2014 Annual Report The University of Vermont Children’s Hospital

The University of Vermont Children’s Hospital
The University of Vermont Department of Pediatrics
2014 Annual Report
I
t gives me great pleasure to
introduce this year’s Annual
Report for the Department of
Pediatrics at the University of
Vermont College of Medicine
and the University of Vermont
Children’s Hospital. This report summarizes my 20th year
as Chair of the Department,
and also celebrates our name
change as noted above from
what was formerly the Vermont
Children’s Hospital at Fletcher Allen Health Care thanks to our
being part of the new integrated health system—the University
of Vermont Health Network.
This report covers the period from January through December
2014, and captures the contributions, highlights, and achievements of the remarkable group of people that make up our
department and children’s hospital. It tells the story of how each
and every day we further our mission and vision to improve the
health of children in our region as well as of children nationally
and internationally through our clinical, educational, research
and advocacy efforts.
Our report this year has more photographs and at the same
time concisely highlights an extraordinary amount of activities,
achievements and awards as garnered by the various medical,
surgical, neurologic and psychiatric divisions and departments
who care for the children and families we serve. If you have
seen our prior reports, you cannot help but notice our ongoing
growth in the quantity and quality of our faculty, our residency
and student teaching programs, our health services research, and
in our advocacy efforts. In addition our increased philanthropic efforts over the past year also described in this report have
allowed us to expand programs and services in ways requested
by our patients.
Kennith Sartorelli, M.D.
A Hospital within a Hospital
Behind every child stands a family. At
The University of Vermont Children’s
Hospital we believe that to truly care
for that child, you must also care for the
entire family.
At the UVM Children’s Hospital we
combine knowledgeable expertise with
advanced techniques in pediatric care
with a family-centered approach. In this
model, parents are not just involved in
the process, but are encouraged to take
a lead role in shaping the care their child
receives.
The University of Vermont Children’s
Hospital is a hospital within a hospital.
It includes all areas at The University of
Vermont Medical Center where children
are treated—from the maternity unit to
the Emergency Department, from our
Children’s Specialty Center to our pediatric primary care clinics.
All of these partners are committed to
providing area families with the highest-quality care possible in a child-friendly, family-centered medical facility, which
is also part of an effective and integrated
health care system.
The UVM Children’s Hospital is the result of a very special partnership among
The University of Vermont Medical
Center, the University of Vermont
College of Medicine and College of
Nursing and Health Sciences, and the
people of Vermont and northern New
York who are served by the member institutions of the University of Vermont
Health Network.
At The University of Vermont Children’s
Hospital our missions are: Patient Care,
Education, Research, and Child Advocacy. These missions call for our services
to reach far beyond the campuses of the
medical center and into the communities
we serve. Our focus is always fixed on
children and their families—and in doing
so—the future of our community.
Most importantly this report illustrates how we are all working
together to further the legacy of Dr. R. James ( Jim) McKay
whose vision continues to enable us to be the highest quality,
collaborative patient and family-centered department and
children’s hospital possible. I am delighted to be a part of the
remarkable team that makes our department and children’s hospital so special and hope you feel similarly after reading through
this year’s annual report.
Lewis First, M.D.
The University of Vermont Department of Pediatrics,
Chairman and Professor
The University of Vermont Children’s Hospital, Chief of Pediatrics
Children’s Health Care Service, The University of Vermont
Medical Center, Physician Leader
2014 Annual Report
The University of Vermont Children’s Hospital
and Department of Pediatrics
Contents
2
Adolescent Medicine. . . . . . . . . . . . . . . . . . . . 2
Child Abuse Program. . . . . . . . . . . . . . . . . . . . 3
Cardiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Developmental Behavioral Pediatrics & . . . 5
Primary Care. . . . . . . . . . . . . . . . . . . . . . . . . . .
Children with Special Health Needs
Endocrinology. . . . . . . . . . . . . . . . . . . . . . . . . .
Gastroenterology, Hepatology &
Nutrition. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
7
Genetics and Dysmorphology. . . . . . . . . . . . 8
Hematology/Oncology. . . . . . . . . . . . . . . . . . 9
Immunology and Infectious Disease. . . . . . 10
Inpatient and Critial Care . . . . . . . . . . . . . . . 11
Neonatology. . . . . . . . . . . . . . . . . . . . . . . . . . 12
Nephrology. . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Palliative Care. . . . . . . . . . . . . . . . . . . . . . . . . 14
Pulmonology. . . . . . . . . . . . . . . . . . . . . . . . . . 15
Rheumatology. . . . . . . . . . . . . . . . . . . . . . . . . 16
Anesthesiology. . . . . . . . . . . . . . . . . . . . . . . . 18
Neurology . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Pathology. . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Psychiatry. . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Psychology . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Radiology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
General Surgery . . . . . . . . . . . . . . . . . . . . . . 22
Neurological Surgery. . . . . . . . . . . . . . . . . . 22
Otolaryngology. . . . . . . . . . . . . . . . . . . . . . . 22
Plastic Surgery . . . . . . . . . . . . . . . . . . . . . . . 23
Urology. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Research. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24
Education. . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
Philanthropy . . . . . . . . . . . . . . . . . . . . . . . . . 27
Faculty and Community Faculty. . . . . . . . 28
Academic General Pediatrics
Division DIRECTOR
Jerry Larrabee, M.D.
Primary Care
medical DIRECTOR
Stanley Weinberger, M.D.
University of Vermont Children’s Hospital Pediatric Primary Care serves as a
comprehensive, family-centered medical
home for a diverse population of children
from all over Chittenden County and
Central Vermont. A faculty of fourteen
is situated across two sites, the UHC
Campus in Burlington and the Blair Park
campus in Williston. In addition to patient care, they precept the primary care
continuity clinics for the UVM Pediatric
Residency program and are active in community advocacy, academics and research.
Summary of Highlights
UVM Children’s Hospital Pediatric Primary Care is a recognized medical home
providing comprehensive, family-centered
care and patient outreach. Some services
include directing the school-based clinics
in the Burlington School District and the
Pediatric New American Clinic, directed
by Andrea Green, M.D., which provides
care for all new refugees in Vermont
through the Vermont Refugee Resettlement Program. In addition the clinic
works closely with mental health providers and the community health team and
hosts Karyn Patno, M.D., in the ChildSafe
clinic, which evaluates suspected child
abuse. The clinic also now has an Adolescent Medicine specialist, Erica Gibson,
M.D., seeing teens in primary care and
taking community referrals.
health. Richard “Mort” Wasserman,
M.D., continues to lead PROS – Pediatric
Research in Office Settings, which is a
subsidiary of the AAP.
The faculty all engage in teaching, hosting
Family Medicine and Psychiatry residents
and UVM College of Medicine clerkship
students, in addition to the UVM Pediatric residency. This past year, Jerry Larrabee, M.D., expanded his role, becoming
the UVM Pediatric Residency Director.
The clinic also works very closely with
the Vermont Child Health Improvement
Program (VCHIP), with Erica Gibson,
M.D., joining that team to assist with
adolescent quality of care issues across
Vermont. UVM Children’s Hospital Pediatrics is part of VCHIP’s CHAMP quality
improvement network with focuses over
the past year on adolescent mental health,
breastfeeding and healthy weight and
activity.
Major Highlights
Faculty are also active in research and advocacy. Eliot Nelson, M.D., has continued
his statewide efforts around firearm injury, violence and suicide prevention as well
as concussion care. He continues to serve
on the Vermont Child Fatality Review
Board and worked this past year on child
abuse prevention as an invited member of
the Vermont Citizens Advisory board for
our Department for Children and Families. Barb Frankowski, M.D., currently
serves as the President of the Vermont
Chapter of the American Academy of
Pediatrics and received the Milton J.E.
Senn award at the national AAP meeting
for her leadership and advocacy in school
Adolescent Medicine
■
arb Frankowski, M.D., was awarded
B
the Milton J.E. Senn lectureship award
at the AAP national conference for her
long-standing advocacy and leadership within the Academy of Pediatrics
towards school health.
■
ndrea Green, M.D., concluded her
A
trial in the mental health screening of
newly arrived refugee children as part
of the Vermont Passport to Health
Project (awaiting publishing). She also
presented nationally on this topic at
the North American Refugee Health
Conference and on a Medical Home for
Immigrant and Refugee Children at the
AAP national conference.
Program Director
Erica Gibson, M.D.
Our team of highly skilled clinicians is
dedicated to the physical, emotional
and social needs of people from puberty
through young adulthood. The University
of Vermont Children’s Hospital provides
comprehensive preventative and primary
care, as well as specialty care for specific
disorders and chronic conditions.
Patients benefit from access to the newest
treatments and therapies—and care—informed by the latest scientific knowledge
and research. Our services go beyond the
treatment of medical problems, offering
adolescents personal counseling, education and support to help them as they
navigate the transition to adulthood.
andrea green, M.D.
Services for Young Adults
We offer services for a wide range of
health concerns and disorders:
primary care and routine health checkups; abdominal pain, acne and dermatological problems, behavioral issues,
chronic pain, injury prevention, eating
disorders, gynecological problems, nutrition and fitness, sports-related medicine,
smoking, HIV infection, sexually transmitted diseases, substance abuse, teen
pregnancy, weight issues, and hormonal
issues.
Child Abuse Program
Program Director
Karyn Patno, M.D.
The Pediatric S.A.N.E. and ChildSafe
programs at The University of Vermont
Children’s Hospital coordinate to provide
comprehensive medical services for child
victims of abuse, and work closely with
community partners like the Children’s
2
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Advocacy Center, law enforcement, the
Department for Children and Families
(child protection services), and others to
provide high-quality, compassionate, and
coordinated care to children who have
been victims of abuse, and their families.
From medical treatment to injury documentation and mental rehabilitation and
from investigation to prosecution, please
know that the safety, mental and physical
health, and security of child victims of
abuse is our top priority.
The ChildSafe program is an office-based
clinic, staffed by pediatricians from The
UVM Children’s Hospital, who treat
children suffering from sexual abuse,
physical abuse, medical abuse, emotional
abuse and neglect. Children who need
urgent care will be evaluated first in the
Emergency Department by the Pediatric
S.A.N.E. program and referred to the
ChildSafe program if appropriate. The
ChildSafe program and the S.A.N.E.
program work together to provide highquality care 24 hours per day.
A ChildSafe clinic evaluation includes
taking a detailed history and a medical
forensic exam. The medical exam allows
providers to recognize injuries that are
a direct result of the abuse, as well as
diagnose and treat any related infections
or conditions. The exam also helps ensure
that the child gets the needed follow-up
including mental health interventions.
