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Upstate Golisano Children’s HospitalUpstate Medical UniversityDEPARTMENT OF PEDIATRICSREPORT750 EAST ADAMS STREETSYRACUSE, NY 1321018-0104 Rev. 4/2018January 1, 2017 – December 31, 2017

PUBLICATIONSINTRODUCTION FROM THE CHAIR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1DEPARTMENT LEADERSHIP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2PEDIATRICS BY THE NUMBERS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3PEDIATRIC CRITICAL CARE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4EDUCATION PROGRAMS IN PEDIATRICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6PEDIATRIC EMERGENCY MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10PEDIATRIC ENDOCRINOLOGY, DIABETES & METABOLISM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12PEDIATRIC GASTROENTEROLOGY, HEPATOLOGY AND NUTRITION . . . . . . . . . . . . . . . . . . . . . . . . . . . 14GENERAL PEDIATRICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16PEDIATRIC CLINICAL GENETICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19PEDIATRIC HEMATOLOGY/ONCOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20PEDIATRIC HOSPITAL MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24PEDIATRIC INFECTIOUS DISEASES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26PEDIATRIC NEPHROLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29NEURODEVELOPMENTAL PEDIATRICS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31PEDIATRIC NEUROLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34PEDIATRIC PULMONOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35PEDIATRIC RHEUMATOLOGY AND INTEGRATIVE MEDICINE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37PEDIATRIC SURGICAL SPECIALTIES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38PEDIATRIC ANESTHESIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38PEDIATRIC CARDIOVASCULAR-THORACIC SURGERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39PEDIATRIC SURGERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39PEDIATRIC NEUROSURGERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40PEDIATRIC OPHTHALMOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41PEDIATRIC ORTHOPEDIC SURGERY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42PEDIATRIC OTOLARYNGOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43PEDIATRIC UROLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43AFFILIATED FACULTY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44PEDIATRIC CARDIOLOGY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44NEONATOLOGY: CROUSE HOSPITAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44AWARDS AND PEER REVIEW HONORS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45HONORARY MEMBERSHIPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45EDITORIAL SERVICE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46PRESENTATIONS AT SCIENTIFIC MEETINGS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47PUBLICATIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52

DEPARTMENT REPORT 1INTRODUCTION FROM THE CHAIRI am excited to be sharing with you our department academic report for 2017. This reportdetails the activities of our divisions in clinical care, education, and research. We have anadditional annual report to the community, which focuses on the people and facilities of theUpstate Golisano Children’s Hospital, as well as some of our patients.Since our last department report, we have continued to experience significant faculty growth,having welcomed 11 new pediatric or affiliated faculty. This growth has allowed us to expandcapacity in most of our clinical programs, as well as undertake a number of new initiatives.Our rheumatology division, for example, has expanded to include pediatric integrativemedicine. Caitlin Sgarlat, DO, division director, is also fellowship trained in integrativemedicine. We can now offer a complete array of services to children with chronic painconditions, anxiety disorders and difficulty coping with the stress of chronic disease. Ofcourse, our two pediatric rheumatologists and their staff continue to care for children with thefull spectrum of childhood arthritis and auto-immune disorders.With the recent opening of our new cancer center, we are now operating a dedicatedchild-friendly “infusion center” for all children requiring intravenous medications as anoutpatient. Staffed with nurses highly trained in IV placement and the use of implantedvascular access, the unit has an on-site physician overseeing therapy. With the wealth of newdrugs available for chronic diseases, the center treats children with gastrointestinal, genetic,renal, rheumatologic, immunologic and other conditions. In 2017, the unit provided 2162treatments.On the horizon, we are soon to open our pediatric dialysis center for children requiringhemodialysis or peritoneal dialysis. Although we have long offered these services, we now willdo so in a new child-only facility. We also have just received approval from New York State toopen an eight bed adolescent psychiatry unit, the only such facility in our region. We are alsoworking with New York State to open a 12 bed, inpatient facility for children with dual (mentalhealth and behavioral) diagnoses.Our education programs continue both to train the next generation of pediatricians, as wellas helping all of our regional providers stay up to date with the many advances in child healthcare. In last year’s report, I mentioned our plans to launch Project EHCO. I am excitedto report that this initiative is moving forward, and will soon link an extensive network ofprimary care providers in our region to real-time teleconference subspecialty consultation.The report also demonstrates the growth in our research programs, with 71 presentations atscientific meetings and 102 publications in peer-reviewed journals. Several of our investigatorshave received recognition and awards.This will be my last report as Chair. I will be stepping down in mid-2018 to retire, althoughI will continue some pediatric nephrology clinical activity in the GCH. I appreciate yoursupport and interest over the past 17 years!We always welcome and value your feedback. You can continue to keep up with our programsthrough our newsletter at: hp or through our website:http://www.upstate.edu/gch/.Thomas R. Welch, MDStanley A. August Professor and ChairDepartment of PediatricsUpstate Medical UniversityMedical DirectorUpstate Golisano Children’s Hospital

