Seattle Children's Provider News

Medical Staff

Richard George Cuddihy, MD, Community Pediatric

Whitney, Margeret Eng, MD, Hematology Oncology

Elyse Marie Keane, MD, Pediatrics

Yong Kyong Kwon, MD, Transplant Surgery

Mark Evan Landau, MD, Neurology

Jr, Robert Emmett Minahan, MD, Neurology

Venkatesh Narayan, Nagaraddi, MD, Neurology

Ohlsen, Timothy James Daeeun, MD, Hematology – Oncology

Isha Kirti Patel, OD, Ophthalmology

Weston Thomas Powell, MD, Pulmonary and Sleep Medicine

Desiree Ann Yeboah, MD, Hospital Medicine

Allied Health Professionals

Keedra Giraldi, ARNP, Community Pediatrics

Karielle Burgman Jewell, PA-C, Orthopedics

Justin Thomas Marzean, PA-C, Cardiac Surgery

Jennifer Jean Perfect, ARNP, Pediatrics

Miriam Paula, Rubenson, PhD, Psychology

Paul Nicolai Carranza Songco, ARNP, Emergency

Taylor Jolie Wasserman, PA-C, Neurology

Anna Weissman, ARNP, Pediatrics

From: Dr. Jeff Ojemann, SVP and Chief Medical Officer, Dr. Ruth McDonald, VP and Associate Chief Medical Officer (Hospital Operations) and Dr. Tony Woodward, ED Medical Director

The ongoing youth mental health crisis is contributing to high patient volumes, high patient acuity and significant boarding in our Emergency Department (ED).

1. Patients experiencing an emergency should come to the ED without hesitation.
2. We have re-activated an Emergency Operations Center to ensure systemwide coordination as our leaders and teams address extreme capacity constraints in the ED with multiple, simultaneous approaches.
3. The Psychiatry and Behavioral Medicine Unit (PBMU) currently has limited capacity due to ongoing facility improvements for patient safety. Patients who require a psychiatric inpatient admission will be referred to all appropriate inpatient pediatric psychiatric facilities in Washington State. 
4. 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.
5. When sending your patient to the ED, please contact our Mission Control team at 206-987-8899 and alert families to potentially expect longer-than-normal wait times.

For More Information:  Resources that may help providers manage patients in primary or urgent care instead of sending to the ED:

1. Emergency or Urgent Care Referral Guide
2. For urgent medical care not related to mental and behavioral health, remind families to schedule an in-person or virtual Urgent Care appointment as early as possible to help them get timely access. They can use the UC online scheduling system or call the hospital’s main number at 206-987-2000.
3. Algorithms and other PCP resources for 65+ conditions
4. The Partnership Access Line (PAL) supports primary care providers (doctors, nurse practitioners and physician assistants) with questions about mental health care such as diagnostic clarification, medication adjustment or treatment planning. Our child and adolescent psychiatrists are available to consult during business hours.
5. The Washington Mental Health Referral Service connects patients and families with evidence-supported outpatient mental health services in their community. This free, telephone-based referral service provides thorough mental health referrals for children and teens 17 and younger from across Washington.
6. First Approach Skills Training (FAST) programs are designed to provide brief, evidence-based behavioral therapy for youth and families with common mental health concerns, in settings such as primary care clinics or schools where longer-term treatment is not typically provided. Program materials, as well as engagement and assessment tools for Mental Health Clinicians are available on the FAST Website.
7. Seattle Children’s online mental health hub: provides resources for families and caregivers to reference for their child’s mental health and wellness. You can learn about common mental health problems in children and teens, how to recognize the signs of a problem and crisis, and learn how to help your child or teen as well as what services are available.
8. Family Resource Center – Child Mind Institute: provides information families and caregivers to help support children who are struggling with mental health, behavior or learning challenges.
9. Strategies for Clinical Settings for Youth Suicide Prevention (aap.org): provides a clinical pathway for addressing suicide prevention in pediatric practice.
10. Mental Health Practice Tools and Resources (aap.org): provides resources to help providers promote healthy mental development and address mental health concerns.

