July 22, 2014


“Please don’t hurt me. Heal me, and be nice to me.”

In that order, those are our patients’ most basic needs. Preventing errors and not harming patients are the most important responsibilities of every Texas Children’s employee.

Organization-wide Error Prevention Training launched last week to help ensure every one of us is equipped with the information and tools to keep patients safe.

This video explains why preventing errors is so critical and how each of us can make care safer at Texas Children’s.

“We take care of the sickest of the sick at Texas Children’s, and when you’re taking care of that many severely ill children, it’s a real challenge,” said President and CEO Mark A. Wallace. “Everyone recognizes that creating a safe environment – focusing on safety and error omission – is job one. Doing no harm to our patients is first and foremost.”

The Error Prevention work launched as part of the CareFirst initiative, began in January. CareFirst is primarily two things: an intense study of our core clinical areas at the main campus and an aggressive, strategic plan for how we will address our most crucial needs in those areas. The initiative is focused on the main campus Emergency Center, Critical Care units, and the Operating Rooms/PACU, because these areas provide the highly complex services that our most critically ill patients need. While CareFirst centers around expanding to better accommodate the critical needs of these high patient volume areas, its purpose is greater.

“If we don’t have the right environment, the right tools, the right people or the right structure, then it becomes very challenging to deliver the very best possible care – the safest care,” said Surgeon-in-Chief Dr. Charles D. Fraser. “Systems under duress – whether it be in the operating room or the emergency room or the intensive care unit – where there’s duress, then people become fatigued or distracted, and that’s an environment that is ripe for an error.”

The staff and employees involved in CareFirst work are vetting options to create the physical space and support needed in the core patient care areas. Combined with the Error Prevention training that kicked off last week, CareFirst ultimately will advance our efforts to ensure an optimal environment to receive and give the safest possible care.

“CareFirst is about making a promise to every child and woman who comes here that we will not harm them and equipping our facilities to ensure we keep that promise,” Wallace said. “It is far more comprehensive and much more important than expanding and building. It’s about doing what’s right for our employees and medical staff, and most importantly, what’s right for our patients, their families and their care. Ultimately, it’s about putting the care and safety of all of our patients and our people first.”

Error prevention training began in Hematology/Oncology in mid-July and will continue throughout other clinical areas over the next several months. In addition, online training will be provided for all non-clinical employees. Ultimately, every staff member and employee within Texas Children’s will receive error prevention training.

“My wish, my hope for every one of the 10,000 employees that will be going through training, that will hear about CareFirst, is that they stop and think about their individual role in supporting and delivering on zero harm,” said Chief Nursing Officer Lori Armstrong. “Everyone plays a role.”


Houston has its share of sporting events but hosting the Transplant Games of America was particularly special for Texas Children’s. As one of the lead sponsors, the hospital supported the games by promoting them, encouraging employees to volunteer, as well as organizing participation by patients. President & CEO Mark A. Wallace joined other leaders from the medical center at the opening ceremonies to carry out the official game flag that had traveled the country and been signed by transplant donors and recipients.

For Liver Transplant Coordinator Sarah Koohmaraie, the Transplant Games of America was a very special event. Koohmaraie was participating for herself, her father and her patients. To know how much this means to Koohmaraie, you would have to go back a few years.

In December of 2007, a little more than a week after graduating from nursing school, Koohmaraie went into surgery. Just months before that day, she found out her father was in need of a kidney transplant. While he was hesitant to let his daughter be the donor, Koohmaraie said she insisted.

“I kind of went behind his back and got tests done and made sure it would work out,” said Koohmaraie. “I knew I wanted to be the donor.”

The transplant was a success and a couple of months later, Koohmaraie was back at the hospital, this time as a transplant nurse. She moved to Houston in 2012 and began her position as a transplant coordinator at Texas Children’s. She said when she found out through work that some patients were participating in the transplant games, she knew she wanted to join them. She felt the camaraderie as she participated in all of the events.

