Seattle Children's Provider News

Special Update: Seattle Children’s Remains In Active Code Yellow for High Census and Capacity Constraints

  • Seattle Children’s is experiencing record-setting census for inpatients, intensive care units (ICUs) and the Emergency Department (ED).
  • We also continue to treat high numbers of patients experiencing mental and behavioral health crises.
  • Regionally, hospitals across Washington state continue to report strained pediatric capacity.
  • Seattle Children’s has implemented a variety of surge plans to help us meet the demand for our services while ensuring we deliver the best possible care. Many of those plans are having a positive impact, but the capacity situation is still critical.
  • Leaders are huddling daily to monitor the situation and propose additional solutions.
  • When sending families to the ED, please call our Communications Center first (206-987-8899) to help with staffing and space planning. Advise families to expect longer-than-typical wait times and that we are triaging to see the sickest patients first.

For More Information: Please refer to our Emergency or Urgent Care Referral Guide when sending patients to Seattle Children’s.

Autoimmune Encephalitis (AIE) in Children: A Q&A with Drs. Catherine Otten and Stephen Wong

Catherine Otten, MD, and Stephen Chee-Yung Wong, MD, lead the Inflammatory Brain Disorders Clinic at Seattle Children’s. With increasing evidence that children with severe problems related to thinking, learning and mental health have inflammatory brain disorders, Seattle Children’s created the clinic in 2021 to bring the latest advances in this fast-growing field to children in our region. The most common condition Drs. Otten and Wong see in patients is autoimmune encephalitis (AIE).

Q: Can you give us a quick reminder of what AIE is?

Autoimmune encephalitis is an inflammatory brain disease associated with antibodies that bind to cells in the brain. It is a type of noninfectious encephalitis. Patients can experience a wide range of neurologic and psychiatric symptoms, including seizures, abnormal movements, behavior changes, psychosis, autonomic dysfunction, cognitive symptoms, or altered level of consciousness. Different types of AIE can affect children and adults at different rates and with different symptoms. Often, patients may present with acutely to subacutely altered mental status, behavioral changes and seizures. Clinicians may be considering different types of encephalitis, including infectious and autoimmune encephalitis, in their differential diagnosis. Symptoms can progress, and a good portion will need critical care, and nearly all will be hospitalized acutely for treatment and management. Long-term, children typically continue to need treatment to manage relapses, refractory disease or sequelae from their AIE.

Q: How common is autoimmune encephalitis?

It is likely more common than we recognize! For instance, the California Encephalitis Project tracked the causes of encephalitis, and autoimmune causes of encephalitis were more common than any infectious agent. The most common type is anti-N-methyl-D-aspartate receptor encephalitis, or NMDARE, which affects women and children in higher proportion. AIE is not expected in very young infants under 6 months of age, but affects all ages otherwise. Read full post »

Unique Education Program for New Diabetes Patients Is Helping Some Families Avoid the ED and/or Inpatient Stays

At most children’s hospitals, a multiday inpatient education process is the standard of care for children and teens presenting with the new onset of type 1 diabetes. Seattle Children’s Kate Ness, MD, MSCI, and members of the Endocrinology and Diabetes team believed there was a better solution. In late 2019, shortly before the arrival of the COVID-19 pandemic, they opened the Outpatient New Onset Diabetes Program. The results have been dramatic.

Kate Ness, MD, MSCI, Seattle Children’s Endocrinology and Diabetes team

Dr. Ness witnessed the positive effects of outpatient diabetes education during her fellowship training at Vanderbilt University Medical Center. When she arrived at Seattle Children’s in 2009, “it came as a surprise to me to see that we were keeping kids in the hospital for three days, primarily for educational purposes. We know that not all of our patients medically need an inpatient hospital bed, and there is literature that supports outpatient education being as safe and effective as inpatient education.”

Being diagnosed with diabetes is a life-changing event for children and families, and the sheer volume of new information — counting carbohydrates, calculating insulin doses, persuading a child to have their finger poked and to get an injection — to say nothing of the emotional rollercoaster, can be overwhelming.

