October 26, 2016

102616chroniclenowad250Texas Children’s is the honored sponsor for every Tuesday’s “Houston Legends” series. We will showcase the legendary care Texas Children’s has provided since 1954, and focus on milestone moments in our unique history. Also, a complementary website offers a more detailed look at our past, our story and our breakthroughs.

On the right is the Texas Children’s ad that is featured in this week’s Chronicle. Click the ad to visit our companion website at texaschildrens.org/legendarycare. The website will change weekly to complement the newspaper ad, which will be published in section A of the Chronicle on Tuesdays for one more week. We also will spotlight this special feature weekly on Connect, so stay tuned to learn and share our rich history.

October 25, 2016

Angela Logan held up the sleeve of her Halloween-themed scrub and looked stoically ahead as a nurse with Employee Health & Wellness gave her an annual flu vaccine.

Logan, a certified medical assistant, said during one of Employee Health and Wellness’ recent flu vaccine events that she’s been getting the flu shot since she was 14 or 15 years old.

“My mom was a pediatric nurse and she always encouraged me to get it,” Logan said. “She told me it was to protect myself and those I love and care for both at home and at work.”

So far this flu season, Logan is one of 7,000 Texas Children’s employees who have gotten their flu shot, bringing our vaccinated employee population to 60 percent. The remaining 40 percent of Texas Children’s employees are highly encouraged to get their free flu vaccine from Employee Health and Wellness at one of the remaining flu vaccine events or by contacting Employee Health and Wellness to schedule a time to come by the Employee Health Clinic to receive a shot.

Click here for flu vaccine event schedules and here to see pictures from one of the events. It is recommended that employees complete their online consent form via the Employee Health and Wellness Portal before attending a flu vaccine event – click here for instructions. However, employees are able to fill out the consent form at the events as well.

Texas Children’s provides the seasonal influenza vaccinations at no cost to:

  •  Texas Children’s employees
  •  Texas Children’s medical staff
  •  Texas Children’s volunteers
  •  Baylor College of Medicine employees working in Texas Children’s facilities
  •  Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will receive separate instructions from their leaders about seasonal flu vaccination.

Influenza (the flu) is a contagious respiratory illness caused by influenza viruses. It can cause mild to severe illness and can even lead to death. Older people, young children, and people with certain health conditions are at high risk for serious flu complications. The best way to prevent the flu is by getting vaccinated every year.

“The benefits of not having to worry about the flu and the benefits of not having to worry about giving the flu to someone else are way better than any side effects that are common from the it,” said Dr. David Huss, a resident with the Child Neurology Program. “Your arm might be sore for a couple of days but that’s worth the cost.”

Stay tuned for updates about Texas Children’s seasonal vaccination program. If you have questions, please call Employee Health at 832-824-2150, option 1.

For more information about the flu and the flu vaccine, visit the Centers for Disease Control and Prevention website here.

102716towere640“It’s amazing how quickly the pediatric tower is being built,” said WenZheng Zhang, an administrative coordinator at Texas Children’s Cancer Center, as he observed the progress from his15th floor window at the Feigin Center. “It’s like watching ants use one LEGO block at a time to build the whole tower.”

Last December, the only visible sign of construction was the installation of the tower crane that was hoisted over the south end of Texas Children’s Pavilion for Women. Nearly one year later, tremendous progress has been made on the pediatric tower’s 19-floor vertical expansion project.

“We’re thrilled to see all of the pieces coming together,” said Jill Pearsall, Texas Children’s assistant vice president of Facilities Planning and Development. “So far, we’ve completed 12 floors, added 17 new elevators, and we have begun installing our Texas granite exterior walls on the structure.”

Beyond these visible achievements, lots of progress is also being made inside the tower. Earlier this year, a series of simulation activities were conducted to ensure the final layout of the pediatric tower would be designed in a way that promotes the safest possible environments to care for our critically ill patients and their families.

In June, Dr. Jennifer Arnold’s simulation team and the CareFirst Quality, Service and Safety Project Team led by Dr. Angelo Giardino, Trudy Leidich and Maria Happe, successfully completed two pre-construction simulation-based design tests on the proposed layouts for the OR/MRI and the Cath Lab/MRI suites.

Inside a large warehouse mock up resembling the planned design of the operating room and adjacent MRI, a multidisciplinary team of neurosurgeons, radiologists, nurses, respiratory therapists, anesthesiologists, patient families and other support staff participated in simulated patient care scenarios and provided their feedback. After OR/MRI simulations, the operating room was re-constructed as a Cath Lab and MRI.

“The design based simulations were invaluable,” said Janet Winebar, director of perioperative services at Texas Children’s. “With the Pediatric Tower, we are trying to create designs that drive efficiency and safety for our patient care, not just recreate our existing OR suites. Having actual spaces to simulate that care helped us to test our thoughts for design. We found that some of our designs needed tweaking to make them work.”

Key recommendations that emerged from the simulations included reconfiguring the MRI control rooms in the Cath Lab and Neuro OR to improve patient visibility and team coordination, modifying room entry doors to prevent barriers to safe access and patient transport, and repositioning equipment for easy access for all providers.

