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Seattle Children’s

Community
Benefit Report 2009

www.seattlechildrens.org
Our Mission
Seattle Children’s vision is to be the best
We believe all children have unique children’s hospital, because we believe
needs and should grow up without
illness or injury. With the support of
the community and through our spirit
children enduring illness and injury
of inquiry, we will prevent, treat and
eliminate pediatric disease.
deserve nothing less. Children’s is
deeply committed to improving the
Our Vision health of children through superior
We will be the best children’s hospital.
• We will provide patients and medical care, pioneering research,
their families excellent care
with compassion and respect. community partnerships, education
• We will provide superior,
accessible, cost-effective service. and advocacy. That means we offer
• We will attract and retain the
best talent at all levels of the
the range of pediatric medical care and
organization.
• We will be one of the top five
support services that our community
pediatric research institutions.
needs, even when those programs
• We will be the nation’s premier
pediatric educator. operate at a financial loss.
• We will achieve worldwide
prominence by integrating
patient care, research,
education and advocacy. The 2009 Community Benefit Report
showcases how Children’s work makes
a difference for children and families
in the Northwest and beyond. More
information about our programs and
services — including medical care,
research and education — is available
at www.seattlechildrens.org.
Left: Amanda Jones, PhD, leads the Science
Adventure Lab, which is equipped so
that students conduct real health-related
experiments at no cost to the schools.

Top Right: Drowning prevention expert


Tizzy Bennett fits a life jacket at Denise
Louie Education Center’s Children and
Families Festival.

Bottom Right: Kids learn about health and


safety at Children’s Community Health Fair.
Total 2009 Value to the Community:
$194,187,000 Contents
Through our investments in patient care, research, medical 2 Uncompensated Care
education, advocacy and partnerships with families and
the community, we remain committed to our mission to 4 Research
prevent, treat and eliminate pediatric disease.
8 Education

Health Professional Community Programs 14 Patient Care


Education and Services
$17,174,000 $8,799,000
20 Partnerships

24 Advocacy

28 Contact Us

Research Programs Uncompensated Care


$71,809,000 $96,405,000

Seattle Children’s Community Benefit Report 2009 1


Uncompensated Care
Seattle Children’s provides necessary medical care to all kids in our region,
regardless of a family’s ability to pay.

Illness and injury can strike any child at any time. Even Approximately 43% of Children’s patients are covered
healthy, active kids can endure unexpected, life-threatening by Medicaid, a government program that provides medical
conditions. Seattle Children’s is committed to providing coverage at no cost to low-income families. However, the
the best medical care to every child in Washington, program reimburses Children’s for only 68% of treatment
Alaska, Montana and Idaho who needs us — regardless costs. Uncompensated care makes up the difference.
of insurance coverage or financial circumstances. Families with private insurance are also struggling
Children’s continues to honor this founding promise, financially as a result of job losses and reductions in
even in the midst of an economic downturn. In 2009, health benefits. Many are paying “out-of-pocket” for
Children’s provided a record $96.4 million in uncomp- services that were covered by insurance in the past.
ensated care, including $85.2 million in Medicaid payment And some families of longtime patients who used to
shortfalls and $11.2 million in financial assistance to make an insurance co-payment per hospital admission
families in need. are now paying the same amount per day of each stay.
When a hospital bill exceeds a family’s ability to pay,
Children’s financial assistance program provides relief.

Almost half of our


patients are covered
by Medicaid, which
reimburses Children’s
for only 68% of
treatment costs.
Uncompensated
care makes up
the difference.

$96.4 million
in uncompensated care provided
during 2009.

2 Seattle Children’s Community Benefit Report 2009


Children’s financial
assistance program
helps families with
private insurance,
such as the Yosts,
when hospital bills
exceed their ability
to pay.

The Yost Family’s Story


One week before his 10th birthday, Gary Yost was Gary’s parents didn’t want to think about it, but
diagnosed with Ewing sarcoma, a rare form of bone they were concerned about the cost of Gary’s treatment.
cancer. A tumor the size of a softball was wrapped Though they have good health insurance, the out-of-
around his ribs and pressing on his lung. Gary needed pocket expenses would be substantial. “We were prepared
lifesaving treatment immediately. to do whatever was necessary to pay for Gary’s treatment,”
Fortunately, the Yost family didn’t have to travel far says his mom, Paula Yost. “Fortunately, our anxieties
to get the best care for their son. Dr. Douglas Hawkins, about our finances were alleviated when we found out
associate chief of Seattle Children’s cancer program, is we qualified for financial assistance from Children’s.”
one of the world’s leading experts in pediatric sarcomas. Yost says the value of the assistance they received
The treatment plan prescribed by Hawkins was extends far beyond the dollars credited to their
grueling. Gary underwent one surgery and 14 rounds of hospital bills.
chemotherapy. He spent 52 nights in the hospital, and “Financial aid relieved us of tremendous stress and
endured several emergency room visits and numerous anxiety. It allowed us to direct our energy to things that
tests over the course of five months. were really important, like making sure Gary’s complex
treatment schedule was running smoothly and taking care


of our youngest son,” she explains. “Things that we used

The freedom to focus on to take for granted — like taking time to eat a healthy meal
— suddenly became a big deal. The freedom to focus
our family instead of our on our family instead of our finances was invaluable.”
Gary is cancer-free today, but he continues to see
finances was invaluable.” Hawkins for follow-up care. “We are so thankful for the
amazing care that Gary receives at Children’s and the
— Paula Yost, Gary’s mom payment assistance that allows us to focus on his
recovery,” notes his mom.

Seattle Children’s Community Benefit Report 2009 3


Research
Our research isn’t motivated by market forces or shareholder expectations. Rather, Children’s
mission drives our spirit of inquiry: to prevent, treat and ultimately eliminate pediatric disease.
As one of the top five pediatric research centers in the nation, Seattle Children’s Research
Institute brings together the best minds to set new standards of pediatric medical care
and find new cures for childhood diseases.

Comparing schizophrenia treatments


Children treated for psychiatric problems — including
mood, behavior, and aggression disorders, autism and
schizophrenia — typically receive “second-generation”
antipsychotic medications, including olanzapine and
risperidone. However, there has never been evidence
that these drugs are more effective than first-generation
drugs. Investigators at Seattle Children’s Research Institute
were part of the team who discovered that molindone,
a first-generation drug, is just as effective as the newer
medications and may be safer. “Because the second-
generation medications are being prescribed widely
for many children, this study has broad public health
implications,” says Dr. Jon McClellan, a child psychiatrist
at Children’s, and one of the study’s lead authors. Though
Dr. Bryan King’s research found that citalopram, a medicine prescribed to
each medication studied demonstrated a similar reduction
children with autism and obsessive-compulsive disorders, was no more
effective than a placebo at reducing repetitive behaviors.
in psychotic symptoms, researchers found that both
olanzapine and risperidone were associated with
significant weight gain and the risk of developing
Identifying the Best Treatments heart disease and diabetes.

Advancing autism care


Research led by Dr. Bryan King, director of the Department
of Psychiatry and Behavioral Medicine at Seattle Children’s,
revealed that citalopram (Celexa), a medication commonly
prescribed to children with autism spectrum disorders
(ASD), was no more effective than a placebo at reducing
repetitive behaviors. Because citalopram is also prescribed
for patients with obsessive-compulsive disorders (OCD),
the results may challenge the belief that repetitive
behaviors in children with ASD are similar to those found
in cases of OCD. “We continually learn new information
about the variables that may cause or contribute to autism
spectrum disorders, as well as how to treat them,” says
King. “While our study’s results may be frustrating news
for hopeful families and clinicians, each new finding helps
us revise treatment plans, refine future studies and build
upon what we know as we search for effective treatments
and eventually cures for this complex group of disorders.”

