DEPARTMENT OF Pediatrics and Child Health...Department of Pediatrics and Child Health is tremendously grateful for the vision and growth Dr. Klassen drove, and it will continue to

Pediatrics and Child HealthDEPARTMENT OF

Strategic Plan Update | July 2014 - June 2019Driving excellence in research and knowledge-sharing to improve patient outcomes

Strategic Plan Update | Page 2

Dr. Birk’s message 03Faculty members 05 Department chairs 06By the numbers 07Community outreach 08Epilepsy Monitoring Unit 10

Preventing pain 12 Leadership collaboration 14New Women’s Hospital 15Setting children up for success 16TREKK and IPCT 18Engaging stakeholders 20CHRIM 22Diabetes 24

Medical Hall of Fame 27Pediatric residency 28 Pediatric Undergraduate 30 Medical ProgramGlobal health 32Departmental members 34Partnerships 38

Contents

MissionTo create, preserve, communicate and apply knowledge, contributing to the cultural, social and economic well-being of the people of Manitoba, Canada and the world, through the provision of high quality medical education, participation in first class research, and through collaboration aimed at healthier children by providing high quality, comprehensive, family-centered health care.

VisionTo take our place among leading universities through a commitment to transformative research and scholarship, to innovative teaching and learning, and to high quality, comprehensive, family-centered health care, as close to home as possible, uniquely strengthened by Indigenous knowledge and perspectives.

ValuesTo achieve our vision, we require a commitment to a common set of ideals. The University of Manitoba Department of Pediatrics values: academic freedom, accountability, collegiality, equity and inclusion, excellence, innovation, integrity, respect, sustainability. The Shared Health, Child Health Program values provincial, professional, patient and family-centered, inclusive, accessible and equitable, effective and accountable care provision.

Strategic Plan Update | Page 2 PHOTO FRONT COVER: Chief Resident Dr. Jacqueline Richelle talks about her experience on page 28

Every Child, Every Time–our commitment to prevent and relieve pain– incorporates research, teaching and care programs to inform strategies to provide the best possible care experience to children, youth and families experiencing and /or supporting painful procedures. It is an excellent example of how the Learning Healthcare System can function: care informing research and teaching, and vice versa. The priority for excellence in education led to an ambitiously articulated vision on education, successful recruitment of excellent trainees to our programs, and clear deliverables

Dr. Patricia BirkHead, Department of Pediatrics and Child Health

Planning provincially, delivering

locally

Social pediatrics:

understanding poverty

The Learning Healthcare

System

Building faculty through

mentorship

STRATEGIC PRIORITIES

Excellence in education

Every Child Every Time: prevent and manage pain

Continued next page

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Message from the Department Head

The best outcomes for patients and families

As the Head of the Department of Pediatrics and Child Health, I am proud to present a visionary departmental report. As a university department, we are committed to driving excellence in research and knowledge translation to improve outcomes of children in Manitoba and around the world.

Aligning with priorities at the University of Manitoba, Faculty of Health Sciences and Shared Health, Manitoba, the department’s strategic plan for 2014-2019 was centred on six priority areas:

and acknowledgement of educational efforts of our faculty members. Making provincial planning a priority allowed us to build awareness and have important conversations about providing care close to home, and about our aspiration to find new and meaningful ways to work with Indigenous families and communities. In this report, you will read about these and other examples of the impactful developments in our department and in healthcare facilities.

Members of our 23 academic sections are each providing an area of specialty care in our environment, but they also find ways to collaborate and create synergies with each other. The co-location of multidisciplinary teams at Specialized Services for Children and Youth (SSCY.ca) is a great example of these innovations. Clinical Immunology, developed as a new service by members of our Hematology-Oncology and Allergy specialists, has found a permanent home in the Section of Allergy and Clinical Immunology. The Ambulatory Section formally changed its name to Social and Northern Ambulatory Pediatrics (SNAP) to acknowledge that providing provincial services, tailored towards the most vulnerable in our population, is what ‘SNAP’ is all about.

Strategic Plan Update | Page 4 Strategic Plan Update | Page 5

The department has seen tremendous growth in numbers: since 2014, 12 new full-time faculty positions were added. Children in our province already benefit from this expansion, for example, through the provision of Tuberculosis Specialty Care and the opening of an Epilepsy Monitoring Unit.

In recent years, many clinical endeavors have been supported to improve the outcomes of hospitalized children. The SPOT AKI program (Surveillance of Patients On nephroToxic medications for Acute Kidney Injury), is funded by the Children’s Hospital Foundation Innovators and led by members of the section of Pediatric Nephrology and Pharmacy. It is a tangible example of how intra-professional collaboration and evidence-based research can improve long-term renal outcomes. Additionally, the sections of Pediatric Hospital Medicine and Pediatric General Surgery have partnered with Nursing Leadership to improve flow processes to ensure that children receive the most timely medical and surgical care. Our flow metrics now rank among the best in Canada.

In partnership with generous donors like the Rh Institute Foundation Board, the department has expanded from one to five Endowed Research Chairs. Almost one third of our full-time faculty has more than 35% protected time for research and 16 faculty members have more than 70% dedicated protected time. Research funding held by our researchers has more than tripled since 2008, and due to the energy and support from the Children’s Hospital Research Institute of Manitoba and the Children’s Hospital Foundation, researchers affiliated with these

institutions have continued to expand their funding envelopes, even in recent years.

We are immensely grateful to our administrative team members for their leadership and support of the day-to-day work of faculty members and trainees in our department. Medical staff, nursing and allied health work collaboratively to give children in our province, country and around the globe the best care and support possible. Together, we can drive excellence and improve outcomes for children to ensure a brighter future.

CARE

Patients | CliniciansCommunitiesSCIENCE EVIDENCE

Every Child, Every Time—our commitment to prevent and relieve pain—incorporated research, teaching and care programs to inform strategies to provide the best possible care experience to children, youth and families experiencing and/or supporting painful procedures.

One terrific team

Faculty

96

1048

Physician Faculty Members in 23 sections

Full time faculty

PhD Scientists

45 male59 female

10Emeriti

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Faculty member promotionsPromotion to

Assistant Professor

Promotion to

Full Professor

Promotion to

Associate Professor

6114

3 females 3 males

6 females5 males

3 females1 male

PHOTO ABOVE: Faculty members of the Department of Pediatrics and Child Health

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Dept. of Pediatrics and Child Health research funding

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Dr. Bradley DobleBihler Chair in Stem Cell Research

Dr. Kelly RussellRobert Wallace Cameron Chair in Evidence Based Medicine

Dr. Kristy WittmeierDr. John M. Bowman Chair in Pediatrics and Child Health

Dr. Meghan AzadCIHR Tier II Canada Research Chair

Dr. Jennifer ProtudjerChair in Asthma, Allergy and the Environment

Over the course of this strategic cycle, the department successfully established four new Endowed Research Chairs, some of which have been filled with faculty members who bring new and exciting innovations to our department. In addition, the department successfully recruited a CIHR Tier II Chair and was invited to appoint a new faculty member to the College of Medicine, Bihler Chair in Stem Cell Research.

Research Chairs and Endowed Research Chairs


Dr. Terry Klassen

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Research timeClinician scientists and PhDs16

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In 2010, Dr. Klassen returned home to Winnipeg when he accepted the position of CEO and Scientific Director of the Children’s Hospital Research Institute of Manitoba, and Professor in the University of Manitoba, Rady Faculty of Health Sciences, Max Rady College of Medicine, Department of Pediatrics and Child Health. (An avid Jets fan, Dr. Klassen remarked how the Winnipeg Jets left when he did and followed his lead and returned home). Dr. Klassen was Head for the Department of Pediatrics and Child Health from 2014-2019 and under his engaging

leadership, many of the great developments noted in this report saw the light of day. Dr. Klassen’s vision included a Learning Healthcare System, whereby clinical care, research, education and administration inform and enrich one another. As he returns to his previous positions, the Department of Pediatrics and Child Health is tremendously grateful for the vision and growth Dr. Klassen drove, and it will continue to build on the principles of the Learning Healthcare System.

Dr. Terry KlassenFormer Head, Pediatrics and Child Health, August 1, 2014 – July 31, 2019


At the request of First Nations Inuit Health Branch (FNIHB) and in conjunction with Manitoba Keewatinowi Okimakanak (MKO) Dr. Lane adds that the Department of Pediatrics and Child Health has developed a plan to deliver coordinated services from general pediatricians and a tuberculosis specialist to children and youth in First Nations communities. An important partner facilitating this care is Ongomizzwin Health Services (previously known as the Northern Medical Unit).

The Department of Pediatrics and Child Health values its collaborative relationships with service providers and advocacy groups. Dawyduk explains the importance of building capacity for care at the local level by first going to a community and hearing and learning how to best serve their needs. “We want to learn about a community’s environment, including understanding family dynamics, the school system, approach to parenting, nutrition and other factors that can inform our work so we can deliver it in meaningful ways to patients and their families. Each community is different, each child is different, and in this way, we can work towards delivering culturally-safe care in a spirit of Truth and Reconciliation.”