When Joy Briggs, RN, MBA, MSN, was offered the opportunity to become the practice manager for the New Onset Outpatient Diabetes program in 2018, she jumped at the chance to make a difference for children like her son. Read full post »

Improving Urologic Outcomes for Newborns and Young Children With Spina Bifida

From the On the Pulse blog of Seattle Children’s, by Ashley Speller

Researchers at the Centers for Disease Control and Prevention (CDC) have teamed up with clinicians at Seattle Children’s to identify and evaluate the best urologic management for newborns and young children with spina bifida in a nationwide study called Urologic Management to Preserve Initial REnal function (UMPIRE).

Launched in 2014, the multisite, multiyear UMPIRE program aims to increase the understanding of kidney, bladder health and function, which are closely linked, in the early years. It also brings together a unique collaboration of doctors and nurses from more than 20 clinics across the country, including Seattle Children’s Urology Program, which has been ranked among the top 10 pediatric urology programs in the United States for the past three years by U.S. News & World Report. Read full post »

Synagis Season Is Underway

Seattle Children’s began palivizumab (Synagis) administration in mid-October due to increasing respiratory syncytial virus (RSV) rates.  Our providers will identify and refer their eligible patients. We ask that community providers with patients who need Synagis provide it directly rather than referring patients to Seattle Children’s due to capacity constraints at the hospital.

The American Academy of Pediatrics (AAP) continues to recommend five monthly doses for eligible patients while recognizing the need for monitoring and flexibility in what might be an atypical season. See the AAP recommendations.

Seattle Children’s Is Providing Influenza Vaccinations to Patients

Seattle Children’s is providing influenza vaccinations to inpatients and outpatients. Patients will be screened for eligibility. Seattle Children’s is also offering influenza vaccination to Emergency Department and Urgent Care patients. All vaccinations given to patients are documented in the Child Profile Immunization Registry.

We are providing flu shot vouchers to patients’ family members and household contacts age 3 and older during patient visits and stays.

    • Families in Washington or Idaho: The vouchers can be used at Rite Aid or Bartell Drugs (owned by Rite Aid) with no out-of-pocket cost. Rite Aid or Bartell Drugs will bill family members’ insurance, if available, and charge any remaining balance to Seattle Children’s. Families can also download the voucher from seattlechildrens.org.
    • Families in Alaska or Montana: The vouchers can be used at CVS in Alaska and Montana only with no out-of-pocket cost. CVS will bill family members’ insurance, if available, and charge any remaining balance to Seattle Children’s. Families can also download the voucher from seattlechildrens.org.

Family members and household contacts ages 6 months to 35 months will need to get their flu vaccine at their primary care provider’s office.

Seattle Children’s efforts to vaccinate patients are in accordance with recommendations from the Centers for Disease Control and Prevention to increase access to the vaccine in healthcare settings.

For questions about flu vaccinations at Seattle Children’s, email infectious diseases specialist Dr. Matthew Kronman at Matthew.kronman@seattlechildrens.org.

COVID-19 Bivalent Boosters For Kids Ages 5 and Up Are Available at Seattle Children’s

Seattle Children’s is now offering the Pfizer-BioNTech mRNA COVID-19 bivalent vaccine to individuals 5 years and older. We have the Moderna mRNA COVID-19 bivalent vaccine for individuals 12 years and older. Appointments are required and can be scheduled on our COVID-19 vaccine page.

Individuals are eligible to receive a bivalent booster if it has been at least two months since they have completed their primary vaccination series or have received the most recent booster dose with any authorized or approved monovalent COVID-19 vaccine.

The current monovalent vaccines are no longer authorized for use as boosters in individuals 5 years and older. Children ages 6 months to 4 years remain eligible for the primary, monovalent COVID-19 vaccine series from both Pfizer-BioNTech and Moderna and are not currently authorized for any COVID-19 booster doses.

For more information, please visit our website or email COVIDVaccine@seattlechildrens.org.

Algorithms and Other Resources for PCPs From Our Specialists

Seattle Children’s specialists have worked with PCPs to create over 60 algorithms and other resources for PCPs to support your care of your patients. You can find them on our website listed A to Z here. They are an important part of Seattle Children’s commitment to helping children remain in the primary care setting when appropriate and improving timely access to specialty care.

Please consider bookmarking the algorithms page and/or posting at your workplace the Algorithms and Other Clinical Resources flyer that includes a QR code to help health care providers easily access the site.

We welcome your questions or suggestions that will help improve our PCP resources. You can contact us at Physician.relations@seattlechildrens.org.

