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Creating a Culture of Inclusive Excellence

Cammy Bellis, MEd and Francisco Lucio

DMG/ Valleywise Health

                                          September 12th, 2023

7:30am to 8:30am

General pediatric staff, Inpatient Pediatric Staff, Outpatient Clinical Staff, Community Clinical Experts

• Define and examine what constitutes a culture of inclusive excellence.
• Understand structural competency and structural racism as frameworks to understand health inequities in Pediatrics.
• Identify current research related to the importance of a diverse workforce and inclusive practices and identify action steps towards inclusive excellence at your clinic.

Surgery Grand Rounds Guest Speaker 

About the presenter:

Karin Muraszko, M.D., grew up in New Jersey and received her undergraduate degree from Yale University. She then continued to Columbia University in New York where she received her medical degree and completed her residency training in Neurological Surgery and completed fellowships in pediatric neurosurgery.

Following her training at Columbia, Dr. Muraszko was a researcher at the National Institutes for Health for 2 years before joining the team at the University of Michigan. In 2005, Dr. Muraszko was chosen to head the Department of Neurosurgery at the University of Michigan, becoming the first woman to chair an academic neurosurgery department in the United States.

Dr. Muraszko specializes in pediatric neurosurgery. She is board certified by the American Board of Neurological Surgeons, and is a member of the American Association of Neurological Surgeons (AANS) and the Congress of Neurological Surgeons (CNS) along with several pediatric professional associations. Her research interests include Immunotoxin therapy for brain tumors, the biology of brain tumors, Chiari malformations, craniofacial anomalies, congenital anomalies of the brain and spine and hydrocephalus.

Dr. Muraszko lives in Ann Arbor with her husband and 2 children.

Additional links:

Dr. Karen Muraszko's Video Profile

Karin Muraszko Dr. Muraskos PubMed Publications

Karin Muraszko Michigan Research Experts Website

Pediatric Venous Access Devices Presenter: Scott D. Willard, MD Pediatric Interventional Radiologist, Phoenix Children's

At the end of this presentation, participants should be able to:

• Choose a venous access device best suited to the indicated use and duration.

• Understand the unique challenges and approaches to our smallest patients, premature infants and neonates.

• Watch for and help avoid venous access device-related complications.

Behavioral Problems in the Toddler: How to manage in limited time.

Nilam Khurana, MD

DMG/ Valleywise Health

Session Objectives:

• Utilize screeners to guide parents on behavioral problems in toddlers.
• When to refer and who to refer to for social, developmental, trauma or parenting concerns.
• Understand the consequence of not recognizing or not referring.

NOTE: THIS TALK WILL BE GIVEN AT PEDIATRIC UPDATE AT THE SCOTTSDALE PLAZA AND BROADCAST LIVE TO THE COHEN CONFERENCE CENTER.  ANYONE WHO WANTS TO ATTEND THE ZOOM SESSION IN ANOTHER LOCATION NEEDS TO REGISTER FOR PEDIATRIC UPDATE AT www.pchpediatricupdate.com

Children’s Neuroscience Grand Rounds 

Presenter Afra Can, MD

Deep Brain Stimulation for Pediatric Movement Disorders

Learning Objectives

1. Review deep brain stimulation and use in pediatric movement disorders.
2. Discuss a remarkable patient case.

Presenter: Dr. Cristine Velazco the Chief Peds Surgery Fellow

At the end of this presentation, participants should be able to:

• Define bowel movement

• Provide details on how to manage bowel movement

• Explain the process of a bowel movement program

Meet the presenter:

Dr. Velazco, is a board-certified General Surgeon. She is currently the Chief Pediatric Surgery Fellow at Phoenix Children’s Hospital/Mayo Clinic Graduate School of Medical Education. She completed a master’s degree in Anatomy and Neurobiology at Virginia Commonwealth University School of Medicine and earned her MD at the University of Vermont College of Medicine. Cristine completed her residency at Mayo Clinic Arizona in General Surgery. During her residency she was an Instructor of Surgery and completed a Research Fellowship at Harvard University/Boston Children’s Hospital, working in the Center for Advanced Intestinal Rehabilitation on short bowel syndrome and intestinal failure, as well as working with the Vermont Oxford Network. She also was a member of the Mayo Clinic Education Committee for both Arizona and Mayo Clinic’s tri-site committee. After residency, she completed a fellowship at Cincinnati Children’s Hospital in Pediatric Colorectal Surgery prior to returning to Phoenix to start her fellowship in Pediatric Surgery. Cristine has written numerous peer-reviewed publications and book chapters.

