MEDICAL CURRENTS Children’s National

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Children’s
National
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MEDICAL
CURRENTS
A Children’s National Medical Center Quarterly Publication for Physicians
®
®
Transforming Care in
Our Intensive Care Units:
PICU and CICU Receive
National Award...Page 4
FALL 2009
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MEDICAL CURRENTS ■ Fall 2009
CHILDREN’S RESEARCH INSTITUTE
HIGHLIGHTS
New Surgery Institute
Aims to Improve Surgery
and Eliminate Pain
Kurt Newman, MD, senior
vice president for the
Joseph E. Robert, Jr., Center
for Surgical Care, describes
how this transformational
gift will benefit children
around the world.
$150 Million Gift is Largest Ever
for Pediatric Surgery
O
n September 16, Children’s National Medical Center
announced the creation of the Sheikh Zayed Institute
for Pediatric Surgical Innovation. With the largest gift
ever donated to pediatric surgery, the new institute
brings together surgeons and researchers from seemingly
disparate fields of medicine and research under the shared
goal of improving surgery for children.
The Institute will focus on four initiatives that together
will open a new era for pediatric surgery:
• Pain Medicine Initiative: By developing a device
that measures pain accurately, we will learn how to
eliminate pain with more effective medications and
treatments.
• Bioengineering Initiative: We will harness the
power of biomedical imaging and the computational
sciences to provide surgeons with unprecedented
levels of precision.
®
®
Proud to be Among
America’s Best
Children’s Hospitals
IN THIS ISSUE:
2 ..... CRI Highlights
3 ..... New Services for Referring Physicians
4 ..... Transforming Care in Our Intensive Care Units
6 ..... New Faculty
7 ..... Children’s News Notes
8 ..... People Notes
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www.childrensnational.org
• Immunology Initiative: We will create innovative
immunotherapies to suppress or stimulate a child’s
own immune system to cure disease – eliminating
the need for surgery.
• Systems Biology Initiative: With the decoding
of the human genome, we will begin a new era of
predictive, preventive, and personalized surgery for
every child based on their specific genetic makeup.
Our plan is to apply business model principles of
innovation management to the practice of surgery to
expedite discovery and bring new therapies to children
as quickly as possible.
In addition to the four initiatives, the institute also will
create fellowships in Pediatric Surgical Innovation. The
fellowships, eight in total, will be named the Robert
Fellowship, in honor of our longtime supporter, Joseph E.
Robert, Jr. The two-year fellowships will allow promising
young surgeons and researchers to study the innovation
management framework and apply it to surgery and research.
Each year, Children’s National performs 15,000
operations on infants, children, and young adults. This
institute offers the potential to help all children, even those
who never come to our hospital. By tackling these four
initiatives collaboratively, our aim is to quickly translate
research to care, share new knowledge and medical
discoveries, and benefit children across the country and
around the world.
Visit www.childrensnational.org/surgeryinstitute
for more details.
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MEDICAL CURRENTS ■ Fall 2009
New Services for Referring Physicians
Discounted EMRs for Pediatric Practices
Children’s IQ Network Offers Discounts on Best-in-Class
EMR Software: eClinical Works
Children’s IQ Network® is a health information exchange specifically designed
for pediatrics. Healthcare delivery for children is unique given the significant impact
of variation in patient size, developmental age, metabolism, and family structure on
both health and illness. The network links the essential health information, such as
physician visits, medications, allergies, problems, laboratory results, and immunization
histories for children throughout the region.
Participation in the network is available on a voluntary basis to physicians who
care for children in Washington, DC, Virginia, and Maryland. Children’s National is
partnering with community pediatric practitioners and eClinicalWorks as the ambulatory
electronic medical record (EMR) vendor. Community pediatric providers who join the
network agree to share essential healthcare data within the larger region and participate
in quality initiatives. Participating providers in turn receive a significant subsidization
to the costs of a state-of-the-art highly rated EMR to replace paper records and improve
healthcare delivery. Practices remain responsible for the costs of practice management
systems and office hardware. Providers who join the network may be eligible for
additional incentives through the American Recovery and Reinvestment Act.
For detailed cost and implementation information, visit
www.childrensnational.org/CIQN.
