The Bulletin: December 2006

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

Bronchiolitis Guidelines Reduce Unnecessary Interventions

Children’s has long-standing clinical guidelines and a pathway for bronchiolitis that reflect current evidence-based practice. These guidelines have reduced unnecessary interventions without increasing the length of stay and readmit rate or causing patient dissatisfaction.

Children with other risk factors, particularly prematurity, appear to have higher risk for prolonged hospitalization and should be placed on this clinical pathway with caution.

Both Children’s guidelines and the AAP guidelines suggest there are limited benefits from a range of treatments such as bronchiodilators, antibiotics and steroids. Excessive use of these treatments is discouraged.

Chest films are not specific and often lead to over-diagnosis of pneumonia and over-use of antibiotics. RSV testing has not been shown to be helpful in managing children with clinical bronchiolitis during the typical respiratory season. Continuous oxymetry is useful during the acute portion of the hospital stay, but can be discontinued safely if oxygen saturations are stable. Spot oxygen saturation measure is adequate to safely monitor clinical progress.

Children’s guidelines and pathways for bronchiolitis, as well as asthma, cystic fibrosis, diabetes, Kawasaki disease, urinary tract infection and suspected occult infection in young infants, are available in the secure area of the Medical Staff Web site.

Resources to Help Manage Pain

Helping parents manage their children’s pain is a priority at Children’s. When a child has a procedure here, the Pain Medicine Program staff work with the health-care team and the family to minimize the child’s pain and discomfort. Patients and families can also access therapies such as acupuncture, healing touch, yoga and massage through the Complementary and Integrative Medicine Program.

Children’s offers a handout with tips on assessing and controlling pain from surgery, medical procedures, illness and injury. Available in four languages, the handout recommends treating pain early and describes complementary measures parents can use to distract or relax their child.

For more information on the Pain Medicine Program at Children’s, contact Dr. Corrie Anderson, director, or Dr. Anjana Kundu, director of Complementary and Integrative Medicine, at (206) 987-2704.

On the Medical Staff Web Site

Looking for previous editions of the Quarterly Consult? You can find archived issues on the Medical Staff Web site.

All issues from 2004 to the present are available, on topics ranging from behavioral disorders to managing childhood overweight and vascular anomalies.

New Orthopedics Site Live on Children's Web Site

The new Orthopedics site features information about which conditions are treated and what families can expect.

The site also provides information about Orthopedics research and advances at Children’s. Other Premier Program sites include the Heart Center, Craniofacial Center, Transplant Center and Neurosurgery.

New Craniofacial Center Fax

Please note in your Physicians Directory that the Craniofacial Center’s new fax number is (206) 987-3064.

Children's Prepares to Launch Center for Diversity

Children’s and the University of Washington Department of Pediatrics are preparing to launch Children’s Center for Diversity. The center will set standards for cultural competency in pediatrics and eliminate pediatric health disparities by integrating research, education, advocacy and service quality. The center will use hospital indicators and clinical outcomes to improve Children’s care for diverse children and families.

A national search for the chief of the Children’s Center for Diversity is underway. The chief will be appointed at the associate professor or professor level and will lead efforts to educate residents, faculty and staff about providing culturally effective care; to increase the diversity of hospital staff and faculty, encouraging youth from diverse backgrounds to pursue careers in health care; and to partner with the UW, public health authorities and diverse communities to conduct research to eliminate child health disparities.

Dr. Benjamin Danielson, the medical director of the Odessa Brown Children’s Clinic, is chair of the search committee. Children’s encourages colleagues to send a resume or nominations to Kate Kingsley, KLKingsley Executive Search, at Kate@klkingsley.com, or to contact Danielson at (206) 987-7220.

HIPRC and Children's Hospital to Study Pediatric Brain Trauma

The Harborview Injury Prevention & Research Center and Children’s Hospital and Regional Medical Center in Seattle have been awarded a $3.2-million grant to study pediatric disability that occurs after a traumatic brain injury. Children’s Hospital of Philadelphia is also involved in the study.

