Clinical Programs in Pediatrics

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Below are listed a variety of clinical programs in which members of the Department of Pediatrics participate. These programs take place in a variety of settings, including the Kingston General Hospital and the Hotel Dieu Hospital.

Click on the title of the program you would like to more about to expand the area and read more.

Ambulatory General Pediatrics

Our General Pediatric unit is committed to offering a comprehensive variety of services in consulting and ambulatory pediatrics. We currently have 3.5 hospital-based pediatricians, and 2 community based pediatricians on our team. 

A same day consultation and urgent care service operates at Hotel Dieu Hospital weekdays from 9am-4:30am. This service provides acute, same day consultation to family physicians and other providers in addition to serving the needs of pediatric patients who arrive without an appointment. This program also serves as a major site for postgraduate and undergraduate medical and nursing education. Referring physicians are asked to contact the pediatrician on duty at 613-544-1365 prior to the arrival of the patient.

A medical day procedure program permits us to offer sedation for radiology, audiology and other procedures by appointment. Other medical procedures can also be carried out in the centre.

Non-acute general pediatric consultation is also available by appointment for a wide range of pediatric problems. Referring physicians may send requests by fax to 613-544-3559.

Our main research interest is educational research, which serves to better shape, inform and prepare pediatricians of the future.

Inpatient Pediatrics

Our Inpatient Pediatric Services are located at Kingston General Hospital. The pediatric unit is a 14 bed medical, surgical and oncology unit that serves patients from birth until their 18th birthday.

We are dedicated to providing a warm and positive environment for all our patients. Much of this atmosphere is created by our tightly-knit unit, which is staffed by nurses and other health professionals trained in pediatric assessment and management.  The attending staff, residents and nursing staff know each other well, thereby creating a fantastic platform for trust, intercollaborative learning, as well as a superior working environment.  This extremely beneficial and symbiotic relationship also means that families who spend significant amounts of time in the hospital develop a comfortable familiarity with the staff and vice versa.

To further our commitment to the well-being of our patients, we have partnered with the Child Life Program – a system adopted by pediatric departments nationwide to promote a supportive hospital experience by focusing on the social and emotional impact of illness and hospitalization. Specialists work with their young patients, using play as a tool for socialization, preparation, expression of feelings, normalization and learning. Pediatricians, pediatric surgeons and other professionals also provide compassionate specialty care to the patients and their families.

As part of our dedication to education, our pediatric unit serves as a thriving training location for residents and medical students from pediatrics and surgery. Nursing students and allied health professionals from St. Lawrence College and Queen's University are also trained on-site.

Neonatology

infantwithwendy.jpgThe Neonatal Intensive Care Unit, located at the Kingston General Hospital,  is dedicated to providing the most advanced and compassionate care for our youngest patients. While most of the infants we care for are premature, some are full-term babies who have complications.

We are proud to be one of the six designated Level 3 perinatal centres for the province of Ontario. There are approximately 400 intensive care patients admitted annually to our 22 bed facility. A wide range of medical and surgical neonatal conditions are treated, including all forms of neonatal life support, with the exception of ECMO.

Dr. Robert Connelly, Dr. Kimberly Dow, Dr. Michael Flavin and Dr. Faiza Khurshid are our full-time neonatologists, Dr. Kathuria joins us as a locum neonatologist and Dr. Amy Acker  rounds out our team as an assisting pediatrician.

Our primary research interests focus on decreasing the risk of chronic lung disease in premature infants, preventing hospital acquired infections and the prevention of Necrotizing Enterocolitis (NEC) - an severe disease affecting the intestines of premature babies.  

Pediatric Critical Care

The Queen's Pediatric Critical Care service is designed to provide the support required for those patients whose needs range from close monitoring to more invasive ventilation and cardiovascular support.  We treat patients from birth up to their 18th birthday. The majority of our patients are from Kingston and surrounding areas, but we do treat children from as far away as Moose Factory and other distant Ontario communities.  We are one of the five tertiary care members of the Ontario Pediatric Critical Care Network.

Our active six bed critical care unit provides support for non-invasive forms of ventilation and monitoring.  The occupancy rate within the last year has been around 70%. More complex care of intubated patients occurs either in the Adult ICU or in the satellite pediatric critical care unit that is currently attached to the NICU.  Both facilities are located at Kingston General Hospital.

While our division allows for continued provision of care to some of the sickest children, it also trains residents in stabilization process as well as critical care patient transportation procedure.

