News Briefs

Children’s National leaders join with Governor Martin O'Malley

Facial analysis technology successfully used to identify Noonan syndrome in diverse populations

facial recognition of noonan syndrome

According to an international study led by the National Human Genome Research Institute (NHGRI), researchers have successfully used facial analysis software, developed by the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National, to identify Noonan syndrome in diverse populations.

Noonan syndrome is relatively common, affecting between 1 in 1,000 to 1 in 2,500 children, however few studies have been conducted in non-Europeans. For this study, the researchers evaluated children (average age of eight) with Noonan syndrome from 20 countries. Using the facial analysis software and clinical criteria, the researchers compared 161 white, African, Asian and Latin American children with Noonan syndrome with 161 people of the same age and gender without the disease. Using the software to analyze facial features, they were able to correctly diagnose patients with the disease from each ethnic group with 94 percent or higher accuracy.

“Our algorithm found widely spaced eyes as a significant facial feature in all ethnic groups and also highlighted facial features that are relevant to diagnosing the syndrome in each group,” said

Marius George Linguraru, D.Phil., developer of the facial analysis technology and an investigator in the study from Children’s National.

Linguraru and his team are working to create a simple tool that will enable doctors in clinics without state-of-the-art genetic facilities to take photos of their patients on a smartphone and receive instant results.

Children’s National leaders join with Governor Martin O'Malley

Landmark CDC report finds easy, painless test decreases infant cardiac deaths by 33 percent

Stakeholders meeting at American College of Cardiology’s Heart House

Stakeholders meeting at American College of Cardiology’s Heart House in February 2012 to discuss U.S. implementation and recommendation of pulse ox screening.

Congenital heart disease (CHD) is the most common birth defect, affecting approximately eight out of every 1,000 babies born in the United States. The most severe cases, critical congenital heart disease (CCHD), affect three in every 1,000 babies. Just a few years ago, many of these seemingly healthy infants were discharged from the hospital only to suffer severe complications, brain damage or even death due to their undiagnosed conditions.

In 2009, Children’s National Cardiologist and Medical Director of Global Services Gerard Martin, M.D., and the nursing staff within the Children’s National Heart Institute took on this challenge with peers around the country by urging legislators and educating clinicians that implementing a simple, painless test called pulse oximetry (ox) could identify infants who may suffer from undetected CCHD.

Today, 49 out of 50 states in the United States mandate pulse ox screening, which uses a small, red light, or “probe,” to measure the percent oxygen saturation of hemoglobin in the arterial blood. Use of pulse ox also is included in the Recommended Uniform Screening Panel (RUSP), endorsed by the Secretary of the U.S. Department of Health and Human Services.

This week, the Centers for Disease Control and Prevention released a report presenting definitive evidence that these efforts are saving lives. Published in JAMA, the report shows a 33 percent reduction in pediatric CCHD deaths from 2007 to 2013 in states with mandated pulse ox screening compared to states without screening policies. The study also found a 21 percent drop in infant deaths from other or unspecified cardiac causes in those states. Applying the data to the United States as a whole, this equates to preventing the deaths of 120 newborns each year.

“This is a landmark moment for the countless parents, clinicians, industry partners, legislators and many others who fought tirelessly to have this lifesaving screening added to the routine panel of tests every child receives before they leave the hospital,” says Dr. Martin. “We now have concrete, measurable evidence that their efforts are saving lives.”

Physicians and staff at Children’s National and Holy Cross Hospital in Silver Spring, Md., began their campaign by initiating a research study to examine the feasibility of implementing pulse ox screening for CCHD in a community hospital setting. Their findings not only showed it was possible, but it also only required approximately 3.5 minutes per baby, and it could be integrated into existing workflow without adding additional nursing staff.

Children’s National leaders join with Governor Martin O'Malley

Children’s National leaders join with Governor Martin O’Malley and Maryland legislators for the signing of SB 786 and HB 714, mandating pulse oximetry screening across the state on May 19, 2011.

The findings also led to the development of an educational toolkit – now available in English, Spanish, Arabic, French, Chinese and Russian – which Dr. Martin and the Children’s National Heart Institute’s nursing staff have used to teach upwards of 3,000 hospitals, globally, how to implement the screening. Children’s National, in partnership with Baby’s First Test, also released two videos for parents and clinicians respectively, to forward knowledge about pulse ox.

Simultaneously, the Children’s National team worked as national and local advocacy leaders. Dr. Martin served as part of the federal Advisory Committee on Heritable Disorders in Newborns and Children that issued national recommendations to add screening for congenital heart disease to RUSP in 2011. The team also spearheaded efforts that led to the passage of legislative mandates and helped to implement screening for all newborns in Maryland, Virginia and Washington, D.C.

“When we started this work nearly a decade ago, I’d meet so many moms who were crying because they had lost their child to critical congenital heart disease. Now, we meet moms who are crying because their baby’s condition has been found and their life has been saved,” says Dr. Martin. “This report shines a light on so many heroes–the parents who spoke up, the members of the federal advisory committee, the nurses and clinicians who learned and taught others how to implement the screening. Today is a victory for all of us.”

Dr. Martin hopes this announcement will prompt Idaho, the only state that has not adopted universal CCHD screening, to take action. He also says health leaders need to continue to invest in smarter technology and testing capabilities, as well as advance training and education for more thorough prenatal ultrasounds, so that every baby with CCHD is found early and receives lifesaving care.

Roger Packer high fives patient Olivia Enos

Kids’ resilience pushes neurologist to seek better therapies

Roger Packer high fives patient Olivia Enos

“I get strength from kids and families, strength like that shown by Nick and his family,” answered Roger Packer, M.D., when Quicken Loans owner Dan Gilbert asked how he copes with the stress of seeing children struggling with brain tumors and other neurological problems every day.

