September 25, 2018

For months, teams have been preparing for the opening of the new Texas Children’s Heart Center® in Legacy Tower. The outpatient clinic went live on September 18. And this week, Move Day into our inpatient space has finally arrived.

Before the flurry of activity, we had the opportunity to sit down with new Chief of Congenital Heart Surgery Dr. Christopher Caldarone, who shared a little about his background and his vision for the No. 1 heart center in the nation.

Tell us a little about yourself. Where’d you grow up?

“I was born in Boston and grew up in Upstate New York and New Jersey. We still have a lot of family in Boston and spend time there in the summer.”

Were you always interested in medicine as a career?

“I had a predisposition toward engineering and science as a kid. I ruptured my spleen in a high school wrestling match and spent a few months in hospitals. I was fascinated by the environment and I think that’s when it really started for me. I went to college at Johns Hopkins for bioengineering but found the subject matter to be too dry. I realized I really liked the medical part of my studies, so I switched over to pre-med.”

How did that lead to your interest in surgery?

“Sometimes people find that they just fit in a field. You just feel like there are places in life where you belong and others you don’t, and I always felt like I belonged in surgery.”

How does it feel to be a part of the team at Texas Children’s?

“It feels amazing. I think that for those of us who’ve been at other institutions, it’s easy to appreciate how special this place is. It’s a spectacular environment.”

What was it about Texas Children’s that attracted you?

“It was all about fit and impact. I spent fifteen years in Toronto with a great team. But from the very first call from Texas Children’s, I felt that we shared a common vision and I felt that I was a good fit for what they were looking for in a very genuine way. That was very compelling. Secondly, the potential here to make a difference is vast. There is an opportunity to take what I learned in my previous role as surgeon-in-chief and refocus on congenital heart disease, which is the area that interests me the most.”

Why is multidisciplinary collaboration so important?

“Being part of a team and functioning as a team is my preferred environment. I just enjoy it more. But that isn’t the reason why it’s important. It’s important because the congenital heart program at Texas Children’s is already competing at the Olympic level. The gradations between the best pediatric hospitals are so fine that to compete at this level, you have to optimize every aspect of the entire program. People can’t work harder and there are no better people to hire. The only option we have is to create an organizational structure that functions more efficiently than other programs, if we want to improve faster than they’re improving. That’s why a multidisciplinary team approach is important. It’s literally the only way to compete at this level.”

How does the layout of the new Heart Center help facilitate improved interaction?

“Architecture influences culture. It can enhance or detract from it. Locating cardiology, cardiac surgery, anesthesia, perfusion, the advanced practice providers and our administrative staff in one environment helps make magic. Having everyone in close proximity on the same floors is enormously beneficial for our patients and our care providers.”

You have an active translational research background. Will you continue to build on that?

“I want to continue my own research, but my main objective here is to support other clinician’s translational science efforts throughout the Heart Center. I’ve found that if you get a team together, find resources and focus on a target, you can produce powerful results. My role is to support an environment where multidisciplinary teams routinely get together, target specific areas and create impact. I think of it as translational science ‘one step removed’. I think that’s one of the reasons I’m here.”

What’s something you want people reading this to know about the leadership team’s vision for the Heart Center?

“I want people to know that the Heart Center leadership is dedicated to creating a shared stewardship model, through which we work together to identify specific targets, pool our resources and act upon those targets as a unified group. The model makes collaboration the expectation rather than the occasional nice outcome. In most other institutions, collaboration can happen; there’s nothing to restrict it. But if it doesn’t happen, it’s a silent failure and a missed opportunity.

“Here, we have a group of leaders that is accountable to see that our resources are deployed in a meaningful way that drives change. This creates the dynamic that is necessary to provide that Olympic level of care. If the patient is truly our focus, then every little thing we do here has to be better. Everything has to keep improving. And every single person in the Heart Center has a role and the potential to influence how we extend our lead and, more importantly, how we can improve care for our patients.”

Time for rapid fire: What’s your favorite film?

“The Year of Living Dangerously.”

Favorite sport?

“I don’t really have a favorite. I appreciate a good contest, regardless of the sport.”

Favorite place you’ve traveled?

“Thailand.”

What are you listening to right now on the way to work?

“NPR.”

Beatles or Rolling Stones?

“Tough one! It’s a toss-up. Depends on my mood.”

