Seattle Children’s

Community
Benefit Report 2009

www.seattlechildrens.org
Our Mission
Seattle Children’s vision is to be the best
We believe all children have unique children’s hospital, because we believe
needs and should grow up without
illness or injury. With the support of
the community and through our spirit
children enduring illness and injury
of inquiry, we will prevent, treat and
eliminate pediatric disease.
deserve nothing less. Children’s is
deeply committed to improving the
Our Vision health of children through superior
We will be the best children’s hospital.
• We will provide patients and medical care, pioneering research,
their families excellent care
with compassion and respect. community partnerships, education
• We will provide superior,
accessible, cost-effective service. and advocacy. That means we offer
• We will attract and retain the
best talent at all levels of the
the range of pediatric medical care and
organization.
• We will be one of the top five
support services that our community
pediatric research institutions.
needs, even when those programs
• We will be the nation’s premier
pediatric educator. operate at a financial loss.
• We will achieve worldwide
prominence by integrating
patient care, research,
education and advocacy. The 2009 Community Benefit Report
showcases how Children’s work makes
a difference for children and families
in the Northwest and beyond. More
information about our programs and
services — including medical care,
research and education — is available
at www.seattlechildrens.org.
Left: Amanda Jones, PhD, leads the Science
Adventure Lab, which is equipped so
that students conduct real health-related
experiments at no cost to the schools.

Top Right: Drowning prevention expert

Tizzy Bennett fits a life jacket at Denise
Louie Education Center’s Children and
Families Festival.

Bottom Right: Kids learn about health and

safety at Children’s Community Health Fair.
Total 2009 Value to the Community:
$194,187,000 Contents
Through our investments in patient care, research, medical 2 Uncompensated Care
education, advocacy and partnerships with families and
the community, we remain committed to our mission to 4 Research
prevent, treat and eliminate pediatric disease.
8 Education

Health Professional Community Programs 14 Patient Care

Education and Services
$17,174,000 $8,799,000
20 Partnerships

24 Advocacy

28 Contact Us

Research Programs Uncompensated Care

$71,809,000 $96,405,000

Seattle Children’s Community Benefit Report 2009 1

Uncompensated Care
Seattle Children’s provides necessary medical care to all kids in our region,
regardless of a family’s ability to pay.

Illness and injury can strike any child at any time. Even
healthy, active kids can endure unexpected, life-threatening
conditions. Seattle Children’s is committed to providing
the best medical care to every child in Washington,
Alaska, Montana and Idaho who needs us — regardless
of insurance coverage or financial circumstances.
Children’s continues to honor this founding promise,
even in the midst of an economic downturn. In 2009,
Children’s provided a record $96.4 million in uncomp-
ensated care, including $85.2 million in Medicaid payment
shortfalls and $11.2 million in financial assistance to
families in need.
Approximately 43% of Children’s patients are covered
by Medicaid, a government program that provides medical
coverage at no cost to low-income families. However, the
program reimburses Children’s for only 68% of treatment
costs. Uncompensated care makes up the difference.
Families with private insurance are also struggling
financially as a result of job losses and reductions in
health benefits. Many are paying “out-of-pocket” for
services that were covered by insurance in the past.
And some families of longtime patients who used to
make an insurance co-payment per hospital admission
are now paying the same amount per day of each stay.
When a hospital bill exceeds a family’s ability to pay,
Children’s financial assistance program provides relief.

Almost half of our

patients are covered
by Medicaid, which
reimburses Children’s
for only 68% of
treatment costs.
Uncompensated
care makes up
the difference.

$96.4 million
in uncompensated care provided
during 2009.

2 Seattle Children’s Community Benefit Report 2009


The Yost Family’s Story
One week before his 10th birthday, Gary Yost was
diagnosed with Ewing sarcoma, a rare form of bone
cancer. A tumor the size of a softball was wrapped
around his ribs and pressing on his lung. Gary needed
lifesaving treatment immediately.
Fortunately, the Yost family didn’t have to travel far
to get the best care for their son. Dr. Douglas Hawkins,
associate chief of Seattle Children’s cancer program, is
one of the world’s leading experts in pediatric sarcomas.
The treatment plan prescribed by Hawkins was
grueling. Gary underwent one surgery and 14 rounds of
chemotherapy. He spent 52 nights in the hospital, and
endured several emergency room visits and numerous
tests over the course of five months.
“
The freedom to focus on
our family instead of our
finances was invaluable.”
— Paula Yost, Gary’s mom
Children’s financial
assistance program
helps families with
private insurance,
such as the Yosts,
when hospital bills
exceed their ability
to pay.
Gary’s parents didn’t want to think about it, but
they were concerned about the cost of Gary’s treatment.
Though they have good health insurance, the out-of-
pocket expenses would be substantial. “We were prepared
to do whatever was necessary to pay for Gary’s treatment,”
says his mom, Paula Yost. “Fortunately, our anxieties
about our finances were alleviated when we found out
we qualified for financial assistance from Children’s.”
Yost says the value of the assistance they received
extends far beyond the dollars credited to their
hospital bills.
“Financial aid relieved us of tremendous stress and
anxiety. It allowed us to direct our energy to things that
were really important, like making sure Gary’s complex
treatment schedule was running smoothly and taking care
of our youngest son,” she explains. “Things that we used
to take for granted — like taking time to eat a healthy meal
— suddenly became a big deal. The freedom to focus
on our family instead of our finances was invaluable.”
Gary is cancer-free today, but he continues to see
Hawkins for follow-up care. “We are so thankful for the
amazing care that Gary receives at Children’s and the
payment assistance that allows us to focus on his
recovery,” notes his mom.
Seattle Children’s Community Benefit Report 2009 3
Research
Our research isn’t motivated by market forces or shareholder expectations. Rather, Children’s
mission drives our spirit of inquiry: to prevent, treat and ultimately eliminate pediatric disease.
As one of the top five pediatric research centers in the nation, Seattle Children’s Research
Institute brings together the best minds to set new standards of pediatric medical care
and find new cures for childhood diseases.

Comparing schizophrenia treatments

Dr. Bryan King’s research found that citalopram, a medicine prescribed to
children with autism and obsessive-compulsive disorders, was no more
effective than a placebo at reducing repetitive behaviors.
Identifying the Best Treatments
Children treated for psychiatric problems — including
mood, behavior, and aggression disorders, autism and
schizophrenia — typically receive “second-generation”
antipsychotic medications, including olanzapine and
risperidone. However, there has never been evidence
that these drugs are more effective than first-generation
drugs. Investigators at Seattle Children’s Research Institute
were part of the team who discovered that molindone,
a first-generation drug, is just as effective as the newer
medications and may be safer. “Because the second-
generation medications are being prescribed widely
for many children, this study has broad public health
implications,” says Dr. Jon McClellan, a child psychiatrist
at Children’s, and one of the study’s lead authors. Though
each medication studied demonstrated a similar reduction
in psychotic symptoms, researchers found that both
olanzapine and risperidone were associated with
significant weight gain and the risk of developing
heart disease and diabetes.

Advancing autism care

Research led by Dr. Bryan King, director of the Department
of Psychiatry and Behavioral Medicine at Seattle Children’s,
revealed that citalopram (Celexa), a medication commonly
prescribed to children with autism spectrum disorders
(ASD), was no more effective than a placebo at reducing
repetitive behaviors. Because citalopram is also prescribed
for patients with obsessive-compulsive disorders (OCD),
the results may challenge the belief that repetitive
behaviors in children with ASD are similar to those found
in cases of OCD. “We continually learn new information
about the variables that may cause or contribute to autism
spectrum disorders, as well as how to treat them,” says
King. “While our study’s results may be frustrating news
for hopeful families and clinicians, each new finding helps
us revise treatment plans, refine future studies and build
upon what we know as we search for effective treatments
and eventually cures for this complex group of disorders.”

