Monroe Carell Jr. Children’s Hospital at Vanderbilt delivers high-quality care, creates a welcoming environment for parents and children, and serves as a resource for the surrounding community. None of these things would be possible without the people who make up Monroe Carell — from the physicians and nurses who provide care for sick children to child life specialists, social workers, pharmacists and more. This wide array of expertise means Monroe Carell is equipped to handle any issue a child may face — no matter how complex.
Andrea Hughie, MSN, RN, NEA-BC
Associate Nursing Officer
When Andrea Hughie, MSN, RN, NEA-BC, joined Monroe Carell Jr. Children’s Hospital at Vanderbilt as administrative director of nursing in 2017, she brought with her 15 years of pediatric nursing experience including pediatric critical care, case management, pediatric primary care, and various leadership roles in hospitals in her home state of New Jersey and in New York City.
She quickly put her expertise, including a Lean Six Sigma Black Belt Certification, to use as she worked with Case Management and the Behavioral Health Patient Safety Team to identify and implement process improvements to deliver better patient care.
Hughie helped standardize the work of the Case Management team to ensure every patient had everything required to transition safely home or to another facility for additional therapy or rehabilitation when discharged.
She worked with Behavioral Health to create the Patient Safety Team to more effectively provide one-on-one observation for children with psychiatric needs. Hughie also worked hard to ensure children on public insurance or who are uninsured with psychiatric needs get connected to needed services in a timely manner.
As a result of that work, in the summer of 2022, three members of the Tennessee State Mobile Crisis Program began working from the Monroe Carell Emergency Department to more effectively assess children experiencing a mental health crisis.
“I enjoy the advocacy part of my role,” Hughie said. “I have a passion for populations that don’t have a lot of representation or who are underserved. There’s a national crisis with kids with psychiatric needs, and I love being able to impact that.”
Hughie became a new mother in 2020, while isolated from family and friends due to the pandemic. Her son, Jacob, was born prematurely and spent five weeks in the Neonatal Intensive Care Unit at Monroe Carell. Jacob was diagnosed with a chromosomal abnormality, and he receives therapy and other services both at the hospital and through outside resources.
She and her partner, Jason Hall, gained hard-earned but invaluable insight as they experienced the care of a hospitalized child from a parent’s perspective.
Seeing how advocacy was critical as she sought services for her son, Hughie is energized by recent appointments that will allow her to be a public advocate for children throughout Tennessee.
Hughie was appointed to a task force working with the Metropolitan Nashville Juvenile Justice System to better serve children going through the courts who have psychiatric needs. Hughie was also tapped to serve on the board of the Tennessee Early Intervention System, a program that provides services to infants and young children with disabilities or other developmental delays.
“That’s direct community impact,” Hughie said. “Care doesn’t just happen within our four walls. It’s an honor to be able to represent Vanderbilt and extend our impact outside the clinical space.”
Tracy Hills, DO
Assistant Professor of Clinical Pediatrics/ Hospital Medicine Section Head, Pediatric Palliative Care
Tracy Hills, DO, assistant professor of Clinical Pediatrics and director of Pediatric Palliative Care at Monroe Carell Jr. Children’s Hospital at Vanderbilt, cites an American Academy of Pediatrics quote that sums up palliative care: “The goal is to add life to the child’s years, not simply add years to the child’s life.”
When she and her team meet a young patient experiencing a serious illness, they discuss and plan for physical, psychological, social and spiritual needs, and they incorporate the patient’s and family’s wishes to guide the decision-making process as much as possible. Because of this, one of the hardest situations a family can experience can also become a time of empowerment and understanding.
When Hills came to Monroe Carell in 2016, she and a nurse practitioner provided palliative care services. Now the interdisciplinary team has expanded to include a second physician, a nurse coordinator and a social worker. Their patients range from unborn children with serious or life-limiting diagnoses (the team meets with families at the Reed Family Maternal Fetal Clinic at Vanderbilt) to young adults with complex medical conditions.
“We’ve spent a lot of time helping families and clinicians realize that we’re not just end-of-life care,” Hills said. “Palliative care includes so many other things, such as understanding the patient’s and family’s goals, improving quality of life, pain management and symptom management. We see patients with many different medical conditions, and we’ve established relationships with clinical groups throughout the hospital. Each year we’ve been able to do more.”
During high school in Portland, Oregon, Hills volunteered at a Ronald McDonald House, where families with seriously ill children can stay near the hospital. There she witnessed how a child’s illness impacts the entire family, and, for the first time, she interacted with children who died from their illnesses.
Hills also connects her career path with the year she turned 25. Her mother was diagnosed with lung cancer, and she died just a year later.
“I remember as she got sicker, we had to ask, ‘Should we get hospice involved now?’ Her providers didn’t bring up palliative care or hospice. We were fortunate that we were able to keep her at home and respect her wishes. I’m so grateful for that and to the hospice team that took care of her.”
Hills is keenly aware of the long-term needs of grieving families, and one of her team’s goals is to establish hospital-based grief support for families, with a pilot group that began in the summer.
“For many families — especially those whose children have long-term illnesses — the hospital becomes their second home,” she said. “When they lose their child, family members have shared that they also feel like they’ve lost their second family. They really want grief support that is affiliated with the hospital.”