Update _ Summer 2012

Children’s Hospital Taps Leading Pediatric Pulmonologist as New Chairman

Internationally renowned pediatric pulmonologist Giovanni Piedimonte, MD, has been named the new Chairman of Cleveland Clinic Children’s Hospital and Pediatric Institute following an extensive national search.

Dr. Piedimonte is a pioneering physician-scientist who brings to the position a wealth of demonstrated leadership in research, administration, innovation and education.

He comes to us from West Virginia University (WVU) School of Medicine in Morgantown, where he was Chair of Pediatrics and Physician-in-Chief of WVU’s Children’s Hospital since 2006. He also served as founding Director of the WVU Pediatric Research Institute and as WVU’s first Wyeth Research Scholar.

Before coming to WVU, Dr. Piedimonte served for more than a decade as Chief of the Division of Pediatric Pulmonology at the University of Miami Miller School of Medicine, where he established a number of clinical and educational centers and programs.

In his new role, Dr. Piedimonte will oversee more than 300 full-time pediatricians and subspecialists employed by Cleveland Clinic Children’s Hospital.

“I am excited by the prospect of leading one of the country’s top children’s hospitals,” he says. “I am very much looking forward to furthering our many new initiatives that are advancing medical knowledge and patient care.”

Dr. Piedimonte’s research interests include airway inflammation in pediatric respiratory disease, the role of early viral respiratory infections in the pathogenesis of asthma, and the neurobiology of the developing respiratory tract. He holds 17 international patents and has been principal investigator or co-investigator for more than 30 research projects funded by the National Institutes of Health, the Cystic Fibrosis Foundation, the American Lung Association and other sources. He is widely published, serves on the editorial boards of several journals and presents frequently at national and international medical meetings.

He earned his medical degree from the University of Rome School of Medicine in Italy. He completed his pediatrics residency at the University of California, San Francisco, and his pediatric pulmonology fellowship at the University of North Carolina, Chapel Hill. He is board-certified in general pediatrics as well as in pediatric pulmonology.

Dr. Piedimonte starts at Cleveland Clinic on August 6, 2012.

A New Arrival for New Arrivals: Universal Newborn Screening for Congenital Heart Defects Introduced

Cleveland Clinic has begun performing universal pulse oximetry screening in healthy newborns to detect congenital heart defects – collectively known as critical congenital heart disease (CCHD) – in infants in whom they would otherwise be missed.

The universal screening policy was launched at Cleveland Clinic’s Hillcrest Hospital at the beginning of May; implementation at Fairview Hospital is slated for June, with other Cleveland Clinic community hospitals with birthing centers soon to follow.

CCHD: Relatively common, potentially catastrophic

CCHD is not detected in some newborns until after their hospital discharge, which results in significant morbidity and occasionally in death.

“Congenital heart disease is one of the most common birth defects and often goes undetected in the newborn period,” explains Thomas Edwards, MD, Department of Pediatric Cardiology. “By using pulse oximetry, we hope to prevent the catastrophic events that occur with late diagnosis.”

The seven heart defects classified as CCHD — and routinely detectable by pulse oximetry screening — are hypoplastic left heart syndrome, pulmonary atresia, tetralogy of Fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia and truncus arteriosus.

What the screening involves

A pulse oximeter is used to noninvasively measure the proportion of hemoglobin in the blood that is saturated with oxygen. Under Cleveland Clinic’s screening policy, a positive screen is defined as a pulse oximetry reading of less than 95 percent or a difference of 3 percent or more between preductal and postductal saturations. A positive screen triggers an urgent echocardiogram and consultation with a neonatologist.

Universal pulse oximetry screening of newborns for CCHD has been endorsed by the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services, but it is not mandated by either the federal government or the state of Ohio.

Northeast Ohio’s First Pediatric Airway Lab Opens

In May, Cleveland Clinic opened a dedicated education laboratory for pediatric airway management, the first of its kind in Northeast Ohio.

The Debra Ann November Pediatric Airway and Pulmonary Mechanics Lab, part of Cleveland Clinic’s growing Multidisciplinary Simulation Center, offers training in airway and ventilation management in young patients to caregivers from Cleveland Clinic Children’s Hospital – and soon to caregivers from other organizations as well.

State-of-the-art equipment, strategically placed

The simulation facility is equipped with an ICU ventilator, lung simulators, a high-fidelity bronchoscopy simulator and child-sized high-fidelity mannequins. It is housed directly above operating rooms and the emergency room on Cleveland Clinic’s main campus, where it can be used for preoperative rehearsals and just-in-time teaching opportunities for trainees.

“Airway compromise is a significant cause of pediatric injury, illness and death,” says Stephen Kimatian, MD, Chair of Pediatric Anesthesiology. “As more procedural work is done outside of the operating room, requiring varying degrees of sedation, competency in airway skills will be an important aspect of providing safe and effective patient care.”

Will address range of training and credentialing needs

The lab was designed to provide an airway-focused curriculum for physicians, fellows, residents and nurses that will cover the fundamentals of pediatric airway management, including the complex competencies needed for diagnosis, decision making and team leadership.

The Multidisciplinary Simulation Center will be establishing that curriculum over the next 18 to 24 months. Initial modules will focus on the airway skills required to provide credentialing for procedural sedation as well as the simulation-based experience requirements of the American Board of Anesthesiology’s maintenance-of-certification program, according to Dr. Kimatian. As these modules become available, they will be posted on the Multidisciplinary Simulation Center website. Interested providers also can use this website to contact the center to request specific training opportunities for larger groups.

