January 27, 2015

12815kidneydialysis640

This month, Texas Children’s Renal Center delivered more than 100 acute therapies in less than 10 days – a remarkable milestone that demonstrates the value of teamwork and our hospital’s commitment to putting patients’ needs first.

“This is an incredible accomplishment,” said Texas Children’s Chief of Renal Services Dr. Michael Braun. “As the demand for our services continues to grow, so has our collaborative spirit to ensure critically-ill patients receive efficient, high quality care every time they walk through our doors.”

During the past three years, our Renal Center – ranked No. 1 in Texas and No. 4 nationally by U.S. News and World Report – has seen a 20 percent annual increase in the volume of acute therapies delivered to patients during their hospital stay.

Unlike chronic kidney disease – which is incurable and tends to worsen over time prompting the need for dialysis or kidney transplant – acute kidney disease develops suddenly due to injury or underlying health problems. In many cases, the kidneys regain full function once the cause is addressed.

The Renal Center at Texas Children’s delivers two types of acute therapies – dialysis for the treatment of kidney failure, and apheresis, which separates unwanted cells or components from a patient’s blood and returns the desired components to patients with a wide range of illnesses.

Last year, 2,400 acute therapies were delivered to patients, averaging six treatments per day. To achieve this month’s milestone – 124 acute therapies in less than 10 days – the renal staff collaborated with numerous multidisciplinary teams across the organization to deliver results.

“Our success is contingent upon the support we received from fellows, nurses, blood bank, transplant services, supply chain, the intensive care units, as well as the critical care physicians, surgeons and radiologists who placed dialysis catheters into our patients prior to treatment,” Braun said.

The Renal Center’s exceptionally dedicated dialysis team worked tirelessly to ensure our acute and chronic kidney disease patients received life-saving treatments.

“Nurses and clinical hemodialysis technicians voluntarily worked extra hours and shifts to meet the increasing demand for renal services,” said Valesca Adams, assistant director of Nursing for Texas Children’s Renal Center. “It was a lot of work, but at the end of the day, our primary focus was – and still is – fulfilling our patients’ needs.”

“I am proud and humbled that our teams pulled together to achieve a performance record of this kind,” Braun said. “It is great to celebrate this milestone but even more importantly that we meet the standard of excellence that our patients have come to expect.”

Besides treating kidney disease, the Renal Center provides services to transplant patients, critically-ill ICU patients, as well as patients who have undergone cardiovascular surgery. The renal team delivers extracorporeal therapy to liver patients to help reduce the disease burden as they await a transplant.

To learn more about Texas Children’s Renal Center, click here.

12815mentalhealth550

One in five Americans has a mental illness and many are reluctant to seek help or might not know where to turn for care. On top of that, the symptoms of mental illness can be difficult to detect. Even when friends and family of someone who appears to be developing a mental illness can tell that something is amiss, they might not know how to intervene or direct the person to proper treatment, which means that all too often, those in need of mental health services do not get them until it is too late.

Here at Texas Children’s we are working to build a community that is highly educated about mental illness and extremely compassionate toward those who might be experiencing it. One of the main ways we are going about creating this community is by offering a world-renowned course that helps people identify, understand and respond to signs of mental illness and substance use disorders. Called Mental Health First Aid, the 8-hour course teaches people how to help someone who is developing a mental health problem or experiencing a mental health crisis.

The course introduces participants to risk factors and warning signs of mental health concerns, builds understanding of their impact, and overviews common treatments. It uses role-playing and simulations to demonstrate how to assess a mental health crisis, select interventions and provide initial help. It also helps connect people to professional, peer and social supports as well as self-help resources.

Jill Fragoso, director of employee health and wellness, took the Mental Health First Aid course a year ago, and said it was invaluable to her professionally and personally.

“It provided me with a toolkit and an action plan that I can use if I ever find myself in a situation where I am dealing with a person with a mental disorder,” said Fragoso, who is also a registered nurse. “It also helped educate me on what is and what isn’t a mental disorder so that I can better determine how to help someone.”

Terese Walsh, senior organizational development consultant, said the course cleared up some misconceptions she had about what to say and do to support someone with a mental illness.

“I encourage everyone to take it,” she said of the course. “It was well done and provided me with valuable information.”

