Sujit Iyer, M.D., found his calling in pediatric emergency care when he learned that most emergency pediatric care occurs in community hospitals.
Asking himself, “How could I most benefit the community with all this emergency department training?” Iyer found the answer in building new educational programs focused at the individual trainee and patient level.
Sujit Iyer, M.D.
Q&A With Iyer:
What drives your efforts to bridge the gap between community pediatric emergency care and big children’s hospitals?
I am the director for the pediatric emergency medicine fellowship at Dell Children’s Medical Center and Dell Medical School. I also serve as chair of the faculty senate and have experience in teaching, quality improvement, community outreach and program development. While my training was always in traditional “big” children’s hospitals, I became aware of the statistics of pediatric emergency room care in the community as I finished my fellowship: 80% of all children who go to the emergency room do not go to big children’s hospitals — most children are cared for in community emergency departments, where there is variability in experience, comfort and even supplies to care for kids.
As I was finishing 11 years of training, I wondered how I could best serve the community. Austin had a unique scenario where the main referral hospitals also have close partnerships with the community hospitals: Physicians and nurses across the network know each other. There was a culture of growth and trying new things when I got here. It was the perfect opportunity to try different things to spread education, information and best practices across our community through training and useful tools.
How have you implemented training and protocols to improve care in community emergency departments?
Improving care has included work in creating a fellowship that encourages trainees from emergency medicine who will work in the community in the future, helping to develop evidence-based protocols for community emergency departments and delivering education on how to maximize the quality of pediatric care in community emergency departments for common conditions such as broken arms, asthma and even lacerations.
A few years after starting my current job, I received a call about a very sick child with asthma from a physician in an adult emergency department who had previously rotated within Dell Children’s. I was impressed by what the providers had done to make the child feel better despite not being used to seeing sick kids. The physician explained that their training at our hospital had taught them what to do, as they referenced an evidence-based pathway Dell Children’s created.
As an educator and someone involved in the improvement of quality of care, you have the chance to positively affect patients, even ones you may never directly interact with. This really solidified the idea that taking the time to teach and help others implement best practices can multiply in ways I may never see but continuously value.
What insights have you gained about the broader influence of education and quality improvement initiatives in pediatric emergency care?
Nothing in my career has been a linear path; it has been driven by the motivation to help teach young physicians the best way to take care of kids, and to contribute solutions for caring in every environment. Sometimes that means creating the best pediatric emergency room fellowship in the country that focuses on the trainee as an individual with their own set of strengths and attributes they can contribute to patients. Sometimes it means creating evidence-based algorithms to help guide community pediatric care. Sometimes it means creating an online curriculum for others to access across the United States. Sometimes it is mentoring trainees — and reminding them that, often, the first things we work on serve as the launching pad for their future careers.