The ChildSafe program is able to document any injuries with high-quality digital
camera and video, and will do so when
appropriate. Patient confidentiality is
strictly adhered to in both the ChildSafe
program and the S.A.N.E. program. The
ChildSafe program welcomes children
from all across Vermont and northern
New York.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
3
Cardiology
Division Chief
Scott Yeager, M.D.
The Division of Pediatric Cardiology
provides a full range of clinical services,
including fetal diagnosis, outpatient and
inpatient management of congenital and
acquired heart abnormalities, outreach
clinics, and both diagnostic and interventional catheterization. In addition, the
Division is active in quality initiatives,
research projects, and the education of
students and residents.
Summary of Highlights
The Division is actively participating in
the Boston Children’s Hospital-based
Standardized Clinical Assessment and
Management Plan (SCAMP) quality
initiatives. Dr. Niels Giddins has been
involved in developing both syncope
and long QT protocols, and the division
is submitting data on eligible patients
with the aim of improving outcomes and
patient satisfaction while controlling
resource utilization. Dr. Nancy Drucker is
working with the Vermont Child Health
Improvement Program on a project
addressing assessment, documentation
and intervention in childhood obesity. Our educational activities include
clinical core students at outpatient clinics,
students and residents participating
in our month-long elective program,
clinical core student lectures, monthly
lectures to the house staff and cardiology
fellows, quarterly reviews of abnormal
fetal echocardiograms with obstetrics
and radiology, participation in pediatric
advanced life support instruction, as
well as regularly scheduled lectures to
parent groups, physical therapy students,
catheterization staff, nursing groups, and
outreach education in community hospitals. A computer-based, comprehensive,
multimedia examination has been developed to focus and evaluate students and
residents through pre- and post-rotation
assessment of core cardiology knowledge base. Current research activities
include analysis of practice variation in
the regional management of aortic valve
disease. Dr. Yeager is co-founder and
president of the New England Congenital
Cardiac Research Foundation, dedicated
to supporting multi-institutional research
and education programs based in the six
New England states, and to providing
seed money to help young investigators
become more competitive for national
funding.
Major Highlights
■
■
isher JG, Bairdain S, Sparks EA, Khan
F
F, Archer JM, Kenny M, Edwards EM,
Soll RF, Modi BP, Yeager SB, Horbar
JD, Jaksic T. Serious Congenital Heart
Disease and Necrotizing Enterocolitis
in Very Low Birth Weight Neonates:
A Prospective Cohort. J Am Col Surgeons. In Press
ood RJ, Canale SK, Goodman RL,
G
Yeager SB. Identification of Critical
Congenital Heart Disease in Vermont:
The Role of Universal Pulse Oximetry
Screening in a Rural State. Clinical
Pediatrics. In Press
Nancy Drucker, M.D.
4
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Developmental Behavioral Pediatrics &
Children with Special Health Needs
Division Chief
Stephen Contompasis, M.D.
The Division continues to collaborate
with the Vermont Department of Health
Children With Special Health Needs Program (Maternal Child Health Division)
to provide clinical services and leadership
training in neurodevelopmental disabilities through the Vermont Interdisciplinary Leadership Education for Health
Professionals Program (VT-ILEHP).
Clinical Services
The Vermont Department of Health,
Children with Special Health Needs
program, provides statewide developmental pediatrics services through its Child
Development Clinic, led by Carol Hassler,
M.D., and joined by Steve Contompasis,
M.D., and Johana Brakeley, M.D. Clinics
are held in Burlington, Barre, Bennington, Brattleboro, Middlebury, Morrisville, Newport, Rutland, St. Albans, St.
Johnsbury, Springfield, and White River
Junction, and provide evaluation and follow-up to Vermont children with developmental concerns. Emphasis is on the early
diagnosis of young children with neurodevelopmental conditions, including autism
spectrum disorder, and on collaboration
with Vermont’s early intervention and special education systems, as well as medical
homes. The Child Development Clinic
also provides developmental pediatrics
evaluation and follow-up for infants and
toddlers who have received care in the
Neonatal Intensive Care Unit (NICU) at
the UVM Children’s Hospital. The program also funds the Autism Assessment
Clinic, led by Jeremiah Dickerson, M.D.,
child and adolescent psychiatrist, at the
Vermont Center for Children, Youth, and
Families at UVM, as a diagnostic clinic for
Vermont children covered by Medicaid
insurance.
Leadership Training
VT-ILEHP/VT-LEND
The Vermont Interdisciplinary Leadership Education for Health Professionals
(VT-ILEHP) program will change its
name to VT-LEND (Vermont Leadership
Education in Neurodevelopmental Disabilities) in 2015.
VT-LEND is one of 43 LEND
Programs found nationally
at other University Centers
on Excellence in Disabilities
Education Research and Service.
VT-ILEHP/VT-LEND is strategically focusing its efforts on issues
of health disparities and inequities,
providing distance technology outreach
to leadership training, and upon the
placement of social work and nursing
leaders as care coordinators in Blueprint
Medical Homes.
Stephen
Contompasis, M.D.
Recent Highlights
■
■
■
aming Mercedes Maria Avila, Ph.D.,
N
as Multicultural Director, focusing on
cultural and linguistic competency
training, applying the federal CLAS
Standards programmatically, multicultural recruitment, including outreach to
immigrant and refugee populations.
urther increasing our multicultural
F
efforts this year by hiring Fatuma Bulle
as Family Resource Consultant, Esther
Doh as program assistant, and Daline
Derival, M.P.H., as program evaluator.
ecruitment of three leadership
R
trainees from our Bhutanese refugee
resettlement population, assisting them
to reestablish their previous careers in
health and education serving children
with special health needs populations.
■
r. Avila was elected co-chair of the
D
National Multicultural Council of the
Association of University Centers on
Disabilities (AUCD), which also places
her on the AUCD Board of Directors.
■
Jean Beatson, Ed.D., R.N. (training director), Mary Alice Favro, M.S. (clinical
director), and Dr. Avila have successfully designed a Technology Distance
Outreach Program.
■
ive current and former leadership
F
trainees are providing care coordination services in Chittenden County
pediatric medical homes or to Pediatric
Blueprint Community Health Teams.
Major Highlights
■
e development of Autism Spectrum
Th
Disorder Fact Sheet for Parents with
recently diagnosed children available
in ten languages (Arabic, Bosnian, Burmese, English, French, Nepali, Somali,
Spanish, Swahili, and Vietnamese).
■
reation of two videos for Somali
C
Bantu community members.
■
T-ILEHP has reached a 30-40%
V
racially/ethnically diverse program goal
with an anticipated 50-60% for academic year 2015-2016.
■
r. Avila received the 2014 Edith D.
D
Hendley Award recognizing a woman
who has demonstrated excellence in
research, scholarship and teaching, and
community service.
■
T-ILEHP was nominated for the 2014
V
AUCD National Multicultural Council
Award for Leadership in Diversity.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
5
Gastroenterology, Hepatology & Nutrition
Paul Zimakas, M.D.
Division Chief
Michael D’Amico, M.D.
The Division of Pediatric Gastroenterology, Hepatology and Nutrition offers
consultation for a variety of disorders
of nutrition and growth, the GI tract,
the liver and pancreas, obesity, lipid
disorders, and feeding problems. The
division continues to grow and is now
comprised of pediatric gastroenterologists Dr. Richard Colletti, Dr. Michael
D’Amico, Dr. Jillian Sullivan and
newly arrived Dr. Pamela Puthoor,
as well as nurse practitioner, Bridget
Thabault.
Summary of Highlights
Dr. Sullivan has been awarded a 3
year grant from the Cystic Fibrosis
Foundation as part of the Developing
Innovative GastroEnterology Specialty
Training (DIGEST) to help meet the
Endocrinology
Division Chief
Paul J. Zimakas, M.D.
The Pediatric Endocrinology Program
provides consultative subspecialty care to
children and adolescents from Vermont
and northern New York State. Under the
supervision of pediatric endocrinologists,
Dr. P.J. Zimakas and Dr. Martina Kacer,
the service provides both ambulatory and
inpatient care for patients with a variety of
complex endocrine disorders (including
disorders of the thyroid gland, growth,
sexual development, glucose metabolism,
bone and calcium metabolism, the pituitary
gland, and the adrenal gland) and diabetes
mellitus. Using a family centered approach,
patients receive the highest quality of care
from a multidisciplinary team, consisting of
physicians, certified diabetes educators, an
endocrine nurse, a pediatric nutritionist, a
social worker and a pediatric psychologist.
Dr. Zimakas also serves as the Pediatric
Endocrine Consultant to the Vermont
Department of Health’s Newborn Screening
Advisory Committee. Dr. Kacer is in the
process of developing a multi-disciplinary
clinic (in collaboration with the divisions
of gynecology, urology and psychology)
dedicated to providing care and support for
transgender adolescents and young adults.
In collaboration with the adult Endocrine
6
division, a formal Pediatric to Adult Endocrine Transition clinic exists to ensure a
seamless transition from pediatric to adult
endocrine care for young adults with chronic and complex endocrine conditions.
The division provides outpatient diabetes
education to newly diagnosed children with
diabetes and their families, as well as the
frequent follow-up of established patients.
The clinic is recognized as a center of excellence in diabetes education by the American
Diabetes Association. Chronic care and
around the clock support is provided by certified diabetes educators and physicians that
are available to address individual patient
questions and concerns, and to provide
and maintain education materials regarding
diabetes management in schools (including
a formal presentation for school nurses biennially). Dedicated care is also provided to
patients with cystic fibrosis related diabetes
in conjunction with the division of pediatric
pulmonology.
In continuing collaboration with the Vermont Child Health Improvement Program
(VCHIP), the clinic has developed a comprehensive data base registry for patients
with diabetes mellitus. This registry has been
used to ensure that quality of care standards
for children with diabetes are being met. It
gastroenterologic needs of patients
with Cystic Fibrosis and to develop
experts in CF-related gastrointestinal
diseases. She is the Associate Pediatric Program Director of the Vermont
Cystic Fibrosis Center and is currently studying the use of probiotics
in patients with cystic fibrosis. The
Vermont Children’s Hospital Pediatric
Inflammatory Bowel Disease Program
continues to participate in the ImproveCareNow Network, working to
improve the care and outcomes of children and youth with Crohn’s disease
and ulcerative colitis using improvement science, population management,
pre-visit planning and self-management support. Dr. Jillian Sullivan is
the Vermont Physician Leader, and
Dr. Richard Colletti continues as the
national Executive Network Director
of ImproveCareNow.
Major Highlights
■
e multidisciplinary Aero Digestive ProTh
gram won the prestigious UVM Medical
Center “Becoming One” Award, recognizing the effort of the program’s organizers
and members in providing coordinated,
unified care for its patients and families.
