November 11, 2014

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Chief of Plastic Surgery Dr. Larry Hollier has been appointed to two new and exciting positions in the Department of Surgery – surgical director of patient experience and surgical director of the operating rooms.

Patient experience and operating room efficiency are critical areas of focus in our aspiration to deliver the highest level of service and care to our patients. Hollier has been instrumental in catalyzing improvements in these areas and in collaborating with colleagues from surgery, anesthesia, and operating room leadership. These new roles formalize our structural commitment to these efforts.

As surgical director of patient experience, Hollier will continue the exceptional work being done to improve patient and family experience. To date, he has played a key leadership role in implementing same-day appointments and direct scheduling for the Department of Surgery. These initiatives have helped improve our Texas Children’s Pediatrics referral processes and time to the third available appointment. Hollier also has led the following pilot projects to improve the experience of a patient’s arrival on the day of surgery:

  • New wayfinding system to help families find the different surgical areas;
  • Streamlined pre-surgery instructions to ensure consistent messaging for families; and
  • Addition of greeters to help families upon their arrival at the hospital.

As surgical director of the operating rooms, Hollier will partner with Dr. Steve Stayer and Judy Swanson in leading our operating theaters. This team will continue to work to improve efficiency in scheduling and the implementation of best practices, including developing focused specialty teams of nurses, anesthesiologists, and surgical staff.

111214ChesterKoh175-2The Auxiliary to Texas Children’s Hospital recently awarded Dr. Chester Koh and Dr. Robert Williamson with $75,000 research awards.

Koh, a pediatric urologist at Texas Children’s and the director of the organization’s Robotic Surgery Program, earned the Denton A. Cooley Fellowship in Surgical Innovation Award, which is given to a physician whose surgical research focuses on innovative ways to help children and to save lives. Williamson, an otolaryngologist with Texas Children’s and a professor with Baylor College of Medicine, received the Outcomes Fellowship Award, which supports patient care, education and research.

Koh is an internationally recognized expert in minimally invasive surgery, and has been instrumental in developing minimally invasive techniques with both laparoscopic surgery and da Vinci® robotic surgery to treat children. The hospital’s program serves as a pediatric robotic surgery research and training center that collaborates with other institutions in the Texas Medical Center.

Williamson studies functional outcomes of cochlear implants and the effects of language spoken by the implant team and by the family of the child who receives the implant. Little data is available on outcomes in implant recipients where the native language spoken in the home is different from that spoken by members of the cochlear implant team.

Williamson’s study will retrospectively analyze and compare cochlear implant recipients from non-native English-speaking households to recipients from English-speaking households, and analyze outcomes from patients with similar clinical characteristics.

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Two research residents with the Department of Surgery were recently recognized at the International Pediatric Surgical Oncology and International Society of Pediatric Oncology meeting in Toronto.

Dr. Yan Shi won best overall paper for his work on “MDM4 is a Potential Novel Therapeutic Target in Hepatoblastoma.” Shi is a research resident in the lab of Dr. Sanjeev Vasudevan, a pediatric surgeon at Texas Children’s and an assistant professor in the Division of Pediatric Surgery at Baylor College of Medicine.

Dr. Yesenia Rojas’ paper, “Adrenocortical Carcinoma in Children: A Review of the National Cancer Database,” was chosen as one of four papers presented in the “Best of International Pediatric Surgical Oncology” session and will be fast-tracked for rapid publication in “Pediatric Blood and Cancer.” Rojas is a research resident in the lab of Dr. Jed Nuchtern, who is chief of pediatric surgery at Texas Children’s.

November 4, 2014

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Texas Children’s cares for some of the country’s most critically ill patients, and safe, quality care for every patient is the most important responsibility of each staff member and employee here. Equipping our staff and employees with the knowledge and tools to take preventive action is key to creating an environment of safe patient care.

In an effort to illuminate the importance of everyone’s role, each month we will share patient safety stories that help heighten staff and employee alertness and accountability and, ultimately, reduce harm. This month’s story is a reminder that being familiar with your surroundings and knowing what to do in an urgent situation can help improve the outcome.

When congenital heart disease patient Emily came to the hospital for diagnostic testing, her family and the diagnostic team expected a routine clinical visit like she’d had many times before. But this visit ended differently. During testing, Emily’s condition began to deteriorate unexpectedly. The diagnostic team rarely treated acute patients and was not accustomed to calling for help. Their unfamiliarity with emergency protocol delayed a call to *9999, and once the response team arrived, there was additional delay in finding the code cart.*

Actions everyone can take:

  1. Know how to get help in an emergency. If you don’t know, ask your leader today.
  2. Know your surroundings and the location of emergency equipment. Some areas have code carts, automatic electronic defibrillators, panic buttons and other emergency equipment. Make sure you know what emergency support is available in your area, where it is and when it should be used.
  3. Be alert. Don’t take routine situations for granted, even if it’s something you’ve done many, many times before.

