August 15, 2017

Dr. Rebecca Schultz, a member of Texas Children’s Epilepsy team in Pediatric Neurology was recently named the 2017 recipient of the Association of Child Neurology Nurses (ACNN) Excellence in Child Neurology Practitioner Award.

This prestigious award recognizes and honors the nurse practitioner or physician’s assistant who, as a member of the ACNN, has rendered distinguished service within the profession of child neurology nursing.

Schultz is one who demonstrates, through strength of character and competence, a commitment to the care of children with neurological disorders and their families. She is acknowledged by her peers as one who exhibits qualities of compassion, resourcefulness, leadership, knowledge, communication and inspiration.

August 8, 2017

Nurses at Texas Children’s are natural innovators. They ask questions, ponder processes and think outside the box to develop solutions that improve care and outcomes for patients. For nurses Michael Pickett, Nicholas Keith and Anthony Bentley, a shared passion for patient-centered innovation ultimately brought them together.

“After working on projects of our own, we talked and realized we all faced the same kinds of challenges and frustrations,” said Keith, a float pool nurse at Texas Children’s. “Knowing how grueling the process can be to implement a new idea, we set out to develop a council that would support frontline staff using a bottom-up approach to give life to ideas from end users.”

The idea to create a venue that would bring end user needs, ideas and solutions to clinical practice provided the visionary roadmap they needed to launch Texas Children’s first-ever Innovative Solutions Nursing Council that would be run entirely by staff nurses.

“While none of us had prior shared governance experience, we approached our nursing leaders, Emily Weber and Charley Elliott, who supported our idea,” said Pickett, a nurse practitioner in the Anesthesia section at Texas Children’s. “We presented our strategic plan at several leadership meetings. Our leaders supported us and assigned a senior project manager who helped us with the council start-up process.”

After months of planning, the council – comprising 12 staff nurses and an advisory team – held its first operational meeting in May 2016. The broad array of specialty areas represented on the council included physical therapy, supply chain, biomedical engineering, information services, business development, nursing quality and nursing research.

Developing solutions to support new ideas

Once a month for an hour and a half, the council and support staff meet to brainstorm new ideas, deliver strategic guidance, and create and implement action plans for nurse-led projects that address particular needs or concerns. This unique style of collaboration sets the stage for significant results.

The council receives ideas or identified needs from various sources. For example, a staff member may have a solution but not know how to get support; or a leadership initiative or staff member may identify a need, but have no clear solution for how to address the challenge. Once an idea is introduced, the process of developing a solution begins with council members conducting a thorough needs and solutions analysis.

“Combining research data, surveys and end-user feedback, we simulate and prototype the solution to develop and vet the proof of concept before presenting collaborative recommendations to leadership for their support,” Pickett said. “We are continuously evaluating and making adjustments throughout this process to ensure that the final design of the product will meet the specific needs of the end user.”

Collaboration leads to innovative solutions

Since the council was formed, the team has already reached innovative milestones that would not have been possible without support from collaborative partners and executive leaders including departmental colleagues, nursing leadership and the council leadership sponsors.

Working with Pryor Products, a leading manufacturer of IV poles and accessories, the council helped staff co-design a prototype IV pole to which an oxygen canister and chest tubes could be more easily attached. The council also worked with GCX, a worldwide leader in medical instrument mounting, to develop a more secure method for mounting a monitor on the IV pole.

Previously in the cardiovascular intensive care unit, the attachment of these medical items created a patient safety concern. Oxygen tanks were hung too loosely, allowing them to swing. Monitors and chest tubes were tied to the poles with rope and secured with tape and trach ties. Heart line transducers were hung at inappropriate levels and would not fit on the poles at patient level.

“Our innovations provide a safe and secure holder for oxygen tanks and chest tubes,” Keith said. “We now have a mount on the IV pole that keeps our monitors visible and holds them securely in place and a pole extension for our transducers that will remain at the appropriate level of the patient.”

Another example was the production of a 360-degree virtual reality video that simulated, inside a pre-construction mock-up space, proposed neurosurgical and MRI facilities for Texas Children’s Legacy Tower. The video proved to be a valuable tool that allowed the team and leaders involved in the design process to re-evaluate the space in real time.

