Family Health: Children’s hospital level of care comes to Missoula

When a child is sick, the phrase “They took her to Seattle” is like a signpost that tells you the situation is very serious. But these words are also hopeful. Seattle Children’s Hospital is one of the best in the world, and you know children who go there will get the highest level of care. A partnership between Seattle Children’s Hospital and Community Medical Center now brings that same level of care to Missoula. 

According to Daniel Beals, a pediatric surgeon at CMC, it’s an important arrangement for a community hospital. “It would be easy to say, ‘We’re doing the best we can with what we have,’ ” Beals says. ”But that’s not good enough. All our cases are managed the same way as at Seattle Children’s.”

That doesn’t mean every sick child can stay at Community – children with certain conditions still go to Seattle for treatment. For example, hospitals must do 150 to 200 pediatric heart surgeries each year to be really good at these procedures. That kind of volume is unlikely in a rural state like Montana.

On the other hand, many sick children who would have made the trip to Seattle in the past now stay here for treatment. That includes infants born with serious conditions such as esophageal atresia, where the esophagus ends before it reaches the stomach, and gastroschisis, in which the baby’s intestines protrude through a hole in the abdomen. And children who do need to be treated in Seattle can usually have their follow-up care back at Community.

A big part of the reason for this expanded care is Beals himself, who brought his 25 years of experience as a pediatric surgeon in large hospitals to Missoula last summer. Many surgeries that are rare in Montana are routine for him.

The other part is Community’s partnership with Seattle Children’s, which began nearly 15 years ago and has been recently reinvigorated. It involves these practices:

  • Surgery outcomes at Community are reviewed using the same criteria as at Seattle Children’s, and refined until they meet those standards.
  • Seattle Children’s extends specialized non-surgical care to Community to diagnose and treat children with urologic and bowel problems.
  • Beals holds weekly web conferences between Community and Seattle Children’s to assess quality of care and how to improve it.
  • Patient evaluations are done the same way as at Seattle Children’s. That way if a child does need to be transported there for care, the evaluation won’t have to be repeated.
  • Beals will soon be getting privileges at Seattle Children's Hospital where he could travel to Seattle with his patients, who need to go there, to participate in their surgeries.
  • Providers from Seattle Children’s will come to Community to assist with complex surgeries if the need exists.

The advantages of this partnership go both ways. As a teaching hospital, Seattle Children’s benefits from treating cases from Montana that may be unusual or complex. Plans are in the works for Beals to teach medical students in Seattle, and medical residents from University of Washington may come to Community. “Practicing in a rural setting, where you may have to make decisions quickly on your own, is an experience young doctors should have,” Beals says.

Seattle Children’s Hospital also partners with hospitals in Great Falls and Billings, as well others in Washington and Alaska. Most of these relationships aren’t as extensive as the one with Community. But according to Beals, they’re all valuable. “It’s all about getting quality care close to home,” he says.