2009 annual report

H o p e l i v e s h er e.

A n n u a l R e p o r t

Founded in 1855, The Children’s Hospital of Philadelphia is the birthplace of pediatric medicine in America. Throughout its history, a passionate spirit of innovation has driven this renowned institution to pursue scientifi c discovery, establish the highest standards of patient care and train future leaders in pediatrics. For a century and a half, Children’s Hospital has served as a haven of hope for children and families worldwide.

www.chop.edu

The Children’s Hospital of Philadelphia and the logo are registered marks of The Children’s Hospital of Philadelphia.

©2010 The Children’s Hospital of Philadelphia, All Rights Reserved.

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Ho

pe lives h

ere.

Lighting up the cover: Avery,

soccer player, kindergartener, son

This exuberant 5-year-old has sickle cell

disease and has been cared for by

a team at The Children’s Hospital

of Philadelphia since infancy.

These are just a few of the countless children who have

been helped by the Hope Lives Here campaign.

Thank you!

You Gave Us Hope.

Hope lives here.Three small words that somehow encompass the work of more than 9,000 individuals, and the generosity of more than 216,000 donors. Three small words that have served as a rallying cry for the largest fundraising effort in the history of The Children’s Hospital of Philadelphia.

Over seven years, including several marked by severe economic downturn, the Hope Lives Here campaign engaged thousands of new donors, strengthened our bonds with long-standing supporters and exceeded its ambitious goal of $400 million by $76.5 million.

The results are everywhere you look throughout the institution: breathtaking scientifi c advances with the potential to change the face of pediatric medicine, re-envisioned models of patient care designed to keep CHOP at the forefront of patient safety, state-of-the-art new facilities commensurate with our clinicians’ and researchers’ abilities, and innovative platforms to advocate for children far beyond our own walls.

But our good fortune is also a reminder of CHOP’s profound responsibility. No institution is better poised to make the next great advances in pediatric healthcare — and no institution has a greater obligation to do so. The well-being of our children, our future, depends on it.

I am immensely grateful to our philanthropic partners for providing the fuel to deliver on our promise of better health for children. I am also proud of the leadership and guidance provided by our Board of Trustees. And I am honored to work side by side with employees and staff renowned for their innovation, resilience and extraordinary commitment to the children we serve.

Steven M. Altschuler, M.D.President and Chief Executive Offi cer

Report from the Chairman

The bottom line for a nonprofi t organization is different from that of a business. The critical questions the nonprofi t sector must ask are not about returns or revenues, but about how effectively we deliver on our mission and how deep of an impact we make.

At The Children’s Hospital of Philadelphia, we measure ourselves by the lives we save, by the medical discoveries we make, and by the hope we provide to sick kids and struggling families here and around the globe.

The economic downturn of last year tested the fi nancial mettle of charities and businesses alike. For healthcare nonprofi ts like Children’s Hospital, the potential for systemic reform added another layer of uncertainty. In a defi ning year when everyone was forced to look hard at their own bottom lines, the leadership of CHOP stayed laser-focused on our core mission of compassionate patient care, research and teaching. This commitment has kept CHOP at the forefront in the fi ght for healthy children.

The Board of Trustees will remember fi scal year 2009 for its challenges, but also for its many achievements. We celebrated the successful close of our Hope Lives Here campaign, the Hospital’s largest-ever fundraising effort. Many of the fruits of this outpouring of generosity are described in this report. My fellow trustees and I are deeply moved by what our community of donors has made possible at CHOP.

In fi scal year 2009, we also saw the breathtaking potential of translational research and medicine at CHOP. We have sped the pace of discovery and pushed the horizons of medicine. Diseases that have vexed scientists for years, and robbed children of their childhoods, are now yielding their secrets and giving way to hope.

Our goals for the future are bold, as they must be for the children we serve. CHOP will be the safest children’s hospital in the nation. We will create the paradigm of personalized medicine. We will continue to recruit the fi nest medical and scientifi c talent. Because our bottom line is a better world for children. That is why hope lives here.

Stephen B. BurkeChairman, Board of Trustees


Grace, 11, orthopaedic patient since she was 14 months, has had numerous procedures at CHOP, including one as an infant to release a tethered spinal cord.

4 – 13 Special Section: The Hope Lives Here Campaign Highlights of the largest fundraising effort in the Hospital’s history.

14 Found in TranslationGene discoveries at CHOP fuel new treatments for childhood cancer in record time. Also: major advances in autism and HIV.

18 Keeping Jaylisse SafeThe nation’s top children’s hospital focuses resources at every level on patient safety.

22 Tender Loving CareIt’s the big things and the tiniest things that make nursing in the N/IICU so rewarding — and help CHOP to retain its best and brightest nurses.

26 Eat Well. Stay Safe. Be Happy.The fi rst Healthy Kids Day strengthens CHOP’s mission of education, outreach and service to our local community.

