June 29, 2016

7616DrElizabethCollins175Dr. Elizabeth Collins, associate professor of Pediatrics, Baylor College of Medicine; and Texas Children’s Health Center for International Adoption received the Alumni of the Year Award from Southern Illinois University School of Medicine.

The award was presented at the commencement ceremony in May in Springfield, Illinois for Distinguished Service and “for an outstanding commitment to the health & welfare of their patients and their community and for humanitarian activities.”

June 28, 2016

View a testimonial from Pharmacist Margo Hanerhoff about what is like to work at Texas Children’s.

62916DrSchutt640Hearing the words, “you’re pregnant” can be an exciting, life-changing moment. But for many couples struggling with infertility, the journey to parenthood can be filled with frustration, stress, and at times, hopelessness.

Dr. Amy Schutt, a reproductive endocrinologist and surgeon who recently joined the Family Fertility Center at Texas Children’s Pavilion for Women, knows these struggles since she faced infertility challenges of her own.

“While in medical school, I was learning how to be a physician, but at the same time – unknown to most family, friends and colleagues – I was also learning how to be a patient,” Schutt said.

After a miscarriage, two surgeries, countless ultrasounds and unsuccessful infertility treatments, Schutt and her husband ultimately conceived their now 7-year-old daughter through in vitro fertilization (IVF).

“My daughter was born in my fourth year of medical school and she is a living, breathing testament to the medical and scientific advances that made her possible,” Schutt said. “What I didn’t know then, but know now, is that facing infertility taught me lessons about caring for women in ways that the classroom could never teach me.”

With her uniquely compassionate approach to care that comes from her own experience as an infertility patient, Schutt combines her clinical knowledge, surgical skills and research to advance the understanding of infertility and subsequently develop innovative treatment approaches to improve successful pregnancy outcomes.

While specializing in the care and treatment of reproductive and hormonal disorders like polycystic ovary syndrome, Schutt has extensive training in groundbreaking surgical techniques to treat the most challenging reproductive and endocrinology cases, including rare congenital anomalies of the reproductive tract. She finds it highly rewarding to provide continuity of care for her patients, helping women achieve conception after successful surgical treatment.

Schutt’s contributions to research has helped advance the treatment and understanding of reproductive and endocrinology disorders, including the influence of maternal health factors such as diet and obesity on a woman’s fertility and the long-term health of her baby. Currently, Schutt is collaborating with colleagues to examine the effects of protein restriction on egg quality before pregnancy to see whether a diet rich in protein optimizes egg health and development. In a separate study, Schutt is also looking at the effects of obesity on female fertility by studying the granulosa cells collected during IVF. These cells feed signals to the egg during the maturation process.

Prior to joining the Family Fertility Center, Schutt received her medical degree from Texas Tech University School of Medicine followed by an OB/GYN residency at the University of Virginia Health System. She recently completed a three-year fellowship in reproductive endocrinology and infertility at Baylor College of Medicine.

“We are excited to have Dr. Schutt join our team,” said Dr. William Gibbons, director of the Family Fertility Center and chief of reproductive endocrinology services at Texas Children’s. “She brings compassion, ability, enthusiasm and a diverse skill set to our Family Fertility Center family. I can’t wait to watch where she takes us.”

For Schutt, there’s one thing that fuels her passion more than anything – helping her patients achieve their dreams.

“I look forward to calling my patients with positive pregnancy tests, to celebrating pregnancy ultrasounds and to receiving birth announcements,” Schutt said. “My personal and educational experiences have taken me full circle and I look forward to being part of this incredible team at the Family Fertility Center.”

Click here to watch a video tour of the Family Fertility Center. If you have questions, want to schedule an appointment with the Family Fertility Center team of Drs. William Gibbons, Amy Schutt, Terri Woodard and Paul Zarutskie, or learn more about the benefits available to full-time Texas Children’s employees, call Ext. 6-7500.

62916usnews640It’s one of parents’ worst fears – their child has a complex or life-threatening illness. How do they decide where to go for the comprehensive care their child needs?

Over the years, the U.S. News & World Report Best Children’s Hospitals rankings have helped thousands of parents identify top sources of care for children with the most difficult medical problems. And Texas Children’s Hospital has consistently been among them.

On the 2015–16 Best Children’s Hospitals Honor Roll, which recognizes pediatric centers that are highly ranked in multiple specialties, Texas Children’s, working closely with academic partner Baylor College of Medicine, ranked no. 4 in the nation for the fifth consecutive year. It is the only children’s hospital in Texas on the Honor Roll.

