September 26, 2018

 

As the largest children’s hospital in one of the fastest growing cities in the country, Texas Children’s high-quality care is always in high demand. However, due to high volume, getting patients and referring providers the answers and access they need in a timely fashion can be a challenge, which is why improving access has been a key focus at Texas Children’s in recent months.

Since the March 2018 launch of the Patient Access Initiative, several key improvements have been made to streamline processes for patients, including standardized clinic sessions and enhanced implementation of MyChart. On September 5, the Department of Surgery took a major step in improving access for referring providers with the launch of 1-855-TCH-KIDS, Texas Children’s new Provider Priority Line, available 24/7 exclusively for referring physicians and advanced practice providers.

“The Provider Priority Line creates a pathway for referring providers to have easier access to Texas Children’s surgeons for questions about patients,” said Dr. Sohail Shah, surgical director of Perioperative Services at Texas Children’s. “We want to make ourselves available to referring providers to assist them in the care of children across the state of Texas, and ultimately the region.”

Previously, if a referring provider had a question for a Texas Children’s surgeon, the communication pathway might route them across numerous Texas Children’s campuses, offices, clinics, and health and specialty care centers. This fragmented approach had the potential to result in multiple call transfers, which could contribute to delayed response times. Now providers can simply call the Provider Priority Line and reach on-call attending surgeons for specialties including Neurosurgery, Ophthalmology, Orthopedics, Otolaryngology, Pediatric Surgery, Plastic Surgery and Urology.

Department of Surgery leadership partnered with Texas Children’s Mission Control and Telecommunications Services to develop the line’s efficient communication flow.

  • When a referring physician calls the line, the call is triaged through Mission Control.
  • Mission Control gathers patient information, and determines the specialty area needed and whether the call is urgent or non-urgent.
  • The call is routed to the on-call attending surgeon at the Texas Children’s campus nearest to the referring provider’s location.
  • The attending surgeon calls Mission Control and is connected to the referring provider on a recorded line, which closes the communication loop.

Early metrics have shown rapid connection times between providers and on-call specialty surgeons, with responses for urgent calls occurring in 15 minutes or less. Initial referring provider reactions have been overwhelmingly positive.

“An early call we received was from a physician at a regional emergency center who had a question about a 14-year-old patient,” Shah said. “He was pleased to be able to speak directly with a pediatric surgeon and relay a care plan to the family immediately afterward. He said the usual course of action would have required an opinion from a local adult surgeon, which often led to a delay in definitive care.”

The Provider Priority Line will not only create easier access to Texas Children’s pediatric surgical expertise, it will also make interactions with providers more customer focused.

“Dr. Shah and his team, in collaboration with Mission Control, have developed a system that delivers an enhanced level of service for our referring providers, who very much appreciate help and advice when seeing pediatric patients who are dealing with complex problems,” said Texas Children’s Surgeon-in-Chief Dr. Larry Hollier. “As the largest children’s hospital in the country with the largest number of surgeons and operations, we should be able to provide them with the help they expect from us. With the Provider Priority Line, we can show them we’re committed to meeting and exceeding their expectations.”

In the near term, the service will be promoted to referring providers across the region with the ultimate goal of routing all such referring provider calls through the Provider Priority Line for a more streamlined experience. The long-term goal will be to extend the service to emergency centers and urgent care facilities as well. And in addition to 1-855-TCH-KIDS, there is also a local number available: 832-TCH-KIDS.

Learn more about how Texas Children’s is improving access.

Texas Children’s senior leadership has announced that the top three credit rating agencies – Moody’s, Standard & Poor’s (S&P) and Fitch – have affirmed Texas Children’s ratings of Aa2, AA and AA, respectively, as well as a stable financial outlook. Affirmation of the Aa2 and AA ratings are a reflection of the high quality of the Texas Children’s system and its standing as an organization with very low credit risk.

“We are excited to have received affirmation of our ratings from all three agencies,” said Texas Children’s President and CEO Mark Wallace. “These ratings, combined with our stable outlook, will provide us greater access to financial markets and enable us to focus available funds on our ongoing mission to provide the very best care for our patients and families.”

