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Updated: December 9, 2019 / 2019 Health Care Heroes Honorees

Pelegano creates settings that improve pediatric care

By Karen Sackowitz

 

Category: Advancements in Healthcare — Innovation

Dr. John Pelegano, Chief of Pediatrics, Hospital for Special Care, New Britain

If the key to innovation is an insatiable appetite for learning, it’s no wonder Dr. John Pelegano has gained recognition as an innovator over his 30-year career.

As chief of pediatrics at the Hospital for Special Care in New Britain, Pelegano has fostered an environment of teamwork among medical specialists, volunteers and families, all with the singular goal of helping young patients overcome difficult challenges.

“John is a lifelong learner. He’s curious to find new ways of doing things, and asks questions others won’t,” says Dr. Hassan Minhas, medical director of outpatient autism services at the hospital.

In the early days, Pelegano says there wasn’t a lot of direct contact between medical staff, therapists and patient families. By including families in review meetings and bringing specialists together, he built a collaborative setting specially suited for the challenges faced by pediatric patients.

“These children tend to be very complex to care for and no one person can do it unassisted,” he says. “We actively worked to incorporate everybody into decision-making for the children. The nurse is more involved with the therapist; the respiratory therapist is more involved with the dietician and pharmacist. The more people watching what’s going on, the better the care tends to be.”

Pelegano says that as a clinician rather than a researcher, his innovations have been predominantly environmental.

“A hospital is not a good place for a child to hang out for long periods of time. Our program is unique because we put a great deal of effort into trying to enrich the environment to promote normal development,” he says. “We have a lot of people on the unit because children need to be picked up, held, talked to, played with. We have a morning group with songs and stories, like a daycare setting. We have active volunteers who come in to interact with the children to compensate for the fact that they’re not home.”

Improving care for children treated at the hospital also means expanding beyond it.

“We put a great deal of emphasis on trying to get the children out of the hospital,” he says. “We started working with area school systems and had several children go out to school on a daily basis, some with nursing support. We do a lot with our therapeutic recreation staff to get the kids out to fun activities — to the mall, movies, park, a children’s museum — wherever we can arrange a visit to get them out mixing in the community.”

Pelegano’s efforts have benefitted the Outpatient Autism Center, where he focuses on finding the most advanced practices possible for early diagnosis.

“Autism outcomes are better with early diagnosis, yet most times it’s difficult to identify in children when they are young,” Minhas explains. “John is well trained in the more nuanced deficits of this age group; he has become a leading expert in diagnosis and care for these younger children.”

“There’s been an evolution in this area of developmental pediatrics,” says Pelegano. “In the early days, autism diagnosis was made by one clinician — a neurologist, a pediatrician — and the incidence rate was one child in a thousand. With subtler forms of autism being identified over time, the diagnostic criteria changed as well. The term Autism Spectrum Disorder [ASD] recognizes these milder forms of the disorder.”

Their facility is now the first and only pediatric development center to do the type of ASD testing they offer. Their team has grown as well, adding layers of treatment and support for patients and their families.

“Today, children who come in with their parents might be seen by two or three professionals to be evaluated; a consensus conclusion will be reached by the team, followed by a collaborative treatment plan,” Pelegano said.

Pelegano is scheduled to retire at the end of the year, but Minhas says his influence will undoubtedly live on.

“John’s dedication to continuous learning and teaching has made him a mentor to a new generation of physicians, nurses, respiratory, physical, speech and occupational therapists,” he says. “He has seen and led some amazing innovations in complex clinical care for pediatric patients over the course of his career, and in doing so has shaped the professional growth of countless physicians and positively impacted the recovery of thousands of children.”

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