The critical care program supports services such as pediatric surgery, oncology and trauma. Dr. Basem Alsaati is our critical care intensivist. Drs. Amy Acker, Michael Storr and Keith Gregoire provide additional clinical support. Dr. Alsaati is actively involved in post-graduate education.

Our service is further comprised of a highly-specialized and dedicated interdisciplinary team of pediatric intensivists, pediatricians, nurses, dieticians, pharmacists, social workers, physiotherapists, and pediatric residents and senior medical students.

Developmental Pediatrics

Queen's Pediatric's division of Developmental Pediatrics is dedicated to providing family-centered care for patients in Kingston and surrounding areas.  We are located in the Child Development Centre (CDC) at the Hotel Dieu Hospital in Kingston and are one of the nineteen Children's Treatment Centers in the province.

Our multi-disciplinary unit consists of over forty professionals and support staff, including developmental pediatricians Dr. Garth Smith and Dr. Dawa Samdup, as well as a team of social workers, physiotherapists, psychologists, occupational therapists and speech therapists. The CDC serves children and youth with congenital and late onset disorders that affect physical and cognitive development of the child. The teams provide diagnostic evaluation, follow up, support and advocacy in the community for children and their family.

In fact, our treatment philosophy is deeply rooted in a family-centric, naturalistic approach. We believe in demystifying developmental conditions through creating and nurturing open communication with the parents of our young patients. Our goal is to help the family understand the condition, and the treatment options available. Most of all, we aim to make sure our pediatric patients want to be active participants in their treatment by making the experience as enjoyable as possible.

The most common conditions we see in the clinic are muscular dystrophy, spina bifida, acquired brain injury, cerebral palsy, genetic syndromes, global developmental delays/mental retardation, ADHD, feeding disorders and autism. More than ten thousand patients visit the CDC each year and an average of three hundred and eighty new patients annually. 

The CDC has the following clinics:

  • Myelo-rehabilitation (Spina-bifida clinic)
  • Acquired brain injury (ABI)
  • Neuromuscular
  • Feeding
  • Neurodevelopmental (Preschool and school age)
  • Developmental
  • Orthotics/seating

The staff is also involved with special infant clinic and hearing-impaired clinic at the Hotel Dieu hospital.

Our commitment to continuing growth and expanding knowledge means we the CDC also serves as an important teaching centre for the Queen's University community. Clinical students, residents, and occupational therapy, physiotherapy and psychology students rotate through the centre regularly.

We are involved in a number of research projects locally and nationally. Ongoing division endeavours includes research on autism, muscular dystrophy, acquired brain injury, alternative therapy in children with chronic medical conditions, use of melatonin in sleep disorders in children with neurodevelopmental disorders, co-morbid disorders in children with cerebral palsy and idiopathic toe walkers. 

Location: Child Development Centre
Hotel Dieu Hospital
166 Brock Street
Kingston, ON K7L 5G2
Telephone: 613-544-3400 ext 3175

Child Abuse and Neglect Program

The Queen's Pediatric Child Abuse and Neglect Program is a vital service for the Southeastern Ontario. We provide medical consultation to family physicians, child welfare agencies and police on matters of child sexual and physical abuse and neglect.

All suspected cases of child abuse and neglect must be reported to a child welfare agency. Numbers for these agencies are found at the front of most phone books.

Acute and historical sexual abuse concerns are addressed through the Kingston General Hospital Sexual Assault and Domestic Violence Program. Acute cases should proceed directly to the Emergency Department for evaluation. All other inquiries should be forwarded to the Program Manager at 613-549-6666 ext 4880.

Acute physical abuse concerns should also be presented to an Emergency Department or the Children's Outpatient Centre at Hotel Dieu Hospital. All other inquiries, including non-acute cases should be directed to the program office at 613-544-3400 ext 3359.

Pediatric Endocrinology

The division of Pediatric Endocrinology at Queen's is dedicated to diagnosing, treating and educating patients and their families about diabetes and many other endocrine and metabolic disorders. We serve the pediatric population ranging from newborns to 18-year olds. Most of our patients are from the greater Kingston area and other tertiary areas, namely, Belleville, Brockville, Gananoque, Napanee, Trenton, etc. We are located at Hotel Dieu Hospital.

The head of the division is Dr. David Saleh. Dr. Saleh is also affiliated with the Children's Hospital of Eastern Ontario – a pairing that provides an excellent opportunity for combined research and enriching educational activities.

