Two exceptional members of the Children's Wisconsin team have been selected to the Milwaukee Business Journal's "40 under 40."
In 2015, Kyle Landry, MEd, was hired at the Herma Heart Institute at Children’s Wisconsin with a singular objective: Solve a new and unique problem affecting millions of kids in the United States.
Heart defects are the most common birth defect, impacting nearly 1 percent of all births every year. As recently as 20-30 years ago, most babies with heart defects didn’t survive. But thanks to major medical advancements, these children are now living well into adulthood. Whereas before they rarely made it out of the hospital, this new group of survivors are now making their way into the classroom and presenting a unique set of challenges to teachers and schools.
Numerous studies show a direct connection between heart defects and neurodevelopmental delays later in life, which can impact learning, cognition, motor skills, language development, social-emotional functioning, attention, behavior and executive functioning. These delays can range from subtle to significant, placing many children with heart disease at a tremendous disadvantage in the classroom. Sadly, for too long, cardiac centers and schools didn’t know how to help.
In 2015, Children’s Wisconsin came up with an idea to create a team who had knowledge of both the educational and medical system to serve as a liaison between the family, the school and the medical team to help bridge that gap. That’s where Kyle came in.
With a background in education — Kyle was a teacher with Milwaukee Public Schools for five years with a specialty in literacy and advocacy for at-risk youth — she was uniquely suited to bring that school perspective to the medical team. That was the creation of the Educational Achievement Partnership Program (EAPP), one of the first programs in the country to have this systematic educational intervention as part of standard cardiac care.
As the program’s manager, Kyle began building the framework of how EAPP would serve as a communication hub linking the family, school, hospital and community agencies. Kyle worked with a team of advisors to craft the EAPP’s mission: To advance long-term educational achievement in children with chronic illness through collaboration, knowledge, advocacy and commitment, ultimately allowing every child the opportunity to reach their optimal potential.
To achieve this goal, every child enrolled in the program is assigned an education specialist who collaborates with the school and other stakeholders to boost academic success, motivation, attendance, attention, behavior and social-emotional functioning. The specialists are experienced educators with special training in the neurodevelopmental impacts of chronic illnesses. With Kyle’s mentorship and guidance, the specialists establish collaborative partnerships with families, schools, medical teams, and community care providers to interpret how a child’s health affects the brain and body, and facilitate communication around the overall needs of the child. This service is offered to families completely free of charge as a standard of care.
Kyle’s dedication and drive to meet the urgent school support needs of patients and families has driven the explosive growth of the EAPP over the past seven years. In the program’s first year, there were only 12 kids and it was limited to school-aged heart transplant patients. The second year, it grew to 42 kids. By 2019, the program expanded to a team of four staff serving more than 350 patients with heart disease from preschool through college-age. In 2021, the program tripled in size to a team of 12 staff serving 700 children with five types of chronic illnesses: heart conditions, cancer, asthma, neuropsychological deficits, and complex/special health care needs.
Thanks to amazing medical advancements, kids born with congenital heart defects and other complex health conditions are living longer than ever before. While their hearts may be mended and diseases treated, this new population of survivors still face many unique challenges. Kyle Landry saw these challenges and took them as an opportunity to innovate and create something brand new and vital. She and her team have successfully broken down barriers to ensure this new community of survivors get the support they need for full and successful lives.
Kyle’s vision for the EAPP isn’t limited to Wisconsin children with just five types of chronic illnesses. Her long-term goal is to create a system of hospital-based school support that can be replicated in other medical centers across the United States to extend services to an estimated 1 million children living with congenital heart disease and 18 million children living with chronic illness. Kyle’s commitment to these children and families is tireless — she will not rest until the gold standard of pediatric follow-up care has evolved to allow every child with chronic illness access to services like the EAPP and the opportunity to reach their optimal potential.
This work is deeply personal for Kyle. In 1987, Kyle’s little sister, Leigh, was born with hypoplastic left heart syndrome (HLHS), a rare and serious heart defect in which the left side of the heart doesn’t full develop. At that time, very few babies born with HLHS survived. Sadly, Leigh was one of them. Kyle was only 2 years old at the time, but that experience guided and influenced Kyle’s motivation to build a career teaching and advocating for children with health and learning disparities. She has dedicated her life to helping kids all over the world be able to live the full lives that her little sister was unable to.
Read Kyle's profile in the Milwaukee Business Journal here.
If not for Michelle Pickett, MD, MS, an emergency room physician at Children’s Wisconsin, more than 4,700 families may not have ever realized their child was at risk of suicide before it was too late.
In 2018, Dr. Pickett piloted a suicide screening program at Children’s Wisconsin. By the time the COVID-19 pandemic started, which exacerbated the mental health needs of many children, the screening had become a standard part of care for kids 11 and older who come to Children’s Wisconsin Emergency Department (ED).
