FALL 2017

THE PEDIATRIC CENTER NEWS EMORY UNIVERSITY SCHOOL OF MEDICINE

CHILDREN’S HEALTHCARE OF ATLANTA

The National Institute of Health (NIH) renewed the designation of the Marcus Autism Center as a national Autism Center of Excellence (ACE), including an $11.25M, five-year research grant. Only five institutions in the United States are designated ACE centers in the highly competitive program, which supports large-scale multidisciplinary studies of autism spectrum disorder (ASSD), with the goal of identifying causes and best treatments.

Amazing Accomplishment!

Pediatric Faculty and Staff: Dear Friends, It is that time of the year when my heart fills with joy and gratitude as I think about the amazingly caring, dedicated, and happy group of people we are surrounded with! We truly have so much to be thankful for: our clinical and academic missions are the best they have been; we have had amazing success in recruiting new talent; our training programs are thriving and excelling; our research program has achieved the highest ranking ever and we just heard of our institutional K12 grant funding which will allow us to grow our cadre of young clinician scientists!

Work related to the Pediatric Institute is proceeding smoothly and we expect the master affiliation agreement between Emory and Children’s to be signed before the end of the year. We will continue to keep you posted about new initiatives and the implementation timeline. This note is simply to thank you for everything you do to make us what we are. From Ms. Shirley who keeps our hallways clean to Chris Mercer who keeps us wired and connected, to Dr. Dean McKenzie who operates on tiny hearts in premature infants, I can’t thank you enough for everything you do and, most importantly, for the “can do” attitude you bring to work every day!

Happy Thanksgiving to all! Lucky

FALL 2017

FACULTY UPDATES 1. Parminder Suchdev, MD, Associate Professor of Pediatrics, has been awarded the 2017

Emory University School of Medicine Dean’s Teaching Award. This award recognizes Dr. Suchdev as a role model and mentor for students in Emory classrooms and/or clinics, in addition to his service to the education mission of the School. The conferral of this award signifies that Emory University students and colleagues hold Parminder in the highest esteem for his dedication and skill in teaching students.

2. Susie Buchter, MD was elected Chair of the ACGME Pediatrics Residency Review Committee. The RC Chair is selected by members of the Committee for a three-year term and this selection reflects the support and admiration of a highly elite, specialty group. 

3. Raymond Schinazi, PhD, DSc, Professor of Pediatrics, Frances Winship Walters Professor of Pediatrics and Director of the Laboratory of Biochemical Pharmacology, has been appointed as the Affiliated Professor of the lnstitut Pasteur for his role in creating several major HIV and Hepatitis C drugs that are still in use today. The Institut Pasteur is an international research and education institute that is committed to advancing science, medicine, and public health. The four core missions of public interest include research, education, the health of populations and people, innovation development and technology transfer.

4. Lindee Morgan, PhD, Assistant Professor of Pediatrics, has been appointed to serve on the Executive Board of the Atlanta Autism Consortium.

5. Mindy Scheithauer, PhD, Assistant Professor of Pediatrics, has been appointed for a 2-year term as an Associate Editor for the Journal of Applied Research in Intellectual Disabilities.

6. Will Sharp, PhD, Professor of Pediatrics, co-chaired the formation of the Interdisciplinary Pediatric Feeding Research Consortium (IPFRC), comprised of multidisciplinary feeding programs throughout the United States who offer intensive day or inpatient treatment for children with chronic and severe feeding difficulties. Members include Children’s Hospital of Philadelphia, Children’s Hospital of Wisconsin, and the Kennedy Krieger Institute at Johns Hopkins.

7. The Aflac Cancer and Blood Disorders Center was once again named one of the best pediatric cancer programs in the country by U.S. News and World Report. This honor is in recognition of outstanding clinical care we provide as well as the advances we are making in translational research for our children with cancer and blood disorders.

8. Robert Sidonio, MD, Assistant Professor of Pediatrics, was elected to the Medical and Scientific Advisory Council (MASAC). MASAC was created in 1954 to issue recommendations and advisories on treatment, research and general health concerns for the bleeding disorder community.

9. Bernardo Mainou, PhD, Associate Professor of Pediatrics, was appointed Interim Director of the Center for Childhood Infections and Vaccines (CCIV). In addition, Dr. Mainou is also serving on both the Recruitment Committee and Executive Board of the Microbiology and Molecular Genetics Graduate Program.

FALL 2017

10.Ann Chahroudi, MD, PhD, Assistant Professor of Pediatrics, served on the Scientific Committee of the 35th Annual Symposium on Nonhuman Primate Models for AIDS in Madison, WI in August 2017.

