March 21, 2017

Imagine spending several months trying to find the pathogen responsible for a cluster of Burkholderia cepacia infections among critically ill, hospitalized patients. For infection preventionists, solving this mystery can be a daunting task but not impossible if you have the epidemiology skills and collaborative resources in your investigative toolbox.

When Texas Children’s had a small outbreak of B. cepacia infection last year, Texas Children’s Quality and Safety Director Elaine Whaley immediately sprang into action to identify the cause of the outbreak. Her extensive experience in infection prevention and control coupled with her professional networking skills helped her locate an infection preventionist at another pediatric hospital one-thousand miles away who had experienced a similar outbreak. Together, they identified the pathogen responsible for the B. cepacia outbreak in their respective hospitals.

Partnering with Infection Preventionist Angela Rupp of Lurie Children’s Hospital of Chicago, their collaborative investigation expedited the nationwide recall of liquid docusate, a medication used to treat constipation. This product was later found to be contaminated with the bacterium B. cepacia, which was directly responsible for the sudden outbreak of infection at both hospitals.

As a result of their work and commitment to promoting a culture of safe patient care, Whaley and Rupp will be recognized with the Heroes of Infection Prevention Award during a special ceremony in Portland by the Association for Professionals in Infection Control and Epidemiology (APIC).

“It is a great honor to have one of our own be nationally recognized for this heroic award in patient safety,” said Trudy Leidich, Texas Children’s assistant vice president of Quality and Safety. “We are grateful to Elaine and our Infection Control team for identifying the direct source of contamination in order to keep our patients safe and free from preventable harm.”

B. cepacia is the name for a group of bacteria that can be found in soil and water and are often resistant to antibiotics. The bacterium can cause life-threatening infection in high-risk, medically complex children, such as children with cystic fibrosis and immunocompromising conditions.

In February 2016, when a small cluster of patients at Texas Children’s and Lurie Children’s Hospital came down with B. cepacia infection, Whaley and Rupp initiated separate outbreak investigations. But once the two hospitals’ clusters were confirmed to be identical, the patients were combined to facilitate the investigation.

After thorough analyses, their investigation found that the ducosate product at each hospital came from the same manufacturer. After reporting these findings to the Centers for Disease Control, the Food and Drug Administration was called into the investigation which subsequently resulted in a national product recall. This recall protected patients at Texas Children’s and patients at other pediatric hospitals across the nation from this serious pathogen.

March 14, 2017

Texas Children’s recently celebrated the opening of the neonatal intensive care unit (NICU) E Pod, a newly designated 9-bed infant acute cardiac care unit at West Tower. Since opening on February 22, NICU E Pod has helped to significantly reduce the occurrence of cardiac case cancellations.

“Over the last six months, we were seeing an alarming increase in the cancellation of surgical cases and cath procedures due to a lack of inpatient bed capacity,” said Matt Timmons, director of Cardiology at Texas Children’s Heart Center. “During the last 18 days since the unit opened, we have had no cardiac case cancellations, which is a huge step forward in improving the care and experience we deliver to our patients and families.”

To create additional Heart Center capacity, Texas Children’s physician and nursing leadership teams from the Heart Center, Critical Care and Newborn Center – and many other subspecialties and support services across the organization – collaborated to expedite the successful opening of the new unit.

“We were fortunate to have the NICU E Pod available,” said NICU Nursing Director Heather Cherry. “After meeting with several subspecialty leadership teams, we collectively decided to open the NICU E Pod to provide additional bed capacity for our acute cardiac care patients. This collaborative decision allowed us to support an additional nine patients needing our care.”

Recently, acute care nursing partnered with the Heart Center to successfully add capacity for cardiac patients in the four-bed cohort on 10 West Tower. While this has been extremely helpful, the need for additional capacity still existed. The NICU E Pod provides an extension to 15 West Tower for acute cardiac care patients under 12 months of age. While the cardiology team oversees the treatment of these acute care patients, the NICU E Pod is staffed by the Newborn Center nursing team.

For patient families like Randal and Sabrina Pemberton from Lubbock, Texas, the opening of the unit could not have come at a better time. Since the first day the NICU E Pod opened, they have been with their daughter Aaliyah, who at just 8 days old, had surgery to repair an aorta and two holes in her heart.

“We’ve had a wonderful team of doctors who are taking great care of our daughter and the nurses have been fabulous as well,” Sabrina Pemberton said. “Overall, given our circumstances, it’s been a great experience at Texas Children’s Hospital. We couldn’t have asked for anything more.”

Besides collaboration from clinical staff, reaching this milestone so quickly – in a matter of one week – would not have been possible without the help from Texas Children’s support services which included Information Services, Facilities, Epic, Biomed, Supply Chain, Pharmacy and Environmental Services.