Dr. Jon McClellan is one of the authors of a study that discovered


that the drug molindone is just as effective for treating children
with psychiatric problems as newer medications, and may be safer.

4 Seattle Children’s Community Benefit Report 2009


Almost

$72 million
devoted to research in 2009.

Linking Cause and Effect


Revealing new insights about type 1 diabetes
The links between type 2 diabetes and excess weight are
well documented, but until recently, they were less clear
in type 1 diabetes, which is more common in children and
young people. Dr. Lenna Liu, an investigator with Seattle
Children’s researchers found that teens often discuss activities such as
Children’s Research Institute, recently found that while sexual behavior, substance abuse or violence using MySpace. The study
most children with type 1 diabetes are of a healthy weight, also showed that teens may be amenable to online interventions.
a proportion of them are more likely to be overweight
than children without diabetes. “Knowing the prevalence
of overweight and obesity in children and young people Preventing sexually transmitted disease
with type 1 and type 2 diabetes is very important, as it While condoms are known for preventing the spread of
helps us identify those individuals who face the greatest HIV, chlamydia and gonorrhea, their effectiveness as a
risk of clinical complications,” says Liu. “Further studies barrier against HSV-2 — the virus that causes genital
will help us understand how weight causes complications herpes — has been unclear until now. A study conducted
in the growing number of children and young people by Dr. Emily Martin at Seattle Children’s Research Institute
with diabetes, and they will help us improve diagnostic found that people who use condoms consistently can
techniques and treatment.” reduce their risk of getting genital herpes by 30%. “Even
though the decrease is smaller than you would see with
Preventing Illness and Injury other STDs, this study shows condoms offer some
protection,” says Martin. The study also revealed that the
Observing risky teen behaviors risk of contracting genital herpes increases steadily and
Investigators in the lab of Dr. Dimitri Christakis at Seattle significantly with each unprotected sex act. Given that
Children’s Research Institute found that 54% of adolescents this research offers new scientific evidence about genital
frequently discuss high-risk activities including sexual herpes prevention, Martin hopes more sexually active teens
behavior, substance abuse or violence using MySpace, the and young adults will use condoms. “Using a condom not
popular social networking Web site. Though parents may only reduces the odds of getting herpes, but of getting
worry about their kids’ use of social media, Dr. Megan other STDs as well,” she says.
Moreno — one of the lead researchers — says study results
indicate the potential for preventing those behaviors
before teens act on them. “Online displays of risky
behaviors may actually just be displays,” notes Moreno,
formerly a research fellow at Children’s and now assistant
professor of adolescent medicine at the University of
Wisconsin School of Medicine and Public Health. “Some
teens may be grandstanding, or may be indicating intention
or considered behavior. If that’s the case, this presents
opportunities for education and prevention before risky
behavior takes place. The good news is that teens may
be amenable to participating in online interventions. Our
related study looked at this, and we were happy to see
that even a brief e-mail intervention may be feasible
and showed promise for influencing online behavior.”

Seattle Children’s Community Benefit Report 2009 5


People Making a Difference: Dr. Dimitri Christakis
Researcher
Dr. Dimitri Christakis
looks for answers
to a question many
parents ask: How
does our media-rich
environment impact
the development of
children and teens?
His studies aim to
provide guidance to
caregivers worried
about the effects
of television and
computers on
their kids.

More than half of parents say they are worried about the Most recently, Christakis discovered that the amount of
effects of television and computers on their children. television viewed by young children in childcare settings
Dr. Dimitri Christakis, who directs the Center for Child Health, doubles the previous estimates of early childhood screen
Behavior and Development at Seattle Children’s Research time, with those in home-based settings watching significantly
Institute, is providing crucial guidance. His work is helping more on average than those in center-based daycares. This
families everywhere make better screen-time choices for study is the first to examine screen time in child-care settings
young children. Christakis regularly speaks to parents, in more than 20 years.
teachers and librarians about healthy media usage, and “It’s alarming to find that so many children in the United
he is a co-author of The Elephant in the Living Room: States are watching essentially twice as much television as
Make Television Work For Your Kids. we previously thought,” says Christakis. “Research continues
Christakis’ research has revealed that watching television to link excessive preschool screen time with language delay,
and videos during the first three years of life can lead to obesity, attention problems and even aggression, depending
problems with language, attention and cognitive development. upon content. At the same time, studies show that high-
In addition, watching violent cartoons during preschool years quality preschool can be beneficial to children’s development.
is associated with aggression in children ages 7 to 10. Unfortunately, for many children, the potential benefits of
preschool may be displaced by passive TV viewing. I suspect


many parents are unaware of the frequency and extent of
Research continues to link TV viewing in daycare settings. Hopefully, these findings
excessive preschool screen will serve as a wake-up call.”

time with language delay,


obesity, attention problems
and even aggression.”
— Dr. Dimitri Christakis

6 Seattle Children’s Community Benefit Report 2009


Every year, more
than one million
babies die because
they were born too
early. The Global
Alliance to Prevent
Prematurity and
Stillbirth (GAPPS)
is working to
understand the
causes and
magnitude of
prematurity and
stillbirth and to
prevent them.

Saving Babies from Seattle to Sri Lanka


Throughout the world, prematurity is the leading cause “Prematurity and stillbirth do not discriminate; this
of newborn death. In the United States, one in eight tragedy affects low-, middle- and high-income countries,”
babies is born preterm, or before 37 weeks. Worldwide, says Dr. Craig Rubens, executive director of GAPPS. “It
more than three million stillbirths occur annually. A third happens to women in Seattle and Sri Lanka. It happens to
of those stillbirths happen just minutes before birth — women who go to every prenatal care appointment, and
and could be prevented with cesarean sections and it happens to women who simply cannot see a doctor
other proven interventions. while they are pregnant because they live too far from
Though prematurity and stillbirth are critical global a medical facility.”
health problems, these issues have received only limited In May 2009, GAPPS took a bold step forward by
funding, research and attention. As a result, scientists know hosting the International Conference on Prematurity
very little about the causes of prematurity, and current and Stillbirth, where nearly 200 experts from multiple
healthcare strategies cannot prevent a preterm birth. disciplines gathered in Seattle to develop the Global
In response to these challenges, Seattle Children’s Action Agenda for preterm birth and stillbirth — a
launched the Global Alliance to Prevent Prematurity and roadmap for future research, interventions and advocacy.
Stillbirth (GAPPS). The alliance brings together internat- “This conference marks the beginning of an exciting
ional experts to better understand the magnitude of new collaboration between Children’s and many internat-
prematurity and stillbirth, to learn about the causes ional organizations that are deeply committed to saving
and to ultimately prevent these devastating problems the lives of infants around the world,” says Children’s
throughout the world. CEO Dr. Thomas Hansen, a neonatologist who is one
of the GAPPS team’s core investigators. “Thanks to the
hard work of the GAPPS team, we are advancing global
research on prematurity and stillbirths, and helping
ensure that interventions will reach women and
Worldwide, more than families here at home and around the world.”

3 million
children are stillborn each year.

Seattle Children’s Community Benefit Report 2009 7


Education
Seattle Children’s staff and clinicians take many different roads to reach the ultimate destination
of improving the health and well-being of children in the Northwest.
Children’s health education activities for families — and our training programs for healthcare
providers — improve the health and well-being of children in our community and beyond. We
invest in training medical students, residents and fellows to provide expert family-centered medical
care for children. We serve as a training site for many other healthcare providers as well, including
nurses and respiratory therapists. We also offer a variety of continuing medical education programs
for community clinicians.

