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Bearings - Winter 2011


Children’s National Environmental Health Experts Highlight Issues Impacting Kids

Children’s National Medical Center has developed dedicated resources to assess environmental health issues that affect the children who live in your neighborhoods.

The Mid-Atlantic Center for Children’s Health and the Environment (MACCHE) is the pediatric environmental health specialty unit serving Maryland and the Mid-Atlantic region. MACCHE is based at Children’s National and the George Washington University School of Public Health and is indirectly funded by the Agency for Toxic Substances & Disease Registry (ATSDR), which is part of the Centers for Disease Control and Prevention, and the Environmental Protection Agency (EPA).

MACCHE provides scientifically-based information to health professionals, public health officials, parents, school officials, legislators, and others about issues such as lead poisoning, indoor and outdoor air pollution, water pollution, chronic pesticide exposures, and a host of other topics.

Jerry Paulson, MD, FAAP, serves as the director of the MACCHE. A Baltimore native, Dr. Paulson earned his undergraduate degree from the University of Maryland-College Park and returned to Baltimore after medical school for pediatric training at Johns Hopkins and Sinai Hospitals. In addition to the MACCHE, Dr. Paulson serves as chair of the executive committee of the American Academy of Pediatrics’ Committee on Environmental Health, as well as the Children’s Health Protection Advisory Committee for the EPA.

MACCHE focuses on a number of environmental issues that impact the health and well-being of children. They include:

Fracking

The Marcellus Shale, a geologic formation of rock that extends from New York through Western Pennsylvania, Western Maryland, and further south, contains a significant amount of trapped natural gas. A process known as hydrologic fracturing, or fracking, is used extensively in Pennsylvania and in other shale deposits in the United States to recover the natural gas.

There are a number of public health concerns associated with fracking, including natural gas leaking into water wells and exposing people to methane, other gases, and the toxic components of the fluid used to fracture the rock. These components contain carcinogens and chemicals that may cause brain damage and disrupt the body’s endocrine system. Extensive air pollution can result from the diesel trucks and off-road equipment used to build and service the wells and from the gas itself that can leak in large quantities into the atmosphere. The drill sites and associated equipment may also be located in close proximity to homes and schools.

Given that the Marcellus Shale extends into Western Maryland, this issue and the need to protect citizens from potential hazards may require attention from the General Assembly. The New York General Assembly has already issued a moratorium on drilling in the Marcellus Shale until there is more scientific information about the hazards and how to manage the gas extraction in a safer manner.

Intersex Fish

Intersex fish, an unnatural phenomenon, have both male and female sexual organs. These fish can be found in the Potomac and Anacostia Rivers. While the precise cause of this situation is unknown, it most likely relates to the exposure of the fish to chemicals that disrupt their endocrine system. These chemicals can range from lead, pesticides, components of household products, or human and veterinary medications.

These chemicals can accumulate in fish. As a result, individuals who regularly consume fish from these rivers are exposed to higher concentrations of chemicals. While water purification systems are effective at removing microbial contaminants from drinking water, they are not designed to remove these types of chemical contaminants. Therefore, drinking water derived from these rivers runs a high risk of exposure to these and other chemical contaminants.

Climate Change

In the absence of a uniform, federal approach to the issue of climate change, many state legislatures have taken their own action. In an effort to reduce carbon footprints, some states’ procurement policies require purchase of lower emission vehicles while others have considered a requirement that a certain portion of the energy sold in the state come from renewable sources.

The Maryland Climate Change Commission's Climate Action Plan was released on August 27, 2008. The MACCHE encourages the General Assembly to ensure that all appropriate and reasonable recommendations are implemented and that the means of updating the plan are in place.

For more information on these issues and MACCHE, call 866-622-2431 or 202-471-4829, or e-mail macche@childrensnational.org.

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Children's National Named to the 2010 Leapfrog Group Best Hospitals List

2010 Leapfrog Top Hospital
Children’s National Medical Center is one of only seven children’s hospitals in the country named to the Leapfrog Group’s 2010 Top Hospitals List. The list is based on results from the Leapfrog Hospital annual survey, which focuses on objective measures and processes in crucial areas of patient safety and quality. Children’s National is the only pediatric hospital selected from the mid-Atlantic region to receive this designation.