We conduct a half-day general pediatric endocrinology outpatient clinic. Here we treat children with endocrine disorders, involving pituitary, thyroid, parathyroid, pancreas, adrenal, and gonads. Our division also provides consultative evaluation of children with abnormal growth and/or sexual development and bone and mineral metabolism.

Children with diabetes are treated in a separate outpatient clinic. Our diabetes program employs a multidisciplinary approach in which a team consisting of a pediatric endocrinologist, one pediatrician, registered diabetic nurses, a registered dietician, a registered social worker, a child life educator, and trainees – pediatric residents and senior medical students -  provide care to children and adolescents with diabetes. Our team also provides an extensive one-to-one support to the diabetic children and their families.

In addition to the above services, we provide consultative services concerning various endocrine disorders in children in the inpatient wards of the Kingston General Hospital.

Practice location:
Hotel Dieu Hospital
Children Outpatient Clinic (COPC)
166 Brock Street
Kingston, Ontario K7L 5G2

For appointments:

Tel: (613) 544-3400 ext. 3359
  (613) 544-2153
Fax:  (613) 544-3559

Pediatric Cardiology

Although we tend to think of heart disease as a problem of later life, approximately 1% of children have a heart condition. This is why pediatric cardiologists, pediatricians who have specialization in this area, provide an essential component of pediatric tertiary care. Dr. John Smythe is a pediatric cardiologist who provides care for children with heart disease in our community. Our cardiology program is one of 5 academic pediatric cardiac programs in Ontario.

Pediatric Cardiology is decidedly different from adult cardiology. Adults with heart disease usually develop it over many decades. In contrast, most children with heart disease are born with it, due to abnormal formation of the heart at an early stage of pregnancy. Therefore heart defects are often able to diagnosed during the middle stages of pregnancy by fetal cardiac ultrasound (fetal echocardiography) and pediatric cardiac management may begin in the womb. The involvement of prenatal and neonatal experts and other support services prior to birth can enhance the care and outcomes of many of these children and their families.

Our Fetal Echocardiography Service is an important element of the High Risk Prenatal Obstetrical program overseen by Dr. Greg Davies and Dr. Graeme Smith, and the Queen's Genetics Program, run by Dr. Jennifer Mackenzie and Dr. Jagdeep Wallia.

Fortunately, due to the incredible advances in surgical and catheter-interventional procedures for childhood heart disease in the last 50 years, most children with even the severest forms of heart disease survive well into adulthood and live full and productive lives. Therefore a discipline for adults with childhood forms of heart disease, Adult Congenital Cardiology, has evolved.

Our Adult Congenital Heart Disease Service includes an outpatient clinic and inpatient consultation service and is another key element of lifetime care for children born with heart defects. The outpatient clinic is run by two adult cardiologists, Dr. Henry Kafka and Dr. Amer Kafka, as well as Dr. Smythe. This team provides an invaluable transitional health care bridge between the pediatric and adult cardiac worlds. On average, we see about 1,000 outpatients and perform 1,400 echocardiograms every year.

Dr. Smythe provides inpatient and outpatient consultant care for children with known and suspected heart disease. He is the only pediatric cardiologist in this region and he has developed strong ties with CHEO and Sick Kids, the two centers that provide the surgical and interventional care for our patients. Dr. Smythe provides round-the-clock consultative coverage which is facilitated by our 24-hour echocardiographic service. CHEO importantly offers consultative support to Queen's Pediatrics when Dr. Smythe is out of town. This distance coverage by CHEO is greatly aided by our telemedicine link which allows transmission of echocardiographic images and in-person discussions if needed.

In addition to projects in clinical pediatric cardiology, Dr. Smythe has a research interest in Mindfulness Training for Health Care Professionals. He has ongoing research studies in this area, including one that is funded through a Faculty of Health Sciences Innovation Grant. We also provide important teaching opportunities for medical trainees from the Queen's Undergraduate and Postgraduate programs.

Pediatric Gastroenterology and Food Allergy Program

The Pediatric Gastroenterology Unit at Queen's University is compromised of a highly skilled team of specialists dedicated to providing tertiary care to our young patients in the greater Kingston area. This service provides comprehensive care for infants, children and adolescents with a variety of gastroenterological, liver, feeding and nutritional problems associated with gastrointestinal disease. We see patients from birth up to their 18th birthday.