Outcomes of Hearing Rehabilitation in Congenital CMV - Dr. Punam Patel

Presented by: Dr. Damon Dixon, Pediatric Cardiolgy, Phoenix Children's

At the end of this presentation, participants should be able to:

• Explain Pediatric Dyslipidemia Subclinical State
• Apply Lipid Biomarkers for Pediatric Dyslipidemia Management 
• Differentiate “Genetic Dyslipidemia” and “Atherogenic Dyslipidemia”

Pediatric Grand Rounds *Via Zoom*

https://dmgaz.zoom.us/j/95025222368?pwd=cjVHU00vMXYySjFZVDFPOFRRTVRzZz09

Meeting ID: 950 2522 2368
Passcode: 146939

Contact Stephanie Perkins to claim CME credit for this session:

Office: 602.344.5418 | Cell: 775.846.5924; Email: Stephanie_Perkins@dmgaz.org

Hot Topics in Pediatric Hospitalist Medicine

Presenters: Drs. Jared Kusma, Sagar Shah, Merritt ten Hope 

At the end of this presentation, participants should be able to:

• Recognize how social determinants of health impact hospitalized and readmitted pediatric patients

• Better understand current pediatric residency program practices and curricula with regards to billings, coding and documentation, and demonstrate the need for developing a formalized curriculum

• Demonstrate the role and potential pitfalls of procalcitonin as a biomarker in identifying bacterial infections in febrile infants

At the end of this presentation, participants should be able to:

• Describe the health risks faced by individuals with congenital heart disease as they enter adulthood.
• Describe the goal of behavioral lifestyle interventions.
• Identify at least two risk factors for lower physical activity engagement among adolescents and young adults with congenital heart disease.

Presented by: Shahan Fernando, MD, Pediatric Gastroenterology, Phoenix Children's

At the end of this presentation, participants should be able to:

• Review the workup for binary obstruction

• Understand the therapeutic advantages of advanced endoscopic procedures

• Know the available resources for patients in need of advanced endoscopic therapies

Quality Day Grand Rounds

Keynote speaker to be announced.

Presentation details will be provided at a later date.

Guest presenter: Blyth Lord, EdM, Courageous Parents Network

Learning objectives will be provided at a later date.

Necrotizing Pneumonias, Empyema’s, Pulmonary Abscesses, Chest Tube Management and Bronchopleural Fistulas- A Surgeon's Approach to Complex Infectious Lung Pathology

Presentation details will be provided at a later date.

Meet the presenters:

Barry Markovitz, MD, MPH, has served as Chair of the Department of Anesthesiology Critical Care Medicine at Children’s Hospital Los Angeles since 2018, providing administrative and clinical leadership in alignment with the institution’s mission, vision, values and goals.

Dr. Markovitz joined Children’s Hospital Los Angeles in 2006 to head the hospital’s Division of Critical Care Medicine and  serve as Medical Director of the Pediatric Intensive Care Unit. He is also a professor of Clinical Pediatrics and Anesthesiology at the Keck School of Medicine of USC. Dr. Markovitz is Board-certified in anesthesiology and pediatric anesthesiology, as well as pediatrics and pediatric critical care medicine. He has been involved in numerous research studies related to intensive care throughout his career, including transfusions, relationships between Pediatric ICU volume and outcomes, and the treatment of sepsis and acute respiratory distress syndrome.

Dr. Markovitz is a member of the Pediatric Section of the Society of Critical Care Medicine, the Pediatric Cardiac Intensive Care Society, and he has served on the Executive Committee of the critical care section of the American Academy of Pediatrics. He serves on several editorial boards and was Chair of the Research Committee of VPS, LLC (Virtual Pediatric Systems), an international pediatric ICU quality and research collaborative. He also recently completed a term as Chair of the Scientific Committee of PALISI (Pediatric Acute Lung Injury and Sepsis Investigators), the largest pediatric critical care research network in North America.

Dr. Markovitz earned his medical degree from the University of Pennsylvania School of Medicine and received a master’s in public health from St. Louis University. He did his pediatric internship and residency at Children’s Memorial Hospital, Northwestern University Medical Center, and an anesthesiology residency at the Hospital of the University of Pennsylvania. Dr. Markovitz completed his fellowship in pediatric anesthesiology and critical care medicine at Children’s Hospital of Philadelphia. 

