F O R T H E E M P L O Y E E S O F C I N C I N N AT I C H I L D R E N ’ S
MAY/JUNE 2013
RE-IMAGINE
WHAT’S INSIDE
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Assembling a Picture of Hope— One Puzzle Piece at a Time
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Design Makes the Difference: Creating Well-Thought-Out Work, Healing Spaces
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Joint Commission Learning Visit: Blazing New Trails Quest for Answers Transforms Care for Vascular Anomalies
RE-IMAGINE. Welcome to the inaugural issue of 360°, our new publication that celebrates employees of Cincinnati Children’s. By now you’ve noticed this isn’t your old ’Round the Center, with its eight-page newsletter layout. We’ve adopted a magazine format and a new design that gives the content room to breathe and flow. With bigger photos and typographic treatment, we hope you’ll find it more enjoyable to read and easier to follow the story threads. About those stories…our editorial and graphics team sat down together and considered the feedback you’ve given us via our employee communications surveys, focus groups and other channels. Repeatedly, you’ve told us how busy you are and how difficult it is to sort through the large amount of information that comes at you daily. Your bulletin boards, break rooms and email boxes are full of communications, and yet, you have told us you want more stories that connect you to the work of Cincinnati Children’s and the contributions of your fellow employees. In response, we decided to re-imagine our employee communications, starting with this print publication. Each issue will be centered on an idea, value or quality that relates to the spirit and vision of Cincinnati Children’s. The stories within these pages will tell how you are demonstrating that idea, value or quality in your own areas, in your own lives. They will convey more of the behind-the-scenes experience of what it’s like to work here—not so much the what, when and where, but more of the why and the how. (This issue is, appropriately, dedicated to how you re-imagine or help patients re-imagine better outcomes.) Frankly, these aren’t stories you have to read to do your job. But we hope these are stories you’ll want to read to be inspired by your colleagues and gain insight into all the ways each of us contributes to making Cincinnati Children’s the world-class organization it has grown to be. We’ve changed the name to 360° to reflect the global spectrum of our reach and impact. We’re no longer that local children’s hospital of old, where you could literally walk ’round the center within one city block. We’ll be publishing new issues six times a year instead of 12, which will reduce paper and distribution costs. For your convenience, we’ll place copies in more areas where you want to read, like the cafeterias. And we’re also adding an online component to the magazine, which you can access on CenterLink. The goal with the digital version is to give you the option of delving deeper into different aspects of the stories. Of course, we’d love to get your feedback on this issue and subsequent issues of 360°. We welcome your comments and your story ideas at 360@cchmc.org.
Cindy Duesing, Editor
Volume 1, Issue 1 | 360° is an employee
To give us your feedback or request additional
Editor: Cindy Duesing
publication of Cincinnati Children’s Hospital
or fewer copies of this newsletter, email us at
Contributor: Kar yn Enzweiler
Medical Center, produced by the Department
360@cchmc.org.
Senior Art Director: Anna Diederichs Designer: Elyse Balster
of Marketing and Communications, MLC 9012, Cincinnati Children’s Hospital Medical Center,
ON THE COVER:
Design Intern: Jessica Kaising
3333 Burnet Avenue, Cincinnati, OH
Erika Loescher, mental health specialist,
Contributing Photographers: Cindy
45229-3039, 513-636-4420.
is serious about play as a way to build
Duesing, Joe Harrison, Tine Hofmann,
therapeutic relationships with her patients.
Cathy Lyons and Mark Lyons Contributing Illustrators: Elyse Balster and Caroline Williams
milestones 20
Congratulations to the following employees who celebrate 20+ years of milestone service anniversaries in M AY and J U N E !