“This unit was a great example of collaboration by multiple subspecialties and departments, and shows how we are all “One Texas Children’s Hospital,” said Chief of Cardiology Dr. Daniel J. Penny. “The ability to open this unit so quickly and safely exemplifies our commitment to our patients and their families.”

With Texas Children’s anticipated growth, the Pediatric Tower – which is slated to open in August 2018 – will house 126 beds for pediatric and cardiovascular intensive care patients, which will provide additional bed capacity and even more opportunities to serve our patients and their families in the future.

“The Pediatric Tower is the long-term solution for our Heart Center’s rapid growth,” Timmons said. “The NICU E Pod and the 10 West Tower cardiac cohort are successfully bridging the gap until we move into the new tower.”

Texas Children’s Hospital recently launched a pediatric orthopedic surgery physician assistant fellowship program that provides advanced pediatric orthopedic subspecialty training to physician assistants. The program is the first of its kind in the country to offer a 12-month didactic and clinical pediatric-specific training program.

“Our fellowship ensures a unique opportunity to gain experience in pediatric orthopedic surgical subspecialties and to participate in leading edge work, both through didactic and clinical opportunities,” said Chief of Orthopedic Surgery Dr. John Dormans. “The fellowship also demonstrates the commitment Texas Children’s has to advancing the field of pediatric orthopedic surgery and the passion it has for surgical education and research.”

The year-long program includes 10 months of core clinical rotations through the pediatric orthopedic surgical subspecialties at Texas Children’s Hospital. Fellows also will be given two elective months to repeat rotations through a subspecialty of their choosing. All training is provided within the Texas Children’s system, both in the Medical Center and surrounding locations, by department supervising physicians.

Megan Lomax, from Arkansas, and Darius Dranginis, from San Antonio by way of Lithuania, are the programs first fellows. With just two months of the program under their belts, both said they already have learned so much.

“I’ve already learned more than I expected,” Dranginis said. “I am surrounded by top professionals in their field who are always willing to help and that makes a big difference.”

Lomax said the fellowship has been the opportunity of a lifetime and is giving her a chance to give back to patients the way medical staff gave to her when she came to Texas Children’s in college to receive surgery for an eye condition called strabismus.

“I feel like I have come full circle in my experiences as a patient and now fellow provider at Texas Children’s,” she said. “I love being surrounded by healthcare providers who share the same passion for kids as I do, and I look forward to learning all that I can about orthopedics during this fellowship year.”

The launch of the pediatric orthopedic surgery physician assistant fellowship follows the start of the Texas Children’s Hospital surgical physicians assistant fellowship program in 2015. The program touted by the Association of Postgraduate Physician Assistant Programs as an “innovative fellowship program” graduated four fellows during its first year and six fellows in 2016. Another six fellows began the program in January.

“The program is drawing people from across the world, which speaks to the visibility and the quality of the program as a whole,” said Fellowship Program Medical Director and Chief of Plastic Surgery Dr. Larry Hollier. “Having an opportunity in a subspecialty such as orthopedics will just add to that allure and will most likely open doors to programs in other subspecialties.”

On February 27 and 28, Primary Nurse Planner Amanda Garey, MSN, RNC-OB, and Texas Children’s Pavilion for Women hosted the 34th Annual Kaleidoscope Perinatal Nursing Conference at the Galveston Convention Center in collaboration with the March of Dimes and Houston Area Collaborative Perinatal Program.

The Kaleidoscope Conference planning committee included 33 perinatal experts and consisted of teams representing the Pavilion for Women and Nursing Professional Development.

The conference featured 52 podium speakers and 17 poster presentations from 13 different organizations throughout the greater Houston area. These presentations highlighted the latest nursing topics related to neonatology, obstetrics and professional practice. Of these presenters, 28 presentations were delivered by Texas Children’s employees or physician partners.

The two-day conference attracted a historic 347 participants and 50 vendors from across the United States. Attendees enjoyed a fun and interactive drawing from sponsorship donations.