28 A Voice for All ChildrenDr. Altschuler goes to Washington — to keep children’s needs at the center of healthcare reform.

30 Financial Information, Our Donors and Who’s Who

T h e C h i l d r e n ’ s H o s p i t a l o f P h i l a d e l p h i a4

A Campaign Concludes,

Hope Is Born Anew.

Special Section T h e H o p e L i v e s H e r e C a m p a i g n

A decade ago, the Board of Trustees of The Children’s Hospital of Philadelphia recognized an opportunity to create a bold new model for children’s healthcare.By constructing extraordinary facilities, attracting and retaining the world’s best physician-scientists, and embracing a commitment to translational medicine, Children’s Hospital would seek to become the world’s premier pediatric research hospital.All that was missing was the funding — the spark to ignite this fi re and make a revolution in pediatric medicine possible.And so, on January 1, 2003, The Children’s Hospital of Philadelphia embarked upon the largest fundraising effort in its history: the Hope Lives Here campaign.The enormity and urgency of the campaign became evident at once. Every sick child who came through our doors, every disease that still

lacked a cure, reinforced the truth that our work must not stop. And the global economic uncertainty of the past year has been a stark reminder that our resources are precious. Every dollar raised is vital to the life of this institution and to our dream of a better, healthier world for all children.Today, seven years since the campaign’s start, Hope Lives Here has exceeded its $400 million goal by more than $76.5 million. In this special Annual Report, we look back on an outpouring of extraordinary generosity that has strengthened the fi ber of every part of the institution. We are honored to share with you some glimpses of what support for the Hope Lives Here campaign has wrought at Children’s Hospital.

And we can never say it enough: thank you.

H o p e l i v e s h e r e . 0000Spe

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gnMakai, 6, diagnosed at CHOP at 3 months of age with tuberous sclerosis, has undergone brain surgery and is followed by Neurology.

In 1855, its fi rst year, 63 patients

were treated at The Children’s

Hospital of Philadelphia. The

three physician-founders and

a team of nurses mended, set,

stitched, prescribed, healed and

offered hope, working in a small building with 12 beds.

In the past seven years, the

Hospital has experienced

unprecedented growth, fueled

by the Hope Lives Here fundraising

campaign. Our Main Campus has

nearly doubled in size: The additional

1.2 million square feet represent

fl oor space equivalent to 21 football

fi elds. Today, the Hospital has 443 beds, where children heal and fi nd hope.

Hope Builds


T h e H o p e L i v e s H e r e C a m p a i g nSpecial Section

B

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A

F

E

New and Improved (clockwise)(A) A colorful glass façade welcomes children, families and visitors. (B) With more imaging suites, the Radiology Department is able to schedule same- or next-day appointments for most patients. (C) Now with 70 beds, the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit treats more than 1,000 babies annually. (D) An Emergency Department expansion included 10 additional treatment rooms and a larger waiting area. (E) The chapel was renovated as the Schlimm Center for Prayer and Refl ection, a place of peace. (F) Seven additional operating rooms in the main Surgical Suite alleviate waits for nonemergency surgeries. (G) At the center of every decision about expansion and improvements: the patient.

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Main LobbyThe new entrance includes

a large information desk and warm lighting.

The Garbose Family Special Delivery UnitMore than 250 babies have been born at the world’s fi rst delivery unit for infants with birth defects diagnosed in utero.

Cardiac Operative and Imaging ComplexState-of-the-art space for surgery and catheterization is just steps away from cardiac inpatient beds.




In their four decades as trustees and philanthropists, Ruth M. and Tristram C.

Colket, Jr. have helped transform Children’s Hospital into a world leader in pediatrics. Their $25 million contribution opened the Hope Lives Here campaign, and is the largest individual gift in the Hospital’s 155-year history.

As a little girl, Mrs. Colket accompanied her father, a minister, while he offered comfort on his rounds at a local hospital. She went on to become a nurse. Children’s Hospital has benefi ted from her wise counsel, always informed by her experience and her love and concern for children and families.

Mrs. Colket stepped down from the Board of Trustees in 2009. In 2010, she and her husband will be honored during the opening ceremony for the Ruth M. and Tristram C. Colket, Jr. Translational Research Building (shown here). The 11-story, 450,000-square-foot building, across from the Main Campus, will house the world’s most elite pediatric researchers.

Someday, scientists in this building may discover a cure for childhood cancer. And that will be just the beginning.

Thank you.

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They are a gift from physicians

who believe their contribution to pediatric medicine should endure long after their own practice.

They come from families grateful for the care their children received here.

And from familiesgrateful that their children have never needed our care.

HonorSeat of



The reasons for endowing a chair at The Children’s Hospital of Philadelphia are as varied as the individuals who do so. But the result is universal: a seat of honor among a very special cadre of leaders. A powerful tool to reward and retain the fi nest clinicians and researchers.2009 marked the 21st anniversary of the Hospital’s fi rst endowed chair — the C. Everett Koop Endowed Chair in Pediatric Surgery. Today, there are 74 fully funded chairs, among the largest number of any pediatric institution. Their total value now exceeds $130 million.

