A closer look at one of the world’s premier pulmonary care hospitals, National Jewish Health in Denver, which was ranked #2 in best pulmonology programs by US News & World Report in 2014.
By Cassandra Perez
National Jewish Health (NJH), a nonprofit hospital based in Denver, aims to integrate the latest scientific discoveries with coordinated care for lung, heart, and immune diseases. Founded in 1899, this world-renowned healthcare facility is exclusively dedicated to the treatment of patients with respiratory, cardiac, and immune disorders. With a history as a clinical, research, and educational facility, NJH strives to provide personalized medicine designed to heal, and research that aspires to educate.
Adult and Pediatric Pulmonology
For patients in need of pulmonary care, National Jewish Health has two distinct divisions for pulmonary medicine: the Division of Pediatric Pulmonary Medicine and the Division of Pulmonary, Critical Care and Sleep Medicine for adults. The pediatric and adult pulmonary divisions each provide care for patients with a variety of respiratory diseases. In addition to pulmonary care, the adult division also incorporates the Section of Sleep Medicine, whose multidisciplinary staff treat the full spectrum of sleep disorders, and the Section of Critical Care Medicine, whose staff specializes in the care of acutely ill patients and those with severe or life-threatening conditions.
According to National Jewish Health, the goal of the Division of Pulmonary, Critical Care and Sleep Medicine is to diagnose and treat adult patients with both common and unusual respiratory diseases, such as autoimmune lung disease, respiratory failure, pneumonia, chronic cough, and tracheobronchomalacia. Patients in this division are evaluated and treated in both clinic and hospital settings, and basic science, clinical, and translational research are conducted in the areas of COPD, asthma, sleep disorders, interstitial lung diseases, and other related conditions. The research aims to advance the understanding and treatment of pulmonary diseases.
Kaci Chacon, RN, BSN, pulmonary clinic nurse manager, says the adult pulmonary clinic sees patients ranging from 18 to 20 years of age through 90 years of age. In addition, this division treats patients who are local as well as out of state and out of the country. Kaci Chacon said the out-of-state program in the clinic initially sees patients for an extensive evaluation with as much testing as possible conducted in-house. Following testing, the patient will have a follow-up appointment to review test results with their physician, who then makes recommendations for the patient to take back to their local physician and medical care team.
Kaci Chacon said patient education is the main focus of the nursing staff and the team works to ensure patients understand their disease and how to treat and manage it. In addition, the care team within this division provides extensive follow-up services to assure the appropriate care is being carried out at home. “I think the follow-up care we provide for patients is a great service. [We] really spend the time to follow up with them, make sure that they’re following our recommendations, [and] being taken care of at home,” Kaci Chacon said.
The Division of Pediatric Pulmonary Medicine aims to provide care to children of all ages who have respiratory problems by conducting detailed assessments as well as testing. The assessments may include reviews of prior evaluations, while the testing can include assessment of lung function, radiographic studies, and direct examination of airways through bronchoscopy. The overall goal for young patients in this division is to establish a diagnosis and develop a plan of care that will allow the child to be as symptom-free as possible, according to NJH.
David Nichols, MD, division head of pediatric pulmonology, explained that the diversified team of the division is comprised of varying healthcare professionals, including pediatric pulmonologists, who see patients ranging from newborns to 18 years of age, and even adults 20 to 22 years old. Nichols said the pediatric division team manages a range of diseases, including asthma, adult cystic fibrosis (CF), upper airway disorders, and chronic lung disease.
“We’re a small division, but I’m very proud of all of the members in our division and our ability to work very well together as a group…and develop kind of a niche in the field,” Nichols said. “I think that the quality of the providers and our…ability to work together and communicate well with our patients…is appreciated by our patients and their families.”
Adult Cystic Fibrosis Program
One of the specialized programs offered by NJH is the Adult Cystic Fibrosis Program, which is the largest adult CF center in the United States, according to NJH. The program provides ongoing treatment for more than 400 adults, and as part of the Cystic Fibrosis Therapeutics Development Network (TDN), the center presently has 25 ongoing clinical trials that evaluate the effectiveness and safety of CF therapies.
