March 8, 2016

Pediatric Tower E simulations

What happens when a multidisciplinary team engages in 32 hours of simulated-based design tests on patient care spaces inside a mocked-up “critical care” warehouse? More than 100 latent safety threats are detected before construction begins.

As part of the Pediatric Tower E vertical expansion project, Texas Children’s Simulation Center and the CareFirst Quality, Service and Safety (QSS) Project Team coordinated a series of high-risk patient care scenarios to drive the design of the space for the patient rooms in the cardiovascular intensive care unit (CVICU), pediatric intensive care unit (PICU) and the progressive care unit (PCU).

“A specific concern in a new healthcare facility or patient care process is the existence of unrecognized or latent threats to safety that could affect actual patients once the facility opens,” said Texas Children’s Simulation Center Medical Director Dr. Jennifer Arnold. “Simulation allows us to test patient care spaces before final design decisions are made to avoid costly mistakes that could potentially impact patient safety, patient/family experience and provider satisfaction. To make modifications after a facility is built can be very expensive or sometimes even impossible.”

Following a needs assessment to identify the high-priority areas for testing of the new space, patient care simulations including the worst case scenario in the intensive care unit were conducted inside a large warehouse mock-up that resembled a critical care environment. A multidisciplinary team of intensivists, nurses, surgeons, anesthesiologists, respiratory therapists, patient families and other clinical support staff, participated in the four-day simulations and provided their feedback.

“I was involved on the PICU and PCU days and the staff who participated made me so proud,” said Texas Children’s Clinical Care Nursing Director Shannon Holland. “They were engaged and committed to ensuring we create the best possible environments to care for our patients and their families.”

During these simulations, 115 latent safety threats were identified and categorized based on Safe Hospital Design Principles outlined by the Agency for Healthcare Research and Quality.

Recommendations for design were received on the areas below. Clinicians prioritized recommendations and are continuing to work with the design team to incorporate into the final design.

  • Visibility into room
  • Visibility and monitoring between rooms
  • Equipment and technology placement within room
  • Storage solutions within room
  • Family space design

“All patient rooms will be configured to provide dedicated space for our patients, providers and families,” said CareFirst Clinical Senior Project Manager Maria Happe. “Providing a dedicated family space within the intensive care rooms helps to promote and enhance family engagement and patient and family-centered care for our most critically ill patients.”

Family advisors like Ed Wolff and his wife, whose daughter spent five and a half months in the NICU at Texas Children’s in 2004 followed by three and a half months in the CVICU, were key partners in the simulations. They shared valuable perspectives on how to customize the new space to fit the unique needs of patients and families in a critical care environment.

“These new rooms will bring family-centered care to the next level,” Wolff said. “A nurse may be with your child for 12 hours, and they see a lot, but the parents are there 24 hours a day during shift changes. By adding a family space, parents can be at the bedside with their critically ill child and can easily observe the monitors from the family space, which I think in the end, will lead to even better outcomes.”

Dr. Patricia Bastero, a pediatric intensive care physician and associate director of ECMO at Texas Children’s Heart Center, says these collaborations reflect our unwavering commitment to patient care.

“Building a simulated hospital to test all possible scenarios in real life, discard all the bad options and come up with the best solutions exemplifies our passion for what we do,” Bastero said. “This was a team effort on many different levels to ensure a safe environment of care is cultivated for our critically ill patients and their families.”

In just five short years, Texas Children’s Hospital West Campus has gone from being a brand new suburban hospital to a staple in the West Houston community. The services patients and their families previously drove to the Medical Center for are now at a convenient and accessible location near their own backyards.

Designed exclusively for children, West Campus boasts a highly trained pediatric team that engaged in more than 300,000 patient encounters last year through services in outpatient care, inpatient care, surgery and the emergency center. The number of patient encounters has tripled since West Campus opened its doors in April 2011 and totals 750,000 for the past five years.

