Tuesday, November 26, 2013

Giving Spirit: USFSP Pre-med Student Forms Club To Help Cystic Fibrosis Patients At All Children’s

Erik Richardson enrolled at the University of South Florida St. Petersburg planning to make business his major. Instead, he has made it his business to help dozens of cystic fibrosis patients at nearby All Children’s Hospital and create a major impact as a senior USFSP pre-med student.

The 25-year-old Floridian by way of New England is the founder and organizer of Pre-Med Pals, a program that allows 16 of his pre-med classmates to volunteer at All Children’s. The focus of the group, which started a year ago, is to spend several hours, two nights per week, with cystic fibrosis patients – playing games, watching TV, helping with homework or just hanging out.

    Erik Richardson with fellow USFSP students Keun Young Jo,
Everett Rogers, Stephanie Tominaga and Jordan McBride.

As a busy senior with a demanding school schedule, it would be understandable if Richardson simply buried himself in his biology studies and focused on graduating in May. Far from it. He has made the spirit of giving and volunteerism at All Children’s as much a part of his curriculum as class time.

In his freshman year, Richardson volunteered in the hospital pharmacy. He enjoyed the work and decided to earn his license to become a pharmacy tech, allowing him to work part-time at All Children’s the past two years. Being immersed in the hospital atmosphere – coupled with a profoundly meaningful mission trip to a health clinic in Guatemala – made Richardson know he’d made the right decision to switch his major and focus on a medical career.

But he didn’t stop there. On campus, he formed a USF pre-med club for future physicians to meet and support one another. And at the hospital, he began volunteering in Parent Coffee, the program in which staffers make early-morning rounds to hospital rooms and deliver free coffee and pastries to grateful, bleary-eyed parents.

That’s when it hit him. “Doing Parent Coffee gave me the idea of finding a way for members of my pre-med club to volunteer at the hospital, too,” he said. “When I was working in the Pharmacy IV room, you're completely isolated. But Parent Coffee gave me the chance to see patients I was preparing medication for. I wanted my club members to be able to experience that same kind of one-on-one interaction."

Richardson contacted Ryan Perry, then managing Volunteer Resources, to discuss ways members of his group to offer their services in a useful way. Perry was intrigued and brought the idea up to his wife, Carolyn Perry, RN of the All Children’s infection prevention department.

“She’d been telling him about a group of CF patients and how they were in need of extra volunteers,” Richardson recalled. “So he said, ‘What if we took your club and worked with this group of patients – that’s what we need right now. Is this something you’d be interested in?’  I said, ‘’Yes, definitely.’ ”

Child Life embraced the initiative, playing an integral role in coordinating the visits of the premed volunteers. Meanwhile, the students learned of the extra care that needs to be taken with kids dealing with the chronic disease of the lungs and digestive system.

The thick mucus that clogs the lungs can lead to infections, requiring that patients remain in isolation for as long as two weeks while receiving treatment informally called “tune ups.”  As a result, the patients wear protective masks when they leave their rooms and can’t be in the presence of other CF patients – and Pre-Med Pals volunteers had to be trained in isolation techniques, learning the proper times to wear masks, gowns and gloves.

The question of how to make the goodwill visits work still needed to be resolved. The ranks of his premed club had already swelled to some 180 students, far too many to bring in his volunteers at All Children – especially considering the long list of people waiting to volunteer at the hospital already. Richardson addressed the issue by using a software program to create a rotation of students from his pre-med club, filling two open slots every Monday and Thursday (though sometimes more come).

Initially, the USF volunteers participating in Pre-Med Pals numbered seven, but the group has expanded to 20 – and students now have to apply due to competition for limited slots. There’s even talk of bringing the program to other populations of patients. Richardson has moved from a volunteer role to that of coordinator.  And members of Child Life work closely with each student, letting them know what patients are in the hospital and need a boost from a visitor.

“Because it’s 6-8 p.m., it’s kind of a transition time – parents may be arriving or not there yet and the kids may be eating dinner,” Richardson explained. “It’s kind of a lonely time of night.  So it’s a great time for us to show up. We can spend up to two hours with one patient. We can just chill or play video games with them, or take a walk in the hospital if the nurses are okay that the child leaves the room.”

On a recent evening, 18-year-old Alex Dobbs was one of only a handful of CF patients on 8 South, the unit where CF patients are usually found. They welcomed a visit from USF students Everett Rogers, Keun Young, Jordan McBride and Richardson. Alex has especially enjoyed playing pool during the pre-med visits. On this night, they chatted outside his room and joined him for some TV-watching. Invariably, the pre-med contingent seems to get just as much out of these sessions as the patients.

“When I first heard the program, I thought it sounded like an awesome opportunity,” said Rogers, a Clearwater native. “It sounded like a win-win-win – a win for us that we get to come in and get experience in the hospital working with kids; a win for the kids because they get some entertainment and someone to hang out with; and a win for the hospital because they get volunteers that they need. The Child Life specialists get spread kind of thin. So I see this as a very valuable use of my time.”

Jordan McBride of Indian Shores echoed the sentiment: “You can go home and study when you want to. And you can also come in here and help other people. That’s what we want to do being in the end, so this gives us hands-on experience and a chance to brighten other people’s day.”

Fellow USFSP student Stephanie Tominaga, who moved to the area from Brazil, credits Richardson for making it all happen.

“We owe everything we’re doing here to Erik,” she said. “He’s done so much – not only for our community and the kids here, but for the students as a whole.”

His work is equally appreciated by the hospital. "Erik is a person with a lot of passion and compassion, and his dedication in putting this program together with all the demands on his time is very impressive," said Brittany Nelms, a Volunteer Services Coordinator at ACH. "We really appreciate everything he's done."

Richardson first learned about All Children's when he suffered a serious knee injury while playing for Shorecrest Preparatory School's basketball team as a junior. Though he wound up graduating from high school in Fort Myers, he never forgot about how he'd received such good care from the hospital. And he liked the idea of giving to it when he enrolled at USFSP four years ago.

It made further sense given the medical background of his parents. His mother was an OB/GYN and his father worked as a pharmacist in Tampa. After earning his pharmacy technician license, Richardson spent a year working alongside his dad to learn get hands-on experience before becoming an ACH pharmacy tech two years ago.

All the while, he’s set his sights on another calling at All Children’s – becoming a surgeon. He looked up several ACH surgeons on line to learn about them and see their photo, then introduced himself when he ran into them in the hospital. That led to him shadowing several physicians, hoping to learn more about his primary interest of minimally invasive surgery. Richardson already has a plan for his future. He will be applying to USF’s College of Medicine for 2014 – and hopes to wind up practicing at All Children’s, making a difference in the lives of kids in need.

You might say he’s already off to a great start.

Faces and Places” is a regular column written by Strategic Communications Editor Dave Scheiber highlighting people, places and things that make All Children’s Hospital special. If you have an idea for a story, please contact writer Dave at ext. (727) 767-2490 or dave.scheiber@allkids.org.

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.