Dr. Jon McClellan is one of the authors of a study that discovered

that the drug molindone is just as effective for treating children
with psychiatric problems as newer medications, and may be safer.

4 Seattle Children’s Community Benefit Report 2009

Almost

$72 million
devoted to research in 2009.

Linking Cause and Effect

Revealing new insights about type 1 diabetes
The links between type 2 diabetes and excess weight are
well documented, but until recently, they were less clear
in type 1 diabetes, which is more common in children and
young people. Dr. Lenna Liu, an investigator with Seattle
Children’s researchers found that teens often discuss activities such as
Children’s Research Institute, recently found that while sexual behavior, substance abuse or violence using MySpace. The study
most children with type 1 diabetes are of a healthy weight, also showed that teens may be amenable to online interventions.
a proportion of them are more likely to be overweight
than children without diabetes. “Knowing the prevalence
of overweight and obesity in children and young people Preventing sexually transmitted disease
with type 1 and type 2 diabetes is very important, as it While condoms are known for preventing the spread of
helps us identify those individuals who face the greatest HIV, chlamydia and gonorrhea, their effectiveness as a
risk of clinical complications,” says Liu. “Further studies barrier against HSV-2 — the virus that causes genital
will help us understand how weight causes complications herpes — has been unclear until now. A study conducted
in the growing number of children and young people by Dr. Emily Martin at Seattle Children’s Research Institute
with diabetes, and they will help us improve diagnostic found that people who use condoms consistently can
techniques and treatment.” reduce their risk of getting genital herpes by 30%. “Even
though the decrease is smaller than you would see with
Preventing Illness and Injury other STDs, this study shows condoms offer some
protection,” says Martin. The study also revealed that the
Observing risky teen behaviors risk of contracting genital herpes increases steadily and
Investigators in the lab of Dr. Dimitri Christakis at Seattle significantly with each unprotected sex act. Given that
Children’s Research Institute found that 54% of adolescents this research offers new scientific evidence about genital
frequently discuss high-risk activities including sexual herpes prevention, Martin hopes more sexually active teens
behavior, substance abuse or violence using MySpace, the and young adults will use condoms. “Using a condom not
popular social networking Web site. Though parents may only reduces the odds of getting herpes, but of getting
worry about their kids’ use of social media, Dr. Megan other STDs as well,” she says.
Moreno — one of the lead researchers — says study results
indicate the potential for preventing those behaviors
before teens act on them. “Online displays of risky
behaviors may actually just be displays,” notes Moreno,
formerly a research fellow at Children’s and now assistant
professor of adolescent medicine at the University of
Wisconsin School of Medicine and Public Health. “Some
teens may be grandstanding, or may be indicating intention
or considered behavior. If that’s the case, this presents
opportunities for education and prevention before risky
behavior takes place. The good news is that teens may
be amenable to participating in online interventions. Our
related study looked at this, and we were happy to see
that even a brief e-mail intervention may be feasible
and showed promise for influencing online behavior.”

Seattle Children’s Community Benefit Report 2009 5

People Making a Difference: Dr. Dimitri Christakis
Researcher
Dr. Dimitri Christakis
looks for answers
to a question many
parents ask: How
does our media-rich
environment impact
the development of
children and teens?
His studies aim to
provide guidance to
caregivers worried
about the effects
of television and
computers on
their kids.

More than half of parents say they are worried about the
effects of television and computers on their children.
Dr. Dimitri Christakis, who directs the Center for Child Health,
Behavior and Development at Seattle Children’s Research
Institute, is providing crucial guidance. His work is helping
families everywhere make better screen-time choices for
young children. Christakis regularly speaks to parents,
teachers and librarians about healthy media usage, and
he is a co-author of The Elephant in the Living Room:
Make Television Work For Your Kids.
Christakis’ research has revealed that watching television
and videos during the first three years of life can lead to
problems with language, attention and cognitive development.
In addition, watching violent cartoons during preschool years
is associated with aggression in children ages 7 to 10.
Most recently, Christakis discovered that the amount of
television viewed by young children in childcare settings
doubles the previous estimates of early childhood screen
time, with those in home-based settings watching significantly
more on average than those in center-based daycares. This
study is the first to examine screen time in child-care settings
in more than 20 years.
“It’s alarming to find that so many children in the United
States are watching essentially twice as much television as
we previously thought,” says Christakis. “Research continues
to link excessive preschool screen time with language delay,
obesity, attention problems and even aggression, depending
upon content. At the same time, studies show that high-
quality preschool can be beneficial to children’s development.
Unfortunately, for many children, the potential benefits of
preschool may be displaced by passive TV viewing. I suspect

“
many parents are unaware of the frequency and extent of
Research continues to link TV viewing in daycare settings. Hopefully, these findings
excessive preschool screen will serve as a wake-up call.”

time with language delay,

obesity, attention problems
and even aggression.”
— Dr. Dimitri Christakis

6 Seattle Children’s Community Benefit Report 2009


Saving Babies from Seattle to Sri Lanka
Throughout the world, prematurity is the leading cause
of newborn death. In the United States, one in eight
babies is born preterm, or before 37 weeks. Worldwide,
more than three million stillbirths occur annually. A third
of those stillbirths happen just minutes before birth —
and could be prevented with cesarean sections and
other proven interventions.
Though prematurity and stillbirth are critical global
health problems, these issues have received only limited
funding, research and attention. As a result, scientists know
very little about the causes of prematurity, and current
healthcare strategies cannot prevent a preterm birth.
In response to these challenges, Seattle Children’s
launched the Global Alliance to Prevent Prematurity and
Stillbirth (GAPPS). The alliance brings together internat-
ional experts to better understand the magnitude of
prematurity and stillbirth, to learn about the causes
and to ultimately prevent these devastating problems
throughout the world.
Worldwide, more than
3 million
children are stillborn each year.
Every year, more
than one million
babies die because
they were born too
early. The Global
Alliance to Prevent
Prematurity and
Stillbirth (GAPPS)
is working to
understand the
causes and
magnitude of
prematurity and
stillbirth and to
prevent them.
“Prematurity and stillbirth do not discriminate; this
tragedy affects low-, middle- and high-income countries,”
says Dr. Craig Rubens, executive director of GAPPS. “It
happens to women in Seattle and Sri Lanka. It happens to
women who go to every prenatal care appointment, and
it happens to women who simply cannot see a doctor
while they are pregnant because they live too far from
a medical facility.”
In May 2009, GAPPS took a bold step forward by
hosting the International Conference on Prematurity
and Stillbirth, where nearly 200 experts from multiple
disciplines gathered in Seattle to develop the Global
Action Agenda for preterm birth and stillbirth — a
roadmap for future research, interventions and advocacy.
“This conference marks the beginning of an exciting
new collaboration between Children’s and many internat-
ional organizations that are deeply committed to saving
the lives of infants around the world,” says Children’s
CEO Dr. Thomas Hansen, a neonatologist who is one
of the GAPPS team’s core investigators. “Thanks to the
hard work of the GAPPS team, we are advancing global
research on prematurity and stillbirths, and helping
ensure that interventions will reach women and
families here at home and around the world.”
Seattle Children’s Community Benefit Report 2009 7
Education
Seattle Children’s staff and clinicians take many different roads to reach the ultimate destination
of improving the health and well-being of children in the Northwest.
Children’s health education activities for families — and our training programs for healthcare
providers — improve the health and well-being of children in our community and beyond. We
invest in training medical students, residents and fellows to provide expert family-centered medical
care for children. We serve as a training site for many other healthcare providers as well, including
nurses and respiratory therapists. We also offer a variety of continuing medical education programs
for community clinicians.