The Aero Digestive Program is a combined
effort between Pediatric GI, Pulmonary,
ENT, Nutrition and Speech Language
Pathology providing high-level care to patients with a variety of special needs in one
coordinated, collaborative setting.
■
is year, the division was the recipient
Th
of two large funded grants, furthering
its long tradition of investigation and
collaboration. Dr. Colletti’s ImproveCareNow national consortium for
pediatric Inflammatory Bowel Disease
and Dr. Sullivan’s DIGEST grant studying pediatric cystic fibrosis.
is also used to direct quality improvement
research, such as improving influenza vaccination rates and adherence with the recommended complication-screening guidelines.
The division is also dedicated to providing
clinical educational experiences for pediatric
residents, adult endocrinology fellows, and
reproductive-endocrinology fellows. Dr.
Zimakas lectures in several of the courses of
the integrated curriculum for first year and
second year medical students at the University of Vermont. Dr.Kacer is an instructor
in the Doctoring Skills course for first year
medical students and is on the medical
student admissions committee.
Major Highlights
■
e division hosted the first in a series of
Th
patient education nights for adolescents
with Type 1 diabetes. This interactive
meeting was designed to educate and empower patients in caring for their chronic
condition.
■
In continuing collaboration with the Vermont Child Health Improvement Program
(VCHIP), the clinic is engaged in a quality
improvement initiative designed to improve adherence with the recommended
guidelines of screening for diabetes related
complications.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Michael D’Amico, M.D.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
7
Genetics and Dysmorphology
Division Chief
Leah Burke, M.D.
The Vermont Regional Genetics Center has
a new name. We are now the University of
Vermont Medical Center (UVMMC) Clinical Genetics Program, but our commitment
to keeping abreast of the rapid changes in
the world of genetics and genomics and
providing innovative care to the children
and families of Vermont and parts of New
York State has not changed.
Research/Quality
Improvement
At the UVMMC Clinical Genetics
Program, every effort is made to ensure
that our patients have access to all the
latest treatments and research studies. We
continue to participate in research studies
with national centers of excellence in
genetics and genomics.
The UVMMC Clinical Genetics Program has been a part of a regional quality
improvement project on the evaluation of
children with developmental delay with
the New England Genetics Consortium
that has been expanded to include children
with two metabolic disorders. We also
participate in a UVMMC Children’s Hos-
pital project in collaboration with VCHIP
looking at the transition of children with
chronic conditions.
Economics Committee to develop educational members for the regional Medicare
provider for New England.
Education
Dr. Burke and one of the genetic counselors from the UVMMC Clinical Genetics
Program, under the auspices of the New
England Genetics Collaborative, continue
to develop the website (GEMSS – Genetics Education Materials for School
Success) to provide practical and useful
information about genetic conditions to
teachers and school personnel in order to
improve the care of children with genetic
conditions in the classroom. The website
was recently changed in order to adapt to
mobile devices.
The members of the UVMMC Clinical
Genetics Program are involved in the
education of medical students, residents
and fellows, in the form of formal lectures
and clinical clerkships. Evaluations of these
teaching efforts are consistently in the good
to excellent range. Our group has been
active in giving presentations at regional and
national meetings, including clinical case
presentations, research presentations and
invited lectures, webinars, and workshops.
Innovation
Innovation in genetics has changed both
the diagnosis and treatment of genetic conditions. The UVMMC Clinical Genetics
Program is dedicated to providing the
most up to date and effective therapies
for our patients. Because of the rapidly
changing world of genetic testing, the
insurance companies often have questions
and concerns. We work closely with the
insurance providers to help them understand the medical necessity and benefits
of genetic testing. Dr. Burke worked with
the American College of Medical Genetics
Major Highlights
■
New Clinic: Upper Extremity Clinic
– multidisciplinary clinic with plastics,
physiatry and physical therapy
■
New book chapter: Burke LW
and Laub DR (ed.). Incidence and
syndromes associated with congenital
anomalies of the upper limb. Congenital Anomalies of the Upper Extremity:
Etiology and Management. 2014;
27-38.
Leah Burke, M.D.
8
Alan Homans, M.D.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Hematology/Oncology
Division Chief
Alan Homans, M.D.
The Pediatric Hematology/Oncology
Clinic continues to see all referred patients
with hematological or oncologic problems.
Our staff includes two full time physicians
(with the addition of a third in 2015), two
Pediatric Nurse Practitioners, two clinical
research associates, and staff who offer social support social work. The program has
been recognized for having Association of
Pediatric Hematology/Oncology Nurses
(APHON) certification for all chemotherapy nurses. The Pediatric Oncology Program is an active member of the Children’s
Oncology Group (COG), an international
consortium of over 200 pediatric oncology
centers, which allows us to offer families
current treatment regimens with access to
the most recent investigational agents and
molecular testing. Our research program
has an active interest in clinical research,
with the majority of our patients receiving
their therapy in the context of front line
COG investigational treatment protocols.
This year saw the introduction of an infusion program for patients needing chronic
transfusion therapy, a new pediatric oncology brain tumor clinic, and participation in
regular regional telemedicine tumor board.
Additionally, the Pediatric Oncology
program is an active participant in the
Consortium for New England Childhood
Cancer Survivors, a group of New England
programs dedicated to improving the
survivorship of childhood cancer patients
and their families. We are also members of
the Vermont Regional Hemophilia Center
and participate in the activities of Region I
in providing hemophilia care.
Research
nursing students and in the American
Society of Pediatric Oncology Nursing
(APON) chemotherapy courses for staff
nurses. The Pediatric Oncology staff also
provides service to the University as
well, and serves on the Committees for
Human Research in the Medical Science
(UVM’s IRB) and the Faculty Standards
Committee.
We are committed to continuing the
improvement in childhood cancer care
through research. The majority of pediatric oncology patients are enrolled in front
line clinical investigations through COG.
Most are also enrolled in epidemiology or
late effects studies as well. Our oncologists have participated in publications for
COG and CONNECS in the last year.
Philanthropy
Education
The event, benefitting the Pediatric Cancer Research Foundation in its support of
the University of Vermont Cancer Center
and University of Vermont Children’s
Hospital, raised more than $60,000 in net
proceeds for pediatric cancer research.
Medical students and Pediatric residents have the options to participate in
our Pediatric Hematology/Oncology
rotation. In addition, students attend
one of our clinics as part of their clinical
outpatient rotations. Our staff is actively
engaged in teaching medical students in
the Professionalism, Communication
and Reflection course and in a number of
other lecture opportunities. Our nurses
and practitioners are engaged in providing both lectures and preceptorships for
Vermont native Keegan Bradley, the 2011
PGA Tour Rookie of the Year and a star of
the 2012 U.S. Ryder Cup team, returned
to the Woodstock Inn & Resort in Woodstock, Vermont, on Aug. 25, 2015 with
fellow PGA Tour winner Brendan Steele
to host the third annual Keegan Bradley
Charity Golf Classic.
“We’re proud to support Vermont causes
and children’s cancer is an important
one,” said Bradley. “Our outing last year
was a great success and we hope to have
as much fun and raise even more money
for children’s cancer research this year.”
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
9
Immunology and
Infectious Disease
Inpatient and Critical Care
Division Chief
CRITICAL CARE
Barry Heath, M.D.
Division Chief
William Raszka, M.D.
Pediatric Infectious Diseases and Immunology has seen dramatic changes over
the past few years. Screening of pregnant
mothers and effective anti-retroviral
therapy has dramatically reduced the
incidence of perinatally acquired HIV
infection. Expanded use of vaccines has
made previously common bacterial and
viral infections less frequent. However,
the service sees many children with
infections caused by resistant bacteria or
opportunistic infections, children with
hereditary immune deficiencies or periodic fever syndromes, or those seeking
pre-exposure advice before traveling.
The service provides inpatient, outpatient, and telephone consultation
services for acute and chronic infectious
disease issues. Working with the pediatric
hospitalist team, the service gives advice
regarding central catheter placement and
home intravenous antibiotic use. The
service works with the adult infectious
disease service and pharmacy to practice
antibiotic stewardship. Additionally, the
service runs a travel clinic for children
and adults traveling with children to
give pre-travel advice and prophylaxis.
Approximately 400 travelers are seen each
year for pre-travel counseling.
10
inpatient pediatrics
medical director
Karen Leonard, M.D.
The Pediatric
Hospitalist Program
The Pediatric Hospitalist Program at University of Vermont Children’s Hospital
provides hospital-based care to children
from Vermont and northern New York.
There are now ten pediatric hospitalists
in the pediatric hospitalist program who
are available 24 hours a day, 7 days a week
to provide care for pediatric inpatients,
newborns in the newborn nursery, pediatric patients in the emergency room, and
inpatient consultations for surgical and
sub-specialist services. In addition, pediatric hospitalists offer lactation consultation/breast-feeding education, neonatal
circumcision, and conscious sedation for
inpatients.
william raszka, m.d.
Education
The service is very active at all levels of
medical student and resident education. Dr.
Raszka is the Course Director for the Foundations Level Attacks and Defenses Course,
and the Pediatric Clerkship. The service
regularly facilitates small group learning
sessions among students and residents. The
Pediatric Infectious Disease elective remains one of the most popular electives for
■
is year, a multidisciplinary group of
Th
hospitalists, pediatric residents, nurses,
parents and quality improvement
experts launched a Family Centered
Rounds improvement project on the
pediatric inpatient floor. This goal of
the project is to improve communication among all members of a hospitalized child’s care team, enable families
to be active participants in their child’s
care and improve the experience for all.
■
he Lactation/Newborn Clinic at
T
Vermont Children’s Hospital was
developed by physicians who are
board certified in Lactation Consultation to provide consultation
for infants with medical challenges
to breastfeeding such as tongue tie,
prematurity, cleft lip/palate, and
poor weight gain. The clinic is run
by pediatricians Molly Rideout,
M.D., IBCLC, FAAP and Rebecca
Goodman, M.D., IBCLC, FAAP; and
family physician Anya Koutras, M.D.,
IBCLC, FAAFP.
Quality
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
In the past year, members of the Pediatric
Hospitalist group have been active in
multiple innovations. Members of the division have spearheaded the re-invigoration of multiple elements of the residency
curriculum, including the development of
an emergency department curriculum, a
night rotation curriculum, and a longitudinal quality improvement curriculum.
The Pediatric Hospitalist group is also
working on a multidisciplinary quality
improvement project to improve Family
Centered rounds, as well as the development of regional infant sepsis guidelines
to improve care of young infants with
fever. Members of the division have
presented their work at both regional and
national conferences over the past year.
pediatric critical care
medicine service
The Pediatric Critical Care Medicine
Service at the University of Vermont
Children’s Hospital provides inpatient
care for children with life-threatening
illnesses or injuries.
