The Bulletin: March 2008

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

Remembering Dr. Ron Lemire

On Feb. 4, Dr. Ronald J. Lemire, director of inpatient services at Children’s, died at his home in Kirkland, Wash., at the age of 74.

Dr. Ron Lemire

Lemire came to Children’s as a resident in 1965 and joined the faculty in 1968. For nearly 40 years, he served in various capacities including attending physician in the Birth Defects Clinic, director of the pediatric residency program, and member of the Children’s Hospital Steering Committee and Medical Executive Committee as well as several other hospital committees. Lemire was a professor of pediatrics at the University of Washington School of Medicine. He was also involved in the Airlift Northwest program and was the liaison between Harborview Medical Center and Children’s.

“Nobody ever cared more for Children’s Hospital,” says Dr. Bruce Beckwith, former chief of pathology at Children’s and close friend of Lemire. “Ron was a unique human being who cared greatly about doing the job right, and not at all about getting the credit. He was equally comfortable and respected in the laboratory and in the clinic — a compassionate physician, a wise observer, a respected counselor, and a wonderful friend, who loved good people from every walk of life and received their love in turn.”

Messages of condolence and remembrances may be sent to Kathy Lemire, c/o Pastoral Services at Children’s Hospital and Regional Medical Center; 4800 Sand Point Way NE; Seattle, WA 98105.

New Marrow Failure Clinic Open

Children and adolescents can now be seen at Children’s Bone Marrow Failure Clinic, which is part of the Hematology/Oncology Division.

Dr. Akiko Shimamura

This service offers comprehensive diagnostic evaluations and ongoing medical management for acquired and inherited marrow failure syndromes, such as aplastic anemia.

The Bone Marrow Failure Clinic works in collaboration with the Hematopoietic Stem Cell Transplant Program to provide cutting-edge treatments for patients with marrow failure. Inherited marrow failure syndromes commonly present with multi-organ system abnormalities, so clinic staff work with other Children’s subspecialty clinics to facilitate the complex multidisciplinary care of these patients.

The clinic is directed by Akiko Shimamura, MD, PhD, who previously led the Bone Marrow Failure Clinic at Children’s Hospital Boston.

Appointments are available Thursday mornings. To refer patients, call the clinic directly at (206) 987-2106. For urgent clinical questions, Shimamura may be paged through the physician operator at (206) 987-7777.

Children's Sports Medicine Program -- Not Just Injury Treatment

Children’s is rolling out a comprehensive Sports Medicine program that encompasses a full range of services including injury prevention, sports psychology, rehabilitation, imaging, integrative medical treatment and health promotion. This program addresses the special needs of children and adolescents whose bodies are still developing and who have different risks than adults.

Joining Dr. Greg Schmale are Dr. Brian Krabak, who has been the physician
for several Olympic teams and is nationally recognized for his work with “extreme sports”; Dr. Monique Burton, a University of Washington team physician, who also works with the U.S. Track and Field team; and Dr. Cora Breuner, who specializes in eating disorders and the female athlete. Dr. Tom Jinguji, a sports medicine physician in Federal Way, has also joined the program full time.

Several physician assistants, Anju Jain, Patrick Parenzin, and Jim Anderson, join Cheryl Parker, who has been with the program for many years.

Sports Medicine services are now being offered in Seattle, Bellevue and Federal Way. The program offers same-day access and will have extended hours, including early morning, evening and weekend hours. Referrals from PCPs are not required. Patients and providers may call (206) 987-2109 for appointments at any of the locations.

Federal Way Clinic Adds Targeted Rehabilitation Services

Children’s Federal Way clinic now offers specialized occupational, physical and speech therapy services.

These new services provide short-term intensive therapy for postsurgical children and teens, and deliver ongoing therapy to children with acquired traumatic brain injury or spinal cord injury. Children who experience cognitive and physical changes due to tumors and those with neurological disorders or orthopedic diagnoses, such as brachial plexus, are also being seen at this clinic.

Patients and families living in the south Puget Sound area can expect integrated care coordination among the master’s-level OT/PT/ST providers, as well as strong advocacy and support for school reintegration.

Therapy services are available in Federal Way on Mondays, Wednesdays and Thursdays from 9 a.m. to 6 p.m.

Questions about the new services can be directed to Karen Baughman, Federal Way clinic manager, at karen.baughman@seattlechildrens.org or (253) 838-5878. Families with referrals may schedule appointments by calling (206) 987-1267.

New Medical Photography Policy Protects Patient Privacy

To ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) privacy and confidentiality requirements, Children’s has implemented a new policy regarding the use of personally owned photographic equipment.

Medical photography of patients at Children’s is permitted only when necessary for diagnostic, treatment, research or educational purposes or as covered under a separate policy for external media and communications. Staff may not use personal cell phones or other digital assistant devices for photography of Children’s patients. Other personal photographic devices may not be used to take or store images in which patients are identifiable outside of the procedures in this policy.