Educating Healthcare Providers

Engaging community providers
More than

Seattle Children’s Continuing Medical Education (CME)
accredited programs help to bridge gaps in healthcare
providers’ knowledge, skills and performance, leading to
improved patient care and outcomes. Children’s experts
present a variety of courses, hands-on workshops and
case-based discussions that enable community providers
to keep current with best practices in pediatric medicine.
Children’s also offers weekly pediatric Grand Rounds
presentations on timely topics ranging from clinical care
and research to advocacy and bioethics. Grand Rounds
presentations are offered free of charge as a community
service. Participants may attend in person or via live
streaming over the Internet. One year from the date of the
original presentation, providers can view archives on Seattle
Children’s Web site and receive Category 1 CME credit.
$17 million
invested in training health professionals.
Enhancing nursing education
Seattle Children’s Nursing Education team hosts monthly
“Lunch Time Seminars” to advance pediatric nursing
practice in the Northwest and beyond. Each seminar is
broadcast to video teleconference sites at healthcare
organizations across the region, including sites in Montana
and Alaska. Sessions include evidence-based practice
review and interactive case-study discussions. Community
nurses can also participate from their computers via live
Internet streaming. All seminars are videotaped and
archived on the Children’s Web site to reach as many
community nurses as possible. Continuing education
credit is also available.

Children’s pediatricians-in-training, including chief resident Dr. Shaquita Bell

(pictured here with her mentors Drs. Jim Stout and Ben Danielson) rotate
between regional teaching hospitals and community clinics that serve a
diverse group of families.

8 Seattle Children’s Community Benefit Report 2009

 Dr. Aaron Grigg’s
residency exper-
iences in Pocatello,
Idaho, and with
pediatrician and
mentor Dr. John
Schreuder (right)
at Mercer Island
Pediatrics influenced
his decision to
practice in a
rural Washington
community when he
graduates in June.

Training the Next Generation
Educating resident physicians and fellows
As the only pediatric residency program in Washington,
Wyoming, Alaska, Montana and Idaho, the University of
Washington School of Medicine Pediatric Residency
Program prepares pediatricians to provide outstanding
medical care for children in the Northwest. The program
— which is housed at Seattle Children’s — is ranked among
the top 10 programs in the country by U.S. News & World
Report. In addition to completing rotations at Children’s,
residents train in a network of regional teaching hospitals
and community clinics that serve a diverse group of
children and families. Many residents continue their
education at Children’s with fellowships in areas such as
cardiology, emergency medicine, neonatology, nephrology
and rheumatology. The training of top-notch pediatricians
ultimately benefits our society as a whole and especially
our local community, with over half of Children’s residents
choosing to stay in Washington after they graduate.

Seattle Children’s Community Benefit Report 2009 9


Dental Camp gives students a chance to learn about oral health and
dental careers. Photo by UW School of Dentistry.
Introducing youth to careers in dentistry
For adolescents across Washington state, Dental Camp
might be their first step toward a dental career. Each
half-day session provides student “campers” with an
opportunity to learn about oral health and dental careers
by performing hands-on activities in the simulation lab-
oratory. The camp primarily serves youth from communities
traditionally underserved by the dental profession. Dr.
Doug Jackson, a dentist and chief of Seattle Children’s
Center for Diversity and Health Equity, has been involved
with Dental Camp since its launch in 2002. “We hope this
program will serve as a career catalyst,” says Jackson. “Our
goal is to increase the diversity of oral health professionals
in Washington and to eliminate the magnitude of oral
health inequities and disparities.” This year’s program
was a collaboration between Children’s, the University
of Washington and other community partners.
10 Seattle Children’s Community Benefit Report 2009
Educating Community Members
Supporting siblings
Siblings of children with special medical or developmental
needs — such as ADHD, autism, diabetes, cancer and Down
syndrome — often feel isolated as they struggle with
feelings of guilt, sadness and anger. They may also have
trouble coping with their siblings’ unpredictable behaviors.
Seattle Children’s Sibshops program offers support and
education, along with opportunities to discuss common
joys and concerns in a relaxed, recreational setting.
Sibshops sessions also help siblings learn about the
implications of their brothers’ and sisters’ special needs.
“If you can teach siblings they are not alone, you create
the possibility of a healthier adult sibling relationship,”
says Cathy Harrison, Sibshops program coordinator.
Promoting health and safety
Local and national media outlets call on the experts at
Seattle Children’s for advice on numerous health and
safety issues, from obesity prevention and vaccine safety
to the top 10 conversations parents should have with their
kids. Dr. Bryan King, an international expert in autism and
director of Children’s Psychiatry and Behavioral Medicine,
contributes to the ABC News OnCall+ Autism Center, a
Web site for families of individuals with autism spectrum
disorders. To date, topics King has offered expert advice
on include behavioral interventions, communication, diet
and research.
Allowing kids to “just be kids”
A growing number of specialized summer camps staffed
by volunteers from Seattle Children’s allow kids with special
health needs to forget about their conditions and “just be
kids” with fellow campers who understand them. At Camp
Oasis, children with Crohn disease and ulcerative colitis
enjoy traditional camp activities — including arts and crafts,
sports and campfires — with 24-hour medical support.
Stanley Stamm Summer Camp also offers round-the-clock
medical care so that children with a broad range of serious
illnesses can go fishing, ride horses and take part in other
activities typical of summer camp. Families appreciate a
week of rest while their children gain confidence and make
new friends in a safe, medically supervised environment.
 Asian-American
children in
Washington state
drown at more than
twice the rate of
other children. The
water safety team
at Children’s works
on many activities
to prevent drowning,
including increasing
life-jacket loan
programs and
promoting lifeguards
at beaches and learn-
to-swim programs.

Teaching water safety programs, and learn-to-swim programs. As a result of

Since Dr. Linda Quan discovered that Asian-American
children in Washington state were drowning at more than
twice the rate of other children, she has been involved
in numerous activities to promote water safety in the
Vietnamese community. A pediatric emergency medicine
physician at Seattle Children’s, Quan has worked to
increase awareness of drowning risk and to prevent
drowning through lifeguarded beaches, life-jacket loan
Quan’s work, Children’s has worked with Seattle Parks
and Recreation to create a water-safety brochure in
Vietnamese, increase lifeguard staffing at city beaches,
support low-cost swim lessons, and place a life-jacket
loaner board, with translations about life-jacket use in
eight languages, at all lifeguarded Seattle swim beaches.

Seattle Children’s Community Benefit Report 2009 11

People Making a Difference: Mental Health “Coaches”
Mental health
coaches Amber
Persons and Dave
Hall explain the
“trigger cards,”
which they use to
help patients in the
Inpatient Psychiatric
Unit get through
difficult situations.