Caldarone is an internationally recognized leader in congenital heart surgery and most recently served as surgeon-in-chief at The Hospital for Sick Children in Toronto. He received his undergraduate degree from Johns Hopkins University and his medical degree from Columbia University, and he completed his general surgery and cardiothoracic surgery residencies at Beth Israel Deaconess Medical Center/Harvard Medical School. He also completed a fellowship in congenital heart surgery at The Hospital for Sick Children. Caldarone is a member of the American Association for Thoracic Surgery, the Society of Thoracic Surgeons and the Congenital Heart Surgeons’ Society. His specific research interests include the role of apoptosis related mitochondrial dysfunction and remote ischemic preconditioning as mediators of reperfusion injury. Most recently, Caldarone has focused on pulmonary vein stenosis and tissue engineering of pulmonary valves.

September 10, 2018

Texas Children’s Physical Medicine and Rehabilitation Electrodiagnostic Laboratory has received Laboratory Accreditation with Exemplary status from the American Association of Neuromuscular & Electrodiagnostic Medicine (AANEM). Dr. Suzanne Woodbury is the laboratory’s medical director and said she is very excited to receive AANEM Laboratory Accreditation status.

The AANEM established laboratory accreditation criteria for electrodiagnostic (EDX) laboratories to ensure patients receive quality medical care in a safe environment. Laboratory accreditation provides patients, referral sources, and payers with a credible measure to differentiate the laboratory’s quality of care. The accreditation standards evaluate the diagnostic services and clinical operations essential to providing quality patient care, which include:

  • Clinical staff qualifications and continuing education
  • Physical facilities
  • EDX equipment
  • Protocols for performing EDX studies
  • Patient reports
  • Policies for ensuring the health and safety of every patient

Exemplary Status is the highest level of accreditation an EDX laboratory can achieve under the AANEM Accreditation Program. To be awarded Accreditation with Exemplary Status, physicians performing studies in the laboratory must:

  • Have completed a neurology or physical medicine and rehabilitation residency program; and
  • Have completed a minimum of three months of training in EDX medicine as part of a residency or fellowship program; and
  • Be certified by the American Board of Electrodiagnostic Medicine (ABEM), or by the American Board of Psychiatry and Neurology (ABPN) in clinical neurophysiology, or by the ABPN/American Board of Physical Medicine and Rehabilitation in neuromuscular disease.

AANEM is a nonprofit membership association dedicated to the advancement of neuromuscular, musculoskeletal, and electrodiagnostic medicine. For more information about AANEM, or to learn more about laboratory accreditation, visit www.aanem.org.

Texas Children’s Hospital has been recognized as a Clinical Research Center of Excellence (COE) for CDKL5 Deficiency Disorder and is one of only five pediatric institutions in the country to receive this honor.

The International Foundation for CDKL5 Research selected Texas Children’s and its academic partner Baylor College of Medicine as a Center of Excellence for its medical expertise and extensive clinical research experience in the field of Rett syndrome and Rett-related disorders including CDKL5 Deficiency Disorder.

“It’s an honor for our hospital to be chosen as a center of excellence for CDKL5 deficiency disorder research,” said Dr. Bernhard Suter, who is the director of the CDKL5 Center of Excellence at Texas Children’s. “We look forward to collaborating with other centers across the country to accelerate CDKL5 research in order to provide the best care possible for these patients.”

Once considered an atypical form of Rett syndrome due to its overlapping symptoms and similar medical needs among patients with either condition, the symptoms associated with CDKL5 deficiency disorder and its genetic cause are distinct from those of Rett syndrome. CDKL5 deficiency disorder is now considered a separate condition.

The CDKL5 gene provides instructions for making a protein that is essential for normal brain development and function. When the CDKL5 gene is mutated, patients with CDKL5 deficiency experience a variety of symptoms including difficult-to-control seizures, repetitive hand movements and severe neuro-developmental impairment. Seizures usually begin within the first three months of life, and can appear as early as the first week after birth.

As a Center of Excellence, Texas Children’s multidisciplinary CDKL5 clinic (housed in our Rett Syndrome Clinic) provides comprehensive care to patients by allowing them to see several specialists in the same clinic visit – including neurology, genetics, GI, pulmonology, physical medicine and rehabilitation – resulting in more personalized treatment plans for newly diagnosed patients.

“After an extensive search of top notch medical facilities, we found that Texas Children’s Hospital was the perfect pairing of medical expertise and research initiatives into this condition that so tragically affects those suffering with CDKL5,” said IFCR President Karen Utley, who also is a parent of a child with CDKL5. “We are proud to partner with Texas Children’s Hospital in order to improve the quality of life and to find a cure for our children.”