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Beth Haberman, MD, Neonatology and Pulmonary Biology
Dorris Ball, Outpatient Registration
Tamara Kluemper, Child Life and Integrative Care
Catherine Busemeyer, RN, B5/Critical Care
Susan Kossen, Radiology
Linda Meirose, RRT, Transport
Deborah Lipps, Ophthalmology
Estelle Riley, Facilities Management
Shelley Longnecker, RN, Operating Room
Vanessa Smith, Access Services
Ann Malinowski, RN-CNP, Advanced Practice Nurses Patricia Nordbloom, RN, Operating Room Joseph Palumbo, MD, Hematology Dawn Poteet-Freeman, Infectious Diseases Barbara Schott, Liberty Campus Laboratory
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Pamela Sierra, Early Education and Care Janet Whitt, Dentistry
Diane Allgeyer, Clinical Translational Research Center
Jeanette Williams, General and Community Pediatrics
Lisa Bowens, RN, B4/Newborn Intensive Care Unit
Helena Wong, Emergency Medicine
Debra Chandler, RN, Adolescent Medicine Regina Coleman, RN, Liberty Campus/Surgery Janet Cremons, RN, Neurology and Neuroscience Penny Eggemeier, RN, B1/Emergency Department
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Michelle Hils, RN, Neuroscience Outpatient Treatment Center Bruce Honsaker, RN, Orthopaedic Outpatient Treatment Center Mar ty Huber, RN, Managers of Patient Services
Kimberly Bartholomew, RN, Same Day Surgery
Diane Lemen, RN, Liberty Campus Clinics
Angela Bonavita, RN, A5 Central
Katherine Littmann, Occupational Therapy/Physical Therapy
Teresa Couch, RN, Clinical Development and Education
John Maybur y, Cincinnati Children’s Research Foundation
Robin Currie, Special Needs
Lisa Meiners, RN, Orthopaedic Outpatient Treatment Center
Gina Davidson, RN, Liberty Campus/Anesthesia
Lisa Nelson, RN, Specialty Resource Unit
Bessie Egelston, RN, Vascular Access Team
Gerr y Pandzik, RN, Physician Hospital Organization
Sherrill Ferrell, Graduate Medical Education
Deborah Reeves, RN, Nephrology/Urology Outpatient Center
Karen Frietsch, RN, Outpatient Diabetes/Endocrinology
Michelle Rodgers, RN, Neuroscience Outpatient Treatment
Carla Glos, RN, Post Anesthesia Care Unit Pamela Groh, RN, Neuroscience Outpatient Treatment Center
Center Virginia Tyus, Hospital Billing
George Harris, Operating Room Patricia Johnson, RN, Specialty Resource Unit Michelle Kyle, RN, Same Day Surgery Paula Mateo, RN, Home Care Connie Meeks, RN, Pulmonary and Allergy Outpatient Treatment
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Center Kathy Meyer, RN, The Heart Institute
Susan Fabe, Social Services
Tracy Robbins, Radiology
Jeanette Marshall, Gastroenterology
Mary Ann Sackenheim, RN, Liberty Campus/Same Day Surgery
Cr ystal Williams, Dentistry
Jennifer Schwarz, RN, B1/Emergency Department Marcus Scott, Emergency Services Registration Janalee Taylor, RN-CNP, Advanced Practice Nurses Jacqueline Taylor, RD, Nutrition Therapy Melissa Tripp, RN, Liberty Campus/Post Anesthesia Care Unit Sarah Wilson, RN, A3 North
A S S E M B L I N G A PI C T U R E O F H O PE— One Puzzle Piece at a Time
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t’s 9 am on a Thursday at Cincinnati Children’s College Hill Campus. Lois Carter, clinical counselor, P3 West, is seated in a small conference room, rounding on patients with other members of the multidisciplinary care team. Together, they review each child’s treatment plan and daily goals and discuss any adjustments that need to be made. Carter is passionate about helping the adolescents who come here for treatment. Their lives have been derailed by mental illness, substance abuse and chaotic family situations. Some have major depressive disorders, bipolar disorders or psychosis; others are dealing with gender issues. They may also have chronic conditions like diabetes that need to be managed. Carter, who has worked at Cincinnati Children’s for seven years, takes a holistic approach to helping these kids.
“I try to think globally and look at all the pieces—the family, how the patients view themselves, how they function in school, their spirituality, autonomy, social history, and any legal issues they may be having,” says Carter. “I consider how the patient and family view mental illness and whom they’re working with in therapy.”
FIRST STEPS
When Carter sits down with families, she talks with them about their concerns, about what brought their son or daughter here. “We ask what their goals are,” she explains. “Often, their goals are different than ours. We have suicidal patients, homicidal patients, aggressive and psychotic patients. So our goals are always focused around their safety, as well as staff safety.” Carter prepares parents for what they’ll see on the unit. Their child will be dressed in hospital clothes first, and as they work through their treatment plan, they can earn privileges that include wearing their own clothes, listening to music, or ultimately, leaving the unit to go to the gym. They receive individual services and participate in peer group therapy. The value of peer group therapy, or milieu management, is that teens generally respond better in a peer setting. Any negative behaviors that occurred at home will show up in the group and can be addressed. The average patient stay on the unit is five to seven days.
Having all this information helps Carter and the care team develop a treatment plan, in partnership with community agencies, that fits the context of the patient’s life. Meeting patients and families where they are gives them a better chance at being successful.
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“We help the patients become more aware of their behavioral triggers and teach them coping skills. We also help families understand those triggers and talk to them about what they can do differently at home.”
