Dr. Mike DiStefano’s favorite part of his job is swapping his suit and tie for a lab coat and a 12-hour emergency room shift.
As chief medical officer at Children’s Hospital Colorado, Colorado Springs, ER shifts are not exactly part of the job description for DiStefano anymore. But the Texas native doesn’t want to lose sight of the reason he chose pediatrics as a career field: being around children.
“Truly, I have fun in the emergency room. … I value [kids’] perspectives; I value how they look at their challenges,” DiStefano said. “Personally, they help me — so I don’t want to ever give that up.”
DiStefano joined the Children’s Hospital Colorado staff in 2012, spending seven years in Denver before transferring to Colorado Springs in January to serve as chief medical officer for the new facility. He has a bachelor’s degree in biomedical science from Texas A&M University and a medical degree from Baylor College of Medicine.
DiStefano spoke with the Business Journal this week about the role Children’s Hospital plays in the continuum of care for local pediatric patients.
Why pediatrics specifically?
I’ve been around kids my entire life. I was a swimmer and a swim coach. … It actually seemed like all my jobs have been around kids. … I actually liked everything I did in medical school, but the one common factor, and what I always came back to, was children and being an advocate for kids.
… I knew I didn’t want to do general pediatrics. I wanted to do some sort of acute care, and emergency medicine was a good fit — the varying shifts, the varying diseases, meeting families that are at a point of crisis and being able to have a positive impact at that point of crisis.
What are your responsibilities as chief medical officer?
I’d sum it up as [being] responsible for all of the physicians and the medical care provided by the physicians in the facility — so looking at quality, safety, outcomes and ensuring that we have a robust system to take care of all the needs of the community. I think the corollary would be the connection between the hospital and the community physicians, so trying to have a continuum of care between those two different systems of care, and trying to make it continuous as best we can.
Why is that important?
I think in health care we’ve typically been siloed, meaning that we do things in the hospital and then we do things on the outpatient [side], and I think that will get us only so far. I think as we realize that we are just a point in time in a child’s health care … that we have to come together as a team to ensure that we are delivering the best outcomes. One of the reasons why I took this job was because of that system of care and trying to … think about it in a different way so that we can deliver it at a higher quality that we haven’t necessarily seen before. So [we are] really trying to partner, and make sure that we’re delivering that care that makes sense at the right time for the right patient at the right place.
Talk about establishing a new health care facility.
It’s been very exciting. There has been pediatrics within the city of Colorado Springs for many decades and there’s a rich history there, but having the opportunity to stand up the next chapter in pediatric care has been incredible. … It feels good to be able to do that.
It’s also been challenging. We are starting a new system here, and so [we are] really trying to figure out how we want to deliver that care. I think we’re now getting into the fun part. We’ve organized, we put up the building — now we’re really talking about how to impact the care outside of just the physicians that end up touching the patient. It’s really looking at our system of care.
What do those conversations look like?
It’s really about partnership, not only here locally, but up at Anschutz [Medical Campus in Aurora]. So what ends up happening in pediatrics [is] you have a lot of sub-specialization, and so utilizing not only the physician experts here, but also utilizing those physician experts that may end up dedicating their entire life to the small set of whatever specialty they’re in, and bringing that down here to the families and really making sure that we have the right experts at the table to take care of patients.
It’s been fun to think about it because this is our first true hospital outside of Anschutz. We have our south campus, which is a smaller scale, but serving a higher acuity and complexity that we’re not doing up at Anschutz has been a really good experience.
What are some of the challenges of establishing a new health care facility?
We’re new to the area, so developing those relationships with other health systems has been not necessarily a challenge, but we’ve had to work at it. We’ve been welcomed into the community as a partner, but it’s been multiple conversations of, ‘How do we leverage each other’s expertise to care for the community?’
… What’s been interesting is that not everyone has walked in our doors and trusted us. … We have to earn their trust because they don’t know us. Despite us being a system, we feel like we owe that to the families — that they need to trust us and the care. Usually it’s meeting the physicians — we’ve had to meet the pharmacists as well — and really trying to develop those relationships that are so very important when you talk about delivering care to complex patients.
That was a surprise to me — I thought, ‘Oh you open the doors, put Balloon Boy on [the wall] and we’re here,’ but it hasn’t been as easy as I would have thought. I now understand that dynamic a lot better.
Talk about the difference between a pediatric emergency room and a general emergency room.
I always break it up into two buckets. One of it is around the medical knowledge, but then it’s around the care of a patient, which is totally different. How do you handle them? How do you talk to them? How do you engage them? How do you decrease their stress? … Every single [piece of] equipment is geared for kids, which is different than the general emergency department. We stock every single size that a child would ever need.
… In a lot of ERs, they do a lot of really good things with the bread and butter. But even in that bread and butter, we try to test minimize. Radiation doses are less here. … We try to minimize tests because there is an impact to the patient. We realized that the more you stick them, the more they’re not going to like me, so we try to minimize it for what they truly need.
… This whole building was designed from the eyeballs of the child. As you walk through, you’ll see things here that you’re not going to see in other hospitals, like windows or doors or little architectural features that only a child will be able to engage in.
How do your 12-hour emergency room shifts inform your administrative work?
It’s a healthy balance for me. … I think it keeps me grounded in my daily job of administration. I get to experience our system as a provider and not just as an administrator. … I get to experience some of the challenges that our doctors and some of our nurses have, and I think from those experiences, I can bring them into this office and try to help problem solve and figure out, ‘How do we make their work environment better?’ And if we can make their work environment better, easier, simpler — that all trickles down to the patient.
What is the most rewarding part of your job?
From the administration side, it’s looking at patient-level outcomes and moving the needle, whether it is with specific procedures or with processes that help identify diseases — to say, ‘OK, we have a disease entity, and we want to deliver a higher quality of care.’ I believe our care is the highest in the state when it comes to pediatrics, but there’s always room for improvement — I don’t think we’ll ever get to the point where we look back and say, ‘OK, we’re done.’
Clinically, it is coming up with solutions for families that are in the emergency department. I don’t see my role as a diagnostician because I don’t always diagnose, but if I have a path to a solution for the family, that is just as rewarding as making the diagnosis for me.
As chief medical officer, what do you want most for kids and families in Colorado Springs?
From a hospital perspective, I’d like them to come through our thresholds and find what they’re seeking — whether it’s a diagnosis, a treatment or support, because sometimes it’s just support — and when they find it, they leave our doors with a smile. I would also bring that out to the community and seeing that we partner with the health system within Colorado Springs to further the health care of kids, and realizing that we are just a small portion of that care.