Each year, these agencies analyze financial, operational and strategic data to determine credit ratings. The ratings reflect the agencies’ view of a borrowing organization’s, such as Texas Children’s, capacity and willingness to meet financial commitments as they come due, and thus determine the organization’s creditworthiness. The Aa2 rating and equivalent AA ratings denote Texas Children’s high level of financial stability and our very strong capacity to meet our financial commitments.

“This is fantastic news for Texas Children’s,” said Executive Vice President and CFO Weldon Gage. “Each agency noted similar themes for conferring these ratings, among them our track record of successfully implementing growth strategies and large capital plans, our strong market position and brand equity, and our significant fundraising capabilities.”

Additionally, the agency reports cited Texas Children’s extensive research programs and clinical excellence, its exceptional regional and national presence and reputation, and a historically strong financial position as reasons for the ratings. Long-term, the ratings also signify the agencies’ confidence that Texas Children’s will continue to benefit from its presence as one of the nation’s leading children’s hospitals.

Moody’s, S&P and Fitch have affirmed Texas Children’s positive ratings for the past 22 consecutive years. We are one of less than about 50 hospital systems nationally and among only three hospitals in Texas that demonstrate this level of financial stability.

Sickle cell disease affects more than 100,000 Americans and millions more worldwide. This red blood cell disorder can be treated, but a widely available cure has yet to be found. Texas Children’s hematologist and Assistant Professor of Pediatrics Dr. Vivien Sheehan has recently developed a new sickle cell treatment based on her laboratory research. Sheehan has found that metformin, a commonly used medication for diabetes, has the ability to induce fetal hemoglobin in developing red blood cells.

Since higher levels of fetal hemoglobin reduce sickling in red blood cells of patients with sickle cell disease, the medication could potentially be useful in reducing the severity of sickle cell complications in patients. It also can be taken with another drug that increases fetal hemoglobin, hydroxyurea, to get even more clinical benefit.

Sheehan has been a part of Texas Children’s Cancer Center faculty since 2012, working tirelessly toward advancing sickle cell treatments. During a cancer related conference she attended, it was mentioned that the drug metformin could help with cancer by increasing amounts of proteins that her research showed increased fetal hemoglobin. This led Sheehan to wonder if the drug would increase fetal hemoglobin in cells from patients with sickle cell disease, and sure enough, it did.

“Because metformin is so well studied, so safe, there are millions of people literally taking it,” Sheehan said. “I then went to my Institutional Review Board (IRB) and asked if I could start a clinical trial of metformin in sickle cell patients since it was known to be safe, and wouldn’t cause hypoglycemia even in non-diabetics.”

With funding from Pfizer, in 2016 Sheehan and other researchers were able to launch a clinical trial that is currently assessing the effectiveness of metformin to make fetal hemoglobin in patients with sickle cell cared for here at Texas Children’s Hospital Hematology Center. Pfizer is a world leader in global medical advancement that provides medical research grants and scholarships for new drug development and the latest in cutting edge technology and applications. This not only led to developing the clinical trial, but also led to other acknowledgements and funding such as Sheehan’s Best of ASH recognition, given by the American Society of Hematology at the 2016 annual meeting.

“Her passion truly exudes from her and so a lot of times when you get into conversation with her, you always leave so much more educated because she’s letting you know the newest things that she has learned,” said nurse practitioner Precious Uwaezuoke. “She’s letting you know how her research studies are going. Thus, hearing her speak is always so rewarding and fun. I truly have this huge respect for her just because of how passionate she is about Sickle Cell Disease and our kids.”

Uwaezuoke works closely with Sheehan and the research team, as well as patients, and is responsible for helping to determine who may be good candidates for clinical trials. Fighting sickle cell herself, she knows that at times handling the disease can be very difficult; so she verses how important research is to getting closer to finding a cure for the disease.