The concept of what can be different at home is an idea Carter consistently brings up in her meetings with patients and families. It can be a revelation for those who’ve become stuck in destructive behavioral patterns. Her approach is low-key, compassionate, non-judgmental and empowering. She is especially enthusiastic when the whole outpatient team is present. “We all come up with a plan to coordinate treatment,” says Carter. “We also connect with the schools if there are bullying issues or suspensions. We develop school plans, maybe a decreased work level if the patient is under a lot of stress. Collaborating with all the providers helps you see the whole picture of the person. You get more than one version of the story. And you can be more resourceful in putting a plan together and getting the family on board.” Changes in Medicaid make coordination of care even more important. “Medicaid discourages re-admitting kids within 30 days of hospitalization, although we do re-admit if it’s necessary,” explains Carter. “Having them connected to the right resources in the community means families have a place to go where the providers are familiar with their child when they are in crisis again. Hospitalization breaks up continuity for kids. It can be very traumatic.” Change isn’t easy, but families whose children are admitted to College Hill are in crisis. They are frightened, frustrated, and in most cases, desperate for a shred of hope that life can be better. “It’s a wake-up call for them,” says Carter. “The families rally to work together. We see a lot of tears. We have a few families who dig in their heels when we recommend new approaches, but most of them are wonderful. I have such respect for them.” PREVENTING BURNOUT
Carter’s workday can be intense. She sees patients; gives parents updates on treatment; schedules and participates in family meetings, and acts as a liaison between the patient, the family and the doctor. “The challenges some of our families face are enormous,” she says. “At the end of the day, I think, if it’s this exhausting for me, a professional, how exhausting is it for the children!” She takes time to decompress by talking to her peers, and when she goes home, she walks the dog, exercises or reads.
Lois Carter, clinical counselor, P3 West, helps adolescent patients imagine different possibilities for their lives.
“I don’t take my work home with me. You have to set up really good boundaries. You can’t get overly involved. You can’t rescue. It’s natural to want to get rid of the patient’s pain right away, but you have to advocate so they can work through it themselves.” Burnout in the mental health field is very high, but Carter and her colleagues knew that going in. “We chose this field because there are challenges, because we know people can triumph,” she explains. “We don’t welcome crisis, but we don’t shun it. Symptoms have meaning. Challenge and conflict can produce positive outcomes. We are committed to wanting to do good work, to having patients and families leave here with a more positive approach to mental health and the resources and support they need.” Katherine Salisbury, a behavior specialist on P3 Southwest, is a slender young woman with long, dark hair and a wide smile. She’s worked at Cincinnati Children’s since 2005. This is her fourth year on the unit. When she arrives in the morning, she checks in with every patient to make sure they have their ADL
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supplies (activities of daily living, e.g., toothbrushes, towels, clothing, etc.), as well as supplies for their specific behavior plans. Likewise, she touches base with the treatment team and the floor staff to make sure they have the appropriate personal protective equipment (PPE) for interacting with their patients. Patients on this unit range in age from 3 to 21 years old and have a dual diagnosis: a neurological disorder and a psychological disorder, such as intermittent explosive disorder (IED), Asperger’s or autism. Many of them are nonverbal. Many are aggressive. The safety of both the patients and staff is the top priority, and staff have worked hard to reduce injuries. Staf f psychologist Michael Lind, PhD, designed an initial assessment form that details a patient’s behavior, including self-injury and aggression, and provides a decision key for what kind of PPE is needed for the patient and for staff.
Another useful tool is the five-second rule, which goes into effect when a staff member recognizes a patient is struggling to maintain self-control. “When a staff person calls out ‘5-second rule,’ everyone in the vicinity has 5 seconds to remove themselves from the scene,” Salisbury explains. “It keeps the other patients safe and gives the patient who is struggling a chance to pull himself together without being embarrassed in front of the other kids. It’s a proactive way of dealing with a potentially volatile situation.” S M O O T H I N G A P AT H
Patience and consistency are important in teaching these children how to cope. Posted on the wall in the main area is a visual schedule for the day. Some patients also have a blue binder with the visual schedule inside. “The schedule on the wall is too abstract for them,” Salisbury explains. “They need to keep it with them and hold it in their hands. It helps them know what to expect. We schedule something they enjoy, then we have a period of work or a learning activity. The kids have to learn that the work doesn’t go away until it’s completed. Sometimes, it takes three days to get them to do the work without displaying aggression.” The kids are smart. They’ve learned very quickly that when someone makes a demand on them, pinching, biting and kicking will make a person back off. “When they come here, we deliberately set up a pattern of doing something fun, followed by making a demand for work, then rewarding them with something fun. When they resist, we stay close to help them follow through on what they’re supposed to do.” Staff members use three-stepped prompting to accomplish this. First, they tell the patient what they want him to do; then they show him. If he still is uncooperative, they put their hand over his and gently but firmly make him do it. The goal is to extinguish the negative behavior and model the positive. It’s one thing to do this with a 3-year-old, but it can be downright scary when dealing with a very large and very strong 21-year-old who has an explosive disorder. Is Salisbury ever afraid?
Katherine Salisbury, a behavioral specialist on P3 Southwest, practices three-step prompting with a patient, which includes hands-on modeling of desired behaviors.