September 4, 2018

Dr. Michael Blaine Zelisko and Brian M. Davis recently received the Best of the West award. Dr. Zelisko is recognized for his work as Clinical Director of Anesthesia and Assistant Professor of Anesthesia, and Davis for his work as Technical Supervisor of the Blood Bank.

The award recognizes employees each quarter who have exceled at demonstrating Texas Children’s values – leading tirelessly, living compassionately, amplifying unity and embracing freedom. Zelisko and Davis both exemplify the many qualities of Best of the West; they constantly find opportunities to demonstrate the values of the organization.

Some of Zelisko’s colleagues and patient families have said the following about him:

  • “He has done a great job taking over as clinical lead for the campus.”
  • “He is a clinical superstar with strong skills in the regional anesthesia program at West Campus.”
  • “He is engaging and thoughtful with significant system growth in radiology surgery.”
  • “He leads his staff with integrity and empathy, making every effort to make each day a smooth operation.”
  • “He gives his all to his work, his patients, and his staff.”
  • “He is always open to new ideas and supports changes that improve our system.”
  • “He is an exceptional provider and is often requested by families.”

Some of Davis’ colleagues and patient families have said the following about him:

  • “Brian has improved workflow for the staff and easily accessible guides to accomplish their jobs.
  • “Brian created a Massive Transfusion Protocol (MTP) lab testing form and MTP guides for staff, and trained the staff of the new protocol.”
  • “Brian monitors Blood Bank activity closely and responds to issues by reaching out to stakeholders to both understand the issue and then to develop a resolution to the issue.”
  • “He is very responsive not only to Pathology staff but also to the nursing staff and their leaders.”
  • “Brian is very dedicated and provides the best quality services.”
  • “His attention to detail and passion for his work is evident in the processes that he has developed and the effectiveness of the Blood Bank processes.”

Please join West Campus in congratulating and thanking Zelisko and Davis for showing us what it takes to be the best of the west.

August 27, 2018
Members from the August 7 (top) and August 16 (bottom) rescues are recognized.

When people tell stories about the care Texas Children’s provides, they often use the same word: miraculous. With the heroic actions of our Kangaroo Crew in two recent cases, it’s easy to see why.

The first story took place on August 7. The team in Texas Children’s Mission Control received a frantic call from a surgery center north of Houston.

“There was a very panicked voice on the other end,” said ETM dispatcher Amber Lieberman. “She said, ‘We need your team, we need blood and we need you now.’”

A 6-year-old patient had suffered a lacerated carotid artery during a routine outpatient procedure. The surgical team had applied pressure to stop the bleeding, but the patient had lost too much blood and there was no emergency blood on hand. Without immediate assistance, the child might die.

Mission Control immediately sprang into action. A Kangaroo Crew team at Texas Children’s Hospital The Woodlands was dispatched to the patient. On the scene, the team swiftly assessed the situation and began preparing the patient for transport, taking special care to keep the patient as secure as possible since the team at the community surgery center was still applying pressure on the artery. One wrong move could mean disaster.

Meanwhile, Mission Control also dispatched the Kangaroo Crew from Texas Children’s medical center campus to take the emergency release blood to The Woodlands team. In a stunning display of coordination, Mission Control and the two teams orchestrated a hand-off of the blood just off Interstate 45 between The Woodlands and Houston. They planned down to the exact moment when each vehicle would arrive and also on which side of the highway they would meet. In the parking lot of an abandoned restaurant, the two teams connected almost simultaneously and the blood was handed off.

Once the patient was stable, the medical center campus Kangaroo Crew followed The Woodlands Kangaroo Crew to the Texas Medical Center in case support was needed during the drive. Mission Control constantly tracked the movements of each vehicle and coordinated our teams in the emergency center (EC) and operating room and interventional radiology (IR), providing constant updates on the patient’s condition and ETA.

When they arrived at the EC, Kangaroo Crew team members assisted the emergency staff until the patient was taken to IR. This is a story that could have had a much different ending.

“Because of the seamless coordination with Mission Control, it’s amazing what we can accomplish,” said Kangaroo Crew transport nurse Roma Frier. “It wouldn’t have happened like it did without the transfer center and the way it operates.”