Summary of Highlights
The Pediatric Critical Care Medicine
Service has been active in a number of areas
in the past year. Medical Simulation and resuscitation training is provided by members
of the Critical Care staff. PICU members
actively engage in medical student and
resident education and Continuing Medical
Education in local and national venues. The
Division participates in clinical research
with poster presentation at the Pediatric
Academic Societies annual meeting, and
participation in the Pediatric Acute Lung
Injury and Sepsis Investigators. Members
are also active in the Pediatric Residency
Clinical Competency Committee. A Quality Improvement project involving parent
satisfaction and involvement in family-centered rounds is in progress. A member of
the Pediatric Critical Care Medicine Service
received the Department of Pediatrics
“Teacher of the Year Award.”
Major Highlights
medical students in the Department. While
on the pediatric infectious disease service,
medical students and residents participate
in all aspect of patient care.
The service is very active in infection control policy design, surveillance, and resource
utilization. Working with the University of
Vermont Medical Center Infection Control
team, Department of Pathology, and nursing staff, the service recommends infection
control policies, implementation of routine
testing, and outbreak control. The service
provides consultation to the Vermont
Department of Health for the management
of outbreaks, epidemiologic investigations,
and vaccine issues.
Summary of Highlights
Barry Heath, M.D.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
11
Neonatology
Division Chief
Professor
Charles Mercier, M.D.
The Division of Newborn Medicine
provides medical care to premature and
sick newborn infants, including inpatient
intensive care, inpatient convalescent
care, acute patient transport, outpatient
medical follow up care and outpatient developmental surveillance. Neonatal care
at The University of Vermont Children’s
Hospital serves Vermont, northern New
York and New Hampshire; neonatal care
units have an average daily census of 19
infants accounting for over 4,500 patient
days annually.
Education
The Division actively supports graduate
and post graduate medical education, including a subspecialty fellowship training
program currently directed by Dr. Berg.
For the College of Medicine, Dr. Mercier
is the medical director of the Vermont
Regional Perinatal Health Project, providing continuing education activities to
physicians and hospital-based perinatal
staff throughout our referral area.
Research
Research activity within the Division is
principally based in clinical and translational science and quality improvement.
Dr. Horbar, the Jerold F. Lucey Professor
of Neonatal Medicine, is the Chief Executive and Scientific Officer of Vermont
Oxford Network (VON), a working collaboration of over 900 NICUs worldwide
dedicated to improving the quality and
safety of medical care for newborn infants
and their families. Dr. Soll, the H. Wallace
Professor of Neonatology and President
of VON, serves as the Director of Clinical
Trials and Research at VON. Drs. Soll and
Mercier direct a international effort at
describing health and neurodevelopmental follow-up outcomes of extremely low
birth weight infants.
Innovation
Support of evidence-based medicine and
medical decision making is complex.
The Neonatal Cochrane Review Group,
directed by Dr. Soll, is an international
effort focused on producing and disseminating systematic review of evidence for
neonatal healthcare interventions. The
care of opioid exposed infants in the outpatient setting is challenging and resource
intensive: Dr. Anne Johnston is currently
a co-investigator of a National Institutes
on Drug Abuse funded study addressing
issues of health care management for this
population of newborns.
Quality
An active NICU member of VON, Dr.
Mercier chairs the quality improvement
collaborative work group which aims
to reduce the incidence of chronic lung
disease in the very low birth weight infant
by increasing and improving the use of
non-invasive modes of respiratory support. The group also focuses to improve
the experience of families of infants
requiring NICU care.
Elizabeth Lyster, RN.
12
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Ann Guillot, M.D.,
Jenny eddy, Child Life Specialist
Nephrology
Division Chief
Ann Guillot, M.D.
The Division of Pediatric Nephrology
at the University of Vermont Children’s Hospital includes many members of several different departments
and multiple disciplines, as caring for
children with kidney disease requires
a multi-specialty and collaborative
approach.
Children and families come to the Division for management of a wide variety
of problems ranging from the acute and
fairly straightforward to the life-long and
complex. These include hypertension of all
causes, prenatal management and counseling about genitourinary anomalies, bladder
dysfunction, all forms of chronic kidney
disease, and acute kidney injury.
We have a close working relationship with
the Pediatric Urology Division and the
Transplant Division in the Department of
Surgery, with whom we co-manage many
patients. We also work closely with the
Transplant Nephrology Division in the
Department of Medicine.
We offer dialysis modalities to patients
from birth to early adulthood and renal
transplantation to older children and
adolescents, as well as pediatric apheresis. Our pediatric dialysis team includes
some of the best pediatric dialysis
nurses around. Our Division has been
a participant for over 25 years in the
North American Pediatric Renal Trials
and Cooperative Studies group, which
includes almost all of the pediatric renal
transplants in the country. This allows
for both participation in multi-center
trials and for benchmarking our performance against that of the other participating centers. Our transplant team
includes a dedicated pediatric transplant
coordinator and close collaboration
with the University of Vermont Medical
Center Renal Transplant surgeons and
transplant nephrologists.
Our core pediatric nephrology team
includes two pediatric nephrologists, a
nurse clinician, a dietician, and a social
worker. We coordinate care with our patients’ medical homes and with the school
nurses in the patients’ towns, allowing
complex chronic disease management
to be carried out, as well as to optimize
school participation.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
13
(PCEP) program at Harvard
Medical School, and will be
devoting more time specifically to palliative care. Diana
Barnard, M.D., and Laurel
Audy, R.N., from the adult
Palliative Care Service are
providing coverage for pediatric patients and attending the
monthly meetings of the Pediatric
Advanced Care Team.
Palliative Care
On a programmatic level, Vermont
Children’s Hospital was one of only three
hospitals in the U.S. chosen to pilot the
“Conversations Matter” project. Created
by the National Institute for Nursing
Research, “Conversations Matter” is
intended to focus attention on palliative
care needs of children and their families,
and after incorporating feedback on the
pilot project it will be rolled out to children’s hospitals nationwide.
Division Chief
Robert Macauley, M.D.
This was a very exciting year for pediatric
palliative care. Iris Toedt-Pingel, M.D.,
a pediatric intensivist, is attending the
Palliative Care Education and Practice
Thanks to a donation from a grateful
family, over 50 nurses from Fletcher
Allen and throughout the state completed
ELNEC (End-of-Life Nursing Education
Curriculum) training. And on the state
level the Vermont Pediatric Palliative
robert
macauley, M.D.
Care Program has continued to grow,
now providing palliative care services
to over 60 children and their families
statewide. The program also provided
additional training to over 50 nurses
and social workers at a September 2014
conference entitled “Pediatric Palliative
Care 2.0 – Improving Care and Advancing Delivery.”
Robert Macauley, M.D., continued his
work with the American Academy of
Hospice of Palliative Medicine (as a
member of the ethics committee, and
co-chair of the Annual Assembly planning committee) and on the American
Board of Internal Medicine test-writing
committee for the hospice and palliative
medicine board exam.
Major Highlights
■
■
linical care expanded through
C
the involvement of Iris Toedt-Pingel,
M.D., a pediatric intensivist, and Diana
Barnard, M.D., and Laurel Audy, R.N.,
from the adult palliative care service.
ver 50 nurses at Vermont Children’s
O
Hospital and throughout the state
completed the ELNEC program.
Thomas Lahiri, M.D.
Pulmonology
Division Chief
Thomas Lahiri, M.D.
The Pediatric Pulmonology Division
provides outpatient and inpatient care to
children with respiratory and airway disorders. Our cystic fibrosis (CF) program
is accredited by the CF Foundation. The
division participates in multidisciplinary
neuromuscular and aerodigestive clinics,
and has recently created a tracheostomy/
home ventilation clinic.
Summary of Highlights
The Pediatric CF Program has again
achieved upper quartile metrics for
lung function, nutritional status and for
meeting recommended guidelines as
reported in the CF Foundation (CFF)
Patient Registry. Dr. Lahiri co-chaired the
CFF Preschool Guidelines Committee.
National presentations were given by
faculty at both the North American CF
Conference and the American Thoracic
Society annual meeting in 2014. The Division continues to be actively involved in
14
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
medical student and resident education.
The division continues to participate in
CF clinical research trials as a Therapeutic
Development Center as awarded by CFF
Therapeutics, Inc. as well as in asthma
trials through the American Lung Association in conjunction with the Vermont
Lung Center. The CF Center continues
to be a member of the Northern New England CF Consortium. Several investigator initiated projects have been undertaken with a focus on quality improvement.
In order to better serve the needs of our
expanding population of children who
require home mechanical ventilation, a
Tracheostomy and Ventilation Clinic has
been established.
Conditions We Treat:
Major Highlights
Sweat chloride testing by quantitative
pilocarpine iontophoresis
■
■
ecipient of the 2014 Quality Care
R
Award from the Cystic Fibrosis
Foundation
Asthma
Cystic fibrosis (CF)
Chronic lung disease of prematurity
Complicated pneumonia
Neuromuscular disorders
Airway and pulmonary malformations
Immune mediated lung disease
Recurrent aspiration
Interstitial lung diseases
Pulmonary hypertension
Chronic home invasive and non-invasive
assisted ventilation management
Procedures Include:
Pulmonary function testing
Flexible laryngoscopy and bronchoscopy
ultidisciplinary Clinics: CF, M.D.A,
M
Pedi Aerodigestive, Tracheostomy/
Vent
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
15
Other Pediatric Specialities
Rheumatology
Division Chief
Leslie Abramson, M.D.
The Division of Pediatric Rheumatology provides subspecialty care to
children with a variety of rheumatic
diseases. Leslie Abramson, M.D., Division head, is a board certified pediatric
rheumatologist working with a pediatric nurse coordinator to evaluate and
treat children with a variety of autoimmune disorders that often involve
the musculoskeletal system as well as
multiple body systems. The diseases
we treat include Juvenile Idiopathic
Arthritis, Juvenile Dermatomyositis,
Lupus, Scleroderma, Vasculitis and a
variety of other autoimmune disorders.
Dr. Abramson is actively involved at
the national level in clinical research
activities aimed at improving the care
of children with rheumatic disease. She
is a participating member of the Childhood Arthritis and Rheumatic Disease
Research Alliance (CARRA) and the
Pediatric Rheumatology Collaborative
Study Group (PRCSG), two leading
national organizations in collaborative
research amongst pediatric rheumatology centers in North America. She is a
primary investigator in CARRA registry, a national registry for children with
rheumatic diseases and also participates
in a variety of investigations through
the PRCSG looking at efficacy as well
as adverse events related to the use of
biologic medications in the treatment
of pediatric rheumatic diseases. She
has also been involved in ARCHIVE,
a U.S./Canadian registry for children
with vasculitis. She has authored the
Juvenile Idiopathic Arthritis patient
information sheet for the American
College of Rheumatology for several
years and has been involved in patient
advocacy activities through the ACR
as well. She participates in educational
activities of medical students and pediatric residents as well as adult rheumatology fellows at University of Vermont
Children’s Hospital.