The Texas Children’s planning committee members worked tirelessly to make this a unique and memorable event. Special thanks to:

  • Committee Chair Amanda Garey, MSN, RNC-OB, C-OB, C-EFM
  • Lynda Tyer-Viola, PhD, RN, FAAN
  • Nan Ybarra, DNP, MBA, RN, NEA-BC
  • Elizabeth Bolds, MBA, RN, NEA-BC
  • Kina Foster, MBA, BSN, RNC-MNN
  • Dionne J. Walker, MSN, RNC-OB
  • Tara Barrick, BSN, RNC-OB
  • Denisse Gonzalez, BSN, RNC-MNN
  • Glenda Patrick, MSN, BN, RNC-OB
  • Jenny O’Dowd, BSN, RNC-MNN
  • Leslie R. Williams, BSN, RN, CCRN
  • Delinda Castillo, BSN, RN
  • Angie Rangel, MSN, RN, CCRN, LNC
  • Jaime Choate, BSN, RNC-OB
  • Sharon Demel, MSN, CNS, RNC-NIC
  • Megnon Stewart, MSN, RN
  • Lindsay Gregory, MSN, RN, CPN
  • Tanya Nelson, BS, RN, RNC-NIC
  • Sonia Alvarado, Administrative Assistant
  • Emily Lamport, Marketing

This week — March 12 through March 18 — is National Patient Safety Week. It also is that time of year when college basketball teams give it their all for the ultimate title. With a little imagination, this is what it might look like if we combined Patient Safety at Texas Children’s and March Madness.

To win at patient safety and basketball, a team of dedicated coaches and players is needed! At Texas Children’s, we have hundreds of great Safety Coaches, 372 recruited and trained to be exact, much more than any basketball team.

Team Texas Children’s is comprised of multiple devoted and enthusiastic players and they are: Texas Children’s Hospital West Campus, Texas Children’s Pavilion for Women, Texas Children’s Medical Center Campus, Outpatient Clinics & Health Centers, and Texas Children’s The Woodlands, our newest member to the team. Each player performs a vital role in Texas Children’s pursuit of the ultimate goal, Zero Patient Harm.

The scoreboard shows that West Campus is scoring big for Patient Safety with day and night executive safety walk rounds, monthly microsystem Safety Coach meetings, daily campus safety briefings, and multidisciplinary case conferences to learn from precursor and/or near miss safety events.

The Pavilion for Women is a proven player. They hit the target of 100 percent compliance with antenatal steroids administration; reduced obstetric adverse events by almost 50 percent; saw a significant reduction in post cesarean surgical site infections; and are implementing the use of a Fetal-Maternal Early Warning System for early recognition of a patient who may need a higher level of care.

Main Campus is a versatile player. When playing as a point guard, they lead the team in assists and aid in directing plays to improve patient safety. Main Campus has been working hard at implementing new practices to prevent intraventricular hemorrhages in newborn patients, enhancing staff knowledge about alarm management, and establishing new processes to care for aggressive behavioral health patients, which help keep patients and staff free from harm. They also provide leadership to the Safety Coach Program.

Outpatient Clinics and Health Centers have exceptional moves aimed at fall reduction, critical lab reporting, recognizing and responding to medical emergencies, and the identification of potential safety issues with the help of a Safety Coach.

New to the team this year is The Woodlands. The Woodlands ballers have been busy perfecting their game. They participated in three days of “live action” simulation activities prior to the opening of the ambulatory clinics, where they identified possible threats to patient safety that could be eliminated before seeing their first patient! All of the Woodlands team leaders completed “QI Boot Camp” (a review of quality improvement principles) and all staff and leaders completed Error Prevention Training to further emphasize the importance of building a culture of patient safety. Patient safety is being especially highlighted at the Woodlands through more simulation training and testing throughout the month of March as they prepare for their April 11 inpatient opening.

The Team’s playbook is full of special moves to eliminate harm. It includes the use of error prevention tools and techniques, compliance with steps to prevent CLABSIs, CAUTIs, VAPs, SSIs, PIVIEs, ADEs, pressure injuries, unplanned extubations, falls, readmissions, and more. Team Texas Children’s outperforms any college basketball team when it comes to key plays.

Whether your role is on the court, providing patient care, or off the court like keeping things clean, repaired, and ready to go, you are part of Team Texas Children’s. You are instrumental to Team Texas Children’s ultimate goal! Zero Patient Harm is within our reach!

To assist Team Texas Children’s in Scoring Points for Patient Safety (and have a little fun too), click on the links below.

March 10, 2017

The Texas Children’s Hospital Resident’s Primary Care Group Clinic recently moved from the Clinical Care Tower to the Palm Center at 5400 Griggs Road, Suite 101. The clinic also was renamed to Texas Children’s Hospital Primary Care Practice at Palm Center.

Texas Children’s Hospital Primary Care Practice at Palm Center provides comprehensive routine and preventive health care including well child check-ups, sick visits, sports physicals, immunizations and management of chronic pediatric medical conditions.

The medical staff at the clinic remains the same and will continue to be actively engaged in medical education. Texas Children’s Hospital Primary Care Practice at Palm Center will serve as the largest Texas Children’s Hospital and Baylor College of Medicine practice that provides primary care experience for pediatric medical students and residents.