Dr. Lane says that the Department of Pediatrics and Child Health is committed to cultivating stronger relationships with Indigenous Manitobans. She says The Rady Faculty of Health Sciences acknowledges that the perspectives, understandings and practices of Aboriginal Elders and Traditional Knowledge Keepers are integral to long-term healing and reconciliation and that pediatric caregivers are committed to supporting First Nation, Metis and

Inuit peoples’ cultural revitalization. This means working collaboratively with Indigenous Elders and agencies to plan health service delivery models that meet the needs of children and youth.

To complement care that is delivered directly in communities, healthcare providers also “see” and follow up with patients through Telehealth. Dawyduk explains this high-tech approach allows patients to visit local nursing stations, where they talk and can be seen by doctors and specialists through tv screens and special devices. “For example, a doctor can see skin lesions through a special camera or listen to heart and lungs through a special device,” says Dawyduk.

Telehealth is proving to be an effective and efficient way to deliver care by providing quick appointments with doctors and avoiding unnecessary travel time and costs.

Summarizes Dr. Lane, “It’s all about collaboration and putting children and youth first to deliver the best care possible when, where and how it’s needed. Funders and clinical partners are working together under the Jordan’s Principle Child First Initiative to ensure all families and caregivers have the capacity to support their children and youth through ready access to the knowledge, services and resources they need.

Delivering timely and appropriate care to all children and youth in Manitoba is a strategic priority for the Department of Pediatrics and Child Health, and that direction is evident in all the department’s clinical and educational efforts.

Dr. Margo Lane, Head of the Section of Social, Northern and Ambulatory Pediatrics, says “One way we provide optimum care is through community outreach programs. We recognize that partnering with communities to care for children in their home

environments is essential to helping children develop to their full potential.”

Sections of the Department of Pediatrics and Child Health have a long history of travelling to northern and remote communities to provide services in Manitoba and Nunavut. General pediatricians, as well as sub-specialists in Allergy, Cardiology, Child Development, Endocrinology and Nephrology have been visiting communities throughout Manitoba and Nunavut for many years, saving families and patients the long, and sometimes difficult journey to Winnipeg.

According to Dr. Lane, Jordan’s Principle Child First Initiative provides the means to build

on these established practices. “The implementation of Jordan’s Principle has meant that we now have funds to enable pediatricians to travel to 10 more First Nations communities, allowing us to increase our outreach to a greater group of Indigenous children.”

Nurse Practitioner Brenda Dawyduk who delivers programming through the Jordan’s Principle initiative from her base in Thompson, Manitoba echoes Dr. Lane. She adds that the funding means that she can facilitate better access to multidisciplinary care for children in her care.

In 1999, a child from Norway House Cree Nation named Jordan River Anderson was born at the Children’s Hospital in Winnipeg with multiple disabilities including a rare genetic syndrome affecting his muscles and general development.

The syndrome required years of hospital treatment, and when Jordan was two years old, doctors said he could move from the hospital to a special family home where he could continue to receive medical care. However, Jordan never left the hospital. Federal and provincial governments could not agree on who should pay for his home-based care, and during the ongoing debate, Jordan passed away in the hospital at the age of five.

Funding and delivery of the services Jordan needed fall under provincial/territorial jurisdiction for most children in Canada, while responsibility for services to First Nations children is often shared by federal, provincial/territorial and First Nations governments.

In 2007, the House of Commons passed Jordan’s Principle in memory of Jordan. Jordan’s Principle is a legal commitment for equitable access to all government-funded public services for First Nations children living on and off reserves. It is intended to ensure that First Nations children get the products, services and supports they need without delay, based on the needs of the child. The government of first contact pays for the service and resolves jurisdictional/payment disputes later.

jordansprinciple.caPHOTOS: Children receive care at northern outreach clinics

Partnering with communities to care for children in their home environmentThrough Jordan’s Principle Child First Initiative


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If you build it, they will come. Besides being a well-known line from the movie Field of Dreams, this phrase also applies to the progressive approach that the Department of Pediatrics and Child Health has used during the past five years to improve patient care.

Departmental leaders continuously identify areas of patient needs. Working with stakeholders and multidisciplinary partners, they set about meeting those needs by building or enhancing programs and attracting top-level experts to the team to develop and run these programs.

One such example relates to the faculty who worked together to conceptualize, develop and run the new two-bed Epilepsy Monitoring Unit (EMU) in Children’s Hospital—a continuous EEG video recording that is done while a child is admitted to the hospital. The new EMU was unveiled in late 2018, following a $2 million donation in 2017 to the Children’s Hospital Foundation of Manitoba from Michael and Lilibeth Schlater. The couple sought to realize the aspirations of Director of Epilepsy Surgery Dr. Demitre Serletis towards formation of a pediatric epilepsy surgery program in

Winnipeg. Together with Child Health leadership and project management oversight from the George and Fay Yee Centre for Healthcare Innovation, Dr. Serletis conceptualized and designed the pediatric EMU. Formation of this unit quickly led to recruitment of two new specialists to help with the project: Dr. Qi (Helen) Xu and Dr. Aoife O’Carroll—both Pediatric Neurologists/Epileptologists in the Department of Pediatrics and Child Health (and the only two such specialists in the province). Says Dr. Xu, “The reason I came here in 2017 was to be associated with the Epilepsy Surgery Program

and the new EMU, which changes the whole story for children with epilepsy for the better.”

Dr. Serletis explains that the EMU means that children no longer need to travel out of province for specialized treatments and epilepsy procedures. Moreover, the most complex surgical procedures for epilepsy, including invasive EEG monitoring, are hopefully forthcoming in the near future, as the program continues to expand.

The new equipment allows us to learn more about a child’s seizures, which in turn enables us to determine the most appropriate treatment and provide the best possible care.

The EMU features two dedicated in-patient beds, a central monitoring unit and two portable EEG machines that can be used in the operating room or Intensive Care Unit.

Dr. Xu continues on stating, “This equipment can also perform invasive EEG monitoring which records brain activity directly from the brain after the electrodes have been surgically implanted on the surface or within the depth of the brain. This type of invasive EEG information is done to better localize the regions of seizure onset and provide crucial information for the planning of epilepsy surgery.”

Children’s Hospital records show that there are approximately 19,000 patients with epilepsy in the Winnipeg Regional Health Authority catchment. Of these, an estimated 6,300 patients remain resistant to anti-epileptic medication, with one-half of those being children. By carefully screening anywhere from 50 to 100 pediatric patients in the EMU on an annual basis, it

is anticipated that the majority of these children will benefit from improved medical and/or surgical intervention. Importantly, the EMU allows for screening of refractory patient candidates who stand to benefit from epilepsy surgery, which can offer rates for seizure freedom ranging anywhere from 50 to 85% (as compared to 10-15% with medication alone).

Children may present with seizures across a wide range of ages – including newborns – and these seizures may arise in the context of birth traumas, infections (including meningitis), traumatic injuries, brain tumors, stroke, metabolic and genetic diseases, brain malformations, and other etiologies.

Parent Meredith Walker says her son Morgan, 14, was officially diagnosed with epilepsy when he was in grade one and after many years of treatment, they are really excited about the commitment to the EMU. “We’re so fortunate to have this incredible facility in Manitoba and to work with the new specialists. Dr. Xu has such progressive ideas and is always learning new things.”

Walker adds that before the EMU, Morgan would need to be monitored for a long period of time in a very confined space, which added to what was already a stressful situation. The new unit means Morgan will be more comfortable while specialists collect important data to develop his treatment plan. “Morgan is a real trooper, and we see new hope, opportunities and possibilities for him and our family.”

Epilepsy Monitoring Unit delivers new possibilities for treatment

Dr. Aoife O’Carroll

PHOTO ABOVE: Patient Morgan Walker being treated in new EMUPHOTO RIGHT: EEG Technician, Gillian Teillet, reviewing EEG Tracing to flag any concerns to the neurologist

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is a non-profit organization for pediatricians in Manitoba, and a subdivision of the Canadian Pediatric Society.

MPS advocates for the health of children in Manitoba by creating a forum for

important issues to be raised and addressed.

Six annual meetings open to pediatricians, subspecialists and interested parties provide opportunities for education

and networking.

Additional events are organized to promote resident education, advocacy and appreciation.

Annual membership is encouraged.

Attendance at individual events for those who may not be able to attend all events is also possible. To become a member or receive

mailings, contact:

[email protected]

Pain related to injuries, illnesses and medical treatment remains a problem for children of all ages.

In fact, today we know that suffering from pain early on as children can influence how the body handles pain for the rest of our lives. The fear of suffering may last into adulthood and may result in avoidance of healthcare.

Working collaboratively—nurses, therapists, child life specialists, pharmacists, psychologists, physicians and parents have formed Every Child Every Time to prevent and relieve pain for all children and adolescents. The initiative aims to prevent and relieve pain from medical treatment, acute pain from injuries and illnesses, pain in palliative or end-of-life care and chronic pain through:

• Advocating for children to have access to all tools to prevent and reduce pain;

• Educating healthcare providers to offer all possible tools;

• Educating patients and families to raise awareness about options available;

• Putting guidelines into practice to prevent and relieve pain by all possible means

According to Nurse Educator Mary-Ellen Lee, “Our pain management vision, or comfort promise is based on the principles of ChildKind International, a well-recognized international, non-profit organization that promotes pain prevention and relief for all children.” ChildKind International certifies healthcare facilities like ours that have made the “comfort promise” come true.

