PARTNERSIN PEDIATRICSISSUE 1, 2017

PEDIATRIC SURGERY

TEAM EXPANDSPAGE 4

KEEPING TRAUMA CARE ON TRACKPAGE 6

NEXT-LEVEL VISION FOR NEUROLOGYPAGE 8

Visit us on the web.Direct admit to main campus or Phoenix Children’s at Mercy Gilbert Medical Center.

Physician Assistance Line

H. Stacy Nicholson, MD, MPHPhysician in Chief

Daniel J. Ostlie, MD Surgeon in Chief

Debra J. Stevens, MBADirector, Marketing and Communications

Stacy Dillier Specialist, Marketing and Communications

Lori Moix Senior Graphic Design Specialist

In Partnership with True North Custom:

Debra BransonAccount Manager

Candice St. Jacques Senior Managing Editor

Jordan SagerDesigner

Contributing Writers: Thomas Crocker, Valerie Lauer, Katy Mena-Berkley, Hannah Stuart, Trevor Willingham

Photos byTacC Photography Harley Bonham

DEAR COLLEAGUES,SINCE MOVING TO Arizona from the Midwest to join Phoenix Children’s earlier this year, one of my main objectives has been to ensure the continued growth and development of surgical services and education and research within the surgical divisions for the entire

enterprise. With our top-notch surgical programs ranked by U.S. News & World Report in 2016–17, we will continue to build on the foundation set by these world-renowned programs.

With growth and expansion in health care comes an increased need for sought-after programs and talented providers. As we continue to make great strides in improving the patient experience and achieving exceptional surgical outcomes, Phoenix Children’s has set its sights on adding even more skilled surgeons and programs to bring the latest surgical knowledge and innovation to Phoenix Children’s. Most recently, we have expanded in the areas of pediatric general surgery, congenital heart surgery and plastic surgery. Over the coming months, we will continue to recruit for and build out essential surgical services, including pediatric ophthalmology and otolaryngology.

As we advance our pediatric surgery services through programs and providers, we recognize a need to grow in square footage as well. To improve access for patients and continue to treat the children who need it most, we seek to address operating room expansion at the Phoenix Children’s surgery centers. Also, as we look forward to the opening of our new Emergency Department and American College of Surgeons-verified Level 1 Pediatric Trauma Center, we expect to see an increased need for surgical services to advance Arizona’s pediatric trauma care.

With significant growth and expansion on the horizon, I am proud to be a part of Phoenix Children’s, an organization working to increase access in all areas of the ever-growing and changing health care marketplace. I look forward to working with you and the entire Phoenix Children’s family to provide the very best care to Arizona’s children and their families.

Sincerely,

Daniel J. Ostlie, MDSurgeon in Chief

3 Improved spine care for patients with complex disorders

4 Pediatric surgery team expands

6 Keeping trauma care on track

7 Powerful connections to improve the patient experience

8 Next-level vision for neurology

TABLE OF CONTENTS

2 Partners in Pediatrics

ADVANCED INTERVENTION PUT AINSLEE BACK IN THE SADDLE Waddell resident and rodeo enthusiast Ainslee Flusche, 16, developed an aggressive case of scoliosis at age 12. Despite bracing, the curve in her back reached 59 degrees with twisting that threatened heart and lung damage. Dr. White recommended surgery.

“The first thing I asked was whether I would ever ride again,” Ainslee said. “His reply was, ‘of course!’”

Dr. White performed a spinal fusion on Ainslee in December 2012. Two weeks after surgery, she took herself off pain medications and began visiting her horse twice a day for motivation. Within two months, she was riding again, gradually moving from a walk to a trot. Six months later, she entered her first post-surgery rodeo.

THIS FALL MARKED THE OPENING OF THE COMPREHENSIVE SPINE PROGRAM AT PHOENIX CHILDREN’S. THE PROGRAM COMBINES ARIZONA’S BEST PEDIATRIC ORTHOPEDIC AND NEUROLOGICAL/NEUROSURGICAL CARE TO BENEFIT PATIENTS WITH COMPLEX SPINE AND SPINAL CORD ISSUES.