Just over a week later, on August 16, the Kangaroo Crew was transporting a patient from another hospital in the Texas Medical Center to Texas Children’s neonatal intensive care unit (NICU). As they passed the Jan and Dan Duncan Neurological Research Institute, Michael Johnson, the EMT on the team, saw something startling at a nearby bus stop.

“There was an individual giving chest compressions to a man,” Johnson said. “I turned and yelled to the back, ‘We need to stop, I don’t think this guy’s breathing.’”

The Kangaroo Crew immediately stopped to assist. Members of the team sprinted to help and began CPR while another crew member stayed with the stabilized patient on board and contacted Mission Control, who alerted paramedics. Less than three minutes later, the Houston Fire Department (HFD) arrived on the scene and a unified command was initiated. HFD, assisted by the Kangaroo Crew, began administering advanced cardiac life support.

Within moments, the patient was revived.

As HFD and EMS prepared the cardiac arrest patient for transport to an adult hospital, the Kangaroo Crew proceeded to Texas Children’s NICU with our patient, who had been stabilized and monitored throughout the rescue.

This is another story that could have ended in tragedy. However, both the NICU patient and the gentleman are alive today, and the prognoses are excellent.

“This is a story that deserves celebration,” said Texas Children’s President and CEO Mark Wallace. “The heroes in the Kangaroo Crew and Mission Control are such a big part of this one amazing team. They are always running toward the problem, and they make such a huge difference here at Texas Children’s.”

Also awed by the heroic actions of the Kangaroo Crew that day was Craig Moreau, HFD captain and paramedic from Fire Station 33.

“I am convinced that the early decisive actions of the members of the Kangaroo Crew gave this patient the best possible chance for survival,” Moreau said. “If in the unfortunate event something drastic is to occur to me or any members of my family, I hope the Kangaroo Crew is nearby to assist. Their efforts went above and beyond the call of duty.”

The heroes on August 7 were:

Mission Control
Mona McPherson, Pediatric Medical Control
Amber Lieberman, Dispatch
Gloria White, Charge Nurse

Kangaroo Crew Transport Team 991 from The Woodlands
Adrian Gonzales, EMT
Shawnaka Holland, RN
Ryan Seaholm, RRT
Jacob Willits Martinez, Orientee

Kangaroo Crew Transport Team 992 from Main Campus
Ray Estlinbaum, RRT
Roma Frier, RN
Kim Karn, RN and Orientee
Michael Johnson, EMT

The heroes on August 16 were:

Kangaroo Crew Transport Team
Ashley Griffin, Orientee
Michael Johnson, EMT
Kristine Knight, RRT
Jennifer Rinaldo, RN

Click here to learn more about the Kangaroo Crew.

Click here to learn more about Mission Control.

On August 18, Texas Children’s Hospital the Woodlands employees attended the annual Chamber of Commerce’s 2018 Chairman’s Ball, and snagged a few awards as well. This year’s theme was “Star Wars: May the Force be with You and Beyond.” The team won the “Best Done For You” award and orthopedics physician assistant, Danielle Comeaux, won “Best Costume” with her Padme look.

“There’s definitely a sense of pride that we’ve only been in this community as a full hospital for such a brief period, but have already made our presence felt with a number of awards and recognition,” said the Director of Business Operations, Eric Allum.

The annual event is a black-tie affair honoring the Chairman of the Board, Frank Holmes of Sam Houston State University, while celebrating the accomplishments of The Woodlands Area Chamber of Commerce. Along with costume and table decorating contests, the event was a night of food, fun, and mingling with many other organization from the community.

“It was a lot of fun. The Star Wars theme really allowed us to show our fun side as a children’s hospital,” Allum said. “It shows how much we support The Woodlands Chamber and our ongoing commitment to this community.”

It is important for Texas Children’s to attend these events to show the support that we have to the community inside and outside of the hospital.

“The Chamber puts on a first class event and we feel it’s important that the health care community is well represented,” Allum added. “We look forward to celebrating with our community partners again and seeing what fun theme is presented next year.”

Texas Children’s Pavilion for Women and two of its surgeons recently received superior patient care designations from the Surgical Review Corporation, which develops and administers best-in-class accreditation programs for surgeons, hospitals and freestanding outpatient facilities throughout the world.

After a rigorous review process, the SRC accredited the Pavilion for Women as a Center of Excellence for Minimally Invasive Gynecology and two of its surgeons – Dr. David Zepeda and Dr. Xiaoming Guan – as Surgeons of Excellence in Minimally Invasive Gynecology.