Adds Medical Lead for Every Child Every Time Kerstin Gerhold “Our entrance level survey showed what we already know from

other facilities that started this work: a lot can be done to give children and youth a much better experience. That survey, and the programs we have put into place afterwards, are our first steps to be acknowledged as a ChildKind healthcare program. We can proudly say we are well on our way to being certified and providing best level care for children in our care.”

Every Child Every Time works under the umbrella of the Child Health Program of the Winnipeg Regional Health Authority and the Department of Pediatrics and Child Health of the University of Manitoba. The initiative is funded by the Children’s Hospital Foundation of Manitoba.

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Needles don’t have to hurtEvery Child Every Time – our commitment to prevent and relieve pain

The

Manitoba Pediatric Society

A D V O C A C Y | E D U C AT I O N | P H I L A N T H R O P Y | N E T W O R K I N G

PHOTOS ABOVE: Numbing cream, sugar water, comfort positioning and distraction make a difference so that needles don’t have to hurt anymore.


The well-known acronym TEAM—Together Everyone Achieves More—is a guiding principle for hospital leaders as they build collaborative, interdisciplinary teams to deliver optimal patient care.

The Shared Health, Child Health Program Management Team (PMT) provides leadership to our provincial Child Health Program. The PMT includes Monika Warren (Nicole Sneath in an acting capacity as of Oct 28, 2019), Dr. Patricia Birk, Dr. Richard Keijzer, Jennifer Luong and Cheryl Susinski.

Monika Warren, Program Director, Women’s Health at the Children’s Hospital talks about the benefits of this model: “When leaders are united and work in a standardized, collaborative way, patients benefit all around. That’s evident, for example, when patients transition from one area

Leaders have been using a collaborative approach to establish the new Women’s Hospital. Explains Warren, “Hospital leaders worked with health care professionals, designers and the community to create a state-of-the-art facility for women and children built to support a family-centred model of care.”

Some of the new hospital features include private in-patient rooms, sleeping areas for families and a 60-bed neonatal intensive care unit (NICU) that consolidates the Health Science Centre’s existing facilities for moms and infants who require specialized care. There is a specific family zone where parents can share a meal with other parents, have a meeting with the team to make decisions about their child’s plan of care and take a step away from the clinical area when needed. “The space really allows parents and family members to be here more often and be more involved in the care of their child throughout their hospital stay,” says Warren.

Hospital leaders worked with health care professionals, designers and the community to create a state-of-the-art facility for women and children built to support a family-centred model of care.

Hospital staff are trained to use new technologies in this world-class centre. Says Warren, “The new NICU features electronic charting and a voice-activated communication system. We will be the first site in Manitoba that will be using medical device integration where the cardio-respiratory monitor feeds the electronic chart with clinical information and alerts the nurse when a clinical value is outside of the normal range.”

Warren explains that providing patient and family-centred care means being responsive and respectful to the needs of individuals—including respecting the values and cultural practices of Manitoba’s diverse population. She says the Children’s Hospital and The Children’s Hospital Foundation of Manitoba are working together on an initiative to create special healing and ceremony rooms for spiritual health. “Creating an environment where our patients and families feel respected, safe and welcome is a priority.”

of care to another. Families get clear, consistent messages about their child’s plan of care.”

Department of Pediatrics and Child Health sub-specialists not only work together within the hospital, but they go where they are needed by patients. “For example, gastroenterologists and general surgeons go to the Specialized Services for Children and Youth Centre to meet with families, who on the same day, are also meeting with their child development specialist, physiotherapist or other members of their healthcare team,” explains Warren.

Together, everyone achieves more – for greater patient care

The new HSC Women’s Hospital opens!

Monika Warren

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Ambulatory Care Clinics

• These clinics which were previously separated across the campus are now co-located here, making it it much easier for patients who need to visit several clinics and allowing us to use resources more efficiently.

Triage • Layout offers privacy for patients during their initial assessment – a significant improvement. 9 private rooms (each with their own washroom), 3 stretcher bays with one shared washroom for very short-stay patients, and a “Labour Lounge” for patients who are not yet in active labour.

Surgery • 7 operating rooms; in each OR all equipment is ceiling mounted so moving around the room is much easier and safer, and cleaning between cases is more efficient.

Neonatal Intensive Care Unit (NICU)

• Currently, our NICUs are distributed in three locations – almost half a kilometre apart – and special equipment is required to transfer these sick or premature newborn babies from one to the other. All three NICUs will be amalgamated into this new multi-acuity NICU. Each baby is in a private room with a pullout bed for family.

NICU Family Zone

• A baby may stay in NICU for several months, so it’s important to celebrate during critical times. Families can book a family conference room in this area that’s equipped with oxygen and suction so a baby can be included in family celebrations. The Zone also features play areas with soft seating, TV, a kitchen, and breast pumping room.

Care stations

• 3 to 6 care stations are located within each unit, rather than one central nursing station for the entire floor. Each care station looks after approximately 8-12 patient rooms, to keep our teams close to patients.

Spiritual Health

• These Spiritual Health spaces can be booked for ceremonies, sacraments and rituals to provide support for patients and families, and celebrate diverse values and beliefs. Both the Sanctuary and Ceremonial Room are ventilated to accommodate smudging.

Rooftop Garden

• Seasonal access during daytime hours for patients, visitors and staff to enjoy fresh air and sunshine. The landscaping reflects Manitoba’s natural beauty and tranquility.

WN-INFO-NOV2019 www.hsc.mb.ca • Phone: 204-787-3661 • Toll-free: 1-877-499-8774

Ambulatory Care Clinics

• These clinics which were previously separated across the campus are now co-located here, making it it much easier for patients who need to visit several clinics and allowing us to use resources more efficiently.

Triage • Layout offers privacy for patients during their initial assessment – a significant improvement. 9 private rooms (each with their own washroom), 3 stretcher bays with one shared washroom for very short-stay patients, and a “Labour Lounge” for patients who are not yet in active labour.

Surgery • 7 operating rooms; in each OR all equipment is ceiling mounted so moving around the room is much easier and safer, and cleaning between cases is more efficient.

Neonatal Intensive Care Unit (NICU)

• Currently, our NICUs are distributed in three locations – almost half a kilometre apart – and special equipment is required to transfer these sick or premature newborn babies from one to the other. All three NICUs will be amalgamated into this new multi-acuity NICU. Each baby is in a private room with a pullout bed for family.

NICU Family Zone

• A baby may stay in NICU for several months, so it’s important to celebrate during critical times. Families can book a family conference room in this area that’s equipped with oxygen and suction so a baby can be included in family celebrations. The Zone also features play areas with soft seating, TV, a kitchen, and breast pumping room.

Care stations

• 3 to 6 care stations are located within each unit, rather than one central nursing station for the entire floor. Each care station looks after approximately 8-12 patient rooms, to keep our teams close to patients.

Spiritual Health

• These Spiritual Health spaces can be booked for ceremonies, sacraments and rituals to provide support for patients and families, and celebrate diverse values and beliefs. Both the Sanctuary and Ceremonial Room are ventilated to accommodate smudging.

Rooftop Garden

• Seasonal access during daytime hours for patients, visitors and staff to enjoy fresh air and sunshine. The landscaping reflects Manitoba’s natural beauty and tranquility.

WN-INFO-NOV2019 www.hsc.mb.ca • Phone: 204-787-3661 • Toll-free: 1-877-499-8774

PHOTOS ABOVE: Impressions of the new Women’s Hospital

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As medical advances lead to more babies surviving prematurity and complex medical conditions at birth, the need for ongoing specialized developmental care becomes increasingly important to ensure children’s long-term well-being and success.

Unfortunately, many infants born in these circumstances can be at risk of having major disabilities that can significantly affect their quality of life. This can include disabilities related to learning, communication, fine and gross motor skills, visual-motor skills, behavioural issues and other complex neuropsychological challenges that require specialized care over the long term.

Developmental Pediatrician Dr. Diane Moddemann reports, “To meet the needs of the many children born at risk, a model that efficiently integrates a family-centred approach with multidisciplinary community resources is vitally important.” She adds that model works best when it includes surveillance, screening and care services provided through family-centred community services, parent support systems, family physicians and community pediatricians with formal specialized services such as neonatal follow-up programs and developmental pediatrics services.

The Specialized Services for Children and Youth Centre (SCCY), which opened in 2016, is an initiative that works to meet that need. Executive Director, Rehabilitation Centre for Children Cheryl Susinski states, “The Centre houses about 250 staff representing a collaborative team of government

departments, the Winnipeg Regional Health Authority (WRHA) and various service provider agencies. Together, we focus on providing integrated services for more than 10,000 Manitoba children and youth with disabilities and special needs.” Susinski adds that having multiple services under one roof benefits patients and their families in many ways. “Sometimes it means that patients and their families can see several specialists in one appointment—providing a holistic approach to patient and family well being.”

“Family engagement and participation are key parts of our program both at an individual child and system level at SSCY. We have an active family council and family network that provide input into program planning and offer a wide range of supportive and educational events to families and caregivers.”