Educating Healthcare Providers


Engaging community providers
More than

$17 million
Seattle Children’s Continuing Medical Education (CME)
accredited programs help to bridge gaps in healthcare
providers’ knowledge, skills and performance, leading to
improved patient care and outcomes. Children’s experts
present a variety of courses, hands-on workshops and invested in training health professionals.
case-based discussions that enable community providers
to keep current with best practices in pediatric medicine.
Children’s also offers weekly pediatric Grand Rounds Enhancing nursing education
presentations on timely topics ranging from clinical care Seattle Children’s Nursing Education team hosts monthly
and research to advocacy and bioethics. Grand Rounds “Lunch Time Seminars” to advance pediatric nursing
presentations are offered free of charge as a community practice in the Northwest and beyond. Each seminar is
service. Participants may attend in person or via live broadcast to video teleconference sites at healthcare
streaming over the Internet. One year from the date of the organizations across the region, including sites in Montana
original presentation, providers can view archives on Seattle and Alaska. Sessions include evidence-based practice
Children’s Web site and receive Category 1 CME credit. review and interactive case-study discussions. Community
nurses can also participate from their computers via live
Internet streaming. All seminars are videotaped and
archived on the Children’s Web site to reach as many
community nurses as possible. Continuing education
credit is also available.

Children’s pediatricians-in-training, including chief resident Dr. Shaquita Bell


(pictured here with her mentors Drs. Jim Stout and Ben Danielson) rotate
between regional teaching hospitals and community clinics that serve a
diverse group of families.

8 Seattle Children’s Community Benefit Report 2009


Dr. Aaron Grigg’s
residency exper-
iences in Pocatello,
Idaho, and with
pediatrician and
mentor Dr. John
Schreuder (right)
at Mercer Island
Pediatrics influenced
his decision to
practice in a
rural Washington
community when he
graduates in June.

Training the Next Generation residents train in a network of regional teaching hospitals
and community clinics that serve a diverse group of
Educating resident physicians and fellows children and families. Many residents continue their
As the only pediatric residency program in Washington, education at Children’s with fellowships in areas such as
Wyoming, Alaska, Montana and Idaho, the University of cardiology, emergency medicine, neonatology, nephrology
Washington School of Medicine Pediatric Residency and rheumatology. The training of top-notch pediatricians
Program prepares pediatricians to provide outstanding ultimately benefits our society as a whole and especially
medical care for children in the Northwest. The program our local community, with over half of Children’s residents
— which is housed at Seattle Children’s — is ranked among choosing to stay in Washington after they graduate.
the top 10 programs in the country by U.S. News & World
Report. In addition to completing rotations at Children’s,

Seattle Children’s Community Benefit Report 2009 9


Educating Community Members
Supporting siblings
Siblings of children with special medical or developmental
needs — such as ADHD, autism, diabetes, cancer and Down
syndrome — often feel isolated as they struggle with
feelings of guilt, sadness and anger. They may also have
trouble coping with their siblings’ unpredictable behaviors.
Seattle Children’s Sibshops program offers support and
education, along with opportunities to discuss common
joys and concerns in a relaxed, recreational setting.
Sibshops sessions also help siblings learn about the
implications of their brothers’ and sisters’ special needs.
“If you can teach siblings they are not alone, you create
the possibility of a healthier adult sibling relationship,”
says Cathy Harrison, Sibshops program coordinator.

Promoting health and safety


Local and national media outlets call on the experts at
Seattle Children’s for advice on numerous health and
Dental Camp gives students a chance to learn about oral health and safety issues, from obesity prevention and vaccine safety
dental careers. Photo by UW School of Dentistry. to the top 10 conversations parents should have with their
kids. Dr. Bryan King, an international expert in autism and
director of Children’s Psychiatry and Behavioral Medicine,
Introducing youth to careers in dentistry contributes to the ABC News OnCall+ Autism Center, a
For adolescents across Washington state, Dental Camp Web site for families of individuals with autism spectrum
might be their first step toward a dental career. Each disorders. To date, topics King has offered expert advice
half-day session provides student “campers” with an on include behavioral interventions, communication, diet
opportunity to learn about oral health and dental careers and research.
by performing hands-on activities in the simulation lab-
oratory. The camp primarily serves youth from communities Allowing kids to “just be kids”
traditionally underserved by the dental profession. Dr. A growing number of specialized summer camps staffed
Doug Jackson, a dentist and chief of Seattle Children’s by volunteers from Seattle Children’s allow kids with special
Center for Diversity and Health Equity, has been involved health needs to forget about their conditions and “just be
with Dental Camp since its launch in 2002. “We hope this kids” with fellow campers who understand them. At Camp
program will serve as a career catalyst,” says Jackson. “Our Oasis, children with Crohn disease and ulcerative colitis
goal is to increase the diversity of oral health professionals enjoy traditional camp activities — including arts and crafts,
in Washington and to eliminate the magnitude of oral sports and campfires — with 24-hour medical support.
health inequities and disparities.” This year’s program Stanley Stamm Summer Camp also offers round-the-clock
was a collaboration between Children’s, the University medical care so that children with a broad range of serious
of Washington and other community partners. illnesses can go fishing, ride horses and take part in other
activities typical of summer camp. Families appreciate a
week of rest while their children gain confidence and make
new friends in a safe, medically supervised environment.

10 Seattle Children’s Community Benefit Report 2009


Asian-American
children in
Washington state
drown at more than
twice the rate of
other children. The
water safety team
at Children’s works
on many activities
to prevent drowning,
including increasing
life-jacket loan
programs and
promoting lifeguards
at beaches and learn-
to-swim programs.

Teaching water safety programs, and learn-to-swim programs. As a result of


Since Dr. Linda Quan discovered that Asian-American Quan’s work, Children’s has worked with Seattle Parks
children in Washington state were drowning at more than and Recreation to create a water-safety brochure in
twice the rate of other children, she has been involved Vietnamese, increase lifeguard staffing at city beaches,
in numerous activities to promote water safety in the support low-cost swim lessons, and place a life-jacket
Vietnamese community. A pediatric emergency medicine loaner board, with translations about life-jacket use in
physician at Seattle Children’s, Quan has worked to eight languages, at all lifeguarded Seattle swim beaches.
increase awareness of drowning risk and to prevent
drowning through lifeguarded beaches, life-jacket loan

Seattle Children’s Community Benefit Report 2009 11


People Making a Difference: Mental Health “Coaches”
Mental health
coaches Amber
Persons and Dave
Hall explain the
“trigger cards,”
which they use to
help patients in the
Inpatient Psychiatric
Unit get through
difficult situations.

