The Bulletin: February 2008

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

Quarterly Consult: Children with Cleft Lip and Palate

Dr. Michael Cunningham, medical director of Children’s Craniofacial Center, provides information for primary care providers on cleft lip and palate.

Dr. Arnold Smith Returns to Children's

The Department of Pediatrics and Division of Pediatric Infectious Diseases at the University of Washington School of Medicine are pleased to announce the return of Dr. Arnold L. Smith as professor of pediatrics.

Dr. Arnold Smith

Dr. Smith is an outstanding pediatric infectious disease physician-scientist who was a member of the Department of Pediatrics and chief of the Division of Pediatric Infectious Diseases from 1979 to 1994. Smith left to become department chairman of Microbiology at the University of Missouri in Columbia until joining the Seattle Biomedical Research Institute (SBRI) in 2002, where he was the director of Bacterial Pathogenesis. He is rejoining the Department of Pediatrics as of March 1, 2008.

Smith brings his very productive and successful research program on the pathogenesis of bacterial infections caused by the etiologic agent Haemophilus influenzae. His laboratory program will be located at the new Seattle Children’s Hospital Research Institute in the Center for Childhood Infections and Prematurity Research, and he will have a joint appointment in the Center for Clinical and Translational Research.

Smith is highly regarded for his extensive expertise in infectious diseases in children, his long and very productive research program on bacterial diseases in children, and his expertise in mentoring young investigators. Smith is the recipient of the Society for Pediatric Research Maureen Andrews Mentor Award. “Having Arnie Smith return to our department is like having Ken Griffey Jr. return to the Mariners. I am very pleased to have Smith as a leader and mentor in our Department,” said Dr. Bruder Stapleton, chief academic officer of Children’s.

“Arnie’s the best! I am thrilled and honored to have him return to the division and new center at the institute. He created the legacy of pediatric basic science research and scientist training at Children’s. To have my own mentor and role model return to work alongside us in the laboratory is fantastic,” said Dr. Craig Rubens.

Extended Hours In Effect for Centralized Scheduling

Centralized Scheduling is now open to schedule appointments from 8 a.m. to 8 p.m. Monday through Friday and from 8 a.m. to 5 p.m. on Saturdays.

Hours were extended for the convenience of providers and families.

Centralized Scheduling represents the following clinics: Adolescent Medicine, After Hours, Child Wellness, Cystic Fibrosis, Dermatology, Endocrine/Diabetes, Gastroenterology, General Surgery, Growth and Feeding Dynamics, Infectious Disease, Neurology, Nutrition, Ophthalmology, Orthopedics, Otolaryngology, Pain Management, Plastic Surgery, Pulmonary, Rheumatology, Sleep, Urology and Virology.

To reach Centralized Scheduling, and for scheduling in other departments during business hours, providers and families can call their selected clinic directly or go through the hospital operator at (206) 987-2000.

Physician-to-Physician Patient Handoff

What if Joint Commission surveyors appeared on-site tomorrow?

What if they asked you the following three questions — would you know the answers?

Do we have a standard for handing off patients from one physician to another?
Where would you find that standard written down?
What IS the standard?

It is highly likely that surveyors will ask this question. Do you know the answers? Please review the correct answers so you’ll be ready when asked. View answers

Academic Enrichment Fund Applications Available

The Academic Enrichment Fund (AEF) supports research projects by awarding grants up to $25,000 per individual applicant and up to $50,000 for projects that involve multiple eligible investigators from different divisions or departments.

Applications and more information are available on the Medical Staff Web site. Completed applications and detailed budget justification must be submitted by June 1, 2008, to Dr. Bruder Stapleton, Children’s chief academic officer. Only one application per investigator will be accepted. Preference will be given to projects that are collaborative activities involving multiple divisions.