Dr. Packer, senior vice president of the Center for Neuroscience and Behavioral Medicine at Children’s National Health System, joined Mr. Gilbert and his son, Nick, who was treated for neurofibromatosis at Children’s National, for a panel discussion at the recent Crain’s Health Care Heroes event. The discussion focused on Nick Gilbert, now a college student, and how he has stayed positive while undergoing intense treatments for neurofibromatosis since he was 15 months old.

Dr. Packer met Nick at age 10, when he first came to Children’s National for its world-renowned expertise in neurofibromatosis research and care. After their experiences, the Gilberts generously supported the creation of the Gilbert Family Neurofibromatosis Institute at Children’s National Health System to continue research into new and innovative treatments for the disorder.

Mr. Gilbert credits Dr. Packer with taking on difficult cases and having a positive impact on both Nick and himself. “When other doctors give up on patients, he intervenes with magic and saves lives.”

The reason, according to Dr. Packer, is that kids like Nick “don’t want to give up.” Thankfully, he notes, better tools to treat diseases like cancer and neurofibromatosis have finally arrived. “There are remarkable advances that were not possible five years ago,” he said.

The full session at the Health Care Heroes event was featured in Crain’s Detroit Business.

Zhe Han

Research led by Zhe Han featured on cover of JASN, leading kidney disease journal

Journal of the American Society of Nephrology September 2017 cover

Coenzyme Q10, one of the best-selling nutrient supplements to support heart health also could be beneficial for kidney health, according to research conducted in transgenic fruit flies that was led by Zhe Han, Ph.D., associate professor at Children’s Center for Cancer and Immunology Research.

Nephrocytes, filtration kidney cells in Drosophila, require the Coq2 gene for protein reabsorption, toxin sequestration and critical cell ultrastructure.  Silencing the Coq2 gene results in aberrantly localized nephrocyte slit diaphragms and deformed lacunar channels, Han and co-authors found. Nephrocytes closely resemble the podocytes of the human kidney.

The research team’s paper, published online April 2017, this fall was featured on the cover of Journal of the American Society of Nephrology, the No. 1 kidney disease journal.

“I am honored that the JASN editors chose to feature my lab’s work on the cover of this prestigious journal,” Han says. “This underscores the utility of our gene-replacement approach, which silenced the fly homolog in the tissue of interest – here, the kidney cells – and provided a human gene to supply the silenced function.”

Dorothy Bulas

Congratulations to Dorothy Bulas, M.D. – 2017 RSNA Outstanding Educator recipient

Dorothy Bulas

Dorothy Bulas, M.D., section head of ultrasound and fetal imaging at Children’s National Health System, was honored with the RSNA 2017 Outstanding Educator award at the Radiological Society of North America’s (RSNA) Annual Meeting, held November 26 – December 1 in Chicago, Illinois.

The winner of the award is selected annually by the RSNA Board of Directors based on the awardee’s significant contributions and long-term commitment – 15 years or more – to radiologic education.

“In addition to being a talented clinician and an accomplished researcher, Dr. Bulas is an extraordinary teacher who has made tireless contributions to the educational programs of RSNA,” said RSNA President Richard L. Ehman, M.D. “For more than three decades, she has been a passionate and effective advocate for improving pediatric radiology worldwide – especially in poorly served countries – by participating in educational outreach.”

Combined FACT accreditation related to cellular immunotherapy spotlights Children’s ongoing commitment to revolutionary cancer therapies

DNA strand and Cancer Cell

As new immunotherapy treatments are starting to hit the market, care-delivery must adapt so that facilities are prepared to deliver these novel treatments to patients. Children’s National is proud to announce that it became the first pediatric medical institution in the United States to receive accreditations for both immune effector cells and more than minimal manipulation from the Foundation for the Accreditation of Cellular Therapy (FACT). Considered the threshold for excellence in cellular therapy, FACT establishes standards for high-quality medical and laboratory practice in the field.

“We are proud to receive these critically important seals of approval,” said David Jacobsohn, M.D., ScM, division chief of the Division of Blood and Marrow Transplantation at Children’s National. “Our patients are our highest priority and having these accreditations only further demonstrates our commitment to providing the most innovative care.”

The first new designation, FACT Accreditation for Immune Effector Cells, certifies that Children’s National is able to safely administer cutting-edge cellular therapies and monitor and report patient outcomes. The designation applies to CAR-T cells and therapeutic vaccines, among other therapies.

“We continuously set high standards for cellular therapy within the walls of Children’s National, and we are thrilled to be recognized for our leadership in this field,” said Catherine Bollard, M.D., M.B.Ch.B., director of the Center for Cancer and Immunology Research within the Children’s Research Institute. “Cell therapies represent the next generation of cancer treatment, and we are excited to continue our journey in revolutionizing patient care.”

Children’s National also received FACT Accreditation for More than Minimal Manipulation,

a designation that is unique to only a few pediatric institutions in the United States. This accreditation certifies that Children’s National is prepared to safely manufacture its own cellular therapies.

“Being accredited for More than Minimal Manipulation is a tremendous achievement for us as a stand-alone pediatric institution; it exemplifies our ability to manufacture our own innovative cellular therapy products for patients in need,” said Patrick Hanley, Ph.D., director of the Cellular Therapy Laboratory where the cells are manufactured for clinical use. “These two accreditations allow Children’s National to serve as a complex immunotherapy center that is capable of providing immunotherapies and gene therapies from external groups and companies.”