Establishment of the Pediatric Airway and Pulmonary Mechanics Lab was made possible by a gift from Mort and Iris November in memory of their daughter, Debra Ann.

Who’s New? Staff Spotlight

Pediatric Dermatology

Joan Tamburro, DO
Practice perspectives: “I enjoy pediatric dermatology because of the wide range of common and uncommon skin disorders seen in children.”
Specialty interests: Pediatric dermatology, with particular interest in vascular anomalies and atopic dermatitis
Locations: Cleveland Clinic Children’s Hospital, main campus; Richard E. Jacobs Health Center, Avon
Phone: 216.445.3658
Email: tamburj@ccf.org

Community Model Brings Broad General Surgery Services Close to Home

Single-port laparoscopic appendectomy is now available for pediatric patients at Cleveland Clinic community hospitals at convenient locations throughout Northeast Ohio in addition to our main campus Cleveland Clinic Children’s Hospital location.

Our pediatric general surgeons have begun performing the procedure at Cleveland Clinic’s Hillcrest Hospital in Mayfield Heights and Fairview Hospital on Cleveland’s western edge, offering close-to-home access for families throughout much of Northeast Ohio.

“We are pleased to extend this less-invasive approach for a common procedure to our patients and referring physician partners close to where they live and practice,” says David Magnuson, MD, Chairman of Pediatric General Surgery.

“Referring physicians can be assured that we perform single-port laparoscopy using technology and techniques specifically tailored to and appropriate for pediatric patients,” Dr. Magnuson adds, noting that the same team of pediatric surgeons practices at both our community hospitals and our main campus.

Latest of many community hospital offerings

Single-port laparoscopic appendectomy is the latest of many pediatric general surgical procedures, both inpatient and outpatient, offered at Hillcrest and Fairview Hospitals. Others include:

  • Urgent surgery in neonates, including minimally invasive procedures (such as for pyloric stenosis)
  • Repair of inguinal hernias and hydroceles
  • Repair of undescended testicles
  • Excision of pilonidal and congenital cysts
  • Removal of foreign bodies
Different settings, same specialty support

At both Hillcrest and Fairview, our pediatric surgical patients benefit from the same level of specialty and supportive care – from pediatric surgeons, pediatric anesthesiologists, pediatric radiologists, neonatologists, child life specialists and advanced practice nurses specializing in pediatric surgery – that they do at our main campus hospital. And both community hospitals now provide 24/7 pediatric surgical coverage for their pediatric emergency rooms, pediatric inpatient units and neonatal ICUs, making urgent surgery an option for the youngest of their patients.

Our main campus Children’s Hospital location remains the site for more complex procedures, such as general surgery of the chest and abdomen, surgical oncology, musculoskeletal and reconstructive operations, and endocrine surgery.

“Our model gives us a platform to match patient needs and preferences to the most appropriate surgical location,” explains Dr. Magnuson. “While clinical considerations loom largest in these decisions, convenience and overall patient experience matter a lot too.”

CME from the Pediatric Institute

Live CME

Aug. 27-31, 2012

Renaissance Cleveland Hotel, Cleveland, Ohio
Cleveland Clinic Children’s Hospital 18th Annual Pediatric Board Review Symposium
Comprehensive five-day review course for board certification or recertification. Features board simulation sessions, case-driven format, interactive audience response system, much more.

Sept. 27, 2012, 5:30 p.m. – 9 p.m.

Medina Hospital (Conference Room 3), Medina, Ohio
Neonatal Update (Dinner Program)
For information and registration, email zaibekj@ccf.org

Oct. 3, 2012, 5:30 p.m. – 9 p.m.

356th Fighter Group, North Canton, Ohio
Perinatal Updates (Dinner Program):
Managing the High-Risk Mother and Infant with Cardiac Issues

For information and registration, email zaibekj@ccf.org

Oct. 4-5, 2012

InterContinental Hotel and Bank of America Conference Center, Cleveland, Ohio
7th Annual Cleveland Clinic Obesity Summit
Includes sessions on childhood obesity, including “Unfattening Our Children” and “Practical Management of Childhood Obesity.”

Oct. 17, 2012, 5:30 p.m. – 9 p.m.

Dino’s, Willoughby, Ohio
Perinatal Updates (Dinner Program):
Managing the High-Risk Mother and Infant with Cardiac Issues

For information and registration, email zaibekj@ccf.org

Oct. 24, 2012, 5:30 p.m. – 9 p.m.

Deluca’s Place in the Park, Lorain, Ohio
Perinatal Updates (Dinner Program):
Managing the High-Risk Mother and Infant with Cardiac Issues

For information and registration, email zaibekj@ccf.org

Nov. 9, 2012

Cleveland Clinic Main Campus (NA5-08 Amphitheatre), Cleveland, Ohio
Sleep Problems in Children with Special Needs
Four-hour morning course on disorders of breathing during sleep, with emphasis on children with special needs. For primary care providers, nurses and others.

Pediatric Institute Virtual CME

Online case-based lessons on well baby care, early signs of autism spectrum disorder, more.

New Physician Referral Line

For referrals to any Cleveland Clinic department or institute, physicians can now call one toll-free number: 855.REFER.123 (855.733.3712)

Pediatric Physician Liaison

For a direct, personal link to Cleveland Clinic Children’s Hospital, contact Physician Liaison Janet Zaibek, RN, at zaibekj@ccf.org