2 DEPARTMENT OF PEDIATRICSDEPARTMENT LEADERSHIPWe have a group of vice chairs who have primary responsibilities for a variety of functions within the department. Thisgroup meets weekly and together acts as a deliberative body to set policy and direction. Each of these individuals is alsoempowered to make independent decisions within his or her area of responsibility. Although I am always availableto speak with referring physicians regarding hospital or department issues, these individuals may also be contacteddirectly in regard to matters within their respective purviews.Ann Botash, MD (botasha@upstate.edu) is Vice Chair for Educational Affairs, with ultimate responsibility for all aspectsof education in the department: undergraduate, graduate, and continuing. The enormous growth in our educationservices is outlined in the education section of this report. Ann also serves the institution in several educational roles.Ann is a well-known figure in pediatrics nationally. She has received the Advocacy Award from the AmbulatoryPediatrics Association, is past-president of the Helfer Society, and is a child abuse pediatrician.Scott Schurman, MD (schurmas@upstate.edu) continues to serve as our Vice Chair for Clinical Affairs. Scott also directsour highly-regarded and growing program in kidney diseases.In his Vice Chair role, Scott has ultimate responsibility for all inpatient and outpatient activity in the department. Hehas played an important role in our recent growth in faculty and programs. As we have grown and expanded into newambulatory areas, Scott has overseen these as medical director.Leonard Weiner, MD (weinerl@upstate.edu) rounds out the department leadership team as Vice Chair for AcademicAffairs. A former interim chair of our department, with a national reputation for clinical care and research ininfectious diseases, Len is well suited for this role.In addition to responsibility for the department’s faculty promotion and tenure process, Len has overall responsibility forour research programs. We have made some steady strides in this area, as indicated by the individual division and sectionreports. A recent bequest to establish a Pediatric Research Institute has lead to further growth in this important area.The leadership team is supported by Cherlynn Clarry (clarryc@upstate.edu), department office manager, Barbara Delaney(delaneyb@upstate.edu), assistant to the chair, and Leo Sawyer, business manager. Bonnie Miner, MS, RN, CNS acts as ourpatient safety officer and is important in coordinating our collaborative safety projects. James Peacock, MS, plays a veryimportant role in the department as Education Program Administrator, especially with residents and medical students.

DEPARTMENT REPORT 3PEDIATRICS BY THE NUMBERSA few pertinent metrics provide a summary of our child health care activity during the period of this review. Moredetailed information is highlighted further within the clinical snapshot listed at the end of each individual divisionreport.Measure2017Inpatient admissions5,553Observation patients1,496Total inpatients7,049Average length of stay4.00Pediatric ED visits30,825Admissions from ED4,595% of Peds admissions that came from ED65%Pediatric outpatient visits67,930Pediatric surgery procedures6,629