Ann F. Schrooten

Ann is the mother of four children. Her third child, Jack, was born with a rare congenital muscular dystrophy that affected his muscles, eyes and brain. Jack had a trach and required the support of a ventilator; he was non-verbal, non-mobile and required around the clock care. Jack died eight years ago at the age of 15 from complications of his disease. Ann has experienced hundreds of encounters with doctors and other medical professionals, beginning with Jack’s premature birth and complicated first year where he spent many months in the Pediatric Intensive Care Unit, through his diagnosis odyssey, the many procedures, surgeries and hospitalizations he endured, his transition to palliative care and, finally, to hospice care at the end of his life.

She co-authored a chapter titled “Parent Perspectives on Neuromuscular Disorders: From Diagnosis, to Parenting and Living With, to Advance Care Planning and Preparing for Death” in Neuromuscular Disorders in Children: A Multidisciplinary Approach to Management (Mac Keith Press 2019). She was a parent advisor for the development of videos portraying family experiences with decisions about home mechanical ventilation (Johns Hopkins) and the related article, “Family Experiences Deciding for and Against Pediatric Home Ventilation” published in The Journal of Pediatrics (2021) and she is the parent co-editor with Dr. Barry Markovitz of Shared Struggles – Stories from Parents and Pediatricians Caring for Children with Serious Illnesses (Springer 2021).

Ann has a Bachelor of Science from Arizona State University and a Juris Doctorate from University of Arizona. She is an estate planning and probate attorney. She is the founder of The Willow Tree Foundation, an Arizona non-profit organization that funds respite for parents of medically fragile children. She lives in Chandler, Arizona with her husband and their three adult children, and she enjoys hiking the many beautiful trails in Arizona.

Presenter: Dr. Shagun Kaur

Phoenix Children's Grand Rounds 2024 - Newborn Screening and Inborn Errors in Metabolism

January 16, 2024 – 7:30 AM

Phoenix

Overall Activity Objectives:

1 Implement appropriate strategies for diagnosing pediatric conditions.

2 Evaluate and implement appropriate, current treatment options vis a vis emerging therapeutics.

3 Implement in practice developing areas of research and evidence-based recommendations within a diverse range of pediatric specialties.                                                                                                                                                              

Session Objectives:

1 Discuss the history and principles of newborn screening

2 Identify resources to use in the event of an abnormal newborn screen

3 Recognize ethical challenges in newborn screening 

Point of Care Ultrasound (POCUS)

** Surgery Grand Rounds

At the end of this presentation, participants should be able to:

• Understand the complexity of developing new therapies
• Know the options and outcomes for patients of spina bifida
• Know about advanced options for care of fetal patients

PCH Grand Rounds - Locally-acquired Dengue virus in Maricopa County - Dr. Nick Staab

Children’s Neuroscience Grand Rounds 

Presenter: Rebecca Silverstein, DO  

Fundamentals and Applications of Magnetic Resonance Imaging and Common Artifacts

Learning Objectives

1. Describe the basic principles of MRI imaging.
2. Recognize various applications of MRI sequences to help determine diagnosis.
3. Recognize common MRI artifacts and apply fundamentals to detect artifacts.

Speaker panel:

Dr. Michael Henry - Lymphoma

Dr. Jennifer Hess - Leukemia

Dr. Alexandria Walsh - Survivorship

Objective:

To increase awareness among general pediatricians about childhood cancer.

https://dmgaz.zoom.us/j/96336555388?pwd=S3pMcmg2ZkFQN0xrSkpwVktBT1VHdz09

Meeting ID: 963 3655 5388
Passcode: 762046

Contact Megan Jehlicka to claim CME credit for this session:

Office: 602.344.5418 | Cell: 775.846.5924; Email: megan_jehlicka@dmgaz.org

PCH Grand Rounds - Treatment of OSA after Tonsillectomy/Adenoidectomy - Dr. Patrick Scheffler

Learning objectives:

• Recognizing the beliefs & values of Native Americans and the view of traditional Indigenous health
• Understanding the role of generational trauma in Indigenous health outcomes
•  Understanding the role of Native American physicians within the Indian Health Service

Presenter: Jared Gilliland, DDS, Oral & Maxillofacial Surgery, Phoenix Children's

At the end of this presentation, participants should be able to: 

• Know the available surgical procedures for patients with skeletal malocclusion and temporomandibular joint disorders 
• Understand indications and benefits of orthognathic surgery (also known as corrective jaw surgery) 
• Learn the diagnosis and management of temporomandibular joint pathology and disorders

Children’s Neuroscience Grand Rounds

Early circuit-directed rehabilitation mitigates late-onset sensory hypersensitivity after traumatic brain injury

Presented by: Gokul Krishna, PhD

Learning Objectives:

1. Recognize the contribution of maladaptive circuit reorganization as a pathophysiological process underlying late-onset neurological deficits after concussive brain injury.
2. Evaluate the efficacy of early rehabilitation for lessoning deficit severity and improving circuit function in a well-established model of diffuse axonal injury.