11.Gregory Melikian, PhD, Professor of Pediatrics, has been appointed as the Chair of the National Institutes of Health, AIDS Molecular and Cellular Biology Study Section.

12.W. Matthew Linam, MD, Associate Professor of Pediatrics, has been appointed Chair of the Society for Healthcare Epidemiology of America 2018 Spring Meeting Planning Committee. The Society for Healthcare Epidemiology of America (SHEA) is the main academic society for healthcare epidemiologists and physicians working to reduce healthcare associated infections and improve antibiotic stewardship. In addition, Dr. Linam has also been appointed as the Medical Director for Quality Improvement for Pediatric Infectious Diseases and as the Medical Director of the Vascular Access Team starting in August of 2017.

13.David O’Banion, MD, Assistant Professor of Pediatrics, was selected as a young investigator research scholar by the Society for Developmental and Behavioral Pediatrics to present an abstract on proposed research in resident education using an interactive and investigational screening measure. In addition, Dr. O’Banion led a committee meeting at the national Society for Developmental and Behavioral Pediatrics meeting in Cleveland, OH in October 2017.

14.Stephanie Holt, MD, Assistant Professor of Pediatrics, has been selected to be part of the Society for Adolescent Health and Medicine Education Committee which is a national committee dedicated to creating and disseminating adolescent curriculum materials to adolescent health professionals and trainees.

15.Douglas K. Graham, MD, PhD, Professor of Pediatrics, was honored at this year’s American Cancer Society Hope Ball, receiving a Rising Star Award. The theme of this year’s Hope Ball was childhood cancer awareness and Dr. Graham’s lab was the recipient of the American Cancer Society Boost Award.

16. Karen Effinger, MD, Assistant Professor of Pediatrics, was awarded a 2017 Synergy Award based on the original and collaborative ideas of the proposed project. The Synergy Award is for a pilot project entitled Improving Health-Promoting Behaviors in Adolescent Cancer Survivors Using AWAKE: A Feasibility Trial. The project will focus on improving wellness in AYAs.

17. Mehul V. Raval, MD, MS was named Director for the Center for Clinical Outcomes Research & Public Health (CORPH), with a special focus on surgical outcomes.

18. Clint Joiner, MD, PhD, was appointed as the Emory University Department of Pediatrics Vice Chair for Research.

19.William Sexson, MD, MAB, FAAP was awarded the 2017 Leila D. Denmark Lifetime Achievement Award. This is the highest award the Georgia Chapter of AAP can bestow and is awarded to a Chapter member in recognition of their lifetime of work and contributions in pediatrics.

Welcome to Stefan Sarafianos, PhD who has joined us in the Division of Biochemical Pharmacology and will serve as the Nahmias-Schinazi Chair. He comes to Emory after serving as the Chancellor’s Excellence Endowed Chair in Molecular Virology at the University of Missouri and Professor of Molecular Microbiology & Immunology as well as Biochemistry.

FALL 2017

IN THE NEWS:

The U.S. Food and Drug Administration has deemed an anemia test developed at Emory, Georgia Tech,  and Children’s Healthcare of Atlanta to be as safe and effective as similar devices in the marketplace. The test, called AnemoCheck, received FDA approval as a 510(k) “premarket submission,” which signifies a major step forward in bringing the test to the clinical marketplace. A product of Sanguina — an Emory and Georgia Tech startup— AnemoCheck was invented by Georgia Tech biomedical engineering student Erika Tyburski and professor and pediatric hematologist/oncologist Wilbur Lam. The test may ultimately supplant standard lab tests by screening for anemia in just a couple of minutes, using less than a half a d rop o f b lood . More about AnemoCheck : h t tps : / /www.sanguina.com/anemocheck

New digestive/liver disease gene identified by international teamWoodruff Health Sciences

In a study published in September in Hepatology, a multinational team of researchers describes a newly identified cause of congenital diarrhea and liver disease in children.The rare disorder is characterized by significant diarrhea beginning soon after birth, low serum levels of fat-soluble vitamins and evidence of liver disease. Despite continued symptoms, with medical support, the children grow and develop normally, at least to the age of 12.Researchers from Emory University School of Medicine and Children’s Healthcare of Atlanta , working with colleagues from Makassed Hospital, Al-Quds University and Hadassah Medical Center, Hebrew University of Jerusalem studied a family with two children from the Palestinian territories who suffer from the disorder. The team found that both children had inherited a mutation in a gene responsible for the transport of bile acids, which facilitate the digestion and absorption of dietary fats and fat-soluble vitamins. Although mutations had been identified in other genes important for the recycling of bile acids, this is the first report in humans of disease-associated defects in this gene, called Organic Solute Transporter-beta (SLC51B).Almost 20 years ago, pediatric GI & hepatology researcher Paul Dawson, PhD, and colleagues identified mutations in another bile acid transporter gene (ASBT; SLC10A2) that caused congenital bile acid diarrhea.Read more: Click Here