In many institutions, endowments primarily support the chair holders’ salaries. At CHOP, the funding supports clinical and research activities in the chair’s area of specialization — a model that keeps the Hospital’s mission to advance pediatric healthcare front and center.

The Hope Lives Here campaign provided a major boost for endowed chairs at CHOP, spanning a host of innovative endeavors.

Steven D. Handler, M.D., M.B.E., an E.N.T. surgeon, and his wife Cynthia Solot, M.A., C.C.C., a senior speech pathologist —

both longstanding CHOP staff members — endowed the Hospital’s fi rst chair supporting a full-time medical ethicist. It is also among the fi rst such endowments at a pediatric hospital. Chris Feudtner, M.D., Ph.D., M.P.H., holds the chair.

Longtime benefactors Jean and Richard Wood Jr., whose family has been integral to the growth of Children’s Hospital since its founding, stepped up once again — in partnership with Wawa Inc. — to establish the Wawa Endowed Chair in International Adoption. The chair, one of the only of its kind in the nation, is held by Susan Friedman, M.D.

In total, donors to the Hope Lives Here campaign enabled CHOP to double its number of endowed chairs.

As Chief Scientifi c Offi cer Philip R. Johnson, M.D., says: “Endowed chairs are a way to recognize what outstanding individuals have done until now and what they will do in the future.”

Surgeon-in-Chief N. Scott Adzick, M.D., himself holder of the Koop Chair, prefers the term “hot seat.” “An endowed chair,” he says, “is a constant reminder of the responsibility to use one’s gifts passionately and well.”

For a complete listing of endowed chairs at The Children’s Hospital of Philadelphia, see Page 61.


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A Legion of Contributors


(Jan. 1, 2003, to June 30, 2009)

Hope Lives Here: By the Numbers

Total Gifts by Source (in millions)

Individuals

Faculty

Corporations

Foundations

Government

$96

$183

$105

$37

$55

Total Gifts by Specifi c Designation (in millions)

Programs

Research

Unrestricted

Facilities

Social Impact

$165

$89

$186

$28

$8

Thanks to the generosity of more than

216,000 donors, 190,000 of whom gave

for the fi rst time, the Hope Lives Here

campaign exceeded its $400 million goal

by $76.5 million.

The Hospital received a remarkable nine

gifts in excess of $10 million, including

the largest individual gift in its history,

from Ruth M. and Tristram C. Colket,

Jr., and the largest corporate gift in its

history, from State Farm Insurance

Companies.

This outpouring of support resulted

from outstanding leadership from

the Board of Trustees, a commitment

to excellence from the Hospital and

medical staff, and a shared conviction

that Children’s Hospital was one of

the few institutions in the world with

the talent, track record and resources

to usher in a new era of hope in

pediatric medicine.

Total Donors by Fiscal Year

24,337

25,170

*Start of the campaign+Completion of the campaign

30,795

25,763

23,496

99,070

114,110

2007

2008

2009+

2006

2004

2005

2003*

Special Section T h e H o p e L i v e s H e r e C a m p a i g n

A Celebration of Hope and CommitmentOn Sept. 17, 2009, Children’s Hospital donors, board members and institutional leaders gathered at Karamoor, the home of Nicholas and Athena Karabots, to mark the extraordinary success of the Hope Lives Here campaign.

It was an evening to honor the exemplary commitment of CHOP’s philanthropic partners and to celebrate the Hospital’s unprecedented growth.

From left: Steven M. Altschuler, M.D., president and CEO, with CHOP supporters Susanna Saunders, Lisa Carr, Ruth Colket, Nicholas and Athena Karabots, and Debbie Weise.

Trustee and benefactor Lynne Garbose, left, with N. Scott Adzick, M.D., surgeon-in-chief and director of the Center for Fetal Diagnosis and Treatment, and his wife, Sandy. Garbose, with her husband, Bill, funded CHOP’s Garbose Family Special Delivery Unit, the world’s fi rst birth facility devoted to babies with birth defects.

Hosts Nicholas and Athena Karabots share in the Hope Lives Here celebration with Robin and Steven M. Altschuler, M.D.


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“When Dr. Mosse told us that she had found the gene that causes

neuroblastoma, we were elated! When she said it

would not have been possible without our funding, it made us

realize how honored we are to be able to

support an incredible doctor’s work and the institution that saved

our daughter’s life.” Jocelyn Hillman, mother of a Cancer Center

patient. Hillman and her husband, John, made a major gift to the neuroblastoma research

program during the Hope Lives Here campaign.

Found inTranslation

H o p e l i v e s h e r e . 15

A Very Good Year The clinicians in our fi rst-of-its-

kind Cancer Survivorship Program have the great joy of seeing their patients reach some of life’s most

signifi cant milestones. In 2008, the program celebrated one of its own:

its 25th anniversary. !U.S.News & World Report

ranked The Children’s Hospital of Philadelphia No. 1 in Cancer Care in its 2009 America’s Best

Children’s Hospitals issue.

