the player goes out of the designated safety zone, the game will project the child’s environment on the headset to prevent injury. For parents who may be concerned about extended reality’s effects on vision, Lai says short-term studies currently show there is no effect on vision. The main factor parents should consider is the minimum age requirement of 10 years old, established by the headset manufacturer. Future of Lai’s Research Lai has conducted several virtual reality projects that have been funded by the National Institutes of Health, the Forge AHEAD Center, the Center for Engagement in Disability Health and Rehabilitation Sciences, and the UAB Department of Pediatrics. These projects have allowed Lai to test various extended reality therapies for children in a variety of settings, including the pediatric intensive care unit, physical and occupational therapy clinics, pediatric cancer rehabilitation, participants’ homes, and even local schools. A recently completed study at Pelham High School demonstrated that a clinical program can be delivered safely for children as part of their physical education curriculum at school. The program is run by and for children with disabilities. The success of this program has sparked interest in adopting similar programs in the Trussville City School System.

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Growth & Technology

“ Should this project be successful, it could open up a means for employment for youth with disabilities, when the project is delivered on a national scale.”

“Should this project be successful, it could open up a means for employment for youth with disabilities, when the project is delivered on a national scale,” Lai said. “This project is also the first collaborative project with the community by the Division of Pediatric Rehabilitation Medicine at UAB and Children’s of Alabama, which could open doors for further projects and services.”

– Byron Lai, Ph.D.

This project was funded by both the Center for Engagement in Disability Health and Rehabilitation Sciences and the Forge AHEAD

Center, which is a regional comprehensive research center dedicated to advancing the prevention and management of cardiometabolic diseases, including obesity, diabetes and hypertension, which disproportionately affect communities in Alabama, Mississippi and Louisiana. CEDHARS was established in 2019 with a mission to perform cutting-edge inclusion science research, train future students and researchers, and develop novel approaches to promoting the health and well-being of children, adults and seniors with disabilities. Lai and the division team are currently working on two other exciting extended reality projects. One study aims to develop a protocol for improving the physical and mental health of pediatric cancer rehabilitation patients, which was funded by the highly prestigious Kaul Pediatric Research Grant of the UAB Department of Pediatrics. Another study, funded by the National Institutes of Health, is confirming whether an aerobic extended reality exercise program can improve blood-related health among children with cerebral palsy. Lai is awaiting review of a large grant that will improve the mental health of children with disabilities through online peer-networking and mindfulness meditative practices.

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New Programs

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New Programs

Intensive Outpatient Program Helps Patients Return to Normal Life

A much-needed bridge between inpatient and outpatient care for adolescents facing mental health challenges arrived at Children’s of Alabama in 2020 in the form of the Partial Hospitalization Program (PHP). This program offers more intense treatment than typical outpatient structure provides and encourages success in symptom management and recovery. Following increased demand for the program in the wake of the COVID-19 pandemic, Children’s has now launched an Intensive Outpatient Program (IOP), an extension of the PHP, designed to better help these young patients adapt to daily life.

Lauren Byrd, MS, LPC

Just as the PHP was created to fill the gap between inpatient and outpatient services, the IOP is meant to help these young patients make another crucial step—back to normal living. “Many times, our parents and families say they wish there was something available between the PHP and outpatient setting,” program manager Lauren Byrd, MS, LPC, said. “This is something our community has been asking about for some time.”

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“ “The PHP is designed to prevent or reduce the length of an inpatient stay. So the IOP is a natural progression to our efforts to reduce the time we’re removing a child from a home environment and helping them meet their goals in the least disruptive, least traumatic way possible.”

– Lauren Byrd, MS, LPC

In 2021 and 2022, The PHP served about 100 adolescents, most of whom were coping with depression with suicidal ideation, Byrd says. About 140 such patients accessed the program in 2023, and referrals continue to increase those numbers.

community resources for patients and families that help adolescents build a comprehensive support network to enhance treatment outcomes. “The PHP is designed to prevent or reduce the length of an inpatient stay,” Byrd said. “So the IOP is a natural progression to our efforts to reduce the time we’re removing a child from a

“Both the PHP and IOP have been really sorely needed for some time in our area for adolescents

with mental health issues,” Byrd said. “Combine that with the pandemic—which was really a traumatic experience for a lot of youth in Alabama—and the need has only increased. If a silver lining could exist, the

home environment and helping them meet their goals in the least disruptive, least traumatic way possible.” are involved in the programming as well, including weekly sessions and education. “We’ll