Seattle Children’s mental health specialists help patients

in the Inpatient Psychiatric Unit (IPU) build critical skills
to manage their feelings. These professionals, known as
“

We focus on supporting
our patients from a place
“coaches,” use skill and compassion to guide patients of compassion.”
through difficult situations.
— Ann Moore, Inpatient Psychiatric Unit Director
“It’s like doing drills when you play a sport,” says coach
Amber Persons. “Our patients practice coping skills when
control when they get upset,” says Dave Hall, supervisor of
they’re not feeling sad or upset, and we hope they can call
the senior pediatric mental-health specialists. “Our staff is
on the skills later when they need them. Patients also learn
amazing at finding teachable moments in every situation.
to identify strong emotions and make a plan for how to
We can’t make patients do anything they don’t want to do,
deal with those emotions.”
but we usually accomplish our goals by validating their
The process begins when patients arrive in the IPU. They
experiences, remaining calm and compassionate, and
complete personalized “trigger cards” identifying things that
partnering with them to help them learn new skills.”
cause anger, sadness or anxiety. Patients carry the cards
A few years ago, if a child was threatening a staff member
around at all times — whether they are on the unit, going
or engaging in other potentially harmful behavior, the patient
to the swimming pool or leaving for a few hours with their
might have been physically restrained or placed in a locked
family. Staff coaches are always on the lookout for signs
bedroom or a seclusion room. Now, instead of seclusion or
that a patient’s mood has changed, and they use the trigger
restraint, the coaches close off an entire wing of the unit and
cards to pinpoint what patients are feeling, and coach them
give the patient space to be alone, monitoring them closely
through their distress.
and waiting for the moment of crisis to pass.
It’s a new approach that teaches invaluable skills
“We focus on supporting our patients from a place of
and lessons.
compassion,” says Ann Moore, IPU director. “That means
“The goals of the trigger cards are to help kids increase
coaching them to develop coping skills that will help them
their awareness of personal triggers and warning signs, and
be successful here and when they go home.”
to have a coping plan in place so things don’t get out of

12 Seattle Children’s Community Benefit Report 2009


Connecting Kids to Science
With generous support from the community, Seattle
Children’s launched the Science Adventure Lab in 2009,
creating the first mobile science lab program in the
Pacific Northwest.
Custom-built for Children’s, the Science Adventure
Lab is a rolling laboratory that helps students in grades
four through eight explore the connection between science
and health through hands-on experiments. Working in
teams of four, students perform one of several experiments
chosen by their classroom teacher based on what the
students are currently studying.
One experiment asks students to analyze the sugar
content of various beverages. Another involves viewing
their own cheek cells under a microscope and then
isolating the DNA from inside the cells.
“In each case, we’re advancing the Seattle Children’s
mission of helping children stay healthy by educating
them about the science behind how the body works,”
says Amanda Jones, PhD, who directs the Health and
Science Outreach Program.
That’s important for many reasons, starting with the
connection between science and health. For example,
when students analyze the sugar content of various
beverages, they’re not only conducting a chemistry
experiment, they’re learning about nutrition.
The Science Adventure Lab did 75 visits to
54 schools across Washington state. The visits
are at no cost to the school, the students or
the teachers.
In the Science Adventure Lab, Mark Ruffo, PhD,
instructs students at Northgate Elementary in
Seattle as they isolate the DNA in their own
cheek cells.
Because schools differ in their ability to provide strong
science education programs, the Science Adventure Lab
targets schools where students may lack ready access to
professional equipment and trained instructors. The lab
brims with some of the same science equipment —
microscopes, centrifuges and vortex mixers — that
Children’s scientists use.
Who knows? A visit from the Science Adventure Lab
could inspire a student to become the next Jonas Salk
or Marie Curie. Or not. “They won’t all pursue careers in
science or medicine, but they will learn critical thinking
skills that they can use throughout their lives,” Jones says.
“
We’re advancing our mission
of helping children stay
healthy by educating them
about the science behind
how the body works.”
— Amanda Jones, PhD, Health and Science
Outreach Program Director
Seattle Children’s Community Benefit Report 2009 13
Patient Care
Children’s invests hospital resources in many clinical programs and “extras”
that support patients and their families.

After a transplant
to treat a liver
disease, Camren, 2,
is ready to get back
to his busy toddler
life. But first, Home
Care nurse Teresa
Taylor (center)
teaches Camren’s
mother Melody
McDonough to
administer IV
antibiotics.

Caring for Kids Closer to Home Connecting to remote clinics

Keeping families together
Twenty years ago, medically fragile children who required
round-the-clock attention were rarely cared for at home.
But that’s changed, thanks to technological improvements
and resources like Seattle Children’s Home Care Depart-
ment. The team does whatever it takes to help families
transition a child’s medical care from the hospital to home.
Home care providers set up any necessary equipment —
such as ventilators and pumps to supply nutrition and
hydration — and train parents to use the equipment safely.
The Home Care team delivers or ships medications, formula,
equipment and supplies directly to families when needed,
and experts are available 24 hours a day for consultation
and family support.
Seattle Children’s Telemedicine program enables our
experts in Seattle to care for children closer to their
homes through videoconferencing. Clinics throughout
Washington, Alaska, Montana and Idaho use cameras,
microphones and TV monitors that allow families to
consult with our medical teams in real time, without
the expense and stress of extensive travel. Children’s
clinics equipped for telemedicine include Cardiology
(for echocardiograms), Endocrinology, Genetics,
Neurodevelopmental, Neurology, Nutrition Services,
Psychiatry and Behavioral Medicine, Pulmonary
Medicine and Rheumatology.

14 Seattle Children’s Community Benefit Report 2009

Supporting Healthy Families
Bonding with baby
When children’s social and emotional needs have not been
met, they are more likely to face challenges at school or
to have behavioral problems. A new program for parents
of babies and toddlers at Odessa Brown Children’s Clinic,
“Promoting First Relationships,” helps parents learn to
meet those needs through a series of sessions with a
mental health therapist right in their own homes. “Just as
you would want a child to eat the best possible food, you
want their socio-emotional needs to be met so that they
can have a good sense of self and of the world around
them,” says Mark Fadool, clinical director of Psychiatry
and Behavioral Medicine at Odessa Brown. Parent Robin
Lieb agrees. “Promoting First Relationships helped me
see the impact of our interactions on my daughter’s
development,” she says. “I think any mother would
benefit from this program.”
The Promoting
First Relationships
program helps
parents like Robin
Lieb learn to meet
the needs of babies
and toddlers.
Supporting teens in recovery
Teens recovering from substance abuse and addiction
often need extra support to prevent a relapse. The
“Teens Mastering Recovery” program at Seattle Children’s
— available free of charge to teens who have successfully
completed treatment — offers powerful tools to sustain
a substance-free lifestyle. Over the course of 12 weeks,
participants benefit from speakers, support groups and
activities like yoga. In addition, two special sessions
teach parents how to support a teen in recovery, how to
recognize situations when teens may be vulnerable to
relapse and how to help prevent relapse. Parents also
learn about normal adolescent development and how
mental health conditions can impact that development.
Environment(al) Matters:
Providing a Healing Environment
Reducing costs and solid waste
Seattle Children’s ongoing efforts to “go green” and
reduce waste are resulting in significant benefits for the
hospital, our patients and the environment. In addition to
recycling hundreds of tons of materials annually, we are
exploring new ways to reduce our environmental impact.
For example, the Cardiac Catheterization Laboratory
saved $100,000 in 2009 by reprocessing equipment
instead of buying it new. “Initially, our staff was concerned
about the quality of reprocessed equipment,” says Michael
Alotis, manager of Strategic Sourcing. “But reprocessing
is regulated by the Food and Drug Administration, and
everything goes through an inspection and testing process
that is more rigorous than the process for new equipment.
Ultimately, reprocessing helps reduce the cost of health-
care and keeps waste out of landfills and incinerators.”
Expanding green initiatives
Seattle Children’s Dietary Department is among the
hospital’s “greenest” heroes. For starters, they use
environmentally-friendly products like unbleached paper
napkins and compostable plates. And Children’s kitchen
is a leader among hospitals in composting and recycling.
During fiscal year 2009, Dietary staff composted more
than 62 tons of food by-products. “We’re continuously
decreasing the volume of our waste and increasing the
volume of our composting and recycling,” says Walter
Bronowitz, executive chef and Dietary manager. Most
recently, the kitchen began composting cold cups made
from corn. The Dietary Department also works with
Full Circle Farms to bring fresh produce to families and
employees through the farm’s Community Supported
Agriculture program.
Seattle Children’s Community Benefit Report 2009 15
Offering a place of respite
The grounds surrounding Seattle Children’s are a
botanical paradise teeming with brilliant colors and
interesting shapes throughout the year. Some emit
mouthwatering scents — like the leaves from katsura trees
— which smell like burnt sugar. “Children’s has understood
the importance of the environment in reducing stress for
patients, their families, and employees for over 100 years,”
says Jeff Hughes, grounds and sustainability manager.
“The surroundings here are designed to promote healing
and to offer respite from the difficult things that may be
happening inside. No matter who you are or when you
choose to step outside for a break, we want something
you see to delight you.” Visitors enjoy more than 2,000
species of trees, plants and flowers from all over the
world, including rare species like an heirloom apple
tree first discovered in England during the 1800s.
Patient Declan Morrow visits the Playroom to take a break from medical
procedures. Therapeutic Play staff and volunteers help patients cope
through music, art and play.
Enhancing care through play
On any given day at Seattle Children’s, patients struggling
with serious illnesses experience breakthrough moments
through the power of play. Children’s team of Therapeutic
Play staff and volunteers promote healing with music, art
and animal-assisted activities. Musicians visit children in
waiting areas, the Sibling Playroom and individual patient
rooms. Volunteers roll “art carts” through the medical units
to offer arts and crafts activities that relieve boredom. Pet
Partner volunteer teams bring specially trained therapy
dogs to play areas and patient rooms. In addition, art
and music therapists offer individual support to patients
who are having difficulty adjusting to the hospital setting
or patients undergoing treatments that are stressful
and painful.
16 Seattle Children’s Community Benefit Report 2009
Inspiring hope among families
When a child is diagnosed with an ongoing health
condition that may require frequent medical care, families
often experience a range of emotions and feelings of
uncertainty about the future. Seattle Children’s Parent
Support Program connects families of children with
special health needs to experienced parent volunteers
who have lived through similar situations. The program
also refers families to support groups. “Talking with peers
who have walked a similar path can be supportive and
powerful for parents,” says Lawrie Williams, who coord-
inates the Parent Support Program. “These connections
can provide support for the practical challenges that
families face each day, and offer hope that they too
can get through difficult times, and although life may
be different, it can also be okay.”
Breaking Through Language
and Cultural Barriers
Improving health equity
Families who speak limited English have a new resource at
Seattle Children’s: patient navigators. “We want to make
sure all families are able to participate as full partners in
their child’s care,” says Sarah Rafton, director of Children’s
Center for Diversity and Health Equity. Patient navigators
encourage families to ask questions and ensure they
understand what is being said. The navigators also help
families schedule appointments, work with interpreters,
secure transportation and apply for financial assistance.
Over time, they prepare families to make their own way
through the healthcare system, both inside and outside
the hospital.
Patient navigator Blanca Fields helps Anabel Cisneros and Ignacio Larios
with how to partner with their healthcare team when bringing their son
Isai to be treated for hydrocephalus.