“Moving this clinical practice to the Palm Center neighborhood in Houston’s Third Ward offers a great opportunity to serve the community while modeling best practice to the next generation of pediatricians,” said Clinic Chief Dr. Teresa Duryea. “We are excited to build collaborations within the community and advocate for the needs of the children.”

The clinic’s new location offers free parking and is conveniently located at the Palm Center Station on the MetroRail’s Purple Line. Please call 346-227-7275 to facilitate transfers. Referrals can be made in Epic to Primary Care Practice (TCH Resident Continuity Clinic). Appointments can be made through Central Scheduling at 832-822-2778.

For more information on Texas Children’s Hospital Primary Care Practice at Palm Center click here.

March 3, 2017

One of Texas Children’s most recognizable buildings now has a brand new name. The Clinical Care Tower has been renamed the Mark A. Wallace Tower in honor of Texas Children’s long-time President and CEO.

The announcement of the renaming came at the culmination of a Board of Trustees meeting on Thursday evening. It was the work of the Board and a complete surprise to Wallace. As the meeting appeared to arrive at its routine close, Board Chair Ann Lents opened the doors of the board room to welcome a few guests – Wallace’s wife Shannon and the entire Executive Council. Lents then proceeded with reading the Board’s resolution to rename the building in honor of Wallace’s 27 years of leadership and service to the organization.

“When you came to Texas Children’s, our hospital was a good but regional provider,” Lents said. “Now Texas Children’s is the largest and most comprehensive provider of children’s and women’s services. You brought a sense of mission and unbounding energy and a generosity of spirit to the job that are all the more remarkable given that you’ve been at it since 1989.”

Wallace and his wife were filled with emotion as the announcement unfolded in the room of about 100 Board members and executives. Expressing his appreciation, Wallace recognized the commitment of the Board, staff and dedicated employees.

“When [late Board member] George Peterkin recruited me, he convinced me that with this Board, Dr. Feigin and this community that we could do something incredible,” Wallace said. “I never imagined anything like this. We’ve gone from one location, seven floors, 350,000 square feet and 1,400 employees to all of this because of the Board, the great medical staff and our employees. Our employees are so committed to this organization and to the children, women and families we take care of. I can’t adequately put into words how much this means to me.”

When Wallace took the helm of Texas Children’s in 1989, the hospital was still contained in a single building – the seven-story Abercrombie Building. The West Tower and Clinical Care Tower (now, the current Feigin Tower) were completed shortly after in 1991. In 2003, as part of a $345 million project, the West Tower was expanded and a new, 16-floor Clinical Care Tower was built at the corner of Holcombe and Fannin. The building houses most of Texas Children’s outpatient clinics, including Texas Children’s Cancer and Hematology Centers, Neurology and Orthopedics.

Because of the prominent location of the clinical building, it continues to be one of the most visible of the Texas Children’s medical center buildings, making it a perfect choice for the naming honor. But Lents noted that the honor is a milestone in a continuing journey.

“This is not a capstone naming, this is an interim recognition,” Lents said. “We are looking forward to many more years of your leadership.”

TEXAS CHILDREN’S BOARD OF TRUSTEES RESOLUTION

WHEREAS, upon arriving at Texas Children’s as President and Chief Executive Officer, Mark A. Wallace stated that “my goal is for Texas Children’s to be the preeminent pediatric hospital in the world”;

WHEREAS, in his pursuit of that goal, Mark A. Wallace’s visionary leadership and tireless commitment have elevated Texas Children’s to a level of excellence and preeminence not even imagined when he joined Texas Children’s in 1989;

WHEREAS, integral to the goal of preeminence, Mark A. Wallace’s vision has encompassed and supported the development of leaders at all levels, based on his steadfast belief that “leadership always influences or determines outcomes — not some of the time, but all of the time”;

WHEREAS, the members of the Board of Trustees of Texas Children’s wish to express their deep gratitude and sincere appreciation to Mark A. Wallace and honor, recognize and commemorate his inspirational leadership as well as his unwavering pursuit of excellence;

IT IS NOW, THEREFORE, RESOLVED that in recognition of his devotion and personal commitment to Texas Children’s, we hereby rename the Clinical Care Tower as the Mark A. Wallace Tower at Texas Children’s Hospital; and

BE IT FURTHER RESOLVED that the Board of Trustees looks forward to many more years of Mark A. Wallace’s commitment and extraordinary leadership in guiding Texas Children’s to continued preeminence in creating a healthier future for children and women throughout our global community by leading in patient care, education and research.

UNANIMOUSLY adopted this 12th day of January, 2017.