May 20, 2014

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For Chief Nursing Officer Lori Armstrong the NICU is a special place. It’s where she began her career 29 years ago and where she learned the skills she now uses as a leader for the nursing team of nearly 2,500. Armstrong, who joined Texas Children’s a little more than two years ago, has already changed the face of nursing here through the reinvention of the nursing staff, advocating for more front-line managers, a reinvigorated system for retention and nurse development as well as more full time positions to focus on patient and family-centered care and improve outcomes. Her hard work and dedication was recently highlighted as she accepted the Dr. Jennifer L. Howse Award for Excellence in NICU Leadership at the annual NICU Leadership Forum in Florida.

“I am honored to have even been considered worthy of this nomination,” said Armstrong. “To be selected is overwhelming, humbling and the greatest honor of my career.

Click here to jump to the photo gallery of Lori’s journey in nursing and messages from her nursing staff

The Dr. Jennifer L. Howse Award for Excellence in NICU Leadership is dedicated to the president of the March of Dimes Foundation whose leadership and vision have helped promote research, programs and partnerships that benefit the health of babies in the NICU. Each year the award is given to a recipient who has demonstrated the vision and courage of a strong leader, has wielded significant influence within and beyond the NICU walls and leads with care and compassion for patients, families, colleagues and staff. Armstrong’s nomination letters came from three colleagues both here and outside of Texas Children’s who shared their personal letters about what Armstrong’s enthusiasm and leadership has meant.

52114armstrongawardinside640“Lori’s passion for neonatal care, leadership, and the profession of nursing make her the perfect applicant for this award,” said Shannon Holland, a former NICU leader. “Her enthusiasm for excellent family centered care and passion for continuous learning and growth are inspirational.”

The award recipient is judged on three characteristics which are highlighted by Dr. Howse including Leader Sight, Leader Care and Leader Courage. For Armstrong, each of those areas is an important part of the nursing leadership here at Texas Children’s. Armstrong explains Leader sight as the tremendous responsibility of leaders whose sight and vision for nursing galvanizes the staff, the leadership team and the physician partners which ultimately impacts the health of babies. Leader care is something she learned from a former patient family.

“A parent once told me of his amazing definition of nurses,” said Armstrong. “He defined nurses as people who care and then care some more.”

Armstrong’s definition of courage is about finding your voice and the ability to use it when caring for patients who are too small to speak, too sick to speak and too scared to speak.

Her biggest message to not only the nursing leaders but her entire nursing staff is about their contribution to the organization and the lives of the children that are cared for here.

“I want them to know that there is an inseparable link between your sight, your care and your courage and the outcomes of the tiny infants in your care.”

Howse Excellence in NICU Leadership Award

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Dr. Huda Zoghbi, founding director of the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s Hospital, has established a special fund to help young scientists launch their independent research careers.

When Zoghbi started her career 30 years ago, it was easier to pursue bold ideas. “It wasn’t as hard to get funding, and we didn’t feel the same pressures young scientists face today, Zoghbi said. “I had no research experience when I decided to learn genetics, but Dr. Arthur Beaudet took me into his lab anyway. That would be very hard to do today.”

Zoghbi, who also is a Howard Hughes Medical Institute investigator and professor of molecular and human genetics, neurology, neuroscience and pediatrics at Baylor College of Medicine, wants to support the next generation of budding scientists by giving them “room to pursue creative ideas as they’re beginning to launch careers.”

“The transition to independence is the most difficult period in a young scientist’s career,” Zoghbi said. “This kind of funding gives them a measure of freedom and signals our faith in their abilities to carve out their own niche.”

To accomplish this mission, Zoghbi has created a special fund at the NRI, one of the world’s first basic research institutes dedicated to childhood neurological diseases. The fund will provide one year of support to postdoctoral fellows who want to test bold hypotheses that would not be supported by conventional grants. When Zoghbi learned recently that she’d won the 2014 March of Dimes Prize in Developmental Biology, she decided immediately that she would add the $250,000 prize to the fund.

“This is a very prestigious award, and we are so fortunate that one of our own received this prize for her work to help advance our understanding of birth defects,” said Texas Children’s President and CEO Mark A. Wallace. “But we are even more honored and excited that this prize is being donated by Dr. Zoghbi as a generous gift to the NRI to help young scientists.”

Zoghbi’s gratitude and desire to give back is driven particularly by three individuals who had a profound impact on her career.

“Dr. Ralph Feigin recruited me to the pediatric residency program at Baylor College of Medicine and taught me clinical scholarship,” she said. “He also became a second father to me. Dr. Marvin Fishman was such an exemplary clinician that I was inspired to become a pediatric neurologist, where I met the patients who changed the course of my career. When I decided I wanted to pursue basic research, Dr. Beaudet, one of the finest geneticists in the country, took me into his lab and taught me how to be a scientist.”

Zoghbi hopes that with support from this fund, combined with hard work and protected space for intellectual freedom, many young scientists will enjoy similar success.

Click here for more information on the 2014 March of Dimes Award.