Mental Health First Aid was created in 2001 by Betty Kitchener, a nurse specializing in health education, and Anthony Jorm, a mental health literacy professor. Kitchener and Jorm run Mental Health First Aid™ Australia, a national non-profit health promotion charity focused on training and research. The United States is just one of the many countries that have adapted the program.

Texas Children’s Employee Assistance Program started offering the program to its employees free of charge in 2014. So far, feedback to the program “has been fantastic,” said Brent LoCaste-Wilken, program manager of the Employee Assistance Program. “Our goal is to get as many people trained as possible,” he added.

This year there will be three opportunities to take the course, the first being from 7:30 a.m. to 4:30 p.m. Tuesday, February 17, in the Pavilion for Women fourth-floor conference center. The second course will be broken up into two four-hour sessions. The first session of the second course will be from 8 a.m. to noon Wednesday, May 13. Both sessions will be held in the Pavilion for Women fourth-floor conference center. The last course will be from 7:30 a.m. to 4:30 p.m. Tuesday, August 4, in the Pavilion for Women fourth-floor conference center.

To sign up for one of the Mental Health First Aid courses, go to the Learning Academy on Connect or contact the Employee Assistance Program at Ext. 4-3327 or eap@texaschildrens.org.

12815Valentines640

It’s time to spread the love. Many patients who spend Valentine’s Day with us don’t get to be a part of their school’s Valentine’s Day celebrations and miss out on the opportunity to exchange Valentine’s with other kids their age. That’s where you come in!

Texas Children’s Patient Activities Team makes sure these kids get to celebrate the holiday. The team is sponsoring a Valentine’s Day card drive Monday, February 2, through Friday, February 6. This year’s drive is only a week long and only handmade cards are being accepted, so make sure you don’t miss this opportunity to bring smiles to the faces of our patients.

The cards will be delivered to patients on inpatient floors Friday, February 13. To volunteer for card delivery, e-mail Irma Vargas.

Signed Valentine’s Day cards can be placed in collection boxes at the following locations starting February 2.

  • Abercrombie first-floor information desk
  • Meyer Building first-floor security desk
  • West Tower third-floor information desk
  • Nabisco Building (in the cafeteria)
  • 8080 N. Stadium Drive
  • Bank of America Building 12th floor

Please do not include any patient names, religious statements or get well messages on the cards. For example, you may write “to a cool kid” or “to a friend.” Here are additional guidelines:

  • Use bond paper and non-toxic markers, crayons or water-based paints only.
  • Draw with stencils or decorate with stickers.
  • Do not glue solid items on the cards.
  • Do not use glitter or glitter glue.
  • Do not include anything edible on or with the cards.
  • Do not include any religious messages.
  • Do not specify gender, name or ethnicity.

12815SSMelissaSmith175Melissa Lewellen Smith from Texas Children’s Heart Center is the latest Texas Children’s Super Star employee. “My consistent motivation for providing good care and service is knowing that I am helping to improve the experiences and outcomes of our patients and families,” Smith said.

Read more of Smith’s interview:

Q&A: Melissa Lewellen Smith, October 2014 Employee

Your name, title and department. How long have you worked here?
Melissa Lewellen Smith, Registered Nurse, Pacemaker & Electrophysiology Services (Within Cardiology). I have worked here 16 years.

What month are you Super Star for?
October 2014

Tell us how you found out you won a super star award.
I returned to work after two weeks of vacation on October 9, 2014 and was in our morning EP service meeting. Our meeting was interrupted by our administrative assistant to let us know our director of cardiology called an urgent meeting in the living area on the 19th floor. When our team arrived, everyone was cheering and clapping. I was totally confused. Our director, Matthew Timmons, then announced the fantastic news. We had a celebratory breakfast and I was presented with flowers and a gift. It was such a phenomenal surprise that I will never forget!!

What does it mean to be recognized for the hard work you do?
As a nurse, your main drive is to take care of the patients/families you’re servicing and to try and give your best while providing great care. When providing care, the furthest thing in my thoughts is being recognized for that service. It is always wonderful and special to be recognized for good work and deeds.

What do you think makes someone at Texas Children’s a super star?
Consistently going above and beyond the call of duty without being asked to do so. Having a strong passion and love for what you do on a daily basis that always shines in the care and service that you provide to others.

What is your motivation for going above and beyond every day at work?
My consistent motivation for providing good care and service is knowing that I am helping to improve the experiences and outcomes of our patients and families.