Karen Netzel, Coordinator of Neonatal Intensive Care Unit (NICU) Veteran Parents within Health Science Centre’s Volunteer Services, echoes the importance of family engagement in a child’s care. Netzel, whose son spent time in intensive care following his premature birth in 1996, now coordinates other veteran parents’ volunteer work to support families with babies in the NICU. This work

ranges from a program to read to babies to a drop-in support group to teaching infant massage. Says Netzel, “Parents are the one constant in their baby’s care. They are being recognized as such and, for example, they are integrated into care by sharing their thoughts and concerns during doctors’ rounds. This involvement helps parents during the hospital stay as well as when they transition home with baby.” Netzel adds that she sits on two multidisciplinary committees and represents parents’ perspectives. “The Family Integrated Care Committee has four pillars—staff education and support, parent education, NICU environment and psycho-social support—which guide how we provide care.”

The “wraparound care approach” is also supported by The Child-Bright Network, a multicentre program of research that has two ongoing projects at SSCY. These research projects will ensure that the best and latest knowledge is used to support families. The Child-Bright Network works to make the future brighter for infants, children, and youth with lifelong brain-based developmental disabilities and their families. This includes individuals with a diagnosis of a

brain-based disorder (e.g. autism spectrum disorder, attention deficit hyperactivity disorder, fetal alcohol spectrum disorder, cerebral palsy, intellectual or learning disabilities), and individuals at high risk for a brain-based disorder (e.g. preterm birth, congenital heart disease, genetic anomaly). The Child-Bright Network is funded by the Canadian Institutes of Health Research (CIHR) and other funding partners, including the Children’s Hospital Research Institute of Manitoba and Research Manitoba.

As healthcare providers, our goal is to support and work with children and their families. We care about supporting children and their families from birth through their developmental journey to ensure the very best outcomes, enhancing quality of life and self-management.

Setting up children for success through wraparound care and specialized services

Dr. Diane Moddemann

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PHOTOS: While in hospital, children receive play programming


Consider this: when kids need emergency care, only 15% of children are first brought to a children’s hospital. Most go to a general adult facility. So, how does the latest, evidence-based knowledge make its way to general emergency healthcare practitioners and families so that kids receive the very best care?

TREKK—or TRanslating Emergency Knowledge for Kids, was established in 2011 to meet that challenge. TREKK’s national network of clinicians, researchers, parents and families work collaboratively to ensure that up-to-date research in pediatric emergency care is available to all children—whether they live in large, urban centres or small, rural or remote communities.

TREKK Executive Director Lisa Knisley shares, “Our strategy involves collaborating with healthcare professionals to develop evidence-based information, tools and training that meet their needs. Building connections between general and pediatric emergency departments is important. Equally important is our work with parents to develop resources that are meaningful and useful for them when their child is sick or injured.”

The Children’s Hospital Research Institute of Manitoba (CHRIM) is home to both TREKK’s head office and to the Innovative Pediatric Clinical Trials Program (IPCT). This proximity helps facilitate a strong linkage between emerging research, knowledge-sharing and clinical application.

IPCT works to address the issue that so many treatments provided to kids are only tested on adults.

Tannis Erickson, Executive Director of the Research Support Unit at CHRIM adds, “We are making new discoveries every day that can positively impact pediatric emergency care. For example, recent research has resulted in new treatments for early onset type 2 diabetes.” TREKK responds to new research like this with timely preparation and distribution of information.

Clinical trials to specifically treat children are so important because of their different physiological makeup and responses to medications.

TREKK began its work in 2011 with a needs-assessment. It surveyed more than 1,400 health professionals and nearly 900 parents at 32 general emergency departments to identify pediatric information needs and preferences and build its program.

Today, TREKK offers robust resources, tools and outreach programs that include an app, a website—trekk.ca—and on-site teachings to general emergency department staff.

What’s ahead? Collaborations are underway to adapt TREKK tools to meet the needs of health care professionals working in remote nursing stations (with Indigenous Services Canada) and United States emergency departments, further demonstrating the need and enthusiasm for these resources.

120education sessions delivered over 2015 to 2019, reaching over

550Bottom Line Recommendations for diagnosis and treatment downloaded more than

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320increase in access of resources on trekk.ca from 2017/18 to 2018/19

%increase in the number of general emergency departments and nursing stations connected with TREKK

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physicians, nurses, respiratory therapists, pharmacists, and paramedics.

Working together to improve emergency care for all kids across CanadaTREKK and IPCT

Tannis Erickson

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PHOTO ABOVE: Patient receiving care in the emergency department of the Children’s Hospital


The Children’s Hospital recognizes the value of engaging parents and other stakeholders and encouraging them to share their firsthand experiences to help shape programs and services for children and youth.

The Rehabilitation Centre for Children (RCC) Parent Advisory Council is an example of an engagement mechanism. The Council provides parents’ perspectives for the Specialized Services for Children and Youth Centre (SCCY), which opened in 2016. It had significant input into many aspects of the Centre including how the building was designed, to best accommodate needs of patients and families.

RCC/SSCY Council Chair, Carrie Costello is a mother of three children, whose middle daughter receives treatment at SSCY Centre for a developmental

delay. Costello is also a parent advisor for the BRIGHT Coaching project—a part of the CHILD-BRIGHT Network. The Network aims to improve life outcomes for children with developmental differences and their families.

Recently, Costello took the initiative to bring a series of workshops to the SSCY Centre through a CHILD-BRIGHT KT Café grant. Costello wanted to share information about the importance of bringing siblings of children with developmental disabilities into family-centred care. She reached out to BRIGHT Coaching’s Manitoba research

team for support to apply for the grant. Although KT Café grants are typically awarded to researchers, the CHILD-BRIGHT Knowledge Translation Program was open to Costello’s application, and together with Dr. Kristy Wittmeier—a University of Manitoba research lead appointed to the Dr. John M. Bowman Chair in Pediatrics and Child Health, a submission was developed.

Costello explains her motivation for applying for the grant: “Siblings often represent the longest relationship a person with a disability will have, but they are often figuratively and literally left in the waiting room. It’s so important to involve them in care, and give them space to share feelings, play and connect with other siblings who are in the same boat.” Costello adds that siblings of those with developmental delays can fall into the category of caregiver, perfectionist or develop feelings of anger and frustration if left out.

Dr. Wittmeier, who was awarded appointments to the University of Manitoba, Shared Health, SCCY and the Children’s Hospital Research Institute of Manitoba (CHRIM) for her innovative contributions to parent engagement and knowledge transfer adds, “Healthcare and research become stronger when family members are involved in planning and decision making. Carrie, specifically, has driven our team to think more broadly about what family-centered care means.”

The grant was approved, and Costello used the funds to bring in specialists to speak at a workshop for parents and other events for healthcare professionals. Costello says, “These presentations involved hearing from a sibling about her experience and a more scientific approach to what concerns siblings typically have at certain ages. As well, there were practical suggestions on how to involve siblings in work with their

families.” With additional funding and support provided by CHRIM, local social worker Julie Walsh ran a series of “SibShops” specifically created for the sibling of children with disabilities.

Overall, the events supported by the grant had more than 125 participants across all aspects of a child’s care: siblings, families, therapists and other medical professionals.

Costello reported that while it was challenging to complete the research part of the application for the grant, she received great support from researcher Dr. Wittmeier, and would do it again.

All in all, it has been a really fulfilling process to be directly involved and able to affect change.

PHOTO ABOVE: Parent Carrie Costello with her daughter

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Parents provide input into children’s programs and services

Another example of family engagement is the iCARE Participant Advisory Group, which is made up of youth and caregivers living with type 2 diabetes in Manitoba. This group shares their lived experiences to ensure research and healthcare services are listening to the needs of patients and their families. It plays an important role in growing type 2 diabetes research in the province and across Canada.


Carrie Costello

PHOTO LEFT: iCARE Participant Group Advisory members provide feedback about their experiences

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CHRIM brings together top researchers from a variety of health disciplines who share a common goal of improving the health of children and youth. By including a wide range of disciplines, CHRIM has the unique ability to look at the overall picture of pediatric health – not just one area.

The Institute offers a unique model that fosters a collaborative and innovative research environment. Researchers are

Top researchers work to develop a healthier future for children and youth

brought together with clinicians who are seeing the children, assessing them and facing these very tough medical issues. The clinicians can then work directly with the scientists at the Institute, offering hope to children and their families as researchers work towards medical breakthroughs and cures for childhood illness.

“This is only possible because of the tireless effort of our researchers, their staff and students, CHRIM support staff,

research participants, volunteers, and donors. We are incredibly grateful for your passion and commitment to a healthier future.” Dr. Terry Klassen, CEO and Scientific Director, Children’s Hospital Research Institute of Manitoba.

There are two primary research themes at the Institute. The first theme—Biology of Breathing (BoB), is made up of 15 principal investigators who are working together to carry out innovative

research in pediatric pulmonary disorders such as asthma, oxidative stress, newborn apnea, and more. A strong focus within BoB is a group dedicated solely to asthma and allergies in children, on the development origins of health and disease (DOHad). These scientists work together to examine the key biological and environmental factors in early life that may cause/prevent these diseases.