“This video has benefited staff and leaders because it provides a 360-degree view of the room,” Keith said. “The viewer can select which point of view to experience by simply restarting the video and changing their focus.

The council has many more projects in the pipeline, including developing solutions to reduce neonatal vibration in isolettes and resolving skin care challenges in patient care units.

“Our council is a huge resource for Texas Children’s,” said Bentley, a nurse with Texas Children’s Kangaroo Crew. “Employees and staff now have a place where their ideas can take root, be nurtured, and one day produce measurable outcomes for patients and their families. We are grateful to our leaders for their instrumental and continued support that led to the success of this project.”

Texas Children’s is a large and growing health system with many specialties and sub-specialties. We take care of the sickest of the sick and provide routine pediatric care to otherwise healthy children. Many times that care involves not one medical expert but a team of medical experts, including pediatric anesthesiologist.

“The core role of the Department of Anesthesiology, Perioperative and Pain Medicine is to provide surgical anesthesia, but we are not just in the operating room,” Anesthesiologist-In-Chief Dr. Dean B. Andropoulos said. “We provide care in radiology, our Pain Medicine Clinic, in the Intensive Care Units, and at all three Texas Children’s Hospital campuses. We also are in the laboratory doing cutting edge research, writing some of the top textbooks in our field, and educating and training the next generation of pediatric anesthesiologists.”

During a recent Department of Surgery Grand Rounds, Andropoulos discussed the strategic goals of his growing department and how it touches almost every aspect of patient care.

The department’s 78 pediatric anesthesiologists represent the largest group of pediatric anesthesiologists in the country. All are board certified or are in the process of becoming board certified and all provide anesthetic care in almost 60 locations on a daily basis.

Across these locations, Texas Children’s anesthesiologists were involved in 43,456 cases last year, a 36 percent increase from the number of cases anesthesiologists participated in seven years ago. The majority of the cases worked last year, 68 percent, occurred in the operating room. The remaining 32 percent of cases happened outside the OR in various inpatient and outpatient settings.

“The fact that we do more than 40,000 anesthetics in a year lends to the level of expertise of our group,” said Medical Director of Perioperative Services Dr. Chris Glover. “I don’t know of another place where you can take your child to get the amount of expertise that exists here.”

This level of expertise was recently exemplified by the expansion of the Pre-Anesthesia Screening Service (PASS) Clinic to Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands. These clinics are involved in pre-anesthetic consultation and planning for patients with complex medical problems or who are undergoing complicated surgical procedures.

Patients are evaluated by anesthesiology nurse practitioners and anesthesiologists, and an anesthetic plan is developed that is communicated to parents, surgeons and procedural physicians. This planning leads to improved patient and family education, better outcomes and fewer delays and cancellations of surgery. This service emphasizes the increasing role of pediatric anesthesiologists as perioperative physicians whose expertise benefits patients all across the Texas Children’s system.

Being part of an academic center, Baylor College of Medicine, allows the Department of Anesthesiology, Perioperative and Pain Medicine to continue to strengthen and grow its already solid knowledge base, Andropoulos said.

In addition to providing top notch clinical care, the department’s clinical staff is involved in numerous clinical and basic science research protocols, many of which are funded by the National Institutes of Health.

Just last year, the department’s faculty published over 40 articles peer reviewed journals. They also served as editor and/or author of eight textbooks, including Anesthesia for Congenital Heart Disease, 3rd Edition. The textbook is the leading reference source for the field.

The department has taken a lead in educating anesthesiologists at Texas Children’s and beyond about the Federal Drug Administration’s recent warning that repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 or in pregnant women during their third trimester may affect the development of children’s brains.

“Parents know we are up-to-date on the very latest information,” Andropoulos said. They also know we all are aware that taking care of their child is a privilege, a real responsibility that we take extremely seriously.”

Members of the Department of Anesthesiology, Perioperative and Pain Medicine are always striving to do better and have set out three primary strategic goals for the next few years. These goals are:

  • To enhance patient experience by design and enhanced method of measuring anesthesiology patients satisfaction data.
  • Expand pain services by creating a strong business model for the service line and engaging and strengthening collaborative partnerships with clinical specialties to increase access to care for pain patients.
  • Increase research grant funding and resources by growing the volume of peer reviewed journal publications and grant proposals in the department and acquiring more funding from major grant proposals.

