Friday, November 22, 2013

Anthony Napolitano, M.D. – A Leader Who Knows the Heartbeat of All Children’s Hospital

When Dr. Anthony Napolitano reflects on the path that led him into medicine, he remembers the many times as a teen that his northern New Jersey home would suddenly stir to life in the dead of night.

His father and several brothers were volunteer firemen, and his sister a volunteer ambulance paramedic, in the Bergen County township of Woodcliff Lake.  To alert them of trouble, they placed a special Plectron alarm box inside their house that would send out warning beeps and directions  whenever they needed to dash off to fight a blaze.


The only problem was that they were heavy sleepers, so they placed the Plectron inside the bedroom of the lightest sleeper of the family, high-school student Tony.

Ultimately, he was the first one with a hand on the pulse of an unfolding problem, rushing to awaken his dad and siblings so they could hurry into action.

“I’d watch my father and my brothers running down the hall, fighting over who was going to drive the car to the firehouse,” he says. “So I sometimes think responding to emergencies was in my blood, because you understand the mentality of it.”

In a way, the experience served as a fitting launching board for the career he would choose.  Not only has he been a crucial guiding force for the neonatal and pediatric emergency transport operation at All Children’s, Dr. Napolitano still has a hand on the pulse all manner of pressing issues.

He knows the heartbeat of the hospital like no other – a man who has played a formative role in the growth of All Children’s neonatal intensive care unit over the years as Senior Neonatologist, and the man who now brings his proven leadership and deep connection to the ACH mission to a new role as Chair of the Department of Pediatric Medicine at All Children’s Hospital Johns Hopkins Medicine.
It is a vital position in the new physician-oriented hierarchy created by All Children’s President and Vice Dean Dr. Jonathan Ellen, who simultaneously named Dr. Paul Colombani as Chair of Pediatric Surgery – calling the appointments significant milestones in the academic transformation of the hospital.  
The two senior physicians bring complementary assets to the goal of increasing physician involvement in leadership process, beyond both being extraordinary practitioners of their craft. Dr. Colombani possesses a wealth of knowledge of the culture of Johns Hopkins Medicine and experience as a former Children’s Surgeon In-Charge at JHU’s School of Medicine; and Dr. Napolitano knows  the doctors, medical staff and inner workings of All Children’s as well as anybody. And his humble, compassionate style and skill have long earned him the respect of his colleagues.
“I’ve tried to figure out what I add, and I think I come with the history of the hospital and the culture,” he says. “I was initially interested in the position but I thought because I was a neonatologist it might be viewed as somewhat limited.”
Then again, Dr. Napolitano’s track record for excellence has been well established for years: a past president of the Florida Society of Neonatology; clinical research that includes persistent pulmonary hypertension in newborns and directing All Children’s participation in the early multicenter trials of nitric oxide therapy for this condition; important work on neonatal abstinence syndrome; forming a NICU Parent Advisory Committee to enhance communication between parents, physicians and staff; and recipient of a slew of honors – including “Attending of the Year” award from All Children’s pediatric residents.
Small wonder that many fellow ACH physicians came to Dr. Napolitano and asked him to apply for the job.
“You know, I’ve been here on the front line, not someone who’s just been in an office,” he says. “I’ve actually been able to see the hospital not only from an intensive care side, but I’ve also worked with the hospitalist program, so I know what’s happening on the floors. I understand what’s happening on transports, and know what is coming in. And I have a sense of how information flows here.”
In his new role, Dr. Napolitano is engaged on many fronts, such as been reaching out to the directors of the nursing divisions and various medical units.
“Everyone is unique, and part of my role is to make sure that I’m communicating Dr. Ellen’s message and direction to the medical staff,” he explains. “But at the same time, I need to make sure that I’m hearing what they have to say – and making sure that he’s hearing it. So the notion of communication, communication, communication is very important.
“What we’re trying to do is get some clarity and transparency. I think the waters here have been a little on the muddy side in the past and we’re trying to clear the water a little bit – and make sure we’re being as up front with people about what’s happening here.”
But there’s another high priority on his task list as well.
“My other role is that I really need to bring the physicians to the table,” he says. “This hospital is going to be much more directed by physicians, as we have a chief who was a physician himself. The anticipation is that physicians need to be more actively involved as leaders, because, really, they are leaders of the programs. And my goal is to facilitate getting them engaged in leadership. As you look at everything that’s going on, nurses can pull these things together but without the physicians, it’s not going to go anywhere. They’re recognizing that we need physician champions, physician leaders. And that’s where the future really is.”
