Spotlight on Dr. Moromisato
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My Biography
I chose to work with children because . . .
 I like taking care of all patients. But the thing that I love about taking care of kids is that they are so resilient.
I joined Children's Hospital Los Angeles because...
This is the best cardiothoracic center in the Western United States for children, and I wanted to be a part of it.
I work in Cardiothoracic Intensive Care because...
I always knew that I wanted to work in intensive care because you make such an immediate difference in a child's life right away. The choice to specialize in cardiothoracic care was a slow evolution over a period of years when I began realized what a phenomenal difference intensive care can make with children who have heart disease.
I come to work everyday because...
What makes my work so rewarding for me is knowing that, when I take care of a child, I’m taking care of someone so that they live another 70 or 80 years. I’m intervening at a time when I can make their potential the best it can possibly be.
My favorite part of my job is...
The best part of my job is being at the bedside – taking care of the children. In addition, I enjoy my interactions with people, the families of the children we care for, and all of my colleagues. We have a great atmosphere here – it’s very supportive.
My greatest accomplishment is...
I would have to say my most satisfying area of accomplishment has been in advocating for the values of Children's Hospital Los Angeles – Respect, Service, Excellence, Knowledge, Teamwork. By carrying these principles out on the unit, I play a part in influencing the culture at the hospital for the better.
My Role at Children's
 What my day is like...
I wake up at about 4:30, go to the gym, and get here by 7:00 a.m. When I arrive, I debrief with the nurse and the physician on call. At 7:30 a.m., we have daily rounds for about 2-3 hours. During that time, the entire team goes around to all of the children on the unit and creates a daily plan of care. After rounds, the kids who have just had heart surgery begin coming to our unit for care. This is when they are the most fragile and need the most attention. Once we stabilize them, I participate in teaching conferences where fellows meet to go over difficult cases and learn from them.
Each day I interface with...
The CTICU is incredibly multidisciplinary. You can look around the room in our quality meetings and see that we have nurses, respiratory therapists, pharmacy staff, critical care experts, cardiothoracic surgeons, and the ECMO coordinator (ECMO is equipment that provides oxygen to the blood for patients whose heart and lungs are not performing properly).
What my job means...
As the medical director, it’s my responsibility to make sure that the outcomes for children as good as they possibly can be. What that ends up requiring, is for me to rely upon the talents of every one of our multidisciplinary team members who work on the unit.
Staff look to me for...
Perspective. We must take our jobs seriously, but not necessarily ourselves. One of the most important things that the leaders in the Unit must do is keep morale high on the team. Individuals may get upset or disappointed in the moment, but if I allow morale to break down, the integrity of a close-knit team like ours begins to break down as well. This is going to sound corny, but on our unit, “we’re all heart.” People are very happy here and like each other. The ultimate result of all of this is the best care for the kids.
Strategic Initiatives
 Reducing Bleeding for Patients with Complex Care Needs
We are constantly developing new initiatives to improve our patient care. One in particular that stands out is our recent efforts to lower the incidence of bleeds for children who undergo ECMO treatment (ECMO is an acronym used for a machine that puts oxygen in the blood for children unable to do this for themselves).
For children who require ECMO intervention, blood thinners are required. In about 20% of cases, children are susceptible to bleeding at the site of the surgery, as well as in the brain.
As part of our constant quality improvement efforts for the care of children, the unit studied the incidence of bleeding complications associated with our patients. We compared our outcomes with those reported by other leading centers around the country and found our levels to be comparable. This was reassuring, but it wasn’t good enough for our staff.
We were determined to lower the rates of bleeding. The staff involved in this project reviewed the literature and wrote a new cardiac ECMO anti-coagulation protocol (formula for providing care).
The results of this initiative have been pretty impressive. Since we implemented the new protocol, surgical site bleeding has decreased by 40% and intracranial bleeds have decreased by 75%. We were quite pleased with the results, and will be presenting them at a national ECMO conference this year. Now, we are collaborating with other hospital units to revamp the ECMO admission orders care set, and, the Newborn and Infant Critical Care Unit is creating their own protocol as well.
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BACKGROUND AND TRAINING
Medical School
Loyola University Stritch School of Medicine
Internship
LAC-USC Medical Center; Pediatrics
Residency
LAC-USC Medical Center; Pediatrics
Fellowship
LAC-USC Medical Center; Pediatrics
Certifications
Pediatric Critical Care Medicine, American Board of Pediatrics
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