Neuroblastoma is one of the most puzzling childhood cancers. In some cases, it simply vanishes. In most others, it kills.

Its causes have long eluded researchers, who have spent decades searching for better treatments — and for a cure.

In 2008, a team led by John M. Maris, M.D., chief of the Division of Oncology, and Yael Mosse, M.D., identifi ed mutations in the ALK gene as the main cause of the hereditary form of neuroblastoma. The team also found that the same mutations can occur in the cancer cells in the nonhereditary form of the disease.

Less than two years later, in September 2009, Mosse opened a clinical trial of a drug that the team hopes will kill cancer cells by deactivating the ALK gene. It’s a promising new treatment option for a group of patients who have very few — and researchers were able to get it to them remarkably quickly.

These advances have been made possible by support from donors like the friends and family of CHOP patient Andrew Accardi, the Evan T.J. Dunbar Neuroblastoma Foundation, and Jocelyn and John Hillman.

“If you ask most people how long it takes to go from a discovery to a clinical trial, they’ll tell you it typically takes 10 years,” says Maris. “We want this to be the new paradigm.”

With a donation of $1 million, GlaxoSmithKline created the

Hope for Families Fund, which helps patients with

relapsed cancer (like Elijah, opposite page) cover the costs of

traveling to CHOP for treatment. This visionary gift will make it

possible for many more children to benefi t from our researchers’

remarkable work.

Thank you.

Elijah Talley, 9, has participated in several neuroblastoma clinical trials since doctors in his hometown of LittleRock, Ark., fi rst referred him to CHOP in 2008. TheTalleys are frequent guests at the Philadelphia RonaldMcDonald House, where this photo was taken.

Less than two years after researchers discovered the gene for a rare childhood cancer, a clinical trial of a new treatment begins.



The view from the 450,000-square-foot Ruth M. and Tristram C. Colket, Jr. Translational Research Building, where researchers will continue to do the kind of work that will change and save lives: (from left) Hakon Hakonarson, M.D.,

Ph.D., director, Center for Applied Genomics; Philip R. Johnson, M.D., executive vice president and chief scientifi c offi cer; and John M. Maris, M.D.,

director, Center for Childhood Cancer Research, and chief, Division of Oncology. “Translational research” refers to the process that turns laboratory

science into effective, evidence-based treatments for patients.


The Cancer Center is just one of the areas that benefi ted from the funds raised for translational research during the Hope Lives Here campaign. Here are highlights of the other research discoveries that our generous donors helped make possible.

New Directions in the Fight Against AIDSSince the 1980s, researchers have had little success developing an HIV vaccine. A decade ago, Johnson decided it was time for a different strategy: Rather than trying to stimulate the body’s immune response, gene transfer technology could be used to introduce an effective antibody against the virus. In 2009, Johnson’s team was able to successfully protect monkeys from being infected by the simian immunodefi ciency virus, which is closely related to HIV. The study was so successful that trials of the vaccine in humans may begin within two years.Johnson is heartened by the success, but recognizes that the pace of discovery can always be accelerated: “We can never stop working. Research, like patient care, doesn’t know a calendar, or a schedule.”

Uncovering the Causes of AutismUsing highly automated genotyping technology to look at the DNA of more than 10,000 children, researchers, led by Hakon Hakonarson, M.D., Ph.D., director of the Center for Applied Genomics, found that children with autism spectrum disorders were much more likely to have gene variations affecting the way brain cells communicate with each other. Hakonarson believes these variations may contribute to as many as 15 percent of autism spectrum disorder cases. The discovery is especially promising because it dovetails with independent fi ndings about the brain from functional magnetic resonance imaging (fMRI) and anatomical research. According to Philip R. Johnson, M.D., executive vice president and chief scientifi c offi cer, it “moves the fi eld of autism research signifi cantly ahead and provides a starting point for translating biological knowledge into future treatments.”

“We can never stop working. Research, like patient care, doesn’t know a calendar, or a schedule.” Philip R. Johnson, M.D. Executive Vice President and Chief Scientifi c Offi cer

17

18 T h e C h i l d r e n ’ s H o s p i t a l o f P h i l a d e l p h i a

Broviac catheterBefore interventional radiologists (who use live imaging tools to insert catheters and perform other procedures) placed Jaylisse’s Broviac® catheter as a permanent way to give medication, they read safety checklists out loud three times. Checklists improve communication to limit misunderstandings and improve safety.

Allergy alertJaylisse had medication allergies. A red band signaled her care providers to carefully check her chart before giving medicine or food. At CHOP, a patient’s allergies become part of her electronic medical record. Any time the record is retrieved, whether for inpatient or outpatient care, an alert fl ashes on the screen.

