Your doctors and nurse practitioners at Cary/Fuquay/Apex Pediatrics are here for you, not only for medical care, but as a source of reliable and sane information. We suggest you look at COVID-19 information from two perspectives.
The best way to stay healthy is by practicing good hand washing, remembering not to touch your face, and staying away from large gatherings. Take advantage of the nicer weather and get outdoors. If you or any one in your family is sick, stay home. When needed, cough into your elbow. If your child is sick, please call us.
For the time being, our Apex office will be seeing all the patients that are sick with fever or respiratory symptoms like cough. If you child has one of these complaints, then you will be asked to be seen in the Apex office. This will allow us to have both the Fuquay-Varina and Cary office to see our well patients.
If you child has a rash or other non-respiratory complaints, then they will be seen in Fuquay-Varina or Cary. We very much want to protect the children of our community, while at the same time allow us to provide care for those who are sick. We ask you to please not come to our Fuquay-Varina or Cary offices if you are sick or bring along siblings who may be sick.
We ask for understanding and patience as there may be some last minute cancelation of your children’s appointments so that we can continue to provide the very best and safest care to all of our patients. We encourage you to keep your scheduled well care appointments. Children still need to get physicals and the vaccines that protect them from illnesses much more serious than coronavirus. All of our offices have implemented procedures to keep you safe. We are following appropriate CDC recommendations. We are cleaning intensely and often.
We are here for you, our community, just as we have been since 1976, and we will continue to be here for you when this pandemic is over. Our providers and staff are taking this very seriously and will continue to be vigilant for our precious families.
So what exactly are we doing?
We are screening extensively for COVID-19 symptoms prior to scheduling our patients.
We are monitoring our staff daily, recording temperatures, and identifying potential symptoms.
Our Cary and Fuquay-Varina offices are designated as our “well” offices. This protection for our patients is key and helps provide a safer zone. NO ONE WITH COUGH OR FEVER IS ALLOWED IN THE DOORS. If you have these symptoms, you will be directed to our Apex location.
Beginning this week, all employees who have direct contact with patients in our well offices will be wearing a mask. This is to protect us from potential asymptomatic carriers. You may want prepare your younger children for this. For our sick office in Apex, you will see us in full PPE. Thank you to the many wonderful people and businesses who have donated PPE.
We are practicing social distancing so that no family should be within six feet of another family. We are also requesting that only one caregiver accompany their child to visits. The only exception to this is for our newborn and two-week-old visits.
We are excited to now be offering telehealth. If you have a concern that you feel can be handled virtually, we are more than happy to schedule that for you. Examples may include: medication checks, rashes, behavior concerns, quarantined families, etc. Our nurses are ready to help make that decision daily with you.
We are constantly updating our website with the latest information, sending out email newsletters like this, and posting on our social media sites. (If you don’t already follow us on Instagram or Facebook, you should!)
In short, stay home, stay safe, and if you do need to see us, we are here for you!
In the lists below you will find our recommendations for accurate and helpful resources.
What else can you do? Shut off the TV and give yourself and your children a break. When possible, keep their schedules normal. If your district is open, send them to school. Look for anxiety symptoms – such as moodiness, trouble sleeping and separation anxiety. Talk to your children about their fears. Reassure them. If you or your kids are feeling stressed or overwhelmed, consider looking at this simple but helpful tool from ImaginAction.
Anxiousness, sadness, and other mood and behavioral concerns seem to be on the rise in our community and across the country. We at Cary Pediatrics agree with the American Academy of Pediatrics that screening for these issues is important at least once a year as part of a child’s annual physical. Research shows that addressing issues early leads to quicker improvement in how a child feels, and reduces risk for larger concerns in the future. We employ a variety of tools such as the Edinburgh PostPartum Depression Screen, PSC-17, PHQ 2 and 9, and RAAPS questionnaires to assess for symptoms. If these screens are concerning, or if a family has a concern at any time beyond the screening tests, we know a number of local resources, including counselors, therapists, and psychologists, to help you and your family take positive steps forward.
We are incredibly excited in 2019 to be partnering with Reach Out and Read and to provide new books to children at their checkups from ages 6 months to 5 years of age. Like Reach Out and Read says, ‘We encourage parents to read aloud daily to their infants, toddlers and preschoolers, as a simple and effective way of fostering nurturing, language-rich family interactions that support brain development and provide a foundation for success.”
Dental caries are a significant problem for children. The risk of developing caries can be decreased by using fluoride. In 2014, the American Academy of Pediatrics issued a policy recommending fluoride treatments for babies. In our office, we apply topical fluoride every 3-6 months starting when the first tooth erupts. During all of your well child checks, we also address dental health and proper dental care that is age appropriate. We also will recommend home treatment with fluoride supplements when medically necessary.
