June 10, 2014

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FFirst, it was the construction of Texas Children’s new pediatric community hospital in The Woodlands slated to open in 2017. Now, a new David Clinic will be built at The Woodlands campus, which means children affected by immune deficiencies will receive world class care and diagnosis in their own community.

On June 4, David Elementary School presented Texas Children’s with a donation of more than $38,000 raised by students and families that will be used to construct the new facility.

The facility will serve as an extension of the already established David Center at Texas Children’s main campus, which provides care and research for primary immune deficiencies, which are inborn diseases of the immune system that make children susceptible to auto immunity and infectious diseases.

“With the growing city of Houston and Texas Children’s Hospital facilities, it makes sense to put an extension of the David Center in David’s own community and in our new hospital in The Woodlands to increase awareness and provide greater access to patient care and treatment,” said Dr. Jordan Orange, chief of Immunology, Allergy and Rheumatology at Texas Children’s.

The David Clinic and the David Center are named in honor of David Vetter, the Texas Children’s Hospital patient from the 1970s known as the “Bubble Boy,” who suffered from Severe Combined Immune Deficiency (SCID), which required him to live in a plastic bubble to protect him from germs and bacteria.

“This rare illness that David succumbed to affects about 1 in 50,000 babies,” said Dr. Orange. “Due to remarkable advances in immunology research and treatment, this immune deficiency is almost 100 percent curable if identified within the first three months of life.”

Since December 2012, every baby born in Texas is screened for SCID to ensure prompt diagnosis and best outcomes.

Besides the generous gift from David Elementary School, which is also named after Vetter, the school hosted David’s Dream Run last month. This annual event has raised more than $350,000 since its inception and all proceeds support The David Center and its research. All funds from the run through 2016 will support construction of the David Clinic in The Woodlands.

To learn more about David, visit the artifacts exhibit on the third floor of the Feigin Center in the Allergy and Immunology department. The David Center Wall on the ninth floor of the Clinical Care Center features a collection of photos highlighting David’s long-term association with Texas Children’s.

Watch the newest “I am Texas Children’s” video featuring employee Susan Fernandez in West Campus Emergency Center. “I knew this would be an awesome place to work,” Susan said. “Everyone is so kind and generous, especially to the children.”

Check out her video, and find out how you and your coworkers can be featured in the “I Am Texas Children’s” section on Connect

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Many hospitals have Neonatal Intensive Care Units (NICUs), but not all NICUs are the same.

Texas Children’s Newborn Center is one of the only level IV NICUs in the Houston region that is able to provide babies with the highest level of care. In fact, many area hospitals with less advanced NICUs transfer infants to us when more experience and specialized care is required.

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The American Academy of Pediatrics differentiates between units by defining levels of care based on the complexity of medical conditions the facility is equipped to treat. We hope this will help you better understand the different levels of care in the NICU:

Level I: Regular nursery care available at most hospitals that deliver babies

Level II: Intensive care for sick and premature infants

Level III: Comprehensive care for more seriously ill newborns

Level IV: Major surgery, surgical repair of serious congenital heart and anomalies that require cardiopulmonary bypass and/or extracorporeal membrane oxygenation (ECMO) for medical conditions. Level IV units include the capabilities of level III with additional capabilities and considerable experience in the care of the most complex and critically ill newborn infants and should have pediatric medical and pediatric surgical specialty consultants continuously available 24 hours a day.

Many area hospitals have level II or III NICUs, but are not equipped to provide the most advanced level of care some newborns need. Our combined level II and III NICUs offer specialty care for newborns. An additional level IV NICU located across the connecting bridge gives babies more extensive support and access to dozens of pediatric subspecialists.

Texas Children’s Newborn Center was recently ranked no. 2 in this year’s U.S. News & World Report survey, a gain from last year’s no. 17 ranking. As you know, U.S. News ranks the top 50 pediatric centers in 10 specialty areas, so being recognized within the top two is no small feat.

Our commitment to improving neonatal outcomes is really something to be proud of, and I am grateful that our diligent efforts are making a positive impact in the lives of so many babies.