Two-Sided Business Cards Are Here

University of Washington faculty at Children’s can now have one business card that has their Children’s affiliation on one side and their University of Washington School of Medicine (UWSOM) position on the other. Two-sided cards are also available for the Seattle Children’s Research Institute, with the address of either Metropolitan Park or Building One on one side and UWSOM information on the other.

Templates are available on CHILD, and you can order the cards through your department or division program assistant in the same way you order one-sided cards.

Questions about the two-sided business cards may be directed to Margot Kravette, director, Physician Relations.

Gel In and Gel Out of Gloves

The Centers for Disease Control and Prevention recommends that you clean your hands both before and after wearing gloves to prevent the spread of infection.

Research has shown that gloves are not an absolute barrier to contamination.

A 2004 study from University of Geneva Hospitals showed that there are high levels of colony-forming bacteria on your hands after three minutes of providing respiratory care or changing a diaper even if you are wearing gloves (CL Pessoa-Silva et al. Infect Control Hosp Epidemiol 2004;25:192). The number of colony-forming units (CFUs) on the hands of providers after providing respiratory care increased on average by 84 when they were wearing gloves and by 148 when they were not wearing gloves.

As a point of comparison, there were about 100 CFUs on the hands of providers after touching intact skin without wearing gloves. In other words, CFUs on one’s hands when touching intact skin without gloves are comparable to CFUs on one’s hands after providing respiratory care with gloves. That’s why it’s important to use hand-sanitizing gel even before putting gloves on and after taking them off.

Obesity Web Site Updated

The Children’s Obesity Action Team (COAT) Web site now includes more current and complete information on childhood obesity, as well as links to relevant resources.

COAT is a multidisciplinary group of health-care professionals at Children’s Hospital. This group works to decrease childhood obesity by providing education and resources and pursuing solutions through research.

The Web site features information about clinical services offered on Children’s Hospital’s main campus and in the community, and provides access to training and resources that support primary care practices and families. Users can also learn about local and statewide coalitions and initiatives, including the Strong Kids and Strong Teens programs for 8- to 14-year-old youth (greater than 85th percentile BMI) and their adult family members at area YMCAs.

Krengel Named Chief of Spine

Dr. Walter F. Krengel III will join Children’s Hospital’s Department of Orthopedics this month as chief of spine.

Dr. Walter Krengel

Krengel joins us from Proliance Orthopedics and Sports Medicine in Bellevue where he has practiced since 2000. He was at Northwest Spine Surgeons from 1994 to 2000.

“Dr. Krengel comes to direct our multidisciplinary pediatric spine service with a distinguished background in private practice, where he specialized in treating adolescents with spinal scoliosis,” says Dr. Chappie Conrad, director of Children’s Department of Orthopedics. “He brings great surgical expertise and a particular interest in surgical outcomes.”

Krengel grew up in Seattle, attending Lakeside School. After finishing his undergraduate and medical degrees at Stanford University, Krengel completed his internship, residency and fellowship at the University of Washington Medical Center.

Well recognized in the field of spine surgery, Krengel has published and presented widely. His current research project is an FDA phase 3 trial, Safety and Efficacy of Titanium Surgical Mesh and Moss-Miami Pedicle Instrumentation for Spinal Fusion.

A member of the American Academy of Orthopedic Surgeons, the North American Spine Society and the Scoliosis Research Society, he has also served as vice president of the Washington State Orthopedic Society since 2004.

Facilities Update: Why Children's Must Expand in Its Present Location

The following is a commonly asked question about Children’s Hospital’s future growth and reasoning to consider when responding:

Question: Why expand in Laurelhurst instead of building more inpatient facilities somewhere else?

Many Children’s patients need care from different types of specialists and subspecialists
because of their complex conditions. With the national shortage of pediatric subspecialists, duplicating these providers to staff multiple inpatient facilities would not be practical or efficient.

However, Children’s is relocating certain functions, such as research, to other locations. We are also expanding our regional clinics to provide greater access for families and to reduce the number of outpatients coming to the Seattle campus.