The Pavilion for Women is now one of three hospitals in Houston and one of five in Texas with the Center of Excellence designation.

“Earning this accreditation signifies our ability to consistently deliver the safest, high-quality care to our patients,” said Nakeisha Archer, director of perioperative services for the Pavilion for Women. “Our program fosters quality improvement in surgery, and commitment to this process has focused our team on exceeding clinical benchmarks and guidelines. Most importantly, our commitment to excellence will improve the health and well-being of our patients. We are so proud to be leaders in quality care for women.”

Minimally invasive gynecologic surgery includes hysteroscopic, laparoscopic and/or vaginal procedures such as hysterectomies, fibroid removals and myomectomy excisions. Surgeons at the Pavilion for Women did almost 500 minimally invasive surgeries in 2017 and are on track to do more this year.

Karen Rosser recently had a minimally invasive procedure done with Zepeda and said her experience with the surgeon and the Pavilion for Women was incredible.

“I felt comfortable every step of the way,” said Rosser, who suffered chronic pain for years due to adenomyosis. “I never flinched at moving forward with surgery and am confident I received the best care.”

Zepeda said he is proud of the designations and believes they distinguish the Pavilion for Women as a leader in minimally invasive surgery.

“SRC’s accreditation program recognizes surgeons and facilities that demonstrate an unparalleled commitment and ability to consistently deliver safe, effective, evidence-based care,” he said. “This has always been our focus at the Pavilion for Women and always will be.”

Guan agreed and said he hopes patients looking for quality care can now be even more assured that the Pavilion for Women is the place to be knowing we have met rigorous standards for delivering high-quality perioperative and long-term follow-up care.

More about the surgeons

Dr. David Zepeda was born and raised in Houston and attended The University of Texas at Austin. Zepeda received his medical degree at the University of Texas at San Antonio Health Science Center in 1974. He completed obstetrics and gynecology residency at Baylor College of Medicine in Houston in 1978. Zepeda maintains an academic appointment as clinical associate professor at Baylor College of Medicine, where he is involved in residency and medical student education. He’s recognized in the Texas Medical Center for his expertise in gynecologic surgery, including pelvic reconstruction, DaVinci Robotic Surgery and advanced laparoscopic and hysteroscopic procedures. He is board-certified by the American College of Obstetrics and Gynecology and has voluntarily recertified numerous times. He has been awarded the Distinguished Surgeon of the Year in Houston and has been voted among the Best Doctors of America. In addition to teaching, Zepeda has been involved with National Scientific Meetings in Ob/Gyn and has published on laparoscopic surgery. He is actively involved in continuing medical education through the medical center and national meetings in the specialty as well as numerous professional societies.

Dr. Xiaoming Guan
Dr. Xiaoming Guan is the Section Chief and Fellowship Director of Minimally Invasive Gynecologic Surgery at Texas Children’s and is an associate professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine. Dr. Guan earned his medical degree at Fujian Medical College, Fuzhou in Fujian, China. He completed his Obstetrics and Gynecology residency at St. Joseph’s Hospital, a Mount Sinai School of Medicine affiliated hospital, in Paterson, NJ, followed by a fellowship in Minimally Invasive Gynecologic Surgery at Baylor College of Medicine in Houston. Dr. Guan brings extensive experience in treating complex and challenging cases of endometriosis, uterine fibroids, and pelvic masses. He is a leader in minimally invasive gynecologic surgery and a pioneer in the use of state-of-the-art robotic single-site technology and traditional single site and transvaginal Natural Orifice Endoscopy Surgery (NOTES) for advanced pelvic surgery. He also applies single-site or NOTES surgical technique in treatments of cervical incompetence with abdominal cerclage, urinary incontinence with sling, and pelvic organ prolapse with sacrocolpopexy. He serves on the editorial boards of the Journal of Minimally Invasive Gynecology and he is the author of numerous more than 40 publications.

More about SRC
Established in 2003, SRC is an internationally recognized patient safety organization dedicated to recognizing and refining surgical care. SRC is the leading administrator of quality improvement and accreditation programs for surgeons and hospitals worldwide. SRC’s proven methodology, known as the “Cycle of Excellence,” results in quantifiable and unparalleled improvement in the outcomes, patient safety and costs across surgical specialties. To measure improvement and develop best practices, SRC offers a multispecialty outcomes database that is the world’s largest repository of clinical patient data for minimally invasive gynecologic and bariatric surgery.