Healthcare Hero: Dr. Gerald M. Loughlin
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Dr. Gerald M. Loughlin, Professor of Pediatrics
Weill Cornell Medicine/NewYork-Presbyterian
Gerald M. Loughlin, M.D., M.S. is Professor of Pediatrics in the Department of Pediatrics at Weill Cornell Medicine, and Attending Pediatrician at NewYork-Presbyterian/Weill Cornell Medical Center and Phyllis and David Komansky Children's Hospital.
He served as Chair and Pediatrician-in-Chief from 2002-2020 and is an internationally recognized authority on pediatric respiratory diseases, including asthma, cystic fibrosis, and sleep apnea.
A Champion for Child Life
Under Dr. Loughlin’s leadership as Chair and Pediatrician-in-Chief from 2002-2020, the pediatric department at NewYork-Presbyterian/Weill Cornell Medical Center and NYP Phyllis and David Komansky Children's Hospital experienced tremendous growth as he built a strong foundation of excellence in pediatrics.
The child life department alone has grown from 3 to 22 specialists under his watch.
During his tenure, Dr. Loughlin realized providing quality care went beyond doctors and nurses. Seeing the benefits they provide to young patients, he quickly became a champion for child life professionals and took steps to make sure they were an integral part of pediatric healthcare at NYP.
Our President & CEO, Michele Hall-Duncan, can attest to the powerful effect that occurs when someone like Dr. Loughlin promotes child life. “I’ve learned over the years that if there is one person you want supporting child life, it’s the head of pediatrics, because if they believe in your program, others will follow suit.”
Dr. Loughlin with the Child Life and Creative Arts team (pre-pandemic)
As he reflected on the last year, Dr. Loughlin proudly shared that child life specialists were crucial during the pandemic. They offered emotional support and coping techniques for adults who were fighting for their lives. Child life specialists’ ability to explain medical terms in easy-to-understand ways ensured loved ones at home, including children and grandchildren, could remain updated when visitation wasn’t allowed or when a patient was unable to communicate.
Dr. Loughlin recalled, “Our child life people were phenomenal. There were adults with significant illness who were not going to make it and so they were switched over to palliative/hospice-type care. The child life people stepped into the breech and they became the communicators between the palliative care team and the family at home.”
Over the last year, Dr. Loughlin saw other departments realizing what he’s known for decades: the tremendous importance of child life skills and the positive difference they make for patients and their families. Other departments began to see the great benefits of child life, even beyond serving children. “We’ve had family and child centered care for as long as I can remember. And I think that we need to translate that to internal medicine. We need to incorporate some of the concepts of family-centered care into adult care as well.”
With a background in child development, psychology and counseling, child life specialists are trained at minimizing psychosocial trauma. As in many other hospitals coping with the emotional and physical strain of navigating this new COVID world, at NewYork-Presbyterian/Weill Cornell, those skills were also directed at lifting their colleagues’ spirits, and they spent many hours simply delivering meals and care packages of snacks and treats to their overwhelmed coworkers. For those who often had little time to take a break, not having to worry about where they were going to get their break meal made a world of difference.
During the height of the pandemic, Dr. Loughlin found himself in a similar position. He often felt his biggest role was as “cheerleader-in-chief.” While his team sought to limit his coronavirus exposure because of his age, he wanted to be in the trenches with them but instead found his place as their morale booster. “I tried to go over and be helpful but because of my age, when I walked on to the unit, the first response was ‘what are you doing here’. My basic role was for morale.”
As a professor, Dr. Loughlin remains focused on imparting his wealth of wisdom with incoming doctors, reminding them to be flexible, calm, and to recognize the importance of public health issues.
We thank Dr. Loughlin for his incredible commitment to providing quality family-centered care to all children and being a champion for child life departments everywhere.
COVID-19 at NewYork-Presbyterian
Innovative ICU Physician Care Models: Covid-19 Pandemic at NewYork-Presbyterian
NewYork-Presbyterian (NYP) is a 10-hospital integrated academic health care system in New York City.
NYP saw their first Covid-19 patient in early March 2020, and in the following 45 days, their hospital system admitted over 7,600 Covid-19 patients.
As they prepared for the impact of Covid-19, it was clear the sheer number of critically ill patients, coupled with the long intensive care unit (ICU) stays (averaging 14–21 days), would necessitate significant growth in their critical care capacity.
It was an imperative to redefine their ICU model of care to accommodate an increase from 421 ICU beds to nearly 1,000 critical care beds across their enterprise within 3 weeks.
As units filled with Covid-19 patients, treating one disease afforded them the flexibility to create blended teams from across specialties — one of their ICUs teams included a cardiothoracic surgery attending, a cardiology fellow, and residents from orthopedics, pediatrics, and psychiatry.
Pivoting During a Pandemic
According to the American Academy of Pediatrics, as of March 11, 2021, more than three million children in the U.S. have tested positive for COVID-19, representing 13% of all cases. Despite this, luckily, children have fared remarkably well with the illness.