Children’s National Gateway
Your Access into Children’s National Medical Records
Children’s National Gateway is a web-based portal that allows referring practices
to access real-time clinical information for inpatients and outpatients referred to
Children’s National. The portal includes physician and nursing documentation, lab
results, and radiology results (for patients from May 18, 2008, to present), as well as
helpful links to Children’s and other medical web sites. Future enhancements are
planned, including access to round reports and problems lists.
To ensure patient privacy, providers will be able to see only the patients who
identify them as their primary care provider. Children’s National must grant secure
access to each physician who will log into the system. Once you request access,
your login and password will be e-mailed to you within one week.
To enroll, visit www.childrensnational.org and click
on the green “For Doctors and Healthcare Professionals”
tab. For questions, please e-mail Cori Ahrens at
[email protected]. To request a visit with a physician
liaison to assist in registering for the portal, contact Shay
Raugh Wilkinson at [email protected].
CHILDREN’S NATIONAL
HEALTH NETWORK
Children’s National Health Network
(CNHN) is the Washington, DC,
region’s largest dedicated pediatric
provider network. CNHN has more
than 750 members, linking
community-based pediatricians in
240 practices with more than 300
pediatricians and specialists at
Children’s National Medical Center.
CNHN improves pediatric care
through improved clinical
communication, and connectivity,
group purchase, educational, and
quality improvement programs. In
particular, CNHN’s group purchasing
program for vaccinations saves
practices money each year. The
network has partnered with the
American Academy of Pediatrics to
offer CNHN-member pediatricians
free access to the AAP’s Pediatric
Care Online and Patient Education
Online. This resource saves a
practice approximately $300 per
physician, per year.
For more information on
joining Children’s National
Health Network visit
www.childrensnational.org/cnhn.
www.childrensnational.org
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MEDICAL CURRENTS ■ Fall 2009
Transforming Care in Our Intensive Care Units
PICU and CICU Receive National Award
Children’s National Medical Center is the first
hospital in the nation to have two pediatric units
receive the award at the same time.
T
he Division of Critical Care Medicine at Children’s
National Medical Center is a national leader in the care
of critically ill and injured infants and children. Staff
members provide 24/7 coverage of patients in the
Pediatric Intensive Care Unit (PICU), Neonatal Intensive Care
Unit, Neuro Intensive Care Unit, and Cardiac Intensive Care
Unit (CICU). Children’s National has the only pediatric-focused
cardiac and neuro intensive care units in the region.
Children’s physicians and nurses are experts in life-support
technologies and techniques for respiratory, neurological,
and cardiac intensive care, including Extracorporeal
Membrane Oxygenation (ECMO) therapy. They also are
national and international authorities in their fields, conducting
research on topics ranging from advances in health services
to brain injury and recovery. This expertise maximizes
patients’ chances of living healthy and productive lives.
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In October, both the CICU and the PICU at Children’s
National received the Beacon Award for Critical Care
Excellence, an award given by the American Association
of Critical-Care Nurses (AACN). The award recognizes the
nation’s top pediatric, progressive, and adult critical care
units across a multitude of hospitals. The recognition
represents extraordinary commitment to high-quality critical
care standards, and dedication to the exceptional care of
patients and their families.
Children’s National Medical Center is the first hospital in
the nation to have two pediatric units receive the award at
the same time.
“We are very excited to be recognized for our commitment
to excellence,” said Janeane Walker, MSN, RN, CPN, CCRN,
a professional practice specialist in the PICU and CICU.
“Through teamwork and collaboration between attendings,
nurses, and staff, we are able to provide the best environment
and outcomes for our patients.”
As Beacon Award recipients, the CICU and PICU succeeded
in the following areas, as measured against evidence-based
national criteria:
• Recruitment and retention
• Education, training, and mentoring
• Research and evidence-based practice
• Patient outcomes
• Leadership and organization ethics
• Healing environment
Children’s ICU care emphasizes compassion and comfort
for families during a stressful time. In Children’s new East
Inpatient Tower, the ICU units have large rooms with private
restrooms, windows, and sleep spaces for two adults. To
improve care, the ICU beds can sit in the middle of the room,
allowing physician and nurse access around the bed.