“This is a big deal because having sickle cell is not easy. It affects way too many people for us to only have developed one therapy 20 years ago,” Uwaezuoke said. “To be able to see something come to fruition like this because somebody had a dream, and chased it and didn’t let it fall to the wayside is exciting. Anytime somebody wins after trying a therapy and it actually helps them, I feel like I won as well.”

Following the clinical trial, the next step will be commercialization. Sheehan says that the progress is very exhilarating and that it is amazing for a process of this magnitude to have been executed in just four years.

“Usually it takes around 15 years,” Sheehan said. “That’s the average time it takes to develop a drug from the bench to the bedside, and that’s a pharmaceutical company with all of their staff. So now we’re in 2018, we’re almost done with the first arm of our clinical trial, patients taking both hydroxyurea and metformin, and can now analyze and publish our results.”

Overall, preliminary research results show fetal hemoglobin induction, the repair of blood vessels, which is so important to help prevent complications of stroke, retinopathy, renal failure, and the other issues that cause a lot of damage or even death to some patients with sickle cell disease.

“Ultimately, I needed to determine whether patients were having more pain crises or less pain crises on metformin and whether they’re needing more transfusions or fewer transfusions”, Sheehan said. “So I compared the time period before they started the drug to the time period on metformin and they were having fewer pain crises and they were needing fewer transfusions.”

Sheehan says that research is key to improving the use of the tools that we already have. She is now looking for a few more participants to complete the second arm of the clinical trial, patients not on hydroxyurea, and also add adult patients up to the age of 40 years. Sheehan has formed a collaboration with University of Texas Health Sciences Center’s Comprehensive Sickle Cell Center and Dr. Juneja and Dr. Idowu to be able to enroll these patients.

“It’s the only way to advance in a meaningful way. You can make incremental advances just by improving access to care or use of the drug, but you’re not going to make a big, significant change without research. Those with Sickle Cell are doing better through childhood, but they’re still not living longer in adulthood and I think it’s the lack of therapies that will continue to work in our older patients and I feel like this is going to be one of them and I want to see it improve life spans and not just number of years, but health.”

This week’s Radio Lollipop broadcast was extra special as Houston Texans offensive tackle Kendall Lamm, center Greg Mancz and Texans Analyst John Harris joined in on the fun! They played games with patients and their families, decorated football helmets, danced to patient-requested songs and spent time in the Kids Own Studio answering questions from patients and families.

Radio Lollipop is a fully-equipped, on-site radio station at Texas Children’s that broadcasts to patients’ rooms via the hospital’s television system. It is a volunteer-driven program that involves children in play and activities, using the sounds of radio to help stimulate the children’s imagination. Volunteer deejays create excitement among patients by playing Top 40 hits, taking call-in requests and putting kids “on-air” to actively participate in the magic of radio. Each on-air broadcast also features games, art projects, storytelling and contests in which kids win prizes.

Texas Children’s is the Official Children’s Hospital of the Houston Texans. To learn more visit texaschildrens.org/texans.

September 25, 2018

For months, teams have been preparing for the opening of the new Texas Children’s Heart Center® in Legacy Tower. The outpatient clinic went live on September 18. And this week, Move Day into our inpatient space has finally arrived.

Before the flurry of activity, we had the opportunity to sit down with new Chief of Congenital Heart Surgery Dr. Christopher Caldarone, who shared a little about his background and his vision for the No. 1 heart center in the nation.

Tell us a little about yourself. Where’d you grow up?

“I was born in Boston and grew up in Upstate New York and New Jersey. We still have a lot of family in Boston and spend time there in the summer.”

Were you always interested in medicine as a career?

“I had a predisposition toward engineering and science as a kid. I ruptured my spleen in a high school wrestling match and spent a few months in hospitals. I was fascinated by the environment and I think that’s when it really started for me. I went to college at Johns Hopkins for bioengineering but found the subject matter to be too dry. I realized I really liked the medical part of my studies, so I switched over to pre-med.”

How did that lead to your interest in surgery?