For more information about Texas Children’s Pavilion for Women and our Neonatal Intensive Care Unit, visit here and to take a video tour of our NICU, visit here.

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On 14 West Tower, there is a new four-bed unit designated solely for diabetes patients who visit our hospital’s inpatient units. It’s a small area that’s going to make a big difference, maybe even help save lives.

The plans for the unit began as part of Delivering On the Vision (DOTV), the hospital wide effort to impact patient care and outcomes. DOTV created a Care Process Team to combat Diabetic Ketoacidosis or DKA. DKA is a life-threatening condition that diabetics encounter which could affect morbidity and mortality. The team discussed the work processes and potential areas of focus for quality improvement, deciding that a diabetes center of excellence was vital in improving our patient care and outcomes for diabetic patients.

“The dedicated Diabetes Care Unit allows for highly specialized care by a cohesive, expert team in a location where care is brought to the patient,” said Rhonda Wolfe, who is leading the Care Process Team along with Dr. Rona Sonabend. “The impact of a highly trained, expert team will mean improved quality, decreased length of stay, better preparation for discharge and ultimately better outcomes for our patients and families.”

Bedside nurses received advanced training to enhance their expertise with this patient population. This team is able to provide focused, expert care, involving all disciplines and providing a care model that is accessible, regardless of time of day or day of the week.

The team continues to receive ongoing training and will prepare for higher acuity patient admissions to the Diabetes Care Unit this coming fall.

June 3, 2014

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Some children with autism appear to be developing normally when they are very young. They babble or even talk, make eye contact with their parents and crawl and walk on schedule. Then suddenly, these skills seem to vanish.

Described as developmental regression, this loss of language, motor or social skills occurs more often in Black and Hispanic children compared to White children, according to a study led by Dr. Adiaha Spinks-Franklin, associate director of the Meyer Center for Developmental Pediatrics at Texas Children’s Hospital.

“Lost skills are very difficult to recover and unfortunately, there is no way to prevent developmental regression,” said Spinks-Franklin. “What we know is important is helping children with autism learn to communicate better, develop improved social skills, engage in more functioning behaviors, participate in an appropriate school curriculum that addresses their unique needs and learn to function as independently as each child can.”

Spinks-Franklin and her team analyzed data on 1,353 preschool children with autism enrolled in the Autism Speaks Autism Treatment Network database between March 2008 and December 2011. The database includes demographic and medical information on each child enrolled at one of 17 locations across the United States and Canada. Information collected included whether parents reported that their child had lost skills.

Results showed that 27 percent of children experienced developmental regression according to their parents. Black children were twice as likely to have parent-reported regression compared to White children. Hispanic children were about 1.5 times more likely than White children to lose early skills according to their parents. This difference was apparent even when researchers controlled for primary caretaker’s education and the child’s insurance status.

“Each child with autism is a unique individual with their own strengths and challenges,” said Spinks-Franklin. “It is very important that all parents in all communities become aware of the early signs of autism – poor communication skills, impaired social skills and unusual behaviors and interests.”

According to Spinks-Franklin, the rates of Autism are the same among African American, Hispanic and White children. However, African American and Hispanic children are generally diagnosed with Autism at later ages than White children and have less access to much-needed educational, therapeutic and medical resources that are designed to help address the needs of children with Autism.

The study, which is an insightful exploration of racial disparities among children with Autism, is Spinks-Franklin’s latest step towards understanding how culture impacts child development. Her previous research experience includes studying the development of children in Senegal, West Africa, and studying the mental health impact of the aftermath of Hurricane Katrina on school-aged African American children in Houston, as well as exploring the racial identity development of school-aged African American and Latino children in the Houston area who participated in a reading intervention program.

“The earlier a child is diagnosed with Autism, the better chance they have to receive the help and interventions the child needs to function to the best of their ability,” said Spinks-Franklin. “One of my goals is to increase awareness of Autism in underserved communities in the Houston area in order for all children to have a better chance of obtaining the help they may need.”

If a parent reports that a child has lost a developmental skill, health care providers should address the parent’s concerns with appropriate screening and referrals. Texas Children’s staff should be aware that there are many community-based and school-based services available to support and help children who have Autism and their families.