What is the best thing about working at Texas Children’s?
I’ve always loved the sense of “family” at Texas Children’s. Working at Texas Children’s almost 16 years now, the relationships you develop from physicians and nursing colleagues to patients and families feels more like an extended family than it does a job. A lot of my patients I have known since they were newborns or very young children. You watch these small children grow into young adults or from young adults into adulthood. Those children and their families come to see you as not only a health care professional and caretaker but a member of their own family. In turn, my job as a nurse over time, has become more than just taking care of my “patients.” It has evolved into feeling like I am taking care of members of my own family. I truly embrace the lasting friendships and relationships I have developed through my role as a nurse at Texas Children’s.

Anything else you want to share?
I am so very appreciative for the recognition!!

January 21, 2015

12115Leung175

Dr. Daniel Leung, medical director of the Viral Hepatitis Clinic at Texas Children’s, has devoted much of his research to improving the outcomes of children with cystic fibrosis and cystic fibrosis-associated liver diseases.

Cystic fibrosis (CF) is a life-threatening illness that causes the body to produce thick, sticky mucus that blocks the airways in the lungs, digestive tract and other parts of the body, including the liver.

“CF is caused by a mutation in the CFTR gene that affects the liver’s bile composition,” said Leung. “When thick bile cannot flow from the liver to the small intestine to digest fats, the buildup of bile rapidly scars the liver leading to cirrhosis, which may require a liver transplant.”

To accelerate CF research and patient care at Texas Children’s, Leung received a $100,000 Developing Innovative Gastroenterology Specialty Training (DIGEST) grant last spring from the Cystic Fibrosis Foundation. This 3-year grant is awarded to physicians across the country who demonstrate promise in changing the field of gastrointestinal (GI) care and research for CF patients.

“We’re paired up with nationally recognized physician mentors throughout the country,” said Leung. “The intent is to enhance CF care and research emerging in each of the institutions where there’s an awardee.”

Through the DIGEST grant, Leung will be working closely with interim CF Center Director Dr. Fadel Ruiz and Pulmonary Division Chief Peter Hiatt to incorporate more pediatric gastroenterology into a multidisciplinary CF clinic for Texas Children’s most challenging patients, as well as develop CF and gastroenterology learning programs and lectures for future trainees and faculty.

Leung, who fosters a special interest in nutritional deficiencies and liver disease in children with CF, is active in on-going multi-center studies funded by the National Institutes of Health (NIH) and the Cystic Fibrosis Foundation, respectively
.
For the last four years, Leung has served as co-lead principal investgator of the CFF-funded Baby Observational and Nutrition Study (BONUS) that examines how diet and nutritional supplements impact growth in CF patients during the first year of life. Specimen samples – stool, urine, DNA and serum – are collected to identify potential markers that may interfere with an infant’s growth.

Leung also serves as site PI for the NIH’s Cystic Fibrosis Liver Disease Network study called PUSH which is an observational study that tests whether certain abdominal ultrasound patterns determine CF patients’ risk for developing cirrhosis.

“Up to 10 percent of children with cystic fibrosis will develop biliary cirrhosis by the first decade of life prompting the need for a liver transplant,” said Leung. “Through our research, we want to improve these odds to help CF children at Texas Children’s and around the world get off to a healthy start.”

Leung and his research colleagues are working on the first manuscripts for both studies and hope to publish their findings this spring.

January 20, 2015

12115MyChart640

MyChart, the online patient portal that allows patients or their parents to access health information from Epic, recently underwent significant improvements and enhancements.

Now, patient families can:

  • Sign up for MyChart in their doctors’ offices and receive access the same day (with a few exceptions
  • Request, confirm and cancel appointments online
  • Review appointment history, chronic illnesses, medical and surgical history, allergies, medications and after-visit summaries
  • Email non-urgent medical questions to providers
  • Request prescription renewals online
  • Complete medical questionnaires prior to appointments

The increased use of MyChart by Texas Children’s patient families will help providers stay connected to their patients, improve patient care and save time.
Here’s how:

  • MyChart is an effective tool for patient engagement, leading to better outcomes. The more patient families are involved in their care, the better their outcomes.
  • MyChart allows easy login – whether on a computer or a smart phone – so patient families can see their health information and review comments from their physicians.
  • MyChart enhances how physicians communicate directly with their patients, by allowing conversations to occur online and at times that are convenient for the physician and the patient. This direct communication helps patient families feel connected to their care providers.
  • MyChart improves the patient experience by allowing easier access to their health information, such as after visit summaries, immunization histories and more.
  • MyChart promotes efficiency by decreasing the need for printing, mailing and faxing patient information.

