Coordinated care helped one infant thrive


Photo: Mom Brittani Clark looks on as her daughter, Nia, is examined by Porter Ranch pediatrician, Dr. Allison Guimera, at Nia's 1 year appointment. Photo by Reed Hutchinson PhotoGraphics

Three days after delivering at Ronald Reagan UCLA Medical Center, Brittani Clark, a pediatric nurse practitioner, brought in her newborn daughter, Nia, for her first appointment with Dr. Allison Guimera in the Porter Ranch office. Dr. Guimera weighed and examined Nia and talked to Brittani about infant care. Similar well child visits continued at regular intervals until Nia was about 2 months old.

Then, right before Thanksgiving in 2018, Brittani says Nia vomited several times after her evening feedings. Brittani called the pediatrics office and spoke to an on-call physician, who told her to bring in Nia the next day if her symptoms continued.

While Nia wasn’t vomiting the next morning, Brittani noticed that her diaper was lighter than usual. Dr. Guimera saw Nia that day, and was concerned enough about her symptoms to order an urgent ultrasound, which was performed at UCLA’s Santa Clarita imaging center.

Afterward, the radiologist called Dr. Guimera to tell her that the study indicated pyloric stenosis, a condition in which a valve between the stomach and the small intestine blocks food from moving through the digestive tract. The recommended treatment is surgery.

Dr. Guimera called Brittani and told her the diagnosis. She then asked her to bring Nia to UCLA Medical Center, Santa Monica, where she could be directly admitted and have the procedure within 24 hours. The surgery was successful, and after Nia was discharged, Dr. Guimera monitored her to make sure she was healthy and gaining weight.

The office again coordinated Nia’s care when she was 7 months old and needed to see a pediatric neurologist. When Dr. Guimera wasn’t available, her colleague, Dr. Militello, stepped in to handle the referral and check on Nia after she was admitted to the hospital.

In both cases, Brittani says, the entire system worked well.

“Dr. Guimera and the Porter Ranch office were easy to reach and ready to coordinate Nia’s care," Brittani says, "and the hospital team explained everything so that even family members without a medical background could understand what was going on.”

Since then, Dr. Guimera has continued to see Nia for well visits. At her recent 1-year-old checkup, Nia smiled and gave her doctor a high-five.

“In pediatrics, it’s important to establish trust with both the patient and their parents,” Dr. Guimera says. “I want families to think of me as the leader of their child’s health care team, and to consider our office their medical home.”

This content ran in the Winter 2020 issue of The Checkup, a UCLA Health community newsletter on how to live your healthiest live.