“Sometimes people find that they just fit in a field. You just feel like there are places in life where you belong and others you don’t, and I always felt like I belonged in surgery.”

How does it feel to be a part of the team at Texas Children’s?

“It feels amazing. I think that for those of us who’ve been at other institutions, it’s easy to appreciate how special this place is. It’s a spectacular environment.”

What was it about Texas Children’s that attracted you?

“It was all about fit and impact. I spent fifteen years in Toronto with a great team. But from the very first call from Texas Children’s, I felt that we shared a common vision and I felt that I was a good fit for what they were looking for in a very genuine way. That was very compelling. Secondly, the potential here to make a difference is vast. There is an opportunity to take what I learned in my previous role as surgeon-in-chief and refocus on congenital heart disease, which is the area that interests me the most.”

Why is multidisciplinary collaboration so important?

“Being part of a team and functioning as a team is my preferred environment. I just enjoy it more. But that isn’t the reason why it’s important. It’s important because the congenital heart program at Texas Children’s is already competing at the Olympic level. The gradations between the best pediatric hospitals are so fine that to compete at this level, you have to optimize every aspect of the entire program. People can’t work harder and there are no better people to hire. The only option we have is to create an organizational structure that functions more efficiently than other programs, if we want to improve faster than they’re improving. That’s why a multidisciplinary team approach is important. It’s literally the only way to compete at this level.”

How does the layout of the new Heart Center help facilitate improved interaction?

“Architecture influences culture. It can enhance or detract from it. Locating cardiology, cardiac surgery, anesthesia, perfusion, the advanced practice providers and our administrative staff in one environment helps make magic. Having everyone in close proximity on the same floors is enormously beneficial for our patients and our care providers.”

You have an active translational research background. Will you continue to build on that?

“I want to continue my own research, but my main objective here is to support other clinician’s translational science efforts throughout the Heart Center. I’ve found that if you get a team together, find resources and focus on a target, you can produce powerful results. My role is to support an environment where multidisciplinary teams routinely get together, target specific areas and create impact. I think of it as translational science ‘one step removed’. I think that’s one of the reasons I’m here.”

What’s something you want people reading this to know about the leadership team’s vision for the Heart Center?

“I want people to know that the Heart Center leadership is dedicated to creating a shared stewardship model, through which we work together to identify specific targets, pool our resources and act upon those targets as a unified group. The model makes collaboration the expectation rather than the occasional nice outcome. In most other institutions, collaboration can happen; there’s nothing to restrict it. But if it doesn’t happen, it’s a silent failure and a missed opportunity.

“Here, we have a group of leaders that is accountable to see that our resources are deployed in a meaningful way that drives change. This creates the dynamic that is necessary to provide that Olympic level of care. If the patient is truly our focus, then every little thing we do here has to be better. Everything has to keep improving. And every single person in the Heart Center has a role and the potential to influence how we extend our lead and, more importantly, how we can improve care for our patients.”

Time for rapid fire: What’s your favorite film?

“The Year of Living Dangerously.”

Favorite sport?

“I don’t really have a favorite. I appreciate a good contest, regardless of the sport.”

Favorite place you’ve traveled?

“Thailand.”

What are you listening to right now on the way to work?

“NPR.”

Beatles or Rolling Stones?

“Tough one! It’s a toss-up. Depends on my mood.”

Caldarone is an internationally recognized leader in congenital heart surgery and most recently served as surgeon-in-chief at The Hospital for Sick Children in Toronto. He received his undergraduate degree from Johns Hopkins University and his medical degree from Columbia University, and he completed his general surgery and cardiothoracic surgery residencies at Beth Israel Deaconess Medical Center/Harvard Medical School. He also completed a fellowship in congenital heart surgery at The Hospital for Sick Children. Caldarone is a member of the American Association for Thoracic Surgery, the Society of Thoracic Surgeons and the Congenital Heart Surgeons’ Society. His specific research interests include the role of apoptosis related mitochondrial dysfunction and remote ischemic preconditioning as mediators of reperfusion injury. Most recently, Caldarone has focused on pulmonary vein stenosis and tissue engineering of pulmonary valves.