“It was neat to see all of these patients who could have been on death’s door and now they’re doing exactly what I’m doing,” said Koohmaraie. “It was also nice to have my dad out there cheering me on and getting to meet other recipients.”


Team Texas consisted of 300 participants, patients and donors from across the state, including many former Texas Children’s patients, who took part in athletic competition and raised awareness for organ donations. The team had an impressive 450 registered supporters. The oldest participant from Texas was 83 year-old John Cugini and Parson Blue Herrington was the youngest at just two years old. The event brings to light the need for organ donors and brings together transplant patients, donors and families from all over the country. Forty-four teams and thousands of participants competed for gold this year with some states combining to form a more robust team. The games take place every year, going to the world stage in the World Transplant Games every other year.

“It was nice to raise awareness for donation, every one of those people out there wouldn’t have been able to be out there if someone didn’t donate,” said Koohmaraie. “You got to see people who were once very ill and now athletically fit with someone else’s organ in them and you would never know it.”

Team Texas brought home around 104 medals with 63 gold, 26 silver and 15 bronze. Koohmaraie competed in the Cycling 5k and 20K as well as the 1500 meter. She came home with the gold in all three.

See the photo gallery from the Transplant Games of America pep rally below.


When Kansas native Parker Flax was just three-months-old, he developed a fever, rash, conjunctivitis and cold-like symptoms that prompted his parents, Jessica and Daniel, to take him to the pediatrician. He was quickly diagnosed with measles, but after blood work ruled out the initial diagnosis, he was sent home. Parker then began developing extremely high fevers, which hovered around 106 degrees and would not subside with medication. Following a bigger spike in his temperature, his parents took him to a physician in nearby Kansas City who performed a spinal tap and diagnosed Parker with bacterial meningitis. He was admitted to the hospital and given antibiotics. Following further testing, meningitis was ruled out, but the physicians did not know what was causing Parker’s symptoms.

The usually happy, carefree baby continued to have fevers and was oftentimes inconsolable. On September 18, while at home with Parker and his brother, Jessica had to administer CPR on her young son who had collapsed and wasn’t breathing. She knew in that instant that all of Parker’s previous symptoms contributed to this frightening episode. He was admitted to the hospital and the family finally received a diagnosis – Parker had suffered a heart attack and had Kawasaki disease with 100 percent blockage of the right coronary artery as well as dilation of the left coronary artery. The physician told the family he had never seen a patient so young with this diagnosis and sought advice from cardiologists around the country. When he received twenty-two different answers from twenty-two different cardiologists, the Flax family knew they had to take matters into their own hands and find the best possible treatment for Parker. Jessica went online and found Parker’s pediatric cardiologist, Dr. Carolyn Altman, at Texas Children’s Heart Center.

At the end of May, pediatric cardiologist Dr. Caridad delaUz, implanted the 19-month-old with the Reveal LINQ Insertable Cardiac Monitor.

“Parker was the first pediatric patient in Houston, and among the first in Texas, to receive LINQ cardiac monitoring device,” said delaUz. “I’m so glad we’ve been able to give his parents the peace of mind they’ve desperately yearned for since Parker was a baby.”

The device, released in February, is smaller than a key and wirelessly monitors Parker’s heart rhythm with specific parameters set by Dr. delaUz. The monitoring device inside Parker’s chest stores the information which is wirelessly communicated to a hub at his bedside. The device sends transmissions of any abnormal rhythms automatically to his care team here in Houston. The minimally-invasive procedure took less than ten minutes and allows Jessica and Daniel to sleep easier each night because they know Parker is being monitored by the Texas Children’s Heart Center team 24 hours a day.


Each year, around 5,000 children are admitted to the Texas Children’s Hospital Pediatric Intensive Care Units. These are the patients who require the highest level of medical care. Until just a few months ago, a portion of our admissions were children who were transferred from West Campus because of their need for a higher level of care which was not yet available in the community hospital.