Georgia couple raising twins with cystic fibrosis Fox5 News ATLANTA - Checkups at Children's Healthcare of Atlanta are a family affair for Amanda Hively and her husband, Matt, and their 20-month old twins Mason and Grayson. "What they do is fantastic, taking care of 2 kids with cystic fibrosis," says Children's CF specialist Dr. Rachel Linnemann. "Taking care of one kid is hard enough.  It takes a village. And having twins really doubles your work.”Read More: Click Here

FALL 2017

DEPARTMENT OF PEDIATRICS EVENTS RECAP

1. AUGUST 30TH: Raymond Schinazi Distinguished Lectureship featured Professor Peter Vogt, PhD from the Department of Molecular Medicine at the Scripps Research Institute.

2. OCTOBER 17TH: October was a busy month for the Department of Pediatrics. On the 17th we hosted the 2017 Faculty Awards, Dr. Jain was announced Chairman of the Department, Mr. Bernie Marcus met with the 15 Marcus Professors, and we held the Visiting Marcus Professor Lecture!

Professor Peter K Vogt, PhD was trained as a virologist at the Max-Planck-Institute in Tubingen, Germany and at the University of California, Berkley. His lecture focused on MYC and the Non-Coding Transcriptome. He has made ground-breaking contributions to our knowledge of the cellular and molecular biology and to the genetics of retroviral infections, including the interaction between viral and cellular receipts, genetic recombination between retroviruses, and endogenous retroviral genomes. Dr. Vogt is also an avid painter and formally studied under artist, Josef Versl.

The 2017 Faculty Awards

FALL 2017

Research Awards Junior Faculty Researcher: Shri Deshpande (Sibley Heart Center)

Best Scientific Publication- Basic Science: Christopher Doering (Aflac)• Enhancing The Pharmaceutical Properties of

Protein Drugs using Ancestral Protein Reconstruction. Nature Biotechnology

Best Scientific Publication-Clinical/ Translational: Subra Kugathasan (GI)• Prediction of Complicated disease course for

Children newly diagnosed with Chron’s disease: a multicentre inception cohort study. Lancet

Teaching Awards Teacher of the Year- General Pediatrics: Yuri Okuizumi-Wu (Gen Peds)

Teacher of the Year-Subspecialty: Bess Schoen (GI)

Innovations in Teaching Program Development: Kiran Hebbar (CCM) & Kara Prickett (ENT)

Career Teaching Award: Barry Warshaw (Nephrology)

Clinical Awards Joe Snitzer Master Clinician- Excellence in Clinical Judgement: Dawn Simon (PACS)

Innovations in Clinical Program Development: Andrew Muir (Endocrinology)

Humanitarian Award for Compassionate & Patient/Family-Centered Care: Ana Pimentel (General Pediatrics)

Mentoring Awards Research Mentor: Evan Anderson (Infectious Diseases)

Teaching Mentor: David Carlton (Neonatology)

Career Development Mentor: Larry Greenbaum (Nephrology)

Appreciation Awards Service Appreciation: Shirley Harper

Service Appreciation: Diane Callaway

Chair’s Awards Brumley Leadership Award: Ami Klin (Marcus Center)

Chair’s Award for Service to the Department: Chris Mercer (Information Technology)

FALL 2017

Department of Pediatrics Chair Announced

Donna Hyland (CEO of CHOA) and Dr. David Stephens (Interim Dean, SOM)

announced that Dr. Lucky Jain has been named the Chair, Department of

Pediatrics, Chief Academic Officer, CHOA, and Executive Director, Emory

+Children’s Pediatric Institute.

Marcus Visiting Professor Lecture: Stephan Grupp,

MD, PhD Dr. Grupp is the Chief, Cellular

Therapy and Transplant Section and Director, Cancer Immunotherapy Program (CHOP). His engaging

lecture on The CAR T Revolution in Leukemia shared his groundbreaking

work in the field of pediatric oncology research.

Bernie Marcus, along with Dr. Fred Sanfilippo (CMO) and Jay Kaiman (President) of the Marcus Foundation visited Emory and met with the 15 endowed-Marcus Professors in the Department of Pediatrics. They participated in a round table discussion as they shared their research updates with Mr. Marcus. We are indebted to his generosity and support for Pediatrics!

FALL 2017

Resident’s Corner: 5-Word Story Project

As part of their Humanism curriculum, Dr. Hughes Evans worked with the residents on creating 55 word stories.  55-word stories are a quick way to capture the moments in clinical practice or life that are particularly meaningful to the writer.  The prompt for these stories was simply to describe a work-related event that was particularly memorable for you.  The residents wrote these and shared them

with each other.