Providing culturally sensitive dental care
Odessa Brown Children’s Clinic offers the typical range of
pediatric dental services, including checkups, cleanings,
fillings and emergency dental care. But the experience for
patients — many of whom come from diverse families —
is especially tailored for their needs. They can always
count on receiving high-quality care with dignity. “We
have a very diverse staff, with over 90% coming from
different minority groups that are represented in our
community,” says Dr. Chris Delecki, director of the Dental
Clinic. “This ethnic blend enhances our ability to be
culturally sensitive.” For example, the dental assistants
regularly provide care to a broad range of families,
sometimes requiring communication in eight to 10
different languages. They ensure clear communication
with families by using their own multilingual skills and
through interpreters.
Families of all racial
and ethnic back-
grounds receive
high-quality dental
care with dignity
at Odessa Brown
Children’s Clinic.
Helping families adjust to hospital life
A child’s admission to Seattle Children’s is difficult for any
family. But Native Alaskan families face special challenges
as they experience cultural and social isolation in the
midst of a child’s illness. To ease the stress and anxiety,
Children’s provides a variety of special services, including
language assistance, information on where to find
community resources and special foods, video tele-
conferencing to school and family at home, and books for
children in native languages such as Yupik. Guest Services
also works with families to find the best housing options
and personally welcomes families coming for the first
time. Adult family members benefit from the supportive
resources and programs available through the Seattle
Indian Health Board, which serves American Indians and
Alaska Natives living in the greater Seattle area. Children’s
regional care coordinators also work with the Alaska
Native Medical Center to support each child’s needs
while at Children’s and in preparation for discharge.
Seattle Children’s Community Benefit Report 2009 17
People Making a Difference: Dr. Lenna Liu
Pediatrician and
community advocate
Dr. Lenna Liu works
tirelessly to address
the many different
causes of pediatric
obesity. “Obesity is a
symptom of poverty
in many cases, and
for me, it’s an issue
of equity,” she says.

A talented primary care physician at Odessa Brown Children’s
Clinic — and a dedicated community advocate — Dr. Lenna Liu
was recently honored with the Odessa Brown Ken Feldman
Award for her caring service to families and her longtime
work to address pediatric obesity.
“Obesity is a symptom of poverty in many cases, and
for me, it’s an issue of equity,” says Liu. “Many children don’t
have equal access to healthy food and healthy activity.
Fresh produce is more expensive than a box of macaroni
and cheese. It also costs a lot of money to put kids in sports
programs. And in many neighborhoods, kids don’t have a
safe place to go outside and play.”
Recognizing that obesity cannot be addressed with
medical solutions alone, Liu has advocated for a broad,
Liu also helps her colleagues learn to work effectively
with families.
“Many pediatricians don’t feel comfortable talking about
obesity, so we’ve been coaching them on how to provide
counseling around healthy activity and eating,” says Liu.
“Often there are deep emotional issues related to overeating,
so it can be hard to open the conversation. What’s exciting
about being a pediatrician is that we’re all about prevention.
We can certainly do one-on-one counseling with our patients,
but what will really make a difference is if we go beyond our
clinic and partner with community organizations that provide
nutrition support and physical activity for kids.”
Read about Dr. Liu’s type 1 diabetes research on page 5.

“
multidisciplinary approach. For example, she worked with
the YMCA to develop Strong Kids/Strong Teens, an 18-week
What will really make a
program for youth ages 8 to 14 who are overweight or obese difference is if we go beyond
and one of their parents. Focused on promoting active living,
healthier eating habits and self-empowerment, this program
our clinic and partner with
has expanded to 11 YMCA branches in the greater Seattle community organizations
area since it started in 2004. that provide nutrition support
and physical activity for kids.”
— Dr. Lenna Liu

18 Seattle Children’s Community Benefit Report 2009


Bringing Comfort to Bereaving Families
Seattle Children’s Journey Program offers compassionate
support for families who have experienced the loss of
a child.
The program makes a difference for bereaved families
by providing crisis intervention, grief support, counseling,
advocacy and referrals to community resources. During
the first year following the death of a Children’s patient,
Journey Program staff contact families seven times with
messages of compassion and offers of support, including
a personal invitation to the hospital’s annual memorial
service and a card acknowledging the first anniversary
of their child’s death. During 2009, more than 200
families benefited from Journey Program services.
“Each component of the program reflects our
philosophy that grief is a normal, natural process
given the death of a child,” says Jackie Kite, MSW, who
manages the Journey Program. “Our unique services
are offered by licensed social workers dedicated solely
to grief and loss support. Children’s is one of a handful
of pediatric hospitals that provides this level of
bereavement care.”
Support groups are among the most popular services
offered by the Journey Program. “The group setting is
a safe place for parents to speak about their grief, offer
support to each other and remember and honor their
child,” says Kite. Groups typically include five or six
couples who meet every other week for one year to
18 months. During that time they experience many of
the big “firsts” together — the anniversary of their child’s
Jackie Kite,
Jennifer Gutzmer
and Alice Ryan
are part of the
Journey Program
team, which
supports families
who have exper-
ienced the loss
of a child.
birthday, the anniversary of their child’s death, Mother’s
Day, Father’s Day and all the other days and holidays
that feel different after the loss of a child.
The Journey Program also offers individual counseling,
depending on each family’s needs. Counseling might
include outreach to the communities where grieving
families live and work. For example, Kite often spends
time with employers of grieving parents to help their
managers and colleagues provide optimal support.
“We want to make sure families get the support they
need, and that includes advocating for parents returning
to work or siblings returning to school,” Kite explains.
Journey Program services are available to any family
in the community who experiences the loss of a child —
regardless of where the child was treated or died —
and are free of charge and without time limits.
More than
200 families
received services from the
Journey Program in 2009.
Seattle Children’s Community Benefit Report 2009 19
Partnerships
Seattle Children’s collaborates with the community to prevent injuries and promote
healthy families.
Children’s depends on partnerships with community organizations and public health
agencies to improve the health and well-being of children in the Northwest. By joining
forces with others, Children’s community health initiatives benefit more families with
greater effectiveness.