Catherine-Bollard-SIOP

Advancing cures for pediatric cancer: Highlights from leading Children’s National experts at SIOP 2017

In mid-October 2017, nearly 2,000 clinicians, scientists, nurses, health care professionals and cancer patients and survivors gathered in Washington, D.C., for SIOP 2017, the Annual Congress of the International Society of Paediatric Oncology. For four days, attendees heard from world-renowned experts while exchanging ideas and information, all in the name of advancing cures for childhood cancer.

Hosted in the hometown of Children’s National Health System and chaired by Jeffrey Dome, M.D., Ph.D., Vice President of the Center for Cancer and Blood Disorders and Chief of Oncology at Children’s National Health System, more than 20 doctors and nurses from Children’s National made an impact on participants through a series of widely attended sessions and addresses, including:

  • Symposium lecture on the latest approaches in anti-viral T-cell therapy to improve patient outcomes, given by Catherine Bollard, M.D., M.B.Ch.B.
  • Keynote lecture on DICER1 mutations in pediatric cancer, given by Ashley Hill, M.D., whose study of a rare childhood lung cancer and gene mutations set the stage for a better understanding of microRNA processing gene mutations in the development of pediatric cancer.
  • Education session on new therapies for sarcomas, led by AeRang Kim, M.D., Ph.D., and Karun Sharma, M.D., Ph.D., sharing research on new approaches for local control of sarcomas, such as surgery, radiation and other ablative measures.
  • Education session on new therapies for gliomas, led by Roger J. Packer, M.D., with presentations on immunotherapy from Eugene Hwang, M.D., and targeted therapy by Lindsay Kilburn, M.D.
  • Podium paper presentation on a new method to measure cancer treatment toxicities as reported by the child by Pamela Hinds, Ph.D., RN, FAAN, as well as an education session on advanced care planning, led by Hinds with a presentation from Maureen E. Lyon, Ph.D.

“These sessions and lectures provided a glimpse into the groundbreaking work by SIOP attendees from around the world,” says Dr. Dome. “Children’s National is proud to play an active role in the development of life-saving treatments for children with cancer and our clinicians look forward to another year of revolutionary developments.”

For more on this year’s SIOP, see the Children’s National press release.

  • Jeffrey Dome, M.D., Ph.D., addresses a group of international colleagues at a reception at Children’s National.

    Jeffrey Dome SIOP

  • Catherine Bollard, M.D., M.B.Ch.B., addresses a group of international colleagues at a reception at Children’s National.

    Catherine-Bollard-SIOP

  • Lindsay Kilburn, M.D., engages with peers from around the world at a reception at Children’s National.

    Lindsay-Kilburn-SIOP
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The 38th Annual Telly Awards recognizes a Children’s National documentary

Shireen Atabaki

“I was very excited that our documentary was able to receive such an honor. We were able to successfully train 100% of D.C. Public School nurses, which makes all the difference when recognizing concussions in students and athletes,” says Shireen Atabaki, M.D., M.P.H.

The “Play Smart, Your Brain Matters” documentary was recently recognized at the 38th Annual Telly Awards, which honors excellence in video and television across all screens. In light of the Athletic Concussion Protection Act of 2011, the documentary was created as a training tool for the Concussion Care and Evaluation Training Program, funded by the D.C. Department of Health and hosted by Children’s National Health System and MedStar Sports Medicine.

According to the Athletic Concussion Protection Act of 2011, athletic, school and medical personnel are required to receive the proper preparation and training in concussion recognition and response. All athletes suspected of sustaining a concussion are to be removed from practice or play and only allowed to return to sport participation after a written clearance is given by a licensed healthcare provider who is experienced in the evaluation and management of concussions.

Emergency Medicine Specialist, Shireen  Atabaki, M.D., M.P.H., and expert in concussion and knowledge translations says, “I was very excited that our documentary was able to receive such an honor. We were able to successfully train 100% of D.C. Public School nurses, which makes all the difference when recognizing concussions in students and athletes.

StethAid is a low-cost mobile device-based digital stethoscope that lets pediatric healthcare providers know instantly if a heart murmur is innocent or a signal of a more pathological heart problem

AusculTech DX wins Washington Business Journal 2017 Innovation Award

StethAid is a low-cost mobile device-based digital stethoscope that lets pediatric healthcare providers know instantly if a heart murmur is innocent or a signal of a more pathological heart problem

StethAid is a low-cost mobile device-based digital stethoscope that lets pediatric healthcare providers know instantly if a heart murmur is innocent or a signal of a more pathological heart problem.

AusculTech DX, a start-up company that formed within the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Health System, was selected as a Washington Business Journal 2017 Innovation Award honoree for their device, StethAid.

StethAid is a low-cost mobile device-based digital stethoscope that lets pediatric healthcare providers know instantly if a heart murmur is innocent or a signal of a more pathological heart problem. The device was developed by Robin Doroshow, M.D., a pediatric cardiologist at Children’s National, and Raj Shekhar, Ph.D., a principal investigator with the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National to help eliminate unnecessary referrals of patients with Still’s murmurs to pediatric cardiologists.

In studying her extensive library of recorded heartbeats, Dr. Doroshow noticed that the Still’s murmur had the same distinct musical tone, regardless of the patient’s age, size and heart rate. When she realized that there was likely a way to teach a computer to recognize the tone, she approached Shekhar with her idea. He developed a highly accurate computer algorithm, based on AI (artificial intelligence) principles, to recognize the consistent Still’s tone and worked to develop the digital device. In early 2015, the team formed AusculTech DX. In early 2016, a clinical prototype was developed and they began testing the device.

The Washington Business Journal’s annual Innovation Awards honor Greater Washington companies, agencies and teams working to keep the metro on the cutting edge in tech, health care, cybersecurity and more. AusculTech DX was one of the 15 honorees selected for the 2017 Innovation Awards.