During the first year West Campus was open, almost 2,000 surgical procedures and close to 16,000 radiology procedures were performed. Last year, nearly 6,000 surgical procedures and more than 49,000 radiology procedures were conducted at West Campus. That’s an increase of more than 200 percent.
Daily inpatient census at West Campus has skyrocketed too, going from seven during the hospital’s first year to 32 last year, an increase of almost 360 percent.

“West Campus has had unbelievable growth over the past several years,” said West Campus President Chanda Cashen Chacón. “We will continue to build on those successes, listen to the community and provide the services they need.”

Some major milestones for West Campus include:

  • Recognition for the past three years as a Top Children’s Hospital by the Leapfrog Group, an organization that provides the only national, public comparison of hospitals across safety, quality and efficiency dimensions. West Campus is among an elite group of only 12 children’s hospitals and is the only children’s hospital in Houston to be recognized with this prestigious distinction.
  • Activation of the system’s first helipad, which has been used frequently and allows for faster transport and subsequently quicker treatment.
  • Expansion of the Pediatric Intensive Care Unit from eight beds to 16 beds, allowing the unit to see more than 2,000 patients in just five months.
  • Construction of a $16 million, 18-bed expansion of the hospital’s acute care capacity. The new unit includes an eight-bed special isolation unit designed for children with highly contagious infectious diseases, such as pandemic influenza, entervirus D68, Ebola and many others. As a result of Texas Children’s preparation in the area of infectious disease, the medical system was designated by the State of Texas as a pediatric Ebola treatment center, which means if and when a pediatric patient with Ebola symptoms arrives in Texas, they will come to West Campus for treatment.

“The Texas designation as the pediatric treatment site for Ebola is an impressive accomplishment for the West Houston market,” Chacón said. “It really allows us to grow our specialization of care in the community.”

To remain one of the most active pediatric hospitals in the Houston community, West Campus is focusing on expanding inpatient capacity, ambulatory capacity and supporting hospital infrastructure. Last year, the Texas Children’s Board of Directors approved a $50 million capital improvement effort that will help expand the hospital’s acute care capacity and is allowing the hospital to move forward with the following projects over the next few years:

  • Create dedicated suite for Interventional Radiology services
  • Expand perioperative services to include increased pre-operative and post-operative areas as well as operative suites
  • Convert offices within existing clinics into additional clinic exam space to increase access to highly sought after subspecialty care in west Houston
  • Build office and administrative support space for dedicated physicians and providers
  • Expand inpatient acute care capacity by 42 beds to include the 18-bed special isolation unit as well as another 24-bed unit in existing shell space
  • Construct additional outpatient subspecialty clinic space to increase access to our growing patient demand

“The expansion we are seeing on our campus is amazing but what really differentiates us is the people who come here every day to serve the patients who seek our care,” Chacón said. “They go above and beyond because they are passionate about making memories for our patients and families.”

3416ChristianSchaaf175Dr. Christian Schaaf, assistant professor at Baylor College of Medicine and investigator at the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s, has been named the inaugural recipient of the Seldin-Smith Award for Pioneering Research.

The Seldin-Smith Award was established by the American Society for Clinical Investigation (ASCI) to recognize the most promising young physician-scientists in the country. One recipient will be chosen annually for this honor. Founded in 1908, ASCI is one of the oldest and most highly-respected medical honor societies for physician-scientists in the U.S.

“I am humbled to receive this prestigious award named after Drs. Donald W. Seldin and Lloyd H. ‘Holly’ Smith, heroes of academic medicine,” Schaaf said. “For the past 50 years, they’ve provided exemplary leadership in science, medicine and education. This award recognizes contributions to all three areas. For me, diligently pursuing patient care, science, and medical education has made my work profoundly meaningful.”