DREAM, which stands for Diabetes Research Envisioned and Accomplished in Manitoba, is another key theme within CHRIM. Type 2 diabetes is the fastest growing chronic illness in Canada, and Manitoba has one of the highest rates of type 2 diabetes in children in the world. The DREAM theme works towards excellence in epidemiological and basic science research in the area of obesity and type 2 diabetes complications in youth and makes important discoveries that will lead to better prevention and treatment of this disease.

Aside from these the two primary themes, researchers bring their expertise to other programs including emergency medicine and knowledge translation, as well as genetics and rare diseases.

The Children’s Hospital Research Institute of Manitoba occupies two floors of the John Buhler Research Centre and includes 64,000 square feet of research space. This space includes both basic science and clinical space in the Research Support Unit (RSU). Currently, there are 88 research projects underway within the RSU.

CHRIM has 150 faculty members from nine different departments and three faculties in the University of Manitoba, plus

members from other universities. CHRIM is an active partner in recruitment of new faculty members.

The Department of Pediatrics and Child Health collaborates with CHRIM to streamline nearly all research endeavors through the Institute. CHRIM helps facilitate most research in the HSC-Children’s Hospital and maintains important partnerships with other sites, like the research hub in Specialized Services for Children and Youth (SSCY).

The George and Fay Yee Center for Healthcare Innovation (CHI) collaborates with clinicians, researchers, leadership and policy makers to generate and apply patient-oriented research in the health system and health

policy environments. CHRIM’s collaborations with CHI have led to system changes that greatly improve the facilitation of research in Child Health.

Research is the only solution we have to try to advance and improve the care of children. That is why research is so fundamentally important for the health of children and families in this province.

The Children’s Hospital Research Institute of Manitoba (CHRIM) is the research division of the Children’s Hospital Foundation of Manitoba. At the Institute, more than 270 world-class pediatric medical researchers, technical staff, students, and support staff are involved in nearly $20 million of research and clinical trial activity each year. CHRIM is the first research facility dedicated exclusively to pediatric research in the prairie provinces.

Dr. Terry Klassen

64,000

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PHOTO RIGHT: Stephanie Kereliuk, DREAM Trainee in the lab

each year


Just as it takes a village to raise a child, it takes committed clinician scientists to tackle type 2 diabetes in children and adolescents—one of Manitoba’s fastest growing childhood chronic illnesses.

While type 2 diabetes remains relatively rare in children under 18 years of age in other provinces, the rate in Manitoba is 10 to 20 times higher than the national average. For every child diagnosed with type 1 (formerly known as juvenile) diabetes, another is diagnosed with type 2 diabetes.

In 1985, when Dr. Heather Dean, now a retired Pediatric Endocrinologist and Professor Emeritus at the University of Manitoba, saw Canada’s first child with type 2 diabetes, the

scientific and clinical communities didn’t believe her. That’s because, until then, type 2 diabetes was considered an illness of middle-aged and older adults and was not described in children.

Like type 1 diabetes, type 2 diabetes can lead to serious complications including kidney failure and blindness. Studies conducted by members of the Department of Pediatrics and Child Health have demonstrated higher rates and earlier onset of complications in youth with type 2 diabetes compared to both

youth with type 1 diabetes and to those with adult-onset type 2 diabetes. Dr. Elizabeth Sellers, Pediatric Endocrinologist, adds, “Children with type 2 diabetes are developing end-stage complications in their early 20s or 30s.” As Manitoba’s “hot-spot” for type 2 diabetes in children, clinicians are doing everything they can to prevent these complications, and reverse the trend.

When Dr. Dean and her colleagues first tried to publish their findings, they were rebuked. Dr. Dean remained steadfast and decades later, the community cites her and The Diabetes Education Resource for Children and Adolescents (DER-CA) as pioneers in the field, warning Canadian healthcare providers of this emerging health crisis.

The DER-CA is a provincial care program that provides specialized, evidence-based care, education, support, advocacy and research for children living with all types of diabetes, up to age 18.

The discovery, the DER-CA’s fight for awareness and pioneering clinical science, is described in elegant detail in a book by Larry

Krotz, Diagnosing the Legacy: The Discovery, Research and Treatment of Type 2 Diabetes in Indigenous Youth. It details the journey of how First Nations communities, pediatric specialists and health professionals in Manitoba moved from awareness to treatment to become internationally recognized leaders in the area.

Flash forward to 2019. Teams of researchers, clinicians and other allied healthcare workers in the Department of Pediatrics and Child Health, in Shared Health Manitoba and in the Children’s Hospital Research Institute of Manitoba (CHRIM) are working to identify, treat and ultimately find a cure for the disease. Says Dr. Seth Marks, Section Head of Pediatric Endocrinology and Metabolism, “Our team is highly motivated and collaborative so that patients and families receive the best quality of care and can lead a normal lifestyle.”

Adds Dr. Marks, “About 80% of children with type 2 diabetes reside outside of Winnipeg. Outreach and Telehealth programs, along with partnerships with communities and health authorities are an important part of our work.” The DER-CA also partners with researchers in basic and clinical science alongside population health to contribute to new knowledge and sharing of that knowledge with those they serve.

The DER-CA research is supported by its collaboration with the Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) research team at CHRIM. This team involves several of the clinician scientists at the DER-CA including Dr. Elizabeth Sellers and Dr. Brandy Wicklow.

Dr. Elizabeth Sellers

PHOTO ABOVE: Dr. Heather Dean and Bertha Flett, RN on a research outreach visit in Northern ManitobaPHOTO ABOVE RIGHT: Art developed in the Art Therapy Program

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Childhood-onset type 2 diabetes – experts tackling this fast-growing chronic illness


DREAM has three main areas of research that support clinically relevant discoveries that will help to improve diagnosis, prevention and management of both the disease and its complications. A nationally funded study within DREAM, the ‘iCARE’ cohort, focuses on understanding the complex factors that result in kidney complications in adolescents with type 2 diabetes . The “Next Generation” study focuses on improving our understanding of the intergenerational effects of type 2 diabetes with the aim to intervene and break this cycle. DREAM, from its inception, has committed to working alongside Indigenous communities in a

culturally-safe way to make discoveries and improve the lives of children and families affected by type 2 diabetes.

When youth approach their 18th birthday and “age-out” of the DER-CA’s pediatric care, the collaboration and care continue through The Maestro Project. Based on evidence that young adults with diabetes are a vulnerable group needing unique care and health services delivery, The Maestro Project was created to help patients aged 16 to 30 make a successful transition to the adult healthcare system. Catherine MacDonald, an art therapist and coordinator with the Project states that, “Transferring to adult care can come at a time of intense social pressures in addition to physical and lifestyle changes. Young adults can be faced with challenges to navigate an adult-oriented healthcare system that differs in many ways from the pediatric system.”

Working together, DER-CA and The Maestro Project continue to evaluate and develop new initiatives to enhance the transition of care for young adults. Recent initiatives have included creative programs like group art therapy. Adds MacDonald, “Type 2 diabetes is proving to be a disease with intergenerational trauma. Art programs are one way to help young people and their families express their experiences and journey and find meaning.”

We find that art is a good way to make connections and build relationships. And by interpreting the art, we also gain information to help us better understand a patient’s lived experience with their diabetes.

Says Dr. Marks, “The DER-CA team will continue to work hard, lead and collaborate with youth, families, communities, and other healthcare professionals to provide the best care possible to the children of Manitoba living with both type 1 and 2 diabetes. The high rate of type 2 diabetes in Manitoba is unfortunate and challenging, but it offers us the unique privilege and opportunity to care for, advocate and work with children and their families. We continue to try and build on the foundations of care that were initiated almost four decades ago.”

Meet our Canadian Medical Hall of Fame Laureates!The University of Manitoba’s Rady Faculty of Health Sciences has a proud history with the Canadian Medical Hall of Fame. The Department of Pediatrics and Child Health is honoured that two of our members have been recognized with this prestigious distinction in 2017 and 2018.

Dr. Estelle Simons

Dr. Simons’ legacy includes 580 peer reviewed publications, many of which are highly cited (h-index 82). Her innovative research on pharmacologic treatment of asthma, allergic rhinitis and anaphylaxis and on immune modulation of allergic diseases has contributed to mitigation of the impact of the allergy epidemic around the globe.

Born and raised in Vancouver, she received her BSc and MD (Honours) from the University of Manitoba, and studied pediatrics and allergy/ immunology at the University of Washington. In 1975 she founded the Section of Allergy and Clinical Immunology in the Department of Pediatrics and Child Health at the University of Manitoba, and was Section Head until 2005.

Dr. Estelle Simons was inducted into the Medical Hall of Fame in 2017 to honour her leadership achievements in building excellence in healthcare for Canadians and the world. Dr. Simons’ scientific accomplishments are remarkable, because her entire career has been spent at the forefront of discovery.

Dr. Cheryl Rockman-Greenberg was inducted into the Medical Hall of Fame in 2018 to honour her leadership achievements in health promotion, illness prevention and care. An outstanding and highly respected scholar, Dr. Rockman-Greenberg is best known for advancing and translating scientific discovery into new treatments and novel approaches for genetic neuromuscular and skeletal disorders.

Catherine MacDonald

PHOTO ABOVE: Art developed in the Art Therapy Program

Dr. Simons served as President of the Canadian Society of Allergy and Clinical Immunology and as President of the American Academy of Allergy, Asthma and Immunology. Among her more than 60 awards, she has been honoured by both these organizations for her lifetime achievements.