Roberta DeBiasi and Sarah Mulkey

Children’s National experts contribute to new Zika guidelines

Roberta DeBiasi and Sarah Mulkey

Roberta DeBiasi, M.D., M. S., and Sarah B. Mulkey, M.D., Ph.D., members of Children’s multidisciplinary Congenital Zika Virus Program, were among the experts invited to participate in a forum held in Atlanta at CDC headquarters in late August to formulate new Zika recommendations.

The Centers for Disease Control and Prevention (CDC) on Oct. 19, 2017 updated guidelines for evaluation of women, fetuses and infants exposed to the Zika virus during pregnancy. Although only women with symptoms will now be routinely tested, asymptomatic and symptomatic infants born to these women will still be tested for the Zika virus using blood and urine tests.

Infants who appear normal, whose mothers either had negative Zika results or who had not undergone testing, will not undergo Zika testing. These infants still will undergo a standard evaluation, including a detailed physical exam, hearing screen and routine developmental assessments. The revised Zika guidance includes input from practitioners on the front lines of the Zika epidemic, including Children’s National Health System clinicians.

“These changes in the recommendations for Zika testing should not be interpreted as Zika infection risks subsiding for pregnant women and their infants in the United States. It’s simply an acknowledgement of the limitations of current testing methods – which must occur within a narrow window after Zika exposure – and the poor predictive value of Zika testing right now,” says Roberta L. DeBiasi, M.D., M.S., chief of Children’s Division of Pediatric Infectious Diseases. Dr. DeBiasi and Sarah B. Mulkey, M.D., Ph.D., members of Children’s multidisciplinary Congenital Zika Virus Program, were among the experts invited to participate in the Zika forum held in Atlanta at CDC headquarters in late August to formulate the recommendations.

While all infants will receive a standard evaluation, expanded evaluations that include an ophthalmologic assessment, more detailed hearing evaluation and ultrasound of the newborn’s head will be reserved for infants born to mothers confirmed to be Zika positive or Zika probable, or for infants born with abnormalities potentially consistent with congenital Zika syndrome, regardless of maternal status.

The majority of U.S. infants who have been exposed to Zika in the womb appeared normal at birth, according to CDC registries. Now, the next wave of these normal-appearing babies will receive standard evaluations when they are born, including a newborn hearing screening. At each well-child visit, these infants will receive:

  • A comprehensive physical examination
  • An age-appropriate vision screening
  • Developmental monitoring and screening using validated tools

“This is a natural evolution in the diagnosis and screening strategy now that the peak of the first wave of Zika transmission appears to be over,” Dr. DeBiasi says. “While we continue to evaluate new possible cases of Zika infection among pregnant women in our practice, a sizable proportion of Children’s cases are Zika-exposed infants whose physical exam and neuroimaging appeared normal at birth. Through ongoing monitoring, we hope to learn more about these children’s long-term neurodevelopment outcomes.”

Roger Packer, M.D., elected Pediatric Co-Chair by the National Cancer Institute’s Brain Malignancies Steering Committee

Roger Packer, MD

Roger J. Packer, M.D., Senior Vice President, Center for Neuroscience & Behavioral Health at Children’s National Health System, has been elected by the National Cancer Institute’s Brain Malignancies Steering Committee (BMSC) as the committee’s new Pediatric Co-Chair.

One of 16 steering committees formed in response to the recommendations of the Clinical Trials Working Group mandated by the National Cancer Advisory Board (NCAB), the BMSC’s goal is to promote the best clinical and translational research for patients with brain cancer by critically reviewing Phase 2 and Phase 3 clinical trial concepts.

Dr. Packer also directs the Brain Tumor Institute and is principal investigator for the Pediatric Brain Tumor Consortium (PBTC), formed under the auspices of the National Cancer Institute (NCI). He has worked closely with the NCI and the National Institute of Neurological Disorders and Stroke (NINDS), and has served on multiple committees setting the directions for neurologic clinical and basic science research for the future. Much of Dr. Packer’s clinical research has been translational in nature. He has been part of studies evaluating the molecular genetics of childhood and adult neurologic diseases, and has also coordinated the first gene therapy study for children with malignant brain tumors in the U.S.

NICU Nurse Manager receives the 2017 Richard Hader Visionary Leader Award

Maureen Maurano accepts the 2017 Richard Hader Visionary Leader Award at the Nursing Management Congress 2017.

Maureen Maurano accepts the 2017 Richard Hader Visionary Leader Award at the Nursing Management Congress 2017.

Maureen Maurano, NICU Nurse Manager at Children’s National Health System, was honored as the winner of the 2017 Richard Hader Visionary Leader Award at the Nursing Management Congress 2017 held October 2-6, 2017 in Las Vegas, Nevada. The annual award recognizes excellence in nursing leadership and awards a nurse leader who views nursing as both an art and a science by promoting caring and competence as the link between science and humanity.

The winner of the award is nominated by a colleague and is entered into the competition after the Nursing Management journal’s editorial board has received a 2,000 word manuscript detailing the nominee’s accomplishment in the planning, development, implementation and evaluation of a sustainable change in the work environment or clinical practice that has resulted in a positive outcome. The editorial board selects the winner based on the manuscript’s readability, originality, and evidence of credibility. The winning manuscript will be featured in the January 2018 issue of Nursing Management.

“I am truly honored to have accepted this Visionary Leadership Award, however, this could not have been achieved without our amazing leadership and nursing team,” says  Maurano. “It is truly a team effort that empowers our success on a daily basis in providing the most innovative and world-class care for our patients at Children’s.”