The children's outpatient centre is located at Hotel Dieu Hospital.  Here we see all pediatric gastrointestinal, liver and nutritional disorders and perform most endoscopy procedures (endoscopy, colonoscopy). Our consultation service and endoscopic procedures for inpatients is located at Kingston General Hospital.  All of our patients are seen by referral. The Food Allergy Program is also referral based, and offers outpatient consultation services. Our interests include gastrointestinal disorders related to food and other allergies as well as pediatric inflammatory bowel disease.

The Pediatric Gastroenterology unit also serves as a teaching facility, educating medical students, trainees in pediatrics, family medicine and fellowship programs of gastroenterology at Queen's University. 

We now have 2 full-time board certified pediatric gastroenterologists, Dr. Christopher Justinich and Dr. Angela Noble. Both physicians were trained at the University of Montreal-Ste Justine Hospital. Dr. Justinich has garnered international esteem for his work in the field of food allergy and gastrointestinal disorders caused by allergy.  He maintains a basic science laboratory where the team researches the immune system of the gastrointestinal tract, particularly esophagitis from acid and from allergy (eosinophilic esophagitis). This research, combined with a separate food allergy clinic, forms the 'Food Allergy Program'.

Dr. Noble has completed a one year fellowship in inflammatory bowel disease in Philadelphia and does research in clinical epidemiology of gastrointestinal disease. Dr. Noble also has a research interest in nutrition therapy for Crohn's disease.

Both Dr. Justinich and Dr. Noble participate in and collaborate with researchers in the Queen's GIDRU (Gastrointestinal Diseases Research Unit).

Other members of our team include administrative assistant, Stephanie Pilszak, lab technician, Nanette Mak and dietician Teresa Schneider.

More information, including teaching resources for trainees and research activities, can be found on the Pediatric Gastroenterology and Food Allergy Program's website.

Pediatric Respirology

The Department of Pediatrics at Queen's University in conjunction with Hotel Dieu Hospital and Kingston General Hospital offers a multidisciplinary pediatric respiratory and asthma clinic specializing in the investigation and management of childhood lung disorders and chronic or recurrent pulmonary symptoms. 

Our clinics are held at the Children's Outpatient Centre (COPC) of Hotel Dieu Hospital.  The clinics consist of a pediatric respirologist and a certified asthma education nurse with access to further allied health care workers including a social worker and physiotherapist.  Portable spirometry is performed at our clinics on children over the age of 5.  Patients with asthma will also be offered direct referrals to the pediatric asthma education program at KGH. We accept consults on asthma management and diagnosis, chronic respiratory symptoms (cough, dyspnea etc, recurrent pneumonias, persistent radiologic chest abnormalities, chronic respiratory diseases and possible sleep apnea. Additionally we have a separate, accredited multi-disciplinary Cystic Fibrosis Clinic. Consults can be referred by FAX: 613 5481369.

We try to see patients within 1 to 3 months. If you would to review the case more urgently, please feel free to discuss the case with the on-call Pediatric Respirologist through the hospital switchboard. 

Our respirology team consists of Dr. Michael Flavin, a professor with the Department of Pediatrics and the Department of Biomedical and Molecular Sciences at Queen's University. Dr. Flavin received subspecialty training in pediatric respirology at University of Southern California, Children's Hospital of Los Angeles and was appointed as a Queen's National Scholar in 1988.

Other key members of the team are Dr. Keith Gregoire, Nicola Thomas RN, BN, CAE (Certified Asthma Educator) and Jessica Schooley RN, BN, CAE (Certified Asthma Educator), Dr. Richard van Wylick who is the Director of the Cystic Fibrosis Clinic.

Our respirology research is extensive and widely regarded. Dr. Flavin was PI on recent funded studies which showed reduced length of stay in infants with bronchiolitis with inhaled hypertonic saline. He is a co-investigator on evidence-based asthma care and knowledge translation, identifying the needs of patients and parents of children with asthma in a regional asthma network. A new project looks at patient-centered regional sharepoint and electronic registry. Both projects are in collaboration with a large team of investigators based at SEOHC lead by the PI Dr. Lougheed from Adult Respirolgy.

Genetics and Metabolic Disease

The aim of our Medical Genetic and Disease program is to develop and provide services and personnel for the assessment, diagnosis, management and genetic counselling of individuals/families affected with or at risk for the development of genetic disorders through all stages of life, including preconception, prenatal, pediatric, and adult.

In addition, we endeavour to provide opportunities for research, education and responsible leadership in clinical genetics and genetic metabolic disease.