As newer more effective medications
have become available for children with
rheumatic diseases (and especially Juvenile Idiopathic Arthritis) it is important that children suspected with these
diagnoses are evaluated by a pediatric
rheumatologist, diagnosed correctly
and treated appropriately early on in
their disease course to prevent potential
damage to joints as well as other body
systems.
College of Medicine Class
of 2015 student Bruno
cardoso examines a
young patient under
the supervision of CHIP
CHIAPPINELLI, M.D.
Leslie Abramson, M.D.
16
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
17
Neurology
our colleagues in the Neonatal Intensive
Care Unit (NICU). The creation of a
NICU/OR handoff tool is one of the
continued improvements to streamline
our pediatric care.
Research continues to delineate the
effects of anesthesia on the developing
brain. A definitive answer will not be
available for several years. It remains
our goal to provide the safest care based
on current empirical evidence. In this
spirit, we are joining with our Radiology
colleagues to reduce MRI scan times
without compromising imaging results.
This reduction in scan times will minimize the amount of anesthesia given to
pediatric patients, thereby reducing the
potential risk.
Sierra Sheller,
Child Life specialist
Anesthesiology
Division Chief
Ann Lawrence, M.D.
The Department of Anesthesiology,
Division of Pediatrics provides anesthetic care to children of all ages and
medical complexities. Our department
is composed of many anesthesiologists
with pediatric expertise, as well as specialty trained pediatric anesthesiologists
qualified to handle our more complex
pediatric population. Our physicians
provide safe and exceptional care in
locations throughout the University of
Vermont Health Network.
2014 has been a year focused on
improvements. The Comfort Zone has
continued to provide exemplary care to
our patients receiving elective, outpatient procedures. The amazing nursing
staff, along with the help of our Childlife Specialist (CLS) place families and
patients at ease during some of the
18
most anxiety provoking situations. Our
Comfort Zone team continually strives
to make the best possible plans to make
every child’s visit the best it can be. In
addition to our Child-life Specialist in
the “Zone”, we also have fabulous Childlife Specialists in our pre-operative area.
Our team meets to formulate perioperative plans focusing on emotional,
behavioral and social needs. Our goal is
to make each child’s visit to the operating room the most positive experience
possible.
This year brought much cooperation
with our colleagues throughout the
Medical Center. We continue to enjoy
our close partnership with the Pediatric Intensive Care Unit (PICU). This
unique collaboration allows provision of
seamless care to some our most critically
ill patients. We are currently working to
adopt this same strength of care with
As a Division, we remain focused on research and education. Our professionals
thrive to provide the best education, not
only to residents in anesthesia but also to
residents in pediatrics, medical students
and emergency medical technicians. Our
division continues with both research in
the Vermont Infant Spinal Registry and
an on-going partnership with Columbia University. The cooperative effort
with the James Jeffords Center and the
Vermont Department of Education
allowed for the publication of “Cognitive
Outcome After Spinal Anesthesia and
Surgery During Infancy”, in September
2014, Anesthesia and Analgesia.
As the University of Vermont Medical
Center continues to grow and build
its statewide campuses, the Pediatric
Division of Anesthesia will diversify
and grow to provide the utmost care for
young patients throughout Northwestern New England and upstate New York.
Division Chief
Peter Bingham, M.D.
Drs. Bingham, Scott, and Holmes continue to see children at the Children’s
Specialty Center and at the Clinical
Neurophysiology Laboratory of the University of Vermont Medical Center, where
we team up with other pediatric specialists in the care of children with complex
medical problems. We were awarded an
NIH grant to provide a summer research
program in neuroscience for UVM
undergraduates. In 2014, we welcomed
neuroscience graduate students into
our clinic to promote bench-to-bedside
collaborations and translational research.
Outreach education included a forum on
seizures at the Soar Learning school in
St. Albans Bay. The neuromuscular clinic
now serves over 70 children in northern
New York with muscular dystrophy and
other neuromuscular conditions. Publications regarding the referral process were
co-authored by faculty member Dr. Peter
Bingham and collaborators at Yerevan
State University in Armenia, and our section has growing research ties to the renowned University College London. Drs.
Scott’s and Holmes’ laboratory research
has shown how medication for seizures
arising early in life may improve long
term behavioral and cognitive outcomes.
Supported by the University, we started
a clinical project aimed to help children
with asthma to improve their neurosensory skills so that they can better recognize
and manage their condition. In total, our
section published 20 reports in medical
journals in 2014. We are delighted to have
recruited Brad Clopton, nurse practitioner, to increase our access and clinical
services in 2015!
peter bingham, M.D.
Orthopedics
Division Chief
Jennifer Lisle, M.D.
Bone, joint, and muscle problems in
children require specialized, expert care
to ensure a child’s healthy growth and
development. At the Vermont
Children’s Hospital, a team of experienced pediatric orthopedic specialists
are trained to provide the full range of
treatments, with family-centered care that
brings a personal approach to every child
and family we see. Pediatric Orthopedic Services provides advanced care for
children and adolescents with all types
of musculoskeletal problems, including
scoliosis, bone tumors, upper and lower
extremity problems, neuromuscular disorders and other orthopedic conditions.
We also treat children with cerebral palsy,
myelomeningocele, muscular dystrophy and other neuromuscular disorders
through the Vermont Department of
Health. As a university hospital, our
treatments are backed by research-based
expertise, and patients have access to the
latest pediatric orthopedic treatments and
therapies available. Our physicians are
board-certified orthopedic surgeons with
additional specialty training in pediatrics.
They’re also University of Vermont faculty members and are involved in research
and in the education of University of
Vermont College of Medicine students
and orthopedic surgery residents.
Major Highlight
■
illiams RK, Black I, Howard D,
W
Adams D, Mathews D, Friend A,
Meyers HW. Cognitive Outcome
after Spinal Anesthesia and Surgery During Infancy. Anesth Analg.
2014;119(3):651-660
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
19
Psychology
james hudziak, M.D.
Pathology
Division Chief
Suzanne Tucker, M.D.
The spectrum of diseases in children is
significantly different than those affecting
adults. Complications of preterm delivery,
developmental and metabolic derangements all require a unique approach to
diagnosis, treatment and predictions for
recurrence in the family. Pediatric pathology contributes to these efforts both in the
chemistry laboratory, with reference ranges
specific for children, as well as in the surgical
pathology laboratory, where understanding
of human embryology help to explain anatomic malformations of multiple organs.
Children are susceptible to an array of
benign and malignant tumors very different
than those of adults. For the benign tumors,
which are fortunately far more common,
their behavior is unique in that some
disappear on their own, some will enlarge
and some, considered malformations, will
grow with the growth of the child. Here
the pediatric pathologist can discern the
character of the lesion, predict its behavior
and thus direct appropriate treatment.
Malignant tumors affecting children are
also unique, with most of them very rarely
affecting adults. In this setting, the pediatric
pathologist works closely with the pediatric
oncologist. The tumor must be identified
as to its organ of origin, and portions of the
20
tumor are submitted for special studies performed at a large pediatric tumor repository.
Information gained from these efforts of
the pediatric pathologist is used to assess
the child’s overall risk and thereby provide
guidance for appropriate therapy.
These efforts are under the auspices of the
Children’s Oncology Group, a National
Cancer Institute which is the world’s
largest organization devoted exclusively to
childhood and adolescent cancer research.
The Children’s Oncology Group has turned
children’s cancer from a virtually incurable
disease 50 years ago to one that now has a
combined 5-year survival rate of 80%. Not
only has survival improved, but treatments have been modified such that good
response of the tumor is achieved, but with
fewer side effects. These achievements are
firmly founded on the efforts of pediatric
pathologists who diagnosis the tumors and
procure tumor tissue for further analysis.
Psychiatry
Division Chief
James Hudziak, M.D.
The Vermont Center for Children,
Youth, and Families (VCCYF), directed
by James Hudziak, M.D., is an internationally known Division of Child and
Adolescent Psychiatry, and serves the
Department of Pediatrics through patient
care, training, teaching and research
efforts. The VCCYF has robust academic
research programs in genetics, neuroimaging, psychophysiology, multicultural
assessment, temperament, epidemiology,
and public health. The VCCYF participates in bench to bedside research, from
identifying brain regions involved in the
maintenance of attention, aggression, and
anxiety in typically developing children,
to developing a new model of treatment,
The Vermont Family Based Approach.
Outpatient child psychiatry services have
expanded in recent years. The VCCYF
has an active Vermont Child Health
Improvement (VCHIP) program. Dr.
Hudziak and Judith Shaw, Ed.D., M.P.H.,
R.N., in collaboration with members
of the VCHIP and VCCYF teams, have
programs in co-locations and provide
consultations to pediatricians around the
state. The Child and Adolescent Fellowship is directed by David Rettew, M.D.,
and has now graduated four classes. The
fellowship program is unique in its application of research training, telepsychiatry,
and family-based approach toward assessment and treatment. In addition to the
fellowship, members of the VCCYF have
been involved in teaching individuals at
all levels of training.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Division Chief
Marlene Maron, Ph.D.
The Pediatric Psychology Service, a
division of Psychological Services at
University of Vermont Medical Center,
is committed to providing the highest
quality psychological Services, staff consultation, and clinical training. We serve
children, adolescents, adults and families
referred through pediatric specialty
clinics, inpatient general and intensive
care pediatric units, and community
providers. We serve patients from all
over the region and treat a wide variety of
conditions. We serve as a primary referral
and resource for primary care providers
all over Vermont and northern New York.
All of our psychologists have specialized
training and experience in the care of
children and families faced with medical challenges. In addition, we provide
outpatient psychotherapy in our general
outpatient clinical and primary care
settings. We provide cognitive-behavioral
therapies; trauma focused, interpersonal,
family, and psychodynamically informed
interventions; parent training and guidance; parent-child interaction therapy; and
hypnosis and pain management.
Two of our department members are pursuing Board Certification as specialists in
Clinical Child and Adolescent Psychology.
Currently in the second phase of the multistage process, Drs. Courtney Fleisher and
Kimberlee `Roy aspire to be recognized as
two of fewer than 200 Board Certified Clinical Child and Adolescent Psychologists in
the country and the first two in Vermont
before the end of FY 2014-2015. Others in
the department plan to join them.
Highlights of organizational
and statewide service:
Dr. Maron serves as the Psychiatry representative to the VCH Quality Council and
serves on the Psychiatry Health Care Service Medical Staff Credentialing Committee. In the past year, she provided leadership
for planning the 12th annual Children’s
Memorial Service. Dr. Fleisher represents
the UVM Medical Center on the Child
Family Trauma Workgroup, a state-wide
collaborative, which includes the Vermont
Agency of Human Services. Dr. Rebecca
Owen Ruid provided consultation to primary care providers and parents on behavior
management topics.
