February 23, 2016

22416zikatesting640Pathologists and clinical laboratory scientists at Texas Children’s and Houston Methodist Hospital developed the nation’s first hospital-based rapid test for the Zika virus in a matter of weeks as part of the L.E. and Virginia Simmons Collaborative in Virus Detection and Surveillance.

This collaborative program was established to facilitate rapid development of tests for virus detection in a large metropolitan area. These tests are customized to each hospital’s diagnostic laboratory and designed to provide results within several hours. Before the Zika test was developed, physicians faced the possibility of long delays of testing in local and state public health laboratories and the Centers for Disease Control (CDC).

Texas Children’s Pathologist-in-Chief Dr. James Versalovic and Dr. James Dunn, director of medical microbiology and virology, led Texas Children’s team tasked with developing a rapid test for Zika virus.

Transmitted primarily through mosquito bites, Zika is a flavivirus that contains RNA as its genetic material. This new diagnostic test identifies virus-specific RNA sequences to detect Zika virus and can distinguish Zika virus from other virus infections like Dengue, West Nile or Chikungunya. Every viral particle contains genes in its RNA and these RNA sequences are directly detected on blood, amniotic fluid, urine and spinal fluid.

Currently, only registered patients at Texas Children’s or Houston Methodist hospitals can receive the test but the labs will consider referral testing from other hospitals and clinics in the future.

The test will be initially offered to patients with a positive travel history and symptoms consistent with acute Zika virus infection such as a rash, arthralgias or fever, or asymptomatic pregnant women with a positive travel history to any of the affected countries. The World Health Organization has advised pregnant women to consult their doctors before traveling to places with Zika virus outbreaks and consider delaying travel. The CDC issued similar guidelines to pregnant women last month.

“With travel-related cases of the Zika virus becoming more prevalent in the U.S. coupled with the looming increase in mosquito exposure during spring and summer months, we must be prepared for a surge of Zika testing demand,” Versalovic said. “We must provide answers for anxious mothers-to-be and families who may experience signs and symptoms or may simply have a travel history to these endemic areas.”

Click here for more information about the Zika virus and what Texas Children’s maternal fetal task force is doing to develop strategies based on CDC screening guidelines for pregnant women who may have been exposed to the Zika virus.

22416simulationinside640The neonatal team at Texas Children’s Pavilion for Women is always prepared for special deliveries – taking care of newborns is what they’re trained to do. But earlier this month, the neonatal intensive care unit (NICU) received a special delivery that wasn’t quite what you’d expect.

Texas Children’s Simulation Center hosted an open house to introduce Tory, a high-fidelity infant mannequin, and the newest addition to the first-ever Neonatal Comprehensive In Situ Simulation Program launched at the Pavilion for Women’s Newborn Center. The simulation equipment and supplies were purchased with a generous $200,000 grant from the M.D. Anderson Foundation, which will also support an in situ simulation program for the Emergency Center and Critical Care, as well as one for the NICU in West Tower once a dedicated space for simulation has been identified.

“We’re grateful to our Newborn Center leadership for dedicating a simulation room at the Pavilion,” said Dr. Jennifer Arnold, medical director of the Simulation Center. “Now, our NICU providers can train in their actual practice environments during regular workdays to enhance individual and team performance – particularly in high-risk situations – and improve patient outcomes and safety.”

The in situ simulation program focuses on improving crisis resource management skills, one of which is role clarity. During a code, the potential for confusion and chaos can easily set in as responders attempt to care for a patient in a high-risk medical emergency. Clinicians responding to a code may not always be sure of their roles or the roles of their team members when they arrive, and that’s when in situ simulation training becomes crucial to patient safety and care.

“First, we conducted tests to determine the necessary roles in a crisis, whether it’s a resuscitation or a code,” said Dr. Mona Khattab, one of the in situ simulation program directors for the NICU. “By having the necessary personnel at the code, we alleviate staff overcrowding and ensure optimal efficiency and clear communication are achieved while delivering lifesaving treatment to our NICU patients.”

Inside the simulation room, colored labels – red, yellow and green – are affixed to the floor that encircle the bedside. These labels identify the specific roles of each of the code response participants and directs them to their position on the floor during a medical emergency.

  • The red team consisting of clinicians and nurses stand in the innermost circle closest to the bedside where they provide direct patient care.
  • The yellow team is positioned behind the red team. They support patient care providers by documenting the code, handing over equipment, managing the ventilator and medication and blood prep drawers, and providing mentorship and consultations to the team leader as needed.
  • The green team stands in the back of the room near the code cart and provides overall code and room support to ensure everything is running seamlessly.

“When a text message page is sent, the unit reports to the simulation room as if it were an actual page in the unit to respond to a code,” said Kellie Kainer, assistant director of Nursing for the NICU at the Pavilion for Women. “We give them a brief history of the patient and alert them to the code.”

The in situ simulations will occur every Thursday and last 10 minutes followed by 20 minutes of debriefing. The NICU teams alternate every week and are selected based on their current assignment and the flow of the unit on that particular day.

