January 10, 2017

11117clabsi640Texas Children’s neonatal intensive care unit (NICU) 2 nursing team has a big reason to celebrate – they reached 365 days and counting with zero central line-associated bloodstream infections (CLABSI), which demonstrates the value of team work and our hospital’s commitment to cultivating an environment for safe patient care.

In November 2015, NICU 2 reported three CLABSI infections. Since then, the rate of CLABSI occurrences has dropped to zero.

“Last fall, we were concerned about the number of CLABSIs we were having not only in the NICU but across the organization,” said NICU Clinical Nurse Specialist Alex Luton. “Together, with our infection control counterparts in education and vascular access, we implemented a massive educational initiative that trained more than 2,000 nurses across the organization on several key skills in central line care.”

Besides opening dialogue with the bedside nurses and care providers to identify and close any gaps observed around central line care, current hospital policies and practices were reviewed against national standards to identify areas of care that could be standardized to reduce CLABSI occurrences.

“Prior to this initiative, units had their own way of accessing and maintaining the central line,” said NICU Education Coordinator Rachel Leva. “Now, all nurses follow the same standard procedure for central line maintenance across the hospital system which has significantly helped us reduce our CLABSI rates in NICU 2.”

Creating the new role of central line resource nurses (CLRNs) has also provided an added layer of support for CLABSI prevention. To help bedside staff focus on other important patient care responsibilities, the CLRNs round on all patients with central lines during every shift.

“By providing central line care support and education, we’ve been able to address concerns early before they potentially manifest into a bloodstream infection,” said Ivy Lynn Ersan, a CLRN in NICU 2. “For instance, if a patient sweats a lot or has a lot of secretions, we may need to check on the patient more frequently per shift and change the dressing sooner than later to ward off an infection.”

Other strategies implemented in NICU 2 to reduce CLABSI include:

  • Central Line Champions Program – Specially trained to observe and audit central line care practices, these champions serve as coaches to ensure compliance with proven CLABSI prevention strategies. While all NICU staff are trained in CLABSI prevention, central line champions undergo more intensive training and must attend monthly educational sessions.
  • Hand Hygiene – NICU 2 nurses participated in a house-wide hand hygiene competition and posted signs in the unit as a visual cue to keep hand hygiene top of mind. NICU 2 leadership worked closely with Facilities to ensure ample supply of free standing hand sanitizer in the unit.
  • Weekly CLABSI meetings – Meetings are held every Tuesday to review and share information on CLABSI occurrence and identify any gaps in practice that need to be addressed. Attendees at these meetings include members from the vascular access, infection control and CLRN teams. A representative from Facilities also attends to ensure the working environment is conducive to safe patient care.

NICU 2 Assistant Clinical Director Tanya Williams says one important aspect that helped NICU 2 nurses achieve this milestone was their questioning attitude.

“Our nurses are not afraid to ask questions when something doesn’t seem right,” Williams said. “I think fostering this culture of a questioning attitude is how we were able to get this far. I am so incredibly proud of our nurses and our CLABSI partners for helping us achieve this patient safety milestone.”

January 4, 2017

1517urgentcare640Texas Children’s Hospital is proud to announce the opening of its seventh Texas Children’s Urgent Care clinic. Located at 28070 Highway 290, Suite 100, Texas Children’s Urgent Care Fairfield offers high-quality, efficient and affordable pediatric care at a convenient northwest Houston location.

“We are very excited to open our seventh location,” said Kay Tittle, president of Texas Children’s Pediatrics. “Our Urgent Care sites provide an immense resource for the communities we serve and I am looking forward to expanding the services we offer children and families in the Cypress area.”

Texas Children’s Urgent Care Fairfield is open Monday through Friday, 4:30 p.m. to 11 p.m. and Saturday and Sunday, 12 p.m. to 8 p.m. The clinic is staffed by board certified pediatricians and advanced practice providers who have privileges at Texas Children’s Hospital. Clinic staff diagnose and treat a wide variety of ailments, illnesses and conditions, including: asthma, strep throat, fever, minor burns, influenza, ear infections, allergic reactions and more. Procedures provided include: antibiotic injections, breathing treatments, fracture care and splinting, IV (intravenous) fluids, lab services, laceration repair and X-rays onsite.

Oftentimes, families turn to an emergency center after hours, on weekends or perhaps even during the day, when a significant event occurs with their child. Though the emergency center is the right place for some incidents or ailments, the majority of the time minor illnesses can and should be treated at a pediatric urgent care facility.