September 19, 2018

The new outpatient clinic at Texas Children’s Heart Center® is now open! As patients and families came through the doors of the new clinic for the first time on September 18, they entered a space designed from top to bottom with them in mind.

“From the very beginning of the design process, the opening discussion for every space has been about making sure the focus is on the patient and that they have everything they need,” said Texas Children’s Chief of Pediatric Cardiology Dr. Daniel Penny.

The outpatient clinic is situated across the 21st and 22nd floors of Legacy Tower and has been specially configured to offer families a more personal approach to care, and to handle high clinical volume. Last year, there were nearly 29,000 outpatient clinic visits, 2,300 of which were part of the Adult Congenital Heart Defect program, and more than 27,000 echocardiograms were performed.

On a recent walkthrough in advance of the opening of the new outpatient clinic, Penny showed off a few of its special features and described the care and painstaking attention to detail that has gone into every aspect of the facility.

Pod-based model
One of the key differences in the model of care in the new outpatient clinic compared to our previous facilities is the integration of echocardiography and exam rooms. To incorporate the two, a pod-based model that will enhance the patient experience and streamline the care we provide has been implemented.

The clinic houses five pods, each with its own separate waiting area. Two of the pods comprise six exam rooms and four echo rooms apiece. Close proximity between rooms will enable greater coordination of care between care teams. A third pod has been designed specifically for patients in the Adult Congenital Heart Disease Program. It has three exam rooms, two echo rooms and a private waiting area. Two more pods are dedicated for cardiac surgery and arrhythmia specialists and house an additional six exam rooms apiece. Additionally, each pod is equipped with a large, centrally located high-definition care board to help teams monitor patients along the examination and treatment pathway.

“Now, rather than traveling from one side of a building to the other, families will have access to all the care they need in one convenient location,” Penny said. “This system will also encourage closer interaction between care givers. And even with the greatly expanded footprint, we have additional shell space that will allow for additional consult and echo rooms when the demand arises.”

Sedation Area
The Heart Center receives many echo patients, as well as patients transferred from inpatient units, who require sedation. The new outpatient clinic features an expansive six-bed sedation area, with an additional five echo rooms. The sedation area’s layout, similar to an anesthesia area or recovery room, has improved visibility and access, which will allow caregivers to monitor patients more closely. And its location will afford patients and families more privacy.

Exercise labs
One of the most important aspects of a patient’s ongoing assessment is exercise function. For that reason, the new outpatient clinic has two exercise labs. The labs are linked by a central control room, similar to a catheterization lab, from which physicians can supervise tests and monitor real-time patient data displayed on banks of high-resolution monitors. The exercise lab also features a dedicated space for pacemaker care.

Simulation
Simulation and process mapping have been crucial in the clinic’s development. Because the layout of the new clinic’s pod-based space is significantly different than the previous outpatient clinic, simulations were necessary even as part of the initial design process.

High-fidelity simulations used mannequins to test clinical systems, documentation systems, patient safety processes and more for single-patient interactions. Comprehensive workload and patient flow simulations were conducted to test patient movement through the clinic at various volume levels, which is important for a clinic that often sees more than 80 patients in a day. This unique, hands-on process involved clinical staff and simulated patients and families entering the clinic, tracked the flow of multiple patients moving through the clinic simultaneously, and also monitored the utilization of space. Additionally, computer-based simulation models were used to monitor check-in processes, wait times and potential bottlenecks to help make necessary changes to the process flow.

Part of a united heart center
At Texas Children’s, cooperation and teamwork are pervasive across the hospital system, within specialty and subspecialty areas and across service lines. The same is true of the Heart Center, which combines cutting-edge technology and surgical expertise with research and compassionate, family-centered cardiac care – all located in the same, state-of-the-art complex.