Schaaf, a medical geneticist who solves complex and challenging medical mysteries, combines astute clinical observations with meticulous basic research. His studies have led to important contributions in understanding the genetic basis of autism spectrum disorder and to the discovery of several genes for neurodevelopmental disorders and rare genetic syndromes. Two of these rare syndromes now bear his name: Bosch-Boonstra-Schaaf Optic Atrophy syndrome and Schaaf-Yang syndrome. Providing patients with an accurate diagnosis can be empowering. It ensures improved guidance, appropriate genetic counseling, and the ability to connect with similarly-affected families worldwide. These are important steps toward a better quality of life.

For the inaugural Seldin-Smith Award, ASCI sought nominations from outstanding physician-scientists who have demonstrated exceptional creativity and accomplishments in biomedical research. The selection committee comprised top luminaries in academic medicine, including four Nobel Laureates. Schaaf was chosen unanimously after a stringent two-step review of numerous nominations of exceptional early-stage physician-scientists from the U.S. and abroad.

Schaaf will be formally recognized at the ASCI dinner in Chicago on Friday, April 15. Drs. Seldin and Smith, as well as Schaaf’s mentor, NRI Director Dr. Huda Zoghbi, will be among the distinguished guests present at the ceremony.

In addition, Schaaf will receive an unrestricted grant of $30,000 to advance academic efforts, an invitation to deliver a research talk at the 2017 ASCI/AAP Joint Meeting and mentoring by the members of the Seldin-Smith Award Selection Committee and Advisory Committee.

March 1, 2016

3216FraserReunioninside640On a recent Monday afternoon, identical 21-year-old twins Karly and Kestly Tinklepaugh met the man they consider their hero – Texas Children’s Surgeon-in-Chief Dr. Charles D. Fraser Jr.

“We want to thank you from the bottom of our hearts for giving us a life that is as normal and healthy as possible,” Karly and Kestly said in an emotional reunion. “You are one wonderful individual.”

Two decades ago, when Karly and Kestly were just 2-years-old, Fraser performed corrective surgery on the girls, who were born with Tetralogy of Fallot, a rare and complex heart defect that is treated most successfully with open-heart surgery soon after birth.

Since their surgery, Karly and Kestly have grown up to be normal, healthy young adults. Both of them attend Lone Star College with Kestly studying to become a geologist and Karly planning on being part of the Texas Children’s team one day as an echocardiogram technician.

Over the years, the twins, who are patients with our Adult Congenital Heart Disease Program, have often thought of their hearts and Fraser, the man they believe saved their lives. The desire to meet the pediatric heart surgeon grew and led to a late-night email penned by the twins asking Fraser if he would be interested in meeting them.

To Karly and Kestly’s surprise, Fraser responded to their note saying he remembered them quite well and would be more than happy to arrange a meeting. Before the twins knew it, they were standing nervously on the 20th floor of West Tower waiting to shake the hand of the man who last saw them on an operating table. When Fraser arrived, hugs were exchanged and conversation about everything from heart surgery to college and grandchildren ensued.

“We are elated that we got to meet Dr. Fraser,” Karly and Kestly said. “We will forever be grateful to him and Texas Children’s.”

Fraser said he too enjoyed the visit and is grateful the Tinklepaugh’s reached out to him.

“Periodically, I’ve pondered where they were and what life had brought them,” he said. “Now, I know.”

To learn more about the Tinklepaugh’s reunion with Fraser and the twins’ heart condition, click here to watch ABC-13’s coverage of the event. To read a blog post written by the Tinklepaugh’s themselves, click here.

3216SENTAC640The Division of Otolaryngology was well represented at the meeting of the Society for ENT Advances in Children (SENTAC). Otolaryngologist Dr. Karina Canadas and fellow Dr. Kate Dunsky won second place for “A Case of Anaphylactic Shock after Induction Anesthesia and Suspension Laryngoscopy Due to Latex Allergy.”