Vice President of Nursing and Chief Nursing Officer, Linda Talley says, “Maureen is an outstanding nurse leader who exemplifies our core values – commitment, compassion and connection – through her engagement of others, creating a positive work environment and driving change that has a positive influence on the professional practice of nursing.  We are very proud of her and the recognition she has so deservedly earned.”

With a crowd of over 2,000 medical professionals, Maurano accepted her award as a leader of excellence representing the U.S. News and World Report #1 NICU for babies. Congratulations again Maureen for receiving this great honor!

Rahul Shah

Speaking up for safety: Virginia Hospital and HealthCare Association spotlights culture of reporting at Children’s National Health System

Rahul Shah

Rahul Shah, M.D., Vice President and Chief Quality and Safety Officer at Children’s National recently sat down with VHHA’s REVIEW magazine to share best practices and success strategies.

For Children’s National Health System, fostering a culture of safety meant empowering everyone to play a role, from front line staff to providers to the C-suite. Recently, pediatric quality and safety experts at Children’s National sat down with Virginia Hospital & Health Association (VHHA)’s REVIEW magazine to share best practices, success strategies and leadership from Children’s National in this arena. Rahul Shah, M.D., MBA, Children’s National vice president and chief quality and safety officer, and Lisbeth Fahey, MSN, RN, executive director for quality, safety, accreditation, regulatory and emergency preparedness, discussed how establishing a non-punitive culture of reporting where anyone can raise a concern led to improved safety outcomes.

“Our approach has been to make it fun, make it exciting and to reward people,” said Shah, noting the inverse correlation between reporting frequency and safety results.

Children’s National Fetal Medicine Institute hosts 2nd annual International Symposium on the Fetal Brain

The Children’s National Health System Fetal Medicine Institute hosted the 2nd annual International Symposium on the Fetal Brain in August 2017 in Washington, D.C.

Speakers at this year’s symposium focused on the following four areas:

  • Brain Development in an Unsupportive In Utero Environment – Diagnosis and Consequences
  • Supporting Brain Development in the Ex Utero Fetus: How Far Are We From Optimal?
  • Genomic and Epigenomic Mechanisms Underlying Differences in Brain Development
  • The Emergence of Consciousness and Pain Sensation

Adré J. du Plessis, M.B.Ch.B., M.P.H., Director of the Fetal Medicine Institute and Division Chief of Fetal and Transitional Medicine hosted the conference. In his opening remarks Dr. du Plessis noted “Our goal has been to gather together a diverse group from across the spectrum of disciplines focused on the well-being of the fetal brain and to engage all disciplines together.”

Diana-Bianchi-at-ISFB

Diana Bianchi, MD gives her keynote presentation on non-invasive fetal testing at the second annual International Symposium on the Fetal Brain.

Invited, internationally renowned speakers presented on diverse topics, including Diana Bianchi, Director of the Eunice Kennedy Shriver National Institute of Child Health and Human Development who spoke on the “Non-Invasive Fetal Testing Beyond Karyotype: What’s in it for the Fetal Brain?”

A new component to the symposium was the clinically-focused breakfast breakout sessions, created based on feedback from attendees of the 2016 Symposium. Sessions covered varied topics such as “Fetal Ultrasound: the Cornerstone of Fetal Neurodiagnosis,” “The Essentials of Neurogenetic Testing,” “Developing a Transitional Fetal-Neonatal Program” and “Using MRI to Advance Fetal Neurodiagnosis.”

The conference started with an exciting discussion by Alistair Gunn, M.B.Ch.B., Head of the Department of Physiology at the University of Auckland. His presentation “Fetal Heart Rate: What It Does and Does Not Tell Us” explored the considerable body of evidence that essentially all decelerations are mediated by chemoreflex responses to repeated hypoxia and that the parasympathetic autonomic nervous system is the critical regulator of both fetal heart rate and heart rate variation in labor.

Following a voting process from the symposium’s external speakers, the inaugural Andrea Poretti Abstract Award was presented to Katherine Ottolini for her poster titled: Breastmilk Feeds Improve Brain Microstructural Development in Very Premature Infants.

For more information about the sessions and speakers at the 2017 Symposium, please visit our website.

Catherine Bollard and Hemant Sharma

Nationally recognized immunotherapy and pathology experts take on new leading roles at Children’s National

Catherine Bollard and Hemant Sharma

Catherine Bollard, M.D., M.B.Ch.B., has been chosen to serve as director of the Children’s Research Institute’s Center for Cancer and Immunology Research and Hemant Sharma, M.D., M.H.S., will assume the role of chief of the Division of Allergy and Immunology.

Children’s National Health System recently made several exciting leadership announcements in the allergy, immunology and laboratory medicine fields, furthering the hospital’s ongoing commitment to providing the most comprehensive, innovative care for children.

Award-winning hematologist and immunotherapist Catherine Bollard, M.D., M.B.Ch.B., currently chief of the Division of Allergy and Immunology, has been chosen to serve as director of the Children’s Research Institute’s (CRI) Center for Cancer and Immunology Research (CCIR). CCIR includes more than 50 clinicians and scientists performing groundbreaking clinical and translational research in understanding the origins of, and developing and testing novel therapies for childhood cancers and immunologic disorders. The center receives more than $10 million annually from the National Institutes of Health and other external entities. In her new role on the leadership team of CCIR, Dr. Bollard will lead the advancement and oversight of cancer and immunology research performed at Children’s National.

“All of the progress made in cellular immunotherapy here at Children’s National can be attributed to Catherine and her leadership,” says Mark L. Batshaw, M.D., chief academic officer and director of CRI. “We are confident her impact will extend even further in her new role.”