To see a video tour of the ICU, visit
http://media.childrensnational.org.
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MEDICAL CURRENTS ■ Fall 2009
LEADING THE WAY IN
CHILD HEALTH ADVOCACY:
The Pediatric Health Needs Assessment
O
ICUs USE PORTABLE CT SCANNER
TO IMPROVE CARE
Through a generous donation, Children’s National received a
new portable CT scanner called a CereTom®. This device is
one of few in use in pediatric hospitals around the country,
and is one of only a handful in use in any hospital in the
mid-Atlantic region.
The portable CT scanner delivers high-resolution images that
are effective and efficient in diagnosing head and neck injuries
with minimal patient disruption and risk. The scans can be
taken at the patient’s bedside without requiring the child to be
moved. The intensive care and imaging teams collaborate in
diagnosing at the bedside with engagement of parents, using
patient/family-centered care to improve clinical outcomes.
The scanner also has applications in neurosurgery where it
is essential to know “real-time” if a procedure has been
successful before the surgery is concluded. “The portability
of this scanner vastly improves our ability to offer timely
diagnosis of intracranial disease processes outside the
imaging suite,” said Robert Keating, MD, chief of the Division
of Neurosurgery. “This tool has the potential to change the
practice of neurosurgery as we currently know it.”
n October 8, Children’s National Medical Center, in
conjunction with the RAND Corporation, released the
Pediatric Health Needs Assessment for the District of
Columbia. This groundbreaking study was commissioned
to give Children’s National data with which to base the
community benefit program; a strategic foundation for planning
advocacy activities; and a document to share with District
policymakers and pediatric health stakeholders to develop
collaborative programs designed to address the most pressing
pediatric health needs.
“The fact that so many stakeholders came to the table and
cooperated with researchers is news in and of itself,” said
Joseph Wright, MD, MPH, senior vice president of the Child
Health Advocacy Institute (CHAI). “The data used are both
quantitative and qualitative, which is new for RAND, and a
great achievement for children in the District.”
The report will be used to plan advocacy programs –
either those that Children’s National can develop and lead,
those we assist with, and those we can support.
Key findings from the report include:
• The District of Columbia leads the nation in children
with health coverage, with only an estimated 3.5 percent
uninsured children in DC in 2007 vs 9.1 percent uninsured
nationally.
• However, despite high levels of coverage, many barriers
keep children from receiving primary and specialty
health care in community-based settings, including:
– Uneven distribution of primary and specialty care
providers across the District; and
– Infrastructure inequities, related to issues such as
ease of physical access and transportation.
– As a result, many children rely on emergency
rooms and are hospitalized for conditions that
could be prevented.
• Some health issues in the District are particularly
alarming, including the highest or among the highest
rates in the nation of obesity, asthma, sickle cell disease,
HIV/AIDS, adolescent pregnancy, and teen dating
violence.
For more information on the Pediatric Health Needs
Assessment for the District of Columbia, visit
www.childrensnational.org/pediatricneeds.
www.childrensnational.org
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MEDICAL CURRENTS ■ Fall 2009
NEW Faculty
Charles I. Berul, MD
Chief, Division of Cardiology
Charles I. Berul, MD, joins Children’s National from The Children’s Hospital
Boston, where he directed the Pacemaker Program and was a leader of
a Heart Rhythm Genetics and Development research laboratory. An
internationally acknowledged expert in the area of pediatric cardiac
electrophysiology, inherited heart rhythm abnormalities, pacemaker and
defibrillator implantation, and cardiac screening of the pediatric athlete, he has authored more
than 150 publications in the field of pediatric cardiology and is an invited speaker nationally
and internationally.
Anastassios Koumbourlis, MD
Chief, Divisions of Allergy and Pulmonary Medicine and Sleep Medicine
Anastassios Koumbourlis, MD, joins Children’s National from Albert Einstein
College of Medicine and Schneider Children’s Hospital in New York, where
he was the chief of Pulmonology. Prior to this, he was on the faculty of
Columbia University and Director of the Pulmonary Function and Exercise
Laboratories at the Children’s Hospital of New York at Columbia University
Medical Center. Dr. Koumbourlis has extensive experience in pediatric pulmonary medicine
with special interests in congenital lung and airway anomalies, chest wall deformities, and
pulmonary complications of neuromuscular and sickle cell disease.