Docfeedback is Five Years Old

Docfeedback started in 2003 and just completed its fifth year. The e-mail address, docfeedback@seattlechildrens.org, enables both faculty and community providers to communicate directly with hospital and medical staff leaders about concerns, questions, requests and compliments.

Docfeedback helps make the leadership aware of issues that affect the ability of physicians to provide quality care and service to their patients. In the last five years, Docfeedback data has reflected significantly fewer concerns in the following areas:

Clinic access and wait times
Hospital admission process
Telephone access to Children’s physicians
Identifying the correct PCP
Differentiating the PCP and referring physicians
Admission notification
Distribution of clinical notes and test results

The volume of Docfeedback contacts increased from 35 in 2003 to 129 in 2007, and the number of individual providers using this service has risen from 22 to 82. Increasing use of Docfeedback demonstrates the trust physicians have in Children’s to address their concerns. Faculty have done an outstanding job of demonstrating their commitment to patients and families in their positive response to Docfeedback concerns.

To become the best children’s hospital, there is still work to be done. Docfeedback is an important tool in reaching that goal. Please use Docfeedback to communicate your concerns, ask questions, make suggestions and pass along compliments when someone does a great job. Questions about Docfeedback can be directed to Margot Kravette, director, Physician Relations.

Save the Date: Annual Medical Staff Social, April 12

This year’s event will be held at Bellevue Arts Museum. Look for your invitation in the mail!

Attend Dr. Koyle's Welcome Reception

Please help us welcome Dr. Martin Koyle, chief, Division of Urology, on Friday, Feb. 8, from 11:30 a.m. to 1 p.m. in Small Dining Rooms 1, 2 and 3. View flyer

McCauley Recognized for Mentoring

Dr. Elizabeth McCauley, associate director of child and adolescent psychiatry at Children’s, has received the University of Washington School of Medicine (UWSOM) Award for Excellence in Mentoring Women and Minorities.

“Elizabeth is a wonderful role model. She has helped many clinicians launch successful academic careers both here at Children’s and at other institutions in the country,” says Dr. Bryan King, director of child psychiatry at Children’s. “I am delighted to see her recognized with this award.”

McCauley, a professor of psychiatry and behavioral sciences at UWSOM, studies adolescent depression and anxiety. She is a co-principal investigator of the UW Developmental Pathways Project, which aims to understand and prevent depression in adolescence and childhood.

“As a mentor, Dr. McCauley is helping to shape the next generation of physicians and investigators who will one day be making their own significant contributions to pediatric care,” says Dr. Bruder Stapleton, Children’s chief academic officer. “We are fortunate to have her expertise and leadership at Children’s.”

Baby Gorilla Surgery a Success

On Jan. 10, Children’s physicians performed a successful surgery on a 2¹/₂-month-old female gorilla at Woodland Park Zoo’s veterinary hospital.

Photograph by Ryan Hawk of Woodland Park Zoo

Drs. Richard Ellenbogen and Sam Browd of neurosurgery and Dr. Craig Jackson, a neonatologist, became involved with the case due to the complexity of a lesion on the gorilla’s spine that closely resembled a congenital condition found in human infants.

“We were thrilled to collaborate with all the excellent and caring professionals at Woodland Park Zoo,” Ellenbogen said. “We had a lot of information to share and we hope to see Children’s and Woodland Park Zoo undertake more ventures together.”

The one-hour surgery was successful and the yet-to-be-named gorilla was returned to her mother, Amanda, at the gorilla exhibit when she awoke from anesthesia. Here’s an interesting fact: Zoo staff painted Amanda’s nails red during the surgery to distract her so she would be likely to pick at her nails instead of disturbing her baby’s stitches in the grooming process.

Children's Dentist Volunteers in Nepal

Dr. Jeff Marks recently spent a week in Kathmandu, Nepal, providing dental care to children through the Himalayan Dental Relief Project (HDRP).

