Seattle Children's Provider News

Medical Staff

Lauren Nicole Carlozzi, MD, Cardiology

Mustafa Chopan, MD, Plastic Surgery

Erin Chung, MD, Infectious Disease

Isabella Helene Dahlgren, MD, Pediatrics

Natalie Ann Derise, MD, Otolaryngology

Kelsey Bishop Eitel, MD, Endocrinology

Alexander David Gauger, MD, Radiology

Julia Hadley, MD, Hospital Medicine

Matthew Hastings, MD, Neurology

Rachel Hollingsworth Jonas, MD, Otolaryngology

Yamini Satish Kapileshwarkar, MD, Neurology

Kristine Karvonen, MD, Hematology-Oncology

Camille Keenan, MD, Hematology-Oncology

Danielle Crawford Kirkey, MD, Hematology-Oncology

George Edward Koch, MD, Urology

Andrew Daniel Linkugel, MD, Plastic Surgery

Alison Lowen, MD, Community Pediatrics

Brandon Mauset, MD, Infectious Disease

Chinenyenwa Mpamaugo, MD, Community Pediatrics

David Hamilton Noyd, MD, Hematology-Oncology

Murat Alp Oztek, MD, Radiology

Sruti Pisharody, MD, Pediatrics

William Scott Porter, MD, Pediatrics

Todd Raleigh, MD, Neurology

Jeannette Yu Stallworth, MD, Ophthalmology

Kathryn Virk, MD, Cardiology

William Walker, Jr. MD, Developmental Medicine

Allied Health Professionals

Christine Elizabeth Batten, PA-C, Gastroenterology and Hepatology

Marybelle Camacho, LICSW, Psychology

Terrance Chambers, LMHC, Psychology

Amanda Dorr, ARNP

Jason Christopher Field, BCBA, Psychology

Kendra Mae Graham, PA-C, Community Pediatrics

Eileen Venable Magill, ARNP, Community Pediatrics

Jessica Mooney, ARNP, Cardiology

Sandra Linda Rodgin, PsyD, Psychology

Wendy Skarra, LMFT, Community Pediatrics

Romario Solano, LMHC

Sara Elizabeth Taylor, PhD, Psychology

Trista Pauline Trumbo, LMHC, Psychology

Xiahan Zhang, BCBA, Psychology

Since our last update in early June, the Emergency Department (ED) is still over 100% capacity many evenings but has seen some decrease in wait times.  We continue to see many patients presenting for mental health assessment and are still requiring a significant number of those patients to wait more than 24 hours for the next step in care, which may be an inpatient bed in our Psychiatry and Behavioral Medicine Unit (PBMU), a transfer to an outside facility or a safe discharge plan.  As always, please do not hesitate to send patients to the ED when you have emergent concerns.

Overall inpatient census has improved.

We continue to monitor the situation and employ our internal Emergency Operations Center to ensure systemwide coordination to address capacity constraints.

How you can help:

• Please continue to identify and manage lower-acuity complaints in outpatient settings to help maintain our limited capacity in the ED for higher-acuity concerns.
• Before sending your patient to the ED, contact our Mission Control team with as much notice as possible at 206-987-8899. Your early call allows the necessary time to plan for your patient’s arrival, and, in appropriate instances, we may be able to directly admit your patient to the hospital or arrange an urgent ambulatory clinic visit in lieu of an ED visit.

As a reminder: Patients experiencing an emergency should come to the ED (or go to their local ED) without hesitation.

Resources that may help you manage patients in primary or urgent care instead of sending to the ED: Read full post »

Samuel Browd, MD, PhD, is a neurosurgeon and surgical director of the Tone Management Program at Seattle Children’s. He is a world leader in training surgeons in selective dorsal rhizotomy (SDR) procedures. Roughly 1 in 4 surgeons in the United States who offer SDR trained under Dr. Browd, in addition to many doctors from around the world.

Q: Who is SDR for?