In March, partially funded by a generous $1million donation from the Lauren and Lara Camillo Family Trusts, West Campus opened an eight-bed PICU to meet the evolving needs of patients in the community. The family, who’s known in West Houston for their thriving business in homebuilding, Legend Homes, made the donation to create the much-needed intensive care unit which will help care for the growing number of cases being seen at West Campus. This was the second $1million donation from the family, who also donated to the construction of West Campus, said they are giving back to the community that has helped them thrive. Only a few months after opening, Chief of Critical Care Dr. Lara Shekerdemian said it is meeting a great need that has been present for a long time. Already, there has been a steady increase of patients using the West Campus PICU with an average daily census of anywhere between five and seven and an 80 percent occupancy just a few months into opening.

“We’re delivering the right care in the right location for all of our patients who require critical care,” said Shekerdemian.

The unit is staffed by intensive care physicians and advanced practice providers who are all on Faculty at Baylor College of Medicine, Section of Critical Care. All of our caregivers, including our nurses, have experience and training at main campus PICU. Some of the West Campus PICU nurses transitioned from Main Campus and others were recruited from other intensive care units. The new positions were met with enthusiasm and there was no lack of interested individuals who were excited about working in this new setting. Shekerdemian stresses the care at West Campus is equivalent to the main campus intensive care with the same guidelines and protocols, and a highly trained team of providers. The addition of the unit will impact the ability of the West Campus facility to perform more complex surgical procedures, and to admit more patients from the Emergency Center. The unit is not only helping the great need in West Houston, it ensures that we have more space to care for the sickest children across the City.

“We have had to turn down patients at Main Campus needing our critical care services as recently as last winter before the opening of the West Campus PICU,” said Shekerdemian. “This is something that we are very uncomfortable with; we feel a moral discomfort at having to deny admission to any child that’s critically ill.”

Dr. Moushumi Sur, medical director of the West Campus PICU, said this is a situation we hope to ease this winter, with a proposed plan to increase staffing and beds.

“The number of transfers from the Emergency Center at West Campus and from other hospitals in the area to the Main Campus ICU has decreased since we opened the new PICU,” said Sur. “We’ve made an impact in terms of taking care of patients at the same level in a community setting. This is exactly what we hoped.”

Dr. Shekerdemian said while the transfers have decreased, the Main Campus PICU has not seen a major decrease in patient volumes. In fact, she said a proportion of the patients in need of intensive care at West Campus are new to the Texas Children’s Hospital system. As for the build out of the unit at West, Dr. Sur said it’s a breath of fresh air.

“There is more natural light in the unit which helps overall morale not only for our staff but for the patients and their families,” said Sur. “The visibility is also improved and enhanced. The ability for the nurses to have their eyes on their patients even when they’re outside the room is extremely important.”

With an already busy West Campus PICU, the critical care team is planning for the future. Sur is on a committee for The Woodlands Campus to plan an intensive care unit, making sure the facility is built to support the opening of a PICU within the first few months of the campus’ opening.


It’s so exciting when you hear your baby cry for the first time. It’s a sign your newborn has entered the world with a strong, healthy set of lungs. But as the days, weeks and months roll by, the excitement may quickly give way to concern and frustration.

As new parents, you will soon realize that babies cry a lot. Most babies are fussy for a reason and often times it’s something related to digestion like gas or reflux. Infants will cry because they’re hungry, wet, tired or they want to be held.

Sometimes, the reason behind their mysterious wails is not so obvious, which can be frustrating for their sleep-deprived parents.

A few weeks ago, Dr. David Wesson, head of Texas Children’s Level 1 pediatric trauma center, shared a blog about “The Period of Purple Crying” initiative that raises awareness about the effects of Shaken Baby Syndrome and educates parents that crying is a normal and temporary phase in a newborn’s early development. The key word is temporary, because it does get better over time.

We asked some of our Bump Watch moms – Amber Tabora, Veronika Javor, Eden McCleskey and Shelly Lopez-Gray – to share their tips with new and expectant moms on how to calm a fussy baby. We hope you’ll find these tips helpful as you embark on this immensely rewarding journey called motherhood.

