Seattle Children's Provider News

Emergency Department and hospital volumes

• Patient volumes in the Emergency Department (ED) are typical for summer; we continue to experience surges and high patient acuity in the ED.
• Hospital census was higher this summer than in typical summers pre-pandemic. Significant planning is occurring to prepare for the fall/winter surge.

COVID-19

• We are beginning to see increased SARS-CoV2 activity as our testing positivity is increasing; we expect rates to further rise with the start of school.

Chemotherapy drug supply

• The national shortage of chemotherapy drugs continues.
• We continue to monitor our supply closely and work with our distributors to ensure we have adequate quantities including methotrexate.
• We are coordinating our efforts regionally and nationally to look for long term solutions to ongoing medication shortages that impact patient care.

Wade Iwata, MSW, is social work supervisor for Seattle Children’s Cancer and Blood Disorders Center

Q: How would you define wraparound services? 

It’s the support we offer to patients within their whole environment. So that’s the patient with their siblings, their parents, their extended family, their school system, and their community. Because cancer just doesn’t affect the child. It pertains to everybody who’s part of their life.

Q: What do you think is the most important thing that Seattle Children’s does for a family that they may not get at another hospital or a cancer center? 

There are a lot of unique benefits at Seattle Children’s that other facilities don’t typically offer.

• For one thing, we have a really large psychosocial team. We have 11 social workers and then two social service specialists who are dedicated specifically to the Cancer and Blood Disorder Center.
• Our social service specialist team is laser focused on concrete needs, like helping families travel from wherever they’re coming from across the country or from across the world, setting up flights, local housing, and really being that support to them in getting to Seattle. They are like a concierge service.
• We provide in-house school services to keep kids engaged and on-track with their learning.
• Families coming from far away feel like they have a connection here, somebody who is on their side really working to support them.

Q: If a family doesn’t have this kind of support, what is that impact to the care or their outcome, potentially?

I think the social work team in particular has a huge impact on outcomes for kids. Our medical teams of doctors and nurses and others do an amazing job of addressing the medical issues patients are facing. We are here to address everything else: the emotional side of things, the school side of things, trying to create as normal of a life as we possibly can.

These kids are plucked out of their everyday life and brought into a new world and a new system. It’s emotionally and physically traumatic for them. Our work is to process that with them and support not only the patients but also their families, their siblings, their caregivers. Just helping them to address this new situation that they’re facing. And I think this support improves outcomes that are huge for the families because, while they know they’re getting great medical care, the emotional toll of having a child diagnosed with cancer is immense. And we need to process that with them and help support them through that process.

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We hope to see you at What’s New in Medicine (WNIM) on September 8 and 9, 2023. This annual continuing medical education conference brings together medical professionals from across Washington, Oregon, Idaho, Montana and even Canada to hear from dozens of speakers on hot topics in healthcare. If you can’t attend in person, consider our virtual and recorded options.

WNIM includes a day-long track on Pediatrics featuring speakers from Seattle Children’s. Other tracks include Infectious Diseases (Friday, September 8) and Internal Medicine (parallel track to Pediatrics offered on Saturday, September 9)

CME credits: Up to 24 Category 1 CME credits are available (8 on Friday, 16 on Saturday).

Participation options: WNIM allows either in-person, livestream, or recorded participation.  If you register for all three sessions ($300), you can attend two in-person or virtually and then capture the third online (recorded) for up to one year after the conference. If you select only one day ($170), you can select any one of the three sessions either in-person, livestream or recorded.  However, your selection must be done beforehand, and space is limited for those planning to be in-person.   Regardless, your selection can be viewed up until a year later, as all sessions will be recorded.

For more information: Learn more at whatsnewinmedicine.org, or register at the attendee registration page. Questions? Email [email protected] or contact Seattle Children’s physician liaison Kenton McAllister at [email protected].

Agenda: All sessions are listed below. View the full brochure.

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Seattle Children’s is prioritizing making it easier for families to access care, especially in clinics with high demand and long wait times. This work includes making wait times more transparent to both families and referring providers.

We are pleased to tell you about some of the recent changes we have made and improvements that are in the works for the coming year.

Making the most of every available appointment slot

Thirteen Seattle Children’s specialties recently undertook a four- to six-month overhaul of their scheduling systems to optimize appointments scheduled. These include Endocrinology, Adolescent Medicine, Nephrology, Otolaryngology, Orthopedics and Sports Medicine and others. As a result:

• Appointment slots are now filled more efficiently, with fewer appointments going unfilled
• Families can self-schedule for the first time
• If a sooner appointment becomes available, families are automatically notified

Today, families who use MyChart’s self-schedule feature are typically being seen 20 to 50 days sooner on average.

Reducing the number of missed appointments

New tools have helped us correctly identify families who are more likely to miss an appointment and then step in to offer additional support. In 2023 to date, we have averted more than 8,000 missed appointments. Assistance usually takes the form of transportation help, childcare services at the hospital or clinic or switching the appointment from in-person to telehealth.