Seattle Children’s mental health specialists help patients


in the Inpatient Psychiatric Unit (IPU) build critical skills
to manage their feelings. These professionals, known as


We focus on supporting
our patients from a place
“coaches,” use skill and compassion to guide patients of compassion.”
through difficult situations.
— Ann Moore, Inpatient Psychiatric Unit Director
“It’s like doing drills when you play a sport,” says coach
Amber Persons. “Our patients practice coping skills when
control when they get upset,” says Dave Hall, supervisor of
they’re not feeling sad or upset, and we hope they can call
the senior pediatric mental-health specialists. “Our staff is
on the skills later when they need them. Patients also learn
amazing at finding teachable moments in every situation.
to identify strong emotions and make a plan for how to
We can’t make patients do anything they don’t want to do,
deal with those emotions.”
but we usually accomplish our goals by validating their
The process begins when patients arrive in the IPU. They
experiences, remaining calm and compassionate, and
complete personalized “trigger cards” identifying things that
partnering with them to help them learn new skills.”
cause anger, sadness or anxiety. Patients carry the cards
A few years ago, if a child was threatening a staff member
around at all times — whether they are on the unit, going
or engaging in other potentially harmful behavior, the patient
to the swimming pool or leaving for a few hours with their
might have been physically restrained or placed in a locked
family. Staff coaches are always on the lookout for signs
bedroom or a seclusion room. Now, instead of seclusion or
that a patient’s mood has changed, and they use the trigger
restraint, the coaches close off an entire wing of the unit and
cards to pinpoint what patients are feeling, and coach them
give the patient space to be alone, monitoring them closely
through their distress.
and waiting for the moment of crisis to pass.
It’s a new approach that teaches invaluable skills
“We focus on supporting our patients from a place of
and lessons.
compassion,” says Ann Moore, IPU director. “That means
“The goals of the trigger cards are to help kids increase
coaching them to develop coping skills that will help them
their awareness of personal triggers and warning signs, and
be successful here and when they go home.”
to have a coping plan in place so things don’t get out of

12 Seattle Children’s Community Benefit Report 2009


The Science Adventure Lab did 75 visits to
54 schools across Washington state. The visits
are at no cost to the school, the students or
the teachers.

In the Science Adventure Lab, Mark Ruffo, PhD,


instructs students at Northgate Elementary in
Seattle as they isolate the DNA in their own
cheek cells.

Connecting Kids to Science


With generous support from the community, Seattle Because schools differ in their ability to provide strong
Children’s launched the Science Adventure Lab in 2009, science education programs, the Science Adventure Lab
creating the first mobile science lab program in the targets schools where students may lack ready access to
Pacific Northwest. professional equipment and trained instructors. The lab
Custom-built for Children’s, the Science Adventure brims with some of the same science equipment —
Lab is a rolling laboratory that helps students in grades microscopes, centrifuges and vortex mixers — that
four through eight explore the connection between science Children’s scientists use.
and health through hands-on experiments. Working in Who knows? A visit from the Science Adventure Lab
teams of four, students perform one of several experiments could inspire a student to become the next Jonas Salk
chosen by their classroom teacher based on what the or Marie Curie. Or not. “They won’t all pursue careers in
students are currently studying. science or medicine, but they will learn critical thinking
One experiment asks students to analyze the sugar skills that they can use throughout their lives,” Jones says.
content of various beverages. Another involves viewing


their own cheek cells under a microscope and then
isolating the DNA from inside the cells.
“In each case, we’re advancing the Seattle Children’s
We’re advancing our mission
mission of helping children stay healthy by educating of helping children stay
them about the science behind how the body works,”
says Amanda Jones, PhD, who directs the Health and healthy by educating them
Science Outreach Program.
That’s important for many reasons, starting with the about the science behind
connection between science and health. For example,
when students analyze the sugar content of various
how the body works.”
beverages, they’re not only conducting a chemistry
— Amanda Jones, PhD, Health and Science
experiment, they’re learning about nutrition.
Outreach Program Director

Seattle Children’s Community Benefit Report 2009 13


Patient Care
Children’s invests hospital resources in many clinical programs and “extras”
that support patients and their families.

After a transplant
to treat a liver
disease, Camren, 2,
is ready to get back
to his busy toddler
life. But first, Home
Care nurse Teresa
Taylor (center)
teaches Camren’s
mother Melody
McDonough to
administer IV
antibiotics.

Caring for Kids Closer to Home Connecting to remote clinics


Seattle Children’s Telemedicine program enables our
Keeping families together experts in Seattle to care for children closer to their
Twenty years ago, medically fragile children who required homes through videoconferencing. Clinics throughout
round-the-clock attention were rarely cared for at home. Washington, Alaska, Montana and Idaho use cameras,
But that’s changed, thanks to technological improvements microphones and TV monitors that allow families to
and resources like Seattle Children’s Home Care Depart- consult with our medical teams in real time, without
ment. The team does whatever it takes to help families the expense and stress of extensive travel. Children’s
transition a child’s medical care from the hospital to home. clinics equipped for telemedicine include Cardiology
Home care providers set up any necessary equipment — (for echocardiograms), Endocrinology, Genetics,
such as ventilators and pumps to supply nutrition and Neurodevelopmental, Neurology, Nutrition Services,
hydration — and train parents to use the equipment safely. Psychiatry and Behavioral Medicine, Pulmonary
The Home Care team delivers or ships medications, formula, Medicine and Rheumatology.
equipment and supplies directly to families when needed,
and experts are available 24 hours a day for consultation
and family support.

14 Seattle Children’s Community Benefit Report 2009


Supporting Healthy Families Supporting teens in recovery
Teens recovering from substance abuse and addiction
Bonding with baby often need extra support to prevent a relapse. The
When children’s social and emotional needs have not been “Teens Mastering Recovery” program at Seattle Children’s
met, they are more likely to face challenges at school or — available free of charge to teens who have successfully
to have behavioral problems. A new program for parents completed treatment — offers powerful tools to sustain
of babies and toddlers at Odessa Brown Children’s Clinic, a substance-free lifestyle. Over the course of 12 weeks,
“Promoting First Relationships,” helps parents learn to participants benefit from speakers, support groups and
meet those needs through a series of sessions with a activities like yoga. In addition, two special sessions
mental health therapist right in their own homes. “Just as teach parents how to support a teen in recovery, how to
you would want a child to eat the best possible food, you recognize situations when teens may be vulnerable to
want their socio-emotional needs to be met so that they relapse and how to help prevent relapse. Parents also
can have a good sense of self and of the world around learn about normal adolescent development and how
them,” says Mark Fadool, clinical director of Psychiatry mental health conditions can impact that development.
and Behavioral Medicine at Odessa Brown. Parent Robin
Lieb agrees. “Promoting First Relationships helped me Environment(al) Matters:
see the impact of our interactions on my daughter’s
development,” she says. “I think any mother would Providing a Healing Environment
benefit from this program.”
Reducing costs and solid waste
Seattle Children’s ongoing efforts to “go green” and
The Promoting reduce waste are resulting in significant benefits for the
First Relationships hospital, our patients and the environment. In addition to
program helps
recycling hundreds of tons of materials annually, we are
parents like Robin
Lieb learn to meet exploring new ways to reduce our environmental impact.
the needs of babies For example, the Cardiac Catheterization Laboratory
and toddlers. saved $100,000 in 2009 by reprocessing equipment
instead of buying it new. “Initially, our staff was concerned
about the quality of reprocessed equipment,” says Michael
Alotis, manager of Strategic Sourcing. “But reprocessing
is regulated by the Food and Drug Administration, and
everything goes through an inspection and testing process
that is more rigorous than the process for new equipment.
Ultimately, reprocessing helps reduce the cost of health-
care and keeps waste out of landfills and incinerators.”

Expanding green initiatives


Seattle Children’s Dietary Department is among the
hospital’s “greenest” heroes. For starters, they use
environmentally-friendly products like unbleached paper
napkins and compostable plates. And Children’s kitchen
is a leader among hospitals in composting and recycling.
During fiscal year 2009, Dietary staff composted more
than 62 tons of food by-products. “We’re continuously
decreasing the volume of our waste and increasing the
volume of our composting and recycling,” says Walter
Bronowitz, executive chef and Dietary manager. Most
recently, the kitchen began composting cold cups made
from corn. The Dietary Department also works with
Full Circle Farms to bring fresh produce to families and
employees through the farm’s Community Supported
Agriculture program.

