Lorraine McElwain, MD is the Medical Director of the Inpatient Pediatric Unit at The Barbara Bush Children’s Hospital, the Associate Medical Director for the MMP Pediatric Hospital Medicine group and the Division Chief for Pediatric Hospital Medicine at Maine Medical Center. She is an Associate Professor of Pediatrics at the Tufts University School of Medicine.
A native of Vermont, Dr. McElwain attended The University of Vermont, College of Medicine. She then completed her pediatric residency at Maine Medical Center. In 1992, she became the first Pediatric Hospital Medicine physician at MMC. Due to her qualifications in the practice pathway, she was invited to sit for the inaugural Pediatric Hospital Medicine subspecialty exam in 2019, and with her passing score, she has since been a subspecialty board-certified Pediatric Hospital Medicine physician. She cares for hospitalized acute medical patients from birth to 21 years of age, teaches medical students and residents, and using QI methodology researches ways to improve the health of her patients long after they are discharged from the hospital.
After seeing patients and families struggle first hand with compliance to discharge medication plans, she lead a multidisciplinary team and started a bedside delivery of discharge medications and teaching program for the patients on the inpatient pediatric unit. Patient/family noncompliance with and misunderstanding of discharge medication plans dropped dramatically. This work was published in the peer-reviewed journal Hospital Pediatrics in December 2017. Next, she turned to addressing social determinants of health, specifically transportation insecurity, and started delving deeper into this issue. With the help of an interdisciplinary team, she co-lead a quality improvement project screening for transportation insecurity in families with children admitted to the inpatient pediatric unit. Mitigation strategies were developed for those who screened positive. Attendance at post-hospitalization appointments increased dramatically with interventions put into place prior to discharge. This work was published in the peer-reviewed journal Pediatrics in January 2022. She then joined the Newborn Vitamin D Quality Improvement project where the aim was to improve outpatient infant vitamin D supplementation rates by starting babies/families off with focused education regarding the benefits of vitamin D supplementation, dispensing their first bottle of the liquid supplement, and offering hands-on teaching/demonstration on proper administration of the product while in the NBN nursery. During our baseline line period, in 2016, only ~7% of our newborns were going home with their first bottle vitamin D and teaching, by early 2018 nearly 100% of our PHM-Newborn Teaching Service babies were going home with their first bottle of vitamin D. During the same period, measured outpatient supplementation rates of babies in our pediatric resident clinic improved from 49% to 89% (well above the national average). The process was hard-wired for all babies leaving our NBN nursery regardless of attending of record. Dr. McElwain provided input into the paper “Interdisciplinary Quality Improvement Project Increases Vitamin D Supplementation in Infants” published in August 2022 in the peer-reviewed journal Pediatrics.
Scholarship Areas of Interest: Improving the health and well-being of our patients/families. Currently, her research interest is in screening families of inpatient pediatric patients for food insecurity and exploring mitigation strategies to improve food quantity in the home and food preparation of healthy meals/snacks to set the stage for life-long nutritious habits.