Nights Sweats

ER. 5E. ER. 5W. 2:15 already? Cliff bar. Score. Notes complete. Day shift arrives. No calls. Tachycardia stable. Found my car. Was that a stop sign? Home. Fridge empty. Kroger sushi not half bad at 8am. Home. Bed. Finally. Toss. Turn. Tornado sirens? Seriously? Is it considered night sweats if it’s the afternoon?

-- J.P. Stevens

Admitting Day

Cough, fever, runny nose, work of breathing. 5 new patients today, all the same complaints. Smoke, weather changes, everybody sick at school. It is only December and we have a long was to go ‘til spring. My throat feels itchy. ED calls – another new patient has just arrived. Cough, fever, runny nose, work of breathing.

-- Stefani Su

First day. No friends. No family. No shoulders to cry on. Step 1: find the nursery. Looks familiar. Should I be doing something? Visitors, what nice seniors. Rounding. So many babies. I don’t know anything about breastfeeding. Will I ever have the answers? Relief, day done! Now where did I park?

-- Kritika Patel

FALL 2017

RESEARCH UPDATES

2017 preliminary NIH research rankings were announced this week. We made it to #4 among all Pediatric Departments in the country (up from #5 last year)!

Congratulations to our entire research team for this feat!

Emory University School of Medicine recognized the following Department of Pediatric faculty on Researcher Appreciation Day as researchers who are making a difference in their field: Ann Chahroudi, MD, Professor of Pediatrics; Mike Davis, PhD, Associate Professor of Pediatrics; Warren Jones, PhD, Assistant Professor of Pediatrics; Cassandra Josephson, MD, Associate Professor of Pediatrics, Subra Kugathasan, MD, Professor of Pediatrics; Gregory Melikian, PhD, Professor of Pediatrics; Ann Mertens, PhD, Professor of Pediatrics; Cheng-Kui Qu, MD, PhD, Professor of Pediatrics; Mehul Raval, MD, Assistant Professor of Pediatrics; Mehul Suther, PhD, Assistant Professor of Pediatrics; Miriam Vos, MD, Associate Professor of Pediatrics; Elizabeth Wright, PhD, Associate Professor of Pediatrics. Other Department of Pediatric nominees included: Douglas K. Graham, MD, PhD, Professor of Pediatrics; Jennifer Kwong, PhD, Assistant Professor of Pediatrics.

Ann Mertens, PhD, Professor of Pediatrics, was inducted into the Emory Millipub Club, Oct 18, 2017. The article was one of the seminal articles from the large cohort project established by Dr. Mertens while in Minnesota. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, Friedman DL, Marina N, Hobbie W, Kadan-Lottick NS, Schwartz CL, Leisenring W, Robison LL. Chronic Health Conditions in Adult Survivors of Childhood Cancer. N Engl J Med. 355:1572-82, 2006.

Ann Chahroudi, MD, PhD, Assistant Professor of Pediatrics, will serve as a Principal Investigator on the NIH/NIAID “Immune interventions in SIV-infected ART-suppressed infant macaques”. Annual Direct Costs are $480,400, and the Project implementation period is between 8/2017-7/2022. This new R01 funding (R01AI133706) will allow the Chahroudi Lab to test immune interventions in a novel model of postnatal SIV infection

and ART suppression in infant rhesus macaques. If her project is successful, this approach will result in decreased viral reservoirs or virologic control following ART

interruption, thereby providing information that may assist in the design of new therapeutics for HIV-infected babies.

Mehul Suthar, PhD, Assistant Professor of Pediatrics, has new funding - 2U19AI100625-06 (Baric), $35,057, 08/05/2017-08/31/2022 NIAID/University of North Carolina-Chapel Hill, Mouse Core B entitled Systems Immunogenetics of biodefense and emerging pathogens in the collaborative cross. The overarching goal of this project is to utilize the Collaborative Cross and Human cohorts to understand how host genetic variation impacts virus-induced immunity and disease.

FALL 2017

Wellness Corner

Wellness Wednesday’s are off to a great start!

In September we launched our Pediatric Center Wellness Wednesday Initiative which takes place on the first Wednesday of every month. It

focuses on a different wellness-related activities that range from walking groups to cooking demos. Check your email for future events.

Open to all Pediatric Center Faculty and Staff!

November: Mason jar salads are an easy and healthy

lunch to pack! The fast and colorful cooking demo was

enjoyed by all!

October: It was a beautiful sunny day for an outdoor

circuit workout on the HSRB lawn!