Seattle Children’s Community Benefit Report 2009 15


Offering a place of respite Inspiring hope among families
The grounds surrounding Seattle Children’s are a When a child is diagnosed with an ongoing health
botanical paradise teeming with brilliant colors and condition that may require frequent medical care, families
interesting shapes throughout the year. Some emit often experience a range of emotions and feelings of
mouthwatering scents — like the leaves from katsura trees uncertainty about the future. Seattle Children’s Parent
— which smell like burnt sugar. “Children’s has understood Support Program connects families of children with
the importance of the environment in reducing stress for special health needs to experienced parent volunteers
patients, their families, and employees for over 100 years,” who have lived through similar situations. The program
says Jeff Hughes, grounds and sustainability manager. also refers families to support groups. “Talking with peers
“The surroundings here are designed to promote healing who have walked a similar path can be supportive and
and to offer respite from the difficult things that may be powerful for parents,” says Lawrie Williams, who coord-
happening inside. No matter who you are or when you inates the Parent Support Program. “These connections
choose to step outside for a break, we want something can provide support for the practical challenges that
you see to delight you.” Visitors enjoy more than 2,000 families face each day, and offer hope that they too
species of trees, plants and flowers from all over the can get through difficult times, and although life may
world, including rare species like an heirloom apple be different, it can also be okay.”
tree first discovered in England during the 1800s.
Breaking Through Language
and Cultural Barriers
Improving health equity
Families who speak limited English have a new resource at
Seattle Children’s: patient navigators. “We want to make
sure all families are able to participate as full partners in
their child’s care,” says Sarah Rafton, director of Children’s
Center for Diversity and Health Equity. Patient navigators
encourage families to ask questions and ensure they
understand what is being said. The navigators also help
families schedule appointments, work with interpreters,
secure transportation and apply for financial assistance.
Over time, they prepare families to make their own way
through the healthcare system, both inside and outside
the hospital.
Patient Declan Morrow visits the Playroom to take a break from medical
procedures. Therapeutic Play staff and volunteers help patients cope
through music, art and play.

Enhancing care through play


On any given day at Seattle Children’s, patients struggling
with serious illnesses experience breakthrough moments
through the power of play. Children’s team of Therapeutic
Play staff and volunteers promote healing with music, art
and animal-assisted activities. Musicians visit children in
waiting areas, the Sibling Playroom and individual patient
rooms. Volunteers roll “art carts” through the medical units
to offer arts and crafts activities that relieve boredom. Pet
Partner volunteer teams bring specially trained therapy
dogs to play areas and patient rooms. In addition, art
and music therapists offer individual support to patients
who are having difficulty adjusting to the hospital setting Patient navigator Blanca Fields helps Anabel Cisneros and Ignacio Larios
with how to partner with their healthcare team when bringing their son
or patients undergoing treatments that are stressful
Isai to be treated for hydrocephalus.
and painful.

16 Seattle Children’s Community Benefit Report 2009


Families of all racial
and ethnic back-
grounds receive
high-quality dental
care with dignity
at Odessa Brown
Children’s Clinic.

Providing culturally sensitive dental care Helping families adjust to hospital life
Odessa Brown Children’s Clinic offers the typical range of A child’s admission to Seattle Children’s is difficult for any
pediatric dental services, including checkups, cleanings, family. But Native Alaskan families face special challenges
fillings and emergency dental care. But the experience for as they experience cultural and social isolation in the
patients — many of whom come from diverse families — midst of a child’s illness. To ease the stress and anxiety,
is especially tailored for their needs. They can always Children’s provides a variety of special services, including
count on receiving high-quality care with dignity. “We language assistance, information on where to find
have a very diverse staff, with over 90% coming from community resources and special foods, video tele-
different minority groups that are represented in our conferencing to school and family at home, and books for
community,” says Dr. Chris Delecki, director of the Dental children in native languages such as Yupik. Guest Services
Clinic. “This ethnic blend enhances our ability to be also works with families to find the best housing options
culturally sensitive.” For example, the dental assistants and personally welcomes families coming for the first
regularly provide care to a broad range of families, time. Adult family members benefit from the supportive
sometimes requiring communication in eight to 10 resources and programs available through the Seattle
different languages. They ensure clear communication Indian Health Board, which serves American Indians and
with families by using their own multilingual skills and Alaska Natives living in the greater Seattle area. Children’s
through interpreters. regional care coordinators also work with the Alaska
Native Medical Center to support each child’s needs
while at Children’s and in preparation for discharge.

Seattle Children’s Community Benefit Report 2009 17


People Making a Difference: Dr. Lenna Liu
Pediatrician and
community advocate
Dr. Lenna Liu works
tirelessly to address
the many different
causes of pediatric
obesity. “Obesity is a
symptom of poverty
in many cases, and
for me, it’s an issue
of equity,” she says.

A talented primary care physician at Odessa Brown Children’s Liu also helps her colleagues learn to work effectively
Clinic — and a dedicated community advocate — Dr. Lenna Liu with families.
was recently honored with the Odessa Brown Ken Feldman “Many pediatricians don’t feel comfortable talking about
Award for her caring service to families and her longtime obesity, so we’ve been coaching them on how to provide
work to address pediatric obesity. counseling around healthy activity and eating,” says Liu.
“Obesity is a symptom of poverty in many cases, and “Often there are deep emotional issues related to overeating,
for me, it’s an issue of equity,” says Liu. “Many children don’t so it can be hard to open the conversation. What’s exciting
have equal access to healthy food and healthy activity. about being a pediatrician is that we’re all about prevention.
Fresh produce is more expensive than a box of macaroni We can certainly do one-on-one counseling with our patients,
and cheese. It also costs a lot of money to put kids in sports but what will really make a difference is if we go beyond our
programs. And in many neighborhoods, kids don’t have a clinic and partner with community organizations that provide
safe place to go outside and play.” nutrition support and physical activity for kids.”
Recognizing that obesity cannot be addressed with Read about Dr. Liu’s type 1 diabetes research on page 5.
medical solutions alone, Liu has advocated for a broad,


multidisciplinary approach. For example, she worked with
the YMCA to develop Strong Kids/Strong Teens, an 18-week
What will really make a
program for youth ages 8 to 14 who are overweight or obese difference is if we go beyond
and one of their parents. Focused on promoting active living,
healthier eating habits and self-empowerment, this program
our clinic and partner with
has expanded to 11 YMCA branches in the greater Seattle community organizations
area since it started in 2004. that provide nutrition support
and physical activity for kids.”
— Dr. Lenna Liu

18 Seattle Children’s Community Benefit Report 2009


Jackie Kite,
Jennifer Gutzmer
and Alice Ryan
are part of the
Journey Program
team, which
supports families
who have exper-
ienced the loss
of a child.

Bringing Comfort to Bereaving Families


Seattle Children’s Journey Program offers compassionate birthday, the anniversary of their child’s death, Mother’s
support for families who have experienced the loss of Day, Father’s Day and all the other days and holidays
a child. that feel different after the loss of a child.
The program makes a difference for bereaved families The Journey Program also offers individual counseling,
by providing crisis intervention, grief support, counseling, depending on each family’s needs. Counseling might
advocacy and referrals to community resources. During include outreach to the communities where grieving
the first year following the death of a Children’s patient, families live and work. For example, Kite often spends
Journey Program staff contact families seven times with time with employers of grieving parents to help their
messages of compassion and offers of support, including managers and colleagues provide optimal support.
a personal invitation to the hospital’s annual memorial “We want to make sure families get the support they
service and a card acknowledging the first anniversary need, and that includes advocating for parents returning
of their child’s death. During 2009, more than 200 to work or siblings returning to school,” Kite explains.
families benefited from Journey Program services. Journey Program services are available to any family
“Each component of the program reflects our in the community who experiences the loss of a child —
philosophy that grief is a normal, natural process regardless of where the child was treated or died —
given the death of a child,” says Jackie Kite, MSW, who and are free of charge and without time limits.
manages the Journey Program. “Our unique services
are offered by licensed social workers dedicated solely
to grief and loss support. Children’s is one of a handful
of pediatric hospitals that provides this level of
bereavement care.” More than

200 families
Support groups are among the most popular services
offered by the Journey Program. “The group setting is
a safe place for parents to speak about their grief, offer
support to each other and remember and honor their
child,” says Kite. Groups typically include five or six received services from the
couples who meet every other week for one year to
18 months. During that time they experience many of Journey Program in 2009.
the big “firsts” together — the anniversary of their child’s

Seattle Children’s Community Benefit Report 2009 19


Partnerships
Seattle Children’s collaborates with the community to prevent injuries and promote
healthy families.
Children’s depends on partnerships with community organizations and public health
agencies to improve the health and well-being of children in the Northwest. By joining
forces with others, Children’s community health initiatives benefit more families with
greater effectiveness.