Suresh Magge, MD
Neurosurgery
Suresh Magge, MD, joins the Division of Neurosurgery with clinical expertise
in vascular malformations, brain tumors, endoscopic and open craniosynostosis surgery, Chiari malformations, prenatal neurosurgical diagnosis, and
spine and functional neurosurgery. Dr. Magge received his medical degree
from Harvard Medical School and completed his neurosurgical training at
the University of Pennsylvania and The Children’s Hospital Boston. He will see patients in
both Washington, DC, and Northern Virginia and will perform surgery at Children’s National
and Inova Fairfax Hospital.
Marshall Summar, MD
Chief, Division of Genetics
Marshall L. Summar, MD, joins Children’s National from Vanderbilt
University School of Medicine, where he directed the Program in
Translational Genetics. Dr. Summar is an expert in translational studies of
carbamyl phosphate synthetase deficiency, and has completed innovative
work on nitric oxide in urea cycle and related disorders. His interest is in
translating findings from research on genetic disorders to disorders caused by environmental
factors in the broader pediatric population. In addition to his research, Dr. Summar is chief
of the Division of Genetics, which assesses and treats patients and families with a variety
of conditions.
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New Faculty
Adolescent Medicine
Lisa Tuchman, MD
Allergy and Pulmonary Medicine
Anastassios Koumbourlis, MD
division chief
Dinesh Pillai, MD
Anesthesiology and Pain Medicine
Richard Bosco, MD
Andrew Matisoff, MD
Theodore Reyes, MD
Cardiac Surgery
Dilip Sri Nath, MD
Cardiology
Charles Berul, MD
division chief
Niti Dham, MD
Elizabeth Anne Greene, MD
Anita Krishnan, MD
Child and Adolescent Protection
Katherine Deye, MD
Emergency Medicine
Dafina Good, MD
Sabah Iqbal, MD
Alexandra Rucker, MD
Ann Thomas, MD
Theresa Walls, MD, MPH
Epilepsy and Neurophysiology
Tesfaye Zelleke, MD
Gastroenterology, Hepatology,
and Nutrition
Elizabeth Hart, MD
Jaime Wolfe, MD
General and Thoracic Surgery
Evan Nadler, MD
General and Community Pediatrics
Karen Fratantoni, MD
Olanrewaju Omojukun, MD
Genetics
Marshall Summar, MD
division chief
Pranoot Tanpaiboon, MD
Hematology
Amanda Thompson, PhD
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MEDICAL CURRENTS ■ Fall 2009
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Hospitalist Medicine
Karen Smith, MD, interim division chief
Prita Bhansali, MD
Karen Gray, MD
Tina Halley, MD
Elizabeth Shashaty, MD
Sophia Sterner, MD
James Van Beyen, MD
Health Services for Children Pediatric Center
Michelle Elmson, PhD
Rebekah Conroy, MD
Carolyn Wurm, PhD
Mary Washington Hospitalist Program
Leo Altamirano, MD
Andrea Brown, MD
Jean Laurore, MD
Kijana Nix, MD
Neonatology
Brian Stone, MD
Nephrology
Kirtida Mistry, MD
Shamir Tuchman, MD
Neuropsychology
Christopher G. Vaughan, PsyD
Neurosurgery
Suresh Magge, MD
Oncology
Mwe Mwe Chao, MD
Amanda Thompson, PhD
Orthopaedics
Matthew Oetgen, MD
Suzanne Walters, MD
Pathology
Nikki Mourtzinos, DO, MHS
Pharmacy
Jason Corcoran, PharmD, BCPS
Kathy Pham, PharmD, BCPS
Plastic and Reconstructive Surgery
Albert Oh, MD
Rheumatology
Claas Hinze, MD
CHILDREN’S
NEWS NOTES
Children’s National Hospitalists
in Northern Virginia
Children’s National Medical Center and MediCorp Health System are
again partnering to enhance pediatric services to families in the greater
Fredericksburg, Va, area. In September, the pediatric hospitalists in the
pediatric inpatient unit at Mary Washington Hospital became employees of
Children’s National. Francisco Alvarez, MD, a pediatric hospitalist from
Children’s National, is the medical director. He completed his training at
St. Christopher’s Hospital for Children in Philadelphia and has worked at
Children’s National since 2005.
