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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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Our new Access Dashboard – July 2023 tool makes Seattle Children’s wait times more visible to community providers.  It has two pages. Page 1 lists wait times by specialty. Page 2 lists conditions or symptoms considered urgent for scheduling purposes.

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

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

Wait times are currently long in many Seattle Children’s specialty clinics. Many improvements are underway to optimize our scheduling processes and enable Seattle Children’s specialists to see more patients, in a more timely manner, while offering a better scheduling and pre-visit experience for families.  We look forward to telling you more about that later this summer.

PCP algorithms and other clinical care resources 

Seattle Children’s has been working for the last several years to develop a robust toolbox of algorithms and other clinical care resources to help primary care providers (PCPs) manage patients in primary care and know when it is the right time to refer to a specialist. Read full post »

Specialists in our Cancer and Blood Disorders Center have created a new evidence-based algorithm to help PCPs evaluate lymphadenopathy in children and teens, manage pediatric patients effectively, and know when to refer to pediatric oncology.

View the lymphadenopathy algorithm.

Lymphadenopathy is extremely common in pediatrics with the vast majority of cases being benign or related to an infectious etiology. This algorithm will help ensure patients who are at high risk for malignancy are referred to oncology and will help provide guidance for management of patients who are likely to have a benign etiology of lymphadenopathy.

Find other algorithms and other clinical care resources for PCPs on the Seattle Children’s website at seattlechildrens.org/algorithms.

Infectious disease experts from the Pediatric Pandemic Network (PPN) – a group that includes Seattle Children’s and other children’s hospitals – have created a provider focused FAQ to help mitigate the risk and spread of malaria in pediatric patients and pregnant women.

The CDC recently issued a malaria health advisory after four individuals in Florida and one in Texas contracted the disease from mosquitos this spring – the first time in 20 years that locally acquired mosquito-borne malaria has appeared in the United States.

CDC is encouraging providers to consider a malaria diagnosis in any individual with fever of unknown origin regardless of their travel history.

“Malaria is a medical emergency and should be treated accordingly,” the CDC said. “Patients suspected of having malaria should be urgently evaluated in a facility that is able to provide rapid diagnosis and treatment, within 24 hours of presentation.”

The CDC says there is no evidence that the case in Texas is related to the four cases in Florida, and that the risk of locally acquired malaria remains extremely low in the United States. Active surveillance is continuing.

It’s easier than ever to find health education materials on our website. Seattle Children’s new Patient and Family Education webpage links you to hundreds of handouts and other resources designed for families that cover a range of topics. Many are offered in multiple languages. We hope our community provider colleagues will find it helpful to have this information compiled in one place and easily searchable.

You can search for a specific condition or topic, ­­or click on any clinic name — from Airway and Esophageal to Vascular Anomalies — to access a full list of resources.

We’re honored to share that U.S. News & World Report (USNWR) has again named Seattle Children’s among the best children’s hospitals in the nation for 2023–2024. USNWR has recognized Seattle Children’s as a top children’s hospital every year since it began ranking medical facilities more than 30 years ago.

Seattle Children’s is the top pediatric hospital in Washington and the Pacific Northwest and ranked third by USNWR in the Pacific region, which includes Washington, Oregon, California, Alaska and Hawaii.

“It’s an honor to work with such phenomenal teams of providers and staff who are laser focused on providing the highest quality of safe and equitable care for our patients and families,” said Dr. Ruth McDonald, vice president and associate chief medical officer (hospital operations).  “It is through their dedication that Seattle Children’s is again recognized by USNWR as a leader in pediatric health care.”

USNWR ranks the top 50 pediatric hospitals in 10 specialty areas. For more than a decade, Seattle Children’s has been nationally ranked in every area, and for 2023, 4 specialties are in the top 10:

• Urology: #5
• Pulmonology: #7
• Nephrology: #8
• Neurology and Neurosurgery: #9
• Cancer: #13
• Gastroenterology and GI Surgery: #18
• Cardiology and Heart Surgery: #19
• Neonatal Care: #25
• Diabetes and Endocrine Disorders: #20
• Orthopedics: #37

“Our rankings — which we’re thrilled are continuing to rise — reflect the outstanding care we provide for our patients. To be recognized once again this year as a top pediatric hospital is a tribute to the commitment and expertise of our outstanding health care providers and staff,” said Dr. Paul Sharek, vice president, chief quality and safety officer and associate chief medical officer (quality/safety).

The 2023–2024 rankings were created from data collected through a clinical survey sent to nearly 200 hospitals and a peer reputation survey sent to thousands of pediatric doctors nationwide. Although there are many pediatric specialties, USNWR only ranks 10 of them. Eighty-eight of the 199 surveyed hospitals ranked in the top 50 in at least one specialty.