Meghan Delaney

Nationally recognized laboratory medicine expert Meghan Delaney, D.O., M.P.H., has joined Children’s National as chief of pathology and lab medicine.

Hemant Sharma, M.D., M.H.S., will assume the role of chief of the Division of Allergy and Immunology. In 2008, he joined the faculty at Children’s National and started the Food Allergy Program, which he directs today. His areas of interest include health disparities and community-based management of food allergy. He is also site principal investigator of novel clinical trials of immunotherapy for peanut allergy. He serves on the Medical Advisory Board of Food Allergy Research and Education (FARE), and was the recipient of the 2016 FARE Vision Award for his contributions to the national food allergy community. Dr. Sharma also serves as the site director of the allergy immunology fellowship program with the National Institutes of Health and has won various teaching awards.

In addition, nationally recognized laboratory medicine expert Meghan Delaney, D.O., M.P.H., has joined Children’s National as chief of pathology and lab medicine. An expert in the field of transfusion medicine, Dr. Delaney will lead efforts to unify Anatomic Pathology and Laboratory Medicine into a single division, while advancing cutting-edge practices in the lab to ensure the highest standard of quality and safety for patients. Dr. Delaney joins Children’s National from Seattle, where she held many leadership positions including serving as medical director at the Pediatric Apheresis Program at Seattle Children’s Hospital & Seattle Cancer Care Alliance, the blood bank at Seattle Children’s Hospital and the Immunohematology & Red Blood Cell Genomics Reference Laboratory at Bloodworks Northwest.

“Dr. Delaney brings extensive experience in laboratory medicine innovation and program-building, and we are confident she will make a lasting impact on our patients,” said Jeffrey Dome, M.D., Ph.D., vice president for the Center for Cancer and Blood Disorders at Children’s National. “Her leadership will bolster our commitment to providing top quality care for our patients through advancement of lab medicine research and treatments.”

Children’s National Health System advances sickle cell disease cure through Doris Duke Charitable Foundation grant

Sickle-Cell-Blood-Cells

An innovative Children’s National Health System project aimed at improving the only proven cure for sickle cell disease – hematopoietic cell transplantation – will receive more than $550,000 in funding from the Doris Duke Charitable Foundation’s inaugural Sickle Cell Disease/Advancing Cures Awards, which provides grants to advance curative approaches for sickle cell disease. The study, a three-year, multi-center trial that will study a low intensity, chemotherapy-free transplantation approach to cure children with sickle cell disease using a matched related donor, is led by Allistair Abraham, M.D., blood and marrow transplantation specialist, and Robert Nickel, M.D., hematologist, and is one of seven projects receiving approximately $6 million total through the awards.

While transplantation using a matched sibling donor today has a high cure rate (>90 percent) for sickle cell disease, traditional transplant approaches have many risks and side effects in both the short and long term. The study will examine if a chemotherapy-free approach can lead to a successful transplant without resulting in graft-versus-host disease (GVHD). GVHD is one of the most challenging complications of a transplant, in which the transplant immune cells attack the patient’s body. The researchers anticipate that this new transplant approach will be so well tolerated that patients’ quality of life will be maintained and improved throughout the process, with most of the care administered in a clinic setting.

“This approach has proven to be effective for adults with sickle cell disease, so we are grateful for the opportunity to begin this important trial for children thanks to the Doris Duke Charitable Foundation,” says Dr. Abraham. “Children with sickle cell disease are in need of innovative treatments, and we look forward to finding more solutions that improve the quality of life for these patients.”

“Advancing treatment for sickle cell patients to the point where they can live free of the disease is our top priority,” says Dr. Nickel, who is also an assistant professor of pediatrics at the George Washington University School of Medicine and Health Sciences. “This funding is critical to our study and it will accelerate the timeline to achieve the goal of a well-tolerated and safe cure for children with sickle cell disease.”

Matthew Hsieh, M.D., who helped pioneer this work at the National Institute of Health in adults, and Greg Guilcher, M.D., who has used this transplant approach in children, are key collaborators on the project.

The study is projected to begin in December 2018 and continue for three years. The Comprehensive Sickle Cell Disease Program at Children’s National is among the largest in the country, treating more than 1,400 children and young adults with all types of sickle cell disease. Children’s National also offers the largest, most comprehensive blood disorders team in the Washington, D.C., area.

Doctor-putting-mask-on

Promoting a culture of safety with 10,000 good catches

Doctor-putting-mask-on

In today’s fast-paced health care environment, it has become increasingly important to create a culture of safety where improvement opportunities are recognized and welcomed. With medical errors cited as the one of the leading causes of morbidity and mortality in the United States, health care organizations are working to rapidly identify and respond to errors before long-term issues develop.

Improving event reporting is a critical step. To create an effective culture of safety, employees from throughout a hospital or health system must be empowered. They must be educated and have the ability to easily raise awareness of potential problems and risks and they must be able to proactively resolve problems. With this mindset, Children’s National Health System set out to double the number of voluntary safety event reports submitted over a three-year period; the intent was to increase reliability and promote safety culture by hardwiring employee event reporting. With the goal of growing from 4,668 reports in fiscal year 2014 to 9,336 in 2017, the initiative became known as 10,000 Good Catches. And, the positive framing of the endeavor added to a sense of ownership and reporting among staff members.

Following a Donabedian quality improvement framework of structure, process and outcomes, Children’s National formed a multidisciplinary team and identified three key areas for improvement:

  1. Technology: Make reporting user-friendly, fast and easy
  2. Safe to Report: Create a non-punitive environment in which staff feel secure reporting safety events
  3. Makes a Difference: Develop a culture and system to provide feedback and advance meaningful improvements stemming from safety event reporting

Over the next three years, the team, via subcommittees, routinely solicited feedback from front-line users and met as a larger group monthly to propose interventions, review quantitative data and prioritize next steps. In tandem, employees were educated through internal communications on how, what and when to report. The primary outcome measure was the number of safety event reports submitted through the electronic reporting platform. Event report submission time, number of departments submitting events and percent of safety event reports submitted anonymously were also tracked.