Tips to soothe a crying baby

  • Feed your baby – Most babies cry when they’re hungry. Make sure your baby is getting enough milk. Infants go through growth spurts and during this time they want to nurse frequently. Nursing should be an intimate bonding experience between you and your newborn.
  • Swaddle them – Swaddling calms and relaxes newborns and usually helps them sleep better. “Don’t let their wiggly arms stop you from getting them into a tight swaddle,” said Amber Tabora. “It’s a position that mimics the womb and all babies like that.”
  • Allow your baby to suck on a pacifier – Sometimes babies just want to suck on something and it doesn’t need to be you all the time. Pacifiers, or even your finger, can soothe a crying infant and help them go to sleep.
  • Use white noise – Shushing sounds mimic what your baby heard while in your womb. “I use a free Baby Shusher app from my smartphone that repeatedly makes the “shh” sound, and it totally calms my crying baby down,” said Shelly Lopez-Gray.
  • Entertain your baby – Do whatever you can to amuse your baby to help get their minds off of what’s bothering them. “I would set my son in a bouncy seat and play music on my iPhone from Pandora, dance right in front of him and sing along to the music,” said Eden McCleskey. “He seemed very entertained by that and it was a good workout.”
  • Gently sway baby back and forth – Sometimes the motion of the swing can be soothing for babies. Any sort of rhythmic swaying – up and down, side to side, back and forth, or a combination of the two – mimics the experience of being in the womb. Many of the swings come with soothing music that adds to the calming effect for your newborn.
  • Sing songs to your baby – Soft, gentle songs, such as lullabies, sung by a familiar voice can calm a baby’s cries. “I used to walk with her and sing to her as I gently patted her back, in case she had to burp or had some tummy discomfort,” said Veronika Javor. “It helped stop her crying.”

“I recommend this book for all new moms called, “Happiest Baby on the Block,” said McCleskey. “It teaches you the five “S” methods to switch on a really fussy baby’s soothing reflex. For my kids, swaddling them, holding them across my belly and lightly bouncing or swinging them in my arms was usually enough to get them to calm down and fall asleep. I only needed all five elements if the baby was truly having a nuclear meltdown.”


On July 16, patients on 11 West Tower were greeted by three-time Olympian Erin Hamlin. Most recently, she made history and took home the bronze medal in the singles luge event at the Winter Games in Sochi. The 27-year-old brought smiles to patients, showed off her medal and even came with a luge in tow for them to ride. View photos below

July 15, 2014


For the second year in a row, Texas Children’s has received the “Most Wired” designation for outstanding health care-based technology from Hospitals & Health Network Magazine – the flagship publication of the American Hospital Association.

“Earning Most Wired designation for two consecutive years is a tribute to the hard work of Information Services and our many partners at Texas Children’s,” said Myra Davis, senior vice president of Information Services (IS). “It also reflects the foresight of the administration to recognize the role innovative technology can play in supporting world-class patient care.”

Now in its 16th year, the Most Wired Survey polls hospitals and health systems nationwide regarding their IT initiatives. Hospitals that lead the way in technological achievement receive Most Wired designation. Surveys completed in 2014 represent more than 30 percent of all U.S. hospitals.

In 2013, Texas Children’s received its first-ever Most Wired recognition, as well as a Most Wired Innovator Award for innovative use of information technology for the Voalte Rapid Communication Project.

New Most Wired standards
Most Wired adopted a new, more-stringent analytic structure for the survey this year. Rather than technology adoption, recognition for IT excellence among hospitals and health systems is now based more on an organization’s meaningful use based on federal requirements for certified electronic health records.

“Hospital leaders should be commended for the hard work they’ve done under an unrealistic time frame,” states Russell P. Branzell, president and CEO of the College of Healthcare Information Management Executives (CHIME).

The Information Services team will receive the award in San Diego later this month at the 2014 Health Forum and AHA Leadership Summit, where senior executives from the nation’s leading hospitals and health systems will discuss the critical issues facing their organizations and network to find the solutions they need to be more successful.