November 24, 2015

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Dr. Fernando Stein has been elected President of the American Academy of Pediatrics (AAP). This is the first time in the AAP’s 85-year history that a pediatrician from Texas has been elected to this post.

As president of the AAP, Stein will represent all pediatricians and subspecialists across the country, and ultimately serve as Texas Children’s voice on national issues impacting pediatrics and the health and safety of the millions of patients and families we serve.

“Dr. Stein brings enormous vision, wisdom and experience to the presidency of the American Academy of Pediatrics,” said Texas Children’s Physician-in-Chief Dr. Mark W. Kline. “The Texas Children’s family could not be prouder or more pleased to have one of its own in a leadership role for this great organization.”

As medical director of Texas Children’s Progressive Care Unit and a faculty member in the Department of Pediatrics at Baylor College of Medicine for more than 30 years, Stein has dedicated his career to the care of children surviving critical illness and technological dependency. He has been extremely active in global advocacy for children in impoverished regions of the world and in the integrated management of childhood illness. Stein is one of the founding members of the AAP Section on Critical Care and serves on several AAP subcommittees where he has been recognized for his extraordinary service and commitment to children.

“I am honored for this privilege to serve AAP in this capacity,” Stein said. “I have a deep understanding and appreciation for the shareholders of this organization, and my message to shareholder members and colleagues is one of a clear commitment to them, to our traditions of scientific inquiry, altruism and challenge to the status quo.”

Please click here to visit Stein’s website to learn more about our colleague and his goals as president of the AAP.

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Supporters of Texas Children’s efforts to treat children with highly contagious infectious diseases gathered last week to applaud the opening of the organization’s Special Isolation Unit at Texas Children’s Hospital West Campus.

More than 70 people from across the organization and the state attended the unit’s ribbon cutting and open house, during which they got a close-up look at the state-of-the-art facility and heard from people who were critical to the unit’s creation.

“This is an exciting day, a landmark day, in the history of Texas Children’s,” said Physician-in-Chief Dr. Mark W. Kline. “This unit is a real resource for the city of Houston, the state of Texas, for the region, the nation and the world.”

Texas Children’s began working on the unit almost a year ago, shortly after an unprecedented Ebola outbreak that resulted in the realization that we must be prepared to handle emerging infections as an institution. As a result, the state and the Centers for Disease Control and Prevention designated Texas Children’s Hospital as one of several pediatric Ebola treatment centers countrywide.

Texas Children’s special isolation unit is the only one of its kind in Texas and the southwest region, and is among the few in the United States designated just for children. Located on the fifth floor of West Campus, the eight-bed unit is fully equipped to care for any infant or child with a serious communicable disease and has all of the measures available to assure safety of the health care team, other patients and their families.

Children coming to the special isolation unit will receive top notch care from a team of highly-trained nurses and doctors, led by the unit’s medical director, Dr. Gordon Schutze, associate medical director’s Dr. Judith Campbell and Dr. Amy Arrington, and nursing leader, Sondra Morris.

“I am honored to say that when problems threaten our community and our children, Texas Children’s always leads strong,” said West Campus President Chanda Cashen Chacón. “We do not shy away from those who need us the most.”

More than 70 people gathered for the official ribbon cutting held last week for special isolation unit at Texas Children’s Hospital West Campus.

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Texas Children’s Kangaroo Crew unveiled its new state-of-the-art ambulances that replace the old fleet while significantly improving patient and crew safety during emergency transport to Texas Children’s Hospital.

“Our 6-year old ambulances were becoming less reliable,” said Texas Children’s Assistant Director of Transport Services Deborah D’Ambrosio. “Our transport team of registered nurses, registered respiratory therapists and emergency medical technicians designed these four ambulances keeping patient and crew safety as their number one priority.”