Marks was one of four dentists who worked alongside three hygienists and six lay volunteers treating children in a converted classroom. In total the group provided 171 cleanings and fluoride treatments and 414 restorations.

“This is exactly why I became a pediatric dentist,” says Marks. “If I can make a difference in one child’s life, it is worth every sacrifice I have ever made to get here. It makes me a better dentist, a better humanitarian, even a better dad!”

Marks practices at Northwest Pediatric Dentistry and attends at Children’s Odessa Brown Dental Clinic.

Information Sessions for Parents of Children with Hearing Loss

The Childhood Communication Center (CCC) will host free presentations beginning Feb. 6 for parents and adolescent children with hearing loss in Wright Auditorium from 6 to 8 p.m. View flyer

Children's Health Fair for Patients and Families, March 1

The Children’s Hospital Health Fair will be held on Saturday, March 1, from 10 a.m. to 2 p.m.

Children ages 3 to 8 are welcome to participate in this free “hands-on” event where they can learn about health, safety and Children’s Hospital through various fun activities including the Teddy Bear Clinic, a visit from the Tooth Fairy, ambulance tours, finger casting, a wheelchair obstacle course and more.

Children’s is also offering free bike helmets and helmet fitting for adults and children. Quantities are limited and wearers must be present. For more information, e-mail Chelsie O’Neill-Dewing or call (206) 987-1569.

Pathways Parent Lecture Series Begins in March

Children’s and ParentMap magazine are sponsoring the Pathways Lecture Series for Parents.

Tickets can be purchased online or by calling (800) 838-3006. Lectures are from 7 to 9 p.m.

March 5 - Raising An Emotionally Intelligent Child, John Gottman, PhD, at Town Hall, Seattle

March 11 - Hold Onto Your Child: Cultivating Positive Influences, Gordon Neufeld, PhD, at the Annie Wright School, Tacoma

March 26 - Turn it off! (Or not): Is Media Always Bad for Kids?, Dimitri Christakis, MD, MPH, at Newport High School, Bellevue

New Medical Staff and Allied Health Professionals

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

Susan Shenoi, MD, After Hours Clinic, Children’s
Robert Mertz, MD, Pediatrix Medical Group
Anju Jain, PA-C, Orthopedics, Children’s
Paul Kammer, CRNA, Anesthesia, Children’s
Patrick Parenzin, PA-C, Orthopedics, Children’s
Erin Veenker, ARNP, Medically Complex Care Unit, Children’s

Pediatric Emergency Room Medicine for the Primary Care Provider

This course will take place on Saturday, March 1, in Wright Auditorium.

This course is designed to improve your clinical practice by providing up-to-date information and practical evaluation and management strategies for children who present with common medical emergencies encountered in the primary care of children. The curriculum includes lectures and workshops with an opportunity to discuss issues with emergency room experts. See brochure

Annual Duncan Seminar

This seminar will take place on Friday, March 28, in Wright Auditorium.

This one-day interdisciplinary conference on the management of cerebral palsy will update practitioners with new research, new therapies, and new approaches to maximizing a child’s function and improving their quality of life. Workshops will provide clinicians with practical information to incorporate into practice.

The Duncan seminar recognizes the contributions of orthopedic surgeon Dr. William Duncan in developing comprehensive approaches to cerebral palsy.

To register online visit the Medical Staff Web site or contact Marianne Gonterman by e-mail or phone at (206) 987-5318.

Pediatric Nursing Update Conference

This conference will be held Friday, Feb. 29, in Wright Auditorium.

Using case discussions and interactive workshops, experts from different health-care
disciplines will offer updates on Asperger’s syndrome, diabetes management, working with diverse ethnic groups and their cultural belief systems, and other pediatric health concerns.

To register online, visit the Medical Staff Web site or contact Marianne Gonterman by e-mail or phone at (206) 987-5318.

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.