The five-year grant will allow UW researchers at Children’s Hospital and the HIPRC to study the incidence of pediatric traumatic brain injury at different levels of severity, and the disability caused by those levels of injury. Researchers will also examine how the disability changes over time, and identify risk and protective factors for disability due to traumatic brain injury.

The study will involve 1,000 pediatric patients at all ages up to 18, from King County, Wash. and Philadelphia County, Penn. Researchers will study disability in patients and families before the injury and at several points after injury. They will examine physical disability, as well as social, emotional, behavioral and academic disability. Researchers will also study factors such as quality of life, family functioning and parenting stress.

Dr. Frederick Rivara, professor of pediatrics and adjunct professor of epidemiology at UW School of Medicine, is the study’s principal investigator.

Reprinted with permission of the UW School of Medicine Online News

Clinicians Honored With Family Choice Awards

Dr. Barbara Sheller of Dental Medicine, Dr. Carol Wallace of Rheumatology, and Karyn Brundige, ARNP, of Hematology/Oncology recently received the Children’s 2006 Family Choice Awards for providing outstanding family-centered care.

Patients and families nominate physicians, employees, teams or departments for the award, choosing staff members who have made a difference to families during their time at Children’s. The Family Advisory Council reviewed the nominations and chose this year’s award recipients from more than 100 nominations. Dr. Ellie Click received the Family-Centered Care Resident Award, which is based on peer nominations.

Eisenberg Recognized by Children's Staff

Dr. Matt Eisenberg was the first physician to receive the Children’s “ARTist of the Month” award since its inception in 2003. This honor recognizes Children’s staff members who demonstrate the Children’s Service Standards of Accountability, Respect and Teamwork (ART).

John Dwight, Dr. Matt Eisenberg and Dr. Mark Del Beccaro

Eisenberg was nominated for the award by Children’s employees who wanted to recognize his support during the implementation of Ambulatory Computerized Provider Order Entry (CPOE).

He played a key role in the transition to CPOE in the Hematology/Oncology Clinic, where staff face unique ordering challenges because of the complexity of their patients’ medication protocols.

“Matt is an incredibly dedicated and enthusiastic person who brings his knowledge and humor to every situation,” says Dr. Mark Del Beccaro, clinical director, Information Services. “Without his dedication, the online ordering in the Hem/Onc clinic would not have worked.”

Children’s Service Standards define how employees are expected to treat patients, families and everyone else they interact with at work.

Children’s is training all employees on these standards to provide the best service and create a respectful environment for all patients, families and staff members.

Hayes Elected to Institute of Medicine

Children’s Medical Staff member Dr. Maxine Hayes was elected to membership in the prestigious Institute of Medicine (IOM) of the National Academies. The institute carries out studies and advises policy makers, leaders and the public on important health issues in the United States.

Appointment to the IOM is based on professional achievement and commitment to service, and is considered one of the highest honors in the fields of medical sciences, health care and public health.

Hayes is one of only 65 new members elected this year. She joins Dr. Frederick P. Rivara, Children’s attending physician and division chief, General Pediatrics, who was elected to membership last year.

A former medical director of the Odessa Brown Children’s Clinic, Hayes is currently state health officer for the Washington State Department of Health. In that role, she advises Washington’s governor on public health issues. Hayes is also a clinical professor of pediatrics and health services at UW School of Medicine.

Molteni Appointed to Editorial Board

Dr. Richard Molteni, Children’s medical director, was appointed to an expert editorial board established by the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) to oversee the publication of national CMS coding rules and regulations.

The AMA Board of Trustees appointed Molteni as the representative of medical specialty societies on this editorial board.

New Medical Staff

Welcome new Medical Staff members.

James Borowiec, MD, Anesthesia, Children’s
Elizabeth Evans, MD, Emergency Medicine, Children’s
Martha Pankovich, MD, Anesthesia, Children’s
Usha Sankrithi, MBBS, MPH, medical director, Urgent Care and After Hours, Emergency Medicine, Children’s
Tueng Shen, MD, Ophthalmology, UW

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.