VentilatorJaylisse needed a ventilator to breathe. To prevent ventilator-associated pneumonia, an infection too common in hospitals, nurses cleaned her mouth and gums every four hours and elevated the head of her bed. Research has shown patients receiving this care are less likely to get this form of pneumonia.

Central lineJaylisse had a central line, a thin tube that is threaded through the body to deliver medicine to a vein near the heart, and is a potential source of dangerous infections. A Hospital-wide initiative to reduce central line-associated bloodstream infections includes strict protocols for touching central lines, more training and heightened awareness in every unit.

Keeping Jaylisse Safe


Every Child, Every Day: Safety Comes First Jaylisse Rivera is a walking — well, toddling — miracle. Now 18 months old, she is alive today because The Children’s Hospital of Philadelphia was there to provide the most advanced treatment for her pulmonary hypertension, a severe condition affecting the heart and lungs. Born weighing 1 pound, 2 ounces — tiny enough to be held in the palm of a hand — Jaylisse was helicoptered to CHOP at 5 months from another hospital. Over the next 231 days, she was supported by a ventilator, a central line, a feeding tube, antibiotics and blood-thinning medications. The same aggressive treatments that kept her alive, combined with her already frail condition, made Jaylisse vulnerable to infections and other hospital-acquired complications. But she ended her seven-month stay at Children’s Hospital without a single safety incident. Just as her care team had planned. As a world leader in pediatric medicine, CHOP has long embraced its responsibility to advance patient safety as the cornerstone to improving children’s health. “When a child is entrusted to our care, we can never be too vigilant,” says Kathy Shaw, M.D., associate chair for Safety and Quality Improvement. “By empowering our staff, we are creating a safer environment for our patients.” More than a philosophy, safety is a core value at CHOP. Throughout 2008 and ’09, incorporating input from across the institution, the Hospital put in place a series of rigorous safety checks and balances. Drawing upon clinical expertise, advanced technology, a heightened sense of teamwork and simple common sense, staff at all levels have developed innovative systems to prevent mistakes and catch errors before they ever harm patients.

Safe Keeping: Improvements Are Hospital-wide and Personalized for Each Child.

Simulation trainingNurses and respiratory therapists use simulation mannequins to practice safe care for patients, like Jaylisse, who have tracheostomies (an opening in the windpipe to aid breathing). The mannequin will react as a child would. Providers practice responding to potential emergencies, such as the trach tube being dislodged. (A)

AnticoagulantsReceiving anticoagulant medicines (“blood thinners”) was vital to Jaylisse’s treatment. But they are among the drugs most often associated with harmful errors. CHOP requires that a dedicated pharmacist review blood tests and exact dosages daily for each patient on anticoagulants to ensure the child realizes the benefi ts without any complications. (B)

TransparencyTo involve families in safety efforts, staff carefully explain safety precautions and encourage parents to speak up if they see anything they feel could be unsafe for their child. Intensive care units have white boards showing how long each unit has gone without a central line-associated bloodstream infection so everyone — patients, families and employees — knows how that unit is doing. (C)

Infection preventionAs part of the Hospital-wide effort to eliminate central line-associated bloodstream infections, physicians and nurses must wear sterile gowns, masks and gloves before accessing a central line (to inject medicine or change dressings, for example). To make sure each step in the protocol is observed, another nurse reviews a checklist: Was the warning sign posted on the door? Did everyone don sterile garb? Did the nurse scrub the area for 15 seconds with alcohol, then allow it to dry? (D)

Executive safety roundsTo personally see and hear about challenges clinicians face in keeping CHOP patients safe, an administrator and medical leader are paired to conduct monthly safety rounds in a unit. Here, they learn fi rsthand about issues so they can direct resources where needed. Staff on the unit know their patient-safety efforts have support from the top. (E)

AntibioticsDuring her stay, Jaylisse received an antibiotic. Her medical team made sure it was the right drug for her specifi c infection, given for the proper amount of time and by the most appropriate method to treat her in the safest possible way. CHOP’s Antimicrobial Stewardship Program strives to improve patient outcomes, lower the risk of adverse events and reduce resistance to antibiotics by helping care providers make data-driven decisions.


B

C

A

D

EH o p e l i v e s h e r e . 21

Tender Loving CareInnovative projects in the N/IICU engage families and staff — and contribute to a remarkable drop in nursing turnover.


Hope is a thumbprint-size foot in a too-big sock. Hope is a pair of khakis with a 4-inch inseam. Hope is a tiny sweater, a colorful blanket, a frilly tutu. Hope is every dream you ever had for your baby — and it’s everywhere you look in the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU).

For parents of critically ill infants, hope is seeing their babies dressed in colorful, cheerful clothes. That’s the premise behind Grandma’s Attic, a closet in the N/IICU where nurses pick out special outfi ts for patients.

The nurses benefi t from Grandma’s Attic just as much as the parents, says Donna Zerweck, R.N., the 24-year N/IICU veteran who started the project. “The N/IICU is a very sad place sometimes, very intense. Just being able to do something like put an outfi t on a baby is so meaningful for a nurse.”