Improving Public Health

Promoting fitness for kindergartners
Almost

Thanks to a partnership between Seattle Children’s and
Treeswing — a local organization working to prevent child-
hood obesity — every kindergarten student in the Seattle
Public Schools receives a free jump-rope kit through the
JumpUp program. Each jump-rope kit includes information
for parents about the risks associated with childhood
obesity and the importance of establishing healthy habits
at an early age. JumpUp’s goal is to encourage behavior
in children that fosters a lifetime of fitness and healthy
choices. Kids can earn a “Top-Notch Jumper” certificate
by logging daily jumping activity on their JumpUp
Challenge Calendar and submitting the results.
Sharing expert health advice
Seattle Children’s is helping Denise Louie Education Center
(DLEC) improve the health and well-being of the children
and families it serves. DLEC offers Head Start programs
for children ages 3 to 5 in four south and central Seattle
locations, which primarily serve immigrants and refugees.
During 2009, Children’s hosted several health promotion
events for DLEC families, including a “Healthcare Institute”
that taught basic skills like how to take care of a sick child
at home, when to seek medical care and how to use the
healthcare system. During “Oral Health Night,” pediatric
dentistry residents from the University of Washington
provided free dental screenings and education for parents
about the care of their children’s oral health. Experts from
Children’s promoted child safety to DLEC families by
selling and fitting low-cost bicycle helmets and car seats.
Identifying partners for injury prevention
Building connections with community organizations
and individuals, minimizing duplication of services, and
maximizing resources are essential elements of successful
injury prevention programs. The Injury Free Coalition for
Kids of Seattle recently conducted an “organizational
mapping” initiative to identify Seattle-area organizations
working toward similar goals. The project engaged dozens
of citizens who contributed information for the map.
Because injury risk is greatest among children and teens
who live in central and south Seattle, the group ultimately
$9 million
invested in community programs in 2009.
As part of our
partnership with
Denise Louie
Education Center,
which offers Head
Start programs in
south and central
Seattle, we provided
bike helmets to child-
ren and their families.
limited mapping activities to these areas. The Injury Free
Coalition for Kids of Seattle will use the map as a tool to
bridge injury prevention service gaps in priority areas
and to identify opportunities for future partnerships.
Children’s, Harborview Medical Center and Public Health
Seattle & King County formed Injury Free Seattle in 2002.
Educating the community about immunizations
Seattle Children’s wants to help answer the community’s
questions about immunizations. A leadership member
of the Immunization Action Coalition of Washington,
Children’s chairs its Public Education and Awareness
Committee. During 2009, the committee developed
educational materials and Web-based information
at www.immunizewa.org that can help families make
informed decisions about immunizations. The information
covers a range of immunization-related issues relevant to
children of all ages. In addition, Children’s collaborated
with Group Health Foundation, WithinReach, the state
Department of Health and others to understand parental
concerns about immunizations.

20 Seattle Children’s Community Benefit Report 2009

Taking safety on the road
Thanks to a partnership with Kohl’s Department Stores,
Seattle Children’s introduced the Health and Safety Van
to bring safety and injury prevention information and
free or low-cost safety gear to communities throughout
Washington. The program emphasizes service to
communities that may not have ready access to safety
education and tools. The van carries information about
water safety, child passenger safety, childproofing at
home, nutrition, sports injury prevention and other topics.
Safety gear includes bike helmets, booster seats, life
jackets and home safety items. In 2009, the program’s
first year, the van visited community events and Kohl’s
stores throughout the Puget Sound region.
The Health and Safety Van brings safety information and free gear to
communities throughout Washington.
Being a Good Neighbor
Offering transportation options
In an effort to ease traffic concerns in Seattle Children’s
neighborhood — and to reduce environmental impacts
— nearly two-thirds of Children’s employees commute to
work by foot, bicycle, bus, car pool or van pool. Incentives
include free bus passes, fully subsidized van pools, ride-
matching services, shuttles connecting Children’s with the
region’s major transit hubs and innovative bike programs.
Children’s makes bus travel more convenient for employees
through the Transit Now initiative, a partnership with King
County Metro that adds 63 trips per week on bus routes
near Children’s sites. Children’s also launched the Company
Bike program in 2009, which provides employees with
bicycles in return for their pledge to bike to work at
least two days per week. These efforts helped Children’s
earn the prestigious Diamond Ring Award in 2009
from Commuter Challenge, a nonprofit organization
dedicated to solving transportation issues in the
Puget Sound region.
Children’s partnered
with Feet First to
create a walking map
of the neighborhoods
surrounding the
B u i l d i n g W a l k a b l e Communities
hospital to improve
the health of
employees, patient
families and the
community.
Inspiring neighborhood discovery
To improve the health of employees, patient families and
the surrounding community, Seattle Children’s partnered
with Feet First to produce a walking map of attractions
near the hospital. Feet First is dedicated to building
walkable communities in the Puget Sound region. The
“Neighborhoods Around Seattle Children’s” map is part
of Feet First’s “Neighborhoods on Foot” map series. The
Children’s map features routes for nature walks, exercise,
quick breaks and grocery runs. Maps also include safety
tips and a list of community resources for active living and
neighborhood involvement. To date, Children’s has distrib-
uted more than 2,000 maps to employees, patient families
and neighborhood organizations, including schools.
Supporting Organizations with
Complementary Missions
Encouraging healthy lifestyles
Research indicates that kids who develop exercise habits
in their teen years or earlier are more likely to maintain
those habits for life. Girls on the Run of Puget Sound,
with support from Seattle Children’s, is using the power
of running to prepare girls for a lifetime of self-respect
and healthy living. The program combines training for
a 3.1 mile (5K) running event with uplifting lessons that
encourage positive emotional, social, mental and physical
development. Certified athletic trainers from Children’s
provide injury prevention information and advice for
volunteer coaches who work with the girls at various
schools. The program serves girls in third through fifth
grades throughout the Puget Sound region. Ultimately,
Girls on the Run aims to reduce adolescent depression,
eating disorders, substance abuse problems, pregnancies
and confrontations with the justice system.
Supporting community partners
Seattle Children’s supports community organizations
through sponsorships. In 2009, we donated over
$214,000 and sponsored more than 100 organizations.
Seattle Children’s Community Benefit Report 2009 21
People Making a Difference: Katherine Flynn
Katherine Flynn, RN, is passionate about the links that Seattle
Children’s regional clinics create in local communities. As
nurse manager of Seattle Children’s Olympia clinic and a
longtime Olympia resident, Flynn and her team work tirelessly
to improve the health and well-being of children in Olympia
through community partnerships.
“We are part of the fabric of the community. We live here
and raise our kids here, so we feel a sense of urgency about
bringing the same quality of care children receive in Seattle
to families in southwest Washington,” says Flynn.
Most patients come to the Olympia clinic as a result of
referrals from local pediatricians.
“I’m really proud of the partnerships we’ve built with
community physicians, because they’ve been the key to
our success,” notes Flynn. “Children’s has a great reputation
because we are very responsive to the needs of this
community.”
In addition to caring for patients and managing the
Olympia clinic, Flynn helps teach the next generation of
pediatric providers by inviting family practice residents from
Providence St. Peter Hospital and nursing students from
South Puget Sound Community College to train at the clinic.
“We want to light fires in as many young people as possible
about caring for kids in their own communities,” she says.
22 Seattle Children’s Community Benefit Report 2009
Katherine Flynn
creates links between
Seattle Children’s
Olympia clinic and
local communities to
improve the health
of children in south-
west Washington.
“ We are part of the fabric
of the community.”
— Katherine Flynn, Seattle Children’s
Olympia Clinic Manager
Since Flynn began managing the clinic 12 years ago,
she has witnessed a dramatic increase in the number of
overweight and obese children who visit the clinic. But
helping those patients adopt healthy habits proved
challenging due to a lack of community resources.
“We looked for affordable programs that combined
physical activity with nutrition education, but nothing was
available here in Olympia,” recalls Flynn. “I was determined
to do something to help.”
She led the effort to involve Children’s Olympia clinic
in the Strong Kids/Strong Teens program at local YMCAs.
The program teaches families about exercise and nutrition.
“I’m really excited about our new partnership with local
YMCAs,” says Flynn. “Education is a big part of the solution.”