The cystic fibrosis program offers comprehensive care with a multidisciplinary team. Cathy Chacon, RN, BSN, nurse coordinator for the Adult Cystic Fibrosis Center, explained that, in order to be designated a center of excellence for CF by the Cystic Fibrosis Foundation, a multidisciplinary team is needed. As such, the program has a complete team, consisting of a full-time respiratory therapist, two full-time social workers, a full-time dietitian, nurses, pulmonologists, an administrative assistant, and a research staff consisting of eight research coordinators. She added that the center treats adults with CF of all age levels, from 18 years of age to 80 years old.
Cathy Chacon believes the center is most proud of its position as the largest CF center in the United States for adults, as well as the comprehensive care it provides for patients. “We really do hit every area with the social work, nutrition, respiratory therapy, nursing, physicians. I’m really proud that we provide that comprehensive care,” she said.
According to NJH, its COPD Program strives to administer personalized, comprehensive care to patient with chronic obstructive pulmonary disease, which includes emphysema and chronic bronchitis. This full-service specialty program aims to help COPD patients manage their disease effectively by providing personalized patient care, education and group classes, a collaborative approach to enhance quality of life, and nutritional counseling. Additional program services include the latest in diagnostic testing and treatments for COPD as well as specialized pulmonary and physical rehabilitation programs.
The COPD Program also provides comprehensive care with a diverse team of specialists dedicated to helping people coping with this condition. The specialists who comprise this team include healthcare professionals from a range of disciplines, such as rehabilitation services, pulmonary physiology services, neuropsychology, behavioral medicine, and clinical nutrition. The team of specialists aspires to provide patients with the necessary tools patients need to take control of their condition to feel better and improve their quality of life.
Lung Care Centers
The Autoimmune Lung Center at National Jewish Health works collaboratively with the Interstitial Lung Disease Program, in addition to other pulmonary programs at the hospital, to provide assessment and management resources for patients with autoimmune lung disease.
According to NJH, the center works within the framework of a respiratory medical center and provides patients with a cross-specialty approach to care, bringing pulmonologists, rheumatologists, and other healthcare professionals together to coordinate care, evaluation, and disease management strategies. Technology, pulmonary physiology assessment techniques, and cardiopulmonary rehabilitation expertise are further combined to provide excellence in clinical care.
Interstitial lung disease (ILD) refers to a broad category of diseases that affect the interstitium, a lace-like network of tissue that provides support to lung alveoli. NJH’s ILD program has extensive experience providing treatment for these complex conditions, which include idiopathic pulmonary fibrosis, idiopathic pulmonary hemosiderosis, and lupus. According to NJH, the scientists, doctors, and staff of the Interstitial Lung Disease Program work collaboratively to broaden the understanding of ILD causes and create and advance new treatment approaches.
A Bright Future at NJH
NJH has a number of new, exciting opportunities on the horizon, including facility expansion, partnerships, and research. Kaci Chacon said research and trials are continually being performed in order to examine new medications and treatments for the different conditions diagnosed in NJH patients. Another area of research is cystic fibrosis, and Cathy Chacon explained that a great deal of research being conducted has to do with new therapies that treat CF at the cellular level.
In regard to the research being performed at NJH, Kaci Chacon added, “I think it’s exciting…that we are able to offer that here.” Nichols echoed the sentiment, stating, “All of our members are involved in research. There has been and continues to be a lot of focus on research in the field…and we’re all very excited to see those developments.”
Kaci Chacon also explained that NJH is working on several joint agreements with other healthcare systems and has recently partnered with Exempla Healthcare, which is a local health system in Colorado, as well as entered into a joint agreement with Mount Sinai in New York. In addition, Cathy Chacon said a large expansion was recently completed in which their inpatient service was moved to Saint Joseph Hospital in Denver, which will enable them to care for additional CF patients.
Overall, NJH has strengths and assets that enable the multidisciplinary team of the facility to provide comprehensive, exceptional care for patients. Nichols said that several of the strengths that he appreciates and recognizes at NJH include providers who are focused on excellent communication with patients and referring physicians and who are empowered and encouraged to solve complicated cases. In addition, the facility’s providers collaborate and work together with other providers to administer the best care possible.
Kaci Chacon believes that because NJH specializes in respiratory medicine and the facility has leading experts and world-renowned physicians and researchers, patients are at a great advantage. “It’s a very collaborative approach here between all of the subspecialties,” she said. “I think our major focus is on the patient and education, and we’re very patient-centric.”
Cassandra Perez is the former associate editor of RT. For more information, contact [email protected].