September: Walk the Bridge Event. Did you know if you

walk the bridge between the HSRB and ECC buildings 10

times it is .25 miles?

FALL 2017

Wellness Advice & Activities

How Mindfulness Can Make for Better Doctors By: Pauline W. Chen, MD New York Times Oct. 15, 2009

Go to the CareForce internal website for wellness events and workout

class schedules

December 6th Wellness Wednesday:

Join us from11:30-1:30 in the HSRB Cafe for Stress

Free Zone activities & chair massages!

Check out: Journal of American

College of Surgeons: The Hidden Cost of Medicine By: R James Valentine,

MD, FACS

Be on the lookout for Wellness Grand Rounds at Egleston!

Healthy Emory has resources from gym discounts to webinars on eating right! Check it out

Here

Reminder: Get your flu

shot!

One night during my training, long after all the other doctors had fled the hospital, I found a senior surgeon still on the wards working on a patient note. He was a surgeon with extraordinary skill, a doctor of few words whose folksy quips had become the stuff of department legend. “I’m sorry you’re still stuck here,” I said, walking up to him.

He looked up from the chart. “I’m not working tomorrow, so I’m just fine.”

I had just reviewed the next day’s operating room schedule and knew he had a full day of cases. I began to contradict him, but he held his hand up to stop me. “Time in the O.R.,” he said with a broad grin, “is not work; it’s play.”

For several years my peers and I relished anecdotes like this one because we believed we knew exactly what our mentor had meant. All of us had had the experience of “disappearing” into the meditative world of a procedure and re-emerging not exhausted, but refreshed.The ritual ablutions by the scrub sink washed away the bacteria clinging to our skin and the endless paperwork threatening to choke our enthusiasm. A single rhythmic cardiac monitor replaced the relentless calls of our beepers; and nothing would matter during the long operations except the patient under our knife. We had entered “the zone.” We were focused on nothing else but our patients and that moment.

But my more recent conversations with surgical colleagues and physicians from other specialties have had a distinctly different timbre. While we continue to deal with many of the same pressures that my mentor dealt with — decreasing autonomy, increasing administrative requirements, less control over our practice environment — the demands on our attention have gone, well, viral.

Extreme multitasking has invaded the patient-doctor relationship.

Now, along with the piles of forms to fill and blinking lights of phone calls on hold, are threads of text messages, columns of e-mails and lists of electronic medical record alerts to attend to. In this ever-widening sea of distractions, all that once gave meaning to our work and allowed us to enter the zone — the operations, the diagnostic saves, the lifetime relationships — have turned quaintly insufficient.

As one surgical colleague confided, “I still like operating, but it’s not enough. There are so many hassles it’s hardly worth practicing.”

Or as another doctor said to me recently while simultaneously typing an electronic medical record note, checking e-mail and holding a phone to his ear, “It used to never bother me to put in extra time at work. But I cannot do that anymore.”

FALL 2017

The time pressures and demands that drive this endless multitasking and loss of focus on patients have contributed to high rates of burnout among physicians. Depending on the study, anywhere from one out of every three to more than half of all doctors is suffering from burnout, with potential ly devastating cl inical implications. Doctors who are burned out are more likely to depersonalize their patients and treat them as objects rather than as individuals suffering from disease. They are less professional, exhibit less empathy and are more prone to making errors. And these physicians are also more likely to become depressed, commit suicide and leave a profession that is already facing severe shortages in specialties like primary care.

As with most other occupations and aspects of our lives, it is probably impossible to hold back the rising tide of demands on our attention. But within the clinics, the wards and the operating rooms, is there a way for physicians to do all their work and maintain their focus on the patient in front of them, without accelerating the rate of burnout?

It turns out that working and living in the zone, not just getting into it on occasion, may be one solution. Last month, The Journal of the American Medical Association published the results of a study examining the effects of a year-long course for primary care physicians on mindfulness, that ability to be in the zone and present in the moment purposefully and without judgment. Seventy physicians enrolled and participated in the four components of the course — mindfulness meditation; writing sessions; discussions; and lectures on topics like managing conflict, setting boundaries and self-care.The effects of the sessions were dramatic. The participating doctors became more mindful, less burned out and less emotionally exhausted. But two additional findings surprised the investigators. Several of the improvements persisted even after the yearlong course ended. And, those changes correlated with a significant increase in attributes that contribute to patient-centered care, such as empathy and valuing the psychosocial factors that might affect a patient’s illness experience.

I asked Dr. Michael S. Krasner, lead author of the study and an associate professor of clinical medicine at the University of Rochester, about mindfulness and its effects on physician burnout and the patient-doctor relationship.