Need advice from a nurse? Our highly trained nursing staff is available to answer your questions and concerns 24 hours a day. Each day our nurses provide advice on a wide range of topics from fevers, respiratory problems, to medication dosing. During business hours, our experienced in house nurses will be answering your concerns. Each of our LPNs and RNs take turns providing advice. Cindy in Cary, Tina in Apex, and Jennifer in Fuquay-Varina are some of our most experienced nurses providing triage with 82 years of combined experience!. After hours, we have contracted with WakeMed to provide nurse advice.
We are excited to have partnered with Kids in Parks and Walk with a Doc starting in the Summer of 2017. Kids in Parks is an exciting organization that has created a network of trails throughout the area with self-guided brochures that teach kids about nature while being outside. The Walk with a Doc organization works with local doctors to encourage behavior change and healthy living by connecting the physician with their patients outside of the office. The support of these organizations is amazing. Every few months we organize to have several of our doctors, nurse practitioners, nurses, and administrative staff come together for a hike. We invite our patients an their families to join us. The hikes are so much fun and our families love them. Another great aspect about Kids in Parks is that children earn prizes for tracking their adventures outside! You can sign up on their website http://www.kidsinparks.com.
Below are some helpful handouts on the dosing of the most common over the counter medications that we recommend. Please remember that if your child is less than 2 months old and has a fever >100.4, please call our office prior to giving any medications.
In an ongoing effort to improve the care we give our patients and their families, Cary Pediatrics is engaged in a number of projects to look at our practice. Some of these involve our clinical decision making and following clinical guidelines, and some with patient satisfaction.
We are pleased that patients are happy with our practice, and would refer others to see us. But we have heard that our biggest barrier is time waiting in the office to be seen. We have worked with our scheduling staff to ensure that appointments that are made have enough time to discuss the concerns the parents have. We are also working on streamlining the use of our EHR to expedite orders and the gathering of information. We also could use your help: when you call to make an appointment, either a sick visit or a checkup, if you have specific questions or concerns that may require a prolonged visit with your provider, please let us know beforehand, so we can budget time, and be able to give your child as much time as they need, and help keep us on schedule.
We also learned that we are doing a good job with having patients with special health care needs see their primary provider, to ensure consistency and continuity of care. But we also see that we can do better. We have highlighted in our scheduling programs and in our EHR a primary provider for patients with special needs. In this way, we should be able to do even better maintaining that important relationship. Below, blue means a patient saw their primary provider.
We are proud that all three of our office are performing similarly, showing we are all on the “same page” in our approach to our patients.
When you are seeing your provider, you might also hear us mention things like “it is recommended that…” or “guidelines or the American Academy of Pediatrics suggest…” We do our best identifying areas of our practice that have been identified by national agencies as areas of emphasis to improve care, both in the short term and in the long term.
Examples in the past year or two include: following industry standards in vision screening in younger children; cholesterol screening in school-aged children; immunizing children, especially those with asthma against influenza; maintaining appropriate appointment schedules for children on chronic medications; tracking newborn screening to ensure complete results; keeping kids on schedule for their yearly checkups.
We also try to review the medications that we are prescribing. For example we know that cost is very important to parents when it comes to medical care. We also know that generic medications tend to cost less than brand name medications. Unfortunately prescribing generic medications is not always possible, but we want to keep the percentage of generic medications as high as possible while prescribing the best and most effective medications for the patients. Below is the percent of brand name medications we have prescribed for the month of September the past two years.
We strive to continuously improve our practice by reviewing current literature and practicing evidence based medicine. The providers meet frequently throughout the year to discuss the latest literature to ensure that we are all practicing up to date medicine.
We also actively seek feedback from our patients at regular intervals. Formally, we will send out surveys via email after visits for our patients to give us feedback. Our questions on the surveys will change depending on our goals, but mostly involve making sure you were satisfied with all aspects of your visit from making the appointment, to your time with your nurse, and the time with you spent with the provider. We use this feedback to make changes in our workflow and procedures. Listening to our patients is one of our most important goals, so that we can provide the best care and service to our patients.
Cary Pediatric Center is proud to announce that in June 2017 it was recognized by the NCQA Patient-Centered Medical Home (PCMH) 2014 Program. What does this mean, and what does it mean for you as our patient?
The patient centered medical home (PCMH) is a promising model for transforming the organization and delivery of primary care. It means that you will be surrounded by a dedicated team of health professionals, working together with you, to optimize your health goals using the best evidence-based medicine and resources available for you today. Helping and empowering you to take responsibility for your health and giving you the self-management support that you need to succeed.