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“I’m not afraid,” she says. “There’s always other staff around to intervene, and we back each other up. Still, you have to be thinking of how to position your body and verbally re-direct the patient when he stands up. We are trained to de-escalate patients without going
hands-on, so you have to use your best clinical judgment and know the patient’s history to stay on top of the situation.” Staff can call a silent code, if necessary, which summons colleagues via pager from other units to help. “It’s so important, when the patient gets aggressive, to stand your ground and not back away,” says Salisbury. “We have to stay with them and reinforce the positive coping mechanisms we’re trying to teach them.” She acknowledges frustration when she sees a patient on the unit whom she feels could be helped, but insurance won’t pay for a long enough stay. In contrast, some patients end up staying too long because they are waiting for placement in another residential facility while third parties hash out who is responsible for covering the cost. “Sometimes it’s hard to see any progress in a patient’s recovery,” she says. “But if you can find that one little thing that has gotten better, it means a lot.” Salisbury and her coworkers are tuned into each other’s stress levels and will spell each other if someone needs a break. It’s her responsibility to make sure communications flow between the floor staf f and the treatment team. “I have to be able to voice the good and the bad on both sides. I can’t be afraid to speak up, because it all comes back to the patient. If we’re communicating well, the patient will get the best care.” Erika Loescher has been a mental health specialist at Cincinnati Children’s since 2005. On the P3 South unit, she cares for patients, ages 3-10. She does everything, from helping them bathe and dress, to serving them meals, running therapeutic groups, providing crisis intervention and educating parents. “We have a very structured schedule,” she says. “I can tell you what the kids will be doing on any given day at 10:30 am. They respond well to structure. They don’t always have that at home.” The children are here because they behave aggressively or unsafely. Loescher’s job is to help the kids with anger management, self-care and social skills. “We teach them appropriate responses to challenges they face,” she says. Loescher is wearing a bright pink CCHMC T-shirt that reads: “Play is serious.”
“When the kids have a rough day, we have a rough day,” says Erika Loescher, mental health specialist, P3 South.
“Play is very important in our work because that’s how children learn,” she explains. “And it helps us to build a therapeutic relationship with the child.” The children stay on the unit anywhere from seven to 10 days, depending on their behavior, the family situation, safety and insurance. That time is decreasing though, because of Medicaid requirements. When the kids are having a rough day, it’s difficult for the staff. But they support each other. “My team mates completely have my back, and that’s comfor ting,” Loescher says. She is encouraged when she feels like she’s made a difference, even a small one. “I was helping out on the adolescent unit recently, and I saw a patient there who said he remembered me from an earlier stay. He recalled how I used to play cards with him every day. I play cards with many patients, and I honestly didn’t remember him,” she admits. “But it felt good to know that I had given him the experience of having a positive therapeutic relationship with an adult.” Loescher enjoys being with kids and loves their spontaneity. “We can take any idea and just roll with it,” she says. “We color, read stories, play with flash cards and exercise. The kids are so funny. I could write a book of one-liners with all the things they say. They always make me laugh.” Loescher doesn’t have children of her own yet. Meanwhile, her patients teach her a lot. “These are my children,” she says. “And while they’re here in my care, I’m doing everything I can for them.”
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DESIGN makes the DIFFERENCE : C R E AT I N G W E L L -T HOU G H T- OU T WOR K , H E A L I N G S PAC E S
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top by the new Cancer and Blood Diseases (CBDI) Outpatient Clinic, and you’ll see peaceful nature scenes and familiar touches of home. Whimsical fiber quilts and nature-inspired clay sculptures, mandalas with ancient Indian stampings and reverse printings bring to life an environment of strength, courage and love—and an atmosphere steeped in researched design principles that improve outcomes.
Employees, patients and families each had input in the artwork creation, working collaboratively through Ar tWorks with local ar tists Pam Kravetz, Cher yle Pannabecker, Megan Triantafillou and Radha Lakshmi. The designs carefully weave reflections of hope throughout the space. Social workers created beaded leaves sewn onto the quilts. Patients selected words and phrases of inspiration from their personal journeys to inscribe on clay sculptures. Cincinnati Children’s NjoyItAll campers created a jungle scene that complements the “Katie’s Kingdom” mural. The beloved mural, originally painted for the clinic’s previous location in memory of a young cancer patient, was recreated for the new space and set the tone for the overall nature theme.
The newly designed CBDI Outpatient Clinic pops with color.
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“Design has the ability to transform the way we work and improve the experience for patients, families and staff,” said Michael Browning, assistant vice president, Design, Construction and Space Management. “Studies indicate that ar t and nature can improve morale and help reduce stress.” Nature views have a direct relationship on the length of stay and the use of pain medications, according to the Center for Health Design. Serving as a positive distraction, the incorporation of nature reduces the perception of pain and shortens recovery periods. It also contributes to higher satisfaction among staff. GET TING FEEDBACK
Since the planning of 3430 Burnet in 2009, and more recently, in the design of the CBDI Outpatient Clinic, Green Township, and the Family Resource Center, Cincinnati Children’s has engaged staff, patients and families in the creation of the spaces where they spend so much time, not only through art creation but also in pre- and post-construction surveys. “Employees give their perspective on whether the space supports their work, provides personal comfort, and conveys Cincinnati Children’s image for providing
world-class quality and safe care,” said Browning. “Patients and families provide feedback on their impressions of the unit and its ability to meet their needs.” Survey answers inform the design, along with evidencebased research, to help determine how best to use the money allocated for the project and achieve the best possible outcomes. “Our team has gone to great lengths to provide the best patient, family and staf f experience through the integration of art, architecture and interior design. We want each element of the space to fully complement the other in a seamless fashion,” said Browning. “Strategically using construction dollars, we can positively affect both patients and staff by limiting noise and distractions, including natural light, integrating wayfinding systems, and decentralizing floor plans.” DESIGN IN ACTION
Cincinnati Children’s Green Township takes into account the psychological and physiological ef fects of the environment.