“Once again, we are proud to be recognized as one of the top children’s hospitals in the country as recognized by the prestigious Leapfrog Group,” said Edwin K. Zechman, Jr., president and CEO of Children’s National Medical Center. “This year marks the 10th anniversary of the Leapfrog Group’s work to recognize hospitals for their accomplishments in providing high-quality care in a safe environment,” said Zechman. “Recognition by this group of healthcare thought leaders is an important acknowledgement that amplifies other important accomplishments this year, including Magnet® designation by the American Nurses Credentialing Center and our recent Clinical and Translational Science Award, the only CTSA given directly to a pediatric hospital. These accomplishments showcase our commitment to advancing the finest, evidence-based care to children and families.”

Among the criteria that the Leapfrog Group uses to select top performing hospitals are processes proven to reduce errors and enhance quality:

  • Computerized ordering of medicines, tests, and procedures
  • Staffing with appropriately trained professionals in intensive care units
  • Comprehensive systems, including training all staff, to prevent, detect and manage serious errors
  • Focused efforts on preventing infections

“We appreciate recognition from healthcare leaders who see the value in working with hospitals that demonstrate the ability to efficiently deliver high-quality care in a safe environment,” said Peter R. Holbrook, MD, executive vice president and chief medical officer at Children’s National. “This acknowledgement from the Leapfrog Group is especially gratifying given the investment and work Children’s National has put into the technologies, training, and processes that assure world-class care.”

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Children's National Receives Nation’s First NIH Clinical and Translational Science Award Given to a Children's Hospital

Children's National Medical Center, in partnership with The George Washington University Medical Center, received a prestigious Clinical and Translational Sciences Award (CTSA) from the National Center for Research Resources of the National Institutes of Health (NIH).


CTSI-CN principal investigator Jill Joseph, MD, PhD, of Children’s National Medical Center, and co-principal investigator Peter Hotez, MD, PhD, of The George Washington University, talk with research participant Wendy White and her son Mekhi White, 5 months, in the Pediatric Clinical Research Center at Children’s National Medical Center.
CTSI-CN principal investigator Jill Joseph, MD, PhD, of Children’s National Medical Center, and co-principal investigator Peter Hotez, MD, PhD, of The George Washington University, talk with research participant Wendy White and her son Mekhi White, 5 months, in the Pediatric Clinical Research Center at Children’s National Medical Center.

This award, which totals $20 million over five years, is the first CTSA given directly to a children's hospital. The Clinical and Translational Science Institute at Children's National will now join the nationally renowned CTSA consortium, which is composed of institutions that work to transform the local, regional, and national environment to increase the efficiency and speed of clinical and translational research across the country.

Many other CTSA member institutions have research tracks that include pediatric research, but this collaboration will be the first in the history of the award to focus specifically on how scientific breakthroughs from the laboratory bench can be brought more quickly and efficiently to the bedsides of young patients. In addition, the institution's close proximity to the nation's capital will bring basic science into community engagement research and health policy applications, making these discoveries accessible for those most in need.

“Both Children’s National and The George Washington University have long invested significant resources in investigating and understanding the health needs of the children and families of metropolitan Washington,” said Jill Joseph, MD, PhD, principal investigator of the CTSA and Director of the Clinical and Translational Science Institute at Children’s National. “The families of our area, and across the country, have already benefited from what we’ve learned about better clinical treatments and improved community education for common diseases like asthma. We look forward to even greater breakthroughs in providing that care, now bolstered by new research collaborations with consortium institutions.”

The Clinical and Translational Science Institute was created in 2008 as a partnership between Children’s National Medical Center and The George Washington University. Its work focuses on three main areas:

  • Diseases of childhood, such as cancer, birth defects, developmental disabilities, asthma;
  • Childhood diseases that persist into adulthood, or adults living with childhood diseases long term—for example congenital heart disease, cystic fibrosis, and muscular dystrophy; and,
  • Diseases of adulthood that begin in childhood and are worsened or develop with age, such as hypertension, type 2 diabetes, and obesity.