The new fleet includes a number of safety improvements:

  • Equipped with liquid spring suspension, patients and crew experience a smoother ride. This technology decreases vibrations and bumpiness on the road, which can impact a patient’s condition during transport and make it difficult for the crew to provide care while the vehicle is moving. This safety feature also reduces neck and back pain problems that staff previously reported with the old trucks.
  • The five-point safety harnesses allow the transport team to deliver patient care while secured in their seat belts. This new safety feature replaces the standard seat belts.
  • Instead of manually lifting a stretcher or isolette, the ambulances’ power load system easily performs this function with a push of a button.
  • The addition of radios and Wi-Fi connections allow the transport team to remain connected to Main Campus via Texas Children’s intranet for protocols and pharmacy references.
    Advanced GPS tracking system helps the transport team know the precise location of the ambulances. This system also features indicators that can be set to deliver messages regarding a driver’s performance while on transport.
  • Electronic monitors provide the transport team with a constant reading of oxygen levels in the tank replacing the manual system.
  • Additional safety features include back-up and turn cameras and airbags for airway seat.

The new ambulances also have a DVD player for the patient and outlets for families to charge their cell phones.

Texas Children’s Kangaroo Crew brings newborn babies and critically ill pediatric patients to Texas Children’s Hospital for expert care from all over the country. The crew performs more than 1,500 critical transports a year.

“As one parent described them, they are the Navy Seals of Texas Children’s,” said Texas Children’s Assistant Vice President of Nursing Gail Parazynski. “She is absolutely right. This team meticulously designed these new trucks to ensure our most fragile patients are safe while being transported to our hospital.”

Besides providing ground transport service, the Kangaroo Crew’s customized Cessna airplane transports critically ill newborn babies and children from throughout the United States and Central America to Texas Children’s Hospital.

November 17, 2015

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The Epilepsy Monitoring Unit (EMU) had one hospital-acquired pressure ulcer (HAPU) in a period of 892 days, which translates to 647 days and 244 days without a HAPU occurrence. These notable milestones demonstrate the value of teamwork and commitment to cultivating an environment of safe patient care.

When epilepsy patients are admitted to the EMU for an electroencephalography (EEG) study, electrodes are attached to their scalp, forehead and cheeks. These electrodes, which enable the recording of brain wave activity to diagnose seizures and other neurological disorders, can lead to skin breakdown at the electrode sites resulting in a pressure ulcer.

“Before revising our quality improvement practices for HAPU prevention, 10 percent of our EMU patients developed a HAPU, averaging three or four occurrences per month,” Texas Children’s Clinical Specialist Joellan Mullen said. “Today, we have brought our HAPU incidence rate to zero.”

In an effort to reach this milestone, EMU nurses, technicians, physicians and physician assistants collaborated to develop techniques to enhance skin care management and pressure ulcer prevention. These best practices were published in the 2014 issue of the Journal of Pediatric Nursing co-authored by Mullen and Texas Children’s EMU/EEG Clinical Manager Wendy Morton.

Several improvements were implemented to reduce HAPUs:

  • Patients were prepped with a less abrasive solution to remove oils from the skin before electrodes were placed on the scalp and forehead
  • Disposable electrodes were used to reduce the potential risk of infection instead of using the same electrodes for patients following equipment disinfection
  • Crib mattresses were replaced with pressure-reducing cushions to distribute weight evenly
  • A breathable, fishnet dressing was wrapped around the electrodes on a patient’s head to prevent moisture and pressure on the scalp. Prior to this change, the entire head was wrapped tightly in gauze which increased the potential of skin breakdown at the electrode sites.
  • Wireless technology was implemented to allow greater mobility for patients. Instead of being tethered to the wall, the electrodes are hooked up to a small monitor that patients wear as a backpack so they can move freely in the unit instead of being confined to the bed.
  • Nurses performed skin assessments for pressure ulcers twice per shift – before the electrodes were placed on the patient and after they were removed.

Additionally, the Skin Champions Program helped staff significantly reduce the occurrence of pressure ulcers in the EMU and in high acuity areas of the hospital like the intensive care and cardiovascular units.