THE PROGRAM SERVES patients by building upon the current collaborative relationship of neurosurgeons with Barrow Neurological Institute at Phoenix Children’s and orthopedists with the Herbert J. Louis, MD, Center for Pediatric Orthopedics.

COMPLEMENTARY MEDICINE, COLLABORATIVE APPROACHSpinal deformities, spine and spinal cord tumors, spinal lesions, spine trauma, neuromuscular spine conditions, and congenital anomalies can affect both the structure of the spine and the spinal cord, brain stem, and other components of the neurological system.

“Our Comprehensive Spine Program integrates neurological and orthopedic medicine,” said P. David Adelson, MD, director of Barrow Neurological Institute at Phoenix Children’s, chief of Pediatric Neurosurgery and Diane and Bruce Halle Endowed Chair of Pediatric Neurosciences. “Our unified approach means collaborating on evaluations, treatment plans and procedures, and combining research and educational efforts with the aim of improving outcomes at Phoenix Children’s and throughout the region.”

Jamal McClendon, Jr., MD, who completed fellowship training in both orthopedic spine and pediatric neurosurgery, has worked with Greg White, MD, division chief, Center for Pediatric Orthopedics at Phoenix Children’s and co-director of the Comprehensive Spine Program, to develop this multidisciplinary program. The program provides patients and their families access to the full spectrum of pediatric specialty services—experts in imaging, anesthesiology, rehabilitation and other specialties, as well as spine—available in Arizona only at Phoenix Children’s.

“Our program addresses the complex challenges of healing disorders of the pediatric spine,” Dr. White said. “It is our hope this program and method will shape a brighter future for orthopedic and neurologic spine patients.”

To refer one of your patients to the Comprehensive Spine Program at Phoenix Children’s, call (602) 933-3033.

SPINE CARE FOR PATIENTS WITH COMPLEX DISORDERS

IMPROVED

ISSUE 1, 2017 3

ALL ASPECTS OF CARE AT PHOENIX CHILDREN’S HOSPITAL ARE TAILORED TO THE NEEDS OF CHILDREN—A CONSIDERATION ESPECIALLY EVIDENT IN PEDIATRIC SURGERY.

“Our patients range from 2 kilograms in weight up to 18 years of age. The

additions to our team add breadth and depth to our wide-ranging general

pediatric surgery services. From correcting fetal anomalies to treating

ulcerative colitis, we do it all.”

—Daniel J. Ostlie, MD, surgeon in chief and chair of surgery at Phoenix Children’s

PEDIATRIC SURGERY

TEAM EXPANDS

THE GOAL IS for every child who needs a procedure to have access to a pediatric surgeon trained in both the required specialty and the child’s age group. To accomplish that while anticipating the needs of a burgeoning patient population, Phoenix Children’s recently increased the number of pediatric surgeons on its team.

“Most institutions recognize the need for a pediatric specialist when a child presents in a trauma situation, but a more relaxed attitude often emerges when it comes to general surgery,” said Daniel J. Ostlie, MD, surgeon in chief and chair of surgery at Phoenix Children’s. “Our expectation is that the surgical care for the pediatric population from newborn to adulthood should be performed by surgeons with specific pediatric surgical training in an environment that has been created to optimize the highest quality of care and superior outcomes.”

Phoenix Children’s focuses on minimally invasive techniques when appropriate for pediatric general surgery patients. This streamlines care delivery and decreases length of stay—crucial considerations given the challenge of serving a region that includes metropolitan Phoenix and reaches north into Nevada.

Additionally, the overall patient experience is critical, and Phoenix Children’s has gone to great lengths to implement measures to ensure the highest standards of pediatric health care delivery.

