UCSF Benioff Children’s Hospital is distinguished as one of the nation’s best children’s hospitals and one of the top-ranked facilities in California, according to the 2010-2011 best children’s hospitals survey by US News & World Report. In eight of the 10 specialty areas that are part of the evaluation, UCSF Benioff Children’s Hospital ranks among the top 25 nationwide:
David H. Rowitch, MD, PhD, chief of neonatology, works with Kelly Fagan, RN, left, to evaluate an infant being treated for hypoxia, or a lack of oxygen at birth, with a state-of-the-art cooling blanket.
- Diabetes and endocrinology
- Heart and heart surgery
- Kidney care
- Neurology and neurosurgery
“One of the advantages UCSF enjoys is our ability to quickly seize opportunities to better address conditions that threaten death or disability, based upon our research discoveries,” says Stephen Wilson, MD, PhD, associate chief medical officer of UCSF Benioff Children’s Hospital. The hospital’s pioneering Neuro-Intensive Care Nursery (NICN) – the first of its kind in the country – exemplifies this approach.
“Neurological complications are the leading cause of mental retardation and cerebral palsy in the United States,” says David Rowitch, MD, PhD, chief of neonatology. To combat such complications, the NICN brings a team of newborn neurological specialists into the Intensive Care Nursery around the clock. For infants at risk for neurological problems, the specialists and nurses use advanced monitoring equipment and new protocols to enable early diagnoses, improved treatment, and early and informed counseling of families regarding treatment options.
Championed by two internationally recognized clinical researchers – Rowitch and neonatal neurologist Donna Ferriero, MD, interim chair of the Department of Pediatrics – the UCSF NICN has documented some early successes that include:
- Rapid diagnosis of seizures, including clinically silent seizures, the long-term impact of which can then be mitigated with medication.
- Development of a procedure that can lessen the long-term neurological impact on infants whose brains and spinal cords have been deprived of oxygen, a condition known as hypoxic-ischemic encephalopathy.
- Extensive experience with magnetic resonance imaging (MRI) of infants, which enables further identification of potential brain problems.
Cancer is another life-threatening condition that illustrates the advantages of UCSF pediatric care. It begins with rapid response to a patient’s physical and emotional needs. “We usually see newly referred patients the same day,” says Kate Matthay, MD, chief of pediatric hematology and oncology.
Patients then receive treatment at an institution internationally recognized for its expertise across the entire spectrum of childhood cancers. Experience with established protocols is complemented by leading clinical trials.
Child Life specialist Tiffany Martorana and Christopher Weekly in the teen center at the UCSF Benioff Children's Hospital.
“About 40 of us who specialize in pediatric cancer – oncologists, surgeons, radiotherapists, pathologists, radiologists, nurse practitioners and social workers – come together every week to discuss new or difficult cancer cases,” says Matthay. “This multidisciplinary approach has led to tremendous success in treating our patients and improving their quality of life.”
Treatment for leukemia, the most common form of childhood cancer, is a particular strength because individual UCSF oncologists hold leadership roles in the national consortium of pediatric oncology, the Children’s Oncology Group. “Our clinical-translational studies enable us to better identify genetic mutations in pediatric leukemia, as well as to evaluate early response to therapy, leading to more specific treatments,” says pediatric cancer specialist Mignon Loh, MD.
In addition, dramatically improved survival rates for childhood cancer patients have created a new challenge: These patients often experience side effects well into adulthood, including secondary cancers, fertility problems, psychological and emotional problems, learning difficulties, organ dysfunction, and problems getting access to health care and insurance. Since 2005, the UCSF Survivors of Childhood Cancer Program has provided these patients with long-term follow-up care and support for both medical and nonmedical issues.
