The Bulletin: April 2007

The Bulletin is a monthly newsletter for Children's and community providers.

Psychiatry and Behavioral Medicine Focuses on Medically Complex Patients

Children’s Psychiatry and Behavioral Medicine Department is clarifying the scope of its services to focus on the needs of medically complex patients. This focus helps improve access for children and adolescents with complex psychiatric or psychological disorders.

Children’s provides the following consultative services:

Treatment of patients with coping, behavioral or psychiatric concerns such as depression, anxiety, and mood and bipolar disorders associated with acute or chronic medical illnesses or neurodevelopmental disorders
Treatment of patients with complicated or treatment-resistant attention deficit disorders
Pre-care evaluation to assess inpatient treatment and limited outpatient treatment for eating disorders
Inpatient hospitalization for children and adolescents who require short-term stabilization and support for reintegration into their communities
Telepsychiatry services for long-distance consultation with partner sites

Complete information is available on the Medical Staff Web site, including a decision tree to help providers know when to refer patients to Children’s and resources to help primary care doctors locate providers at community mental-health centers and in private practice for patients with primary mental-health issues.

Quarterly Consult: Environmental Health Resource

Dr. Catherine Karr, director of the UW Pediatric Environmental Health Specialty Unit (PEHSU), and Dr. Sheela Sathyanarayana, pediatric environmental health fellow in general pediatrics, provide information for primary care providers on environmental health issues in the Quarterly Consult.

Changes in Otolaryngology Consult and Referral Guidelines

The Otolaryngology guidelines have been modified to reflect that an X-ray of adenoids is no longer necessary for children referred to Otolaryngology for nasal congestion, snoring or large tonsils. However, a lateral neck X-ray and a Waters’ view of the sinuses are still recommended if the child is being referred for sinus problems, is less than 6 years old and has already had an adenoidectomy.

Artificial Heart Keeps 2-Year-Old Alive Until Transplant

A seriously ill 2-year-old boy is recovering from a second heart transplant at Children’s after surviving two months with a mechanical heart that kept him alive until a donated heart was available. The boy was the first person in the Northwest to receive the ventricular assist device, called the Berlin Heart.

He first came to Children’s in January with dilated cardiomyopathy, an enlargement of the heart that can be caused by viral infections or metabolic and genetic defects. He was kept alive with extracorporeal membrane oxygenation (ECMO), a temporary mechanical support of heart and lung function that required him to be sedated.

Meanwhile, doctors at Children’s petitioned the U.S. Food and Drug Administration (FDA) for permission to use the Berlin Heart, which is available in Europe, but does not yet have FDA approval for use in the United States. The FDA allowed Children’s surgeons to move forward on a one-time compassionate-use basis.

“Before, the only option for children under 5 years of age with heart failure was ECMO and then a heart transplant,” says Dr. Gordon Cohen, chief of pediatric cardiothoracic surgery and co-director of the Children’s Heart Center. “The Berlin Heart allows us to buy more time to keep these children alive and bridge them to transplant with a higher quality of life.”

Worldwide, 234 children have been implanted with the Berlin Heart since its invention. In the United States, only 60 children have received the device.

For more information about the Children’s Heart Center, visit the Heart Center site.

Parents Note Hand Hygiene Improvements

Children’s started a hospital-wide campaign in 2002 to promote hand hygiene among physicians, staff members and families. Five years into the campaign, families have noticed marked differences in the hand hygiene of Children’s providers.

Karen Murakami, mother of a patient, learned about hand hygiene out of concern for her daughter’s health and as a participant in the Children’s Hand Hygiene Committee. She says she has seen improvements in hand washing and the use of hand sanitizer gel since she started coming to Children’s eight years ago.

“I’ve seen doctors wash their hands inside the room,” she says. “They may have washed them outside before, but now they wash them inside, and it’s so reassuring. It’s not easy to ask your child’s surgeon to wash their hands. We do ask if we need to, but it’s much more comfortable when you don’t have to say anything.”

“The doctors and nurses gel in and gel out, and parents are using the little stations outside the rooms to get gloves and masks,” she adds.

Register for 2007 Asthma Walk

Children’s is the lead sponsor of the 2007 Asthma Walk of the American Lung Association of Washington on Sunday, May 6, at the University of Washington outside Husky Stadium. This year, the walk is honoring Dr. Gail Shapiro, a Children’s medical staff member and leader in pediatric asthma and allergy care who recently passed away. Drs. Greg Redding and Jason Debley are the co-captains of the Children’s team. Visit the Team Children’s Web site to join the team or make a donation in the name of a team member.

Carter Honored by Children's Staff

Dr. Ted Carter, director of clinical services for the Pulmonary Division, received the “ARTist of the Month” award, which recognizes staff members who demonstrate the Children’s service standards of accountability, respect and teamwork (ART).

Dr. Ted Carter

Carter was recognized for his compassion and his commitment to improving service to families. Staff members commended him for including families in decision-making, empowering families to provide care at home and working to accommodate the scheduling needs of both families and staff.