A NATURAL NEXT STEPThree pediatric surgeons—Justin H. Lee, MD; Katherine P. Davenport, MD; and Katrine Lofberg, MD—recently joined Phoenix Children’s employed physicians group. Eight more physicians from Pediatric Surgeons of Phoenix will come on board in 2017. In addition to Dr. Ostlie and Dr. Egan, the Phoenix Children’s Medical Group Division of Pediatric Surgery includes pediatric surgeons Jae-O Bae, MD; Ramin Jamshidi, MD; Lisa E. McMahon, MD; Mark S. Molitor, MD; David M. Notrica, MD, FACS, FAAP; Dorothy Rowe, MD; and Kathleen D. Van Leeuwen, MD.

4 Partners in Pediatrics

A FULL RANGE OF PEDIATRIC SURGICAL PROGRAMS

Surgeons at Phoenix Children’s Hospital focus on the special needs of pediatric patients of all ages to deliver outstanding care and outcomes. Services include:

• Cardiology—High-volume cardiology and cardiovascular surgeries range from correction of congenital defects to heart transplantation, with post-surgical care provided in a dedicated Cardiovascular Intensive Care Unit.

• Interventional Radiology—Minimally invasive vascular and non-vascular, image-guided procedures include sclerotherapy and liver and renal biopsies.

• Kidney Transplant—Pediatric hemodialysis, peritoneal dialysis and kidney transplant specialists facilitate every stage of the transplant process.

• Liver Transplant—An expert team coordinates the complex process of reestablishing biliary and circulatory system connections with the donated organ.

• Neurosurgery—Comprehensive programs address development, epilepsy, stroke, neurogenetics, neurotrauma, neuro-oncology, movement disorders, and a full range of other neurological and behavioral disorders.

• Orthopedics—Advanced treatment addresses spinal deformities, fractures, sports-related injuries, skeletal dysplasias, muscular dystrophy, pediatric limb reconstruction and other musculoskeletal needs.

• Trauma—Arizona’s only ACS-verified Level 1 Pediatric Trauma Center is the regional hub for specialized pediatric trauma care.

• Additional Specialties—Ophthalmology, otolaryngology, pathology, oncology, urology, and reconstructive or corrective plastic surgery are more of the specialized surgical services available.

“Board-certified pediatric surgeons have undergone at least two extra years of training, specifically focused on surgical care for children. This enables

us to care for each patient according to age, size, and specific surgical issue in the context of the existing pediatric health conditions and family

circumstances, which has been shown to lead to improved outcomes.”

—Craig Egan, MD, chief of the division of pediatric surgery, Phoenix Children’s Hospital

The mutually supported merger recognizes the long-standing, strategic focus on pediatric surgery shared by Pediatric Surgeons of Phoenix and the Hospital. Craig Egan, MD, chief of the division of pediatric surgery at Phoenix Children’s, heads the newly expanded surgical group, which Dr. Ostlie characterizes as unified and collegial.

“The level of care Phoenix Children’s provides is in sharp contrast to what children experience in a hospital that primarily serves adults, where pediatric care represents a small percentage of cases,” Dr. Ostlie said. “Our surgical programs—which include thoracic, orthopedic, oncology, trauma, neurosurgery and transplant procedures—are top-ranked across the board by U.S. News & World Report. All of that talent is available in a freestanding facility built to care for children.”

THE GROWTH TRAJECTORY More skilled pediatric surgeons are joining the teams in the congenital heart, plastic surgery, ophthalmology and otolaryngology service areas, in addition to general surgery.

As the surgical talent pool expands, research interests become increasingly diversified, with studies being developed to explore innovative diagnostic techniques, treatments for childhood diseases and regional management of socioeconomic-affected health care disparities. Medical education opportunities are also likely to expand to encompass training of pediatric surgery fellows and trauma specialists.

ISSUE 1, 2017 5

GROWING TO MEET THE NEED

The Center for Cancer and Blood Disorders at Phoenix Children’s Hospital currently treats more children and teens with cancer, hemophilia and sickle cell than any other facility in the state. The number of patients is expected to rapidly increase due to the Center’s access to the Mayo Clinic proton beam therapy program, the innovative cancer treatments and research of The Chan Soon-Shiong Children’s Precision Medicine Institute, and affiliation with Cancer MoonShot 2020 Pediatrics Consortium.