These efforts paid off, as Children’s National more than doubled the number of voluntary safety event reports filed over the three-year period from 4,668 in fiscal year 2014 to 10,971 in 2017, with steady annual improvements. Other metrics included decreased event reporting time and anonymous reports. Interestingly, there was a marked increase in the number of departments submitting reports.

This successful initiative not only resulted in increased safety reporting and engagement, but was an important step toward improving organizational reliability and building a culture of safety first. Future steps will focus on how to sustain improvement, how to more efficiently leverage reporting data and how to apply the data to prevent future safety events.

$250K awarded to six winners presenting innovative pediatric medical devices

SZI Symposium Winners

Six companies presenting innovative medical device solutions that address significant unmet needs in pediatric health were awarded a total of $250,000 in grant money yesterday in San Jose, Calif. at the Fifth Annual Pediatric Device Innovation Symposium, organized by the Sheikh Zayed Institute for Pediatric Surgical Innovation at Children’s National Health System.

The “Make Your Medical Device Pitch for Kids!” competition is sponsored by the National Capital Consortium for Pediatric Device Innovation (NCC-PDI), an FDA-funded consortium led by Children’s National and the A. James Clark School of Engineering at the University of Maryland. Four companies were awarded $50,000 each and two were awarded $25,000. The six winners were selected from a field of twelve finalists. A record 98 total submissions from five countries were received for the competition this year.

“To improve care for children, it is imperative that we recognize and encourage relevant new solutions in pediatric medical devices, especially in light of the challenges innovators face in addressing this specialized market,” said Kurt Newman, M.D., president and CEO of Children’s National. “Children’s National is committed to fostering collaboration among innovators, clinicians, policy makers and investors to advance pediatric device development for the benefit of children everywhere.”

This year’s winning innovations receiving $50,000 awards are:

  • CorInnova, Houston, Texas – soft robotic, non-blood-contacting biventricular cardiac assist device for the treatment of heart failure in children
  • Green Sun Medical, Fort Collins, Colo. – novel device that provides necessary pressure for the correction of spinal deformity while providing real-time feedback to clinicians
  • Hub Hygiene and Georgia Institute of Technology, Atlanta, Ga. – low-cost, single-use cleaning technology to prevent central line-associated blood stream infections (CLABSI), a hospital-acquired infection by pediatric ICU patients
  • NAVi Medical Technologies, Houston, Texas – device to provide accurate information about the localization of an umbilical venous catheter (UVC) used in critically-ill newborns to reduce the risk of catheter malposition

Winning innovations receiving $25,000 awards are:

  • Prapela, LLC, Boston, Mass. – novel “baby box” that will allow for a non-pharmacological approach to help drug-exposed infants relax and sleep during withdrawal and post-withdrawal care
  • X-Biomedical, Inc., Philadelphia, Pa. – portable surgical microscope for use in surgeries for treatable causes of blindness in low-income countries and under-resourced setting

“We are honored to recognize these outstanding innovations with this funding,” said Kolaleh Eskandanian, Ph.D., executive director of the Sheikh Zayed Institute and NCC-PDI. “We are even more excited about welcoming this new cohort of companies to our family of pediatric device startups and entrepreneurs. Together we can move the needle a bit faster and safer to bring pediatric products to market.”

She added that in addition to the financial support and consultation services through NCC-PDI, the awardees can leverage the validation received through this highly competitive process to raise the additional capital needed for commercialization. Since inception in 2013, NCC-PDI has supported 67 pediatric devices and the companies and research labs owning these devices have collectively raised $55 million in additional funding.

The twelve finalists each made five-minute presentations to the symposium audience and then responded to judges’ questions. Finalists also included Anecare, LLC, Salt Lake City, Utah; ApnoSystems, Buenos Aires, Argentina; Deton Corp., Pasadena, Calif.; Kite Medical, Dublin, Ireland; Moyarta 2, LLC, The Plains, Va.; and Oculogica, Inc., New York, N.Y.

Serving on the distinguished panel of judges were Susan Alpert, M.D., of SFA Consulting, a former director of the FDA Office of Device Evaluation and former senior vice president and chief regulatory officer of Medtronic; Charles Berul, M.D., co-director, Children’s National Heart Institute; Andrew Elbardissi, M.D., of Deerfield Management; Rick Greenwald, Ph.D., of the New England Pediatric Device Consortium (NEPDC); James Love, J.D., of Oblon; Josh Makower, M.D., of NEA; Jennifer McCaney, Ph.D., of MedTech Innovator; Jackie Phillips, M.D., of Johnson & Johnson; and Tracy Warren of Astarte Ventures.

The pitch competition is a highlight of the annual symposium organized by the Sheikh Zayed Institute at Children’s National, designed to foster innovation that will advance pediatric healthcare and address the unmet surgical and medical device needs for children. New this year, the symposium co-located in a joint effort with The MedTech Conference powered by AdvaMed, the premier gathering of medtech professionals in North America.

Keynote speakers at the event included Daniel Kraft, M.D., faculty chair of Medicine & Neuroscience, Singularity University and executive director, Exponential Medicine; Vasum Peiris, M.D., chief medical officer, Pediatrics and Special Populations, FDA;  and Alan Flake, M.D., director of Center for Fetal Research, Children’s Hospital of Philadelphia.