This NIH CTSA will help build the infrastructure to achieve the Institute’s goals, which include:

  • Designing effective, efficient systems that encourage research collaboration across disciplines, track effectiveness, and report results;
  • Addressing health disparities and promoting diverse collaborations among pediatric research teams;
  • Promoting multi-disciplinary team science, and growing collaborations with community partners to tackle pressing pediatric health issues; and,
  • Building better education and training for those interested in translational and collaborative approaches to pediatric research.

“We’re grateful to the National Center for Research Resources for recognizing the importance of fostering research programs that are designed to address health issues on multiple levels at once, especially in pediatrics,” said Mark Batshaw, MD, chief academic officer at Children’s National. “As we’ve learned through our collaborative models in diseases like asthma, when it comes to pediatric health, particularly in urban health settings, the team science model is most successful at ensuring that families who need innovative treatments can access them sooner.”

The national CTSA consortium aims to improve human health by transforming the research and training environment to enhance the efficiency and quality of clinical and translational research. The Clinical and Translational Science Institute at Children’s National is one of only nine awards given this year.

Children’s National would like to thank members of the Maryland General Assembly who provided letters of support for our CTSA application:

  • Former Delegate Bill Bronrott
  • Delegate Kathleen Dumais
  • Delegate Brian Feldman
  • Senator Robert Garigiola
  • Delegate Heather Mizeur
  • Delegate Joseline Pena-Melnyk
  • Former Delegate Craig Rice

Your support truly helped Children's National to obtain this prestigious award, which will help bring more life-saving care to children in your communities.

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Children’s National and Peninsula Regional Medical Center Partner to Expand Services for Children and Families

Beginning in February 2011, Children’s National hospitalists (hospital-based pediatricians) will begin their services and later in spring 2011, Children’s National neonatologists will direct and provide care in Peninsula Regional Medical Center’s (PRMC) Neonatal Intensive Care Unit (NICU), the Newborn Nursery, the Pediatric Inpatient Unit, and will be available for consultation in the Emergency Department. These Children’s National physicians will be available 24 hours a day, 7 days a week, every day of the year.

The collaboration, locally, creates an affiliation with one of the nation’s most respected children’s healthcare providers. With nearly a century and a half of experience, Children’s National will help to ensure that PRMC’s pediatric and NICU processes best meet patient needs. Additional benefits include shared clinical knowledge and best practice ideas between the hospitals, possible expansion opportunities based on identified community needs, new research opportunities, physician recruitment improvements, and seamless transfer, when necessary, to the specialized services provided at the main location of Children’s National.

Pediatric hospitalists previously employed by PRMC have joined the medical staff at Children’s National and will continue to provide care at the Medical Center. Children’s National is also providing additional physician coverage. No clinical staff positions at Peninsula Regional were eliminated as a result of the collaboration.

“We applaud the leadership of Peninsula Regional Medical Center for their initiative in considering the needs of children and families on the Delmarva Peninsula,” said Edwin K. Zechman, Jr., president and CEO, Children’s National. “It is a pleasure to partner with enterprising healthcare executives who are proactive on behalf of their communities.”

“Children’s National is pleased to work with Peninsula Regional Medical Center to enhance pediatric care for children and families throughout the region,” said Peter R. Holbrook, MD, chief medical officer, Children’s National. “Given the level of training required for specialists in pediatrics, and especially in neonatology, the trend is toward collaborations like this one between PRMC and a highly specialized pediatric medical center like Children’s National. We are pleased to work together to provide greater benefit for the region’s children.”

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Did you know?

  • Patients from Maryland comprise almost 60 percent (8,600 children) of Children’s annual inpatient population.
  • 60 percent (3,300) of Children’s National’s employees live in Maryland.
  • 28 percent of patients who annually seek care at Children’s National are Maryland Medicaid beneficiaries.
  • Children’s National employs more than 500 pediatricians, pediatric specialists, and pediatric sub-specialists to guarantee access to care for children in Maryland 24 hours a day, seven days a week.
  • Children’s National is one of only two designated Level I Pediatric Trauma Centers in Maryland and treats the most pediatric trauma cases in the state.
  • Children’s National has five outpatient centers in Maryland that handle more than 56,000 visits annually.
  • Children’s National is a national leader in implementation of electronic health records and is an official partner with Maryland’s Chesapeake Regional Information System for Our Patients (CRISP) Group.

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