Early pharmacological intervention with gabapentin inhibits traumatic brain injury-mediated synaptogenesis in rats

Student Presenter: Caitlin Hair, PhD 

Learning Objectives:

1. Describe traumatic brain injury-induced upregulation of thrombospondins implicated in increased-synaptogenesis as a pivotal process in maladaptive circuit reorganization. 
2. Evaluate the efficacy of early gabapentin treatment to inhibit maladaptive synaptogenesis and improve long-term outcomes.
3. Discuss clinical possibilities of prophylactic use of gabapentin after in TBI patients.

Neuropathology and vulnerability to traumatic brain injury in a mouse model of connective tissue disorders

Presented by: Tala Curry, PhD (Candidate)

Learning Objectives:

1. Identify that connective tissue disorder (CTD) patient populations may be at risk for elevated severity of symptoms after traumatic brain injury.
2. Recognize Marfan Syndrome (CTD) and associated downstream signaling can contribute to neuropathology.

Guest Speaker: Dannah Raz, MD, Developmental Pediatrics 

Grand Rounds " Down Syndrome"

High Flow: When should we use it? Nellie Farrington, MD DMG/ Valleywise Health October 10th, 2023 7:30am to 8:30am

https://dmgaz.zoom.us/j/96336555388?pwd=S3pMcmg2ZkFQN0xrSkpwVktBT1VHdz09

Meeting ID: 963 3655 5388
Passcode: 762046

Contact Megan Jehlicka to claim CME credit for this session:

Office: 602.344.5418 | Cell: 775.846.5924; Email: megan_jehlicka@dmgaz.org

Speaker Dr. Daniel Blatt, Pediatric Infectious Disease, University of Louisville 

Learning Objectives:

• Describe the most common symptoms associated with Post- COVID unwellness in children
• Summarize the lessons learned from having a dedicated clinic for Post-COVID unwellness in children
• Describe the impact of Post-COVID unwellness  beyond the symptoms.

Meet the presenter: 

View Dr. Blatt's About Video

Daniel B. Blatt, M.D., joined Norton Children’s in August 2020 as a pediatric infectious diseases physician. He is a pediatric transplant infectious disease specialist and a member of the Norton Children’s Hospital’s infection control committee. In addition to his clinical role, he is an assistant professor of pediatrics at the University of Louisville School of Medicine.

Dr. Blatt graduated with highest honors from the University of Medicine and Health Sciences in Basseterre, Saint Kitts, where he earned his medical degree in 2014. He completed his residency in general pediatrics in 2017 at University of South Alabama Children’s & Women’s Hospital and then served as a fellow in pediatric infectious diseases at Hasbro Children’s Hospital for three years.

Clinically, Dr. Blatt is interested in transplant pediatric infectious diseases, global health, and infection control and prevention.

In addition to providing care domestically, Dr. Blatt has international experience. He treated residents in a rural village in Nepal in 2014. Two years later, he was the pediatrician for an 80-bed inpatient unit at Kibogora Hospital in Rwanda.

Dr. Blatt views being a physician as one of the most privileged careers because of the responsibility and honor to heal those who are sick. He specifically chose pediatrics because of his natural connection with children.

Dr. Blatt is certified by the American Board of Pediatrics in general pediatrics. He is a member of multiple national organizations, including the American Academy of Pediatrics, Pediatric Infectious Diseases Society, and Society for Healthcare Epidemiology of America.

Maintaining a highly active lifestyle, Dr. Blatt loves downhill skiing, hiking, running, Ultimate Frisbee and biking. He thoroughly enjoys exploring remote areas of the world and spontaneous adventures. He is passionate about maintaining a baseline level of goofiness and corny jokes.

Presentation details will be provided at a later date.