Family members

pandemic did a lot to help us address the stigma of mental health, and it helped more people feel empowered to access care who maybe wouldn’t have.” The IOP, which opened in August 2024, serves adolescents ages 12 to 18 and runs three hours a day, three days a week—a deliberate step back from the PHP’s five-day, six-hours-daily structure. The less-frequent, less-intensive schedule is its main distinction from the PHP. But both programs have the same staff support, including psychiatrists, nurses and other mental health clinicians, Byrd says. The IOP also coordinates a variety of

discuss treatment planning goals with the family and help them however they may need,” Byrd explained. “Usually, that looks like building better communication and helping them understand how things are going to be after discharge.” “The best outcome would be that we continue to grow,” she added. “We want to expand our services and help more kids in the community while providing the same high-quality care we’ve been proud of.”

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New Programs

Children with medical complexity (CMC) suffer from chronic, fragile conditions, functional limitations and frequent dependence upon medical devices. These children often face significant health management challenges, including high hospitalization rates, complex medical needs and fragmented care. In response, the University of Alabama at Birmingham (UAB) Department of Pediatrics and Children’s of Alabama (COA) created the joint Pediatric Complex Care (Teal) Program, a comprehensive initiative aimed at providing compassionate, coordinated and continuous care for these children both in and out of the hospital. CMC, which can include cerebral palsy, major neurological disorders and genetic conditions, requires an integrative approach to treatment. Children with these conditions often require multiple medications, medical supplies and frequent hospital visits, presenting a unique set of challenges for families and healthcare providers alike. Despite comprising less than 1% of all U.S. children, CMC accounts for more than 30% of all pediatric health care costs, 56% of hospitalized patients, 82% of hospital days and 86% of hospital charges in U.S. children’s hospitals. The Complex Care Program’s inpatient team, known as the Teal Team, is part of UAB’s Pediatric Hospital Medicine division. Since its inception in October 2023, the team has cared for more than 160 children. The multidisciplinary team is comprised of physicians, nurse practitioners, pharmacists, nutritionists, case managers and social workers, all working together to provide comprehensive care for children during their hospital stays. At the heart of the Teal Program are four core values: Teamwork, Empathy, Access, and Longitudinal Care. Daily family-centered rounds and Complex Care Team Aims to Reframe Patient Care Through Collaborative Model By Emily Franklin

of all pediatric healthcare costs are related to CMC 30 %

of hospitalized patients are CMC 56 %

of hospital days are for CMC 82 %

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collaboration with specialized teams across the hospital ensure that the Teal Team also offers outpatient care through its Teal Clinic, which opened its doors in May 2024. The clinic helps coordinate care for children with complex conditions by partnering with pediatricians and specialists. This approach ensures that families know and feel they have a unified care team supporting them and their child. Currently, the clinic is staffed by Marie A. Pfarr, M.D., and Andrew Watson, M.D., who oversee the comprehensive care plans for each patient. “The Teal Team really allows for better, more in-depth, personalized coordination of [her] care during her stay,” said one parent. Another family shared, “The familiar faces and knowing that the team actually knows

[my child] and not just his medical history makes hospitalization (which is always anxiety-ridden) that much easier.” A third family noted, “Everyone on the team seemed engaged, invested and genuinely bonded to our child and his well-being.”

The program has received significant philanthropic support from the Meads Miracle Foundation for two consecutive years, which has been instrumental in expanding services and supporting new hires. The foundation’s donations have allowed for the addition of a case manager to support both inpatient and outpatient teams as well as a second nurse practitioner for the Teal Team in the past year. Looking ahead, UAB and Children’s plan to continue expanding the Teal Program’s reach and impact. Over the next few years, the team aims to grow its services, continuing to strengthen partnerships with COA subspecialty care teams and enhance collaboration with local and state organizations. “Building a patient and family-centered program is integral to our mission,” said Pfarr. “We will ensure patient and family voices are represented in every step of our continued development.”

Marie A. Pfarr, M.D.

Andrew Watson, M.D.

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New Programs

New Down Syndrome Clinic Aims to Provide Care Across the Lifespan by Matt Windsor

Not very long ago, in the early 1980s, people with Down syndrome were not expected to live past 25. Today that number is up to 60 years old. But the extra years come with questions that few doctors or parents know how to answer. For instance, many of the relatively small number of people with Down syndrome who have lived to age 40 have developed dementia and other Alzheimer’s-like symptoms by then. But the medications doctors use to treat Alzheimer’s are not approved for people this young.