Panel discussions focused on gap funding for pediatric innovation, the journey from ideation to commercialization, and the pediatric device needs assessment in the future regulatory environment.

A close-up of Dr. Marva Moxey Mims at Children's National.

Children’s National welcomes Marva Moxey-Mims, M.D., renowned nephrologist, as incoming Division Chief

A close-up of Dr. Marva Moxey Mims at Children's National.

Marva Moxey-Mims, M.D., a leading expert in chronic kidney disease and glomerular disease who has conceptualized and overseen multicenter clinical studies aimed at improving chronic kidney disease treatment, has been named Chief of Pediatric Nephrology at Children’s National Health System.

Dr. Moxey-Mims comes to Children’s National from the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health where she served as Deputy Director for clinical science and oversaw a research portfolio that included clinical trials for kidney disease and genitourinary dysfunction in adults and children. As Pediatric Nephrology Division Chief, Dr. Moxey-Mims plans to add new staff and restructure a division already ranked among the nation’s leaders by U.S. News & World Report in order to carve out dedicated time for research and improve care for children with kidney disease.

”Children’s National is honored to welcome Dr. Moxey-Mims as the new leader for our talented nephrology team,” says Robin Steinhorn, M.D., senior vice president of the Center for Hospital-Based Specialties. “She brings unparalleled expertise in this field, is a member of a number of influential national committees and has authored more than 90 scientific publications, including peer-reviewed articles and book chapters. Under her guidance, Pediatric Nephrology at Children’s is well-positioned to continue to lead the nation in clinical care and research.”

“I want to inspire the division,” Dr. Moxey-Mims says. “I want the faculty to be happy in their work here and to look forward to coming to work every day. I want them to have enough time to pursue their academic interests, so clinicians not only continue to provide excellent patient care but also can conduct research. All of the staff has potential projects in mind; it’s just a matter of finding the time to do them.”

From a pragmatic standpoint, Children’s pediatric nephrologists will start with what is feasible: Continuing and expanding current cross-disciplinary research projects.

“There are some research projects that will be important to pursue, but we just don’t have the building blocks in place right now to move in that specific direction,” Dr. Moxey-Mims says. “However, continuing ongoing collaborations with our colleagues in neonatology, oncology, hematology and urology are reasonable places to start. I agree with the cliché that success breeds success. If we have an established collaboration and can build on it, that is how we start expanding our research enterprise.”

To that end, the division is in the early stage of joining an existing consortium that is studying four types of glomerular disease, conditions caused by varying mechanisms that often lead to kidney failure. “Information that is gathered will inform care going forward,” she says. “Part of what is being done in these studies is obtaining a better understanding of how disease progresses in different groups of children and adults and quantifying the impact of varying treatment approaches. It’s very exciting for Children’s National to be a new player in this.”

Dr. Moxey-Mims received her undergraduate degree from McGill University in Montreal and her medical degree from Howard University in Washington, D.C. She completed her pediatric residency and clinical pediatric nephrology training at Children’s National and from 1994 to 1999 worked at Children’s National as a staff nephrologist.

“Returning to Children’s has been a wonderful homecoming,” Dr. Moxey-Mims says. “I wanted to return to the hospital setting and have direct exposure to patients. I missed that. In this new role, I can participate in patient care, as well as foster an environment that spurs even more research. It’s really the best of both worlds.”

Happy girl in hospital bed surrounded by doctors

Addressing MB-CLABSI through innovation – and dedication – to pediatric safety

Happy girl in hospital bed surrounded by doctors

With mucosal barrier central line-associated blood stream infections (MB-CLABSI) posing a serious risk to cancer and other immunocompromised patients, Children’s National Health System was intent on finding a way to prevent them. Through a focused initiative led by Rose Szeles, M.S., R.N., N.E.-B.C., director of nursing for the Center for Cancer and Blood Disorders, the hospital experienced great success, cutting infection rates by more than half.

This was a daunting proposition. Historically MB-CLABSI has not been viewed as a preventable infection due to the side effects typically associated with bone marrow transplants in this patient population. Sores and mucosal disruption that develops in the oral cavity post-transplant are fairly common and make it exceedingly difficult to keep the mouth clean and clear of bacteria. Without regimented oral hygiene in this type of environment, the mouth can quickly develop bacteria putting the patient at risk of a MB-CLABSI.

“We challenged the notion that we could not prevent MB-CLABSI and set out on a journey to try to prevent these types of infections from occurring,” says vice president and chief quality and safety officer, Rahul Shah, M.D. “With leadership from our nursing teams and the infection control and prevention group working together with the physicians, we were able to approach this issue from a unique perspective.”

In 2013, Children’s National launched a MB-CLABSI prevention program focused around saline rinses to improve oral hygiene. The goal was to keep the mouth cleaner to avoid bacteria from forming and ultimately entering the blood stream.

Children’s National put the plan into action through the following measures:

Provider

  • Simplified ordering of saline rinses to increase accountability and compliance with the practice and make it easier for providers
  • Implemented reminders to order saline rinses during daily rounds
  • Added saline rinses to the Medication Administration Record to drive compliance in administration of the task

Administrative

  • Saline rinses were chosen as an indicator to be displayed on public-facing quality boards throughout the hospital
  • Implemented daily audits of the quality board to track opportunities for improving compliance and reducing omissions and errors
  • Standardized daily medical rounds to include review of the quality boards

Patient/Caregiver

  • Implemented discussion of saline rinses of the mouth for oncology and bone marrow transplant patients during daily rounds
  • Standardized education for caregivers of children with central lines

“Through strategic programs like this, our patients are safer and Children’s National continues to be a national pediatric quality leader,” says Dr. Shah.