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St. Joseph’s Hospital and Medical Center is committed to its role as a superior tertiary academic medical center, serving patients from Arizona and the Southwest. As part of that vision, we have dedicated a significant amount of our energy to creating a comprehensive medical facility where children can receive diagnosis, education and treatment for a multitude of diseases, conditions and injuries. To that end, St. Joseph’s Children’s Health Center (CHC) has brought together some of the world’s finest physicians, specialists and other medical staff to care for patients using the latest techniques and equipment in a comprehensive medical campus. Part of the CHC’s success is due to the range of sub- specialties offered, including genetics, neurology, gastroenterology, adolescent medicine, nephrology, cardiac services and pulmonology.

Genetics
The genetics program at the CHC, one of only two in the state, was created in 2004, largely due to the tremendous need for advancement in this area of medicine. Genetically determined disorders account for a major portion of healthcare services. More than half of the children admitted to pediatrics in major medical centers have a significant genetic component of their illness. Some of the most common reasons for referral to the Genetics Program include:

• Abnormal sexual development
• Common birth defects such as cleft lip/palate, neural tube defects, clubfoot and congenital heart disease
• Family hereditary conditions
• Hearing loss
• Known family chromosomal abnormality
• Known or suspected metabolic disorder(s)
• Multiple malformations, mental retardation/develop- mental delays
• Women considering pregnancy with known hereditary disorder

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Program staff include two physicians, two genetic counselors and a metabolic dietician. This team assists with evaluation and diagnosis of potential genetic conditions; helps with the ongoing management of patients with known genetic disorders; provides advice about lab- oratory tests; directs patients to family support groups; and identifies educational, community, social service and financial resources for patients with hereditary conditions.

Neurology
The Division of Child Neurology at the CHC comprises clinical and research faculty dedicated to excellence in patient care, education and research. As the major child neurology group in the state of Arizona, the program is actively involved in the evaluation and treatment of infants, children and adolescents with the full range of neurological and neurodevelopmental disorders, including but not limited to:

• Attention Deficit Disorders
• Autism
• Developmental delays
• Epilepsy
• Headaches/migraines
• Neonatal neurology
• Neurogenetic conditions
• Neuromuscular diseases
• Spasticity

The Division of Child Neurology offers fully accredited physician training programs in general child neurology and pediatric epilepsy, and is actively involved in the education of medical students, residents and fellows from multiple disciplines.

Outpatient clinical activities are held weekly at the Child Neurology offices or at Children’s Rehabilitative Services (CRS). Regional outreach clinics are also held in Flagstaff and Yuma.

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Gastroenterology
The Division of Pediatric Gastroenterology, Hepatology and Nutrition serves infants, children and adolescents who have all types of gastrointestinal and nutritional disorders, such as abdominal pain, inflammatory bowel disease, chronic liver disorders, failure to thrive and feeding disorders. Comprehensive inpatient and outpatient services are available for evaluation, diagnosis, and man- agement of routine and complex gastroentereologic disorders. Staff are dedicated to educating patients, parents, caregivers and healthcare professionals about these diseases and their treatment options while deliver- ing specialized care.

Adolescent Medicine
The Adolescent Medicine Specialty Practice at the CHC delivers care exclusively to patients from ages 10 to 21. The practice was formed in 2004 to serve a growing population of adolescents who have unrecognized needs and complex medical issues. A staff consisting of a physician, psychologist, nurse, registered dietician and 26 pediatric residents provides quality care to patients. In particular, the program provides adolescent health- care services at St. Joseph’s and at Florence Crittenton.

The practice provides physical and psychological assessments for adolescents and offers treatments for:

• Chronic disease acceptance and compliance
• Eating disorders - anorexia, bulimia and obesity
• Family discord
• Menstrual disorders and ovarian cysts
• Psychological disorders - depression, anxiety, obsessive-compulsive and conduct disorders
• Sexually transmitted diseases
• Substance abuse Nephrology A board-certified physicians lead the CHC’s Division of Nephrology.