Only hospital-owned or hospital-approved photographic equipment may be used to take images of patients. The images must be stored according to Health Information Management standards.

Do the WRITE Thing

Clear communication is vital to patient safety. Children’s still uses some handwritten documents, which have a greater potential for error than electronic records.

To minimize mistakes and misrepresentations, Children’s prohibits the use of certain abbreviations and easily misinterpreted decimal notation in any part of a patient’s medical record, including orders, prescriptions, progress notes, flow-sheets or other documentation. Specific abbreviations are referenced in the Dangerous Abbreviations and Decimal Use policy.

The use of any abbreviation in any part of a patient’s chart is strongly discouraged due to the potential for patient harm and putting other providers at risk of making misinformed decisions. To learn more, review the Children’s Do the WRITE Thing toolkit.

Lately, another area of concern is the use of abbreviations for diagnoses. Recent errors have occurred when a diagnosis was abbreviated and interpreted as a different diagnosis; such errors have significant treatment implications.

Also, if you need to make a correction on a written document, cross it out with a single line and initial the change.

Please note that cursive written prescriptions are no longer accepted in any pharmacies in Washington state. Prescriptions must be hand printed, typed or electronically generated.

Regular audits of medical records are made to identify unsafe documentation practices. When occurrences of unsafe documentation are found, direct feedback is given to the individual(s) responsible to remind them of our policy and to discourage unsafe practices.

Additional information and tips can also be found on The Joint Commission Web site.

For an archive of survey preparedness tips, visit the Survey Readiness site.

Please Attend Faculty Survey Results and Action Planning

Drs. David Fisher, Bruder Stapleton and Bob Sawin will present the results of the 2007 faculty survey on March 4 at 5:15 p.m. and March 22 at 7 a.m. in Wright Auditorium. Children’s looks forward to sharing the results, soliciting your input and working with you to develop specific action steps in response to the survey. Your participation is critical to improving faculty experience here at Children’s.

New Medical Staff Resources Page Now on CHILD

A special page, with links to medical staff’s most frequently used sites on CHILD, is now available. Listed at left on the home page of CHILD, Medical Staff Resources displays the title of the link as well as an option to view a description of each.

The site was developed to make finding needed information easier. Links are organized in four sections: Clinical, Educational, Library and Data Bases and Non-Clinical Resources. E-mail Margot Kravette, director, Physician Relations, with suggestions for additional links you would find valuable.

General and Thoracic Surgery Web Site Live

Children’s recently launched the General and Thoracic Surgery Web site. This site provides information about conditions treated, including appendicitis, gallstones and umbilical hernias. The site also features sections about the team, current research and links to other online resources for patients and families.

The goal of this and other specialty program sites is to help families make informed health-care decisions and better understand the comprehensive care that their children will receive at Children’s Hospital.

Other live sites include Cancer and Blood Disorders, Orthopedics, Neurosurgery, Transplant Center, Heart Center and Craniofacial Center.

Record Census: An Update from Dr. David Fisher, Chief Medical Officer

As a member of the medical community, we’d like you to know about the effect of this winter’s viral and respiratory season on Children’s. The hospital census reached a record high during the last week of January, and we continue to have near-capacity numbers of patients in our care.

Although we have 250 beds, we aim to keep patient occupancy below 190 (76%) so we can accommodate patients in an emergency or outbreak. In January our occupancy exceeded 76% for all but four days. On our busiest day, 243 of our 250 beds were full, putting the hospital at 97% capacity. We understand that other hospitals in the area are experiencing the same high occupancy.

In response to this high census, we have added direct patient care and support staff, and have created a temporary inpatient overflow area near our emergency department. During times of very high patient census, there is increased concern about preventing hospital-acquired infections. We are increasing our emphasis on perfect hand hygiene to avoid hospital-acquired infections and unnecessary bed-days, so there will be more available beds for your patients.

While times like this highlight our need for additional patient care space, our providers, nurses and clinical staff are doing an excellent job of providing compassionate, individualized high-quality care to every child.

Kawabori and Stevenson Retire

Drs. Isamu Kawabori and Geoff Stevenson will retire from Children’s Heart Center this month.

Dr. Isamu Kawabori

Kawabori has been on the medical staff since 1974 and served as an associate professor of pediatrics at the University of Washington (UW).

“Dr. Kawabori has been a wonderful leader and clinician and has played a significant role in our regional program,” says Dr. Bruder Stapleton, chief academic officer. “We will miss his calm, caring presence in our Heart Center.”

Dr. Geoff Stevenson

Stevenson joined the medical staff in 1976 and most recently served as the director
of cardiac ultrasound at Children’s and as a professor of pediatrics at UW.

“Geoff is an internationally renowned echocardiographer who has made tremendous advancements in the clinical care of children with congenital heart disease and in surgical repair,” Stapleton says. “He will be irreplaceable.”

A reception honoring Drs. Kawabori and Stevenson will be held on Monday, March 24, from 11:30 a.m. to 1 p.m. in the hospital’s boardroom.

