Seattle Children's H1N1 Flu Response
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Seattle Children’s saw a sharp increase in the number of patients who tested positive for influenza A toward the end of October, with levels that are now higher than the initial novel H1N1 influenza outbreak last spring. The Emergency Department (ED) has been seeing some of the highest patient volumes in its history.
The higher volumes have been concentrated in the evenings and on weekends, which suggests that patients are turning to Seattle Children’s mainly at times when their primary care providers are not available.
“We greatly appreciate the efforts of primary care providers in the community to give guidance to concerned parents and educate them about when to seek emergency care,” says Dr. Russ Migita, clinical director of Emergency Medicine.
“The referrals we have seen from community providers have certainly been cases where emergency care is needed,” he adds. “Children with underlying health conditions are at increased risk, and hospital care is also particularly important for children with concerning respiratory distress or secondary bacterial infections, as well as those who need IV rehydration.”
Measures to protect and treat our patients
- Seattle Children’s is screening all visitors for influenza-like illness and only allowing inpatient visitors over 12 years old.
- We are following guidelines from the Centers for Disease Control and Prevention (CDC) for testing, which means that we are testing only patients with influenza-like illness who are at increased risk for influenza and its complications.
- We are also following CDC guidelines for treatment with Tamiflu, providing it to our patients as appropriate. Given the shortage of the liquid formulation of Tamiflu, we have also been advising families that any retail pharmacy in the community can make the liquid from capsules.
- We are planning to offer H1N1 and seasonal flu vaccine to our patients as a special service given that many patients are at high risk for influenza and its complications. However, we will not be offering vaccinations to other children in the community.
As in other hospitals and clinics, our supply of vaccine has been irregular this year. Please check the patient and family section of our H1N1 page for the most updated information about the vaccine and other H1N1 information for patients and families.
For questions about whether a specific patient might benefit from being seen in the ED, please call the ED Communication Center at 206-987-8899. If you have general questions or comments regarding H1N1 care planning, please call 206-987-1371 and ask for Dr. Russ Migita, clinical director of Emergency Medicine, or Dr. Tony Woodward, division chief of Emergency Medicine.
Initiative 1033 Threatens Seattle Children's Funding
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After months of intense discussions and difficult choices, the state finalized a budget that reduces overall spending by 25%. Children’s is impacted by these reductions in critical healthcare funding. Our reality is a $22 million cut in reimbursement from government health programs like Medicaid over the next two years.
“While the last cycle of budget cuts was significant to us, I-1033 could make the 2009-2011 budget cuts permanent, with no chance of restoration by the legislature,” says Hugh Ewart, director of state and federal government affairs at Children’s. “The state has already cut healthcare funding to the bare bones, and this initiative would have a lasting negative impact on our patients for the foreseeable future.”
Children’s is opposed to I-1033. Children’s and other providers of health services would be the unfortunate targets for these cuts because we rely heavily on state funding to provide care to children and families. Please remember to vote! (The I-1033 section on the ballot is easy to miss — please look for it on the bottom left-hand column.) For further information on this initiative, see the following external links:
Family Activation of Rapid Response Team
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Starting Nov. 2, families will be able to activate the rapid response team (RRT) at Children’s. RRT activation by families has already been implemented successfully at many pediatric hospitals with the goal of encouraging families to voice safety concerns and empowering them to seek help if they notice a serious change in their child’s condition.
Nurses will educate families about the RRT upon admission. They will encourage families to speak first with the bedside nurse or another member of their child’s medical team if they have any concerns. Families will be advised to activate the RRT if they notice a change in their child’s condition and they feel that their child’s health is at risk because of one of the following situations:
- No one is addressing their concerns
- The medical team disagrees about the course of action
“Family activation of RRTs at our peer institutions has resulted in improved communication because families are more likely to talk with the primary care team about their concerns,” says Dr. Jerry Zimmerman, division chief of Critical Care Medicine. “In fact, after implementing family activation, nurses or other care team members tend to call the RRT more often than families.”
Since the introduction of family activation at North Carolina Children’s Hospital, the mean number of RRT calls increased significantly from 16 calls to 24 calls per 1,000 discharges (Willis, unpublished data, 2009). However, only two calls were made directly by a family member during the first year, and staff members have indicated that families prefer to have a member of the care team call on their behalf (Van Voorhis and Willis, Pediatr Clin N Am 2009; 56: 919–933).
Children’s implemented the RRT in 2008, and the use of RRTs is now standard practice, in accordance with requirements of The Joint Commission.
“During its first year, the RRT was activated over 180 times, and 40% of the calls resulted in transfers to the ICUs, which means that it was used appropriately,” says Zimmerman. “By implementing family activation, we believe that we will be able to respond to concerns that we would not necessarily identify without engaging families directly.”
Seattle Children’s South Sound Cardiology Clinic Available November 2009
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Two physicians, Dr. Roberta “Sue” Stephenson and Dr. Donald Trippel, have joined Seattle Children’s Hospital and will practice at Seattle Children’s South Sound Cardiology Clinics. Children’s acquisition of this practice supports access to care for heart patients in the South Sound region. They see patients primarily at their office in Tacoma and hold some clinics in Olympia and Silverdale. The doctors will be able to help patients transition to more specialized care on campus when needed and then back to their home community more smoothly. Both are well established in the Tacoma medical community and have significant experience in pediatric cardiology.
