Sickle Cell Day Hospital at Memorial Regional Hospital Is Only Program of Its Kind in Florida
What Is Sickle Cell Disease?
Sickle Cell disease is an inherited blood disorder that affects red blood cells. There are several types of sickle cell disease, including sickle cell anemia, sickle-hemoglobin C disease, sickle beta-plus thalassemia and sickle beta-zero thalassemia.
Although anyone can inherit the condition, sickle cell anemia occurs most often in African Americans and Hispanic Americans. People with the condition may experience sickle cell crises where irregular, or "sickled," red blood cells block small blood vessels and stop the regular flow of blood and oxygen, causing severe pain throughout the body.
Treatment of complications of sickle cell disease often includes antibiotics, pain management, intravenous fluids, blood transfusion and surgery.
September 2005 — Since 1983, when President Ronald Reagan officially designated the month of September as National Sickle Cell Anemia Awareness Month, much national and local attention has been brought to sickle cell disease. Yet, it was not until Memorial Healthcare System opened its Sickle Cell Day Hospital at Memorial Regional Hospital in May 2003 that a dedicated program for the management of acute and chronic sickle cell syndromes was available to patients in the state of Florida.
Over the past two years, the Day Hospital has treated hundreds of patients 16 years and older. And in March 2005, Memorial Sickle Cell Day Hospital became the first and only program of its kind in the nation to be granted "Disease-Specific Certification" by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an independent, not-for-profit organization that is the nation's predominant standards-setting and accrediting body in healthcare.
Individualized, Compassionate Care
With separate, coordinated programs for adults and adolescents transitioning into adulthood, Memorial Sickle Cell Day Hospital provides a quality of care that many patients have not experienced before, according to Lanetta Bronte, MD, MPH, Director of Sickle Cell Services at Memorial Regional Hospital. "Both teens and adults need a continuum of care to help them avoid hospitalization, as well as to manage and control the pain that comes with sickle cell disease," Dr. Bronte says.
The Sickle Cell Day Hospital is set in a quiet, comfortable environment inside Memorial Regional Hospital. Its dedicated staff of expert physicians, nurses and support personnel works closely with the patient's primary care physician or with a primary care physician at the Day Hospital to deliver appropriate treatment. For patients who do not have a physician for comprehensive care, hematologists at the Day Hospital are available for assistance. In addition, the staff works in partnership with the patient and family members to provide prompt, aggressive treatment to relieve pain as quickly and effectively as possible. With treatment delivered in an average of five hours, the patient often can avoid hospital admission for greater convenience and reduced cost.
Memorial Sickle Cell Day Hospital provides immunizations for sickle cell patients, as well as personalized assistance to help patients manage their condition and avoid acute, painful crises and other complications. Before pain becomes a problem, patients can call the Admitting Nurse - available 24 hours a day, 7 days a week - for medical help, whether to make an appointment for treatment at the Day Hospital or to make arrangements to go to the Emergency Department.
Transitional Programs for Teens
The Adolescent Program at Memorial Sickle Cell Day Hospital specifically addresses the needs of teenagers age 13 to 16. In addition to the services available to adult patients, the program provides the following benefits:
- Age-appropriate care and counseling
- Collaboration between Joe DiMaggio Children's Hospital physicians and adult care physicians who specialize in sickle cell disease and its treatment
- Tracking of a patient's growth, development and pain history to provide highly individualized care and a smooth transition from pediatric to adult care
- Access to a Broward County Public Schools teacher during treatment or hospitalization
New patients must be referred by their primary care physicians, who will transfer medical records to the Day Hospital. In addition, a sickle cell prep test and hemoglobin electrophoresis are administered to determine the type of sickle cell disease. This helps to identify the most appropriate treatment for the patient and eliminate the use of multiple, overlapping therapies. Patients are able to receive their treatment in the same place with the same protocol by the same, dedicated medical team.
Psychological Support
Along with the specialized care patients receive at the Sickle Cell Day Hospital, they have access to a psychiatrist and a monthly support group. "The psychological component of this disease is not always addressed by patients or their primary care physicians," says Dr. Bronte. "They may have become dependent on their family to make their care decisions, they may be unmotivated to take control of their own health or they may be unsure of how to become productive adults. Our monthly support group meetings, led by Lillian Boone, MD, psychiatrist on the medical staff at Memorial Regional Hospital and Joe DiMaggio Children's Hospital, are a great place for patients to connect and help each other." In addition, Dr. Boone has dedicated a day each month to meet with patients one on one.
"This is an ideal way to approach patients with sickle cell disease. In addition to standardizing their care, it also offers a positive scenario for aggressive pain control and psychosocial support," says Luis Salcedo, MD, Director of Pediatric Anesthesia at Joe DiMaggio Children's Hospital and the creator of the pain protocols used by the Day Hospital.
"Sickle cell disease affects every aspect of a person's life, but it doesn't have to keep that person from living a productive and happy life," adds Dr. Bronte. "We see patients who have full-time jobs, patients who have children, and six of our patients have become volunteers for the Day Hospital. By becoming proactive in their own care, and by not allowing themselves to be swallowed into a sea of pain and suffering, our patients can raise their quality of life. We are so fortunate to be a part of their care and their lives."
For additional information or to set an appointment for patients 16 years and older, call the Sickle Cell Day Hospital at Memorial Regional Hospital, Monday - Friday, 9am - 5pm at (954) 265-6945. Assistance is available in English, Spanish, Creole and French. For assistance after hours, please call (954) 265-6338.
To learn about care for children under age 16 with sickle cell disease, call Joe DiMaggio Children's Hospital Pediatric Specialty Center at (954) 265-2234. We are available 24 hours a day, 7 days a week.