Annual Medical Staff Social, April 12

This year’s event will be held at Bellevue Arts Museum. The first annual Richard Molteni Award for Professionalism and Quality will be presented. Look for your invitation in the mail!

Practitioner Well-Being Committee Available for Consultations

The Practitioner Well-Being Committee provides advice and recommendations to medical staff members in distress; services include advocacy, support and education (e.g., referrals and information regarding evidence-based mental health services).

The committee also provides consultation to department chairs and other faculty leaders seeking advice about team members showing signs of distress or impairment. If you would like more information, please contact Matthew Speltz, PhD, committee chair, (206) 987-7577, or any of the following committee members.

Dr. Anthony Avellino, (206) 987-3054
Dr. Cora Breuner, (206) 987-3049
Dr. Michael Cunningham, (206) 987-2528
Dr. Steve Dassel, (206) 525-8000
Dr. Russ Geyer, (206) 987-6664
Dr. Christer Jonmarker, (206) 987-2518
Dr. Karen Murray, (206) 987-2521
Dr. Kathleen Sie, (206) 987-2105
Dr. William Womack, (206) 987-2164
Jeff Sconyers, senior VP/Legal Counsel, (206) 987-2044
Georganna Biggins, Manager, Medical Staff Services, (206) 987-5216

Six Inpatient Units Among Nation's Top Performers

The Medical, Surgical, Neonatal Intensive Care, Pediatric Intensive Care, Rehabilitation and Seattle Cancer Care Alliance units were recently identified as top performers according to Children’s Family Experience Survey vendor, NRC+Picker.

The top performer designation signifies a unit that has scored in the 90th percentile on the question, “Would you recommend this hospital to your family and friends?” Of 323 hospitals in the country, about 33 facilities, or 10%, score in the 90th percentile.

Danielson Receives 2008 MLK Jr. Award

Dr. Benjamin Danielson, medical director of Odessa Brown Children’s Clinic, received the 2008 University of Washington Health Sciences Center Martin Luther King Jr. Distinguished Service Award for his work to address inequality in health care.

“I feel humble,” he said. “If you ever achieve anything, it is through the help of so many other people.”

“Dr. Danielson has embraced the meaning of Dr. King’s words and works tirelessly to address health disparities,” said Kathryn Waddell, executive director of Health Sciences Administration.

Delecki Chosen as Consultant to the American Association of Pediatric Dentistry

Dr. Chris Delecki, dental director at Odessa Brown Children’s Clinic, has been selected as a national oral health Head Start consultant for Native American Indians and Alaskan Natives by the American Association of Pediatric Dentistry (AAPD).

The AAPD recently entered into a contract with the Federal Head Start Program to remove barriers to dental care for Head Start children in the United States.

“Dr. Delecki will serve as a national representative of the work Children’s does with Native American and Alaska Native communities of Head Start Children,” says Dr. Joel Berg, Children’s dental director and trustee of the AAPD.

“This is a testament to Dr. Delecki’s commitment to underserved populations,” says Jeff Sconyers, Children’s senior vice-president and general counsel.

"Daniel's Story" Wins Film Festival Award

“Inside Access: Daniel’s Story” follows a boy born with part of his brain outside his skull as a team of craniofacial surgeons and neurosurgeons at Children’s seals the opening to his brain, protecting him from disease and injury, and giving him a new face.

New York Festivals honored University of Washington TV (UWTV) with a bronze award in its International Film & Video Competition for the production.

“We followed Daniel through a very complex surgery, as doctors at Seattle Children’s Hospital rebuilt his skull,” said Charlie Hinckley, senior producer at UWTV. “When they were done, this little boy was transformed. It was amazing.”

The annual New York Festivals International Film & Video Competition is judged by panels of industry experts, including several hundred producers, directors, writers and other media professionals in the New York area.

New Medical Staff and Allied Health Professionals

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

Monique Burton, MD, Sports Medicine, Children’s
Martin Koyle, MD, Urology, Children’s
John Meehan, MD, Surgery, Children’s
Theresa Walls, MD, Emergency Medicine, Children’s
James Anderson, PA-C, Orthopedics, Children’s
Patricia Berry, ARNP, Neurology, Children’s
Sarah Gadd, CRNA, Anesthesia, Children’s
Dieu-Ha Nguyen, ARNP, Neurodevelopmental, Children’s

Northwest Regional Pediatric Liver Disease Symposium

The Liver Disease Symposium, a free course intended for physicians and other health- care providers, will be held on Friday and Saturday, April 11 and 12, at the SeaTac Hilton.

The goals of this meeting are to raise awareness about prolonged neonatal jaundice, biliary atresia and other pediatric liver diseases.

Families may attend the lunch at 11:30 a.m. on Saturday and have an opportunity to “ask the experts.”

For more information or to register, e-mail comoumi@liverfoundation.org or visit the American Liver Foundation’s Pacific Northwest Chapter Homepage.

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.

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.