Eleven faculty members either had podium presentations or posters. These included Drs. Karina Canadas, Binoy Chandy, Carla Giannoni, John K. Jones, Carol Liu, MaryFrances Musso, Julina Ongkasuwan, Tiffany Raynor, Matthew Sitton, Robert Williamson and division chief Ellis Arjmand.

Five advanced practice providers, one fellow, three Baylor residents and two Baylor medical students were authors or co-authors of podium presentations or posters. Chandy moderated a scientific session and participated in a symposium on quality improvement that Arjmand organized and moderated.

“It was great to see so many participants from Texas Children’s and Baylor at all levels, and our program was definitely noticed by the other attendees,” Arjmand said.

3216Fulbrightinside640Three faculty members in the Texas Children’s Hospital Department of Surgery have been awarded a Fulbright & Jaworski LLP Faculty Excellence Award from Baylor College of Medicine. Drs. Timothy Lee, Monica Lopez and Scott Rosenfeld were recognized in the Teaching and Evaluation category.

To be considered for an award in Teaching and Evaluation, a member of the Baylor faculty must show evidence of quality of teaching, number of teaching hours and diversity in content of material and variety of teaching formats among medical students, residents and fellows.

“Congratulations to Dr. Lopez, Dr. Lee and Dr. Rosenfeld on their accomplishments. All three are very deserving of this award,” said Dr. Charles D. Fraser, Jr., surgeon-in-chief.

Lee, Lopez and Rosenfeld note in their submission portfolios that teaching benefits them as well as their students. All three surgeons find they are successful instructors because they adapt their material to students at their particular stage of training, whether that is medical school, residency or fellowship. They teach at the bedside, in the classroom and in the clinic. Reviewing course evaluation comments, attending educational workshops and experiencing peer review are ways they are able to improve as teachers.

“In my role as chair of Texas Children’s Faculty Appointments and Promotions Committee, I encourage faculty to pursue a Fulbright & Jaworski award as they take steps to advance their careers,” said Dr. David Wesson, associate surgeon-in-chief.

The Fulbright & Jaworski LLP Faculty Excellence Award recognizes Baylor College of Medicine faculty who meet designated standards of quality, quantity and breadth for their sustained exemplary educational contributions to Baylor.

Surgeons interested in pursuing a Fulbright & Jaworski award are encouraged to contact Lisa Thomas, assistant director, Office of Faculty Affairs. Thomas will use her expertise to assist surgeons through the application process. She can be reached at Ext. 6-5768, by email or in her office located in the Department of Surgery Academic Office.

8515Drzoghbi175Dr. Huda Zoghbi, known for her groundbreaking research on Rett syndrome and other neurological disorders, is the inaugural recipient of the Mechthild Esser Nemmers Prize in Medical Science at Northwestern University.

The Nemmers prize, which carries a $200,000 stipend, is awarded to a physician-scientist whose body of research exhibits outstanding achievement in their discipline as demonstrated by works of lasting significance. A jury of distinguished scientists from around the country made the final selection.

Zoghbi, a professor of pediatrics, molecular and human genetics, and neurology and neuroscience at Baylor College of Medicine and director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s, has devoted her career to uncovering the genetic roots of rare neurodegenerative and neurodevelopmental diseases that affect her patients.

“The Nemmers Prize in Medical Science recognizes an outstanding investigator whose discoveries have significantly contributed to improving human health beyond the individual patient,” said Dr. Eric Neilson, vice president for medical affairs and Lewis Landsberg Dean at Northwestern University Feinberg School of Medicine. “Huda is a superb physician-scientist who has transformed the way we think about the genetic determinants and mechanisms of diseases. We are privileged to honor her with this inaugural award and for her to share her work with us.”

In connection with this award, Zoghbi will deliver a public lecture and participate in other scholarly activities at Feinberg in the coming year.

“It is a tremendous honor to be the inaugural Nemmers Prize recipient in Medical Science, and to have the opportunity to share my research with the stellar community of Northwestern University. It is truly humbling to be rewarded for what I love to do,” Zoghbi said.