Education
Our Departments of Psychiatry and Pediatrics faculty continued to provide clinical
training for Child Psychiatry Fellows and
Clinical Psychology Practicum Students.
Dr. Maron presented an annual lecture in
the Generations Course for the College of
Medicine and informal didactic training.
Innovation
Dr. Fleisher partnered with the Telemedicine Program to bring a specific empirically supported treatment for young
children with emotional and behavioral
disorders, Parent-Child Interaction Therapy (PCIT), to families in our region and
beyond. Using bug-in-ear technology and
virtual live-coaching, PCIT focuses on
improving the quality of the parent-child
relationship and modifying patterns of
marlene Maron, Ph.D.
interaction between parents and children.
In an effort to improve the functional outcomes of patients with somatic symptoms,
particularly when medical explanations are
elusive, Dr. Fleisher is collaborating with
psychologists across the nation and with
physicians at the University of Vermont
Children’s Hospital on effective methods
of involving behavioral health specialists
earlier in the child’s care and in a fashion
that is acceptable to patients and families.
Finally, mental health screening of children
and adolescents with CF and their parents
began, with referrals to local and department service providers.
Radiology
Division Chief
Timothy Higgins, M.D.
Pediatric Radiology deals with infants and
children, who present unique imaging
challenges and risks compared to adults.
The spectrum of disease processes and
congenital abnormalities of children are
quite different than those seen in older
populations, requiring an approach tailored
to the individual child rather than a one size
fits all approach.
The Department of Pediatric Radiology at
the University of Vermont Medical Center
uses state of the art imaging technology to obtain the highest possible image
quality, while maintaining safety for the
child. Whenever possible, ultrasound and
magnetic resonance imaging are used to
avoid radiation. For example, ultrasound
and MRI are routinely used to evaluate for
appendicitis and inflammatory bowel disease, processes that formerly were routinely
imaged with computed tomography (CT).
When radiation is necessary, the radiation
exposure is kept as low as reasonably achievable (the ALARA principle). All protocols
are “child-sized”, and radiation reducing
techniques such as Iterative Reconstruction
in CT and pulsed fluoroscopy have reduced
the radiation exposure significantly.
Education of radiology residents, medical
students and residents from other specialties is an important function of the pediatric
radiology department, as is collaboration
in research with other specialties. Ongoing
research into relapsed/refractory neuroblastoma is a current focus.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
21
plastic surgery
Richard Hubbell, M.D.
Pediatric Surgical Specialties
General Surgery
Division Chief
Kennith Sarterelli, M.D.
The Division of Pediatric Surgery is
staffed by two board certified pediatric
surgeons, Dr. Kennith Sartorelli and
Dr. John Lawrence. The spectrum of
conditions we treat range from surgical
disorders in the smallest of premature infants to correction of chest wall deformities in teens and also includes treatment
of congenital anomalies of the head and
neck, chest, and abdomen; care of acute
surgical problems throughout childhood;
surgical management of pediatric tumors;
and coordination of trauma care for
children. Our Division performs around
600 operative procedures each year and
additionally oversees the care provided
to approximately 110 pediatric trauma
admissions each year.
Neurological Surgery
Division Chief
Susan Durham, M.D.
The Division of Pediatric Neurological
Surgery provides comprehensive care for
pediatric neurosurgical patients at the
University of Vermont Children’s Hospital.
This effort is led by Dr. Susan Durham, the
only board-certified pediatric neurosurgeon in the state of Vermont.
22
Since coming to the University of Vermont
Children’s Hospital in the fall of 2013, Dr.
Durham, along with her colleagues in pediatric oncology, have developed Vermont’s
first pediatric neuro-oncology program
in an effort to provide comprehensivemulti-disciplinary care for children with
pediatric brain and spinal tumors.
She is actively involved in the education of
neurosurgical residents and serves as the
Resident Education Coordinator for the
University of Vermont Neurosurgical Residency program. Over the past year, she has
been working to develop evidence-based
guidelines for common pediatric neurosurgical disorders. Otolaryngology
Division Chief
Richard Hubbell, M.D.
The Division of Otolaryngology, Head
and Neck Surgery in the Department of
Surgery served over 6,000 children from
Vermont, New York and New Hampshire
this year. The services for children are
spearheaded and coordinated by Richard
Hubbell, M.D., Professor of Surgery and
Pediatrics, and a Board Certified Pediatric
Otolaryngologist. The department provides a full range of medical and surgical
services for children with ear, nose and
throat issues. In 2014, the department performed over 8,000 operative procedures
with the support of the highly trained
pediatric anesthesiologists as well as pediatric nursing staff and child life specialists.
All staff are geared to the special needs of
children and families.
Division Chief
Donald Laub, M.D.
Dr. Donald Laub is medical director of
the Vermont State Children with Special
Health Needs (CSHN) Cleft Palate/Craniofacial Center and the University of Vermont Children’s Upper Extremity Center.
The Vermont State CSHN Cleft Palate/
Craniofacial Clinic is official certified by
the American Cleft Palate-Craniofacial
Association. Dr. Leah Burke, Dr. Thomas
Connolly, and Dr. Barrett Peterson are also
members of this center. Susannah Offenhartz, R.N. is the nurse coordinator of the
Cleft Palate/Craniofacial Center. 2014
marked the beginning of the University
of Vermont Children’s Upper Extremity
Center for treatment of children with congenital anomalies of the upper extremity,
and cerebral palsy. Dr. Scott Benjamin, Dr.
Peter Bingham and Dr. Leah Burke are
also members of this center. Elizabeth St.
James, R.N., is the nurse coordinator of the
Children’s Upper Extremity Center. Pedi-
Dr. Hubbell, in coordination with his
colleagues in pediatric gastroenterology
and pediatric pulmonology, supports the
pediatric aero digestive clinic.
The cochlear implant program is overseen
by Mark Whitaker, M.D., Board Certified
Neurotologist and supported by Margaret
Sicotte, Au.D. Certified Audiologist and
expert in the rehabilitation of children with
cochlear implants. Gary Landrigan, M.D.,
provides surgical services for children with
cystic fibrosis and sinonasal issues.
As an Academic Health Science Center the
practitioners and staff focus on continuous
examination of their processes, incorporation of new evidence and alteration of
processes and approaches based on their
individual research and the work of colleagues throughout the world. The clinical
efforts of the department are supported by
pediatric and otolaryngology residents as
well as dedicated and experienced staff.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Gerald Mingin, M.D.
atric plastic surgery also involves treatment
of skin lesions such as congenital nevi, and
the treatment of traumatic injuries such as
facial trauma and lawnmower injuries.
Dr. Laub edited the recently published
multi-author textbook: “Congenital
Anomalies of the Upper Extremity:
Etiology and Management.” He also
recently published: “Neonatal Anesthesia
Neurotoxicity: a Review for Cleft and Craniofacial Surgeons.” in the Cleft Palate-Craniofacial Journal. He has also published
several case reports with medical students
and members of the Department of
Pediatrics: “Ulnar-Mammary Syndrome”
with Jameson Loyal, “Femoral-Facial
Syndrome” with Monique-Therese Squiers, M.D. (Class of 2015) and Dr. Molly
Rideout, and “Pai Syndrome” with Jacob
Azurdia, M.D. (Class of 2014) and Dr.
Leah Burke.
Dr. Laub has participated in volunteer reconstructive surgical missions to Ecuador,
Honduras, Vietnam, Brazil and Guatemala
with Interplast, Inc., and Hospital de la
Familia Foundation. This experience has
allowed him to help hundreds of afflicted
people in the third world. He is a member
of the American Association of Pediatric
Plastic Surgeons, the American Cleft-Palate-Craniofacial Association, the American Society for Surgery of the Hand and
that organization’s Pediatric Hand Study
Group.
Urology
Division Chief
Gerald Mingin, M.D.
Dr. Gerald Mingin leading the pediatric
urology team has provided comprehensive urologic care to the children of
Vermont, New Hampshire and northern
New York for the past eight years. Dr.
Mingin continues to expand the care of
children who require complex reconstructive surgeries. Dr. Mingin has been
a national pioneer in advancing robotic
minimally invasive surgery. His team is
one of only a handful of centers in the
country performing robotic assisted
bladder augmentations and bladder neck
reconstruction. Over the last year, Dr.
Mingin has participated in multi-institutional clinical research addressing the
safety of robotic surgery with his work
being presented at several national and international meetings. Dr. Mingin with his
colleagues in Pediatric Nephrology have
recently instituted a multi-specialty
voiding dysfunction clinic in order to
stream line our ability to provide comprehensive diagnosis and treatment of
children with these disorders.
Dr. Mingin is a federally funded NIH
investigator who with his colleagues in
the Departments of Neurological Science
and Pharmacology continues to advance
a scientific understanding of the mechanisms underlying stress and bladder
dysfunction in children. The above seminal
research findings were published August
of this year in the American Journal of
Physiology. Dr. Mingin’s clinical efforts to
the state’s children are further supported
by a dedicated team including urology and
pediatric residents, a nurse clinician and
fellow UVM faculty members.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
23
National Immunization
Partnership with the APA
Research
With our partners at the Academic
Pediatric Association (APA) through
funding from the Centers for Disease
Control, the major objective of this
NIPN project in the first two years is
to establish the “HPV Virtual Learning
and Improvement Network” to increase the number of clinicians strongly
recommending HPV vaccine, assessing
patients’ HPV vaccination status at every
type of healthcare visit, and implementing practice change to increase rates of
immunization. In years three through
5, the project will expand, reaching a
greater number of providers and practices and addressing all immunizations
routinely recommended for adolescents.
ImproveCareNow
richard colletti, M.D.
Vermont Child
Health Improvement
Program (VCHIP)
Director
Judith Shaw, Ed.D., M.P.H., R.N.
The Vermont Child Health Improvement
Program (VCHIP) is a population-based
maternal and child health services research
and quality improvement program of the
University of Vermont. Well known for our
Vermont-based work, VCHIP also provides
leadership and expertise to other states
looking to build their own VCHIP-like programs, called “Improvement Partnerships
(IPs),” through the National Improvement
Partnership Network (NIPN). IPs use measurement-based efforts and a systems approach to improve the quality of children’s
health care and draw from the collective
expertise of their partners to create a unified
vision around issues related to child/adolescent health care and health outcomes and
to develop concrete efforts to achieve that
vision. As a network of more than 20 states
including Vermont, NIPN began partnering
on two major multi-year grants in 2014, as
described below.