“Ted is a fantastic clinician who really embodies ART,” says Dr. Mark Del Beccaro, Children’s pediatrician-in-chief. “He is always there for his patients and his team. He listens well to everyone’s input and gives reasoned advice. I am always glad to have him involved, whether we’re providing care to patients or developing a best practice model for care.”

Rehabilitation Program Receives Outstanding CARF Review

Surveyors from the Commission on Accreditation of Rehabilitation Facilities (CARF) accredited the Children’s program again this year, giving it an outstanding review and identifying many program strengths that set national standards for rehabilitation. The surveyors look at all aspects of rehabilitative care, reviewing the complete patient experience at Children’s from before admission through discharge and follow-up care.

The surveyors found that Children’s was “exemplary” in many areas, including infection control and orientation and competencies. They also commended Children’s staff members for their commitment to improving patient care and their involvement in community-based advocacy outside of their work at Children’s. The surveyors highlighted program strengths, including the accessibility plan, patient information, respect for patient rights, compliance, cultural competency, and data assessment and transparency.

“The two CARF reviewers were seasoned rehabilitation professionals who conducted a thorough, rigorous review of our program,” says Dr. David Fisher, medical director. “The exceptional results of this review are a testimony to the national prominence of our program and the talent and dedication of our staff members.”

For more information about Rehabilitation at Children’s, contact the Rehabilitation Services Office at (206) 987-2114.

Pediatric Bioethics Web Site and Conference

The new Pediatric Bioethics Web site provides information about the bioethics consultation service, which is available to anyone who requires consultation about ethical issues regarding clinical practice and research related to pediatrics. In addition, the site features information on current research projects and a calendar of events with information about upcoming conferences and Grand Rounds.

The third annual bioethics conference, “Navigating Conflicts When Parents and Providers Disagree About Medical Care,” will take place on Friday and Saturday, July 13 and 14, in the Bell Harbor International Conference Center in Seattle. To register, visit the Pediatric Bioethics Web site.

Cancer and Blood Disorders Program Launches Web Site

Children’s recently launched the new Cancer and Blood Disorders Program Web site. The site provides information about services including oncology, hematopoietic cell transplant, hematology and sickle cell disease. The site also features sections about the team, current research and links to other online resources for patients and families.

Children's Researchers Publish Study on Computer Kiosks with Child Health Information

Drs. Darcy Thompson, Paula Lozano and Dimitri Christakis authored the lead article in the March issue of Pediatrics. Their study analyzed the effectiveness of computer kiosks in encouraging parents to adopt new health prevention behaviors and to talk with their child’s doctor about health and safety concerns. Drs. Lozano and Christakis are Children’s medical staff members and faculty members of the University of Washington Child Health Institute. Read press release

Pathways Parent Lecture Series

Children’s and ParentMap are sponsoring the Pathways lecture series for parents again this year. Lecture tickets are $18 in advance and $20 at the door and can be purchased online or by calling (800) 838-3006.

April 17 - Babies and the Brain: Truths, Myths and Politics, Andrew Meltzoff, PhD, and Patricia Kuhl, PhD, at the Seattle Children’s Theatre, Seattle

April 24 - Overdrive: How Too Much Ambition Can Harm Kids, Suniya Luthar, PhD, at the Lincoln Square Cinema, Bellevue

May 9 - How Big IS a Hormone? Tackling Tough Questions Kids Ask, Julie Metzger, R.N. and Dr. Rob Lehman at Seattle Children’s Theatre

May 22 - Coaching Kindness: The Impact of Language on Your Child’s Character, Hal Urban, PhD, Museum of History and Industry, Seattle

New Medical Staff and Allied Health Professionals

Children’s welcomes these new medical staff members and allied health professionals:

Neal Futran, MD, DMD, Otolaryngology, UW
Brian Saelens, PhD, Child Psychiatry, UW
Ofer Yanay, MD, Critical Care, Children’s
Robert Munsen, MD, Ophthalmology, Harborview Medical Center
Primrose Meier, MD, Neonatology, UW
Keri Orozco, ARNP, Emergency Medicine, Children’s

Upcoming CME Courses

Autism, ADHD and Other Developmental-Behavioral Problems, April 14

This seminar will feature lectures discussing critical neuropsychiatric issues and practical diagnostic and management tools. It will be held in the Wright Auditorium at Children’s.

Pediatric Environmental Health Training Program, May 24

Learn about environmental threats to children’s health, exposure prevention strategies and tools for your practice at “Pediatric Environmental Health Toolkit Training Program: Clinical Applications for the Busy Pediatric and Family Practice.” The conference will be held Thursday, May 24, from 8 a.m. to 1 p.m. in the Graham Visitors Center at the University of Washington Arboretum. It is organized by Washington Physicians for Social Responsibility (WPSR) and endorsed by the University of Washington Pediatric Environmental Health Specialty Unit. Contact Nancy Dickeman from WPSR to register.

Grand Rounds

View the schedule of upcoming Grand Rounds.

Grand Rounds Online

View online versions of recent Grand Rounds.

On-Call Schedule

The on-call schedule for inpatient services can be found in the secure area of the Medical Staff Web site. It is updated on a daily basis.