Two skin champions were chosen from each unit to serve as coaches and ensure compliance with proven pressure ulcer prevention strategies. While all EMU staff members are trained in HAPU prevention, skin champions undergo more intensive training and must attend monthly educational sessions with a certified wound-ostomy nurse.

“Ensuring our nurses and technicians are equipped with the knowledge and tools to take preventive action are key to creating a harm-free environment for our EMU patients,” Mullen said. “I am proud of our team for helping us achieve this milestone.”

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The sound of helicopter blades chopping through the air will be a common occurrence at Texas Children’s Hospital West Campus now that the hospital’s helipad has been activated and staff has been trained on how to receive a patient arriving via air transport.

“We are very excited about the opportunity to have helicopters land at Texas Children’s Hospital West Campus,” said Dr. Jeanine Graf, the hospital’s chief medical officer. “It’s been an innovative first for Texas Children’s to begin bringing in children via rotacraft helicopter transport.”

Previously, patients coming to West Campus via helicopter would land at an adjoining facility and then be brought to Texas Children’s via ambulance. Having access to the hospital’s helipad will allow for faster transport and subsequently quicker treatment.

“It’s one more way for us to be there for every child no matter what their needs are,” Graf said, adding that all four predominant helicopter services in southeast Texas now know they can bring patients to Texas Children’s Hospital West Campus. In the near future, they also will be able to land at Texas Children’s Hospital The Woodlands and on the roof of Pediatric Tower E in the Medical Center.

Since late October, four patients have been brought to West Campus via the hospital’s helipad and many more are expected. Before activating the helipad, West Campus received between 10 and 20 helicopter transports a month from nearby facilities. “Now that patients can be brought straight to West Campus’ doorstep, there’s sure to be more and we are happy to be able to serve them,” Graf said.

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Each year, Texas Children’s Heart Center honors its founder, Dr. Dan McNamara, with a grand rounds dedicated to pediatric cardiology. This year’s speaker was Dr. Chris Feudtner from Children’s Hospital of Philadelphia Department of Medical Ethics and the Pediatric Advanced Care Team. Feudtner spoke to a standing-room only audience of physicians at McNamara Grand Rounds in the Texas Children’s Hospital Auditorium. The subject of his talk, compassionate confrontations: integrating hopes, emotions and duties when confronting serious illness, was a message of giving care to families coping with difficult decisions and grim prognoses.

“Even though I am one of you and I like living and working at the hospital, no parents likes hospitals and we have to remember that,” Feudtner said. “When communicating with parents, we need to remember we’re all feeling beings who have thoughts.”

Feudtner gave several examples of relaying difficult news to patient families. He encouraged providers to ask parents their hopes for their child. Acknowledging that hope as well as the hopes that can be achieved.

“Don’t argue with someone’s hope. Respect and honor patient family’s hopes and allow them to share other hopes that can then help you with the course of action you take with their child’s care,” Feudtner said.

Feudtner suggested to thank parents for sharing their first hopes, which will almost always be false hope characterized by Feudtner as “duty-based hope” that allows parents to remain wishful that the prognosis will improve against all odds. His suggestion, acknowledge the importance of this hope and how as a caregiver, you too wish this were possible, but ask for other hopes which opens the door for dialogue.

“The parents then may say they hope their child is not in a lot of pain,” Feudtner said. “When the second and third hopes are shared, it’s easier for you to say ‘I can help with that.’”

Feudtner ended the conversation by encouraging the health care providers to be in partnering relationships with patients to move forward in care.

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Dr. Sandi Lam, co-director of the Texas Children’s Hospital Craniofacial Surgery Program, was recognized at a recent Baylor College of Medicine Neurosurgery Grand Rounds with the inaugural Rising Star in Resident Education award. The award is given to a neurosurgery junior faculty member who demonstrates excellence in teaching.

Dr. Daniel Yoshor, chief of the Department of Neurosurgery at Baylor, presented Lam with the award. “Dr. Lam is a dynamic and natural teacher and has quickly made her mark in resident and medical student education in neurosurgery at Baylor,” he said.