*Patient safety stories are based on events at Texas Children’s Hospital. Patient names and some of the circumstances of the event may have been changed to protect patient privacy.

For the latest quality and safety information, visit the Patient Safety website on Connect.

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The clock is ticking on this year’s 2015 benefits enrollment period, and with only 10 days left, it’s time to make a decision about the coverage you want for you and your family.

Enrollment ends on Friday, November 14. If you want to change plans or coverage levels, or if you want to participate in the Flexible Spending Account, you’ll need to elect your benefits during the enrollment period. If you don’t actively enroll during that time, your current medical, dental and other benefits will automatically carry over next year. Flexible Spending Account participation does not carry over from one year to the next, so you will need to reenroll.

Here are some questions and answers that hopefully will help you make the best decisions about your health insurance.

Where do I get more information about benefits?

Visit www.texaschildrens.org/mybenefits to learn more about your 2015 benefit options.

I need help selecting a plan. What resources are available?

You have access to Decision Direct, an interactive tool designed to help guide your decisions around which plan might work best for you and your family. Decision Direct is available at www.decisionsupportsuite.com/texaschildrenshospital.

Is the most expensive medical plan the best plan available?

Not necessarily. What’s “best” is based on the amount of coverage you and your family actually need. For example, if you enroll in the EPO or PPO option next year but don’t use a lot of health care services or take a lot of prescription medications, you may pay for more coverage than you need. The key is to consider your “total” medical plan costs for next year. That’s how much you contribute from your paycheck and how much you anticipate spending throughout the year combined.

Is one medical plan option better than another?

No. One medical plan option isn’t necessarily “better” than another. They’re designed to give you choices so you can find the option that makes sense for your and your family’s situation. Remember to take your total costs into consideration, which includes what you pay out of your paycheck and what you pay out of your pocket when you receive care (deductibles, coinsurance, copays). For example, if you select the EPO or PPO, you’ll pay more up front in payroll contributions and generally pay less during the year when you need care. With the CPP, you’ll pay less up front in payroll contributions and generally pay more when you need care during the year (but can use money in your HRA).

Are the same services covered by all the medical plan options?

The services that the CPP, EPO and PPO cover through BCBS are identical. They are just covered at different levels. You can find specific plan coverage details in your enrollment guide.

How does the CPP work?

The CPP saves you money up front with lower payroll contributions. You must meet an annual deductible for medical and prescription drug expenses before the plan begins to pay benefits. You will have an HRA account you can access to help satisfy out-of-pocket expenses such as the deductible, coinsurance, and/or other eligible expenses. Once you meet the annual deductible, you pay 20 percent of in-network medical and prescription drug costs until you reach the annual out-of-pocket maximum. Then the plan pays 100 percent of eligible expenses for the rest of the plan year. You have the option to open a Flexible Spending Account (FSA) along with your HRA, into which you can deposit $2,500 out of your check to help pay for your expenses. If you do open an FSA, using your debit card will allow those funds to be used first to pay for services to meet your deductible before the funds will be paid out of your HRA.

How does the CPP encourage informed and smart health care behavior?

Low payroll contributions on the front end and higher deductibles on the back end help you think before you use health care services – like deciding whether to go to an Urgent Care Clinic rather than the Emergency Room (ER) for a sinus infection. This type of plan promotes better decision-making around health care use, which in turn drives down costs.

I want to improve my health in 2015. What other programs are being offered?

You can kick-start your healthy 2015 by receiving your annual physical at the Employee Medical Clinic. Preventive care is covered by all three medical plans at no cost to you and subsequent visits are only $10! Employee Health and Wellness can also support you in achieving your well-being goals through various wellness programs including tobacco cessation programs, chronic condition management, health coaching, and engaging wellness activities. An exciting new offering is that tobacco cessation prescriptions and over the counter treatments are now covered at 100 percent with a prescription. Contact the Employee Medical Clinic at Ext. 4-2150 for a same-day appointment and wellness program details.

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Recently the Department of Pediatrics at Baylor College of Medicine and Texas Children’s Hospital reached a milestone with the hiring of its 1,000th faculty member. Today, more than 1,011 physicians make up that faculty and while the numbers are impressive, the story behind the numbers is what makes this department truly impressive. The latest milestone is part of a continuation of growth the department has seen over the years, more than doubling in size since 2007.