Improving Public Health


Promoting fitness for kindergartners
Almost

$9 million
Thanks to a partnership between Seattle Children’s and
Treeswing — a local organization working to prevent child-
hood obesity — every kindergarten student in the Seattle
Public Schools receives a free jump-rope kit through the
JumpUp program. Each jump-rope kit includes information invested in community programs in 2009.
for parents about the risks associated with childhood
obesity and the importance of establishing healthy habits
As part of our
at an early age. JumpUp’s goal is to encourage behavior
partnership with
in children that fosters a lifetime of fitness and healthy Denise Louie
choices. Kids can earn a “Top-Notch Jumper” certificate Education Center,
by logging daily jumping activity on their JumpUp which offers Head
Challenge Calendar and submitting the results. Start programs in
south and central
Seattle, we provided
Sharing expert health advice bike helmets to child-
Seattle Children’s is helping Denise Louie Education Center ren and their families.
(DLEC) improve the health and well-being of the children
and families it serves. DLEC offers Head Start programs
for children ages 3 to 5 in four south and central Seattle
locations, which primarily serve immigrants and refugees.
During 2009, Children’s hosted several health promotion
events for DLEC families, including a “Healthcare Institute” limited mapping activities to these areas. The Injury Free
that taught basic skills like how to take care of a sick child Coalition for Kids of Seattle will use the map as a tool to
at home, when to seek medical care and how to use the bridge injury prevention service gaps in priority areas
healthcare system. During “Oral Health Night,” pediatric and to identify opportunities for future partnerships.
dentistry residents from the University of Washington Children’s, Harborview Medical Center and Public Health
provided free dental screenings and education for parents Seattle & King County formed Injury Free Seattle in 2002.
about the care of their children’s oral health. Experts from
Children’s promoted child safety to DLEC families by Educating the community about immunizations
selling and fitting low-cost bicycle helmets and car seats. Seattle Children’s wants to help answer the community’s
questions about immunizations. A leadership member
Identifying partners for injury prevention of the Immunization Action Coalition of Washington,
Building connections with community organizations Children’s chairs its Public Education and Awareness
and individuals, minimizing duplication of services, and Committee. During 2009, the committee developed
maximizing resources are essential elements of successful educational materials and Web-based information
injury prevention programs. The Injury Free Coalition for at www.immunizewa.org that can help families make
Kids of Seattle recently conducted an “organizational informed decisions about immunizations. The information
mapping” initiative to identify Seattle-area organizations covers a range of immunization-related issues relevant to
working toward similar goals. The project engaged dozens children of all ages. In addition, Children’s collaborated
of citizens who contributed information for the map. with Group Health Foundation, WithinReach, the state
Because injury risk is greatest among children and teens Department of Health and others to understand parental
who live in central and south Seattle, the group ultimately concerns about immunizations.

20 Seattle Children’s Community Benefit Report 2009


Taking safety on the road Children’s partnered
with Feet First to
Thanks to a partnership with Kohl’s Department Stores,
create a walking map
Seattle Children’s introduced the Health and Safety Van of the neighborhoods
to bring safety and injury prevention information and surrounding the

B u i l d i n g W a l k a b l e Communities
free or low-cost safety gear to communities throughout hospital to improve
Washington. The program emphasizes service to the health of
employees, patient
communities that may not have ready access to safety
families and the
education and tools. The van carries information about community.
water safety, child passenger safety, childproofing at
home, nutrition, sports injury prevention and other topics.
Safety gear includes bike helmets, booster seats, life
jackets and home safety items. In 2009, the program’s
first year, the van visited community events and Kohl’s
stores throughout the Puget Sound region.
Inspiring neighborhood discovery
To improve the health of employees, patient families and
the surrounding community, Seattle Children’s partnered
with Feet First to produce a walking map of attractions
near the hospital. Feet First is dedicated to building
walkable communities in the Puget Sound region. The
“Neighborhoods Around Seattle Children’s” map is part
of Feet First’s “Neighborhoods on Foot” map series. The
Children’s map features routes for nature walks, exercise,
quick breaks and grocery runs. Maps also include safety
tips and a list of community resources for active living and
neighborhood involvement. To date, Children’s has distrib-
uted more than 2,000 maps to employees, patient families
and neighborhood organizations, including schools.

The Health and Safety Van brings safety information and free gear to
Supporting Organizations with
communities throughout Washington. Complementary Missions
Encouraging healthy lifestyles
Being a Good Neighbor Research indicates that kids who develop exercise habits
in their teen years or earlier are more likely to maintain
Offering transportation options those habits for life. Girls on the Run of Puget Sound,
In an effort to ease traffic concerns in Seattle Children’s with support from Seattle Children’s, is using the power
neighborhood — and to reduce environmental impacts of running to prepare girls for a lifetime of self-respect
— nearly two-thirds of Children’s employees commute to and healthy living. The program combines training for
work by foot, bicycle, bus, car pool or van pool. Incentives a 3.1 mile (5K) running event with uplifting lessons that
include free bus passes, fully subsidized van pools, ride- encourage positive emotional, social, mental and physical
matching services, shuttles connecting Children’s with the development. Certified athletic trainers from Children’s
region’s major transit hubs and innovative bike programs. provide injury prevention information and advice for
Children’s makes bus travel more convenient for employees volunteer coaches who work with the girls at various
through the Transit Now initiative, a partnership with King schools. The program serves girls in third through fifth
County Metro that adds 63 trips per week on bus routes grades throughout the Puget Sound region. Ultimately,
near Children’s sites. Children’s also launched the Company Girls on the Run aims to reduce adolescent depression,
Bike program in 2009, which provides employees with eating disorders, substance abuse problems, pregnancies
bicycles in return for their pledge to bike to work at and confrontations with the justice system.
least two days per week. These efforts helped Children’s
earn the prestigious Diamond Ring Award in 2009 Supporting community partners
from Commuter Challenge, a nonprofit organization Seattle Children’s supports community organizations
dedicated to solving transportation issues in the through sponsorships. In 2009, we donated over
Puget Sound region. $214,000 and sponsored more than 100 organizations.

Seattle Children’s Community Benefit Report 2009 21


People Making a Difference: Katherine Flynn
Katherine Flynn
creates links between
Seattle Children’s
Olympia clinic and
local communities to
improve the health
of children in south-
west Washington.