Keeping Kids Safe and Healthy
At the start of the recent recession, communities
throughout the United States identified a troubling trend:
a dramatic increase in child abuse and neglect. At Seattle
Children’s, clinicians noted a spike in the number of
babies who suffered from abusive head trauma.
During a typical year, Children’s and Harborview
Medical Center treat approximately 10 infants for
abusive head trauma. But during the fall of 2008, both
institutions cared for 18 infants with this diagnosis
during a three-month period.
“Though we can’t say there’s a direct cause-effect
relationship between the economic crisis and child abuse,
we can say that an increase in frustration or stress can
lead to abuse, regardless of the reason for the increased
stress,” says Carol Jenkins, manager of Children’s
Protection Program.
To keep children safe, Jenkins says, communities need
to ensure that families feel safe and supported. One way
that Children’s is working to prevent child abuse is through
education. In partnership with the Council for Children &
Families, Conscious Fathering and the Parent Trust for
Washington Children, Children’s created a public service
video to help new parents cope with the stress of a
crying infant — and prevent shaken baby syndrome.
The video, titled “Have a Plan,” features parents who
share real-life experiences and tips.
Staff at Odessa
Brown Children’s
Clinic provide
medical care,
mental health
and legal care to
families through
the Medical-Legal
Partnership for
Children.
Children’s also supports families through the Medical-
Legal Partnership for Children, a service available through
Odessa Brown Children’s Clinic, Harborview Children
and Teens Clinic, and Northwest Justice Project. The
partnership provides legal services to families of patients
who are facing social, housing, immigration, economic
and legal problems that can negatively affect a child’s
health. For example, a child with asthma living in moldy,
substandard housing might make repeated trips to the
hospital with severe breathing problems. Intervention
by a physician, social worker and a lawyer that results in
improving the family’s living conditions can positively
impact that child’s health.
The Medical-Legal Partnership for Children launched
as a pilot project in 2008. Children’s hopes to expand the
program to more families in need when the pilot period
ends in 2011.
Seattle Children’s Community Benefit Report 2009 23
Advocacy
Seattle Children’s doctors, nurses and staff speak up for the health of children and communities.
Advocacy has been a core component of Children’s work for more than 100 years. Working
in partnership with community leaders, organizations, families and policy makers, we draw on
our unique expertise to improve children’s health, safety and access to quality healthcare.

Promoting organ donation

Dr. Frederick Rivara was part of the Institute of Medicine and the National
Research Council, which found that current services for teens need reform.
Dr. Rivara was also a co-editor of the “World Report on Child Injury
Prevention” released by the World Health Organization and UNICEF.
Advocating for the Needs
of Kids and Families
Improving healthcare for teens
Dr. Frederick Rivara of Seattle Children’s was part of an
18-member committee at the Institute of Medicine and the
National Research Council that evaluated healthcare for
adolescents — and discovered that current services need
reform. The report, titled “Adolescent Health Services:
Missing Opportunities,” found that some young people,
particularly those who are uninsured or underinsured,
have little or no access to mainstream primary care
services. The report also expressed concern that many
health professionals lack the skills to interact effectively
with this age group. To address these challenges, the
authors recommend that both federal and state policy
makers develop strategies to ensure that all adolescents
have comprehensive, continuous health insurance
coverage, and that regulatory bodies incorporate
competencies in adolescent care in their licensing,
certification and accreditation requirements.
On any given day at Seattle Children’s, patients are
waiting for a lifesaving or life-enhancing organ transplant.
Our physicians and nurses work diligently to improve their
chances by promoting organ donation and improving
pediatric organ transplantation. Every year during
“Donate Life” month in April, the transplant team
educates families and Children’s staff about organ
donation and becoming a registered donor. The team
is also involved with LifeCenter Northwest — the organ
procurement organization that serves Alaska, Montana,
north Idaho and Washington — and they serve on
committees of the United Network for Organ Sharing
(UNOS), the nonprofit organization that matches
organs with recipients in the United States and
collects transplant data.
Improving environmental health
Dr. Catherine Karr and Dr. Sheela Sathyanarayana,
physicians at Seattle Children’s, are using their expertise
to guide policies in children’s environmental health. Karr
— who studies the role of air pollution, climate change
and pesticides on child health — is a member of the
American Academy of Pediatrics Committee on Environ-
mental Health. In this role, she advises the Academy and
other authoritative bodies, including government, on
emerging issues. Locally, she helps develop policies on
pediatric lead-poisoning prevention and chemical safety
in children’s products. Sathyanarayana is a member of
the Environmental Protection Agency Children’s Health
Advisory Panel and a co-chair of the Academic Pediatric
Association Special Interest Group for Pediatric Environ-
mental Health. She recently served on the Governor’s
Advisory Panel to implement the Washington state
Children’s Safe Products Act. Her research focuses on the
impact of chemicals such as phthalates and bisphenol A
on child development. “Given the wide range of environ-
mental exposures in our society, it’s important that we
translate health risks and effectively advocate for policies
that protect children’s health,” says Sathyanarayana.

24 Seattle Children’s Community Benefit Report 2009

Advocating for global injury prevention
Injuries account for 1 million deaths to children and
adolescents throughout the world, whether they live in
high-income countries such as the U.S. or in low-income
countries in Asia, Latin America or Africa. But 95% of
those deaths occur in the developing world. Dr. Frederick
Rivara of Seattle Children’s co-edited the “World Report
on Child Injury Prevention” with the goal of focusing
attention on childhood injury and galvanizing governments,
nonprofit organizations and donors to action. The report,
which was released by the World Health Organization and
UNICEF, attempts to dispel the misconception that injuries
are “accidents.” Rather, it educates readers about the
predictable and preventable nature of injuries, and it
underscores the fact that prevention strategies can Neurosurgeon Dr. Samuel Browd promoted snow sports safety at
be adapted to the economics, needs and culture of The Summit at Snoqualmie snow resort with the talk “Ten Reasons a
countries and communities. Brain Surgeon Wears a Helmet.” One reason: helmets reduce the risk
of head injury by nearly 60%.