24
Adolescent and Young
Adult Health Collaborative
Improvement and
Innovation Network
Working with the University of California
at San Francisco with funding from HRSA,
this NIPN project aims to strengthen the
capacity of State Title V MCH programs, as
well as public health and clinical health professionals, to augment the comprehensiveness and quality of the clinical preventive
services for adolescents and young adults
through the engagement of state public and
private leaders with expertise in adolescent
and young adult health. This project is
part of the Adolescent and Young Adult
Health National Resource Center and will
be conducted through the mechanism of a
Collaborative Improvement and Innovation
Network, or “CoIIN.”
Highlight
■
S haw, Judith, et al. “The National
Improvement Partnership Network:
State-Based Partnerships That Improve
Primary Care Quality.” Academic Pediatrics 2013; 13:S84-S-94. Visit www.
vchip.org and www.nipn.org for more
information.
Director
Richard Colletti, M.D.
Dr. Richard Colletti, founder of ImproveCareNow, is in his ninth year as
Executive Network Director of this
international rapidly-growing network
of 71 centers working to improve the
care and outcomes of children and youth
with Crohn’s disease and ulcerative colitis. During that time, the remission rate
of children at these centers has increased
from 55% to over 75%.
In the past year, ImproveCareNow
completed a five-year grant from the
National Institutes of Health (NIH)
to create a collaborative chronic care
network, continued its fourth year of a
grant from the Agency for Healthcare
Research and Quality (AHRQ) to create
innovative informatics for improvement
and research, and began participation in
two grants from the Patient-Centered
Outcomes Research Institute (PCORI)
to create a Patient-Powered Research
Network and a Clinical Data Research
Network. Dr. Colletti was a member of
the Center for Medicare and Medicaid
Innovation Technical Expert Panel on
Gastroenterology Payment Reform, and
the National Institutes of Health Collaboratory Strategic Advisory Group on
Value in Learning Health Systems.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Publications Included
■
ark KT, Crandall WV, Fridge J, LeiP
bowitz IH, Tsou M, Dykes D, Hoffenberg EJ, Kappelman M.D., Colletti RB.
Implementable strategies and exploratory considerations to reduce costs
associated with anti-TNF therapy in
inflammatory bowel disease. Inflamm
Bowel Dis 2014;20:946–951
■
orrest CB, Crandall WV, Bailey LC,
F
Zhang P, Joffe MM, Colletti RB et al.
Effectiveness of anti-TNF for Crohn’s
disease: research in a pediatric learning
health system. Pediatrics 2014; 134:37-44
■
orrest CB, Margolis P, Seid M, Colletti
F
RB. PEDSnet: How a prototype pediatric learning health system is being
expanded into a national network.
Health Affairs 2014; 33:1171-7
The Vermont
Oxford Network
Director
Jeffrey Horbar, M.D.
The Vermont Oxford Network is a collaboration of health professionals from over
1000 hospitals around the world dedicated
to improving the quality and safety of health
care for newborn infants and their families.
In support of this mission the Network
maintains a database for infants receiving
neonatal intensive care for use in research
and quality improvement.
In 2014, the Network reached several
major milestones. At our Annual Quality
Congress, a premier educational event for
multidisciplinary NICU teams, we celebrated 25 years of work together. The Network
Database, which includes 2 million records
and over 63 million patient days, now
enrolls 90% of all very low birth weight
infants born each year in the United States
as well as a growing proportion worldwide. The Database has been an important
resource for research leading to numerous
peer reviewed publications. The Vermont
Oxford Network NICQ and iNICQ quality
improvement collaboratives have served
NICU teams from 500 hospitals since
their inception in the mid-1990s resulting
in measurable improvements in quality,
safety, and cost. An important innovation
of these collaboratives has been the intense
focus on engaging families. The Vermont
Oxford Network improvement collaboratives include parents of NICU infants as
working team members and as paid faculty
members.
An important milestone in 2014 was the
signing of a formal Scientific and Educational Collaboration Agreement between the
University of Vermont, the College of Medicine, the Department of Pediatrics, and the
Vermont Oxford Network. This agreement
will combine the strengths of the organizations to create a world leader in neonatal
medicine and quality improvement.
Highlights
■
Scientific and Educational AgreeA
ment with the University of Vermont.
■
etwork Database now enrolling 90%
N
of all VLBW infants born each year in
the US.
Metabolism, Obesity,
and Type 2 Diabetes
Director
C. Lawrence Kien, M.D., Ph.D.
Although Dr. Kien continues to devote substantial time to the Admissions Committee,
to several weeks of teaching in NMGI, and
service to the NIH (two study sections in
2014), the focus of his efforts are nutritional and metabolic research. Over the
last 20 years, our labs have focused on the
biological and clinical importance of dietary
fatty acids and fatty acids synthesized
by bacteria in the colons of humans and
experimental animals. During the previous
12 months, our lab was involved in studies
funded by NIH, industry (Dairy Research
Institute), and the The Center on Aging,
UVM (Armin Grams Memorial Research
Award). Currently, we are working on three
manuscripts related to how the Western diet
promotes inflammation and
perhaps diabetes,
and in 2014, we had a featured abstract
presentation at the annual meeting of the
American Diabetes Association, another
presentation at the Endocrine Society
Meeting, and a paper in the American
Journal of Clinical Nutrition. With Dr.
Julie Dumas and Dr. Matthew Poynter, we
have now completed the clinical aspects
of a study in young women and will soon
complete another study in post-menopausal
women, examining how dietary saturated
and monounsaturated fat, possibly via peripheral monocyte inflammatory pathways,
influence activation of brain networks and
thus cognition, cognitive control of mood,
and executive functioning (including that
regulating physical activity). In addition, in
collaboration with Dr. Jana Kraft, Department of Animal Science, we are exploring if
bacteria-derived fatty acids produced in the
rumen and found in dairy products improve
insulin sensitivity. In part based on our own
preliminary data, Dr. Kien is anticipating
applying to NIH or industry for a preliminary study of how dietary lactose per se may
impact the risk of diabetes.
■
ur paper in American Journal of Clinical
O
Nutrition (March, 2014), based on a
metabolomic analysis and muscle gene
expression in young adults, showed that
the saturation index of tissue lipids and
the accumulation of acylcarnitines (derived from partially oxidized fatty acids)
seemed to mediate changes in the serum
concentration of LDL, suggesting that
lipid oxidation plays a potential role in
the etiology of hypercholesterolemia and
thus atherosclerosis.
■
In addition, the abstract presented at
the American Diabetes Association
addressed, using a novel stable isotope
tracer technique, the mechanism for
increased acylcarnitine concentrations
in blood and muscle as a result of high
saturated fat diets.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
25
Neonatal-Perinatal
Medicine Fellowship
Program
Education
Medical Student
Education
Medical student education is a core mission
of the Department of Pediatrics. Faculty
members participate in all aspects of the
Vermont Integrated Curriculum. In the
Foundations level of the curriculum, pediatric faculty members direct courses, facilitate
small group discussions, and lead small
groups in the year long course Professionalism, Communication and Reflection, and
precept new students in their first pediatric
clinical experiences. Pediatric faculty have
been awarded Basic Science Teacher of the
Year and The Golden Apple for excellence
teaching the basic sciences.
The Pediatric Clerkship is seven-weeks long
with inpatient and outpatient experiences at
the University of Vermont Medical Center
or at one of four affiliate sites: St. Mary’s
Hospital in West Palm Beach, Florida,
Eastern Maine Medical Center in Bangor,
Maine; Norwalk Hospital in Norwalk, Connecticut, or Danbury Hospital in Danbury,
Connecticut. Sharing the same curriculum
across the sites, the clerkship is consistently
one of the highest ranked clerkships in the
Clerkship Year. In the past two years, Pediatric faculty have won Clinical Teacher of the
Year while the department has won Clinical
Department of the Year. All residents have
been nominated for Resident Teacher of the
Year award.
During Advanced Integration, the Department offers one-month acting internships at
the University of Vermont Medical Center
in Neonatology and general inpatient
Pediatric Medicine. These have been much
sought after as the acting interns are integrated into the resident team. A host of electives in primary care, a variety of pediatric
subspecialtes, research, medical journalism,
and teaching are also available.
26
Faculty work with the student-directed
Pediatric Special Interest Group hosting
a variety of events and activities related to
pediatrics and child health.
Pediatrics remains a very popular field at the
College of Medicine with more students
consistently matching in Pediatrics than any
other speciality.
Pediatric Residency
Program
The University of Vermont Pediatric
Residency program provides our residents
with superb training in general pediatrics
through the collaborative efforts of full-time
faculty and community pediatricians. Our
residents come to Vermont from all over the
United States to be a part of our diverse and
talented pediatric community.
Highlight
■
e have made some exciting changes to
W
our curriculum this year, including a new
Pediatric Emergency Medicine rotation as well as an enhanced Adolescent
Medicine rotation. Our residents have
continued to contribute to our pediatric
community through their scholarly work
in advocacy and quality improvement.
Major Highlights
■
■
ver the past year, pediatric residents
O
have presented scholarly work at multiple
national meetings, including the annual
meetings of the AAP, Pediatric Academic
Society, Association of Pediatric Program
Directors, and Pediatric Hospitalist
Medicine.
After our residents lobbied at the Vermont State House, the Vermont State
Legislature passed Transportation Bill
H217 “Ban on smoking in motor vehicle
with child present.”
The Neonatal-Perinatal Medicine Fellowship Program is an integrated part of the
Pediatric Residency Program at The University of Vermont’s Children’s Hospital/The
University of Vermont Medical Center. Our
goal is to foster the development of neonatologists for academic and clinical practice
through an outstanding, evidence-based
clinical education. To that end, we believe
in an apprenticeship model, with supported
fellow immersion in attending-level teaching and clinical activities, as well as active
mentoring.
Our fellowship provides a broad scope of
training coupled with exceptional educational and research opportunities. Fellows
obtain experience with critical patients,
including those requiring high frequency
ventilation, nitric oxide, therapeutic hypothermia, transport stabilization, and surgical
and subspecialty care. Experience with cardiac surgery and ECMO is provided during
a one month CICU rotation at Boston
Children’s Hospital. Fellows are involved
in follow-up for high-risk patients as well as
prenatal consultation.
We hope to foster research projects that
contribute to long-term academic careers.
As such, fellows are able to tailor research
interests to career goals, and recent efforts
have included clinical and outcomes research and quality improvement, as well as
environmental, educational, and family-centered care-based research. Fellows have the
opportunity to be involved with efforts such
as the Vermont Oxford Network and the
Cochrane Collaboration. Recent fellows
have published in high-impact journals and
have presented at national conferences,
including the Vermont Oxford Network
Annual Meeting and the Pediatric
Academic Society.