For more information, please visit our website at Kingston General Hospital.

Pediatric Hematology/Oncology

The Division of Pediatric Hematology Oncology at Queen's University is one of the five tertiary centers in the province that provides care for children with cancer and hematological disorders.

Our oncology clinical service encompasses consultations, outpatient and inpatient chemotherapy services, follow-up clinics, and separate after care clinics facilitating long term follow-up for pediatric and adolescents,  and young adults. We have a comprehensive multidisciplinary team that includes specialized nurses, a social worker, dietitian, physiotherapist, occupational therapist, neuropsychologist, child life workers and pharmacist.

The hematology clinical services include inpatient and outpatient consultations, hemophilia and bleeding disorders clinic, women and bleeding disorders clinic and hematology follow up clinics.  Our physician team is comprised of Dr. Mariana Silva, the division head and full time pediatric hematologist/oncologist, Dr. Michael Hefferon, clinical associate, Dr. Paul Moorehead, pediatric hematologist/oncologist and Dr. Paula James, hematologist.

Our division is very active in research. We are members of the Children's Oncology Group (COG) and have over 35 clinical trials open for enrolment. We are also involved in research projects through POGO (Pediatric Oncology Group of Ontario) and through other national and international collaborations. Dr. Paula James is an internationally renowned researcher in bleeding disorders and is the principal investigator in a number of studies for patients with hemophilia and bleeding disorders. Our research efforts are supported by dedicated data managers and research associates.

We are very committed to education and offer a clinical rotation for all our pediatric residents. There are also educational opportunities both clinical and research oriented for medical students and residents. Weekly clinical teaching rounds are aimed at all members of the health care team. Our administrative assistant, Lorie Myers, can be contacted at KGH at (613) 549-6666 extension 3833 for patient bookings or education and research opportunities.

Pediatric Neurology

Our pediatric neurology department at Queen's specializes in studying childhood epilepsy, headaches, stroke, demyelinating conditions, movement disorders, mental retardation, congenital malformations of the brain. We offer outpatient services at Hotel Dieu and an inpatient program at Kingston General Hospital. The most common problem seen in our neurology clinic is epilepsy, but we also see children with developmental delay, headaches and tic disorders. 

Dr. Athen Macdonald heads up our team as our pediatric neurologist. She was part of  the pediatric demyelinating project organized by Dr. Brenda Banwell at Sickkids and has been involved with the Canadian Pediatric Stroke Registry for many years. Dr. Macdonald runs 1/2 day pediatric neurology clinics four times a week. She also does some work in general pediatrics, seeing children in the pediatric urgent care centre once every two weeks.

The departments' areas of research interest vary with the interests of the students and residents, but all projects relate to better understanding and treating common problems in pediatric neurology.

For more information, please contact us.

Cystic Fibrosis Program

The Cystic Fibrosis (CF) Program is one of 42 clinics supported by Cystic Fibrosis Canada to provide care to patients with CF. 

Our Cystic Fibrosis Team consists of:

Lisa Smith RN MSc BScN GNC(C), CF Nurse Coordinator

Julie Nedvidek RD BASc, CF Dietitian

Kristy Brundage BScPT MSc, CF Physiotherapist

Mary Wilson RPh BScPhm , CF Pharmacist

Cathy Muir RRCP, Director, Pulmonary Function

Tania Nicholls MSW RSW, CF Social Worker

Richard van Wylick MD FRCPC, Pediatric Clinic Director

Diane Lougheed MD FRCPC, Adult Clinic Director (Department of Medicine, Queen's University)

Patients with CF are supported by our multi-disciplinary team from diagnosis through adulthood. Patients are seen by Dr. van Wylick until their 18th birthday and then transitioned to Dr. Lougheed while the rest of the CF Care Team remains throughout.

In addition, our team supports newborn screening for CF in Ontario and sees all infants from South-Eastern Ontario who have a positive CF Newborn Screen for further evaluation.

The CF Team is committed to improving the care of CF patients. We participate in research programs like the Canadian CF Patient Data Registry, studies on defining the diagnostic parameters for CF in newborn screened infants, decision-making in lung transplantation, transition and education of CF patients, depression screening in CF and clinical trials of prospective new therapies.

To learn more about Cystic Fibrosis and Cystic Fibrosis Canada, visit:

www.cysticfibrosis.ca

To learn more about CF Newborn Screening in Ontario, visit:

http://www.newbornscreening.on.ca/bins/index.asp?lang=1