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Eva and Jay Heintz were enjoying a blissfully uneventful twin pregnancy in Hammond, LA, when their world was turned upside down at Eva’s 19-week check-up.

Her MFM specialist detected polyhydramnios in one twin’s sac and oligohydramnios in the other twin’s sac and quickly made the diagnosis of Twin-Twin Transfusion Syndrome (TTTS). From there, the bad news kept coming. Even though Eva’s ultrasound had been normal just two weeks earlier, the disease had progressed rapidly to an advanced stage of TTTS, (Stage 3) which involved cardiac Doppler abnormalities with selective intrauterine growth restriction. Action needed to be taken quickly if there was any hope of saving Eva’s twins.

Her MFM called Texas Children’s Fetal Center with a referral, and by the time she arrived home from her doctor’s appointment, Jayme Molohon, the nurse coordinator at Texas Children’s Fetal Center who received Eva’s case, had already started to make arrangements for Eva to be seen in Texas the next day.

“The nurses simply could not have been more warm and comforting as I prepared for my surgery,” said Eva.

“Once a referral comes through the Fetal Center, we try to get these patients in as quickly as possible due to the nature of the disease,” said Molohon. My relationship with the family starts with the first phone call I make to introduce myself. You can almost feel their anxiety and fear through the phone because you know they just want someone to help their child. My job is to make these families and patients as comfortable as possible and see that they understand their reasoning for coming all the way to Houston.”

But her role as a nurse coordinator extends far beyond that first call. Prepping for surgery involves a comprehensive initial evaluation. Patients like Eva start with an initial anatomy ultrasound, fetal echocardiogram, genetic counseling MFM consultation and fetal intervention consultation. The entire team on the fourth floor of the Pavilion for Women is a part of the patient’s evaluation. If babies meet criteria for surgery, the patient will meet with pre-anesthesia testing and possibly neonatology, if of viable gestational age. The nurse coordinator is then in charge of scheduling all appointments, verifying insurance authorization and also assisting in housing, if the patient has limited means. She also reviews all prenatal records and obtains any additional records depending on maternal conditions. And according to Molohon, one of her most important roles is to offer the family hope and the knowledge that the Fetal Center staff will fight for them.

“I am with the patient and their family every step of the way,” she said. “I develop relationships with patients that go beyond the fetal surgery. All my patients touch my heart in some shape or form. We experience a bond that can never be shared with anyone else. You may not be related to them by blood, but they will never forget how much of an impact you made in their lives and their children’s lives.

Eva underwent laser ablation surgery led by Dr. Alireza Shamshirsaz – a procedure that is still rare in other hospitals, but has become routine at Texas Children’s where the Fetal Center sees TTTS cases every week. Eva’s surgery was a success, but she still wasn’t in the clear.

“The families that go through fetal intervention always understand there is a risk that their children may not make it after surgery,” said Molohon.

After the procedure, doctors explained that the next important step would be surviving the night after surgery. At 6 a.m. the next morning, a team of doctors entered Eva’s room for the important evaluation – and looks of joy were exchanged as they found two heartbeats.

“When I found out that both babies were alive and made it through surgery, I said a prayer,” said Molohon. “Life is so precious and you always want the best possible outcome for these patients. Eva was such an amazing patient and wanted to do everything right to make sure her babies were okay. To see pictures of her twins now and how beautiful they are makes you appreciate all the hard work and dedication that we do every day in the Fetal Center.”

Eva’s story is a prime example of the high level of care that goes into TTTS cases at Texas Children’s Fetal Center.

“I saw and felt what it is like to have doctors invest themselves in, not only your outcome, but in your future and the future of your family, said Eva. “It felt so personal and special, and I will never forget that feeling. Through all the exhaustion and ultimately joy that this experience has brought me, I often reflect of my time at Texas Children’s Hospital.”

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St. Joseph’s Women’s Medical Center in downtown Houston recently cut the ribbon on its newly renovated neonatal intensive care unit. The renovations were a result of a partnership agreement with Texas Children’s Hospital which extends our neonatal care to the downtown hospital. The project cleared the way for state of the art support devices critical for the care of medically fragile infants. Just as important, it improved the environment for the patient and families in ways that have been shown to improve outcomes for critically ill infants.

“This partnership is critical to our overall regional strategy of ensuring the best care is available within reach for babies not just at Texas Children’s Hospital, but across the area,” said Dr. Stephen Welty, chief of neonatology. “We work closely with excellent nurseries in the community to promote the same quality and care standards followed in our level IV NICU.”

Texas Children’s provides St. Joseph’s with administrative and clinical support, giving patients access to the latest treatments available in neonatal and pediatric care, state-of-the-art equipment and pediatric sub specialists. That includes cardiology, neurology, infectious disease, ophthalmology and more.

St. Joseph’s is the seventh hospital in the Greater Houston community affiliated with our NICU. The others include Methodist West Houston Hospital, Methodist Willowbrook Hospital, Methodist San Jacinto Hospital, The Methodist Hospital, St. Luke’s The Woodlands Hospital and St. Luke’s Hospital at the Vintage. The partnerships also mean in the relatively rare circumstances when level IV care is necessary, the patients will be transferred to Texas Children’s Hospital.

