GILLETTE CHILDRENS SPECIALTY HEALTHCARE
200 University Avenue East, Saint Paul, MN 55101 www.gillettechildrens.org

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Organizations Filed Purposes: Gillette Children's Specialty Healthcare (Gillette) provides specialized health care for people who have health conditions that began during childhood. We help children, adults and their families improve their health, achieve greater well-being, and enjoy life.

Provides specialized care for people who have health conditions that began during childhood.

Patient services: Founded in 1897, Gillette is dedicated to providing high quality subspecialty care to children who have complex and/or disabling conditions primarily affecting the musculoskeletal and/or neurological systems. During 2019, the organization saw 25,375 patients from all 87 Minnesota counties, 45 U.S. states, and 13 countries. Gillette operates a 60 licensed-bed specialty hospital in St. Paul, Minnesota; clinics in Alexandria, Baxter, Bemidji, Burnsville, Duluth, Mankato, Maple Grove, Marshall, Minnetonka, St. Cloud, Willmar, and St. Paul, Minnesota, and outreach and telemedicine collaborations across Minnesota and the Upper Midwest.Gillette cares for patients who have some of the most complex, rare and traumatic conditions in pediatric medicine, including cerebral palsy, epilepsy, spina bifida, hydrocephalus, complex orthopedic conditions, craniofacial anomalies, genetic disorders, neurological conditions and brain and spinal cord injuries. Care at Gillette is clinically integrated, bringing experts together from multiple areas to coordinate and care for patients from initial diagnosis through the lifetime of their condition, with individualized care planning at the center of our work. This integrated care model has differentiated us from traditional health systems. For more than 120 years Gillette has led in the diagnosis and management of complex medical conditions through the development of innovative medical and surgical interventions, proven rehabilitative therapies and the novel application of customized services from compassionate health care professionals, Gillette's care helps ensure every child can realize their full potential.Gillette is a regional referral center healthcare destination for people who have complex, rare and traumatic conditions that began in childhood. The diagnosis and management of these conditions requires significant clinical expertise and an integrated and proactive care planning system that support the delivery of a comprehensive treatment plan. The majority of conditions Gillette specializes in treating have courses of care that run for months, years, or an entire lifetime. Although a number of hospitals can and do provide certain pediatric specialty services, Gillette is unique in the region for specializing exclusively in the care and rehabilitation needs of individuals with medical complexity and lifelong conditions that affect the musculoskeletal and neurological systems.Gillette clinics in greater Minnesota improve access to care for families who live outside the Twin Cities metro area, and support local providers by facilitating collaboration with Gillette specialists. Gillette continues to enhance its presence around the state, aiming for a more consistent presence in key communities and providing more consistent scheduling and give families greater access to care. Gillette continues work to implement virtual care (telemedicine) services into its clinics and other care settings. Virtual care enables providers to hold consultations with patients via video conference.During 2019, Gillette treated 25,375 patients from all 87 Minnesota counties, 45 U.S. states, and 13 countries. A large and geographically diverse network of referring physicians has driven growth, with over 2,500 physicians referring patients to Gillette. There were 2,282 inpatient admissions, with an average length of stay of 5.1 days, and 139,316 outpatient visits during 2019. Gillette physicians performed 3,746 inpatient and outpatient surgeries in 2019. The top five conditions seen at Gillette include cerebral palsy, limb-length discrepancy, developmental dysplasia of the hip, scoliosis, and epilepsy.Gillette's areas of expertise, key conditions and services include the following:Cerebral Palsy: Gillette is an internationally recognized leader in the diagnosis and management of spasticity resulting from cerebral palsy and other causes. Gillette offers comprehensive, coordinated care designed to manage the symptoms of cerebral palsy. Services range from infant evaluations to diagnose the condition, to medical and surgical interventions to manage spasticity and related comorbidities as children grow into adulthood. Individualized treatment plans might include developmental assessments, rehabilitation therapies, orthoses, specialized seating, mobility and communicative supports, spasticity management techniques (including surgery), gait and motion analysis, and orthopedic care. Individuals with cerebral palsy often have complex and wide-ranging health care needs. Gillette's unique expertise in the field provides families with healthcare professionals who are aware of the variety of comorbidities commonly associated with cerebral palsy and who are able to identify them early and employ appropriately coordinated management of these conditions.Gillette treats more than 4,000 cerebral palsy patients every year. Gillette is an innovative clinical leader in treating cerebral palsy - from developing new devices to assist in patient care, to the assessments done at the at the James R Gage Center for Gait and Motion Analysis, Gillette is sought out for its care around the world.Orthopedics: Gillette is home to nationally and internationally recognized leaders in pediatric orthopedics. Gillette's staff treats patients who have complex orthopedic problems resulting from cerebral palsy, traumatic brain injuries, neuromuscular conditions, trauma-related fractures, and strokes. Gillette staff members see patients who have permanent joint contractures, extra or missing fingers or toes, brittle-bone disease, and clubfoot. The staff also creates prostheses and treats patients with complex leg- and arm-length discrepancies. Orthopedic surgeons treat children with scoliosis and other spine disorders. Gillette doctors also see patients who have joint disease, joint-overuse symptoms, and other musculoskeletal conditions.Neurosciences: Gillette's neurology and neurosurgery providers provide expert clinical care for children with neurologic conditions and offer a breadth and depth of subspecialty care to provide the most accurate diagnoses and advanced treatments available for patients with conditions including Chiari malformations, hydrocephalus, spina bifida, epilepsy, neuromuscular conditions such as muscular dystrophy and spinal muscular atrophy, rare conditions such as Rett Syndrome, and neurological complications resulting from other complex conditions.Craniofacial Services: Gillette's experts diagnose and treat children with congenital or acquired conditions involving the head and neck. These conditions, often resulting from a genetic anomaly and occurring frequently with other comorbid conditions, require an integrated care team including surgeons, physical, speech and occupational therapists, dental and orthodontics, as well as specialized orthoses. Unique service offerings include the Gillette CranioCap orthosis, a custom-made brace for the skull that corrects deformational plagiocephaly. For many children with cleft lips and palates, orthodontists custom-make Gillette's OrthoCleft retainer, a presurgical appliance that brings gum segments together, reducing the gap in the mouth, and improves sucking and eating abilities for some children awaiting surgery. Both the CranioCap orthosis and OrthoCleft retainer are registered trademarks of Gillette and are used nationally. Gillette's staff also treats children who have hemangiomas and vascular malformations.Rehabilitation: Gillette provides comprehensive inpatient rehabilitation care, as well as outpatient rehabilitation services. As a major referral destination, our pediatric rehabilitation program is one of the largest in the upper Midwest. We also offer the nation's highest concentration of board-certified pediatric rehabilitation medicine specialists, all in a family-centered environment. Our inpatient unit offers comprehensive medical rehabilitation services to children and teens who sustain brain and spinal cord injuries, require post-surgical rehabilitation needs, or have other complex medical conditions requiring rehabilitation services. Gillette Children's Specialty Healthcare has a history of accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF) for pediatric inpatient rehabilitation and our pediatric brain injury specialty program Gillette is one of only eight hospitals in the country with these designations. We also provide outpatient services for such patients after discharge. Gillette provides specialized physical therapy, occupational therapy, speech and language pathology and audiology services to patients who have a wide variety of conditions, including cerebral palsy, spinal bifida, orthopedic conditions and other complex medical issues. Gillette also provides aquatic therapy for patients who have neurological and musculoskeletal problems.