She has also received the Canadian Medical Association Medal of Service, the American Academy of Pediatrics Award for Allergy and Immunology Research, and the World Allergy Organization Scientific Achievement Award. She is a Fellow of the Canadian Academy of Health Sciences and a Fellow of the Royal Society of Canada.

Dr. Cheryl Rockman-Greenberg

Dr. Rockman-Greenberg is the leading Canadian researcher in the treatment of hypophosphatasia (HPP), an often fatal bone disease that results from a missing enzyme.

She also developed targeted DNA-based screening programs for newborns in Manitoba for a number of rare conditions including glutaric aciduria type 1 in the Oji-Cree and carnitine palmitoyltransferase I deficiency in Hutterites. These newborn screening programs were aimed at groups with higher incidence of these treatable conditions than the general population.

Dr. Cheryl Rockman-Greenberg was born in Montreal and received a MDCM from McGill University in 1974. In 1979, she began work as a clinical and

metabolic geneticist for the Winnipeg Regional Health Authority. She was director of the Metabolic Service in the Program of Genetics and Metabolism from 1992 to 2015. From 2004 to 2014, she was head of the Department of Pediatrics and Child Health at the University of Manitoba and Medical Director for the Child Health Program at the Winnipeg Regional Health Authority. She is a clinician scientist at the Children’s Hospital Research Institute of Manitoba. In 2012, she was named one of the Top 100 Most Powerful Women in Canada by the Toronto-based Women’s Executive Network. In 2015, she was bestowed the title of Distinguished Professor at the University of Manitoba. In 2018, she was invested into the Order of Manitoba.


When Dr. Jacqueline Richelle (featured on the cover) was considering where to pursue her postgraduate medical education to specialize as a pediatrician, the choice was clear—The Faculty of Health Sciences College of Medicine.

Now in her fourth year of the program, the Chief Resident says Manitoba is a hidden gem and is becoming known as the place to be. “The training here is like no other program across the country. We’re given more hands-on learning early in the program—within a safe and supervised environment. We become senior residents at the end of our first year—sooner than other programs.”

Approximately 40 residents are in various stages of training in general pediatrics at any given time. Program Director, Dr. Jayson Stoffman, shares “We offer a breadth of academic and clinical experience, and residents find that everything we do here is integrated. The concepts of social pediatrics are applied to all aspects of a child’s needs in care plans.”

Dr. Stoffman explains the program is very attractive to residents looking for broad experience that includes opportunities to try all sub-specialties, rotations in rural and northern communities, research training and contributions to advocacy projects.

“The residents’ rotations in Brandon and Thompson, Manitoba are invaluable for developing community outreach skills,” says Dr. Stoffman. Dr. Richelle agrees and says her remote and rural experiences were rewarding and provided exposure to treating complex health issues in an environment with access to fewer resources compared to a tertiary healthcare centre.

Besides receiving comprehensive academic and clinical training, third year residents choose a topic that they will advocate for change through Manitoba’s unique Advocacy Project. Residents’ advocacy work has resulted in important systemic social changes including legislation requiring mandatory bike helmets and banning tanning beds for youth.

Research and scholarly pursuits are encouraged early in training, with the novel ASK (Academic SKills) curriculum in the first year of residency and collaboration with the Children’s Hospital Research Institute of Manitoba.

All residents are supported to develop and complete a scholarly project, and many have led to a manuscript for publication or presentation at national and international meetings.

Dr. Stoffman says Manitoba’s program gives residents the experience and insight to inform their career plans. “Our fourth year of residency could become the first year of sub-specialty. That year is deliberately left open with lots of room for electives, so trainees can tailor towards their interests, and space to study for important exams.”

What does Manitoba’s program mean to Children’s Hospital patients and their families?

Most of our grads stay where they’ve trained—here in Manitoba. Patients and their families will continue to benefit from the exceptional knowledge, skills, and abilities our residents have acquired.

Dr. Richelle concludes: “I have a commitment to my province, and I plan to stay in Manitoba to practice as a general pediatrician and give back to the community that has given me this wonderful opportunity.”

Pediatric Residency – HSC earns the reputation as the place to be!

Dr. Jayson Stoffman

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PHOTO ABOVE: Dr. Jayson Stoffman, PEDS PGME Director and R1-R4 Pediatric Residents



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Pediatric Education Programs

Students

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Fellows and Subspecialty Residents

Nurse Practitioner Program

Physician Assistant Program

International Medical Graduate Program

11 Sub-specialty Postgraduate training programs

“Innovative”, “continuous improvement” and “a supportive learning environment” are just a few ways to describe the Pediatric Undergraduate Medical Program at the Max Rady College of Medicine.

Program Director Dr. Maury Pinsk shares, “The Program provides the basic knowledge, skills and attitudes appropriate for pediatric medicine, and gives graduates

a solid foundation for being competent healthcare providers both inside and outside of pediatrics.”

At any given time, about 440 students are learning their way through the four-year program which involves two years of Pre-Clerkship followed by Clerkship and a transition to Residency. Dr. Pinsk explains that throughout the program there is “curricular oversight” where students’ progress is reviewed, and gaps are quickly addressed to support a successful learning journey. Program Nurse Coordinator

Gillian Nattress echoes her colleague, “We do really well at assessment—identifying who is excelling and who needs more support.”

During the first two years, pediatric teaching blocks are delivered through lectures, interactive tutorials, small group problem-based learning sessions, independent learning, bedside teaching and clinical sessions with both actual and “standardized” patients. The result is a combination of listening, self–directed study, group study

and hands on experiences for the students. This appeals to students’ different learning styles and provides a framework for the six-week pediatric rotation in the Clerkship years.

Dr. Pinsk says in year three, students gain well-rounded experience by working in outpatient clinics and on wards with children with common and complex medical needs. “Students take on responsibility early in this program and do so in a safe, supported learning environment. This includes opportunities to be first person on the scene and to work one-on-one with faculty and medical staff, including pediatric Residents from the Pediatric Post-Graduate Medical Education Program.” He adds that the curriculum provides many team-based learning opportunities and interprofessional collaborations for nursing and medical students to work together and build understanding and appreciation for each others’ roles.

In the final year of the program—transition to Residency—students can return to pediatric clinics and work in a general or sub-speciality area as well as pursue Pediatric elective rotations.

In 2019, The University of Manitoba’s UGME program underwent an accreditation survey by the Committee of Accreditation of Canadian Medical Schools (CACMS), the overseeing body for medical education in Canada. The undergraduate program received full accreditation in this process, noting that there were many areas of excellence in both curriculum design, assessment,

and student wellbeing. This highlights the strong commitment the Department and University have to ensuring medical learners are supported in achieving excellence in medical training.

440405

Learners

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Undergraduate Medical Education

Pediatric Postgraduate Medical Education

Genetics Postgraduate Medical Education

Results show that students respond well to the many standout features of Manitoba’s program, and find themselves well prepared to deliver top-notch care for Manitoba’s children and youth.

Supportive learning environment leads to top-notch practitioners

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PHOTO ABOVE: Dr. Ming-Ka Chan with medical traineesPHOTO ABOVE RIGHT: Dr. Adena Madison conferring with medical trainees


According to Centre for Global Public Health (CGPH) experts, the leading causes of death among children across the globe are all preventable with good healthcare for mother and baby at the time of birth, along with proper sanitation, nutrition, immunization and treatment of diseases like pneumonia and diarrhea.

Dr. Maryanne Crockett, a global health leader and associate with CGPH, knows this all too well. For the past 10 years, Dr. Crockett has been applying her expertise as a pediatric infectious disease specialist within the Department of Pediatrics and Child Health to improve peoples’ health in impoverished communities in India, Pakistan, Kenya and Nigeria, where CGPH has permanent offices.

Dr. Crockett says, “Ongoing research, expertise and collaborative partnerships are needed to make a real difference over the long term. By working

together, we can enhance the knowledge of local healthcare workers and improve the design and delivery of healthcare programs.”

Dr. Crockett has spent much time in Uttar Pradesh, India—a state with a population of 200 million and a high neonatal mortality rate. She, along with other University of Manitoba doctors and researchers, have had the privilege to improve health in this region and other communities and have seen the number of global child deaths lowered to 5.4 million in 2017 from 12.6 million in 1990.

While we’re seeing positive results through our work, more work needs to be done in order to reach the poorest of the poor and to better empower girls and women.

Dr. Crockett goes on to explain that the health of a woman is directly linked to the health of her children, the family and, in turn, the larger community. “By providing a critical package of intervention to girls from young childhood to pre-pregnancy through motherhood, we can make a huge positive impact on the lives of the entire community.”

We celebrate 30 years of the Convention on the Rights of the Child!Thirty years ago, the Convention recognized children as their own beings entitled to non-negotiable rights. Nearly all governments around the world have pledged to respect, protect and promote those rights.

While progress has been made during the past three decades, significant challenges remain—in particular for girls, children with disabilities and children in disadvantaged and vulnerable situations. The Convention on the Rights of the Child protects the rights of all children, everywhere, to be free from discrimination, violence and neglect. It means that, for example:

• children need to be treated with dignity and respect;

• that they should be cared for, develop and be part of their communities;

• that they have a right to an education, to express their own opinions and to participate in decisions that concern them;

• and that they have the right to be protected against all violence and discrimination, wherever they live, regardless of their ethnic or social origin, property, disability, birth or other status.

