Seattle Children's Provider News

Unprecedented ED Patient Volumes and Inpatient Census

• Seattle Children’s Emergency Department is open and ready to care for all children needing emergency care. Do not hesitate to direct patients to the ED if they need immediate medical attention.
• We continue to see very high levels of inpatient census and ED visits in the wake of unprecedented mid-September volumes, driven primarily by non-COVID-19 respiratory and gastrointestinal illnesses.
• We continue to run under a disaster incident command structure and contingency status for staffing and space.
• We ask that providers continue to manage patients in primary care whenever possible and appropriate.
• When sending families to the ED, please call our Communications Center first (206-987-8899) to help us with staffing and space planning.
• Please advise families to expect longer-than-typical wait times at our ED and that we are triaging to see the sickest patients first.

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Effective September 1, 2022, Seattle Children’s Urgent Care clinics can refer to Seattle Children’s specialists directly. Referrals may be placed without consulting with the specialist team. Urgent Care providers may still send patients back to a PCP for a referral at their discretion. PCPs will be notified when their patient is referred to a specialist through our standard after-visit summary.

We made this change to help improve patient access, decrease work for PCPs, prevent unnecessary emergency department visits and eliminate delayed care.

If you have questions, please contact Alicha.brown@seattlechildrens.org or Tia.rooney@seattlechildrens.org.

The Eating Disorders program will no longer require an EKG or patient labs with referral. We made this change to reduce work for our PCP colleagues and help patients be seen sooner.

Referrals should still contain:

• Growth charts
• A physical exam with vital signs completed at the PCP office within the past 14 days. Physical exam should include HEENT, neck, CV, lungs, abdomen and extremities (e.g., +/– LE edema, capillary refill). Vital signs must include height, weight, heart rate and blood pressure.

All patients referred for eating disorders will be offered a one-time telehealth visit. The current wait time is 4 to 6 weeks. Following the telehealth visit, we will provide the patient with appropriate support and resources to continue their care outside Seattle Children’s. We will share this after-visit information with the referring provider to help guide their continuing care of their patient.

Please visit our Eating Disorders – Refer a Patient page for more details about our referral requirements and resources for PCPs to support their patients with eating disorders.

Seattle Children’s has opened eight new operating rooms (ORs) and two cath labs on two floors in our new building, Forest B. The addition of these new ORs marks a major expansion of our surgical capacity to meet the needs of our growing community.

Dedicated purposes

Two new ORs have adjacent cath labs and are dedicated to cardiovascular surgeries. Two more ORs are dedicated to neurosurgery cases, one OR is for complex general surgery, one is for orthopedic/spine cases and the remaining two ORs will handle other types of surgeries and urgent cases. One OR has an adjacent simulation room for training purposes.

Safety and air quality

To ensure a safe environment, the air supply for the ORs and cath labs is filtered through HEPA (99.97%) filters twice, once at the air handling unit prior to the air entering the duct system and a second time in the ceiling of each room just before the air enters the space.  Washington state code calls for one level of MERV 14 (90 to 95%) filtration in operating room environments either at the air handling unit or at the room. Read full post »

From Seattle Children’s On the Pulse

From an early age, Seth Maharry has been an active kid. He started playing soccer at age 4, joined Little League at 5 and by the time he was 9, Seth earned a spot on a club team in Gig Harbor, Washington, where he played soccer year-round. During a tournament in Portland, Oregon, Seth started to complain about the pain in his hip.

“We figured he’d just been playing soccer all weekend,” said his mom Nora. “We saw the physical therapist and they said everything was fine, but it continued to get worse and worse.”

Seth’s parents decided to take Seth to the doctor but were told it was just growing pains, though it was clear to Nora that this was something far more serious.

“That was our battle for a year and a half,” Nora explained. “My heart just ached because I knew what we were being told was not right.”