Research: Gillette research activities concentrate on clinical applications devoted to finding effective medical interventions for disabling conditions and their related effects. Research at Gillette consists of seven major emphasis areas (gait and motion, health outcomes, neurosciences, nursing, orthopedics, rehabilitation, and spine), all of which seek to improve the lives of children who have disabilities and complex conditions. During 2019, 228 active studies were underway and over 58 studies were published in peer-reviewed journals.The following are several examples of research studies that are currently underway: Gillette is working to understand how the social determinants of health impact the health of medically complex children. Research is underway to evaluate the prevalence of the social determinants of health in our patient population, to identify potential relationships between the social determinants of health and health outcomes, and to improve comprehensive care management to address disparities created by the social determinates of health. Gillette is a leader in pediatric rehab medicine. Work is underway to better measure motor control following a pediatric traumatic brain injury (TBI), as current outcome measures of recovery of walking ability after a TBI are indirect and subjective. The goal of this study is to test the usefulness of an objective measure of dynamic motor control to assess recovery from a TBI. Gillette is a leader in the research and treatment a rare orthopedic condition called Legg-Calve-Perthes (LCP) disease. Investigators are currently working to develop a minimally invasive animal model of LCP to better understand the etiology of this disease which will lead to work on prevention of the sequelae and impact on individuals who present with LCP. Ongoing clinical and pre-clinical studies have prognostic, diagnostic, and therapeutic implications for treatment of LCP. Gillette research teams are working to understand the impact of virtual reality as an adjunct to pediatric cast removal. Virtual reality has the potential to distract children during cast removal through suppression of both auditory and visual aspects of the procedure. The primary objective of this work is to decrease the pain experience during what can feel like an invasive procedure for children.

Education: Gillette provides graduate medical education in collaboration with the University of Minnesota and provides seminars and other educational programs with the goal to share expertise that benefits all children who have complex conditions. Gillette offers residencies and fellowships in orthopedics, and pediatric rehabilitation medicine. Through fellowships, seminars and other educational programs, Gillette strives to share expertise that benefits all children who have complex conditions.Gillette facilities are made available for training of health care students through arrangements with area educational institutions. Gillette offers residencies and fellowships in such specialties as pediatrics, orthopedics, and pediatric rehabilitation medicine. A teaching hospital, Gillette trains residents from the University of Minnesota and Henry Ford Hospital in Detroit, who spend one to three months under the mentorship of Gillette's medical staff. In many cases, Gillette offers physicians their only exposure during residency to patients with certain disabilities. Gillette also offers shadowing and mentorship programs for students, along with professional education opportunities in such areas as physical therapy, radiology, nursing, respiratory care and assistive technology. Some of the students who make use of these training programs ultimately join the staff of Gillette.Gillette also provides extensive Continuing Medical Education services to physicians and other health care providers in our area of expertise. Participants travel from around the region and globe to learn from Gillette experts each year. These programs also support the ongoing development of referral and partnership arrangements and relationships that direct patients to Gillette for their care. Gillette covers the unreimbursed costs of medical education and is fully accredited by the Minnesota Medical Association to provide continuing medical education (CME). Gillette sponsors conferences on topics such as cerebral palsy, orthopedics, Duchenne muscular dystrophy, Rett syndrome, and motion analysis. In 2019, Gillette provided over 150 hours of clinical medical education to more than 400 physicians and 1,500 other health care providers. Typical audiences include pediatricians, family practitioners, nurse practitioners, physician assistants, nurses, physical therapists, occupational therapists, and orthotists.

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