“We’re not a cardiology section and a cardiac surgical section siloed from one another,” Penny said. “In everything we do, we want to emphasize that we are, both culturally and, indeed, physically, a unified heart center. That has been one of the fundamental philosophies of this whole endeavor: we can do more for our patients working together as a comprehensive team.”

Texas Children’s Heart Center is a global leader in pediatric cardia care, treating some of the rarest and most complex heart cases. With several multidisciplinary teams working in conjunction with pediatric subspecialties throughout the hospital, the Heart Center strives to provide unparalleled care at every point from diagnosis through treatment and follow-up to achieve the best outcome for every patient. For the past two years, Texas Children’s Heart Center has led the nation as the No. 1 place for children to receive cardiology and surgery care according to U.S. News and World Report.

Learn more about the Heart Center.

September 18, 2018

Flu season is almost here! While a record breaking 91 percent of our employees received their flu vaccine in 2017, we continue to strive to make the flu vaccination program even more successful. This year we have a lot of exciting new plans to share with you, such as an increased amount of flu vaccination events across the organization and a new online process for employees to submit proof of vaccinations. As a way to encourage our workforce to get vaccinated earlier in the season, all staff who receive their flu vaccine by Friday, November 2, will be entered into a drawing to win one of 25 Nutri Ninja Pro Blenders.

The Centers for Disease Control and Prevention (CDC) predicts this year’s flu season will begin in October. The CDC recommends a yearly flu vaccination as the first and most important step in protecting against the flu and its potentially serious complications. To learn more about the upcoming flu season, click here. Please remind staff that receiving a flu vaccine protects our patients and their families, reduces flu illnesses, doctor’s visits and missed workdays, and; helps to prevent flu-related hospitalizations.

Below is a more in-depth overview of what to expect for our Flu Program in 2018.

Flu Program Details
  • Employee Health will administer free flu vaccines to Texas Children’s employees, Baylor College of Medicine employees working at Texas Children’s facilities, Morrison, Crothall, or Compass contract employees and volunteers of Texas Children’s Hospital. Employee Health will administer free flu vaccines to Texas Children’s employees, Baylor College of Medicine employees working at Texas Children’s facilities, Morrison, Crothall, or Compass contract employees and volunteers of Texas Children’s Hospital.
  • Click on the graphic to the right to view Texas Children’s vaccination event schedule.
  • Upon vaccination at Texas Children’s, staff will receive a 2018-2019 flu season sticker to place on their badges. Upon vaccination at Texas Children’s, staff will receive a 2018-2019 flu season sticker to place on their badges.
  • Employees who receive their flu vaccine by November 2, 2018, will be entered into a drawing to win one of 25 Nutri Ninja Pro Blenders. Employee Health will email winners at 3 p.m. on Wednesday, November 7.
  • In order to protect our patients from exposure to influenza, employees who decline the flu vaccine for approved exemptions should wear a surgical mask when providing direct patient care services for the duration of the influenza season. See In order to protect our patients from exposure to influenza, employees who decline the flu vaccine for approved exemptions should wear a surgical mask when providing direct patient care services for the duration of the influenza season. See Required Influenza Vaccination Policy and Procedure for more details.

Online Consent Form and Proof of Vaccination

  • Texas Children’s employees are to complete their Flu Vaccine Consent Form online via the Employee Health & Wellness Portal prior to attending a flu vaccination event.*
  • This process greatly reduced the wait times for flu vaccination last year, as well as eliminated the need to scan or fax the Flu Vaccine Consent Forms to Employee Health.
  • Click here to view a quick video tutorial on how to access the flu vaccine consent form online.
  • For instructions on how to log in to the portal click here or click here to view step-by step instructions.
  • New Process: Employees who receive their flu vaccine outside of Texas Children’s can easily submit their attestation and proof of vaccination via this online form. Employee Health will no longer accept proof of vaccination via fax or email.

If you have any questions, please contact Employee Health Services at 832-824-2150, option 2.

* Baylor College of Medicine employees working in Texas Children’s facilities will continue to complete paper consent forms when they receive the flu vaccine.