USNWR is the most comprehensive source of quality-related information on pediatric hospitals in the United States. The Best Children’s Hospitals methodology is based on objective measures such as patient outcomes, including mortality and infection rates, as well as available clinical resources, compliance with best practices and commitment to diversity, equity and inclusion. Rankings also factor in each specialty’s reputation, as assessed by thousands of pediatric specialists at peer institutions around the country.

In Part 1 of our Epilepsy Q&A, Dr. Jay Hauptman discussed advances in neurosurgery and the many new options available for children with intractable epilepsy. In Part 2, we hear from Dr. Hauptman and Dr. Ghayda Mirzaa about the genetics of epilepsy and how research is leading to new nonsurgical treatment options.

Dr. Mirzaa is a Seattle Children’s clinical and molecular geneticist at the Center for Integrative Brain Research and Seattle Children’s Epilepsy Program. Dr. Hauptman is a neurosurgeon with Seattle Children’s Epilepsy Program.

Q: What do we know about the role of genetics in epilepsy?

DR. HAUPTMAN: We know genetics contribute significantly to many types of epilepsy. Roughly a third of cases have an underlying genetic cause. We are still learning how and why genetic mutations cause epilepsy in kids.

Q: What is the focus of recent research?

DR. MIRZAA: We’ve made great progress in the last few years, at Seattle Children’s Center for Integrative Brain Research and elsewhere. Our Seattle Children’s team has traced focal cortical dysplasia, which is among the leading causes of intractable epilepsy, to mutations in a family of genes that control important pathways, such as the mammalian target of rapamycin (mTOR) pathway. Now we are exploring if drugs that are known to inhibit this pathway, which are already being used or tested to treat cancer, can be effective for epilepsy too.

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Otolaryngology has experienced a sharp rise in referrals, which has increased wait times for new patients to two to three months. New referral policies will go into effect May 3, 2023, to help ensure those patients who most need specialty care from Otolaryngology have timely access to our specialists. We will reevaluate our capacity and referral policies every three months.

Effective May 3, we will not see patients with the following conditions:

1. Allergic rhinitis
2. Ankyloglossia for children 3 years old and older
   • For concerns about ankyloglossia impacting speech, we recommend submitting a referral to our Childhood Communication Center (CCC) with subspecialty VPD Clinic for a Speech Language Pathology evaluation focused on the impact of oral structure on speech function. Our Speech Language Pathology team will collaborate with Otolaryngology if any concerns are identified that would benefit from our intervention.
3. Chronic cough
4. Globus sensation
5. Hyperacusis
6. Speech delay

• • For concerns about general oral anatomy impacting speech, we recommend submitting a referral to our Childhood Communication Center (CCC) with subspecialty VPD Clinic for a Speech Language Pathology evaluation focused on the impact of oral structure on speech function. Our Speech Language Pathology team will collaborate with Otolaryngology if any concerns are identified that would benefit from our intervention.
  • For concerns about hearing loss impacting speech, we recommend submitting a referral to Audiology for a hearing evaluation.

7. Throat clearing

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Dr. Todd Cooper, Oncology section chief and director of Seattle Children’s Pediatric Leukemia/Lymphoma Program, as well as principal investigator in the Ben Towne Center for Childhood Cancer Research, has been appointed to chair the Children’s Oncology Group (COG) Myeloid Committee, effective May 1.

The COG is the largest consortium of pediatric hospitals providing oncology services in the world. It unites more than 10,000 cancer experts at about 250 hospitals across North America, Australia and New Zealand.

Cooper, who is also a professor of pediatrics at the University of Washington School of Medicine and the Evans Family Endowed Chair in Pediatric Cancer, will be responsible for setting COG’s vision and priorities for clinical/translational research and clinical care for pediatric and young adult malignancies, including acute myeloid leukemia (AML), acute myeloid leukemia of Down syndrome (AML-DS), chronic myelogenous leukemia (CML) and other myeloproliferative neoplasms.

He will work with experts throughout COG institutions to develop and conduct blood cancer clinical trials and protocols, as well as working with other international AML consortia to ensure COG’s clinical/translational priorities are synchronized and complementary. Read full post »

From Seattle Children’s On the Pulse

Senior Medical Director of Seattle Children’s Odessa Brown Children’s Clinic (OBCC), Dr. Shaquita Bell, has been awarded the 2023 Native American Child Health Advocacy Award by the American Academy of Pediatrics (AAP) Committee on Native American Child Health (CONACH).

Dr. Shaquita Bell

The esteemed award is presented each year to an individual who has made significant contributions toward promoting the health and well-being of Native American children and exemplifies a lifelong commitment to Native American children and their communities.

“It is an absolute honor to be given this award,” Dr. Bell shared. “I was nominated by my mentor Dr. Joey Bell, the first Native doctor I ever met. I remember first hearing him speak about his oral health work in the tribal community of Lumbee and hoping that one day, I too could make an impact as big and important as he did. Fast forward almost 20 years, it feels unreal to be receiving this award because of his nomination.”

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