From: Dr. Jeff Ojemann, SVP and Chief Medical Officer, Dr. Ruth McDonald, VP and Associate Chief Medical Officer (Hospital Operations) and Dr. Tony Woodward, ED Medical Director

Measles infection

We want to let you know that a pediatric patient who has tested positive for measles is receiving treatment at Seattle Children’s. The hospital was made aware before the patient arrived. Upon the patient’s arrival on Thursday, May 18, staff and faculty members immediately implemented appropriate infection control procedures, which included isolating the patient and reporting the case to public health authorities. No workforce members or other patient families at Seattle Children’s were exposed.

Seattle and King County public health officials are looking into the source and any potential spread of the measles case. You can find further details in a Seattle Times article here.

Reminders for healthcare providers:

• Isolation is the key to preventing transmission of measles infection. If a patient or family has a fever and rash, isolate them right away using appropriate personal protective equipment.
• Remind any patients and families with a fever or rash to NOT show up unannounced at their local healthcare provider or Seattle Children’s. If sending a patient to Seattle Children’s with measles symptoms please be sure to coordinate with our Mission Control Center in advance at 206-987-8899.

Emergency Department Continues to Experience Extremely High Volumes

Seattle Children’s Emergency Department (ED) is operating under extreme constraints with high acuity patient demand and significant boarding. Our leadership and teams are addressing these constraints with multiple, simultaneous approaches.

To help ensure we are able to provide timely, safe care to patients in the ED:

• We ask for your continued support in managing patients in primary care whenever possible and appropriate. This will help the hospital maintain the capacity to care for the sickest patients.
• When sending families to the ED, please call our Mission Control team first (206-987-8899) to help us 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.

We want to recognize the extraordinary efforts of our provider colleagues in supporting ED care over the last several years, and thank you for your continued partnership.

High volumes hospital-wide including the Emergency Department and PBMU

We are experiencing persistently high demand for medical and surgical services, with acute care beds 90% full if not higher.

The Emergency Department (ED) continues to see record high demand in the setting of a significant increase in mental health boarding. Given the resultant ED physical bed capacity constraints, patients will likely experience longer wait times. The ED remains available for all emergent patients and will continue to prioritize the sickest patients. If patients are non-emergent, please use non-ED alternatives for care whenever possible. When sending patients to the ED, please call ahead to our Mission Control center to alert us. Calling is essential to helping the ED anticipate needs. Please thank families for their patience as we balance all the needs of the community at this time.

Capacity in the Psychiatry and Behavioral Medicine Unit (PBMU) continues to be constrained, with limited ability to accept referrals from other hospitals, due to ongoing facility improvements in the PBMU that are intended to open up more capacity over the long-term for these services.

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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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Seattle Children’s Gender Clinic team is working to broaden our referral network of primary care providers (PCPs) who have experience working with transgender and gender-diverse young people and their families. This will help us with the important task of connecting gender-diverse youth in our region with affirming PCPs close to home.

Are you a PCP who works to create a welcoming clinic environment for gender-diverse youth? If so, please fill out this brief form.

You are also welcome to forward this email to primary care colleagues who might like to add themselves to our referral list. PCPs do not need to be currently prescribing gender-affirming hormones or puberty blockers in order to fill out this form.

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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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We are excited to announce that Seattle Children’s new Behavior and Attention Management Program is offering a wide range of integrated services for youth ages 5 to 15* with disruptive behavior or attention problems.

The Behavior and Attention Management Program follows a stepped care model built around group-based parent behavior management training (children are required to participate only in limited instances). Research shows that providing training and support for caregivers on healthy, safe and effective behavior management strategies is the best therapeutic approach to help youth struggling with behavior or attention.

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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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