seek ‘n’ find pictures and rhyming games to pass the time before appointments. Floor-to-ceiling windows, extending across the front of the building, connect employees and patients to natural light and the outside. A collaborative pod layout allows the care team to respond more quickly to patient needs. Kid-sized sinks identify it as a place specially made for them. “For patients and families, evidence-based design means promoting healing and reducing anxiety. For our employees, evidence-based design means helping them do their jobs safely and more effectively. It means creating a team atmosphere and encouraging mentoring. It means improving employee retention and satisfaction,” said Browning. One oncologist attended the art workshops where he was asked: If you could be anything or change what you do, what would you choose? He said he has the best job in the world and is so inspired by the patients he cares for each day…he wouldn’t change his career in any way. Now, he can also get inspired by the environment he helped create, designed to support him and his patients.
Designers carved out home-like nooks for families to sit in waiting areas. Positive distraction artwork includes
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Design has the abilit y to transform the way we work and improve the experience for patients, families and staf f.
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Plenty of natural light washes this waiting area at Green Township.
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Representatives from the Joint Commission arrived at Cincinnati Children’s earlier this year and dove into an intense agenda of presentations on the Heart Institute’s Ventricular Assist Device (VAD) program. Although it required a hefty chunk of time and preparation on the part of our staff, the effort was worthwhile. The learning visit (which is different from the triennial accreditation sur vey visit) focused on identif ying what changes might be necessary in the certification process of VAD programs in a pediatric environment when the patient is an adult. The Joint Commission already certifies adult hospitals that provide this service. And pediatric specialty hospitals have been exempt from certification when VADs are implanted in children. But Cincinnati Children’s has led the way into new territory by treating adults with congenital heart conditions. “The Joint Commission and the Centers for Medicare and Medicaid Services (CMS) want to ensure the safety
and quality of the care that’s provided with these complex procedures,” says Mary Anne Morris, RN, senior director, Accreditation Services. “They also are being careful stewards of Medicaid and Medicare funds, meaning they want to see that an organization is consistently getting good outcomes for a procedure if Medicaid or Medicare is going to pay for it.”
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The makeup of our VAD team The role our perfusionists play during VAD procedures The way we partner with medical specialties The number of VAD models we use (seven) vs. adult hospitals (two), because our patients vary greatly in size.
Each of these variations in our process calls for a different approach and greater understanding on the part of the reviewer in the certification process. Additionally, although we already participate voluntarily in two NIH-sponsored registries for Mechanically Assisted Clinical Suppor t—InterMACS (adult-focused) and PediMACS (pediatric-focused)—we would be required to participate for certification. Brockway was surprised to learn that we are prohibited from participating in some manufacturer and FDA research trials because we lack VAD certification. This exclusion prevents us from performing certain procedures, except possibly under the compassionate use provision and poses an obstacle for developing our program.
“None of the differences we’ve identified are insurmountable,” said Brockway, “but the selection of the right reviewer will be important. Should they come from the adult or the pediatric world? Do they have expertise about all seven of the devices you use? I don’t think we currently have anyone with the appropriate skills to do this. We would need to train someone.”
DIFFERENCES NOTED
A VA LUA B LE V I S IT
The Joint Commission team, which consisted of Mary Brockway, director, Standards and Survey Methods, and Teresa Gomez, associate project director-specialist, went on a brief tour of our facilities, then spent the day listening to presentations about the VAD program. At the end of their visit, they summarized their findings. Specifically, they identified several areas where we differ from adult hospitals:
As eye-opening as the visit was for the Joint Commission representatives, it was also beneficial for Cincinnati Children’s staff.
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Our patient population, particularly the adults we treat The criteria we use to select adult patients for VAD procedures Our protocols
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“We learned how the Joint Commission will review us and how the certification process is different than an accreditation survey,” says Aimee Gardner, clinical practice leader, The Heart Institute. “We’re on the right path for all our policies, procedures and guidelines. We just need to finalize and approve them. This is important because they will review us against our own policies and procedures to make sure we’re doing what we say we should be doing.”