Spinks-Franklin presented the study, titled “Racial Differences in Developmental Regression in Children with Autism Spectrum Disorders” on May 6 at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, British Columbia, Canada.

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The New England Journal of Medicine (NEJM) is known around the world as perhaps the most prestigious medical publication. The peer-reviewed medical journal publishes research, editorials, review articles and case reports and is a window into the world of medicine. So when the work of three Texas Children’s advanced practice nurses was selected to be published in the journal, they were thrilled about their findings being shared with medical professionals around the world.

Neonatal Nurse Practitioner Amy McCay, director of Advanced Practice Providers Elizabeth “Charley” Elliott, and Nurse Scientist Marlene Walden produced an instructional video on Peripherally Inserted Central Catheter PICC placement in neonates with information on what the complications can be. “Being recognized as a nurse published in a medical journal elevates the science of nursing,” Elliot said. “The selection involves a rigorous process that evaluates manuscripts for scientific accuracy and importance.”

The three learned so much from their investigation that they wanted to share their findings in a publication that would be seen around the globe. They submitted an instructional video on PICC placement in the neonatal patient population and a written overview of the process. The nurses hoped that sharing the knowledge they gained would help other nurses learn the best method for this procedure and how to avoid complications.

“The video is innovative and offers clinicians an opportunity to see into the procedure,” Elliott said. “It brings the process together for those who need visuals and brings the work to a whole new level.”

The journal receives more than 5,000 submissions a year and only about five percent are actually selected and published. All submissions are reviewed by panels of experts that review the current literature and determine if what is being submitted is relevant to current practice and represents evidence.

For the nurses, the process of submission started in 2011 when they began to determine the patients who would be involved in the video, the information that would be presented and how to best present this procedure.

Once submitted, a panel of experts reviews for content, relevance, and best evidence available before they will consent to publish in the journal. Most of the articles published are submitted by physicians and researchers, so the nurses were honored to be selected.

As Elliot puts it, “To have a nurse published in a medical journal is big and validating.”

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When you think of Texas Children’s Neuroscience Center, two distinct attributes come to mind: integrated expertise and comprehensive patient care.

“Every single day, our neurologists, neurosurgeons and clinical researchers work together to pioneer innovative therapies to improve the lives of children with neurological disorders,” said Dr. Gary Clark, chief of Neurology and Developmental Neuroscience at Texas Children’s. “We needed a name that communicated this partnership and our firm commitment to providing high-quality comprehensive care to all of our patients.”

As a result, the neurology and neurosurgery divisions merged under one marketing umbrella to become the Neuroscience Center which focuses on a multidisciplinary team approach for treating childhood neurological disorders. If a neurologist diagnoses a brain disorder in a patient that cannot be treated by medication alone, for instance, then surgical treatment may be required.

Expert teams of neurologists collaborate with neurosurgeons daily to deliver complete care in more than 12 pediatric specialty clinics. Our Neuroscience Center brings together a diverse group of pediatric specialists representing different areas of expertise:

  • Neurology
  • Neurosurgery
  • Neurophysiology
  • Neurological Critical Care
  • Genetics

“By combining clinical care with easy access to surgery, our Neuroscience Center offers patients and their families access to treatment in one centralized location,” said Dr. Thomas Luerssen, chief of Neurosurgery and chief quality officer of Surgery at Texas Children’s. “From diagnosis to treatment, whether it involves surgery, inpatient rehabilitation or access to a clinical trial, our patients will have the full complement of services.”

Texas Children’s has consistently been ranked among the nation’s top children’s hospitals in neurology and neurosurgery by U.S. News & World Report.

“Since neurology and neurosurgery are measured as one specialty program by U.S. News & World Report, it makes sense to market them together as the Neuroscience Center,” said Dr. Clark.

Texas Children’s is one of the largest pediatric neurological service providers in the country. On average, more than 30,000 clinic visits take place every year and more than 900 surgeries are performed by providers in our Neuroscience Center.

Click link to learn more about Texas Children’s Neuroscience Center.