“We all use mindfulness at some point,” Dr. Krasner said. “It’s not something that you go out and get, but it’s something you can cultivate.” Some examples of mindfulness in everyday life include nursing a baby, attending to a young child in distress or, for surgeons, being engrossed in an operation.

“Mindfulness allows us to be in a whole host of situations with a sense of equanimity. We don’t get sucked into how charged an experience is but are simply having that experience.”

While many physicians try to be present for their patients, “there are so many other distractions and traps that pull us away,” Dr. Krasner observed. Those distractions can make practicing mindfulness particularly difficult. “It’s one thing to sit and be comfortable with oneself. But trying to be mindful in a busy clinical practice can be really challenging.”

Over time, the persistent distractions of such a practice can lead to burnout. For many of the study participants, “they barely recognized certain experiences as either powerful or challenging before they moved to the next experience,” Dr. Krasner noted. The word “silo” came up again and again during the course, and the physicians recounted how they “kept their nose to the grindstone” and rarely reflected on their work. “It becomes easy to look at our patients as objects,” Dr. Krasner said, “rather than appreciating the meaning and joy of an experience, even if that experience is difficult. But lack of meaning goes hand in hand with ineffectiveness and a lack of well-being as a physician.”Acquiring the ability to be mindful in the most challenging circumstances can do more than improve a physician’s well-being; it can also sharpen clinical skills. “If something goes wrong and you fail to notice,” said Dr. Krasner, “you end up going down one path in your care. But if you fully accept these challenges — not resign yourself to them but fully accept them — you can see more clearly and proceed down a path where you have a better chance of success.”

Dr. Krasner acknowledges that courses like his may not be helpful for every doctor. “There are people who aren’t going to be interested because it may seem different, even a little frightening, to get together with colleagues and be silent for a while, then talk about these things with one another.” Instead, he proposes offering physicians in the future a “menu of options” to choose from to help prevent burnout. “But I think mindfulness should be among the menu of educational interventions that are evidence-based.”

FALL 2017

“Patients know when their doctors are or are not present,” Dr. Krasner said. “As a practitioner, I know when I’m really there for my patients and when other things are pulling me away and I’m not.” It seems fitting then that physicians, who are constantly asking their patients to be mindful — asking them to talk about how they feel — should also be able to do so themselves.

“One of the most wonderful things about practicing medicine,” Dr. Krasner said, “is that you have the opportunity to be in the middle of challenging events. Reflecting on those events while also holding them in your thoughts has to do with not only physician well-being but also patient healing.”

“If we can be mindful in the midst of those challenging circumstances,” Dr. Krasner reflected, “we can derive a greater sense of meaning from even the most demanding situations.”

Wellness, Mindfulness, Physical Activity, and Work-Life Balance are important for everyone!

Taking a break from work, Egleston Pediatric Emergency Medicine physicians and Hospitalists took a class at Orange Theory Fitness.

FALL 2017

CHOA Physician Corner: Taken from MedBytes

Increasing Census: Steps to Support Operations Children’s is experiencing a significant increase in Emergency department and inpatient volumes. To help support patient care and optimize operations during this busy season: • Consider direct admission. The Children’s Transfer Center can assist in obtaining

floor beds for stable patients in need of hospital admission. Effective Monday, Nov. 6, the Transfer Center will ask referring physicians who are calling in stable patients whether that patient can be directly admitted. As always, unstable patients in need of emergent interventions should be directed to the ED. Learn more.

• Assess non-urgent testing. Evaluate whether a visit to the Emergency room for non-urgent testing is necessary or can wait for a primary care or specialist appointment.

• Evaluate discharge time. Prioritize rounds to see and discharge patients as early in the day as possible.

CDC Releases Guidance for Treating Patients from Hurricane-Affected Areas Because post-hurricane environmental conditions may pose an increased risk for the spread of infectious disease, the Centers for Disease Control and Prevention (CDC) advises clinicians to be vigilant in looking for certain infectious diseases when assessing patients currently in or recently returned from hurricane-affected areas, including Puerto Rico and the U.S. Virgin Islands. Read the CDC’s complete recommendations.

accessCHOA Administrators: Complete Site Verification by Dec. 1 Due to a new security requirement, all practices using accessCHOA must complete site verification every six months to maintain access. The first deadline for verification is Friday, Dec. 1. If you use accessCHOA, confirm that your site administrator—this may be your practice manager, administrative personnel, or another colleague— has completed the verification process. Review a tip sheet for verifying your accessCHOA site and contact the Solution Center, 404-785-6767, for assistance.

Virometer: RSV Maintains High Prevalence The Children’s lab reported another increase in RSV (n=43), with the virus accounting for 20.7 percent of all tests the week ended Sunday, Nov. 5. Test utilization is high. Download the full Virometer and contact Clinical Microbiology Director Robert Jerris, Ph.D., 404-785-4543, before using data for presentations.