“We will continue to strengthen and grow our department,” Andropoulos said. “We want to remain one of the top pediatric anesthesiology programs in the country.”

Department leadership and contact information
  • Anesthesiologist-In-Chief, Dr. Dean B. Andropoulos
  • Associate Anesthesiologist-In-Chief Academic Affairs, Dr. Blaine Easley
  • Associate Anesthesiologist-In-Chief Clinical Affairs, Dr. Emad Mossad
  • Medical Director of Perioperative Services, Dr. Chris Glover

For more information about Texas Children’s Hospital Department of Anesthesiology, Perioperative and Pain Medicine, visit the department’s website at http://www.texaschildrens.org/departments/anesthesiology or call ext. 4-5800.

Megnon Stewart, MSN, RN, education specialist for Nursing Professional Development at Texas Children’s, was recently named the 2017 Star Search winner at the Association for Nursing Professional Development (ANPD) national conference.

Each year, ANPD holds a Star Search competition at the annual convention to encourage aspiring speakers to compete for an opportunity to present a concurrent session at the next annual convention.

Each participant had 10 minutes to give a brief presentation that was judged by members of the ANPD Convention Content Planning Committee (CPC) and the audience. The CPC score constitutes 75 percent of the total score and the audience score constitutes 25 percent of the total. The participant who receives the highest score is invited to present a 60-minute concurrent session at the 2018 Annual Convention in Orlando, FL, and receives one complimentary convention registration.

Congratulations to Megnon for representing Texas Children’s with this prestigious award.

August 1, 2017

Texas Children’s Heart Center has partnered with Project ADAM® to help prevent the deaths of children and adolescents due to sudden cardiac arrest.

Started in Wisconsin in 1999 by a family whose son died from the condition, Project ADAM® helps schools nationwide implement programs to make automated external defibrillators (AEDs) readily available by preparing schools for a cardiac emergency through emergency response plans, staff CPR and AED training, student CPR education and sudden cardiac arrest awareness education.

Melody Stephens brought the program to Houston and reached out to Texas Children’s for help after her 18-year-old son, Cody, fell asleep in a recliner at home and never woke up. Doctors determined the teenager, who had recently been awarded an athletic scholarship to play college football, died from sudden cardiac arrest.

“My primary goal is to help schools to be prepared to respond appropriately to a cardiac emergency so that the victim has the best chance of survival,” Stephens said. “Texas Children’s has embraced the concept and has done everything they can to make schools safer for children with heart conditions.”

Two area schools – Bonnie Holland Elementary in the Katy Independent School District and Crosby Kindergarten in the Crosby Independent School District – have been named Heart Safe Schools through Texas Children’s Hospital’s partnership with Project ADAM®. Five more campuses are awaiting the receipt of the designation and four other schools are in the process of becoming Heart Safe.

In order to become a Heart Safe School, teachers learn about the risks of sudden cardiac arrest as well as CPR training. Texas Children’s physicians and Heart Center team members helped provide the school with the training.

“Texas Children’s Hospital believes prevention is just as important as treatment,” said Texas Children’s Pediatric Cardiologist Dr. Santiago Valdes, who serves as medical director of the local Project ADAM® initiative. “We are more than happy to lend our expertise to these schools while they check items off of the required checklist needed to become a Heart Safe School.”

For more information about Project ADAM® click here. To read a Texas Children’s blog post by Stephens about her and her son’s experience with sudden cardiac arrest, click here.

July 18, 2017

Three years ago, Texas Children’s Hospital West Campus opened an eight-bed Pediatric Intensive Care Unit thanks to a generous $1 million donation by the Lauren and Lara Camillo family. This fall, the last chunk of a $50 million capital improvement effort will expand the unit to 22 beds.

Construction on the project hit a midway point this summer and is expected to be complete in October, providing Texas Children’s West Campus and the entire Texas Children’s system with an opportunity to serve more patients and families that need our care.