N/IICU nurses work with other Hospital staff to make sure the items donated to Grandma’s Attic are available to every baby on the 70-bed unit, including 2-week-old Satya, shown here with her mother, Harsha. “We’re creating a ‘comfort zone’ for families,” says Donna Zerweck, R.N. (below right).“Blankets and clothes help soften a very stressful environment.”


Better and Better: In 2009, the American Nurses Credentialing Center awarded CHOP Magnet status — the profession’s highest honor — for the second time, a testament to the Hospital’s ability to keep improving patient outcomes. “The bar gets higher every time,” says Anne Mohan, M.S.N., R.N., N.E.A.-B.C., director of Nursing Practice and Patient Safety.

Gary Dipple shares a special moment with his 1-day-old son, Connor, in Children’s Hospital’s N/IICU.

Encouraging more nurse-initiated projects like Grandma’s Attic was a particular focus in the N/IICU in 2009, when the unit was one of eight CHOP departments that participated in a remarkably successful effort to improve staff retention.

In the year since Grandma’s Attic opened, it has become one of the best-loved places in the Hospital. “I melt every time I walk by,” says Ursula Guillen, M.D. And for parents, she observes, the Attic’s pull must be even more powerful: “I’m sure they have all the same clothes at home, waiting.”


Gifts like those that established the Ruth M. Colket Endowed Chair in Pediatric

Nursing and the Colket Endowed Lectureship in Nursing give CHOP

nurses many opportunities: to enhance their practice, pursue their

research interests and explore new ways to make a difference in children’s lives.

Thank you.

Here to StayWith approximately 300 nurses, the N/IICU has the largest nursing staff in the Hospital — and one of the happiest. In fi scal year 2009, the unit had no nursing turnover.

Such a statistic would be impressive for any department, says director of Nursing Practice and Patient Safety Anne Mohan, M.S.N., R.N., N.E.A.-B.C., “but when you’re talking about such a large unit, it’s truly, truly amazing.”

Just as amazing are some of the things N/IICU nurses did as part of the unit’s yearlong effort to improve staff retention and engagement. With the support of leaders like Tyonne Hinson, M.S.N., R.N., the unit’s nurse manager, they developed projects like Grandma’s Attic, took on leadership roles in improving patient safety, and collaborated with CHOP’s Center for Quality and Patient Safety to fi nd ways to improve patient outcomes — all work that continues today.

They also got to know each other better at special staff appreciation events hosted by the department — and that’s a good thing for patients. When nurses feel comfortable together, they are more likely to bring up patient care and safety issues, says Hinson. “We’re building a culture where people can be listened to, can be heard and can feel safe sharing their concerns.”

“You build a more collaborative

team when you have people who

are long-term. It’s a big deal when

you have the same players.”

Tyonne Hinson, M.S.N., R.N., nurse manager of the N/IICU

and leader of the unit’s retention project

Nursing Turnover Rates: N/IICU


13.36%

7.69%

02007 2008 2009

25


First Healthy Kids Day Draws Thousands

Eat well. Stay safe. Be happy.


As an institution, The Children’s Hospital of Philadelphia is dedicated to one of the most effective tools in promoting good health: outreach to children and families in our own community. CHOP is the home visitor helping parents of kids with asthma reduce allergens and triggers in their homes, through the Community Asthma Prevention Program. CHOP is the Mobile Safety Center visiting Philadelphia and its suburbs with car seats, smoke detectors and bike helmets. CHOP is the nurse on the other end of the line when a parent calls the region’s Poison Control Center. CHOP is the team of nurses and doctors providing checkups for kids at Philadelphia shelters, through the Homeless Health Initiative. And CHOP is Healthy Kids Day. More than 4,000 kids and family members attended and more than 225 CHOP employees volunteered at this free, fi rst-time event, on a sunny Saturday in May 2009. Organized by the Offi ce of Government Affairs, Community Relations and Advocacy and held at the Mann Center for the Performing Arts, the event demonstrated how much fun a healthy lifestyle can be. Safety: Staff distributed items such as bike helmets and shared information about vaccines, car seats and other topics. Active body: Professional sports teams, a climbing wall and obstacle courses kept kids moving. Sensible diet: Everyone was treated to a delicious, healthy lunch. Healthy Kids Day will be an annual event. This noisy, joyful day represents a message: CHOP cares about its community, and is always here to help.

Thousands of families spent a day together learning about good health

thanks to a gift from Wal-Mart Stores Inc. The corporation’s generosity made Healthy Kids Day possible.

Thank you.



A Voice for All Children

T h e C h i l d r e n ’ s H o s p i t a l o f P h i l a d e l p h i a

Amidst fl uctuations of economy and policy, CHOP maintains a

constant focus on how healthcare serves the needs of children.

28

He presides over the hospital that has brought hope to thousands upon thousands of sick children.