Quest for Answers
TRANSFORMS CARE FOR
Vascular Anomalies
“Our nickname for her is Dr. A. It stands for Dr. Awesome,” said Angie Walters of Denise Adams, MD, medical director, Comprehensive Hemangioma and Vascular Malformation Center. Walters’ son Hunter was diagnosed at age 4 with microcystic lymphatic vascular malformation—a rare, benign lesion that required the insertion of a chest tube seven times in a single year to drain fluid off his lungs. Today, Hunter is 11. He goes to school, makes good grades and lives a ver y normal life, thanks to Adams’ innovation and exploration of vascular anomalies. “As an oncologist, your mind is geared to hypothesisdriven thinking. I remember seeing these patients with the same diagnosis and asking why? Why are they called the same thing when they phenotypically look so different?” said Adams. Adams asked pathologists what they saw under the microscope. She challenged the classification system and questioned treatment, medical therapies, why vascular anomalies happen and why they get worse. Her search for answers to transform the care of patients like Hunter has advanced the field and recently earned her the Marjorie Johnson Chair for Translational Vascular Research. “She has global impact in shaping the specialty of pediatric hematology/oncology, not just in terms of this very difficult and complex field of vascular anomalies. She has provided an organizational approach to it and scientific direction, as well as significant national leadership in shaping our field,” said John Perentesis, MD, director, Oncology. Adams joined Cincinnati Children’s in 2003 as the leader of the medical center’s vascular anomalies program, established three years prior to care for children with these complicated problems. Her mentor, Russell Ware, MD, PhD, Baylor College of Medicine at Texas Children’s Hospital, recalled Adams’ fascination with these patients when he worked with her from 1993 to 2000 at Duke University and her ambition to start a vascular anomalies program there. “She was able to draw in a variety of specialists: ENT surgeons, neurosurgeons, dermatologists, radiologists,
geneticists. It seems very common now, but at the time it was very revolutionary,” said Ware.
Since heading up the multidisciplinary program Denise Adams, MD at Cincinnati Children’s, Adams has helped build one of the top national pediatric training programs and has given new perspective to translational research for vascular anomalies through her funded research program, integrated clinical trials and series of biology and registry initiatives. Of key interest to Adams is the improvement in the care of patients with kaposiform hemangioendotheliomas (KHE) and other rare vascular tumors. Adams and her team have established a clinical registry for patients with these rare tumors to gain insight into the clinical characteristics so that they can follow outcome measures. Michael Snyder’s 3-year-old son Zach is such a patient. He began his journey with Adams when he was born with a purple lump on his neck in 2009. Biopsy proved it to be a KHE lesion. Containing cells that act and replicate like cancerous cells, Adams treated it with a mild chemotherapy drug. Today Zach is a thriving toddler. “She has been a saving grace for our family. She’s not just our doctor. She’s my friend who saved my baby’s life,” said Snyder. This sentiment is shared among her patients and families and staff. “Routinely within our clinic, Denise gets hugs and kisses from the patients and the families because she is that extraordinary. She sits with them. She listens to their concerns. It’s an eye-to-eye-level conversation,” said Richard Azizkhan, MD, surgeon-in-chief. “She talks with the trainees and the staff who are participating in the patient’s care, so they understand what we’re doing, why we’re doing it, and what we don’t know yet.” Much remains unknown about these disorders. Inquisitive and passionate, Adams will continue asking the questions to discover novel, scientifically based solutions.
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snapshots
Department Respiratory Care Role Airway admiral, ventilator manager and utility player in the Post Anesthesia Care Unit Distinction Winner of the 2013 Zenith Award When I’m not here, you can usually find me working in my vegetable garden, learning more old movie trivia or reading A phrase that describes me “I’m someone you want next to you in an emergency.” What I love about CCHMC is being able to use all my professional skills in an environment where innovation is appreciated. Person I admire most The PACU nursing staff I was born in Louisville, KY, and have traveled extensively, including a tour in Vietnam and a wonderful trip to Switzerland and Germany. People would never guess that I cross-stitch. What’s on my bucket list I’d like to take a world cruise, see the Masters golf tournament, live in Italy and learn Italian, and begin learning elementary quantum mechanics.
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Department The James M. Anderson Center for Health Systems Excellence Role Community relations liaison and specialist for population health Distinction Winner of the 2013 Honorary Martin Luther King Humanitarian Award When I’m not here, you can usually find me volunteering in the community, at my church or doing classwork for my PhD in public health policy. A phrase that describes me “Do what you say you’re going to do. Your word is your integrity.” What I love about CCHMC is how we’ve gone from being a service provider in the Tri-state area to having an international presence. I love how dedicated we are to innovation and research that improves care for all children. Person I admire most My dad, for his ethics and attitude of service; my grandmother, for her service to the community; and my first cousin, who has been a major role model for me through education. I was born to serve. People would never guess that I was a star basketball player in my day. I played varsity all four years at Goshen High School.