Initially, 16 of the beds will be used for intensive care and six will be for acute care. Two of the intensive care beds will have negative pressure and can be used for isolation. All of the beds provide more privacy for our patients and families, as well as better visibility and workflow for our nurses and other medical staff.

Located on the fourth floor of the hospital and painted in calming pastels, the unit expansion includes two large nursing stations advanced practice provider workspace, a simulation room, nutrition room, lactation room, call room and conference space.

The patient rooms are spacious and have a private bathroom and seating/sleep area for family. The rooms are lined with windows that face outside, letting in sunlight and allowing for great views of the hospital grounds and surrounding community. The rooms also include several windows that face nursing stations and adjoining rooms, giving medical staff ample visibility at all times.

Equipment in the rooms and on the floor is robust and includes two blood gas machines for respiratory therapy and additional nurse station monitors. In the future, some of the rooms will be able to offer patients who need dialysis the capability of doing so from the comfort of their beds.

Also in the future, six of the rooms will have the ability to be converted into Neonatal Intensive Care Unit rooms. As a result, the unit will incorporate NICU design features such as a family transition room, lactation room and separate entrances to the NICU section of the unit.

“The design of this unit is extremely family friendly,” said Erica Ventura, one of three patient care managers in the PICU. “From the patient rooms to the nursing stations, everything is being constructed with the patient and the medical staff in mind.”

Karen Sripan, assistant clinical director of the PICU, agreed and said the planning and design of the PICU expansion has been going on since March 2016 and was comprehensive.

“We were very thoughtful in our design and engaged staff throughout the entire process,” Sripan said. “We also were mindful of ensuring room design consistency with the Woodlands PICU so that the layout of the rooms are familiar to staff and providers working at both campuses.

PICU Medical Director Dr. Matthew Pesek said he is very excited about the expansion and working in a space that is so geared toward patients, families and medical staff.

“Our staff will have a lot more mobility due to the large size of the patient rooms and families will have a lot more privacy,” Pesek said. “These two things alone will go a long way.”

The PICU expansion is the last project funded by a $50 million capital improvement effort that aimed at growing West Campus’ capacity and capability. To date the following projects have been completed:

  • Additional office and administrative support space for dedicated physicians and providers
  • An 18-bed expansion of the hospital’s acute care capacity, including a special isolation unit designed for children with highly contagious infectious diseases
  • Conversion of offices within ambulatory clinics into additional exam rooms to increase outpatient subspecialty access
  • A dedicated suite for Interventional Radiology service
  • A new 14 exam room clinic for Neurology, Renal & Dermatology

“Since the hospital opened in 2010, West Campus has continued to grow along with its surrounding communities,” said West Campus Assistant Vice President Sara Montenegro. “Texas Children’s is committed to continuing this growth and support of our patients and families in West Houston.”

July 17, 2017

Dr. Jane Edmond has been selected to serve as president of the American Association of Pediatric Ophthalmology and Strabismus in 2020.

The organization’s goals are to advance the quality of children’s eye care, support the training of pediatric ophthalmologists, support research activities in pediatric ophthalmology, and advance the care of adults with strabismus.

Edmond is board certified and a fellow of the American Academy of Ophthalmology. She is a member of the American Association for Pediatric Ophthalmology and Strabismus, and has held many offices within the organization. She is an oral board examiner for the American Board of Ophthalmology. She is on the editorial board of the Journal of AAPOS. She is the author of numerous peer-reviewed journal articles and book chapters. She is a frequently invited presenter at national and international professional society meetings and conferences. She is the recipient of the Secretariat and Achievement Award, presented by the American Academy of Ophthalmology; and an Honor Award, presented by the American Association for Pediatric Ophthalmology and Strabismus. She is considered a national expert in craniofacial disorders and pediatric neuro-ophthalmology.

Edmond’s interests and specialties are:

  • Pediatric neuro-ophthalmology (brain-based vision abnormalities, optic nerve disease, pupil problems, visual impact of brain tumors or other intracranial insults)
  • Craniofacial disorders and their ocular and impact to the visual system
  • Childhood and adult eye strabismus, medical and surgical treatment (all forms of eye misalignment, double vision, eye misalignment secondary to thyroid eye disease)
  • Amblyopia