Texas Children’s Urgent Care accepts major insurance plans and has self-pay rates, which are less than emergency center charges, and there are no hospital fees. A complete list of insurance plans is available on our website. Texas Children’s Urgent Care specializes in after-hours care, but does not replace the need for children to have a general pediatrician. Routine physical exams and vaccinations are services that should be obtained from a general pediatrician, and these services are not available at Texas Children’s Urgent Care.

Texas Children’s Urgent Care has six additional convenient locations:

  • Cinco Ranch located at 9727 Spring Green Blvd., Suite 900 Katy, TX 77494
  • Memorial located at 12850 Memorial Drive, Suite 210 Houston, TX 77024
  • The Woodlands located at 4775 W. Panther Creek Drive, Suite C300 The Woodlands, TX 77381
  • Main Campus located at 6621 Fannin, Suite 2240 Houston, TX 77030 (11 a.m. to 11 p.m.)
  • Pearland located at 2701 Pearland Parkway, Suite 190, Pearland, TX 77581
  • The Vintage located at 10420 Louetta Road, Suite 104, Houston, TX 77070
December 20, 2016

122116physiciansurveyinside640Texas Children’s shined in a recent survey conducted by the Harris County Medical Society to determine physicians’ perspectives and satisfaction in their relationships with local hospitals. More than 2,000 physicians took the survey, providing results for 30 hospitals in the Greater Houston area.

When asked to rate their overall satisfaction with each of those hospitals, 87 percent rated Texas Children’s Hospital West Campus at the top of their satisfaction list. Texas Children’s Hospital medical center campus was next with 83 percent of physicians giving the hospital high satisfaction marks.

Reputation is another area where the Texas Children’s system stood apart from the rest. When asked how physicians rated the overall reputation of each health system represented in the survey, 91 percent placed Texas Children’s at the helm.

“The results of this survey are incredible and speak to the superb quality of work we do across our entire system each and every day,” said President and CEO Mark A. Wallace. “They also are a testament to the relationships we have built and continue to strengthen with physicians in Houston and beyond.”

The purpose of the survey, according to Harris County Medical Society President Dr. Kimberly Monday, is to identify areas of strength and areas of opportunity for improvement in physician/hospital relationships that will create the opportunity for further discussion and will ultimately enhance collective efforts to improve patient care in the Houston area.

“These results will give physicians and hospital leaders a clear picture of the areas where the most work needs to be done,” Monday said. “These issues are too important to the quality of care we deliver to our patients to be dismissed, and we want to show hospital administrators that physicians are eager to work with them to make meaningful improvements to hospital practices and policies.”

Monday added that the impetus for the study was the decision on behalf of the federal government to tie Medicare payments to long-term patient outcomes instead of process. As physicians and hospitals become financially tied to actual outcomes, she said, doctors must know which hospitals provide a culture of quality and safety.

Conducted from May 8 to June 20, the Harris County Medical Society survey asked questions regarding:

  • Safety of medical care
  • Relationships between hospital administration and physicians
  • Hospital policies affecting care
  • Medical staff issues and bylaws
  • Electronic medical records

Texas Children’s system, Texas Children’s Hospital and Texas Children’s Hospital West Campus led several categories in the survey as well and made the top 5 or top 10 list in many others, including leadership and leadership training opportunities, adequate nursing staff and quality of support staff.

“It’s good to hear our partnering physicians view us in such a positive light,” said Matt Schaefer, West Campus president. “Those relationships are extremely important to what we do, which is ensuring the best medical care to our patients and their families.”

Click the links below to view the results of the survey:

2016 Harris County Medical Society physician survey – Texas Children’s Hospital
2016 Harris County Medical Society physician survey – Texas Children’s Hospital West Campus
2016 Harris County Medical Society physician satisfaction survey

December 13, 2016

“We’re on the eighteenth floor of the CVICU and watching the tower every single day make so much progress so quickly, makes us want it right now,” said Jessica Gaustad, a cardiology nurse at Texas Children’s Heart Center.

Like Gaustad and so many other Texas Children’s employees, it’s hard not to notice the incredible progress that’s been made on Texas Children’s Pediatric Tower. As each day passes, the tower is getting taller and taller. Since construction work began one year ago, 16 floors have been built on the existing 6-floor base next to Texas Children’s Pavilion for Women. Three more floors are being built to complete the external structure of the 19-floor vertical expansion of the pediatric tower.

To see how far we’ve come along, you don’t have to look very far. This time lapse video highlighting the pediatric tower construction also includes animation of the different critical care services that will be housed in the tower once the approximately 640,000-square foot structure is completed in August 2018.

Texas Children’s Heart Center will have eight dedicated floors in the new tower to house the Heart Center outpatient clinic, catheterization lab, cardiovascular intensive care unit, a cardiovascular operating room and cardiology acute care beds. Also, the tower will be home to a new Pediatric Intensive Care Unit that will span four floors and open with 84 beds, including neuro ICU rooms, surgical ICU rooms and a progressive care unit.