To refer patients, providers can use the existing referral process or contact the clinic at 253-272-1812.
Health and Safety Web Resources for Providers, Patients and Families
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With the launch of Children’s new Web site, physicians can more easily access important resources to support their clinical practices and the patients and families they serve. These resources cover a wide range, from a “Should Your Child See a Doctor?” search box to information on health-related community programs.
One of the newest patient education pieces is focused on H1N1 flu .
Other types of information for patients and families available on the Web site include:
Feel free to provide links to these sites from your own practice’s Web site. If you would like to use a Seattle Children’s logo for those links, please contact Margot Kravette, physician relations director.
New Associate Dean for Hospital Affairs Named at the School of Dentistry
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Dr. Joel Berg has been named Associate Dean for Hospital Affairs at the University of Washington School of Dentistry. The University’s dean, Martha J. Somerman, announced the appointment on October 20.
“In this new job, I hope to strengthen the working relationships between the School of Dentistry and the Puget Sound hospital community,” Dr. Berg said.
Dr. Berg heads the Department of Pediatric Dentistry at the School of Dentistry as the school’s Lloyd and Kay Chapman Chair for Oral Health and is also director of dentistry at Seattle Children’s Hospital.
Seattle Children’s Physicians Receive Awards
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Jerry Zimmerman, MD, Receives the Distinguished Career Award, Critical Care Section
Each year the Academy’s Section on Critical Care Medicine sponsors the Distinguished Career Award to honor a pediatric intensivist who has made significant contributions to the field of pediatric critical care. Dr. Zimmerman is the chief of the Critical Care Division at Seattle Children’s and professor of pediatrics at the University of Washington School of Medicine.
Rich Molteni, MD, Receives the Charles “Buzzy” Vanchiere Award
The Charles “Buzzy” Vanchiere Award recognizes outstanding contributions in the education of pediatricians in administrative pediatrics, practice management and re-imbursement. Recipients are practicing or administrative pediatricians who enhance the quality of care of their patients by providing educational services to all pediatricians at the local and national levels. Dr. Molteni is the previous medical director at Seattle Children’s.
Don Shifrin, MD, Receives the Holroyd-Sherry Award
The AAP recognizes one Fellow of the Academy whose outstanding contributions have demonstrated that media’s influence on child and adolescent health is an important public health issue, and whose work in the areas of advocacy, legislation, research, and professional or public education addresses and/or suggests solutions to the health implications raised by child and adolescent use of media. Dr. Shifrin is a pediatrician at Pediatrics Associates and is on the medical staff at Children’s.
Wendy Mouradian, MD, Receives the Oral Health Service Award
This award recognizes an individual who, during the course of their career, has made significant contributions to the advancement of pediatric oral health through their activities within the American Academy of Pediatrics. Dr. Mouradian is a faculty member at the University of Washington School of Dentistry.
Paul Williams, MD, Receives the Jerome Glaser Distinguished Service Award
This award recognizes an individual who has provided outstanding service in the field of pediatric dentistry throughout their career. Dr. Williams is a member of the medical staff and practices at Northwest Allergy and Asthma.
Seattle Children’s Recognizes Telecom Operator with the ART Award
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Denice Kinnear, telecom operator for more than 10 years, won Seattle Children’s ARTist of the Month award in October for her support, in part, of referring and faculty physicians. The award recognizes an employee who exemplifies values important to Children’s — accountability, respect and teamwork, or ART. She takes the lead on the physician phone line and supports the team’s effort to build relationships between doctors inside and outside of Children’s.
“Denice is spectacular!” says Dr. Karen Murray, president of the medical staff. “She is efficient, knowledgeable, polite and direct. She does her job with a sense of humor, but with respect, and is ultimately accountable. She is viewed as the leader of her group and is respected by all who know her!”
Faculty Development Workshop for the School of Medicine
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Presented by the Department of Medical Education and Biomedical Informatics and Office of Faculty Development:
"Proven Effective: the Influence of Pharmaceutical and Medical Products Marketing on Patient Care and Drug Safety"
When: Tuesday, November 17, 2009, 8:30 a.m. to noon
Where: South Campus Center, Room 316R
UW Presenter: Linda Pinsky, MD
These workshops are free to all University of Washington School of Medicine faculty and Health Sciences faculty members. Enrollment in each workshop is limited and registration is required. To register, please visit http://www.mebi.washington.edu/facdev.html.
New Medical Staff, November 2009
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Robert Holdefer, PhD, University of Washington, Rehabilitation
Thida Ong, MD, Seattle Children’s, Pulmonary
Bryan Voelzke, MD, Harborview Medical Center, Urology
Agustin Rubio, MD, Seattle Children’s, Cardiology
Tim McQuinn, MD, Seattle Children’s, Cardiology
James Robotham, MD, Seattle Children’s, Anesthesia
Anne Manktelow, MB BS, Community Medical Clinic, Missoula, MT, Surgery
New Allied Health Professionals, November 2009
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Jenna Lane, ARNP, Seattle Children’s, Infectious Disease
Dora Rubanyi, ARNP, Seattle Children’s, Psychiatry