Presenters: Dr Arian Hess and Dr Camille Imbo

Presenters:  Dr. Mark Molitor

Children’s Neuroscience Grand Rounds 

Neuropsychological Functioning in Children

Presented by: Ammiee Hammer, PhD  

Reminder: ALL Barrow at Phoenix Children’s Faculty & Staff Report your Attendance to CAMS

Announcement for October 30, 2023 Pediatric Neuroscience Grand Rounds.

The University of Arizona College of Medicine – Tucson

Barrow at Phoenix Children’s

Neuroscience Grand Rounds

Strategic Opioid Use and Home Naloxone: A Balanced Practice and a New Rescue Option

Ahmar Husain, MD

Phoenix Children's

Learning Objectives

At the conclusion of this activity, participants will be able to: 

1. List the benefits of adequate analgesia and the risks related to different modalities of analgesia.
2. Recognize clinical scenarios that may benefit from multimodal analgesia including regional anesthesia or an ERAS protocol.
3. Identify signs of substance use disorder in pediatric patients.
4. Describe the use and current availability of naloxone at home and in the hospital.

Barrow at Phoenix Children’s

Virtual Live Streaming Neuroscience Grand Rounds

Monday’s from 7:00 – 8:00 a.m.

Zoom Information: CNI Grand Rounds

Meeting ID: 993 7837 3233

Join from PC, Mac, iOS or Android:

https://PhoenixChildrensHospital.zoom.us/j/99378373233?pwd=UXBudHZLemRYK056ZWZvMm8yUzNkUT09

Or join by phone: (408) 638-0968 (US Toll) or (646) 558-8656 (US Toll)

The Attendance code will be listed in the chat at the beginning of the presentation and every 20 minutes thereafter until the conclusion.

Please text the attendance code to the Grand Rounds Attendance number: (866) 327-3062 or log into the CAMS website: http://CME.arizona.edu and enter the attendance code.

• Please make sure to enter your cell phone number in your profile
• Please note that the attendance code is different each week

Attendance codes are only valid 15 minutes before the activity start time and for 24 hours after the activity end time.

Accreditation Statement:

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of The University of Arizona College of Medicine - Tucson and Phoenix Children’s Hospital. The University of Arizona College of Medicine - Tucson is accredited by the ACCME to provide continuing medical education for physicians. 

The University of Arizona College of Medicine - Tucson designates this live activity for a maximum of 1 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Disclosure Statement: 

All Faculty, CME Planning Committee Members, and the CME Office Reviewers have disclosed that they have no financial relationships with commercial interests that would constitute a conflict of interest concerning this CME activity.

For privacy purposes this session was not recorded. 

Shaanan Meyerstein, MD, MPH, FAAP
CDR, US Public Health Service
Team Lead - Medical Services
Division of Health for Unaccompanied Children (DHUC) Office of Refugee Resettlement Administration for Children and Families U.S. Department of Health and Human Services

ChatGPT and Beyond: A Pediatrician's Guide to Generative Artificial Intelligence 

Presented by: Srinivasan Suresh, MD, MBA

March 19, 2024 – 7:30 AM

Session Objectives:

• Define Generative Artificial Intelligence

• Create an effective and appropriate prompt for a generative AI tool such as ChatGPT

• Identify three aspects of pediatric health care where a pediatrician or pediatric specialist can use a generative AI tool to support high quality care or practice

Pediatric Grand Rounds Presenting live from Cohen Conference Center Dr. Who, Me? Professional Identity Formation in Physicians At the end of this presentation, participants should be able to: Explain the theoretical basis behind professional identity formation. Recognize the challenges physicians-in-training face in developing a professional persona. Identify steps medical educators can take to support professionalization in trainees. Zoom details below:

https://dmgaz.zoom.us/j/96336555388?pwd=S3pMcmg2ZkFQN0xrSkpwVktBT1VHdz09

Meeting ID: 963 3655 5388
Passcode: 762046

Contact Megan Jehlicka to claim CME credit for this session:

Office: 602.344.5418 | Cell: 775.846.5924; Email: megan_jehlicka@dmgaz.org

Children’s Neuroscience Grand Rounds 

Recording available for internal purposes only. Please contact Christina Casanova to request access.

Demystifying Functional Neurological Disorders 

Presented by: Amy Schaefer, PsyD 

Learning Objectives:

1. Identify risk factors, presentations, outcomes, and biases associated with functional movement disorders and functional [nonepileptic] seizures
2. Discuss updated recommendations for evidence-based evaluation, diagnosis, and treatment of functional neurological disorders
3. Review current functional neurological disorder guidelines created by interdisciplinary teams at Phoenix Children's