Design teams will integrate the clinical recommendations from all simulation activities into the final interior design of the critical care tower.

Other recent progress updates include:

  • An activation kickoff was held on September 26 for all departments involved in the activation of the Pediatric Tower. The meeting attended by more than 90 participants from over 40 departments revisited the purpose of CareFirst, the initial planning/completed work on the pediatric tower and the next steps for activation.
  • The interior design and color concepts have been finalized for the pediatric tower’s public spaces. The tower’s designated building color will be gold/yellow and the interior design theme is “The Beauty of Texas.”
  • Voalte wireless antennas were added to four ORs. Voalte technology roll-out will be completed by the end of October.
  • Interior build out construction is scheduled to begin in December once the City of Houston issues a building permit.
  • A topping out celebration is scheduled for February 9, 2017, to mark the construction milestone of completing the tower’s structure.

If everything continues to progress on schedule, Texas Children’s pediatric tower is slated to be completed by 2018.

102716starkidsinside350Three years ago, Jessica Coker of Willis, Texas, gave birth to her son, Christopher. Unbeknownst to Coker during her pregnancy, Christopher would be born with various medical issues. Christopher has apert (a cranio facial syndrome) and a heart murmur. He also relies on a trach and has, at times, needed a feeding tube.

After delivering her baby, the new mom was suddenly faced with needing to learn how to care for a child who would have very complex needs, as well as how to manage the comprehensive care he would need from more than two dozen specialists. Just in his first week of life, Christopher had 17 doctor’s appointments. As a newborn, Christopher was transferred to Texas Children’s and had a team of doctors here taking care of him, successfully treating some of his issues and managing others.

Today, the toddler still sees about 24 doctors at Texas Children’s and other medical facilities near his family’s home in Willis. He’s doing well, because he is receiving excellent care – and because his mother has created a system to manage and coordinate his complex care.

“We currently have great access to care,” Coker said. “I can call doctors directly, and they do a fantastic job when I need them the most. It’s a team approach that we’ve worked hard to establish.”

Coker’s fortunate to have figured out a system to manage her son’s care. Learning to advocate for and manage the care of children with complex medical needs is often critical to their ability to thrive and realize a decent quality of life. Beginning November 1, STAR Kids will provide the support these families need, and Texas Children’s Health Plan is leading the way. Last year, the Health Plan was selected by the Texas Health and Human Services Commission as one of three managed care organizations offering the STAR Kids plan in Harris, Jefferson and Northeast service areas.

“The STAR Kids contract allows the Health Plan to increase its reach to about 40,000 new children and teens in 54 counties,” said Texas Children’s President and CEO Mark Wallace. “These children see multiple specialists and therapists, and many receive home care services. They typically see at least one physician every week.

“Coordination and management of care is essential for these children. It helps prevent children with significant intellectual development disabilities or complex medical problems from falling through the gaps and provides a structure where their progress can be followed throughout the system.”

While many of the children transitioning into STAR Kids already are Texas Children’s patients, we expect thousands more to become part of the Texas Children’s system through enrollment in STAR Kids. In preparation for this patient volume, the Health Plan has already hired nearly 300 care coordinators.

“It is the strong partnership between the care coordinators and the families that will make this feel different even for the families already in the system,” said Texas Children’s Vice President Diane Scardino. “These care coordinators are registered nurses and certified social workers who will bring much needed support to families who are managing care for their children in what can sometimes be an incredibly complex system.

“They will visit with families, assess their children’s needs and develop care plans to address those needs. Texas Children’s will provide the resources around care coordination and home based services, creating a much more robust system of care for them.”

STAR Kids’ new care model is a huge step in supporting the unique needs of patients and their families, and improving their access to health care services, while also reducing preventable events or unnecessary visits to the hospital or care provider. There are about 180,000 children across Texas eligible for the STAR Kids program, with about 40,000 expected to be enrolled in Texas Children’s Health Plan.

“Texas Children’s is proud to be a part of this program that will mean so much to help so many families throughout Texas,” Wallace said. “This program and the work we will do to help ensure these families’ needs are met and that their children receive the best possible care speaks to our mission. This is what Texas Children’s has always done.”

Information about STAR Kids

FAQs about STAR Kids and Texas Children’s involvement
STAR Kids information on Texas Children’s Health Plan website
Texas Health and Human Services website

View a testimonial from Sports Medicine Physical Therapist Burke Wilson about what it’s like to work at Texas Children’s.

October 18, 2016

101916patientsafetyinside640Texas Children’s was recently named October 2016 Hospital of the Month by Solutions for Patient Safety (SPS) in recognition of our outstanding achievements in cultivating an environment of safe patient care.

The SPS is a network of more than 80 children’s hospitals across the U.S. that share a common vision that no child will ever experience serious harm while we are trying to heal them.

