A Model for Care

Carrie Byington, M.D. Pediatric and Vice Dean, University of Utah Health Care


Pediatrics is generally a very happy specialty. When it's sad it's a very sad specialty. I think pediatricians bond together for that reason. You know, I've heard people say they can't even walk into the children's hospital. It's too hard, it's too depressing. To me it's a wonderful place filled with hope.

Working with children is difficult because devices, medications, vaccines are all tested on adults. You're always going to be relying on adult studies and children are not just small adults.

About 10% of all infants in the first 90 days will have a fever. It's a really vexing problem especially for young infants. Because any fever could represent a very serious infection you have one chance in the emergency room to get it right. Do you admit them or do you send them home? And you want to make the right choice.

The current recommendation is all of those infants have medical care and that the majority of them would be hospitalized. But that's hundreds of thousands of admissions each year. It's incredibly costly, in the billions of dollars.

For the last 15 years or so, all of my time here at the University of Utah, I have focused on the development and implementation of something we call the Evidence Based Care Process Model. Using input from laboratory staff, nursing staff, administrators and parents we built a care process model that we could all say, "This represents the best possible care that we could give in our system".

We started small with one virus and now we have technology where we can diagnose 15 viruses, we can diagnose bacteria in under an hour. It's now routine in hundreds of hospitals around the country including many children's hospitals. And so being able to go to a parent and say, "I know why your baby has a fever," that is such a relief. And that's where the joy of it is and that's where the benefit of it is. You know that kids are better off not just here but in other places because you did the research.