Neonatology

Leadership

Sandra E. Juul, MD, PhD
Professor of Pediatrics, Division of Neonatology
W. Alan Hodson Endowed Chair in Pediatrics
Head, Division of Neonatology

Overview

Mission Statement

We will improve the neonatal outcome of pregnancy by:

  1. Providing outstanding evidence-based neonatal clinical care
  2. Educating the next generation of neonatal caregivers
  3. Advancing neonatal scholarship

Clinical Programs

University of Washington Medical Center Neonatal Intensive Care Unit:
Thomas P. Strandjord, MD, NICU Medical Director
David Loren, MD, Associate Medical Director
The UWMC NICU admits critically ill newborns from one of the highest risk obstetric services in the nation. The multi-professional NICU team has special expertise in management of the most fragile growth-restricted and premature fetuses and newborns. The high-risk perinatal program receives obstetrics referrals from throughout the WWAMI region for fetal abnormalities, severe maternal illness, and extreme prematurity and is the site of delivery for the most complex birth defects, including infants demanding EXIT procedures for airway anomalies. Additional advanced services include therapeutic hypothermia and the full range of ventilation strategies of a level IIIB unit. The NICU medical team includes neonatal faculty, neonatal fellows, neonatal nurse practitioners, pediatric residents, interns and medical students. Our inter-professional team includes respiratory therapists, neonatal pharmacists, nutritionist, physical therapists, speech language pathologists and social work support. Our nursing team includes three tiers of RN expertise and leadership. A new state-of-the-art 48-bed NICU opened in October 2012. The new unit includes 42 single-bed rooms with space for a family member to stay near their infant plus several additional rooms for multiples as well as an integrated OR for surgical procedures.

Seattle Children's Hospital Neonatal Intensive Care Unit:
J. Craig Jackson, MD, MHA, NICU Medical Director
Linda Wallen, MD, Associate Medical Director
Elizabeth Jacobson, MD, Assistant Medical Director
The Neonatal Intensive Care Unit at Seattle Children’s Hospital has 19 licensed Level IV NICU beds, with plans to expand to 21 in the summer of 2014 and to 26 by summer of 2015. Although NICU graduates currently are transferred to Acute Care at Children’s for convalescence, we plan to offer intermediate neonatal care in our NICU with a second neonatologist team by summer of 2015. Most patients will continue to be transferred back to a NICU closer to home, or to specialty services within the hospital, such as Pulmonary or Nephrology. The NICU medical team includes a faculty neonatology attending, a neonatal fellow or neonatal nurse practitioner, and 3 second-year pediatric residents. They round daily with the patient’s family, nurse, dietician, and pharmacist, with involvement as needed from a NICU respiratory therapist and social worker–in addition to the many general surgeons, sub-specialty surgeons, and pediatric sub-specialists. The NICU team accepts admissions of critically ill neonates up to 44 weeks’ post menstrual age (i.e., up to 4 weeks after due date) from a 5-state area; almost all are transferred from Level III NICUs because of highly complex and challenging problems. Pre-op newborns with cardiac surgical problems are admitted to the cardiac ICU, with involvement as needed by the NICU team. There is no obstetrical delivery service at SCH, but there is a close working relationship with the perinatal and neonatal services at the University of Washington Medical Center 2 miles away, and with the Prenatal Diagnosis Programs at UW and across the street at Springbrook.

Overlake Hospital Medical Center (2003 – Present):
Shilpi Chabra, MD, NICU Medical Director
Thomas P. Strandjord, MD, Associate Medical Director
In 2012, Overlake Hospital opened a new Neonatal Intensive care unit with a total capacity of 18 beds, 13 of which are single-bed rooms with space for a family member to stay near their infant This model fits in well with the patient/family-centered care provided by the Neonatology team. Currently OHMC delivers between 3,700–4,150 babies per year resulting in 400-450 admissions to the NICU annually. The Overlake Hospital NICU’s care model is 24/7 in-house NNPs under the direction of attending neonatologists. Overlake Hospital Medical Center has had a Level III NICU since May 2003, with a total capacity of 14 beds.