“We’re rightfully proud of the great work that Texas Children’s does day in and day out on behalf of sick children and their families, but we know we have room for improvement,” said Texas Children’s Physician-in-Chief Dr. Mark W. Kline. “To the degree that the U.S. News survey can help us develop a blueprint for being the world’s best and highest quality pediatric health care institution, we are pursuing that.”

In a process that has become increasingly rigorous and data driven, the U.S. News rankings enable hospitals to look in the mirror and scrutinize themselves.

“Do we like the reflection? Are we as good as we think we are?” asked Dr. Angelo P. Giardino, senior vice president and chief quality officer at Texas Children’s. “In many cases, we are, and we’re thrilled because we are a really great children’s hospital. But there are opportunities where we look in the mirror and we say, ‘We could really do that better.’”

Rankings evolve

Beginning in 1990, as part of the Best Hospitals list, the pediatric rankings were 100 percent reputational for more than 15 years, based entirely on a survey of pediatricians and pediatric specialists across the country, asking them to identify the best children’s hospitals.

When U.S. News decided to rank pediatric hospitals separately from adult hospitals, the publication faced a challenging absence of data. While adult hospital rankings were drawn from Medicare data, no comparable source of information about children’s hospitals was available. As a result, U.S. News enlisted RTI International, a nonprofit research and consulting firm that was already the contractor for the Best Hospitals rankings, to develop a methodology for obtaining data directly from the hospitals and to analyze the results.

The first rankings incorporating such data were published in 2007 as General Pediatrics. Texas Children’s Hospital was listed among the top 30 children’s centers.

In 2008, rankings in six specialties, including cancer and neonatal care, were added to the children’s hospital rankings. In 2009, a newly created Honor Roll listed the 10 children’s hospitals out of 160 surveyed that were ranked in all the specialties, which had been increased from six to 10.

The 2015-16 Honor Roll required a hospital to rank in the top 10 percent in three or more specialties. Only 12 pediatric hospitals qualified among 184 surveyed nationwide. Texas Children’s has appeared on every Honor Roll.

In 2015, Texas Children’s ranked no. 2 in three specialties: cardiology/heart surgery, neurology/neurosurgery and pulmonology. Texas Children’s ranked among the top five hospitals in six specialties and in the top 30 hospitals in all 10 specialties.

“The original purpose of the Best Hospitals rankings was to inform patients and families and help them make decisions,” said Health Rankings Editor Avery Comarow, who has directed the Best Hospitals projects since their beginnings. “I now recognize that we don’t necessarily have to just reflect performance. We can also drive it by incorporating metrics that reflect that goal. Every year, our contractor, RTI International, meets with medical experts to evolve the methodology in ways that not only reflect what children’s hospitals are doing, but ways in which they could and should be doing better.”

Quality framework

Today, the U.S. News Best Children’s Hospitals rankings use a well-accepted framework for evaluating the quality of health care:

Structure: hospital resources related to patient care, such as the ratio of nurses to patients, specialized clinics and programs, and certification by external organizations.

Process: compliance with best practices in diagnosis, treatment, prevention and patient education. As a part of the process, reputation now counts as 16.7 percent of the overall score, down from the original 100 percent.

Outcomes: factors such as rates of survival, infection, mobility and cure.

The increasing emphasis on quality measures had strong support from the late Dr. Bernadine Healy, a former director of the National Institutes of Health, who was health editor of U.S. News before her death in 2011.

“Her expertise and perspective were invaluable,” Comarow said. “She had such a strong sense of the things that were important to patients and families. She brought that same perspective to some of the choices that we made in trying to decide which measures to highlight, what sort of weight to give them, how many hospitals we should assign rankings to, and where we would run out of meaningful data as opposed to numbers that looked OK but were not terribly reliable statistically.”

As U.S. News shifted the emphasis toward quality measures, Texas Children’s shifted coordination of the survey response from its Marketing/PR Department to its Quality and Safety Department.

Team effort

The evolution into quality led us to bring all the chiefs of medical and surgical services to the table,” said Mary Jo Andre, senior vice president and chief nursing officer and former senior vice president of Quality and Safety. “The more that quality and best practices were built into the survey, the more accountability of the survey shifted from an administrative standpoint to the medical staff.”

To help build physician engagement, Giardino and Thomas Luerssen, chief quality officer – surgery, were appointed quality officers for Pediatrics and Surgery, respectively, in 2013. The next year, Giardino was named to his present position as chief quality officer of Texas Children’s, and Eric Williams, succeeded him as quality officer for Pediatrics. They work closely with teams of physician section chiefs, practice administrators and data specialists.