To support the increasing number of patients needing services and to continue to provide the highest level of care possible, a new outpatient services clinic is currently under construction on the second floor of the Hospital. The clinic will provide multiple infusion rooms on site, so patients won’t require transfer for procedures. If needed, imaging, emergency and inpatient areas will be a quick elevator ride away.

Also under construction is a larger clinical laboratory on the Hospital’s third floor. The space is designed with an open floor plan to increase efficiency and support workflow. An adjacent area is available to accommodate future expansion when needed.

THE EMERGENCY DEPARTMENT AND LEVEL 1 PEDIATRIC TRAUMA CENTER EXPANSION AT PHOENIX CHILDREN’S HOSPITAL REMAINS ON SCHEDULE FOR A NOVEMBER 2017 OPENING.

CURRENTLY, 84,000 PATIENTS are treated annually in a facility originally designed to accommodate closer to 22,000. As Arizona’s only ACS-verified Level 1 Pediatric Trauma Center and the regional hub for specialized pediatric emergency care, Phoenix Children’s projects a yearly volume soon to eclipse 100,000.

The $48 million expansion also includes a number of enhancements aimed to improve care quality.

ALL IN THE DETAILSThe new facility will feature 63 examination rooms, six trauma bays and three procedure rooms with state-of-the-art equipment and carefully considered space planning.

“We didn’t have to start from scratch,” said Dave Cottle, vice president for planning, design and construction. “We worked with some of the best hospital architects available and invited input from the staff members who will be working in these areas.”

To ensure smooth operations, full-scale cardboard models of the new trauma rooms were built so staff could walk within the planned spaces and make recommendations to improve efficiency.

“The new physical location is ideal,” said David Notrica, MD, FACS, FAAP, trauma medical director at Phoenix Children’s. “Everything is designed to dramatically improve our ability to care for children in a quicker, more efficient manner.”

To accomplish this, the new facility is located directly beneath the helipad. The new design puts the ambulance bay within several feet of the trauma bay, while patients coming from home have easy access to and from the parking garage. The new facility is also located adjacent to imaging services to speed diagnostics.

For updates on the expansions, visit us on the web.

KEEPING TRAUMA CARE ON TRACK

6 Partners in Pediatrics

WITHIN 48 HOURS of leaving an appointment with a Phoenix Children’s provider, families can expect to receive a digital survey. Managed by National Research Corporation (NRC), the communication consists of a short series of questions asking family members to evaluate interactions with the Phoenix Children’s team. The aim is to find ways to improve care delivery through objectively measuring the patient experience and developing interventions and practice changes designed to improve the experience. Phoenix Children’s uses the survey results to evaluate how care compares with other hospitals throughout the country from the parents’ perspective. The standardized questions provide scores for the provider and practice, as well as an understanding of whether the family would recommend the practice to others. Specific feedback about quality of care can also be provided.

“We are interested in technical caring as well as compassionate caring,” said Julie Bowman, RN, BSN, MSN, senior vice president of Patient Care Services and chief nursing officer at Phoenix Children’s. “People come to a hospital with an expectation that the technical skills of the health care providers will be excellent, and we deliver on that expectation. What sets a facility apart is compassion. Each family typically wants to be heard and cared for in an empathetic and culturally sensitive manner. The NRC survey helps us determine how well we are meeting that need, and that is what Phoenix Children’s strives to provide and will continue to improve.”

By honing in on the customer service aspect of care, Phoenix Children’s providers also work tirelessly to enhance compliance and clinical outcomes.

“Attending to the customer service aspect of care demonstrates courtesy to patients,” said H. Stacy Nicholson, MD, MPH, physician in chief at Phoenix Children’s. “Miscommunication can spill over into the effectiveness of treatments. For example, compliance can

break down after a medication is prescribed if all of a family’s questions are not answered by their physician, nurse practitioner or pharmacist.

“We want to ensure patients and loved ones are getting the information they need.”