This kind of suicide screening would not have become a standard of care without Dr. Pickett’s leadership. In 2018, she read a study that showed kids would answer a self-administered questionnaire about suicide more honestly than verbal questions. After caring for kids as an attending physician in the Children’s Wisconsin ED for three years, Dr. Pickett intuitively understood that for many kids answering those questions with parents or other nurses and doctors in the room could be difficult.
By the fall of that year, Dr. Pickett implemented a screening that had kids answer a group of five questions on an iPad while parents completed registration forms. The five questions are:
“In the past few weeks, have you wished you were dead?”
“In the past few weeks, have you felt that you or your family would be better off if you were dead?”
“In the past few weeks, have you been having thoughts about killing yourself?”
“Have you ever tried to kill yourself?"
“Are you having thoughts of killing yourself right now?”
The results were immediate, with kids consistently completing the form and an increasing number of kids screening positive. Working with department and hospital leadership, the screening was soon integrated into standard practice within the ED.
And it is needed. Here in Wisconsin, the suicide rate among kids is higher than the national average, and across the country symptoms of depression and anxiety have increased. In the first half of 2021, children's hospitals reported cases of self-injury and suicide in children ages 5-17 at a 45 percent higher rate than during the same period in 2019. And Children’s Wisconsin experienced an 80 percent increase in referrals for mental health services in December 2020 compared to December 2019.
The suicide screening in the Children’s Wisconsin ED is one piece of a bigger picture to address this growing need in our community, which was started a year before Children’s Wisconsin announced a comprehensive $150 million investment into mental and behavioral health. Dr. Pickett was leading her own charge, improving an area of care she knew she could influence and improve.
While her focus remains on improving the care kids receive, she is helping to change the overall conversation around mental health for all kids.
“There are times when I quite literally hear the sighs of relief in their voices upon my follow-up,” said Annie Flanagan, a Children’s Wisconsin mental and behavioral health patient navigator, who follows up and supports families after a positive screening. “Not only does the assessment process allow our teams to begin connecting the family to the right resources and treatment, but it enables us to educate and increase awareness of mental illness within the larger community. Quite simply, Dr. Pickett’s work plays a role in the de-stigmatization of mental illness in Milwaukee and the state of Wisconsin as a whole.”
This suicide screening tool is starting conversations to address mental health in our youth. It is opening a door for parents, guardians and kids to understand how mental health is affecting their lives, and how to start advocating for the support they need.
But above all, it is saving lives. To date, more than 28,851 kids have been screened for suicidal thoughts and nearly 4,700 have screened positive. Those are 4,700 kids who might have otherwise fallen through the cracks, 4,700 kids whose lives may have been lost.
Dr. Pickett is not satisfied knowing that the screening is helping kids who come to the Children’s Wisconsin ED. Children’s Wisconsin is one of only six hospitals across the country completing the suicide screening in this fashion. But the data and evidence Dr. Pickett is producing will help additional hospitals around the country follow suit. She is also working to identify other environments where the screening could be used. She is currently working with Milwaukee Public Schools and their team of school psychologists to see how the tool could benefit the kids they serve.
Dr. Pickett is an associate professor of Pediatrics at the Medical College of Wisconsin (MCW), and a well-published researcher with 20 accepted peer reviewed manuscripts, including in the area of sexually transmitted infections (STIs). She is currently working to address STIs locally as committee member of the United Way of Greater Milwaukee & Waukesha County’s Adolescent Sexual and Reproductive Health Subcommittee, and nationally as a co-leader of the Pediatric Emergency Care Applied Research Network (PECARN) Adolescent Sexual Health Workgroup, a group that leads the way in pediatric emergency medicine research.
Dr. Pickett is also passionate about promoting Diversity, Equity and Inclusion and decreasing disparities in medicine and the community. She recently obtained a certificate in Advanced Diversity and Inclusion. As one of the five Unconscious Bias trainers at MCW, she and her colleagues have trained nearly 75 percent of the 700 members of the Department of Pediatrics, along with many other departments on the MCW campus. Currently, Dr. Pickett is co-developing the next segment of training on microaggressions and microaffirmations. Because of her accomplishments and dedication, Dr. Pickett was recently appointed as the associate vice chair of Diversity, Equity and Inclusion for MCW’s Department of Pediatrics and, on a national scale, was named Disparities Nodal Champion by the Pediatric Emergency Care Applied Research Network (PECARN).
Though we won’t likely understand the profound impact of COVID-19 on our children for perhaps decades, as a hospital system and as a community, we are truly grateful to have people like Dr. Pickett on our team who are always thinking one step ahead. She is using her expertise in emergency medicine to fight the mental health crisis in kids, taking her unique skills to all areas where children can be reached. Dr. Pickett’s work has the potential to shift current emergency medicine practice from acute health encounters to the broader management of public health. That’s a seismic shift that could save the lives of an untold number of kids.
Read Dr. Pickett's profile in the Milwaukee Business Journal here.