4 DEPARTMENT OF PEDIATRICSPEDIATRIC CRITICAL CAREFACULTYNeal Seidberg, MD, Associate Professor of Pediatrics, Division Director1William Hannan, MD, Associate Professor of Pediatrics2Jennifer Zuccaro, MD, Assistant Professor of PediatricsI. Federico Fernandez, MD, Associate Professor of PediatricsRobert Newmyer, MD, Assistant Professor of PediatricsAllison Fahy, MD, Assistant Professor of PediatricsRamesh Sachdeva, MD, PhD, JD, MBA, Professor of Pediatrics3CLINICAL OVERVIEWThe Division of Pediatric Critical Care provides comprehensive medical-surgical care for all critically ill childrenfrom a 17 county referral area. Patients are cared for in a 15 bed pediatric ICU (PICU) by a multidisciplinary team ledby the intensivists. The team consists of dedicated PICU nursing, respiratory therapists, pharmacists, dietitians, andchild life personnel. Surgical patients are co-managed with various surgical teams and include, among others, trauma,cardiothoracic, general pediatric surgery, neurosurgery, urology, otolaryngology and orthopedic patients. The PICUhas access to a full complement of pediatric sub-specialists.The faculty of the PICU provide technologically advanced care across the full range of ICU therapies. Availabletherapies include, but are not limited to, invasive and non-invasive ventilation, ECMO, renal-replacement therapy,invasive cardiovascular monitoring, and neurocritical monitoring.The division is also responsible for the management of a regional transport system dedicated to bringing critically illchildren (non-trauma) from referral hospitals to Upstate Golisano Children’s Hospital. The transport team utilizesspecially trained nurses and respiratory therapists for this service. Our specialized pediatric transport team allows usto bring the resources and expertise of our Pediatric Intensive Care Unit (PICU) and Upstate Golisano Children’sHospital to critically ill children at other hospitals.EDUCATIONAL PROGRAMSThe division provides a variety of educational programs. We participate in the education of pediatric residents fromthe Department of Pediatrics. This activity begins with a yearly series of lectures to the residents and continues at thebedside during the 3 months that residents spend in the PICU. We have past pediatrics residents who have successfullytraining in fellowships for Pediatric Critical Care.The division also provides training for residents from the Emergency Medicine Residency and fellows from thePediatric Emergency Medicine Fellowship. Both spend time in the PICU as a part of their education.The division provides medical student education via an “acting-internship” which allows students to take on manyof the responsibilities of pediatric residents. This course exposes students to a broad range of illness and teaches aphysiologically based, developmentally appropriate approach to caring for ill children. This course has been verysuccessful despite being new to the medical school and has received significant praise from students. Additionally,Dr. Newmyer has been made co-director for the second-year medical student block covering renal, reproductive andendocrinology systems.1 Dr. Seidberg also serves as Chief Medical Informatics Officer for Upstate Medical University2 Dr. Hannan also serves as a member of the Division of Pediatric Rheumatology3 Dr. Sachdeva also serves as Senior Vice President of Strategic Affairs for Upstate Medical University

DEPARTMENT REPORT 5The division also plays a role in educating nurses and other services such as respiratory therapy. We have begun aprogram using the simulation lab to provide advanced training to nurses and therapists that function as a part of ourtransport system. The division also oversees a mock code program to provide ongoing readiness training to residentsand staff in the Children’s Hospital.DIVISION HIGHLIGHTSDr. Fahy has been expanding ICU quality programs. She achieved a skin certification and now leads skin rounds inthe ICU to continue to support the low levels of skin lesions that develop in our ICU. She has also led the procurementof and agreement to join the Virtual PICU. This is a national data and quality system that facilitates benchmarkingagainst other PICUs across the country. Over the coming year she will be leading the effort to begin the data collectionfor this system.Dr. Newmyer continues to lead the transport team. This year the team has worked with IMT and created acomputerized system for documenting patient care during the transport. This data, in turn, will help to improvetransports by providing actionable data for the team.Trauma care has continued to improve. The critical care division has worked with the trauma team to ensure thehighest level of care for trauma patients in this area. This collaboration has culminated in the successful recertificationof both pediatric and adult level one status.CLINICAL SNAPSHOT In 2017 the ICU cared for 770 critical care patients (a 4 year record). Patients were admitted from the Emergency Department (28%), from the operating room (42%) and from outsideof the institution (22%) and other locations. During this past year, 67% of patients had a medical diagnosis, 33% had a surgical diagnosis. Overall survival to discharge rate was 97.5%. Over the last 3 years patients from outside of the hospital have been referred by 40 different institutions.

6 DEPARTMENT OF PEDIATRICSEDUCATION PROGRAMS IN PEDIATRICSFACULTYVice Chair for Educational AffairsAnn S. Botash, MD, Professor of PediatricsGraduate Medical EducationGloria Kennedy, MD, Assistant Professor of Pediatrics, Director of Residency ProgramElizabeth Nelsen, MD, Assistant Professor of Pediatrics, Associate Director of ResidencyOlamide Ajagbe, MD, Assistant Professor of Pediatrics, Associate Director of ResidencyResidency Committee, led by Dr. Kennedy, includes faculty, chief residents and resident representatives from each yearPediatric Residency Evaluations and Promotions (PREP) Advisor Committee, led by Dr. Nelson, includesrepresentative faculty and chiefsUndergraduate Medical EducationAnn S. Botash, MD, Professor of Pediatrics, Clerkship Director, Syracuse CampusLeann Lesperance, MD, PhD, Clinical Assistant Professor, Clerkship Site Director, Binghamton CampusJennifer Nead, M

Upstate Golisano Children’s Hospital Upstate Medical University DEPARTMENT OF PEDIATRICS REPORT 18-0104 Rev. 4/2018

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