CLEAR RESULTSSince implementing the text and email surveys, Phoenix Children’s has seen an increase in patient feedback. The data captured to evaluate performance motivates providers to improve interactions and enhance patient experience scores.

“Monitoring the patient experience is just as important as monitoring traditional quality measures such as surgical site infections,” said Steven Spalding, MD, chief clinical integration and medical officer at Phoenix Children’s. “Referring physicians can have confidence their patients will have a great experience with us.”

To learn more about quality, safety and the patient experience at Phoenix Children’s, visit us on the web.

“We are seeing consistent patient

experience scores in the high 80s and low

90s. This is the result of making every

interaction count.”

—Steven Spalding, MD

IMPROVEPOWERFUL CONNECTIONS TO

THE PATIENT EXPERIENCEPHOENIX CHILDREN’S HAS LAUNCHED AN UPDATED SURVEY PROCESS TO GATHER VALUABLE FEEDBACK REGARDING THE QUALITY OF THEIR EXPERIENCE WITH PHOENIX CHILDREN’S.

Photo by Lynn Dao

ISSUE 1, 2017 7

COMING SOON: A NEW TREATMENT OPTION FOR EPILEPSY As part of the programmatic expansion underway at Barrow at Phoenix Children’s, a minimally invasive alternative to open-brain surgery will soon be available for certain children with epilepsy. Magnetic resonance image (MRI)-guided stereotactic laser ablation allows surgeons to destroy the source of seizures in the brain and sometimes cure epilepsy using a fiber-optic laser catheter inserted through a small puncture in the skull. Dr. Wilfong helped pioneer this technique during his tenure at Texas Children’s Hospital. It is currently available for adults at Barrow Neurological Institute at Dignity Health St. Joseph’s Hospital and Medical Center.

“MRI-guided stereotactic laser ablation hasn’t replaced all types of epilepsy surgery for children, but it’s a great option to have,” Dr. Wilfong said. “This procedure, which surgeons perform through a pinhole-sized opening, has transformed the treatment of some forms of epilepsy. Ninety-five percent of patients who have MRI-guided stereotactic laser ablation are discharged the next day. Children who have open-brain surgery typically spend a week recovering in the hospital.”

THE NEW CHIEF OF NEUROLOGY AT BARROW NEUROLOGICAL INSTITUTE AT PHOENIX CHILDREN’S HOSPITAL HAS AMBITIOUS PLANS TO INCREASE THE SCOPE OF SERVICES AVAILABLE FOR YOUNG PATIENTS.

ANGUS WILFONG, MD, FRCPC, arrived to lead the neurology division in September. A specialist in seizure disorders, Dr. Wilfong has spent his career establishing and growing epilepsy programs at various institutions, including Royal University Hospital at the University of Saskatchewan and Children’s Hospital of Wisconsin. Most recently, he was a professor of Pediatrics, Neurology and Developmental Neuroscience at Baylor College of Medicine and director of the Comprehensive Epilepsy Program at Texas Children’s Hospital. That program has grown into one of the largest in the country since Dr. Wilfong started it 15 years ago.

BUILDING ON A STRONG FOUNDATIONDr. Wilfong believes Phoenix Children’s is well positioned to enhance its reputation as the Southwest’s premier referral destination for children with neurological disorders.

“What attracted me to Phoenix Children’s was the opportunity to further develop the entire neurology division in primary care neurology, neurocritical care and specialty neurology, including epilepsy, movement disorders, metabolic diseases, headaches and neuromuscular disorders,” Dr. Wilfong said. “The Hospital is growing, dynamic and located in an area that is attractive to clinicians. This is an ideal place to continue building a world-class neurology center.”

Dr. Wilfong sees the University of Arizona College of Medicine – Phoenix, Arizona State University and the new Mayo Medical School in Phoenix as invaluable partners for translational research.

“I envision Phoenix Children’s becoming a national and international leader in neurological care for children,” Dr. Wilfong said. “On a community level, our program will continue to be an easy-to-access resource for primary care and other referring physicians whenever a neurological issue arises.”

NEUROLOGYNEXT-LEVEL VISION FOR