Note: BD Pump Security Update Medical technology company BD recently identified a software security vulnerability in the Alaris Point of Care Unit (PCU) model 8015, a pump used at Children’s facilities. While the risk is low—a potential cyberattacker must physically dissemble the pump to access the

FALL 2017

memory card—the Children’s Information Security and Clinical Engineering teams are taking steps to mitigate this and future threats. Learn more

Revised Visitor Restrictions Effective Thursday, Nov. 16 To align with current evidence-based research, Children’s has revised its visitor restriction and screening policies and will no longer restrict visitation by age during certain times of the year. This updated policy (Policy 1.39) is effective Thursday, Nov. 16. To maintain a safe environment for our patients, Children’s encourages staff to ask any ill or symptomatic visitors to remain home if they are unwell. Learn more.

Hospital Planning Workshops: View List of Physician Participants Children’s and architecture firm HKS launched a series of workshops to help plan the layout and design for the hospital at the North Druid Hills campus. View a list of the more than 80 physicians participating in the workshops and contact the representative of your department with ideas and feedback.

Kaprich Joined Children’s as Vice President, Physician Practice Operations and Ambulatory NursingSuz Kaprich joined the Children’s Physician Group (CPG) as Vice President of Physician Practice Operations and Ambulatory Nursing. Suz comes to Children’s from Wellstar, where she served as the Senior Director of Practice Operations. Prior to that her experience includes working at Children’s Hospital at Vanderbilt serving as the Administrative Director for the Outpatient Center, and Director of Pediatric Ambulatory Services for the University of Iowa Hospitals and Clinics. Suz will report to Jill Strickland, Senior Vice President of Physician Practice Operations, and for her Ambulatory Nursing leader role Suz will have a dotted line relationship to Linda Cole, Senior Vice-President of Operations and Chief Nursing Officer. Hicks moves to Senior Director, Physician Practice ServicesPat Hicks has accepted a new role of Senior Director, Physician Practice Services. In this role Pat will help lead our core shared services including the Contact Center, Clinical Education and Support, and Patient Access to name a few. Pat is joining us most recently from the Ambulatory Services department where she served as the Senior Director over Ambulatory Operations. In her new role, Pat will report to Jill Strickland, Senior Vice President of Physician Practice Operations. UPDATE: The Center for Advanced PediatricsThe Center for Advanced Pediatrics remains on schedule and on budget. The building will open in phases based on the completion date of each floor. Dates will be announced once finalized. Each move will be spaced 4 weeks apart with associated administrative moves taking place over a weekend (Friday-Monday) with clinic go-live taking place on Tuesday. Training will be one week prior to each floor’s designated move date. Over the next several months, a training program will be developed to cover building related processes and clinical workflows in the new space.

FALL 2017

North Druid Hills Campus Overview The North Druid Hills Campus will ultimately be home to the replacement hospital for Egleston, the Center for Advanced Pediatrics, a support staff office, acres of greenspace and miles of trails. With easy access from I-85, the new campus will give our hospital system room to grow decades into the future

Check out choa.org/breakingnewground for the master plan renderings and visit the Breaking New Ground hub on Careforce Connection for updates.

FALL 2017

IRB Update Email communication with Study SubjectsYou should not email sensitive information or the informed consent form to a study participant who does not have an Emory-affiliated email address unless you are encrypting your Emory email communication. To learn more about how to encrypt email to external parties (those without an emory.edu or emoryhealthcare.org address) with Outlook 365, check out this information from LITS. You should never use personal email (e.g. Hotmail, Gmail) for communication that involves sensitive information, including blank consent forms if those might expose private information (e.g. a health condition).Reminder: consult the IRB only for questions about Cost/In Case of Injury LanguagePlease check with your IRB study analyst if you want to follow up about your study’s Cost or In Case of Injury language, rather than going directly to OCR or OTT. Our analysts will follow up with those offices if needed to confirm if a determination has been made. Thanks!New brief guidance for screening consent/HIPAAThe IRB has recently published some brief guidance on our website about when your study may require a screening consent. This applies when study subjects will have to provide identifiable information as part of screening but before signing the main informed consent/HIPAA. There is also some handy advice for how to avoid the need for a screening consent. Please check out the template under the heading “Screening Consent” on our Consent Toolkit page and follow the link for more guidance.FDA Guidance for waiving informed consent in minimal risk studiesPreviously, there was no option to waive consent for FDA-regulated research. Now, in keeping with the 21st Century Cures Act, the FDA has released guidance for waiving or altering informed consent in studies involving no more than minimal risk. Please see the published guidance for reference. The IRB reviewer(s) will ultimately determine if consent can be waived for your study.Information about the coming NIH Single-IRB Review PolicyIn January, most new NIH grant proposals for multisite research will need to use a single IRB of record. Per the NIH: "This policy applies to the domestic sites of NIH-funded multi-site studies where each site will conduct the same protocol involving non-exempt human subjects research, whether supported through grants, cooperative agreements, contracts, or the NIH Intramural Research Program.  It does not apply to career development, research training or fellowship awards." See policy here:  https://grants.nih.gov/grants/guide/notice-files/NOT-OD-16-094.html  and an FAQ here. • After lengthy internal discussion and analysis of resources, Emory IRB has determined that we