Although only 10 clinical areas are ranked, a total of about 20 different services contribute to the survey, such as Radiology, Emergency Services, Intensive Care, Social Work and Nutrition. For example, nursing certification, attention to safe practices and increasing specialty roles of nurses appear in each section of the survey. Texas Children’s receives points for safety because of the hospital’s Magnet certification by the American Nurses Credentialing Center.

“Any outcome is a partnership of nursing and physicians,” Andre said. “The question directly related to nursing is about staffing. Seeing how we compared to the rest of the country has been a good thing for nursing, because it’s driven us to have higher standards as well.”

More than 100 people at Texas Children’s contribute to the survey each year, submitting more than 1,500 survey elements in all. Texas Children’s also is represented in four of the working groups that RTI consults each year in continuing to refine the methodology. Involvement in quality improvement at Texas Children’s is even more far-reaching. More than 400 staff members have been trained in Advanced Quality Improvement.

“Quality improvement, which Texas Children’s is passionate about, extends everywhere,” said Dr. Charles D. Fraser, Jr., chief of Congenital Heart Surgery and surgeon-in-chief at Texas Children’s. “Quality starts immediately when the patient or family arrives here. Everyone is important, whether you’re in housekeeping or food services, the cardiac intensive care unit or are an administrative executive. Everyone is responsible for quality.”

Gap analysis

Texas Children’s analytics team provides data to each section chief with a detailed analysis of the gaps between the section and comparable data from top-ranked peer institutions in the Best Children’s Hospitals rankings. The service chiefs and their clinical and administrative teams review the data closely and objectively, identifying gaps and opportunities to improve quality, access or outcomes.

For example, in Texas Children’s Diabetes and Endocrinology section, gap analysis revealed several opportunities for improvement that are being addressed. To help deal with limited patient access, four new pediatric endocrinologists have been hired. To reduce disease complications, timely alerts now appear on physicians’ computers, reminding them to schedule their patients for tests for thyroid problems, kidney complications and early signs of diabetic retinopathy, which is associated with blindness.

“The U.S. News rankings are a wonderful opportunity to shine a light on potential problem areas and to allow us to make the care that we deliver better, more effective and more patient centered,” said Dr. Jake Kushner, chief of Diabetes and Endocrinology at Texas Children’s.

The rankings not only help identify gaps where improvements are needed, but also provide data to build the case for needed changes.

“Many of the service chiefs and practitioners have said, ‘We’ve been wanting this – this process, this equipment, this type of clinic – for years, and here it is in the survey,’” said Terri Brown, assistant director of Clinical Outcomes and Data. “So they are able to leverage the survey to help achieve what they already know to be good ideas.”

As the Best Children’s Hospitals survey focuses more and more on ways to improve outcomes, the transparency and accountability of the published rankings are helping to improve children’s health care nationally.

“If you look at the hospitals on the Honor Roll, we’re all delivering great care to children and families,” Giardino said. “Everybody’s working hard to get better. So the bar keeps moving higher. And that’s the whole point.”

62916NolanDayRings640Watch ABC-13’s story about 4-year-old Nolan celebrating the end of his long journey with cancer by ringing the end-of-treatment bell.

62916HEI640Texas Children’s was recently recognized as a “Leader in LGBT Healthcare Equality” by the Human Rights Campaign (HRC) Foundation, the educational arm of the country’s largest lesbian, gay, bisexual and transgender (LGBT) civil rights organization.

Every year, the HRC conducts a unique survey called the Healthcare Equality Index (HEI), which benchmarks and encourages equal care for LGBT individuals by evaluating inclusive policies and practices related to LGBT patients, visitors and employees in healthcare organizations throughout the nation.

For the HEI 2016 report, more than 2,000 health care facilities nationwide were included in the survey – a record 568 health care organizations voluntarily participated while the rest were proactively researched by HEI. Texas Children’s is one of only three hospitals – and the only pediatric facility – in Houston to achieve the “Leader in LGBT Healthcare Equality” award.

In order to receive this leadership distinction, Texas Children’s fulfilled the HEI’s Core Four Leader Criteria, which focused on policies and practices considered foundational for equitable and inclusive LGBT care such as patient and employee non-discrimination, equal visitation and training of key staff members.

“We are very proud of this designation. Our philosophy of family-centered care is contingent on providing a safe and respectful environment for our patients and their families as well as our caregivers to foster open communication and teamwork.” said David Wykes, director of Employee Relations. “As a leader in pediatric health care, we must lead by example, and this designation further exemplifies Texas Children’s dedication to our mission of providing quality health care to our patients and families regardless of age, gender identity, sexual orientation and ability to pay.”

