A Message from Shelly Voet, MD

January 24, 2022

Hello to my fellow PCPs and providers,

I hope you are doing well as we continue to care for kids during another surge.  Thanks for taking some time to review Synapse. By the time this reaches you, it is likely you will have heard about the devastating loss of Dr. Hector Wong, Vice Chair of the Department of Pediatrics, this weekend. His contributions in pediatric critical care, research, education, and leadership are detailed in this issue.  Those of us who trained while Hector was at CCHMC knew him as an outstanding clinician and educator.  We appreciated his systematic, logical, and calm approach in even the most complex situations. Our hearts go out to his wife Sue Poynter MD, his parents, his children, and his co-workers at CCHMC.

This issue also includes information about the practice based Smoke Free Families QI opportunity from the Ohio AAP; information about two Emergency Department studies that may potentially involve your patient; as well as the obituary for Mrs. Ann Melzer. Ann was the beloved house staff coordinator/”mom” to many CCHMC residents who trained before the mid-1990s.

Here are a few other updates from our CPAC group and Physician Outreach at CCHMC:

COVID-19:

-Town Hall – We appreciate the faculty who presented updates this month and the Physician Outreach team who produced patient/family materials. Clinical updates, the Town Hall, and patient resources are available on the PCP COVID site HERE.

-MIS-C – This guide is updated. You can view the guide HERE. Please note - if ordering serology as part of your evaluation, the best test to order is the COVID-19 Total Antibody Qualitative. The other 2 available antibody tests reflex to quantitative which will increase turnaround time to several days.

-Outpatient treatment – Only Sotrivimab monoclonal antibody and Paxlovid oral are currently available for high risk COVID-19 + patients over the age of 12 years and 40 kg. There is limited supply allocated by the state and distributed through the COVID-19 treatment team at CCHMC. Please review the updated treatment guide HERE.

-Vaccines – This month there were new indications for COVID-19 third doses and boosters in kids:

1. Moderately immunocompromised children 5 and up can now receive a third dose of the Pfizer vaccine 28 days after the second shot to complete their primary series.

2. For those 12 and older, a booster dose of Pfizer can be given 5 months after the primary series.

-School forum – If you have children in school, consider sharing the CCHMC school forum site HERE with your administrators.

-Testing – CCHMC lab has again responded with expanded access and resource allocation due to the current surge. Physician Outreach is aware of a few recent lab courier issues. Emily Kimball (Emily.Kimball@cchmc.org) and her team are working on improvements in the coordination of this service.

Hospital Medicine:

In follow-up to our Hospital Medicine/PCP virtual event this fall, our community contact in Hospital Medicine, Dr. Michelle Parker, has been working with CPAC on a Direct Admissions FAQ document HERE. The purpose is to help PCPs understand the process involved in direct admits. One key point – before joining a call on a possible direct admission, the HM attending will take the time to review the patient’s CCHMC chart and begin an encounter. If you have limited time to hold, you can ask PPL to call you back when the HM attending and Flow Coordinator are both on the call.

Dr. Parker encourages any PCP who has questions or concerns about Hospital Medicine services to reach out to her directly at michelle.parker@cchmc.org. Our CPAC group is grateful for her partnership.

Newborn Follow-up Clinic

This month our CPAC group also met with Dr. Tanya Cahill, who directs the multidisciplinary CCHMC NICU Follow-up Clinic. The criteria for discharged NICU patients to be scheduled with the clinic are listed in the attached guide HERE. Dr. Cahill also noted that the clinic welcomes referrals from PCPs for newborns who were not originally scheduled with the clinic, but may be experiencing complications related to prematurity.

Medical Staff

For CCHMC medical staff members, including community associate staff, we welcome Dr. Elena Duma as the new president of the Medical Staff, and thank Dr. Rich Ruddy for his term which ended in December. Please note that the Medical Staff and Alumni dinner originally planned for April will be rescheduled for the fall at a time to be determined.

Thanks for all you are doing for the kids in our community,

Shelly Voet MD

Pediatric Associates PSC
CCHMC Executive Community Physician Leader