cannot serve as the reviewing IRB for multisite clinical research studies. (We may be able to serve as the single IRB of record for multisite minimal risk studies.)

• If Emory is the lead site on an NIH grant, and is asked to take on the IRB responsibility, then the Emory IRB will work with you to obtain a quote from an independent IRB to serve as the single IRB of record. We have consulted with the NIH, who have confirmed that this option is acceptable, and we have also heard from various peer institutions that they will be taking the same path.

• What this means for you: Early in the proposal stage for multisite studies, where Emory is asked to take on IRB responsibility, you must work with OSP and the Emory IRB to identify the IRB solution, and to ensure that it is worked into the proposed budget. Consult with our IRB as early as possible to avoid complications. And thank you!

• Contact the IRB at irb@emory.edu, by phone (404)712-0720, or by stopping by 1599 Clifton Road, 5th Floor, Atlanta, GA 30322. Resources are available on our website– http://www.irb.emory.edu/

FALL 2017

Announcements & Upcoming Events

BIRCWH Program and Application Workshop

The goal of the highly-selective BIRCWH program is to train junior faculty to become independent investigators who use novel, interdisciplinary approaches to advance the science of women’s health and sex/gender research. View eligibility requirements. A free two-session BIRCWH application workshop on Nov. 28 and Dec. 5, 2017, 9:30 to 11:30 a.m., will review the application process and provide tips on developing a competitive application. To register for the workshop, email jsgros2@emory.edu and bcopel3@emory.edu. Include your name, position,

department, school, title of research study, and NIH Biosketch.

Dec. 1: Seminar with Nature Editor-in-Chief9:30 to 10:30 a.m., SOM 110. Presented by Editor-in-Chief Sir Philip Campbell, this seminar will cover lab

and research group management challenges for aspiring and current principal investigators and

researchers, and the support they increasingly need in today’s publishing environment. Audience: faculty,

postdocs, and students. RSVP by Nov. 24.

What: From the Research IT Toolbox: Tableau and Amazon Web Services

When: Thursday, December 7, 2017, 9:00 am to 10:00 am

Where: Emory-Children's Center, Room 302 Topic: “Tableau and Amazon Web Services”

Sponsored by: Pediatric Research Alliance Add to my calendar

RSVP Flyer

What: Marcus Autism Center Grand Rounds

When: Friday, December 8, 2017, 12:00 noon to 1:00 pm

Where: 2nd Floor Bellsouth Conference Room

Presenter: TBA Topic: TBA

Add to my calendar

What: Wellness Wednesday: Stress Free ZoneWhen: Wednesday, December 6, 2017, 11:30am -

1:30pmWhere: HSRB, Cafe area

Join us for stress-free activities, relaxing music, and sign up for 15 min. chair massages.

FALL 2017

Links to More News and Activities:

Center for Clinical Translational Research

Pediatrics Research

Pediatric Research Administration Services (RAS)

What: Pediatric Faculty & Staff Holiday Mixer

When: Tuesday, December 12, 2017, 4:30 pm to 7:30 pm

Where: HSRB, Cafe areaLive Music provided by the Joe Gonsden

BandRSVP by December 8th to Amanda Cantrell

at adipers@emory.edu

Emory Quality Academy at Grady

Dec. 18 and 21 8 a.m. to 4 p.m., FOB 101.

This two-day course provides an understanding of context,

methods, and culture we need to thrive in the changing health care

environment. Audience: physicians, other providers,

interprofessional team members, administrative partners, residents,

fellows. Register now.

Save the Date! Learning to be Better Teachers

Jan. 8, 2018 8 a.m. to 4:30 p.m.

This annual workshop offers faculty

an opportunity to interact with colleagues across the School of

Medicine and enhance their teaching skills. Dr. Shanta Zimmer from

University of Colorado School of Medicine is this year’s keynote speaker. More details will be

available soon.

Have a story or an update you want to share in the newsletter?

Contact Newsletter Editor Amanda Cantrell at adipers@emory.edu 404-727-1471