In spring 2021, Nationwide Children’s Hospital partnered with St. Vincent Medical Center in Toledo to expand access to comprehensive pediatric specialty services. As part of this initiative, Nationwide Children’s Hospital established a robust pediatric otolaryngology (ENT) service line in Toledo, providing children and families with local access to advanced care, including a top-tier hearing program and some of the region’s first pediatric cochlear implant surgeries.
This collaboration holds unique importance because the Nationwide Children’s Hospital pediatric otolaryngology faculty members also serve as the Division of Pediatric Otolaryngology within the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University Wexner Medical Center. Although Nationwide Children's Hospital and the Ohio State Wexner Medical Center are separate fiscal entities, they share deeply aligned academic, educational and clinical missions. Achievements in Toledo therefore strengthen both Nationwide Children's Hospital's regional impact and the academic footprint of the medical center's department.
“The surgeons from the department in Columbus rotate up to the pediatric otolaryngology department in Toledo, with nearly a dozen surgeons traveling every month,” says Charles Elmaraghy, MD, the John F. Wolfe Endowed Chair in Pediatric Surgery at Nationwide Children’s and the head of Pediatric ENT at Nationwide Children's. He is also division director of Pediatric ENT at Ohio State. “The department thought very strongly about quality, and each of us as surgeons committed to it. It’s an opportunity to provide comprehensive, tertiary pediatric care in Toledo for primary care and surgical subspecialties.”
As the only fellowship-trained pediatric ENT practice in northwest Ohio, the group manages a full spectrum of conditions from airway evaluations and chronic otitis media to complex airway reconstructions, advanced ear surgery, nasal surgery, sleep disorders and neck masses. Clinical and surgical volumes have nearly doubled since the partnership began, making pediatric ENT the most clinically productive NCH service in Toledo.
“We found an underserved population that needed more care than was available in the region,” says Prashant Malhotra, MD, associate professor in the Department of Otolaryngology – Head and Neck Surgery. “Traveling to Toledo means providing more local, accessible treatment for these families. We are elevating the standard of pediatric care in Toledo with the backing of a top 10 children’s hospital. Even if we can’t provide certain treatments in Toledo, we can route to Columbus and the complete team of multidisciplinary specialists.”
The team now provides outpatient services and performs most surgeries, including complex procedures – directly in Toledo, supported by upgraded surgical infrastructure and a dedicated team of pediatric anesthesiologists at St. Vincent Medical Center.
As Patrick Walz, MD, associate professor, explains, “For surgical care, we wanted to ensure that the standard of care we have at Nationwide Children’s wasn’t being sacrificed for convenience. Having that high level of care locally is a huge benefit to the community.”
Replicating a top-tier hearing program in Toledo
Nationwide Children's Hospital operates one of the nation’s highest-volume pediatric hearing programs, encompassing universal newborn screening through interventions for patients up to 21 years old. This multidisciplinary model requiring coordinated care among surgeons, audiologists, speech-language pathologists and therapists has now been successfully extended to Toledo.
“We provide the same high-level multidisciplinary care we do in Columbus wherever we go,” says Dr. Malhotra, who leads the Toledo hearing program. “For children who are hard of hearing, it’s challenging to expect families to travel hours to see us, several times a year.”
Early identification remains critical. Many children receive cochlear implants as early as 9 months old, while others are closely monitored to prevent progression of hearing loss. The program follows national best-practice benchmarks: screening by 1 month old, diagnostic confirmation by 3 months old and intervention by 6 months old.
“If we’re going to make a difference in hearing loss, it’s what we do in the first couple of years of life that sets the trajectory,” Dr. Malhotra explains. “Our goal is to achieve the highest level of success for each child based on their individual needs, whether that’s surgery or other supportive programs, delivered seamlessly.”
Advancing academic care in a community setting
Because Nationwide Children's Hospital pediatric otolaryngologists are also medical center faculty, the collaborative mission in Toledo blends high-acuity pediatric care with the expectations of an academic department.
“As an academic program, we are accountable to outcomes and are data-driven,” Dr. Elmaraghy says. “We offer state-of-the-art care, and research plays a significant role in how we offer support.”
The team has introduced advanced procedures such as intracapsular tonsillectomy (which reduces pain and bleeding risk) and bone conduction hearing implants. Pediatric residents in Toledo also benefit from exposure to academic practice patterns while caring for patients in a community environment.
“For us, this work is very rewarding,” Dr. Walz says. “We’re trying to bring care to patients so they can have access to all the specialties they need without taking a day away from work or school. We’re facilitating the delivery of care we’d want for our own families in a way that is convenient.”
The group’s outreach includes meeting with local pediatric practices to raise awareness of available services. “We want providers to know that we can assess and manage complex issues in their backyard,” Dr. Walz adds. “That saves families the time and cost of four-hour round trips to Columbus.”
“I am deeply proud of the collaborative pediatric otolaryngology model that bridges Nationwide Children’s Hospital and our academic department, where the pediatric otolaryngology group at NCH also serves as the Division of Pediatric Otolaryngology within our Department of Otolaryngology – Head and Neck Surgery at OSUWMC”, says Dr. Rocco, chair of the department.
“Although our institutions operate as distinct fiscal entities, our missions are tightly aligned, and the achievements of the NCH pediatric ENT team in Toledo directly strengthen both organizations. Under the leadership of Dr. Elmaraghy and through the dedication of the pediatric otolaryngology surgeons who travel each month, we are extending high-quality, academically grounded, pediatric ENT care to an underserved region while advancing our shared goals in education, research and clinical excellence. This work exemplifies the best of our partnership and underscores the impact we can achieve when we combine resources, expertise and a commitment to serving patients where they live.”