Dr. Loughlin believes that if both the pediatric and adult health systems had been hit at the same time, we would not have gotten through this. “The healthcare system couldn’t have handled a virus that affected children as adversely as it affected the older adults.”
To manage the influx of adult COVID-19 patients while continuing high-level care for children, NewYork-Presbyterian converted their pediatric units from Brooklyn Methodist Hospital, Queens, and Komansky Children’s Hospital into adult units, and moved the children being served at those facilities to Morgan Stanley Children’s Hospital in Manhattan.
The surge during the pandemic was “a real shock to the system,” Dr. Loughlin shared. “Our doctors who last year were taking care of 6-month-olds with bronchiolitis, were now taking care of 70-year-olds with respiratory failure and pneumonia from COVID.”
Everyone was pulled into roles they normally didn’t occupy. Despite the challenges, Dr. Loughlin proudly credits the staff with doing an outstanding job. “When you look back overall, the survival rate of our PICU was no different from units where patients were being cared for by internal medicine doctors. So our pediatric teams stepped up to the plate like you wouldn’t believe.”
This included child life specialists. Their training in helping patients and families manage what are often the most stressful and traumatic events of their lives, along with the fear, anger, confusion and helplessness that go along with them, greatly assisted the palliative care team. They helped adult COVID-19 patients cope with terrifying uncertainty and played a crucial yet heart-wrenching role in translating messages to families at home. Dr. Loughlin says that their interventions were so effective that “The adult palliative care team wanted to adopt child life techniques to their team.”
One of the biggest stressors of all at the height of the pandemic and for a majority of the year, was restricted visitation. There was no having family and friends at your bedside to hold your hand, no familiar faces with encouraging smiles and words of comfort. “Visitation was not allowed. And at a critical time in a person’s life - being seriously ill and possibly dying - they are basically by themselves. And our staff - the nurses and child life workers - they stepped in and became family surrogates to get people through this illness.”
enCourage Kids Support
enCourage Kids COVID-19 Coping Kits
Since 1997, enCourage Kids has provided more than $591,000 in direct funding to NewYork-Presbyterian/Weill Cornell Medical Center through our Pediatric Hospital Support Program.
Since 2006, this funding has supported a Music Therapy program. This type of therapy has the ability to help patients grow emotionally and developmentally during a challenging time in their lives. Additionally, music therapy helps children manage pain, alleviates anxiety, improves self-esteem, and encourages social activities.
Their music therapist, Brianna, works with children to create their own music, regardless of their ability to play an instrument. This enables each child to engage with music, be creative, and express themselves in a unique way. Music has a unique way of crossing barriers and helps promote wellness regardless of culture or language spoken. enCourage Kids’ support helped the facility to expand the program from part-time to full-time.enCourage Kids supplied children at Komansky Children’s Hospital with COVID-19 Coping and Comfort Kits specifically created with items geared toward teens, an often overlooked and underserved population. These included electronic games, journals, and activity books. The kits provided much-needed distraction and entertainment in between procedures and treatments, and offered fun activities to engage with while alone. Each kit was individually encased in plastic bags to meet infection-control protocols and allowed child life specialists to easily see what was inside and distribute efficiently.
enCourage Kids has placed cuddly teddy Bears into the arms of more than 300 pediatric patients at Komansky Children’s Hospital. The Bear becomes a much-needed friend and hand to hold while undergoing treatments, recovering from surgery, or during long hours of isolation. The Bear can also be used as a child-friendly teaching tool. Child life specialists, nurses, and doctors use the Bear for medical play to help young patients learn what to expect during a hospital visit.
In Tune with Music Therapy
The benefits of music therapy, such as addressing emotional distress and pain, can meet the needs of even the tiniest of patients.
In August 2020, NewYork-Presbyterian/Weill Cornell Medical Centers opened a new Neonatal Intensive Care Unit (NICU), a relocation that was put in place long before the pandemic started, and whose execution now presented an even greater challenge than originally expected.
This required a carefully crafted plan orchestrating the movements of hundreds of staff to transfer the unit’s 50 babies from the main hospital to the new NICU across the street, while maintaining additional COVID-19-related safety protocols to protect the staff, ambulance personnel, and of course, the babies. To do so, the babies were taken one at a time in individual incubators, and brought down the elevator, lifted into an ambulance, and driven to the new NICU.
The very last baby, who was especially fragile, started to get upset about being moved. Bri, a music therapist funded by enCourage Kids Foundation, stepped in and started playing music. As a mainstay in this baby’s care, her music had been a constant source of relief and a method of soothing him during his time at the hospital.
Dr. Loughlin, who was in the room to witness this recalls, “Bri calmed him down, which allowed them to get the baby moved into the transport incubator so they could put him in the ambulance and get him across the street. And she stayed with him during the entire journey. That’s our music therapy program. And it was a stunning example of how the beneficial effects of a music therapy program can have on patient care.”
Future Challenges
In discussions with our pediatric healthcare heroes, an important question emerged: what does the future hold?
The pandemic has brought to light a number of challenges that kids and pediatric patients may face in the next few months and even years.