“Being the first in history means we cover the waterfront,” said Physician-in-Chief Dr. Mark W. Kline. “Texas Children’s forte is taking care of kids with the most complex medical conditions. We have expertise in every conceivable area no matter how complex or serious a child’s illness.”

In the past few years, the organization has added more than 100 new physicians a year across all subspecialties at Main Campus with a much bigger footprint across the community including West Campus, health centers, The Center for Children and Women, newborn units across the community that are staffed by Texas Children’s physicians and our latest partnership with Children’s Hospital of San Antonio.

“It’s a great story of our capacity and expertise,” said Kline. “We are less siloed and leave a mark across a broad geographical area.”

Kline said the vast expertise of the department means a capacity to deliver on every area of the Texas Children’s mission including patient care, education, research and service while driving innovation in health care. Amongst the goals of the department is educating young doctors who are the future of pediatric health care. Last year 40 new pediatric residents began their careers at Texas Children’s, this year that number has grown to 43 and it’s a program that continues to distinguish itself amongst others in the nation. Not only is it the largest program offered, the program includes a general pediatrics track, a global health track as well as the newest addition for 2015 applicants, the pediatrician-scientist training and development program. The program is intended for those with an interest in becoming a physician-scientist.

“I tell applicants it doesn’t matter where your interests gravitate throughout your residency, we have someone who can mentor you in that area,” said Kline. “This is a program to broaden horizons.”

Having the largest faculty and expertise in every recognized subspecialty gives Kline and other leaders the opportunity to recruit the best and brightest faculty. While leading growth has come easy, managing growth while preserving the cultural values of the institution presents a bigger challenge.

“The way we’ve ensured our culture remains strong is having a mix of new talent along with those who have been engrained in the culture for years,” said Kline. “We are creating that same mix at the leadership level to preserve our culture while continuing our growth.”

Kline recently created a new leadership structure with Dr. Susan Blaney, Dr. Sheldon Kaplan and Dr. Gordon Schutze appointed to new executive vice chair positions allowing the strengthening of the leadership structure with broader representation.

Kline said he doesn’t see a plateau in sight and hopes the growth will continue as the hospital continues its efforts to offer the best care at Main Campus, expands its services at West Campus and soon begins its latest venture in The Woodlands.

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Dr. Paul Checchia, medical director of the pediatric cardiovascular intensive care unit, has extensive experience with respiratory syncytial virus (RSV) in various clinical, research and academic settings. In response to the recent Ebola outbreak in West Africa and the handful of cases that have been treated here in the United States, Checchia wrote the following story in an effort to refocus people’s attention to RSV and influenza – two viruses he says are much bigger threats in the United States than Ebola.

11414pchecchia150During the past couple of months we all have seen our fair share of news coverage on Ebola. From turning on your television to walking into a pediatrician’s office and being asked questions about recent travel, the topic is everywhere. It’s not uncommon that with the surplus of information out there, it can begin to cause some anxiety.

While the likelihood of an Ebola outbreak is extremely low, it is still important to stay informed. And at Texas Children’s Hospital we want the community to know that we are fully prepared if an Ebola case were to appear in Houston.

But one thing I can’t help but ask myself is: With so many people worried about the spread of Ebola, why aren’t they also taking every precaution necessary to protect themselves against other diseases? For instance, why are individuals not having the same reaction to the flu as they are with Ebola?

The flu is a preventable disease that affects hundreds of thousands of individuals every year. According to the Centers for Disease Control and Prevention, an average of more than 200,000 people in the United States are hospitalized each year from the flu, with up to 49,000 dying from it. Yet many people are still refusing to get vaccinated. In fact, less than half of the U.S. population receives the flu vaccine each year. The CDC also reports that only 45 percent of children ages 6 months to 17 years got the influenza vaccination during the past 12 months. Only 26 percent of adults 18-49 years of age received theirs.

And what about respiratory syncytial virus (RSV)? While there isn’t a vaccine for RSV, there are many ways in which parents and Texas Children’s employees can actively protect infants and children from contracting this respiratory virus, including, washing your hands and making sure anyone in contact with your infant does the same. It’s also important to keep infants and children away from others who are sick, especially with cold or flu-like symptoms (which is why a flu shot is important for all family members and health care workers). While RSV is not as deadly as the flu, it can spread very rapidly among children. So what’s most important to remember about RSV is that is can be prevented.

As many communities are taking precautions to protect themselves and their families from Ebola, let’s not forget about these other diseases that are affecting so many of us every year. The flu and RSV have regularly impacted our community in more devastating ways than Ebola has. It is important that we not ignore these much greater health threats in the U.S.

So please get vaccinated: Everyone 6 months or older is recommended for flu vaccination. It’s the best way to protect yourself and others.

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic.

Remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3, we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1.