“ We are part of the fabric


Katherine Flynn, RN, is passionate about the links that Seattle
Children’s regional clinics create in local communities. As
nurse manager of Seattle Children’s Olympia clinic and a of the community.”
longtime Olympia resident, Flynn and her team work tirelessly — Katherine Flynn, Seattle Children’s
to improve the health and well-being of children in Olympia Olympia Clinic Manager
through community partnerships.
“We are part of the fabric of the community. We live here Since Flynn began managing the clinic 12 years ago,
and raise our kids here, so we feel a sense of urgency about she has witnessed a dramatic increase in the number of
bringing the same quality of care children receive in Seattle overweight and obese children who visit the clinic. But
to families in southwest Washington,” says Flynn. helping those patients adopt healthy habits proved
Most patients come to the Olympia clinic as a result of challenging due to a lack of community resources.
referrals from local pediatricians. “We looked for affordable programs that combined
“I’m really proud of the partnerships we’ve built with physical activity with nutrition education, but nothing was
community physicians, because they’ve been the key to available here in Olympia,” recalls Flynn. “I was determined
our success,” notes Flynn. “Children’s has a great reputation to do something to help.”
because we are very responsive to the needs of this She led the effort to involve Children’s Olympia clinic
community.” in the Strong Kids/Strong Teens program at local YMCAs.
In addition to caring for patients and managing the The program teaches families about exercise and nutrition.
Olympia clinic, Flynn helps teach the next generation of “I’m really excited about our new partnership with local
pediatric providers by inviting family practice residents from YMCAs,” says Flynn. “Education is a big part of the solution.”
Providence St. Peter Hospital and nursing students from
South Puget Sound Community College to train at the clinic.
“We want to light fires in as many young people as possible
about caring for kids in their own communities,” she says.

22 Seattle Children’s Community Benefit Report 2009


Staff at Odessa
Brown Children’s
Clinic provide
medical care,
mental health
and legal care to
families through
the Medical-Legal
Partnership for
Children.

Keeping Kids Safe and Healthy


At the start of the recent recession, communities Children’s also supports families through the Medical-
throughout the United States identified a troubling trend: Legal Partnership for Children, a service available through
a dramatic increase in child abuse and neglect. At Seattle Odessa Brown Children’s Clinic, Harborview Children
Children’s, clinicians noted a spike in the number of and Teens Clinic, and Northwest Justice Project. The
babies who suffered from abusive head trauma. partnership provides legal services to families of patients
During a typical year, Children’s and Harborview who are facing social, housing, immigration, economic
Medical Center treat approximately 10 infants for and legal problems that can negatively affect a child’s
abusive head trauma. But during the fall of 2008, both health. For example, a child with asthma living in moldy,
institutions cared for 18 infants with this diagnosis substandard housing might make repeated trips to the
during a three-month period. hospital with severe breathing problems. Intervention
“Though we can’t say there’s a direct cause-effect by a physician, social worker and a lawyer that results in
relationship between the economic crisis and child abuse, improving the family’s living conditions can positively
we can say that an increase in frustration or stress can impact that child’s health.
lead to abuse, regardless of the reason for the increased The Medical-Legal Partnership for Children launched
stress,” says Carol Jenkins, manager of Children’s as a pilot project in 2008. Children’s hopes to expand the
Protection Program. program to more families in need when the pilot period
To keep children safe, Jenkins says, communities need ends in 2011.
to ensure that families feel safe and supported. One way
that Children’s is working to prevent child abuse is through
education. In partnership with the Council for Children &
Families, Conscious Fathering and the Parent Trust for
Washington Children, Children’s created a public service
video to help new parents cope with the stress of a
crying infant — and prevent shaken baby syndrome.
The video, titled “Have a Plan,” features parents who
share real-life experiences and tips.

Seattle Children’s Community Benefit Report 2009 23


Advocacy
Seattle Children’s doctors, nurses and staff speak up for the health of children and communities.
Advocacy has been a core component of Children’s work for more than 100 years. Working
in partnership with community leaders, organizations, families and policy makers, we draw on
our unique expertise to improve children’s health, safety and access to quality healthcare.

Promoting organ donation


On any given day at Seattle Children’s, patients are
waiting for a lifesaving or life-enhancing organ transplant.
Our physicians and nurses work diligently to improve their
chances by promoting organ donation and improving
pediatric organ transplantation. Every year during
“Donate Life” month in April, the transplant team
educates families and Children’s staff about organ
donation and becoming a registered donor. The team
is also involved with LifeCenter Northwest — the organ
procurement organization that serves Alaska, Montana,
north Idaho and Washington — and they serve on
committees of the United Network for Organ Sharing
(UNOS), the nonprofit organization that matches
organs with recipients in the United States and
collects transplant data.
Dr. Frederick Rivara was part of the Institute of Medicine and the National
Research Council, which found that current services for teens need reform.
Improving environmental health
Dr. Rivara was also a co-editor of the “World Report on Child Injury
Prevention” released by the World Health Organization and UNICEF.
Dr. Catherine Karr and Dr. Sheela Sathyanarayana,
physicians at Seattle Children’s, are using their expertise
to guide policies in children’s environmental health. Karr
Advocating for the Needs — who studies the role of air pollution, climate change
and pesticides on child health — is a member of the
of Kids and Families American Academy of Pediatrics Committee on Environ-
mental Health. In this role, she advises the Academy and
Improving healthcare for teens
other authoritative bodies, including government, on
Dr. Frederick Rivara of Seattle Children’s was part of an
emerging issues. Locally, she helps develop policies on
18-member committee at the Institute of Medicine and the
pediatric lead-poisoning prevention and chemical safety
National Research Council that evaluated healthcare for
in children’s products. Sathyanarayana is a member of
adolescents — and discovered that current services need
the Environmental Protection Agency Children’s Health
reform. The report, titled “Adolescent Health Services:
Advisory Panel and a co-chair of the Academic Pediatric
Missing Opportunities,” found that some young people,
Association Special Interest Group for Pediatric Environ-
particularly those who are uninsured or underinsured,
mental Health. She recently served on the Governor’s
have little or no access to mainstream primary care
Advisory Panel to implement the Washington state
services. The report also expressed concern that many
Children’s Safe Products Act. Her research focuses on the
health professionals lack the skills to interact effectively
impact of chemicals such as phthalates and bisphenol A
with this age group. To address these challenges, the
on child development. “Given the wide range of environ-
authors recommend that both federal and state policy
mental exposures in our society, it’s important that we
makers develop strategies to ensure that all adolescents
translate health risks and effectively advocate for policies
have comprehensive, continuous health insurance
that protect children’s health,” says Sathyanarayana.
coverage, and that regulatory bodies incorporate
competencies in adolescent care in their licensing,
certification and accreditation requirements.

24 Seattle Children’s Community Benefit Report 2009


Advocating for global injury prevention
Injuries account for 1 million deaths to children and
adolescents throughout the world, whether they live in
high-income countries such as the U.S. or in low-income
countries in Asia, Latin America or Africa. But 95% of
those deaths occur in the developing world. Dr. Frederick
Rivara of Seattle Children’s co-edited the “World Report
on Child Injury Prevention” with the goal of focusing
attention on childhood injury and galvanizing governments,
nonprofit organizations and donors to action. The report,
which was released by the World Health Organization and
UNICEF, attempts to dispel the misconception that injuries
are “accidents.” Rather, it educates readers about the
predictable and preventable nature of injuries, and it
underscores the fact that prevention strategies can Neurosurgeon Dr. Samuel Browd promoted snow sports safety at
be adapted to the economics, needs and culture of The Summit at Snoqualmie snow resort with the talk “Ten Reasons a
countries and communities. Brain Surgeon Wears a Helmet.” One reason: helmets reduce the risk
of head injury by nearly 60%.