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New resources from the Autism Center

We invite you to explore the Autism Center’s newly revamped online resources for patients and families. Many new resources have been added this year. Most resources are now available in both English and Spanish.

A new section of Spanish language resources includes an 11-part video series featuring Seattle Children’s subject matter experts, educational ombudspeople and families across Washington state discussing a range of topics in modules that range from 11 to 39 minutes. All videos except the first, “¿Qué es el autismo? (What is autism?),” are new this year.

Referral policy changes

Effective August 21, Seattle Children’s will no longer redirect referrals internally to the Autism Center when they are initially submitted to Speech, Psychiatry, Neurodevelopmental, Neurosciences or other ambulatory clinics. Instead, the referral will be closed and a notification sent to the referring provider to submit a new referral directly to the Autism Center.

This change will help ensure that all referrals to the Autism Center have a longer shelf-life for scheduling purposes (that is unique to the Autism Center) and that patients enter Autism’s scheduling queue as promptly as possible. Learn more about referral guidelines for the Autism Center.

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A new program for children with tracheoesophageal fistula (TEF) and esophageal atresia (EA) is now part of the hospital’s Airway and Esophageal Center that opened earlier this year.

TEF and EA services are not new to Seattle Children’s but are now integrated within a multidisciplinary program that offers expanded clinic hours and assistance from a program coordinator who helps families experience the best journey and outcomes possible. The TEF/EA Program provides not just surgery but also comprehensive follow-up care throughout childhood until patients transition to adult care.  It is the only program of its kind in the Pacific Northwest.

What to look for: Symptoms of TEF and EA in babies

• TEF and EA: Breathing problems and coughing or choking when the baby tries to swallow. The symptoms show up right after birth.
• TEF only: Severe coughing or choking when the baby tries to swallow, usually after feeding. Some babies may have trouble breathing while feeding. If the patient has TEF alone, it may be weeks or months after birth before TEF is diagnosed as the cause of symptoms.  
• EA only: The baby is not swallowing their saliva, is drooling a lot or has foamy mucus in their mouth or nose. Most often, EA alone is diagnosed before or right after birth.

See our new Case Study: Tracheoesophageal Fistula (1.5-Year-Old Patient with Difficult Swallowing and Recurrent Respiratory Infections).

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Please visit our Access Dashboard – September 2023 to find wait times for many of our ambulatory clinics and a list of conditions considered urgent for scheduling purposes.  We hope this information will support you in making decisions about referring to Seattle Children’s.  Algorithms and other clinical care resources for common pediatric conditions are available at seattlechildrens.org/algorithms.

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Conferences

• What’s New in Medicine 2023: Infectious Disease, Pediatrics and Internal Medicine. Friday, September 8 and Saturday, September 9, 2023. Option to register for ONLY the Saturday conference (Pediatrics), allowing for 8 Category 1 CME credits. Or, register for two days (Infectious Disease on Friday and either Pediatrics or Internal Medicine on Saturday) and view the other Saturday conference anytime via video (up to one year after the event) to attain all 24 Category 1 CME credits.  Participate virtually or in person (Kennewick, WA). For more information, please contact [email protected] or visit whatsnewinmedicine.org. Brochure.

• 2023 Peroxisome Scientific Meeting. September 10–13, 2023. Seattle Children’s Research Institute will host three days of exciting scientific discussions, a keynote address, short talks by invitees and social activities. Learn more: event website.

• 2023 Epilepsy Symposium, “Improving Pediatric Outcomes: Advances in Diagnosis, Management and Treatment.” Saturday, October 14, 2023. Hear from experts from Seattle Children’s Neurology, Epilepsy, Neurosurgery and Genetics Programs. Medical professionals and caregivers of children with epilepsy are welcome to attend. Registration is required. Learn more.

CMEs

• Common Presentations of Childhood Cancer in Children, Adolescents and Young Adults. September 20, 2023 from 6 to 7 p.m. Category 2 CME. Learn more. Register.

• Tried, True and New in Adolescent Idiopathic Scoliosis. October 17, 2023, 6 to 7 p.m. Category 2 CME. Learn more. Register.

Training Event

• Virtual Autism Center of Excellence (COE) Certification Training, Friday, September 29, 2023, from 8:30 a.m. to 4:30 pm. Learn more and register at https://medicalhome.org/coe or contact Kate Orville at [email protected]. Flyer.

Provider Grand Rounds

Year-round on Thursdays from 8 to 9 a.m. Learn more.