Click here to learn more about the HEI.

June 21, 2016

62216globalhealth640Texas Children’s global health initiative recently expanded its services in Europe and Africa, enabling more children and adults across the globe to receive quality medical care. Two of the initiatives will help children in Africa who are suffering from cancer. The third effort will aid both adults and children living in Romania with HIV, hepatitis and tuberculosis.

Romania

The Romania initiative occurred June 6 when Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children’s Hospital (BIPAI) formally opened the expansion of its center of excellence in Constanta, Romania, a port city hit hard by the AIDS epidemic.

“The addition of a third floor to our center of excellence marks an important milestone in our life-saving work here in Romania,” said Dr. Mark W. Kline, Texas Children’s Hospital physician-in-chief and BIPAI president. “What began as a center for children with HIV now has transitioned to a center for the long-term care of adults with HIV, along with the identification and care of patients with hepatitis and tuberculosis.”

AbbVie and the AbbVie Foundation (formerly Abbott and Abbott Fund) have been the lead sponsor of the BIPAI Romania program since its launch 15 years ago in 2001, investing $7.7 million in its HIV/AIDS and hepatitis programs, and providing $35.9 million in medications in partnership with AmeriCares.

“We are grateful for the opportunity to partner with BIPAI in Constanta for the past 15 years,” said Melissa Walsh, vice president of the AbbVie Foundation. “The program has become the model for many pediatric HIV/AIDS centers of excellence around the world, and we are proud to support the broadening of its life-saving work for patients, including liver disease.”

Malawi

The AbbVie Foundation, along with the Abbott Fund, also helped fund the recent cancer initiative in Malawi. On June 9, BIPAI, the AbbVie Foundation and the Malawi Ministry of Health reopened two renovated pediatric wards and dedicated a new pediatric hematology/oncology unit at Kamuzu Central Hospital.

“We are honored to celebrate this milestone for the Baylor College of Medicine and Texas Children’s Hospital,” Walsh said. “The Malawi program has transformed the lives of thousands of children and their families living with HIV/AIDS and we are so proud to support the expansion of that work into the pediatric cancer space.”

In addition to AbbVie, the Chevron Corporation also supports the Malawi program, funding its only pediatric oncologist, Dr. Peter Wasswa of Baylor College of Medicine and Texas Children’s Cancer Center.

“Today’s ceremony provides further evidence of our continued commitment to the children of Malawi,” said Michael Mizwa, chief operating officer, BIPAI, and director, Texas Children’s Global Health. “We look forward to another decade of expanding our programs to meet the needs of sick children, including care and treatment, professional education for physicians and other healthcare professionals, and ground-breaking research.”

Botswana

The second effort dedicated to helping children in Africa with cancer occurred on June 13 in Botswana when the Botswana-Baylor Children’s Center of Excellence and the government of Botswana signed a memorandum of agreement to build the first children’s hematology and cancer center of excellence in Gaborone.

“Approximately 40,000 children a year are diagnosed with cancer in sub-Saharan Africa and 20 percent of those children survive, compared with 80 percent in the U.S.,” said Dr. David Poplack, director of Texas Children’s Cancer and Hematology Centers. “This COE (Center of Excellence), in partnership with the Botswana Ministry of Health, will change those numbers in favor of the children of Botswana.”

When pediatric oncologists from Texas Children’s Hospital began working at Princess Marina Hospital in Gaborone, it was the first pediatric oncology program on the continent. The recent agreement between the Botswana-Baylor Children’s Center of Excellence and the government of Botswana expands that commitment to include the first stand-alone cancer center of excellence devoted exclusively to the treatment of children with cancer and blood diseases.

“The purpose of this agreement is to provide finance, design, construction, operation and maintenance of the state-of-the-art Botswana Children’s Hematology and Cancer Center which will be built next to the teaching hospital at the University of Botswana,” said Shenaaz el Halabi, permanent secretary at the Ministry of Health. “The Ministry of Health has had good relations with BIPAI dating as far back as 1999, which gave birth to the Baylor Children’s Center of Excellence in 2003. Since 2006, pediatric oncologists from Texas Children’s have been working at Princess Marina Hospital.”

The partnership responsible for the development and management of the Children’s Cancer Center includes: the Botswana Ministry of Health, Baylor College of Medicine Pediatric AIDS Initiative (BIPAI) and Texas Children’s.