“We’re focusing on one specific patient case so that everyone gets exposure to that case,” said Dr. Leigh Ann Cates, a neonatal nurse practitioner and a program director for the in situ simulation program. “As our program expands, we hope it will become a model for in situ simulations in other units of the hospital.”

In preparation for this training, all clinicians within the Newborn Center complete an online pre-simulation course through Healthstream. The Simulation Center developed a series of powerpoint presentations covering crisis resource management skills, an orientation to simulation, and what to expect during simulation such as a confidential and psychologically safe learning environment.

22416lifesaving640When Dr. Natasha Afonso clipped in to a bike for a spin class on a recent Thursday evening, she didn’t know the skills she uses each day to treat patients in the CVICU would mean the difference between life and death for a fellow rider. Toward the end of the 45-minute, high-intensity class, Afonso heard commotion behind her as riders were being ushered out of the room. When she turned around she saw 50-year-old Scott Corron lying motionless on the ground.

She jumped off her bike and found Corron cold, clammy and pulseless. Because she didn’t see him fall, she thought he may be dehydrated, but because he wasn’t breathing Afonso immediately started CPR.

“It’s surprising to see someone go into cardiac arrest outside of the hospital setting,” said Afonso. “I didn’t have time to get my own heart rate down much less think about what caused Scott to stop breathing, so I started compressions.”

When the paramedics arrived 15 minutes after Afonso started CPR, she assisted with quickly placing the electrode pads on him. The paramedics shocked Corron before resuming compressions and he was fairly alert as the ambulance whisked him off to the hospital.

Corron, who has ironically worked in cardiology device sales for more than 20 years, credited Afonso’s quick thinking and action which has led to a full recovery.

“Words aren’t enough to thank Dr. Afonso for saving my life,” said Corron. “I hope to be back on the bike soon and am so thankful she decided to take a spin class that night.”

To see the reunion between Afonso and Corron, watch this recent NBC 2 KPRC story.

22416CVS640Texas Children’s works hard to minimize the impact of rising health care costs to our employees. That is why we have partnered with our prescription benefits manager, CVS/caremark to bring an additional benefit. Very soon those enrolled in the Texas Children’s Medical Plan will be receiving an ExtraCare Health Card that provides savings of 20 percent on all CVS/pharmacy brand health-related items. In addition, 2 percent back in ExtraBucks rewards will be awarded when using the ExtraCare Health Card.

That is a 20 percent savings everyday on thousands of items to help you on your path to better health. Think of all the non-prescription items you use on a regular basis in which you can take advantage of these savings, such as:

  • Allergy medicines
  • Cold medicine
  • Eye drops
  • First-aid supplies
  • Pain relievers
  • Vitamins

You will be able to use your card at any CVS/pharmacy location or online at www.cvs.com. Please note, only two ExtraCare Health Cards will be mailed per household. If you already have an ExtraCare Card from CVS/pharmacy, you can simply transfer your current rewards to your new ExtraCare Health Card and start enjoying the 20 percent savings. Savings will be automatically deducted off eligible health-care items.

Don’t forget that CVS/caremark has a mail-order program that offers you deeper discounts through bulk purchasing and no dispensing fees, which mean lower out-of-pocket pharmacy costs. For more information about the benefits offered at Texas Children’s, please visit TexasChildrensBenefits.org.

22416SSAngelinaRangelinside175Angelina Rangel of Nursing Professional Development is the latest Texas Children’s Super Star leader. “A super star is someone who is constantly striving to improve, constantly learning, working to be the best they can be as a person and as a coworker,” Rangel said. “Also this person takes ownership.” Read more of Rangel’s interview and find out how you can nominate a Super Star

Q&A: Angelina Rangel, October – December 2015 Leader

Your name, title and department. How long have you worked here?
Angie Rangel, MSN, RN, CCRN, LNC – Assistant Director of Nursing Professional Development. I have been at Texas Children’s Hospital for 24 years.

What month are you Super Star for?
October – December 2015

Tell us how you found out you won a super star award.
My leader set up a meeting to discuss events for the week. He asked me meet him in the conference room. When I arrived at the conference room, the entire team from Nursing Professional Development was there to surprise me with cake, food and gifts.

What does it mean to be recognized for the hard work you do? How has the organization helped you achieve your personal and professional goals?
I was touched and honored by this recognition. Prior to being employed at Texas Children’s, one of my personal goals was to find an organization where I felt good about going to work. A positive work environment gives any employee motivation throughout the day. I started my career at Texas Children’s as a registered nurse in the NICU-3 in 1991. Honestly I don’t remember a day when I did not feel valued and appreciated by my coworkers and leaders. In turn, I appreciate all of my colleagues as well. With the support of Texas Children’s Hospital’s tuition reimbursement program, I was able to go back to school for MSN/MBA and advance my career from bedside nurse to charge, preceptor, educator, manager and currently as the assistant director of Nursing Professional Development. In every role that I have held, I have felt appreciated and recognized for even the small things that I felt that really didn’t matter. Texas Children’s is a great place to work.