Additional features of the tower include a total of 10 operating rooms, one radiology suite, faculty offices and a helistop on the roof of the tower to transport high acuity patients to Texas Children’s.

Earlier this year, a series of pre-construction simulation activities led by Dr. Jennifer Arnold’s simulation team were conducted to ensure the final interior layout of the pediatric tower would be designed in a way that promotes the safest possible environments to care for critically ill patients and their families.

“We were able to tweak a lot of things from how we envisioned beds being situated in a room to where the code carts are going to be located to even simple things like clock placement,” Gaustad said. “Families were also a big part of this process as well. Their feedback was incorporated into the final design decisions.”

As for the design theme and colors, the pediatric tower’s public spaces will embody the Beauty of Texas. Floors will have different colors for wayfinding. Floor patterns will depict trails and streams. Curving walls and ceilings will mimic canyons, skies and clouds.

While much progress still needs to be made in anticipation of the August 2018 opening, Texas Children’s will host a topping out celebration on February 9, 2017, to mark the construction milestone of completing the tower’s external structure.

“There’s going to be a time before you know it, that we’re going to have space to accommodate families,” said NICU nurse Nicole Leathers. “We’re going to have space to make the patient family experience more comfortable and will have more space to deliver the best care to our critically ill patients.”

For Veronica Velez, an Orthopedic surgery coordinator, she envisions the many benefits the new tower will bring for many years to come.

“When I am a retired nurse and there’s a new generation of nurses working on those floors that are being built right now, they can say a lot of thought went into this and they did a great job.”

121416perfusionists640When a child has open heart surgery at Texas Children’s Hospital, they receive some of the best care in the country. Our Heart Center, ranked No. 2 in the nation, is equipped with state-of-the art technology, highly trained and skilled surgeons and anesthesiologists, as well as a team of unsung heroes called perfusionists.

Perfusionists operate the heart lung bypass machine needed to keep a patient alive during open heart surgery. The machine takes deoxygenated blood out of a patient’s body, runs it through an artificial lung to give it oxygen, and then pumps it back into the patient’s blood stream.

While the idea may sound simple, the procedure and process is not and is performed at the Heart Center by a longstanding team of experienced and professional perfusionists.

“Perfusionists are absolutely vital when we perform open heart surgery,” said Surgeon-in-Chief Dr. Charles D. Fraser Jr. “What they do is extraordinary and allows us to do very complicated operations on children who otherwise would not be able to survive.”

Fraser recognized the benefit of a strong perfusion team early on and is responsible for creating a dedicated pediatric team at Texas Children’s in 1995 shortly after being named chief of Congenital Heart Surgery. All three members of the original team – Mary Claire McGarry, Maryann Mueller and Deb Surprise – are still working in the Cardiovascular Operating rooms today and remember what it was like in the beginning.

Mueller remembered Fraser recruited her and her colleagues from the Texas Heart Institute where they worked with both adult and pediatric patients. The first few years at Texas Children’s, she said, were spent honing their skills to provide the best perfusion for children.

Surprise recalled how Fraser brought with him a new approach to pediatric perfusion. His idea was to create a specialized pediatric protocol that would be tailored to each individual child.

“Everyone was invested in the success of Dr. Fraser and what he was trying to accomplish,” Mueller said. “We wanted him to be successful – and for our patients to come in, have surgery and then head home to lead healthy lives.”

Over time the team grew to what it is today, eight perfusionists who work closely with the surgical team. Due to their ever evolving skill levels, the team continues to see more complex patients, many of whom have benefited from the hard work of the surgeons and clinical staff at Texas Children’s Heart Center.

Fraser and his team recently performed their 10,000th heart procedure with the use of heart lung bypass on Adult Congenital Heart Disease Program patient 31-year-old Stephanie Granger, who was born with a congenital heart defect and had two surgeries as a baby and another when she was 6. Years later, she developed secondary problems from her heart defect.

“I started having some abdomen pain, so I went to my primary doctor,” Granger said. “They ran a CT scan and found there was a problem with my liver due to my heart.”

Soon thereafter, Granger scheduled heart surgery at Texas Children’s not only for herself but for her newly adopted daughter, Zoey, as well. Zoey was born with a similar congenital heart defect and needed surgery just like her mother.

“When we adopted her, we told them we were open to various conditions,” Granger said. “We told them we had a family history of congenital heart disease and that we fully understood it.”

McGarry said she can’t believe the team just reached the 10,000 pump case milestone and that it’s a testament to how far they’ve come.