Part of the bigger picture – improving global health

Dr. Maryanne Crockett

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The Department of Pediatrics and Child Health has long contributed to the fight against some of the world’s deadly diseases. In particular, Dr. Jim Strong is leading studies that illuminate the pathophysiology of Ebola infection and the impact of intensive care on its severe disease. From another angle, Dr. Guillaume Poliquin is investigating the long term protection conferred by the VSV-Ebola vaccine, initially developed by the Public Health Agency of Canada’s National Microbiology Laboratory.

The work can’t happen fast enough as the worst Ebola outbreak in history began in 2013 and in 2019, the World Health Organization declared the recent Ebola outbreak in the Democratic Republic of Congo (DRC) to be a public health emergency of international concern.

The Department of Pediatrics and Child Health is committed to fostering new approaches to patient care both locally and globally, and to supporting the important work of our faculty members.


Social & Northern Ambulatory Pediatrics (SNAP)

General pediatricians in SNAP provide medical care and advice, diagnostics and referrals around the development, care and diseases of infants, children and adolescents.

Dr. Margo Lane, Section HeadDr. Abdalla AliDr. Maureen L. Collison Dr. Megan J. Cooney Dr. Michelle DurstDr. Elske Hildes-Ripstein Dr. Jeffrey R. Hyman Dr. Wail KassemDr. Shamina Kassum Dr. Annika Klopp Dr. Sylvia Kovnats Dr. Shareef F. Mustapha Dr. Diana Popescu

Pediatric Allergy & Clinical Immunology

The Section of Pediatric Allergy & Clinical Immunology focuses on care for children and youth with allergic disease, including food allergy, asthma and environmental allergies, as well as immunodeficiency disorders.

Dr. Elinor Simons, Section HeadDr. Elissa Abrams Dr. Allan Becker Dr. Nestor CisnerosDr. Anna Drewniak Dr. Thomas GerstnerDr. Michelle Halbrich Dr. Tamar Rubin

In the Department of Pediatrics and Child Heath, 96 full time faculty members who are medical doctors, eight full time PhD scientists, and around 148 affiliated faculty members are involved in care, research and education in Manitoba, North Western Ontario, Nunavut and at times, in other provinces. They provide care to children and youth in hospital wards, in outpatient clinics, through Telehealth, and through travel to northern and remote communities. In addition to these members, the department celebrates 10 professor emeriti, one distinguished professor, 22 affiliated medical staff providers, and many trainees and fellows engaged through 17 education programs in the department.

Members are mentioned by their primary specialty or affiliation as of September 1, 2019. Many faculty members however, are active in multiple areas.

Pediatric Cardiology

Pediatric cardiologists specialize in the diagnosis and management of congenital and acquired heart disease in children and youth.

Dr. Reeni Soni, Section HeadDr. Ilan Buffo-Sequeira Dr. Dionissios Pepelassis Dr. Daryl I. Schantz

Child Development

Developmental pediatricians provide assessment, referral, support and treatment for preschool aged children who may have developmental concerns, providing follow up care throughout their childhood and beyond.

Dr. Ana Hanlon-Dearman, Section Head Dr. Janice BlampyDr. Carla BowesDr. Sally LongstaffeDr. Diane Moddemann Dr. Stefanie Narvey Dr. Maria Florencia Ricci BartolDr. Tannis Wiebe

Child Protection

The Child Protection Centre is an assessment and early intervention unit for children who experienced abuse and their families. Child protection specialists provide assessment and/or intervention services, expertise, consultation and educational services to stakeholders.

Dr. Tavis R. Bodnarchuk, Section HeadDr. Stacey A. Bynkoski Dr. Lindsey CunningtonDr. Deborah Lindsay

Faculty Appointed Pediatric Community Pediatricians and Remote and Rural Practicing Pediatricians

General pediatricians in these practices provide primary health care, including diagnosing and referrals, education and advice, and immunizations to children and youth.

Dr. Janet Grabowski, Manitoba Clinic, Section Head

Dr. Adena Madison, Manitoba Clinic, Section Head

Dr. Moyosoluwa Adeyemi, Thompson NHA (Northern Health Authority)

Dr. Narges Afshar, Morden SH (Southern Health)Dr. Lauri Alto, Manitoba ClinicDr. Muhammad Ansari, Manitoba ClinicDr. Wasiu Ayinde, Brandon PMH (Prairie

Mountain Health)

Dr. Barry Bermack, Portage Trail PediatricsDr. Nancy Bowman, Manitoba ClinicDr. Marlen Canlas-Yamsuan, Meadowood

Medical CentreDr. Aubrey Caplan, Red River Medical CentreDr. David Connor, Manitoba ClinicDr. Jennifer M.L. Coombs, Manitoba ClinicDr. Faith R. Cormier, Manitoba ClinicDr. Meghan E. Cranston, Sterling Lyon Pediatrics Dr. Aran Dangerfield, Manitoba ClinicDr. Linda Deonarine, Main Street Clinic Dr. Michelle Feierstein, Manitoba ClinicDr. Fiona Fleming, Manitoba ClinicDr. Rachael Gardner, Manitoba ClinicDr. Ruth Grimes, Sterling Lyon PediatricsDr. Marni K. Hanna, Manitoba ClinicDr. Audrey Javellana, Sterling Lyon Pediatrics Dr. Samuel Jebamani, Jebamani Children’s ClinicDr. Lorraine Kerr, Provencher PediatricsDr. Matthew H. Lazar, Sterling Lyon PediatricsDr. William T. Li, Manitoba ClinicDr. Stanley Lipnowski, Manitoba ClinicDr. Grant L. MacDougall, Manitoba ClinicDr. Eddsel Martinez, Sterling Lyon PediatricsDr. Norman McLean, Manitoba ClinicDr. S. Nazar-Ul-Iman, Manitoba ClinicDr. Sailaja Nemani, Brandon RHADr. Jina Pagura, Sterling Lyon PediatricsDr. Justin Penner, Thompson NHA Dr. Vanessa Percy, Thompson NHA

(Northern Health Authority)Dr. Bradley Pollock, Manitoba ClinicDr. Wesley Robinson, Provencher PediatricsDr. Brett M. Schrewe, RHADr. Natalie Schur, Pritchard Farm Health CentreDr. Jason Tapper, Manitoba ClinicDr. Tiffany Wengel, Portage Trail Pediatrics

Pediatric Dermatology

Pediatric dermatologists diagnose, treat and provide care to children and youth with a wide variety of skin conditions.

Dr. Jill A. Keddy-Grant, Section Head Dr. Beth Collin Dr. John W.P. Toole

Pediatric Emergency Medicine

Pediatric emergency medicine specialists provide care for children and teens who are acutely ill or injured. They are trained to care for a wide range of problems that require immediate medical evaluation.

Dr. Elisabete Doyle, Section HeadDr. Karen Gripp, Section HeadDr. Rami AblemanDr. Darcy BeerDr. Gerald BrennanDr. Stevi Golden-PlotnikDr. Joanne Hamilton Dr. Amin KabaniDr. Terry P. KlassenDr. Shelagh K. MackenzieDr. Bryan D. MagwoodDr. Marilyn RaizenDr. Tracy S. RidleyDr. Scott SawyerDr. Norman SilverDr. Milton Tenenbein Dr. Jennifer F. Teskey Dr. Lynne WardaDr. Susan WebbDr. Andrea Wilkie-GilmoreDr. Grant Yung

Pediatric Endocrinology & Metabolism

Pediatric endocrinologists provide care to children with endocrine disorders, such as those that affect growth, puberty, pituitary function, adrenal function, thyroid function, gender identity and bone health and children living with type 1, type 2 or any other forms of diabetes.

Dr. Seth Marks, Section HeadDr. Katherine Pundyk Dr. Celia J. Rodd Dr. Elizabeth A.C. Sellers Dr. Brandy Wicklow

Pediatric Gastroenterology

Pediatric gastroenterologists are concerned with diagnostics, treatment and care around disorders of the gastrointestinal tract, liver and pancreas.

Dr. Jennifer A. Griffin, Section HeadDr. Wael El-Matary Dr. Quais Mujawar

Genetics & Metabolism

From testing and diagnosis to leading-edge therapies, geneticists and genetic counselors help manage hereditary conditions for patients and families throughout their lives.

Dr. Bernard N. Chodirker, Section HeadDr. Patrick Frosk Dr. Bita Hashemi Dr. Sandra Marles Dr. Aziz Mhanni Dr. Tyler R. PeikesDr. Cheryl Rockman-GreenbergDr. Eugenio Zapata-Aldana

Pediatric Hematology & Oncology

Pediatric hematologists and oncologists diagnose, treat, and provide care to children and youth with cancers, and diseases of blood cells, including disorders of white cells, red cells and platelets and bleeding disorders.

Dr. John J. Doyle, Section HeadDr. Tanya R. M. BrownDr. Ashley J. ChopekDr. Geoffrey D.E. CuvelierDr. Sara IsraelsDr. Magimairajan Issaivanan Dr. Jayson M. Stoffman

Pediatric Hospital Medicine

Pediatric hospitalists are pediatricians who manage inpatients on the Clinical Teaching Units.