“We are excited about the changes that have been made to MyChart during the last six months,” said Dr. Joan Shook, Texas Children’s chief clinical information officer. “Now it’s time for us to enlist all the Texas Children’s medical staff and employees to help us encourage our patient families to sign up and use MyChart.”

If you want to watch the MyChart video outside of the organization on our YouTube channel, click here.

For more information about MyChart, visit the links below:
My Chart Overview
Clinical MyChart Workflows
Workflow and Instructions for Responding to Patient Emails
Details about Outpatient After Visit Summary (AVS)
Results Release

Results Release Tip Sheet
eLearning Results Release Tutorial
PowerPoint Results Release Tutorial

Details about Blocked Lab Results and Sharing Letters

Details about History Questionnaires

Functionality for the Teen Patient and Teen Proxy

12115MataTwinsinside640

Taking care of conjoined twins, Knatalye Hope and Adeline Faith Mata, is hard, even for the highly-trained medical staff charged with looking after the two 9-month-old girls.

Diaper changes, baths, feedings, even moving the girls from one place to the other takes a lot of effort, thought and hands. So, when the team of surgeons assigned to the twins asked the girls’ primary nurses and physical therapist to figure out a way to help the twins sit up, Frank McCormick, Jennifer Pitlik and Jennifer McGinnis were stumped.

“We were all just deer in the headlights,” said Pitlik, one of the twins’ primary care nurses.

McCormick, the twins’ physical therapist, had devised things to hold the girls upright before, but Knatalye and Adeline always outgrew them.

“We had to come up with something else,” McCormick said.

The surgeons wanted the girls upright to keep pressure off the custom-made tissue expanders they put in the girls’ chest and abdomen area last month. The expanders will help stretch the babies’ skin in preparation for their separation surgery, which is expected to take place next month. The surgeons also wanted the girls to spend time sitting up so they could continue to develop normally.

“Most 9-month olds are crawling and pulling up on things,” Pitlik said. “So, for them to just lay in a hospital bed all day is difficult.”

For a little more than a month, Pitlik, McCormick and McGinnis, the twins’ other primary nurse, worked with Hope Whitten, an orthotist and prosthetist at Hanger Clinic, to come up with a device that would safely keep the twins upright for a large portion of each day.

What they came up with was a u-shaped device that supports the twins’ backs, bottoms and heads. The device’s headrests are removable to allow for more movement and the main portion of the device is equipped with growth liners that can be taken out as the girls continue to get bigger.

In addition, the device suspends from a Hoyer, which normally is used to lift patients who are unable to move from one place to another on their own. In the twins’ case, the Hoyer will allow staff to lift the girls up or down while they are in what has come to be called, “the swing.”

“They love it,” McGinnis said of the swing. “They push off with their feet, so they are able to swing and move around, and since they are both upright, they’re able to look at people in the face.”

Whitten, who helped build the device based on a computer-generated model and body scan of the girls, said she knew she had done something right when she saw the girls sleeping in the swing.

“I was really very, very happy,” she said. “I was happy they were comfortable enough to sleep in this device, which is very foreign to them.”

McCormick, who was initially brought on to help the girl’s with their club feet, said the entire experience has been “truly amazing.”

“It’s just been a neat process to watch it (the swing) evolve over time and how things have changed and what we’ve had to do,” he said.

Pitlik and McGinnis agreed and said they both stepped out of their comfort zones to do what was best for Knatalye and Adeline.

“We’re all here for them and we all love them,” Pitlik said. “We have that end in mind.”

Knatalye and Adeline were born April 11 at Texas Children’s Pavilion for Women. Delivered via Caesarean-section at 31 weeks gestation, the twins each weighed 3 pounds, 7 ounces.

The girls’ parents, Elysse and John Mata, and their 5-year-old brother, Azariah, learned during a routine ultrasound on January 13 that Elysse was carrying twins and they were conjoined. Subsequently, the family was referred from a physician in Lubbock, their hometown, to the Texas Children’s Fetal Center where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care.

Now 9 months old, the babies are doing well as they continue to be cared for by a team of specialists in the Level IV Neonatal Intensive Care Unit at Texas Children’s Hospital.