Infrastructure
The Department of Paediatrics at Tawam Hospital has been providing clinical screening tests for newborns, infants and children up to the age of fifteen years in UAE and neighbouring countries.
Tawam Hospital has a total of 129 paediatric hospital beds, of which 36 are medical paediatric beds, 18 are for paediatric oncology, 19 are for paediatric surgery and 41 are neonatal intensive care cots. Additionally, there are 7 beds at the paediatric intensive care unit (PICU) and 8 beds at the paediatric extended care unit (PECU). There is also a dedicated Paediatric Emergency Unit, which provides care for acute and emergency cases.
Patients are assessed in an outpatient facility at the Tawam campus or in a satellite unit at Al Wagan Hospital. In the past decade, the department has broadened the scope of services offering advanced procedures and 'State of the art' treatments for the first time in the region.
The Team
There are a total of 46 physicians in the department comprising 19 consultants, 21 specialists and 6 medical officers. Moreover, there are 35 residents, one medical secretary, one resident program coordinator and two administrative assistants. The Department has ten divisions, and is headed by paediatricians with advanced training mostly in the USA and Europe. These divisions are General Paediatrics, Neonatology, Haematology-Oncology, Nephrology, Endocrine, Neurology, Infectious Diseases, Pulmonology, Cardiology and Metabolic diseases & Clinical Genetics.
History and Services
Annually 3500 newborns are received in the postnatal ward. The American Multi-Room system model was fully implemented in 2010, decreasing time patients spend from registration to discharge by about 30%. Specialty clinics exist for certain patient categories, such as Down syndrome, Wheezy Chest, Failure to Thrive, Newborn and Emergencies clinics. For Neurology services; a 24-hour EEG service with video capability, and for the care of high-risk Pediatric Cardiology patients, ECG with central telemetry monitoring is available.
Tawam Hospital is the only hospital in the UAE that has clinical metabolic and metabolic laboratory teams. The Genetic Metabolic Service at Tawam is the referral centre in the UAE for genetic diseases. It is also the referral centre for infants with inborn errors of metabolism identified by the Ministry of Health's expanded Newborn Screening Program, offering the most common urgent metabolic tests not only to UAE residents but also to all Middle Eastern countries. The metabolic lab currently offers plasma amino acid and urine amino acid analyses for samples from all over the UAE, with about 600 samples being processed annually. Phone consultations are given to the physicians from other Gulf countries.
The Paediatric Department supports paediatric surgery service, several surgical procedures were conducted at Tawam Hospital for the first time. The first laparoscopic cholecystomy was performed in 1997 and the first major liver tumour resection in an infant was performed in 1998. In May 2002, a surgical team entirely from Tawam successfully separated pygopagus conjoint twins. These surgeons have published 43 articles in international paediatric surgical journals in the past 15 years.
The Paediatric Residency Training Program received ACGME-I accreditation in 2012, the only program in the discipline accredited outside USA after Singapore. Amongst new services and clinics introduced are transtelephonic ECG recording, cardiopulmonary exercise testing, tilt-table testing, pre-marital genetic testing with feto-maternal unit, pre-implantation genetic diagnosis in collaboration with IVF unit at University College (London), haemophilia clinic, post bone marrow transplant clinic, paediatric immunodeficiency clinic, antibiotic stewardship program, therapeutic hypothermia, hypoxia testing for fitness to flight, heliox therapy in congenital and acquired airway malformation, pediatric Continuous Renal Replacement Therapy (CRRT), intrathecal baclofen therapy for cerebral palsy and sleep study (polysomnography).
The Antimicrobial Utilization Stewardship program, formed as joint effort of Paediatric Infectious Diseases of the Department and Clinical Pharmacy Department, is truly unique in the region, with the aim to oversee and regulate the use of antibiotics by various providers. The paediatric team also plays an active role in the Pharmaceutical and Therapeutic Committee.
Clinical Facilities
The Neonatal Intensive Care Unit (NICU) at Tawam provides state of the art care to critically ill neonates and was the first to initiate one of the most advanced modes of ventilation called Neurally Adjusted Ventilatory Assist (NAVA). The NICU was the first division among all UAE hospitals to develop "Rapid Sequence Intubation" using premedication before intubations in neonates. The Paediatric Neurology division established the first unit in UAE for long-term epilepsy monitoring service, which includes video EEG.
Tawam hospital's Quality Department meticulously collects data regarding operational and clinical outcomes, including adverse and sentinel events, medication errors, morbidity and mortality reports, and patient satisfaction survey results. In mid-2009, Tawam also implemented the Patient Safety Net (PSN), a webbased event-reporting system, which serves as a data collection tool for all adverse events, errors, service complaints and near misses in both inpatient and ambulatory settings. The Life Support Centre at Tawam has trained physicians in BLS, PALS, basic and advanced NRP.
Key performance indicators of the Department are very impressive thanks to the introduction of Clinical Guideline Pathways. A Paediatric Rapid Response team and Paediatric Early Warning Scoring (PEWS) were implemented in 2010. Ward rounds by hospital executives take place regularly as well as monthly meetings of the Johns Hopkins Comprehensive Unitbased Safety Program (CUSP). Continuous quality improvement activities include improving patient safety, neonatal golden hour, kangaroo-mother care (bonding) and inducing therapeutic hypothermia in the newborn. In fact there is special emphasis on patient and family education.
The Department of Paediatrics has a strong track record of winning scholarships with numerous presentations and publications along with clinical excellence awards, These include; Outstanding Research Awards, Excellence in Teaching Awards, Patients’ Safety Awards and Customer Service Awards. Tawam Hospital was the first hospital in the UAE to implement the Newborn Screening for Congenital Heart Diseases program in April, 2012. It is also the first governmental hospital to implement the universal Newborn Hearing Screening in 2007 for all newborns regardless of the presence or absence of risk factors.
Research and Continuing Medical Education (CME)
Clinical Research was expanded and consolidated as a joint effort with College of Medicine and health sciences (CMHS) of UAEU, which augmented the reputation of the Paediatric Department as a provider of state-of-the-art services. Focusing on clinical research also expanded the knowledge of physicians, trained residents and medical students on cutting edge therapeutics and evidence-based practices. The physicians in the Department of Paediatrics have published over 40 manuscripts in the last three years in highly influential, peer-reviewed journals. Staff physicians are also participating in several Phase III multicenter clinical trials, such as Asphotase Alfa enzyme therapy in treating Alkaline Hypophosphatasia, and Mag-cool trial comparing induced hypothermia in Neonatal Hypoxic-Ischemic Encephalopathy with and without Magnesium Sulphate use.
Educational activities include Al Ain Paediatric Club and a webpage on Tawam Intranet in Arabic and English. For the past eight years the Department has organized its Annual International Paediatric Conference as a three-day scientific and educational event. Several hands on workshops and satellite discussion groups are conducted during the 3 days of the conference with 400 - 500 healthcare providers.
Due to its outstanding contributions to medical education and its pivotal and pioneering role in healthcare provision for UAE and the region, the Department of Paediatrics in Tawam Hospital truly deserves the Hamdan Award for Outstanding Clinical Department in the Public Sector in the United Arab Emirates for the term 2013 - 2014.