“People now from all over the world come to see what we do,” she said. “It’s amazing and makes me very proud to have been a part of the program for so long.”

121416beckywhiteaward640Becky White, a former neonatal nurse and now patient care coordinator at Texas Children’s, recently won the Patients’ View Institute (PVI) Partners in Healing Award during a national ceremony in Washington, D.C. co-sponsored by The Leap Frog Group. Chief Quality Officer Dr. Angelo Giardino also accepted this award on behalf of Texas Children’s.

Each year, this award honors a patient’s story that demonstrates how a partnership between a patient or their loved ones, and their hospital care team, achieved a healing health care event or experience.

When White was pregnant with her son, Wade, doctors told her that her child may not survive due to medical complications. Miraculously, Wade pulled through but his road to recovery would be a difficult one. Born with complex health issues, Wade would undergo more than 50 surgeries before he turned 5.

As the mother of a son with special needs, White struggled trying to communicate effectively with her son’s medical team, at times feeling like she wasn’t being heard. So, she decided to go back to school to become a pediatric nurse, hoping that her medical background could help overcome this communication barrier.

“My experience as a NICU nurse helped me to communicate more effectively with my son’s doctors,” said White, a patient care coordinator at Texas Children’s. “It also gave me the opportunity to connect with hospital executives to help them relate data and patient outcomes to the actual patient experience.”

These opportunities emerged after White read a blog post from Texas Children’s President and CEO Mark A. Wallace about customer service and what every employee can do to ensure patients and their families have an exceptional experience at Texas Children’s. Touched by this blog, White emailed Wallace to share her thoughts and experiences as a parent of a Texas Children’s patient and as a neonatal intensive care unit (NICU) nurse.

“I was very appreciative that our CEO took the time to respond to my email,” White said. “After our initial meeting, Mr. Wallace invited me to shadow him for one day so I could experience firsthand what our administrative leadership team does behind the scenes to support our frontline staff and employees.”

Wallace also shadowed White in the NICU where he met with patient families and Texas Children’s NICU leadership and nurses who shared the remarkable improvements their teams have made to improve patient safety and enhance the overall NICU experience for patients and their families.

“My experience with Becky was just another reminder that whether we work at the bedside or behind the scenes, everyone matters and everyone’s perspective has value,” Wallace said. “Everyone’s work is essential at Texas Children’s, and when we all share this same intense passion for the mission, we drive it forward.”

So far, more than 40 hospital executives have accompanied Becky in the NICU, which prompted leaders to create an organization-wide Executive Rounding Program to be implemented in other areas of the hospital. The program has helped improve communication and empathy with patients and their families.

By advocating for her son, becoming a nurse, and helping health care administrators to better understand patient and family issues, Becky’s story represents an important patient perspective – one that others on both sides of the bedrail can learn from.

Click here to read White’s Voice of Nursing blog about her experience shadowing Mr. Wallace. Click here to read Mr. Wallace’s perspective of his experience rounding with White in the NICU.

121416drluersson175Dr. Thomas Luerssen has been given the 2016 Franc D. Ingraham Award for Distinguished Service and Achievement by the American Association of Neurological Surgeons/CNS Section of Pediatric Neurological Surgery. The award is the highest honor given by the organization and recognizes individuals whose achievements have advanced the field of pediatric neurosurgery. This is only the ninth time the award has been given since its inception in 1988.

Dr. Luerssen is chief quality officer for surgery and a neurosurgeon at Texas Children’s Hospital and a professor of neurosurgery at the Baylor College of Medicine. He is also the former chief of neurosurgery at Texas Children’s.

“It is a true honor for me to follow the great legacy of Dr. Tom Luerssen who has built an incredibly strong neurosurgery service at Texas Children’s,” said Dr. Howard Weiner, chief of Neurosurgery at Texas Children’s.

After graduating many outstanding pediatric neurosurgery fellows over the last decade, as well as recruiting a truly excellent core team of pediatric neurosurgeons here, Luerssen has been recognized for his many leadership roles in pediatric neurosurgery over the course of his career. Among those roles are chairman of the AANS/CNS Section on Pediatric Neurological Surgery and president of the American Society of Pediatric Neurosurgeons. He also spent 18 years on practicing at Indiana University and 11 years at Texas Children’s. These accomplishments are in addition to his many contributions to the fields of neurotrauma, quality improvement and patient safety in pediatric neurosurgery.

Dr. Charles D. Fraser, Jr., surgeon-in-chief at Texas Children’s said, “We are very proud of Dr. Luerssen’s accomplishments and are extremely fortunate to have him as part of the legacy of Texas Children’s Department of Surgery.”