When the family’s insurance changed, Seth’s parents decided to make an appointment at Seattle Children’s South Clinic in Federal Way.

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Please refer your patient to the Gender Clinic only if they are interested in gender-affirming medical care (puberty blockers, testosterone or estradiol). We see patients ages 9 through 16. The wait time for new patients is currently about six months.

• If your patient is not interested in medical care or is outside these ages, please direct them instead to the community resources on our website. If they still have questions, they are welcome to contact our care navigators at 206-987-5768.
• For patients who are interested in gender-affirming surgery only, please refer them directly to the Surgical Gender Affirmation Program for a consultation.
• For patients with Kaiser insurance, we encourage them to seek care through Kaiser’s Transgender Service Program which offers services similar to ours.

Additional resources:

• Gender Clinic referral algorithm
• E-consult: A free service for nonurgent questions about your transgender or gender-diverse patient (response within three business days)
• Gender Clinic Refer a Patient page

Next offered Oct. 19:

• Seattle Children’s class, “Finding Mental Health Care in Washington State: A Class on Where to Start,” will be offered again on Oct. 19, 2022 (English only in October; classes in Spanish are being added).
• No referral is needed. Parents and caregivers can register on the class website.
• The class is free.
• It will be offered virtually on Zoom and includes a question-and-answer session.
• Families who cannot attend the live class have the option of watching a recording, found on the class website.

For More Information: Please direct interested families to the class website in English or the class website in Spanish.

CMEs

• Integrated Behavioral Health and Brief “FAST” Interventions in Pediatric Care (for Anxiety, Behavior, Depression, Parenting Teens, Safety and Trauma). November 3, 2022, 6 to 7:15 p.m. via Webex. Category 2 CME. Speakers: Nat Jungbluth, PhD, co-director of FAST Programs, PAL; Sophie King, Program Manager, SCH Clinically Integrated Network. Learn more. RSVP to physician.relations@seattlechildrens.org. Learn more. 

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Medical Staff

Aaron Bogart, DO, Radiology

Ivana Brajkovic, MD, Neonatology

Mohini Dasari, MD, Surgery

Marco Garcia, MD, Pediatrics

Jennifer Hayek, MD, Genetic Medicine

Cole Murphy-Hockett, MD, Emergency-Urgent Care

Nya Nelson, MD, Pathology

Rebecca Ronsley, MD, Hematology-Oncology

Courtni Salinas, MD, Anesthesia

Emily Shelkowitz, MD, Genetic Medicine

Krista Sirois, MD, Medicine

Katie Strobel, MD, Neonatology

Samuel Wittekind, MD, Cardiology

Allied Health Professionals

Emily Angell, PAC, Hematology-Oncology

Alysse Craft, ARNP, Psychiatry

Grace Gasior, ARNP, Developmental Medicine

Haley Klein, PAC, Neonatology

Danielle Kraft, ARNP, Surgery

Melida Kratzig, ARNP, Surgery

Dayanara Ciara Manansala, ARNP, Pediatrics

Emily Storesund, PAC, Surgery

From: Dr. Elaine Albert, Medical Director of Inpatient Access and Andrew Mullenix, Director of Patient Flow and Inpatient Access

• Seattle Children’s Emergency Department (ED) has had a sustained census above 250% for multiple evenings this week.
• Inpatient acute care census has been greater than 100% for several days.
• Air quality is currently unhealthy for susceptible groups; we are seeing a significant increase in patients with respiratory distress.

• We continue to run under a disaster incident command structure and contingency status for staffing and space.
• It is imperative that providers manage patients in primary care whenever possible and appropriate. If sending patients to the ED, please always call our Communications Center first (206-987-8899).
• Please advise families to expect longer than typical wait times at our ED and that we are triaging patients to see the sickest patients first.

For more information:

• See our Emergency or Urgent Care Referral Guide.
• For patient care algorithms and other PCP resources, visit seattlechildrens.org/algorithms.