Providence Regional Medical Center Everett (2000 – Present):
Michael D. Neufeld, MD, MPH, NICU Medical Director
Paul Mann, MD, Assoc. Medical Director
Providence Regional Medical Center Everett’s 29-bed capacity NICU opened on Mother’s Day in 2002. The unit was developed through the efforts of an alliance between PRMCE and Seattle Children’s Hospital. Individual rooms provide privacy for patients and their families. The multidisciplinary team meets daily with parents and concentrates on family-centered care, teaching parents how to take care of their infants, especially those with special needs. In preparation for discharge, parents are provided in-depth instruction on how to manage emergencies that may arise in the home, including the need for CPR. The care model at PRMCE is 24/7 in-house NNPs under the direction of attending neonatologists.

Franciscan Health Care System Neonatal Intensive Care Unit and Special Care Nursery
Christopher Traudt, MD, Interim Medical Director
Franciscan Health Care System has about 5,000 deliveries annually at its 3 obstetrical facilities: St Elizabeth Hospital in Enumclaw, St Francis Hospital in Federal Way, and St Joseph Medical Center in Tacoma. St Joseph Medical Center has a licensed capacity of 23 neonatal beds (18 Level II and 5 Level III, NICU) and has 24/7 in-house NNPs supported by in-house and on-call neonatologists. St. Francis Hospital has a licensed capacity of 6 Level II beds, with medical care from local pediatricians and with consultation and attendance at high-risk deliveries as needed from NNPs and/or neonatologists. St. Elizabeth is a critical access hospital with 250-300 deliveries a year. Franciscan has recently added two hospitals to their system including Harrison in Silverdale and Highline in Renton. Both have Level II Nurseries. Seattle Children’s Hospital partnered with the Franciscan Health Care System to begin providing Neonatology services and medical direction on April 1, 2013, and St Joseph Medical Center opened its new Level III NICU in June 2013. This partnership has made it possible for the vast majority of patients to stay within their community — close to their family and friends while providing the very best care for their fragile newborns.

Kadlec Regional Medical Center Neonatal Intensive Care Unit:
Eric Mosqueda, MD, Medical Director
The Division has provided neonatology medical direction oversight for the Kadlec Level III NICU since 2007. Staffed by local neonatologists and NNPs, this 16-bed NICU admits about 300 patients per year from its high-risk delivery service and from 4 community delivery hospitals in the Tri-Cities area, including north central Oregon, via the Kadlec ground transport team. Kadlec routinely transfers out newborns with birth weight

Research Programs

Current NIH-funded bench research programs are focused on neurodevelopment and neonatal neuroprotection using state of the art techniques including brain imaging. We use a variety of animal models, from rodents to non-human primates to determine the effects of neonatal stress and neurotropic drugs on the developing brain and to test the safety and efficacy of erythropoietin (Epo) as a neuroprotective therapy. The overarching research goal of the Division is to improve the neurodevelopmental outcomes of at-risk infants. Clinical research is focused on trials of Epo neuroprotection in preterm and asphyxiated infants, evaluation of sedative drugs in the setting of extreme prematurity and asphyxia, prevention of BPD, biomedical informatics, and medical education including the use of newborn infant simulators, as well as global neonatal-perinatal health and epidemiologic research. With the 2011 addition of senior scientist faculty member, Dr. Colin Studholme, we have additional expertise in brain imaging with which to evaluate our neuroprotective strategies. In 2013, Dr. Sunny Juul was awarded a $9 million UO1 grant supporting a 5-year multi-center clinical trial investigating Epo as a neuroprotective agent in extremely preterm infants.

Training Programs

Neonatal-Perinatal Fellowship Program
Taylor Sawyer, DO, MEd, Program Director
Sandra Juul, MD, PhD; Thomas Strandjord, MD; and Christine A. Gleason, MD; Assistant Program Directors

The Neonatal-Perinatal Medicine Fellowship Training Program at the University of Washington began in the mid-1960s. Our mission is to educate and inspire the next generation of neonatologists who will provide state-of-the-art, evidence-based clinical care and to assist and mentor them in finding and pursuing their scholarly passion so they are poised to be the future academic leaders of our field. The program's primary objective is to develop outstanding clinical skills and a high degree of scholarly/ academic competence for those pediatricians committed to a career in academic neonatology. We have designed our program to provide ample protected time for scholarly activities. Our research “areas of excellence” are diverse, including focuses on neuroscience (neuroprotection and neurodevelopment), global health, and ethics. We have strong research mentors both within and outside the Neonatology Division. Several of our Fellows have chosen to combine training in Neonatology with a complementary Master’s degree in Public Health. As of 2013, 53 physicians have successfully completed their clinical and research training and more than 50% have pursued an academic career.

More information is available on the UW Neonatal-Perinatal Fellowship Training Program website.