Their team cares for children with a multitude of conditions relating to the kidneys including:

• Acid-base and electrolyte disorders
• Glomerular disorders
• Hematuria
• Hypertension
• Proteinuria
• Nephrotic syndrome
• Renal failure
• Urinary tract infections

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The practice is currently engaged in several clinical trials in an effort to discover better ways to treat pediatric patients with kidney disease.

Cardiology
The mission of The Congenital Heart Center is to provide the highest quality, family-centered and techno- logically advanced tertiary care for children with heart disease and congenital heart disease. Our physicians are board-certified in cardiology, cardiovascular medi- cine, interventional cardiology, and thoracic and cardio- vascular surgery. St. Joseph’s has always been a leader in cardiovascular care, pioneering new procedures and advancing healthcare technology. Some of the noteworthy cardiovascular programs and services at the CHC include:

• Congenital Heart Center - As part of the Heart & Lung Institute, this program is based on an integrated multidisciplinary physician team, working with dedicated pediatric cardiac nurses, nurse practitioners and support staff. An academic tertiary center, the program employs the latest technologies and participates in ongoing research initiatives. Since 2000, the program has demonstrated remarkable growth and progress, increasing pediatric cardiac surgical procedures by more than 300 percent.
• 3 North-Pediatric Cardiac Floor - This 11-bed unit is designed to accommodate cardiac patients who do not require intensive care. Every room is equipped with centrally monitored pulse oximetery.

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• Cardiovascular Operating Room (CVOR) - The CVOR team has been repairing congenital heart defects for more than 30 years. The team includes skilled surgeons, registered nurses, surgical technolo- gists, clinical monitoring personnel and a patient sup- port associate surgical specialist. In addition to two specially equipped surgical suites, in the future the CVOR will include a state-of-the-art suite with fully inte- grated technology
• Extracorporeal Membrane Oxygenation (ECMO) Program - Since 1987, St. Joseph’s CHC has provided ECMO support for hundreds of patients. The program provides a prolonged version of heart/lung bypass for infants and children with reversible cardiac and respiratory disease. ECMO is currently used in both the Nursery and Pediatric Intensive Care Units to stabilize patients either before or after surgery.
• Cardiodiagnostics Department - Often referred to as the “Echo Lab,” the Cardiodiagnostics Lab acts as a non-invasive ultrasound diagnostic center, utilizing state-of-the-art Acuson Sequoia equipment to image the heart with 2-D technology and to perform hemody- namic flow studies. An integral part of the Congenital Heart Program, the lab provides transesophageal imagery to allow cardiologists and surgeons to better assess cardiac defects

Pulmonology

St. Joseph’s was recently ranked among the top hospitals for respiratory care by U.S. News & World Report. A testament to that prestigious ranking, the Pediatric Pulmonary Program at the CHC provides a continuum of care for premature infants, children and adolescents to age 21. The purpose of the comprehen- sive diagnostic and treatment program is to help children who experience chronic and acute respiratory disorders. The practice is staffed by two of nine pediatric pulmo- nologists in the Phoenix-metro area.

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Many of the patients seen at the practice present with chronic cough or uncontrolled asthma. According to the National Heart, Lung and Blood Institute, asthma affects approximately 18 million individuals younger than age 18, and the incidence has continued to increase since 1980. The Pediatric Pulmonology Program at the CHC also provides evaluation and care for patients with severe pulmonary disorders that include but are not limited to:

• Airway anomalies, with or without associated con- genital heart or lung defects
• Bronchopulmonary dysplasia
• Cystic fibrosis
• Immune deficiencies
• Primary ciliary dyskinesia
• Respiratory problems resulting from neuromuscular disorders
• Sleep-related breathing disorders

The need for pediatric pulmonary services has grown significantly in the past few years, especially in the Phoenix area, due to tremendous population growth. The CHC’s program stands ready to accommodate those needs and ensure that Arizona’s children receive the proper respiratory diagnosis and care.

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