Yet Steven M. Altschuler, M.D., is not content to help only those who

receive direct care from The Children’s Hospital of Philadelphia. He views it as his mission to improve the level of healthcare available to children everywhere.

Which is why a crisp fall morning fi nds Altschuler boarding a train to Washington, D.C. There he will spend the day meeting with legislators, helping to ensure that as the debate over healthcare reform plays out, pediatrics has a prominent place at the table. “As the nation’s leading hospital for children, we have an obligation to serve as their voice,” says Altschuler, CHOP’s president and CEO.

It comes down to dollars and cents. Pediatric health services are generally reimbursed at much lower rates than adult services — as a result, care for children may suffer.

Low reimbursements also discourage talented young doctors from specializing in pediatrics. Funding for pediatric training is undersupported and fl uctuates annually depending on Congressional appropriations. Altschuler argues tirelessly for a fair share of the pie and for changes to Medicaid, the single largest payor of pediatric services.

Also key to the discussion is more effective delivery of healthcare services. “Dr. Altschuler and CHOP are uniquely positioned to lead improvements in delivery,” says Roosevelt Hairston, Esq., senior vice president, Government Affairs, Community Relations and Advocacy.

With its innovative regional network structure, supported by use of the electronic medical record, the Hospital has created a replicable model in which centers of excellence such as CHOP partner with community providers to extend quality care to more children. CHOP’s care models for chronic illness, such as asthma, also provide a platform for effi cient care that other systems can replicate.

As legislative debate began in earnest in 2009, CHOP released “Healthcare Reform for Children Pillars,” a document clearly outlining the principles above and others that need to be considered in any new legislation.

The efforts are making a difference. Healthcare reform legislation pending in Congress is expected to include record funding for Children’s Hospitals Graduate Medical Education, as well as provisions that adjust Medicaid reimbursements for pediatric primary care to 100 percent of Medicare rates.

Altschuler’s is not the only CHOP voice heard in Washington. The Government Affairs team organizes visits by staff and patient families to interact with lawmakers, providing their own compelling perspectives in the debate.

Together, with fi rsthand knowledge and unswerving conviction, they articulate a critical need for those who cannot speak for themselves.


The Children’s Hospital of Philadelphia Foundation and Subsidiaries – Obligated Group

Financial SummaryFOR THE FISCAL YEARS ENDED JUNE 30 FY 2009 FY 2008 FY 2007

Sources of Revenue Net Patient Service Revenue $1,127,118,000 $1,051,795,000 $926,656,000

Other Operating Revenue 12,373,000 168,252,000 11,888,000

Contributions (1) 53,407,000 65,624,000 56,378,000

Research 168,694,000 178,428,000 157,720,000

Total Sources of Revenue $1,361,592,000 $1,464,099,000 $1,152,642,000

Uses of RevenueSalaries, Wages and Employee Benefi ts $579,808,000 $538,809,000 $485,693,000

Supplies and Expenses 311,363,000 307,771,000 270,157,000

Depreciation 107,877,000 98,299,000 80,734,000

Interest 7,706,000 12,016,000 8,479,000

Research Expenses 238,561,000 223,112,000 195,325,000

Uncompensated Care 54,166,000 50,443,000 40,207,000

Provision for Programmatic Investments 62,111,000 233,649,000 72,047,000

Total Uses of Revenue $1,361,592,000 $1,464,099,000 $1,152,642,000

(1) Includes unrestricted, temporarily restricted and restricted contributions.


About Children’s Hospital


Combined Balance SheetFOR THE FISCAL YEARS ENDED JUNE 30 FY 2009 FY 2008 FY 2007

AssetsCash and Short-term Investments $96,682,000 $73,003,000 $97,545,000 Receivables 225,734,000 207,440,000 142,184,000Other Current 159,214,000 195,917,000 92,314,000

Total Current Assets 481,630,000 476,360,000 332,043,000

Investments 1,091,365,000 1,540,019,000 1,603,926,000Property Plant and Equipment, Net 1,480,422,000 1,310,062,000 1,130,962,000Other Assets 22,026,000 11,442,000 19,495,000

Total Assets $3,075,443,000 $3,337,883,000 $3,086,426,000

Liabilities and Net AssetsCurrent Portion of Long-term Debt $11,252,000 $10,751,000 $8,316,000Accounts Payable and Accrued Expenses 297,449,000 348,380,000 212,800,000

Total Current Liabilities 308,701,000 359,131,000 221,116,000

Long-term Debt 606,710,000 617,963,000 631,548,000Other Liabilities 221,967,000 162,731,000 161,448,000Unrestricted Net Assets 1,707,323,000 1,911,391,000 1,746,474,000Temporarily Restricted Net Assets 94,459,000 125,638,000 170,269,000Permanently Restricted Net Assets 136,283,000 161,029,000 155,571,000