Dr. Browd: Any child with high tone (spasticity) in their lower extremities is a possible candidate for SDR [selective dorsal rhizotomy] surgery.  This includes many children with cerebral palsy. Providers and parents often think of surgery as a last resort, but in the case of kids with high tone, we encourage them to think of it as an early option instead. Even if their spasticity is being reasonably well-managed by medication and/or therapies, SDR can help them reduce or even get off their medication. With better physical functioning and mobility, we see kids do better with their social, family and school life too — because they’re putting less physical and mental energy into controlling their body and more time into doing things that are fun for them. Longer-term, kids are less likely to require more surgeries or experience some of the serious health consequences of having high tone.

Ages 3 to 5 is when we like to see kids get evaluated for SDR because their neuroplasticity is so high at that age, but we also consider the surgery for older children.

Read full post »

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.

Seattle Children’s wants primary care providers in Eastern Washington to know about a new program called Supporting Adolescents and Families Experiencing Suicidality (SAFES). SAFES provides rapid psychotherapy interventions to 12- to 18 year-olds in underserved areas of Washington state who are experiencing a suicidality crisis that does not require an Emergency Department (ED) visit. The program is based on the Crisis Care Clinic model developed at Seattle Children’s.

Refer a Patient: A patient’s PCP can call to speak with a child psychiatrist at the Partnership Access Line (PAL) at 866-599-7257. See SAFES flyer.

Patient Eligibility Criteria:

• Must live in a Washington state eligible county (Adams, Chelan, Douglas, Ferry, Grant, Lincoln, Okanogan, Pen Oreille, Spokane, Stevens)
• Age 12 to 18
• Patient’s primary care provider has active concerns for suicidality, but child is not severe enough to need an ED visit
• Child should not be engaged in other mental health services unless the current therapist/provider cannot safely handle the child in the community

Please note there are currently no insurance restrictions.

SAFES is funded through a grant from the Health Resources and Services Administration administered by Washington State Department of Health.

For more information please email: [email protected].

Dr. Bhawna Arya

Dear Colleagues:

I wanted to share with you the hot-off-the-presses updated guidelines entitled “Guidelines and Recommendations for Performance of the Fetal Echocardiogram: An Update from the American Society of Echocardiography” published in the Journal of the American Society of Echocardiography last month. The co-authors are experts in the field, and our own fetal cardiologist Dr. Nelangi Pinto is one of the co-authors.

This new document replaces the 2004 guidelines and is focused on referral indications for fetal echocardiogram and has been updated from the previous American Heart Association (AHA) guidelines from 2014.

There are several important changes to share and a summary created by our Seattle Children’s Fetal Cardiology team is included here along with the original guidelines paper. The highlights are that a fetal echocardiogram is no longer indicated (based on low risk <3%) if the cardiac views are visualized and normal on obstetric anatomy scan and the following are present in isolation:

1. In vitro fertilization
2. Nuchal translucency (NT) less than 3.0 (between 3.0 and 3.5 MAY consider fetal echo)
3. Maternal lithium or anticonvulsant exposure
4. Obesity (BMI >30)
5. Single umbilical artery (two-vessel cord)

Of course, if any concerns are raised by your team or the patient for any reason from a fetal cardiac perspective, the Seattle Children’s Fetal Cardiology team throughout the WAMI region (Washington, Alaska, Montana Idaho) is always more than happy to perform a fetal echo and consult with the patient. Our goal is to provide the best fetal cardiology diagnosis, care and counseling to families and make sure that as providers, your team has all of your questions regarding the fetal heart answered, no matter what the indication.

I am attaching the new guidelines paper (Table 1 includes all of the indications for fetal echo) as well as our Seattle Children’s concise summary of indications. Please reach out with any questions or concerns.

Bhawna Arya, MD

Associate Professor | Department of Pediatrics

Director | Prenatal Diagnosis Program

Director | Fetal Cardiology

Director | Advanced Imaging Fellowship | Division of Pediatric Cardiology

University of Washington School of Medicine

Seattle Children’s Hospital, Heart Center and Fetal Care and Treatment Center

206-987-3934  OFFICE

206-987-3839  FAX

[email protected]

Fetal Care and Treatment Center

Phone: 206-987-5629

Email: [email protected]

Website

Refer a patient

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.