• September 7, 2023: The Genesis of Unequal Burden of Pain: A Selective Review Examining Social Inequities and Unheard Voices. Tarcea Pain Medicine Lecture. Carmen Renee Green, MD, Dean, CUNY School of Medicine, Bert Brodsky Chair; Medical Professor, Community Health and Social Medicine; Professor, Colin Powell School for Civic and Global Leadership, City College of New York (CCNY), Research Hospital.
• September 14, 2023: Scholarly QI: How to Build an Academic Career on the Work You Already Do. Lori Rutman, MD, MPH, Associate Professor of Pediatrics, University of Washington, Attending Physician, Emergency Medicine, Seattle Children’s.
• September 21, 2023: My Child’s Life Is Worth Saving: Addressing Racism in Serious Illness Communication. Mann Family Pediatric Palliative Care Lecture. Tessie October, MD, MPH, Pediatric Intensive Care, Hospice and Palliative Care Medicine, Children’s National Hospital;
  NIH, Pediatric Intensive Care Research
• September 28, 2023: ECMO: Current and Future Status. Robert H. Bartlett, MD, Active Professor Emeritus, Acute Care Surgery, Michigan Medicine, University of Michigan.   

2024 Nursing Events: Save the Date

• 2024 Pediatric Nursing Update Conference: January 26, 2024 (virtual)
• 45th Annual Duncan Seminar: March 22, 2024 (virtual)
• 2024 Nursing Research Symposium: May 10, 2024, Seattle Children’s Sand Point Learning Center

Medical Staff

Lisa Akiyama, MD, Neurology

Erin Anstadt, MD, Plastic Surgery

Erin Balay-Dustrude, MD, Rheumatology

Britany Barber, MD, Otolaryngology

Katherine Bartoletta, MD, Pediatrics

Elizabeth Budnik, DO, Emergency-Urgent Care

Priya Chandra, MD, Nephrology

Benjamin Edmonds, MD, Neurology

Vikramjit Singh Gill, MD, Emergency Medicine

Georgia Griffin, MD, Pediatrics

Lauren Gunderman, MD, Immunology

Christina Hartje-Dunn, MD, Cardiology

Maria Henry, MD, General Anesthesia

Rebecca Hoban, MD, Neonatology

Sandy Johng, MD, Neonatology

Daniel Kaufman, MD, Transplant surgery

Samuel Keller, MD, Cardiology

Sheetal Khiyani, MD, Emergency

Sung Min Kim, MD, General Anesthesia

Lauren Kroll-Wheeler, MD, Pathology

David Le, DO, Orthopedics

Jared Levin, MD, Rehab Medicine

Katrin Lichtsinn, MD, Neonatology

Sarah Lopez-Walters, ARNP, Critical Care

Haytham Maria, MD, Transplant Surgery

Carol McFarland, MD, Cardiology

Andrea Otero Luna, MD, Cardiology and Critical Care

Rachel Rau, MD, Hematology/Oncology

David Shin, MD, Radiology

Dorata Szczepaniak, MD, Pediatrics

Christopher Tapia, MD, Neurology

Michael Wadle, DO, General Anesthesia

Justin Willis, MD, Pediatrics

Scott Yang, MD, Orthopedics

Andrew Yazman, MD, Emergency-Urgent Care

Allied Health Professionals

Kennedy Brinkworth, ARNP, Neonatology

Thuy-Linh Bui, PA-C, Child Psychiatry

Hailey Caudle, PhD, Psychology

Julie Ann DeGregorio, ARNP, Pediatrics

Virginia Dillon, ARNP, Emergency-Urgent Care

Justin Domurat, ARNP, Emergency-Urgent Care

Elizabeth Ferrill, ARNP, Pediatrics

Lauren Hamel, PA-C, Pediatrics

Whitney Hugie, ARNP, Hematology/Oncology

Teneisha Hunt, ARNP, Hospital Medicine

Amber Mashuta, ARNP, Hospital Medicine

Mary Montgomery, ARNP, Psychiatry

Shannon Nash, ARNP, Pediatrics

Kimberly Newell, ARNP, Neonatology

Dawn Niess, ARNP, Hematology/Oncology

Emily Oliver, PA-C, Gastroenterology/Hepatology

Jennifer Souza, ARNP, Pediatrics

Yiwen You, BCBA, Psychiatry

Active Community Medical Staff

Meghan Brombach, DO

Jessica Ebberson, MD, ACMS

Jaime Ruddell, ARNP, ACMS

The new Access Dashboard – August 2023 provides visibility into Seattle Children’s ambulatory clinics’ wait times.  Page 1 lists wait times by specialty. Page 2 lists conditions or symptoms considered urgent for scheduling purposes.

The Access Dashboard can help community providers make decisions about referring to Seattle Children’s versus referring elsewhere or managing a patient in their medical home.

We welcome your feedback on this new tool; contact us at [email protected].

Algorithms and other clinical care resources 

Seattle Children’s has a robust toolbox of algorithms and other clinical care resources to help primary care providers (PCPs) manage patients in primary care and know when is the right time to refer to a specialist.  These resources were created with the help of PCPs and are compiled along with Seattle Children’s clinical standard work pathways at seattlechildrens.org/algorithms.

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