Total Net Assets 1,938,065,000 2,198,058,000 2,072,314,000

Total Liabilities and Net Assets $3,075,443,000 $3,337,883,000 $3,086,426,000


For the fi scal years 2009 2008 2007Specialty Care 289,265 281,785 260,159Kids First 605,241 599,712 581,946Primary Care 107,689 99,845 94,530Emergency 85,450 82,058 75,664Day Medicine 21,910 22,001 18,763Day Surgery 17,162 15,912 14,287

Total 1,126,717 1,101,313 1,045,349

Outpatient Visits

Number of Beds

2012 514 (Estimated)

2009 443

Hospital Admissions and Patient Days

FY 2009 FY 2008 FY 2007

Hospital Admissions

Patient Days

26

,71

4

13

4,3

63

Employees

FY08

FY09 9,116

FY07

24

,23

9

12

1,9

91

25

,69

9

13

0,0

88

9,044

9,762

421

396

12

2008

2007

1855

Hospital and CHOP Care Network Statistics


Admissions from New JerseyTotal: 6,736

By countyAtlantic 560Bergen 38Burlington 1,177Camden 1,342Cape May 161Cumberland 414Essex 121Gloucester 814Hudson 53Hunterdon 62Mercer 411Middlesex 236Monmouth 341Morris 76Ocean 593Passaic 29Salem 68Somerset 90Sussex 29Union 74Warren 47

Charitable Giving by Source FY09Outright gifts and pledges

The Children’s Hospital of Philadelphia Research InstituteAt end of fi scal year 2009

Number of investigators: more than 450 External Grants and Contracts: $141,332,306All Sources of Funding: $210,504,000Includes funds from Endowed Chairs, royalty income, Hospital support and other miscellaneous funding.

Federal Stimulus FundsCHOP has received 45 American Recovery and Reinvestment Act (ARRA) awards totaling $31,611,445 over two years. Many requests for ARRA grants are pending.

Admissions from PennsylvaniaTotal: 18,887

By selected countiesBerks 343Bucks 1,827Chester 910Delaware 2,679Lackawanna 106Lancaster 185Lehigh 223Montgomery 2,441Northampton 214Philadelphia 9,340

23%

41%

18%

18%

Corporations

Individuals

State/Federal

Foundations


Princeton

Saint Peter’sUniversity Hospital

(Cardiac Center)

Springfield

King of Prussia

Atlantic County

Pediatric & Adolescent Specialty Care

UniversityMedical Center

at Princeton

CHOP Newborn & Pediatric Care

Chester Co.Hospital

Shore Memorial Hospital

CHOP Pediatric Care

Abington Hospital

Grand View Hospital

CHOP Newborn Care

Pennsylvania Hospital

Phoenixville Hospital

Holy Redeemer Hospital

Doylestown Hospital

Harborview/Smithville

Harborview/Somers Point

Harborview/Cape May Co.

Kennett Square

West Grove

West Chester

Coatesville

Paoli

North Hills

Salem Road

Mt. Laurel

Indian Valley

High Point

NewtownFlourtown

Springfield

BroomallHaverford

MediaChadds Ford Drexel

Hill

Pediatric & Adolescent Care

Central Bucks

Roxborough

ChestnutHill

University CityMarket Street

CobbsCreek

SouthPhiladelphia

Voorhees

Exton

Bucks County

Pediatric & Adolescent Specialty Care and Surgery Center

Pediatric & Adolescent Specialty Care; Home Care

MONTGOMERY

CHESTER

BUCKS

BURLINGTON

GLOUCESTER

SALEM

ATLANTIC

CAMDEN

NEWCASTLE

DELAWARE

MERCER

MONMOUTH

OCEAN

MIDDLESEX

PHILA.

CUMBERLAND

CAPE MAY

Pediatric & Adolescent Specialty Care

CHOP Newborn & Pediatric Care

CHOP Pediatric Care

CHOP Newborn Care

Pediatric & Adolescent Care

Pediatric & Adolescent Specialty Care and Surgery Center

Pediatric & Adolescent Specialty Care; Home Care

CHOP Care Network

Lighting up the cover: Avery,

soccer player, kindergartener, son

This exuberant 5-year-old has sickle cell

disease and has been cared for by

a team at The Children’s Hospital

of Philadelphia since infancy.

These are just a few of the countless children who have

been helped by the Hope Lives Here campaign.

Thank you!

You Gave Us Hope.


A n n u a l R e p o r t

Founded in 1855, The Children’s Hospital of Philadelphia is the birthplace of pediatric medicine in America. Throughout its history, a passionate spirit of innovation has driven this renowned institution to pursue scientifi c discovery, establish the highest standards of patient care and train future leaders in pediatrics. For a century and a half, Children’s Hospital has served as a haven of hope for children and families worldwide.

www.chop.edu

The Children’s Hospital of Philadelphia and the logo are registered marks of The Children’s Hospital of Philadelphia.

©2010 The Children’s Hospital of Philadelphia, All Rights Reserved.

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