What do you think makes someone at Texas Children’s a super star?
Someone who is constantly striving to improve, constantly learning, working to be the best they can be as a person and as a coworker. Someone who takes ownership, and apologizes if appropriate. Someone who brings high energy, commitment and enthusiasms that causes others around them to respond positively.

What is your motivation for going above and beyond every day at work?
When one feels valued and appreciated, it is a natural motivation to go above and beyond.

What is the best thing about working at Texas Children’s?
As social beings, we naturally seek support from our peers and seek to belong to a group. I found the sense of unity with every team that I have had the privilege of working with at Texas Children’s. A strong team spirit. I appreciate the acceptance and tolerance of differences in perspectives and working styles between team mates. I especially am blessed to be working alongside my current teammates and leaders. There is such cohesiveness among this team.

What does it mean to you that everyone at Texas Children’s is considered a leader? What is your leadership definition?
It means that everyone has a voice. It means leading a life of action. Taking action in your own life, and making the changes that you want to see and focusing on the things you can control. Leadership is a style of persuading. It is about setting an example of inspiration and service. A true leader is a servant, ethical and authentic.

Anything else you want to share?
     Many years ago my father told me “if you want to be a leader, you need to be a servant”. Although at that time, I didn’t understand his statement. But later I understood exactly what he meant. The idea of servant leadership isn’t new. Robert K. Greenleaf first coined the term servant-leadership in a 1970 essay.
     In his works, Greenleaf discusses the need for a better approach to leadership, one that puts serving others – including employees, customers, and community – as the number one priority. Servant leadership emphasizes increased service to others, a holistic approach to work, promoting a sense of community, and the sharing of power in decision making. In his works, Greenleaf discusses the need for a better approach to leadership, one that puts serving others – including employees, customers, and community – as the number one priority. Servant leadership emphasizes increased service to others, a holistic approach to work, promoting a sense of community, and the sharing of power in decision making.
     Some of the characteristics of the servant leader are what I see in the leaders that I work with at Texas Children’s. I have seen the servant leader characteristics in the staff from environmental services to Mr. Mark Wallace. That is why this organization is where it is today. I thank God that I am part of this great organization with leaders who exhibit the philosophy and model of a servant leader. Some of the characteristics of the servant leader are what I see in the leaders that I work with at Texas Children’s. I have seen the servant leader characteristics in the staff from environmental services to Mr. Mark Wallace. That is why this organization is where it is today. I thank God that I am part of this great organization with leaders who exhibit the philosophy and model of a servant leader.

22416blaneyaward640The Children’s Brain Tumor Foundation honored Dr. Susan Blaney with the Pioneer Award for Pediatric Neuro-Oncology, celebrating her 25 years of dedication to the search for new and better treatments for children with brain and spinal cord tumors.

Blaney is the deputy director of Texas Children’s Cancer Center, a professor and executive vice chair of the Department of Pediatrics at Texas Children’s and Baylor College of Medicine, and she also serves as vice president of Clinical and Translational Research at Baylor.

Blaney’s extensive experience in clinical translational research focuses on developing new treatment strategies for children with brain tumors and other refractory cancers. Blaney has been instrumental in developing more new agent clinical trials than anyone in the field of pediatric oncology.

Blaney serves as vice chair for the Children’s Oncology Group and was one of the initial members of the Pediatric Brain Tumor Consortium (PBTC). Additionally, she serves as a mentor to numerous pediatric neuro-oncology fellows and faculty who are current or developing leaders in the field. Among other appointments and positions, she is a member of the National Cancer Institute’s (NCI) Clinical Trial Advisory Committee and serves on the Executive Committee for the NCI-funded Pediatric Brain Tumor Consortium. She has served as a member of the Investigational Drug Steering Committee for the National Cancer Institute and as a regular consultant for the Food and Drug Administration’s pediatric Oncology Drug Advisory Committee.

Blaney has published more than 190 articles in peer-reviewed journals and has authored numerous book chapters. She is dedicated to the development of new anti-cancer agents and therapeutic strategies for malignant central nervous system tumors of childhood and to decreasing the morbidity of current therapeutic strategies. In addition, she is passionate about the mentorship of young faculty members in clinical and translational research to ensure that there is sustained leadership in the field.

22416JenniferDietrichinside175Chief of Pediatric and Adolescent Gynecology Dr. Jennifer Dietrich has been voted president-elect of the North American Society for Pediatric and Adolescent Gynecology.

Her tenure as president-elect begins in April. She will be voted in as president in April 2017.

“I am extremely honored to have been chosen for this position,” Dietrich said. “I will carry my banner for pediatric and adolescent gynecology not only on behalf of the North American Society for Pediatric and Adolescent Gynecology, but also for Baylor College of Medicine and Texas Children’s Hospital.”

The organization is the premier society that provides gynecologic care to children and adolescents.