Dr. Geert W. ‘t Jong , Section Head Dr. Christopher M. Hohl Dr. Alexey LitvinovDr. Jaret K. McLeodDr. Lindsay TeskeyDr. Tiffany Wengel

Continued next page

Members of the Department of Pediatrics and Child Health


Pediatric Infectious Diseases

Pediatric infectious diseases specialists focus on recurring or persistent disease caused by an infectious agent such as a bacteria, a fungus, a parasite or other rare infection.

Dr. Maryanne Crockett, Section Head Dr. Jared M.P. Bullard Dr. Rachel A. DwilowDr. Joanne E. Embree Dr. Sergio T. Fanella Dr. Guillaume Poliquin Dr. Paul G. van Caeseele

Neonatology

Neonatologists provide medical care to newborn infants who are ill or prematurely born.

Dr. Michael R. Narvey, Section HeadDr. Ruben Alvaro Dr. John Baier Dr. Rebecca CacesDr. Aaron ChiuDr. Shyamala Dakshinamurti Dr. Cecilia De CaboDr. Yasser El-SayedDr. Deepak LouisDr. Fabiana A. PostolowDr. Chelsea RuthDr. Mary (Molly) M.K. SeshiaDr. Ganesh Srinivasan Dr. Man (Ann) Yi

Pediatric Nephrology

Pediatric nephrologists diagnose, treat and care for children and youth with disorders affecting the kidney and urinary tract.

Dr. Aviva M. Goldberg, Section Head Dr. Patricia E. Birk Dr. Allison B. DartDr. Kristen L. PedersonDr. Maury Pinsk

Pediatric Neurology

Pediatric neurologists are subspecialists who treat children with neurological disorders, including the brain, spine, nerves, or muscles result in, among other, seizures, headaches or developmental delays.

Dr. Edward Leung, Section HeadDr. Aoife M. O’CarrollDr. Qi (Helen) XuDr. Michael SalmanDr. Samantha E. Marin Dr. Mubeen Rafay

Pediatric Palliative Care

Physicians who work in palliative care specialize in medical care for children living with serious illness and focus on providing relief from the symptoms and stress of the illness, with the goal to improve quality of life for both the child and family.

Dr. Bruce Martin, Section HeadDr. Nadin Gilroy Dr. David LambertDr. Robin McClure Dr. Suzy Pinnick

Pediatric Intensive Care

Pediatric intensivists specialize in the care of critically ill children or adolescents, admitted to the hospital.

Dr. Stasa Veroukis, Section Head Dr. Valerie A. BruléDr. Jeff Burzynski Dr. B.J. HancockDr. Murray S. Kesselman

Pediatric Rehabilitation & Complex Care

These specialists provide treatment and care to children and youth with complex medical issues and coordinate the support from different providers to ensure wrap around care for children and their families.

Dr. Regina R. Rempel, Section Head Dr. Jenette HaywardDr. Kyle Millar Dr. Vera Saad

Pediatric Respirology

Pediatric respirologists provide diagnostics and care to children and youth with lung diseases and issues regarding respiration and ventilation.

Dr. Tareq Alabdoulsalam, Section HeadDr. Raquel Consunji-AranetaDr. Shaikh Mohammed Iqbal

Pediatric Rheumatology

Pediatric rheumatologists provide diagnostics, treatment and care to children and youth with disorders of the musculoskeletal system (joints, muscles, bones or tendons), including arthritis and autoimmune disorders.

Dr. Kerstin Gerhold, Section HeadDr. Siok Hoon (Lily) Lim

Pediatric Sports & Dance Medicine

These specialists diagnose, treat and manage musculoskeletal medical problems of children/teens that relate to injury or illness affecting sports performance, exercise or activity.

Dr. Merrilee Zetaruk, Section Head

PhD Scientists

Faculty members appointed to the Department as full time scientists and educators, with a wide variety of backgrounds and research interests.

Dr. Meghan AzadDr. Bradley DobleDr. Lauren KellyDr. Jon McGavockDr. Jennifer ProtudjerDr. Kelly RussellDr. Kristy WittmeierDr. Teresa Zelinski

Emeritus Appointments and Distinguished Appointments

Dr. Victor Chernick, Professor Emeritus (2002) Dr. Albert Chudley, Professor Emeritus (2017) Dr. Heather Dean, Professor Emeritus (2016) Dr. Marion Lewis, Professor Emeritus (1996) Dr. Sally Longstaffe, Professor Emeritus (2017) Dr. Hans Pasterkamp, Professor Emeritus (2019) In memoriam, Dr. Henrique Rigatto,

Professor Emeritus (2007) Dr. Daniel Samuel Sitar, Professor

Emeritus (2010) Dr. Marlis Schroeder, Professor Emeritus (2015) Dr. Estelle Simons, Professor Emeritus (2016) Dr. Cheryl Rockman-Greenberg, Distinguished

Professor (2015)

Other Medical Staff Members

House medical officers, physician assistants and clinical assistants play an essential role in the day to day care of children and youth who receive care in our facilities, and are closely involved with the guidance of trainees and students.

Dr. Nizar Abazid, HMO, NeonatologyDr. Ebtihal Ali, HMO, NeonatologyDr. Yaser Ali, HMO, NeonatologyDr. Reem Amer, HMO, NeonatologyMohammad Barbari, CA, Pediatric RespirologyDr. Karen Belen, HMO, NeonatologyMeenakshi Chowdhury, CA, NeonatologyAndrew Dick, PA, Hospital MedicineDr. Elwasila Eltayeb, HMO, NeonatologyDr. Mansoor Farooqui, HMO, NeonatologyLauren Girard, PA, Pediatric General Surgery

Mychele Gregoire, PA, Hematology Oncology Service

Cheryl Hirst, PA, Hospital MedicineAamir Hussain, CA, NeonatologyAbrar Hussain, CA, NeonatologyDr. Nnanake Idiong, HMO, NeonatologyCarling McDonald, CA, Pediatric NeurosurgeryMelanie Neuendorff, PA, Pediatric General

SurgeryDr. Ify Ilo Nwankwor, HMO, NeonatologyCurtis Patterson, PA, Hospital MedicineDr. Mohammed Tagin, HMO, NeonatologyDr. Mahmoud Zalam, HMO, Hospital Medicine

Trainees

We would like to acknowledge all the students, residents, subspecialty residents, and fellows appointed to and rotating through our department and program. It is a privilege to educate and train so many outstanding upcoming scientists and clinicians.

Other Academic Researchers, Educators and Clinicians Formally Affiliated with the Department of Pediatrics and Child Health or Located at the Children’s Hospital Research Institute of Manitoba

Dr. Alex O. AregbesolaDr. Frances A. BoothDr. Marlen Canlas-YamsuanDr. Aubrey H. CaplanDr. Bonnie ChamDr. Ming-Ka ChanRishma ChooniedassDr. James DavieBrenda DawydukDr. Mark Del BigioDr. Dawn DanielsonDr. Vernon W. DolinskyDr. Christine DoucetteDr. Michael J. EllisDr. Juliette EnyingiDr. Jane EvansDebbie Fraser

Dr. John Godfrey GartnerDr. Joe GordonDr. Andrew HalaykoDr. Kristin HamiltonDr. Taila Su-Gee HartleyDr. Grant HatchDr. Kent T. HayglassDr. Michael HelewaDr. Paul JellicoeDr. Tobias Kadi KarakachDr. Richard KeijzerDr. Predrag Charles LekicDr. Daniel P. LevinDr. Jennifer McNaughtDr. Meghan McPherson Dr. Muhaned MarahDr. Ruth Ann MarrieDr. Steven MinkDr. Michael Moffatt Dr. Neeloffer MookherjeeDr. Amanda Faith MorrisDr. Margaret MorrisDr. Melanie MorrisDr. Kiem OenDr. Christopher PascoeDr. Brian David PostlDr. Kantilal R. RajaniDr. Martin ReedDr. Leslie RoosDr. Natalie RuestDr. Robert SchrothDr. Lorne SeargeantDr. Demitre SerletisDr. Atul SharmaDr. Anna ShawyerDr. Elizabeth Lynn Spriggs Dr. Katrina StockleyDr. James E. StrongDr. Shayne P. Taback Dr. Kellie ThiessenDr. Barbara Lynne Triggs-RaineDr. Donna A. WallDr. Adrian WestDr. Harley WongDr. Roberta L. WoodgateDr. Rochelle Yanofsky


We celebrate and appreciate the following partnerships

University of Manitoba,

Rady Faculty of Health Sciences,

Max Rady College of Medicine,

Department of Pediatrics and Child Health

www.umanitoba.ca/faculties/health_sciences/medicine/units/pediatrics

HSC - Children’s Hospital

CE 208-840 Sherbrook Street

Winnipeg, Manitoba R3A 1S1

Tel: 204-787-8020

Fax: 204-787-4807

Business Hours: Monday - Friday, 8:00 am - 4:00 pm

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DEPARTMENT OF Pediatrics and Child Health...Department of Pediatrics and Child Health is tremendously grateful for the vision and growth Dr. Klassen drove, and it will continue to