Amid everything else on his plate, Dr. Napolitano continues to serve as medical director for the 24-bed Neonatal Intensive Care Unit at Sarasota Memorial Hospital, through its affiliation with All Children’s. That job has has given him a valuable perspective on ACH as a whole.
“I see our hospital from the outside, as well as the inside, and I think it’s very important because you learn a lot about an institution that way – and you get to listen to others who see it from the outside,” he says. “Sometimes I think you have to get out of the hospital to really see it – and learn what you may need to do differently in interacting with the clinicians.”
Meanwhile, Dr. Napolitano sees a bright future for All Children’s as part of the Johns Hopkins Hospital and Health System.
“We are and were a good children’s hospital,” he says. “I’ve been here since 1988 and watched the faculty grow. And I think if you look at the physicians who are here right now, the quality of care is exceptional.  What Johns Hopkins adds is the ability to push the hospital further than where it was. I think we were kind of maxed out. We’d done everything we needed to do. What they bring on top of this is to propel us.”
Most importantly, he says, being connected to Hopkins has given All Children’s the ability to create its own residency program and undertake important research. “The relationship with USF has been a great one, and I’ve enjoyed teaching their residents and their fellows,” he says. “But Johns Hopkins has the expertise that will allow us to take the next step. Aligning with its mission is a vision that All Children’s at one point had. We want to be on top, and that’s the way we’re going to get there.”
The way to All Children’s for Dr. Napolitano was hardly direct. After earning his medical degree at the University of Brussels, he completed his pediatric residency and neonatology fellowship in 1983 at the Medical College of Virginia in Richmond, where he was an attending neonatologist, assistant professor of pediatrics and – true to his roots – oversaw the emergency neonatal transport operation . When he was hired at All Children’s in 1988, Dr. Roberto Sosa, who helped create the hospital’s neonatology program, was aware that Dr. Napolitano had experience in neonatal transport and put him in charge of it at ACH.
“I’ve been involved with it ever since,” he says. “Most physicians don’t stay with it as long as I have. In the early ‘90s, we went from a neonatal team to a neonatal/pediatric team.”
In the process, the program expanded under his watch from one ambulance to three today, along with  the ability to transport patients via BayFlite or planes for longer travel.
“It’s close to my heart, because I think it’s a very important service that we provide,” he says. “Any patient who’s sick – whether a newborn or a pediatric patient – we not only have the capabilities of extending within our 17 counties but we also service the greater state of Florida and go out of the country as well. And we’re not just swooping in and picking up; we’re bringing intensive care when we get there. It’s very interesting to see the growth and I’m very proud of it.”
Life in the Neonatal Intensive Care Unit in the old ACH building was also far different when he first arrived. An increasing number of transferred newborns were coming in, so expansion of the small unit was a necessity. Intensive care babies were on the first floor, while “step-down” babies (who were getting better) were moved to the third floor. The average number of newborns gradually grew from  45 to close to 60 by the early 1990s.
“As we started getting into the late 2000s, I think we really started recognizing that space was becoming a problem,” he says. “And the nursery we had was becoming more and more congested.”
Today, in All Children’s state-of-the-art new building, the NICU houses nearly 100 beds, double the size it was when Dr. Napolitano started. When he walks though, he often thinks of how far things have come.
“It’s amazing, knowing where I started and where I am today,” he says. “But I reflect most on the quality that is here.  And maybe I’m in this particular position because the quality of the people who have helped me, and given me the opportunity to get to this point. So I’m very humbled by the fact that I’m here because of the physicians around me.

“My challenge now is to make sure that, with them, I can push us to where we need to be.”

It’s a long way from where he once was, rousing his dad and brothers from deep sleep so they could fight a nearby fire.  But he’s still in the heat of the action, doing all he can to keep the pulse of All Children’s steady and strong.
"Faces and Places" is a regular column written by Strategic Communications Editor Dave Scheiber highlighting those people, places and things that make All Children's Hospital special.  If you have an idea for a story, please contact Dave at 727-767-2490 or dave.scheiber@allkids.org.




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