Department Social Services Role Navigator for families in the Transitional Care Center who need help connecting with a labyrinth of services to safely care for their child. Distinction Winner of the Ann Brandner Award What I love most about what I do is taking a problem, pulling it apart like a puzzle and getting the pieces to fit so it makes a better picture. When I’m not here, you can usually find me in the kitchen baking—it’s creative, and it has a beginning, a middle and an end, unlike what I do at work. A phrase that describes me “I’m always up front with families and coworkers. You know where you stand with me.” What I love about CCHMC are the people I work with. Person I admire most “Aside from my dad, I’d have to say Eleanor Roosevelt. She was very courageous and ahead of her time, and she did things without a lot of fanfare.” I was born the oldest of seven children. My mother always said, “Susan has told people what to do all her life, and now she’s getting paid for it.” People would never guess that I am addicted to March Madness.
Department Neuroscience Outpatient Treatment Center Role Care manager and go-to person for patients and families in the general neurology and tuberous sclerosis clinics at Mason Campus Distinction Winner of the 2013 Martin Luther King Jr. Humanitarian Award What I love most about what I do is working with remarkable and inspiring families. When I’m not here, you can usually find me with my grandchildren or at a sporting event. You can also find me on medical mission trips in Haiti. A phrase that describes me “I try to follow God’s lead— some days I do it fairly well; other days, not so much.” What I love about CCHMC is working with colleagues who are so dedicated to our patients and families. Person I admire most “Paul Farmer—he’s a medical anthropologist and a leader who’s worked tirelessly to improve healthcare for the poor in developing countries. I also admire Miss Pat, a 78-year-old nurse who works with the Haitian people. I was born knowing I wanted to help other people, especially children.
insidescoop
Is there a burning question about some aspect of Cincinnati Children’s you’ve always wanted to know the answer to but weren’t sure whom to ask? Or maybe it’s a head-scratcher you’ve pondered but felt too silly to speak up about. Well, wonder no more. The Inside Scoop is the place to send your queries, and our investigative team will dig up the facts for you so you can finally rest easy. Please direct your puzzlers to 360@cchmc.org. We will print as many questions as space allows.
Q
Some years ago, when the old Children’s Hospital building was demolished, the original archway was preserved in place and intact with its carved “Good Shepherd” facade. (“I will bind the broken. I will heal the sick.”)
When the recent construction started on Location T, the archway disappeared. Not sure if it was removed or destroyed. Was this kept intact somewhere, and are there plans to reinstall it/display it somewhere else? It truly would be a shame if such a lovely “mission statement in stone” were lost forever. —Michele Beuerlein, Experimental Hematology
A
The Scoop went to Mike Browning, assistant vice president, Planning and Construction, who explains, “At this time, there are no plans to reinstall it, but we performed a 3D scan of the arch and its elements prior to removing the piece in case we ever want to recreate it in the future. All of the ornate stone pieces were removed and are in secure storage. Many of these pieces were in pretty bad shape, but we’ve kept them all nonetheless.”
Q
With all the parking mess in the North Garage, especially for the 11 am and 3 pm shifts, has anyone considered moving all administrative and other
non-clinical staff to other garages and keeping clinical staff in the North and South garages? This would make parking much more accessible for all involved. It would also alleviate staff stress and improve efficiency by reducing the number of late clock-ins and accidents in the garages that occur when people are struggling to park and not be late to work. —Ashley Elam, RN, Specialty Resource Unit
A
Bob Baer, director, Parking, Transportation and Fleet Management, feels your pain. That’s why making parking more accessible, not only for clinical employees but for all employees and visitors, is key to his department’s current strategy, which they manage daily. In 2011, his department re-assigned over 600 administrative and non-clinical staff from the North and South garages to new garages on the east side of Burnet Avenue. This was done to accommodate an increase of capacity for families and visitors to the medical center when the Central employee garage was converted into visitor spaces.
But the demand for parking is increasing rapidly as the medical center focuses on adding inpatient beds. CCHMC has hired more than 737 new employees since the end of 2011, without the benefit of a new garage or parking lot. “We are very aware of how tight the garages are at 11 am and 3 pm,” says Baer, “and we monitor activity each day while making adjustments to the populations.” He acknowledges that there are still some administrative and non-clinical employees parking in the North and South garages. “There may be several reasons for this, including approval from senior management, handicapped parking access, business justification or very long-term employees,” he explains. “We will continue our efforts to move these employees whenever possible.”
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“I love it—the way it’s shaped with all
thebuzz
the windows is beautiful. And to see it at night is fabulous because it changes colors. Having Guest Services in there is a stroke of genius.” “It’s good for the families to be in the center. It’s right
Teresa Riley, security officer, Protective Services
there as soon as you come in, so they won’t get lost.”
WHAT DO YOU THINK
Jawaun Crosby, patient escorter, Patient Escort
OF THE NEW
FAMILY RESOURCE CENTER?
“I haven’t been in it yet, but every time I walk past, I peek in and go, ‘Ooh, ah!’”