Snehal Khatri, M.D.

“We hear from parents that this is the thing they worry about the most,” said Snehal Khatri, M.D., associate professor in the Division of Developmental and Behavioral Pediatrics, and medical

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“If you look across the health system, there is this gap that happens, which is true across many disciplines,” Hopson said. “Life changes are happening — they are leaving high school, trying to figure out what comes next, and right in the middle of that you have this transition in medical care, with brand-new doctors. If you look at the data, you really see how medical outcomes decline during this time.”

50 %

Dementia will affect 50% or more of people with Down syndrome as they age

Betsy Hopson, Ph.D, MSHA

director of UAB Sparks Pediatrics. With a grant from UAB’s HSF-GEF program, Khatri and Betsy Hopson, director of the UAB Staging Transition for Every Patient Program in the Division of General Internal Medicine, will create a new clinic to focus on care for people with Down syndrome across the lifespan. According to the National Institute on Aging, dementia will affect 50% or more of people with Down syndrome as they age, “and nothing existed for them,” Hopson said. “We are adopting a lifespan model, to be able to say to patients and parents, ‘this is where we know that you are going; this is the trajectory.’” Hopson and Khatri will be able to say to families, “we have a dedicated program that knows everything that will happen to your child and knows who the adult provider is to contact as they age,” Hopson said. “We are excited to build the entire lifespan program, but addressing the palliative and memory challenges will really make us unique to anywhere in the country.” The clinic traces its origins to a conversation that Khatri had with Mitch Cohen, M.D., chair of the Department of Pediatrics. Cohen asked Khatri, who is a member of the board of directors of Down Syndrome of Alabama, to look into reopening a Down syndrome clinic that had operated at Children’s of Alabama until about a decade ago. “We asked the community if this is something they wanted,” Khatri said. “A lot of the feedback we had was related to the issues with transition between pediatric and adult clinics.”

Carlie Stein Somerville, M.D.

“It is a very different experience in the pediatric world and the adult world,” Khatri said. “Insurance changes. What is covered changes. So being thoughtful in planning for these changes early is extremely important.” Khatri was aware of Hopson’s work with the STEP Program, which creates “transition champions” in both the adult and pediatric divisions “to have a warm hand-off,” Hopson said. “ “It is a very different experience in the pediatric world and the adult world. Insurance changes. What is covered changes. So being thoughtful in planning for these changes early is extremely important.””

– Snehal Khatri, M.D.

STEP was created in 2020 through an HSF-GEF grant awarded in 2019 to Hopson and Carlie Stein Somerville, M.D., associate professor in the

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New Programs

Division of General Internal Medicine. “We have had a lot of success with STEP, and we are using that success for the infrastructure of this brand-new program,” Hopson said. “The adult Down syndrome piece is going to happen within STEP, where those partnerships [with various disciplines] will already exist. If a neurologist is needed, that neurologist will be there in the clinic. This new group of patients is really going to benefit from the partnerships and collaborations that have been formed.” Even in the pediatrics realm, many physicians do not keep up with the latest guidelines for care, Khatri says. The American Academy of Pediatrics and the Down Syndrome Medical Interest Group publish guidelines from birth to age 21, including lab work, questions to ask and other milestones to look for as patients age. But “you would be surprised at the number of primary care doctors who don’t know they exist,” Khatri said. “Having a dedicated clinic will improve adherence to medical guidelines for the pediatric patients.” Clinicians will be able to contact the clinic for additional support. “This will not be for everybody,” Khatri said. “It will be for families and physicians who need additional supportive or umbrella services.”

“For the vast majority of patients, we will work with their existing clinicians; it is co-management,” Hopson said. “We will help ensure that intervals are being followed, imaging that needs to take place is scheduled, so the local primary care doctor or pediatrician can focus on acute management. We are really holding the pieces together.” The clinic will be a collaboration not only across UAB Medicine and the Heersink School of Medicine, but across UAB’s other health schools. For example, clinicians often recommend physical therapy and occupational therapy; but when patients and families return to their communities,

especially in rural Alabama, “a lot of that doesn’t exist,” Hopson said. “One of the creative things we wrote into the grant is to work with the School of

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