Range of Treatment and Preventive Services
Other conditions and procedures for which UCSF offers patients and their families unique benefits include:
- Blood and Marrow Transplant: The UCSF Pediatric Blood and Marrow Transplant Program is among the largest transplant centers for children in North America. It is recognized for the use of alternative donors for treating children with leukemia and marrow failure syndromes when a perfectly matched sibling is not available, which happens about 80 percent of the time. UCSF is also known for expertise in treating children with primary immune deficiency (PID) – in particular. severe combined immunodeficiency disease (SCID), also known as bubble boy syndrome. “Our team provides the full spectrum of medical and psychosocial support for patients and their families,” says Morton Cowan, MD, program chief. Cowan is principal investigator of a recently funded consortium of institutions in North America studying children with PID that is aimed at identifying the optimal treatment approaches for these rare diseases.
- Congenital Heart Conditions: The Pediatric Heart Center offers the most advanced diagnostic and treatment techniques for congenital heart disease. Sophisticated imaging detects problems during fetal development, even during the first trimester. This gives families more time to consider treatment choices, and helps health care teams better manage the pregnancy and lessen the risks of potential procedures after birth. For treatment, UCSF clinicians have pioneered interventional catheterization and surgical techniques. “Advanced technology, innovative techniques and extensive surgical experience all contribute to children and adults with congenital heart disease living longer and better lives,” says David Teitel, MD, chief of the Division of Pediatric Cardiology.
- Organ Transplant: In transplant procedures, experience matters. UCSF is home to pediatric liver and kidney transplant programs that are among the oldest and most active in the country. UCSF also is one of the few centers nationwide offering intestinal transplant for children.
- Fetal Treatment: UCSF physicians pioneered the field of fetal intervention. “When there is a clinical advantage in addressing birth defects before birth, our team has more experience with fetal intervention than any institution worldwide,” says Diana Farmer, MD, surgeon in chief at UCSF Benioff Children’s Hospital. Fetal intervention – whether surgery or a less invasive procedure – involves a team of specialists who correct a life-threatening complication in the fetus while it remains positioned in the mother’s uterus.
- Craniofacial Anomalies: Conditions of the face, head and neck, such as cleft lips and palates or congenital skull deformities, can dramatically affect children’s quality of life. The Center for Craniofacial Anomalies, a patient care service of the UCSF Dental Center, addresses all aspects of these conditions with team care that involves surgeons, dentists, nurses, speech pathologists, social workers and genetic counselors. The UCSF Dental Center also operates a pediatric dentistry clinic, which provides basic dental care as well as treatment of unusual dental problems for children and adolescents. In addition, the center operates an orthodontic clinic offering a full range of orthodontic services for both children and adults.
- Sleep Disorders: One in every four children experiences a sleep disorder, which can contribute to mental processing and learning disorders, attention deficit hyperactivity disorder, and aggressive behavior. The Sleep Disorders Center at UCSF can diagnose the problem and work with the referring physician and the family to create an ideal treatment plan.
Meeting Emotional Needs
Teams at UCSF know that caring for an ill child involves much more than medical treatment, emphasizes Roxanne Fernandes, executive director of UCSF Benioff Children’s Hospital. Such understanding is part of every piece of the care process, including programs designed specifically to meet children’s emotional needs.
Child Life Services at UCSF Benioff Children’s Hospital helps children and families adjust to and understand illness and its treatment through programs that include child life specialists, music therapy, art therapy, journal projects and animal therapy, featuring a service dog named Nilani that is specially trained to visit hospitalized children. In addition, while children are in the hospital, they can receive instruction from credentialed teachers. And when they leave, they receive support from a widely respected school reentry program operated by Child Life Services.
And for patients and families facing chronic illness or end-of-life concerns, nurse practitioner Robin Kramer, RN, created the Compass Care program to relieve suffering and improve quality of life.
“Our team of doctors, nurses, social workers, child life specialists, spiritual care staff and pharmacists are specially trained in palliative care, and they work closely with one another to meet a child’s physical, emotional, social and spiritual needs,” says Kramer.