Patients can be admitted to the pediatric inpatient unit from a pediatrician’s
office or directly through the Emergency Department. To begin the direct
admission process, call the Mary Washington Hospital Physician Answering
Service at 540-741-1700. You can discuss the case directly with a
Children’s National pediatric hospitalist.
American Academy of
Pediatrics Conference
and Exhibition in
Washington, DC
Children’s National welcomed
alumni, healthcare professionals, and
friends to the American Academy of
Pediatrics National Conference and
Exhibition (NCE) in Washington, DC,
in October. Over the course of the
conference, Children’s National had
more than 40 featured speakers and
sessions.
In addition, Children’s
pediatrician Dana Best, MD, led the
AAP call for tobacco-free environments
for all children. Dr. Best is one of the
lead authors on a new AAP policy statement on tobacco-free environments
for children. The policy appeared in the November issue of Pediatrics and
was presented at the conference.
Attendees who visited Children’s booth received a “Reducing the Risk of
SIDS” poster for their offices. To request a free copy or print the poster in
English or Spanish, visit www.childrensnational.org/SIDS.
son, PhD
www.childrensnational.org
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Vol. 20 No. 3
Fall 2009
Children’s Medical Currents is a publication
produced four times a year by Public
Relations and Marketing for the Medical
Staff and referring physicians of Children’s
National Medical Center. For information,
call 202-476-4500 or e-mail [email protected].
Edwin K. Zechman, Jr.
president and chief executive officer
Peter Holbrook, MD, executive vice president
and chief medical officer
Jacqueline D. Bowens, executive vice
president and chief Government and
External Affairs officer
Corinne Ahrens, marketing manager
Julie E. Vastyan, editor
Emily Dammeyer, contributing writer
Design Central, Inc., graphic design
Children’s National Medical Center
Corporate Entities:
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Northern Virginia, LLC
Children’s Pediatricians & Associates
Children’s Research Institute
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Safe Kids Worldwide
Visit us on the web at
www.childrensnational.org
Copyright © 2009 by Children’s National Medical Center.
All rights reserved. The bear logo and Children’s National
Medical Center are registered trademarks. The names of the
other organizations within the Children’s National Medical Center
system are service marks of Children’s National Medical Center
and/or its affiliates.
A member of the Children’s Miracle Network
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prohibited by applicable law, including race, color, religion, age,
sex, national origin or ancestry, sexual orientation, marital status,
status as a disabled or Vietnam veteran or as a qualified disabled
individual.
MEDICAL CURRENTS ■ Fall 2009
PEOPLE
NOTES
Gail Pearson, MD,
was awarded the 2009
Distinguished
Achievement Award
by the American Heart
Association and the
Council on
Cardiovascular Disease
in the Young.
Holly Meany, MD,
received the American
Society of Clinical
Oncology’s 2009
Career Development
Award. This 3-year
award provides support
for Dr. Meany to
conduct a clinical
research project on low dose- Azedra (carrier
free 131I-MIBG) for patients with recurrent
neuroblastoma and other neural crest tumors
in collaboration with the Pediatric Oncology
Branch of the National Cancer Institute.
George H. Zalzal, MD,
received the
Distinguished Service
Award from the
American Academy of
Otolaryngology-Head
and Neck Surgery,
(AAO-HNS), the world’s
largest organization
representing specialists who treat the ear, nose,
throat, and related structures of the head and
neck. The Academy presents Distinguished
Service Awards to medical professionals who
demonstrate excellence in their field. Dr. Zalzal
received the award in October at the opening
ceremony of the 2009 AAO-HNS annual
meeting in San Diego.
A. Barry Belman, MD,
was honored by The
Canadian Journal of
Urology as one of its
“Legends of Urology”
in the August issue.
Dr. Belman has been
with Children’s National
for more than 30 years
and is the chair emeritus of the Division of
Urology.