Help With Referrals: Find Out Which Providers and Specialty Services are Available at Our Outpatient Clinics Around Washington

Seattle Children’s brings care closer to home with appointments at our multi-disciplinary outpatient clinics throughout Washington. Details of the specialty services we offer, along with the names of providers and their schedules at each clinic, are found in the site-specific flyers below. Many referring providers have told us they find it helpful to print and post these at work for easy staff reference.

As a reminder, Urgent Care is available on-site at our clinics in Everett, Federal Way and Bellevue seven days a week including holidays.

CMEs, Grand Rounds and Other Events

CMEs and Other Events

  • Integrated Behavioral Health and Brief “FAST” Interventions in Pediatric Care (Anxiety, Behavior, Depression, Parenting Teens, Safety and Trauma). November 3, 2022, 6 to 7:15 p.m. via Webex. Category 2 CME. Nat Jungbluth, PhD, co-director of FAST Programs, PAL; Sophie King, Program Manager, Seattle Children’s Care Network. Learn more. RSVP to Physician.relations@seattlechildrens.org.
  • 8th Annual Vascular Anomalies Retreat. Wednesday, November 9, 2022, from 4 to 7 p.m. via Webex. Topics will include evaluation and treatment of vascular anomalies (targeted therapies and surgery) and cell-free DNA testing for vascular anomalies in the clinical arena. For more information or to RSVP, contact Vanessa Masco at Vanessa.masco@seattlechildrens.org.
  • Reflections on Trust in Medicine. November 30, 2022, 7 to 8 a.m. Join WCAAP and Dr. Douglas Diekema for a discussion about the importance of trust in medicine, the recent decline in trust in society and pediatric patient encounters, the role of trust in vaccine acceptance and vaccine hesitancy, three current approaches to vaccine hesitancy (and why two of those undermine trust) and identifying the elements of a way forward. Learn more. Register.

Quality Improvement Project 

  • Quality Improvement Project: Congenital Heart Disease. November 2022 to August 2023. This project aims to increase the integration between primary care and specialty pediatricians to improve cardiac and non-cardiac health outcomes for children (0-18 years) with CHD. Applications from primary care practices are due November 7, 2022. Apply using the online form at https://tinyurl.com/us72fcya.  Questions? Contact Nataliya Shtym at nshtym@aap.org.

 

Provider Grand Rounds

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

  • November 3, 2022: Making Pain Matter: Prioritizing Prevention and Treatment of Pain in Children and Adolescents. Tarcea Pain Medicine Lecture. Tony Palermo, PhD, Professor, Anesthesiology and Pain Medicine, UW; Adjunct Appointments in Pediatrics and Psychiatry; Hughes M. and Katherine Blake Endowed Professorship in Health Psychology; Associate Director, Center for Child Health, Behavior and Development, Seattle Children’s Research Institute.
  • November 10, 2022: Pigmented Neurodevelopmental Disorders: Giant Congenital Nevi and Neurocutaneous Melanocytosis. Ron Lemire Embryology Lecture. Miguel Reyes-Mugica, MD, Marjory K. Harmer Chair in Pediatric Pathology; Chief of Pathology and Head of Laboratories, UPMC Children’s Hospital of Pittsburgh; Professor, Pathology, University of Pittsburgh School of Medicine.
  • November 17, 2022: Surgical Tone Management for the Treatment of Dystonia and Spasticity in the Pediatric Cerebral Palsy Population. Samuel Browd, MD, PhD, Director, Seattle Children’s Hydrocephalus Program, Medical Director of Seattle Children’s Sports Concussion Program, Director, Sports Institute at UW Medicine.
  • November 24, 2022: No Grand Rounds (Thanksgiving)

 

Nursing Grand Rounds

First Thursday of every month from 1 to 2 p.m. Learn more.

  • November 3, 2022: Integration of Equity & Anti-Racism Into Pediatric Palliative Care. Arika Patneaude, MSW, LICSW, APHSW-C, and Jennifer Kett, MD. See the flyer.

 

Psychiatry Grand Rounds

First Friday of every month October through June from 8 to 9:20 a.m.  Learn more.

  • November 4, 2022: How Neuroscience Education Has Been Enhanced by the National Neuroscience Curriculum Initiative (NNCI), Including How NNCI Has Informed the National Anti-Racism in Medicine Curriculum Coalition (NAMCC). Ashley Walker, MD, Psychiatry Residency Training Director, Associate Professor, Department of Psychiatry, University of Oklahoma, Tulsa.