“I actually took a parent
Katherine Mersch, patient care assistant, Specialty Resource Unit Clinical Support Team
down [to see it], and it’s very calming. It’s beautiful, absolutely beautiful.” Sharon Johnson, access services representative I, CBDI Outpatient Clinic
“It gives the family more room and more space. They need that with the frustration they’re going through.” “It is a wonderful investment for our families. Peaceful, relaxing, and so much natural light, along with multiple services all in one place….it’s incredible!” Karen Schulte, manager, Family Relations
360°
Mike Wilson, technician I, Environmental Services
“I have not seen it, but I read about it on CenterLink. I was pretty impressed with the amenities it has, so I think it should be very good for the patients.” Harold D’Souza, senior associate-Supply Chain, Materials Management
theknow FITNESS ON THE FIELD RETURNS
Mark your calendar for Saturday, June 29, when Cincinnati Children’s will once again host Fitness on the Field at Paul Brown Stadium. This family-friendly event provides employees with many opportunities to participate in fun activities like kicking a field goal, throwing a football, running for a touchdown, taking the stair challenge and much more. You’ll also earn MyHealthPath points. Details about how to sign up will be posted on CenterLink and in the MyHealthPath newsletter. N E I L A R M S T R O N G H O N O R E D AT T H E CELESTIAL BALL
Cincinnati Children’s will honor one of our nation’s heroes, Neil Armstrong, at the medical center’s signature gala event, the Celestial Ball, on Saturday, May 18, at the Duke Energy Convention Center. Proceeds from the event will benefit the Neil Armstrong New Frontiers Initiative at Cincinnati Children’s. Established by the Armstrong family, the fund is dedicated to advancing research and discovery to improve care and find cures for pediatric diseases. PNC is the presenting sponsor of the 2013 Celestial Ball. The VIP Reception is being hosted by The Farmer Family Foundation, and Macy’s is sponsoring the Celestial Ball After Party. Tickets are $250 per person and $2,500 for a table of 10. Cincinnati Children’s will welcome additional guests to the Celestial Ball after dinner. Separate After Party tickets are available for $50 per person for entry to
Volunteers from Sports Medicine demonstrated the art of the balance ball at last year’s Fitness on the Field event.
the event from 10 pm to 1 am. Guests of the Celestial Ball gala do not need to purchase After Party tickets. To learn more about the Celestial Ball and the After Party and to purchase tickets, go to: www.cincinnatichildrens.org/celestialball. FULL OF HEART
The Cincinnati Children’s Heart Mini team gathered on Fountain Square before heading out for the Heart Mini 5K/10K walk on March 17. The medical center had its highest participation rate ever, with 1,073 people contributing more than $78,000. Cincinnati Children’s ranked fourth among all companies that took par t in the event. The American Hear t Association has been funding researchers at Cincinnati Children’s since 1950. We currently have $1.3 million in research grants. GREEN TOWNSHIP OPENS
Cincinnati Children’s opened its long-awaited neighborhood location on the west side of Cincinnati on April 29. Located in Green Township at 5899 Harrison Avenue, Cincinnati, OH 45248, the 80,000 square-foot facility provides a multitude of services, including urgent care; radiology and imaging; laboratory and other testing services; speech-language pathology; occupational therapy and physical therapy; sports medicine; behavioral medicine and clinical psychology; and 20-plus pediatric medical and surgical specialty clinics.
Cincinnati Children’s was well represented at this year’s Heart Mini. We raised more than $78,000.
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3333 Burnet Avenue, MLC 9012 Cincinnati, OH 45229-3026
Why am I here?
Christina Carman
I began my journey as a medical assistant, working for a non-profit organization for six years and another healthcare organization for 3 ½ years. When I came to Cincinnati Children’s in May 2012, I discovered that working here is more than just a job. During my interview, my manager, Toney Honeycutt, asked me what attracted me to Cincinnati Children’s, and I replied, “I want to be a part of something great.” She liked my answer. Over the years I had become burned out in my medical assisting positions. I was looking for something more. I decided four years ago to go back to school and get my associate degree and then work on my bachelor’s. I have since
completed college, graduating last September with my Bachelor of Science in Health Administration Long Term Care. I also have an associate degree in Health Administration Long Term Care. I want to be a part of a real team, to feel like what I do matters. Cincinnati Children’s is the only place I’ve ever worked where leadership strives to be involved with employees, where they appreciate the staff and show it at every turn. In the short time I have been here, I’ve learned that no matter what small role you might play in the patients’ lives here, we are all part of a much larger picture. And from the start, everyone I have met treats me like one of their own, like what I do matters. I am thankful to be at Cincinnati Children’s, and I look forward to working here for many years to come. —Christina Carman, Orthopaedics
a moment in history Louise Flynn, RN, began nursing at Cincinnati Children’s in 1934 as a graduate student. She was appointed director of nursing education of the hospital’s School of Nursing in 1942 and was director of nursing from 1948 to 1974. Among her accomplishments, she introduced the concept of orienting new nurses to the nursing units and initiated the preoperative education program to prepare children and parents for surgery. Both programs continue today.
1950s