“At Texas Children’s, we care for some of the country’s most critically ill patients, and we understand safe, quality care for every patient is the most important responsibility of each staff member and employee here,” said Texas Children’s Chief Safety Officer Dr. Joan Shook. “Ensuring our staff and employees are equipped with the knowledge and tools to take preventive action are key to keeping our patients safe.”

Through our organization-wide error prevention training program implemented in 2014, employees and staff are now more comfortable in applying proven safety behaviors in their everyday work to ensure error prevention alertness and personal accountability are always top of mind. These safety behaviors include effectively communicating concerns requiring action, supporting a questioning attitude and using three-way communication to achieve greater clarity so that everyone speaks a common language in the delivery of patient care.

To propel error prevention training to the next level, Texas Children’s launched the Safety Coach Program which consists of clinical and nonclinical frontline staff and providers who are trained to observe employee interactions and provide feedback to reinforce safety behaviors and skills taught in error prevention training.

“Since the program’s launch in February of last year, we’ve had 16 classes and trained 334 coaches throughout the organization,” said Texas Children’s Patient Safety Specialist Tiffany Wrenn. “Our program has contributed to people’s’ increased comfort level in speaking up when there is a concern resulting in a 5.2 percent significant improvement in communication openness as reported in our latest AHRQ Hospital Patient Safety Culture Survey.”

The SPS also recognized Texas Children’s systemwide efforts in reducing hospital acquired conditions by reassessing current practices to identify areas of improvement.

When patients in the Epilepsy Monitoring Unit (EMU) developed a hospital acquired pressure ulcer (HAPU) due to skin breakdown from the electrodes affixed to their scalp and forehead during an electroencephalography (EEG) study, Texas Children’s Clinical Specialist Joellan Mullen and her EMU colleagues collaborated to develop techniques to enhance skin care management and HAPU prevention, which were later published in the 2014 Journal of Pediatric Nursing.

These best practices included using a less abrasive solution to remove oils from the skin before electrodes were placed on the forehead, wrapping a breathable fishnet dressing around the electrodes to prevent moisture and pressure buildup on the scalp and implementing wireless technology to allow greater mobility for EMU patients.

“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,” Mullen said. “Today, we have seen a reduction in HAPUs within our unit after implementing these changes.” The creation of the Skin Champions Program also helped staff reduce the number of pressure ulcers in the EMU and in high acuity areas of the hospital like the intensive care and cardiovascular units.

Other units experienced their share of collaborative successes. To reduce the occurrence of central line-associated blood stream infections (CLABSI) in the neonatal intensive care unit, clinical specialist teams collaborated with infection control partners to review current policies and practices against national standards which led to the creation of a massive educational initiative for nurses. More than 2,000 nurses across the organization were trained on several key skills in central line care.

“We went through hand hygiene, cap changes, dressing changes, just accessing the central line, since we are doing all of that differently than we used to,” said Nicole Sheets, a nurse in the Pulmonary Adolescent Unit. “No matter where you are in the hospital, the standard of care is now the same across the entire organization.”

To learn more about Solutions for Patient Safety, click here. To read more about our patient safety achievements, click here.

101916easeapp640At Texas Children’s Hospital we understand it’s hard to be a patient and that sometimes it’s even harder to be a loved one of those in our care, especially if they are undergoing surgery.

To help alleviate the anxiety of those sitting in the waiting room while their family member is on one of our operating tables, Texas Children’s Hospital is providing a resource that gives parents and/or guardians real-time status reports from the operating team.

Those updates come in the form of a HIPAA complaint text via an app called EASE or Electronic Access to Surgical Events. EASE allows doctors and nurses to securely communicate with families about their loved one from the surgery suite. Messages disappear within 45 seconds and nothing is saved on any device to insure private information stays that way.

“This application allows our families to leave the waiting room while their child is in surgery but still feel connected to their child’s doctors and nurses, and secure in the knowledge that a member of the OR team can contact them anytime it’s necessary,” said Dr. Larry Hollier, associate surgeon-in-chief for clinical affairs.

Currently, EASE is being used in the West Tower Main OR, the Clinical Care Tower OR and the Pavilion for Women OR. It will soon be used in the West Campus OR and will be available in the Woodlands OR when the community hospital opens next year.

The response from our patients since the application was introduced at Texas Children’s Hospital late last year has been overwhelmingly positive, Hollier said, adding that a nice feature of EASE is the feedback the application provides. At the end of every session, a customizable survey is generated allowing Texas Children’s Hospital to collect valuable patient satisfaction data.

Data collected so far on our patient families shows almost all users had a positive experience. The following comments are from people who used the application in one of our OR waiting rooms:

  • “This program was very nice. Just knowing what is going on really put me at ease.”
  • “Love this program! As a grandmother, it was an added bonus to keep us updated.”
  • “Wonderful way of keeping in touch. The pictures were truly a blessing.”

Director of Perioperative Services Janet Winebar said she is thrilled Texas Children’s Hospital is using EASE to better communicate with our families. She said the application increases their overall experience with the hospital by creating transparency and improving the doctor-patient relationship. It also decreases anxiety, which impacts the overall process for everyone involved.