Fulfilling a Community Need

Raising awareness of snow sport safety
Dr. Samuel Browd, a neurosurgeon at Seattle Children’s,
worries about kids who engage in snow sports without a
helmet. Teenage boys and young men are at the greatest
risk. “They’re the ones who are least likely to wear a helmet,
because it’s not cool and their buddies aren’t wearing
them,” says Browd, who is part of Children’s sports
concussion team and serves the Brain Injury Association
of Washington as a board member. To promote safety
on the slopes, Browd presented “Ten Reasons a Brain
Surgeon Wears a Helmet” to families at The Summit at
Snoqualmie snow resort. As part of his presentation,
Browd described the debilitating nature of brain injuries.
He also educated listeners about concussions, which
account for 15% of all snowboarding injuries. But wearing
a helmet, Browd pointed out, reduces the risk of head
injury by nearly 60%.
Protecting kids with food allergies
The incidence of food allergies in the United States has
doubled during the last 10 years. Until there is a cure,
education about managing food allergies and preventing
severe reactions will help keep kids safe. In partnership
with the Food Allergy Initiative Northwest, Seattle Children’s
offers the Food Allergy Community Health Education
Program, which helps create safer environments for
children. Given that a new law in Washington state requires
schools to adopt food-allergy management policies, the
program meets an important community need. “With
proper training, every school and child-care facility can
have a sensible program that protects children at risk,”
says Hilary Stephens, RN, Children’s food allergy comm-
unity health educator. Stephens provides training and
educational presentations to staff and parents in a variety
of settings, including schools, preschools, daycare centers,
community centers, after-school programs and camps.
Teaching emergency preparedness
Members of Seattle Children’s Safety Systems Department
and Emergency Response Teams use their knowledge and
expertise to educate schools and community groups about
emergency preparedness — free of charge. “When you
talk about disasters, it’s not so much a matter of ‘if’ one
occurs, it’s ‘when,’ says Troy Cook, Emergency Response
Team member. “It’s beneficial to both our community
and to Children’s to be prepared.” For example, keeping
families safe reduces trips to the emergency room. “We
teach people things like not to get out of bed after an
earthquake until you put your shoes on, since stepping on
broken glass is a common after-earthquake injury,” Cook
explains. “By preparing others, we help make sure places
like Children’s, fire departments, police stations and 9-1-1
operators are not overwhelmed in the event of a disaster.”

Seattle Children’s Community Benefit Report 2009 25

People Making a Difference: Dr. Abraham Bergman
For more than 50
years, Dr. Abraham
Bergman has
practiced political
medicine. His lasting
impact ranges from
working on sudden
infant death syndrome
(SIDS) to advocating
for child protection,
bicycle helmet safety,
and regulation of
household products
and flammable
clothing.
© 2009 Will Austin:
Will Austin Photography

A pioneer among child advocates at Seattle Children’s,
Dr. Abraham Bergman’s work over the past 50 years has
improved the lives of children throughout the world.
His career as a pediatrician began in the late 1950s, before
the term “child abuse” emerged. By the mid-1960s, Bergman
had organized the first child-protection team at Children’s,
and he testified before the Washington state legislature in
1969 when the state’s mandatory child-abuse reporting law
was enacted.
An active practitioner of what he calls political medicine
— using the political process to improve public health —
Bergman’s work has resulted in several important pieces of
national health legislation, including the Flammable Fabrics
Act in 1967, the Poison Prevention Packaging Act of 1970,
the National Health Service Corps in 1972, the Sudden Infant
Death Syndrome Act of 1974, and the Indian Health Care
Improvement Act in 1976.
Locally, Bergman is best known for his work at Children’s
on sudden infant death syndrome (SIDS), with colleagues
Dr. Bruce Beckwith and Dr. George Ray. In addition to
publishing numerous research papers and several books,
Bergman served as president of the National SIDS
Foundation in the 1980s.
In 1986, in collaboration with Dr. Fred Rivara, Bergman
carried out a bicycle helmet campaign that raised usage rates
among Seattle children from 3% to over 60% during a five-
year period. As a result, admissions at five Seattle-area
hospitals for bicycle-related head injuries dropped by
approximately 67% among children 5 to 14 years old. The
bicycle helmet campaign remains an international model
for helmet-promotion efforts.
Though the campaign led to helmet usage requirements in
many Washington communities — including Seattle — Bergman
believes more can be done to ensure children’s safety.
“In my mind, the next step is statewide legislation,”
Bergman explains. “We have shown that an increase in helmet
use leads to fewer head injuries among children, and a
substantial financial savings to families and our community.
It’s only logical to ensure their use.”

26 Seattle Children’s Community Benefit Report 2009

 Medical student
Teja Dyamenahalli
provides a physical
exam to a patient
at the Country
Doctor Free Teen
Clinic in Seattle’s
Capitol Hill
neighborhood.

Caring for Homeless Youth

Accessing necessary healthcare is difficult for homeless
teens who have no money or health insurance. And
because many come from abusive homes, asking parents
for help is out of the question.
Fortunately, the Country Doctor Free Teen Clinic in
Seattle’s Capitol Hill neighborhood can help. The clinic,
which provides free primary care, is staffed by Seattle
Children’s pediatric residents under the supervision of
physicians like Dr. Ann Giesel, an attending physician
in the Adolescent Medicine Department at Children’s.
“The experience at the clinic is a chance for trainees
to learn about working with adolescents, and also about
the barriers facing homeless people,” says Giesel, the
The experience prepares residents to work with
vulnerable populations, even if they don’t plan to
work in a community setting.
“Ultimately, working at the Country Doctor clinic
increases the residents’ sensitivity to the needs of
homeless people when they encounter them in their
clinics or in the hospital in the future,” says Giesel.
“But the experience also provides training in listening
and motivational interviewing, where you try to
understand the patient’s needs and help them take
care of themselves. And those skills are clearly an
important part of training for a physician in any setting.”

“
clinic’s medical director. “For example, it’s not realistic to
expect a homeless youth to comply with a complicated
treatment regimen. Or they may not have access to
The experience at the
running water, which is challenging if they need to clinic is a chance for
soak an abscess, for example.”
There are no nurses, no pharmacists, no medical trainees to learn about
assistants — just the attending physician, the residents,
the medical students, a mental health practitioner, an working with adolescents,
acupuncturist, a massage therapist and several volunteers
with a variety of skills and backgrounds. Because the
and also about the barriers
clinic was designed as a training site, residents and
attending physicians manage most aspects of care,
facing homeless people.”
from drawing blood to dispensing medications. — Dr. Ann Giesel, attending physician

Seattle Children’s Community Benefit Report 2009 27

It Takes a Community to Raise Healthy Children
Seattle Children’s works diligently to prevent, treat and ultimately eliminate pediatric disease and
injury. Children’s serves the largest geographic region of any children’s hospital in the country.
Community support makes it possible to serve a growing population with vital services and
special programs alike. We appreciate our many partners — including donors, volunteers and
like-minded organizations — who help Children’s meet the healthcare needs of children and
families in the Northwest.

For more information or to request a printed copy of this Community Benefit Report,
please contact:
Marketing and Communications Department
Seattle Children’s Hospital
Phone: 206-987-5205
marcommrequests@seattlechildrens.org

Office address:
6901 Sand Point Way NE
Seattle, WA 98115

Mailing address:
M/S S-217
PO Box 5371
Seattle, WA 98145-5005

www.seattlechildrens.org

28 Seattle Children’s Community Benefit Report 2009

Stone Fennell fell off
his bike on his way
home from a soccer
game. “My bike
helmet — the one
we got at Seattle
Children’s Health
Fair — even had a
dent in it! I think
it’s really great that
Children’s gives out
bike helmets. One of
them saved my life,”
says Stone.
4800 Sand Point Way NE
Seattle, WA 98105
TEL 206-987-2000
TTY 206-987-2280

www.seattlechildrens.org

© 2010 Seattle Children’s, Seattle, Washington. All rights reserved.