Fellows attend a regular series of core lectures as well as mock codes and interdisciplinary meetings such as perinatal conferences and ethics conferences. We maintain
a 100% pass rate for Neonatal-Perinatal
Medicine board certification. Our fellows
have been successful applicants for competitive attending positions nationwide.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
Philanthropy
T
he physicians, nurses, and other health
care providers of The University of
Vermont Children’s Hospital stand behind
every child and family that comes to the
hospital seeking care. Behind those medical
professionals stand the thousands of
individual donors, as well as many groups,
corporations, foundations and others who
support the work of The University of
Vermont Children’s Hospital. Throughout
the past year these supporters raised more
than $1.3 million to continue the hospital’s
work of providing the best possible care
to children and their families from across
Vermont and northern New York.
Pediatric
Philanthropic Giving
Fiscal Year 2014
[Total Giving: $1,318,066]
A Sampling of 2014 Support
Big Change Roundup
Radiothon
98.9 FM deejays and their loyal listeners,
including schools, businesses and individuals, drive the success of the annual Big
Change Roundup Radiothon. This year
the Big Change Roundup set a record,
bringing in $278,000 in support of critically ill and injured children.
COMMUNITY
FUNDRAISERS
Community fundraisers are led by people
with a passion for pediatric patients. Bake
sales, car shows, sporting events, golf
tournaments, spaghetti dinners, and many
other events are planned by families,
church groups, clubs organizations and
individuals who rally together to help the
UVM Children’s Hospital.
25th ANNUAL
GOLF TOURNAMENT
UVM
Children’s
Hospital
$1,080,473
UVM
Pediatric
Cancer
$46,447
UVM
Department
of Pediatrics
$191,146
You Too Can Help
For more information
regarding current endowments
or if you are interested in
supporting the Department of
Pediatrics or the University of
Vermont Children’s Hospital,
please contact: Ruth Henry,
Director of Major Gifts,
University of Vermont College
of Medicine at:
[email protected]
(802) 656-3225
This year marked the 25th anniversary of this
golf tournament. More than just a day on the
green, this event celebrates The University of
Vermont Children’s Hospitals patients. More
than $130,000 was raised to fund research,
programs and services and purchase life-saving equipment, helping to insure the best care
for children and families throughout Vermont
and northern New York.
CHILDREN’S MIRACLE
NETWORK HOSPITALS
One dollar at a time—that’s how Children’s Miracle Network Hospitals (CMNH)
partners raised more than $477,000. CMNH, an association of retailers, radio
stations, organizations and individuals, helps children’s hospitals increase funds and
raise awareness in their communities. Walmart, Sam’s Club, Costco, Rite Aid, Kinney
Drugs and many other partners in Vermont, northern New York and New Hampshire organized in-store and community campaigns. From selling the iconic Miracle
Balloons to hosting car washes and book sales every partner supports the hospital in
their own unique way. College students and gaming enthusiasts also get involved by
coordinating dance marathons and extra-life gaming events.
2 01 4 A N N UA L REPORT | www.uvmhealth.org/childrens
27
Faculty
Community Faculty
full time
Adolescent Medicine
Erica Gibson, M.D.
Anesthesiology
Melissa Davidson, M.D.
Eva Fraser-Harris, M.D.
Joseph Kreutz, M.D.
Ann Lawrence, M.D.
Monika Modlinski, M.D.
Emily Stebbins, M.D.
Robert Williams, M.D.
Cardiology
metabolism & nutrition
C. Lawrence Kien, M.D., Ph.D.
Neonatology
Child Development
Maria Mercedes Avila, Ph.D.
Stephen Contompasis, M.D.
Nephrology
Child Psychiatry
Ann Guillot, M.D.
Liz Hunt, M.D.
Robert Althoff, M.D., Ph.D.
Allison Hall, M.D.
James Hudziak, M.D.
David Rettew, M.D.
CHILD Psychology
Marlene Maron, Ph.D.
Critical Care
Allison Adams, M.D.
Denise Aronzon, M.D.
Saraya Balu, M.D.
David Beguin, M.D.
Laura Bellstrom, M.D.
Thomas Bolduc, M.D.
Johana Brakeley, M.D.
Jennifer Carlson, M.D.
Harold Chaskey, M.D.
Emanuele Chiappinelli, M.D.
Anthony Ching, M.D.
David Cohen, M.D.
Rebecca Collman, M.D.
Gregory J. Connolly, M.D.
Kristen Connolly, M.D.
Leah Costello, M.D.
P.M. Costello, M.D.
John DiMichele, M.D.
Morris Earle, Jr., M.D.
Monica Fiorenza, M.D.
Bradley Friesen, M.D.
William Gaidys, M.D.
Anthony Garami, M.D.
William Gerson, M.D.
Deanna Haag, M.D.
Joseph F. Hagan Jr., M.D.
Jerry Steve Hale, M.D.
William Raszka, Jr., M.D.
Marie Berg, M.D.
Jeffrey Horbar, M.D.
Anne Johnston, M.D.
Charles Mercier, M.D.
Roger Soll, M.D.
Leslie Young, M.D.
Nancy Drucker, M.D.
Niels Giddins, M.D.
Scott Yeager, M.D.
Community faculty play a key role in our departments’ and children’s hospital’s clinical, teaching,
research and advocacy missions. The wonderful work they do educating our trainees and caring for
patients and families in our region enhances the excellence of our academic and clinical missions and
helps make us the outstanding department and children’s hospital we strive to be each and every day.
Hospitalists continued
Marianne Rideout, M.D.
Paul Rosenau, M.D.
Christa Zehle, M.D.
Infectious Disease
Neurology
Garrick Applebee, M.D.
Peter Bingham, M.D.
Gregory Holmes, M.D.
Susan Durham, M.D.
Orthopedics
David Aronsson, M.D.
Scott Benjamin, M.D.
Jennifer Lisle, M.D.
Pulmonology
residents
Kelly Cowan, M.D.
Thomas Lahiri, M.D.
Rachel Cohen, M.D.
Chief Pediatric Resident
Richard Hubbell, M.D.
Radiology
Martina Kacer, M.D.
Paul Zimakas, M.D.
Palliative Care
Janice Gallant, M.D.
Timothy Higgins, M.D.
Gastroenterology
Pediatrics and
Physiology
Katherine Anderson, M.D.
Daniela Chan, M.D.
Ross Cleveland, M.D.
Jennifer Covino, M.D.
Amelia Fisher, M.D.
Allison Foertsch, M.D.
Delia Horn, M.D.
Whitney Irwin, M.D.
Sara Hedansky, M.D.
Jamie Mehringer, M.D.
Rachel Millner, M.D.
Colleen Moran, M.D.
Catherine Naber, M.D.
Daniel Panek, M.D.
Sean Pyper, M.D.
Peter Reed, M.D.
Courtney Riley, M.D.
Mark Shwayder, M.D.
Rebecca Staub, M.D.
Michelle Yang, M.D.
Rebecca Bell, M.D.
Barry Heath, M.D.
Amelia Hopkins, M.D.
Iris Toedt Pingel, M.D.
Otolaryngology
Endocrinology
Richard Colletti, M.D.
Michael D’Amico, M.D.
Pamela Puthoor, M.D.
Jillian Sullivan, M.D.
Genetics
Leah Burke, M.D.
Hematology/Oncology
Heather Bradeen, M.D.
Joseph Dickerman, M.D.
Alan Homans, M.D.
Hospitalists
Abigail Adler, M.D.
Barry Finette, M.D., Ph.D.
Lewis First, M.D.
Rebecca Goodman, M.D.
Karin Gray, M.D.
Karen Leonard, M.D.
Molly Moore, M.D.
28
Robert Macauley, M.D.
Rheumatology
Leslie Abramson, M.D.
Frederick Morin, III, M.D.
Surgery
Plastic Surgery
John Lawrence, M.D.
Kenneth Sartorelli, M.D.
Donald Laub, M.D.
Primary Care
Barbara Frankowski, M.D.
Andrea Green, M.D.
Pamela Jackson, M.D.
Jerry Larrabee, M.D.
Heather Link, M.D.
Eliot Nelson, M.D.
Lori Racha, M.D.
Mary Lee Ritter, PNP
Catherine Rude, M.D.
Richard Wasserman, M.D.
Stanley Weinberger, M.D.
Ann Wittpenn, M.D.
Nilgun Zimakas, M.D.
Urology
Gerald Mingin, M.D.
vermont child health
improvement program
Sara Barry, M.P.H.
Patricia Berry, M.P.H.
Wendy Davis, M.D.
Thomas Delaney, Ph.D.
Paula Duncan, M.D.
Valerie Harder, Ph.D.
Judith Shaw, Ed.D., M.P.H., R.N.
The University of Vermont Children’s Hospital | The University of Vermont Department of Pediatrics
neonatology
fellows
Shannon Evans, M.D.
Keri Marques, M.D.
Debra Hartswick, M.D.
Carol Hassler, M.D.
Molly Hastings, M.D.
Lynn Herzog, M.D.
Breena Holmes, M.D.
Frederick Holmes, M.D.
James Hughes, M.D.
Elizabeth Hunt, M.D.
Elizabeth Jaffe, M.D.
Elizabeth Jillson, M.D.
Sandra Kapsalis, M.D.
Jean Kellner, M.D.
Barbara Kennedy, M.D.
Edward Kent, M.D.
Tawnya Kiernan, M.D.
Clark Knutson, M.D.
Marshall Land, Jr., M.D.
Daniel Larrow, M.D.
Gwen Lattimore, M.D.
Margaret van Dijk Lindsay, M.D.
Indra Lovko, M.D., FAAP
Heidi Ludwig-Zvolensky, M.D.
Lynn Luginbuhl, M.D.
Martin Luloff, M.D.
Roya Mansoorani, M.D.
Jack Mayer, M.D.
Kate McIntosh, M.D.
Melissa Meyer, M.D.
Pauline Mills, M.D.
Meredith Monohan, M.D.
Heidi Moore, M.D.
Robert Moore, M.D.
Stephanie Moore, M.D.
Thomas Moseley, III, M.D.
Joseph Nasca, M.D.
Audrey J. Naylor, M.D.
Judy Nelso, M.D.
Judy Orton, M.D.
Alyssa Parker, M.D.
Paul Parker, M.D.
Roger Patnode, M.D.
Michelle Perron, M.D.
Sara Quayle, M.D.
Sobia Qudsi, M.D.
Jill Rinehart, M.D.
Valerie Rooney, M.D.
Deirdre Schaefer, DO
Michael Seaton, M.D.
Harriot Shea, M.D.
Susan Slowinski, M.D.
David Stifler, M.D.
Ira Weissman, M.D.
University of Vermont
College of Medicine
Design & Photography
Art Direction by Sylvie Vidrine
Photography by David Seaver, Raj Chawla
Department of Pediatrics
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