“At Texas Children’s Hospital, our mission to build a healthy community of children begins at the very start of life,” said Cris Daskevich, senior vice president of Texas Children’s Pavilion for Women. “Our relationship with St. Joseph’s allows us to partner in providing exceptional neonatal care to the premature and critically-ill infants that need it most, so that babies can have the best possible outcomes.”

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By Julie Griffith

I am a planner by nature. I typically have my major life milestones mapped out before me and am driven by successfully completing goals. My life plan was as follows: 1) Play soccer at Texas A & M – check! 2) Marry an amazing man – check! 3) Complete graduate school – check! 4) Buy a home – check! 5) Establish myself in my dream career at Texas Children’s – check! 6) Start a family – check……finally!

Like most young, healthy couples, we thought it would be a breeze for us to conceive. After more than a year of trying and no sign of a second pink line anywhere in sight, we decided to turn to the Family Fertility Center at the Pavilion for Women last October. After being given a small chance of conceiving naturally, we made the decision to take the next step and pursue IVF. Even though it can be emotionally challenging at times working at children’s hospital and being surrounded by pregnant women, we knew we were in the right place to achieve our goal of starting a family. Our revised baby making plan was as follows: 1) Complete all the necessary doctor’s appointments – check! 2) Attend the IVF class – check! 3) Sign the 27 page consent form – check! 4) “Take a break” and wait to begin the IVF process in the new year.

Then, one Sunday morning in November, on a bit of a whim, I decided to take a test. It had probably been more than six months since I had taken a pregnancy test, because I felt that my heart couldn’t handle the disappointment each month. Well, on this particular day those two beautiful pink lines shined through in all of their glory! I was flooded with emotion, from disbelief to extreme happiness! There was a part of me felt that it was cliché to finally get pregnant while “on a break,” but honestly, I could have cared less how it happened!

My husband, Tyler, was at the gym that morning and the 45 minute wait for him to get home was excruciating! As soon as he got home, I showed him the evidence (three positive pregnancy tests) that would change our lives forever. There were moments of shock and then joy knowing this was really happening!

We believe that our longer than anticipated journey towards starting a family has made us more appreciative of the many wonderful blessings of pregnancy and even more connected to our ultimate goal of having a healthy baby. I am now in my third trimester and have been fortunate to have a happy and healthy pregnancy so far. I think my doctor, Dr. Putterman, with Partners in Ob/Gyn Care, said it best, “Good things come to those who wait.” We have been actively taking advantage of all of the incredible classes and resources available to us at the Pavilion and are looking forward to sharing our journey to parenthood on Bump Watch.

Here’s to conquering life’s next milestones and preparing for our baby boy’s arrival this July!

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The Texas Department of State Health Services announced that Dr. Julie Boom, director of the Immunization Project at Texas Children’s and associate professor at Baylor College of Medicine, has been named Centers for Disease Control and Prevention (CDC) Childhood Immunization Champion for Texas. This annual award, given by the CDC Foundation and the CDC, honors exemplary childhood immunization advocates across the 50 U.S. states, eight U.S. Territories and Freely Associated States, and the District of Columbia.

Recipients of the Childhood Immunization Champions award are individuals who work tirelessly to improve the health and lives of young children by ensuring that immunization is a priority. Boom was nominated by her peers, and selected as a Champion among health care professionals, community advocates, and other immunization leaders for making a significant contribution to public health in Texas through her work in children’s immunization.

When Boom was a medical resident, she treated a 3-year-old girl who died of meningitis. This experience inspired her to devote her career to promoting immunization through education, research, and the development of improved immunization technology and practices. Boom led the development of an automated software tool that forecasts what vaccines each child will need and when, according to the recommended schedule. To remind parents about the importance of vaccines, she helped create Vaccine-Preventable Disease: The Forgotten Story, a book featuring 20 families affected by vaccine-preventable illnesses.

May 13, 2014

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Today marks the opening of the first Texas Children’s Urgent Care clinic, which will offer high-quality, efficient and affordable pediatric care after hours, closer to home.

“Texas Children’s Urgent Care was created to respond to the growing need for expert pediatric urgent care after hours,” says Randall Wright, executive vice president of Texas Children’s Hospital. “Our clinics are conveniently located in your neighborhood, and available evenings and weekends, to continue our commitment to providing care to all patients and families in the Houston community.”

Texas Children’s Urgent Care is open Monday through Friday, 4:30 p.m. to 11 p.m. and Saturday and Sunday, noon to 8 p.m. Clinics are staffed by board certified pediatricians who have privileges at Texas Children’s Hospital. Pediatricians 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 on-site.

“We are excited to bring this expert urgent care model to the Houston community,” says Dr. Gary Gerlacher, Texas Children’s Urgent Care lead physician. “In my experience, I’ve seen firsthand how the urgent care setting has truly helped fill a void in treatment for children and their families.”

The first Texas Children’s Urgent Care clinic is located at Cinco Ranch, and the second, scheduled to open this summer, will be in the Town & Country area.

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 the 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.