Fulfilling a Community Need


says Hilary Stephens, RN, Children’s food allergy comm-
Raising awareness of snow sport safety unity health educator. Stephens provides training and
Dr. Samuel Browd, a neurosurgeon at Seattle Children’s, educational presentations to staff and parents in a variety
worries about kids who engage in snow sports without a of settings, including schools, preschools, daycare centers,
helmet. Teenage boys and young men are at the greatest community centers, after-school programs and camps.
risk. “They’re the ones who are least likely to wear a helmet,
because it’s not cool and their buddies aren’t wearing Teaching emergency preparedness
them,” says Browd, who is part of Children’s sports Members of Seattle Children’s Safety Systems Department
concussion team and serves the Brain Injury Association and Emergency Response Teams use their knowledge and
of Washington as a board member. To promote safety expertise to educate schools and community groups about
on the slopes, Browd presented “Ten Reasons a Brain emergency preparedness — free of charge. “When you
Surgeon Wears a Helmet” to families at The Summit at talk about disasters, it’s not so much a matter of ‘if’ one
Snoqualmie snow resort. As part of his presentation, occurs, it’s ‘when,’ says Troy Cook, Emergency Response
Browd described the debilitating nature of brain injuries. Team member. “It’s beneficial to both our community
He also educated listeners about concussions, which and to Children’s to be prepared.” For example, keeping
account for 15% of all snowboarding injuries. But wearing families safe reduces trips to the emergency room. “We
a helmet, Browd pointed out, reduces the risk of head teach people things like not to get out of bed after an
injury by nearly 60%. earthquake until you put your shoes on, since stepping on
broken glass is a common after-earthquake injury,” Cook
Protecting kids with food allergies explains. “By preparing others, we help make sure places
The incidence of food allergies in the United States has like Children’s, fire departments, police stations and 9-1-1
doubled during the last 10 years. Until there is a cure, operators are not overwhelmed in the event of a disaster.”
education about managing food allergies and preventing
severe reactions will help keep kids safe. In partnership
with the Food Allergy Initiative Northwest, Seattle Children’s
offers the Food Allergy Community Health Education
Program, which helps create safer environments for
children. Given that a new law in Washington state requires
schools to adopt food-allergy management policies, the
program meets an important community need. “With
proper training, every school and child-care facility can
have a sensible program that protects children at risk,”

Seattle Children’s Community Benefit Report 2009 25


People Making a Difference: Dr. Abraham Bergman
For more than 50
years, Dr. Abraham
Bergman has
practiced political
medicine. His lasting
impact ranges from
working on sudden
infant death syndrome
(SIDS) to advocating
for child protection,
bicycle helmet safety,
and regulation of
household products
and flammable
clothing.
© 2009 Will Austin:
Will Austin Photography

A pioneer among child advocates at Seattle Children’s, In 1986, in collaboration with Dr. Fred Rivara, Bergman
Dr. Abraham Bergman’s work over the past 50 years has carried out a bicycle helmet campaign that raised usage rates
improved the lives of children throughout the world. among Seattle children from 3% to over 60% during a five-
His career as a pediatrician began in the late 1950s, before year period. As a result, admissions at five Seattle-area
the term “child abuse” emerged. By the mid-1960s, Bergman hospitals for bicycle-related head injuries dropped by
had organized the first child-protection team at Children’s, approximately 67% among children 5 to 14 years old. The
and he testified before the Washington state legislature in bicycle helmet campaign remains an international model
1969 when the state’s mandatory child-abuse reporting law for helmet-promotion efforts.
was enacted. Though the campaign led to helmet usage requirements in
An active practitioner of what he calls political medicine many Washington communities — including Seattle — Bergman
— using the political process to improve public health — believes more can be done to ensure children’s safety.
Bergman’s work has resulted in several important pieces of “In my mind, the next step is statewide legislation,”
national health legislation, including the Flammable Fabrics Bergman explains. “We have shown that an increase in helmet
Act in 1967, the Poison Prevention Packaging Act of 1970, use leads to fewer head injuries among children, and a
the National Health Service Corps in 1972, the Sudden Infant substantial financial savings to families and our community.
Death Syndrome Act of 1974, and the Indian Health Care It’s only logical to ensure their use.”
Improvement Act in 1976.
Locally, Bergman is best known for his work at Children’s
on sudden infant death syndrome (SIDS), with colleagues
Dr. Bruce Beckwith and Dr. George Ray. In addition to
publishing numerous research papers and several books,
Bergman served as president of the National SIDS
Foundation in the 1980s.

26 Seattle Children’s Community Benefit Report 2009


Medical student
Teja Dyamenahalli
provides a physical
exam to a patient
at the Country
Doctor Free Teen
Clinic in Seattle’s
Capitol Hill
neighborhood.

Caring for Homeless Youth


Accessing necessary healthcare is difficult for homeless The experience prepares residents to work with
teens who have no money or health insurance. And vulnerable populations, even if they don’t plan to
because many come from abusive homes, asking parents work in a community setting.
for help is out of the question. “Ultimately, working at the Country Doctor clinic
Fortunately, the Country Doctor Free Teen Clinic in increases the residents’ sensitivity to the needs of
Seattle’s Capitol Hill neighborhood can help. The clinic, homeless people when they encounter them in their
which provides free primary care, is staffed by Seattle clinics or in the hospital in the future,” says Giesel.
Children’s pediatric residents under the supervision of “But the experience also provides training in listening
physicians like Dr. Ann Giesel, an attending physician and motivational interviewing, where you try to
in the Adolescent Medicine Department at Children’s. understand the patient’s needs and help them take
“The experience at the clinic is a chance for trainees care of themselves. And those skills are clearly an
to learn about working with adolescents, and also about important part of training for a physician in any setting.”
the barriers facing homeless people,” says Giesel, the


clinic’s medical director. “For example, it’s not realistic to
expect a homeless youth to comply with a complicated
treatment regimen. Or they may not have access to
The experience at the
running water, which is challenging if they need to clinic is a chance for
soak an abscess, for example.”
There are no nurses, no pharmacists, no medical trainees to learn about
assistants — just the attending physician, the residents,
the medical students, a mental health practitioner, an working with adolescents,
acupuncturist, a massage therapist and several volunteers
with a variety of skills and backgrounds. Because the
and also about the barriers
clinic was designed as a training site, residents and
attending physicians manage most aspects of care,
facing homeless people.”
from drawing blood to dispensing medications. — Dr. Ann Giesel, attending physician

Seattle Children’s Community Benefit Report 2009 27


It Takes a Community to Raise Healthy Children
Seattle Children’s works diligently to prevent, treat and ultimately eliminate pediatric disease and
injury. Children’s serves the largest geographic region of any children’s hospital in the country.
Community support makes it possible to serve a growing population with vital services and
special programs alike. We appreciate our many partners — including donors, volunteers and
like-minded organizations — who help Children’s meet the healthcare needs of children and
families in the Northwest.

For more information or to request a printed copy of this Community Benefit Report,
please contact:
Marketing and Communications Department
Seattle Children’s Hospital
Phone: 206-987-5205
marcommrequests@seattlechildrens.org

Office address:
6901 Sand Point Way NE
Seattle, WA 98115

Mailing address:
M/S S-217
PO Box 5371
Seattle, WA 98145-5005

www.seattlechildrens.org

28 Seattle Children’s Community Benefit Report 2009


Stone Fennell fell off
his bike on his way
home from a soccer
game. “My bike
helmet — the one
we got at Seattle
Children’s Health
Fair — even had a
dent in it! I think
it’s really great that
Children’s gives out
bike helmets. One of
them saved my life,”
says Stone.
4800 Sand Point Way NE
Seattle, WA 98105
TEL 206-987-2000
TTY 206-987-2280

www.seattlechildrens.org

© 2010 Seattle Children’s, Seattle, Washington. All rights reserved.