August 25, 2020

Pediatric Surgeon Dr. Paul Minifee has worked at Texas Children’s for almost three decades. Over the years, one of his primary focuses has become educating and mentoring residents and medical students on rotations in pediatric surgery.

“I have always enjoyed sharing my knowledge and experience with others, especially young people who are early in their medical careers,” Minifee said. “It’s been one of the most fulfilling parts of my career.”

Recently, Minifee got the opportunity to teach and operate with a very special student – his son, Dr. Chris Minifee, a third-year surgical resident at the University of Texas Medical Branch. Chris is spending two and a half months at Texas Children’s on rotation with the Orthopedic Surgery Department.

The day he collaborated with his dad in the operating room he was performing an anterior scoliosis repair with Dr. Brian Smith, Texas Children’s chief of orthopedic surgery. Paul came in at the beginning and the end of the surgery to open and close the patient’s chest. Chris assisted him with the procedure, a common practice for orthopedic surgeons in cases such as the one they were working on.

“I immediately went to the coaching skills I learned in baseball,” Paul said about how he handled guiding his son in the operating room. “They worked back then and they seemed to work that day too.”

Paul said his son did a great job and that he executed his part of the procedure very well. What made him most proud was the positive comments from his colleagues about his son’s work in the operating room that day and on other occasions during his rotation.

“It was truly a joy to be there with him and to hear from others what good work he’s doing for others,” Paul said. He added that the father-son duo was making history that day in that he, the first Black pediatric surgeon trained in Texas and the second to be licensed in the state, was operating with his son, who is one of a small but growing number of Black surgeons in the state and the nation. “We were making history in there,” Paul said. “I’m glad it was at Texas Children’s, a place where I have always felt comfortable, accepted and able to grow in my career.”

Chris said operating with his dad has thus far been the proudest moment of his medical career. The operating lounge they were in after surgery, Chris said, was the same lounge he saw his dad in years ago when he shadowed him during junior college. It was around then that he decided to pursue medicine instead of his first love – baseball.

“I wanted to be a professional baseball player but that didn’t pan out,” Chris said. “I’m glad I had a backup plan (orthopedic medicine) and that I have come to love it as much as or more so than baseball.”

Chris said a lot of what his dad taught him on the ballfield translated over to the classroom and now the OR. Some of those things include team work, persistence, and the desire and drive to be your best.

Throughout his rotation at Texas Children’s and from what he’s seen and heard through his dad over the years, Texas Children’s is a place where people’s best is exhibited across the board. He said that includes diversity among the organization’s workforce.

While operating at Texas Children’s, Chris said, the OR has been filled with people from different ethnicities and walks of life. “You probably didn’t see that 20 years ago, but things have changed, which is refreshing.” he said.

Volunteer Services hosted several events last week for employees to make face buttons. The buttons worn by employees are intended to help put patients at ease, as they give them a glimpse of the smiling Texas Children’s face beneath the ‘ll and other personal protective equipment.

August 24, 2020

2020 has been an unprecedented year filled with many challenges. We’ve engaged in social distancing practices like we have never done before. We are wearing protective face masks, both at work and in public, in an effort to protect ourselves, each other, and prevent the further spread of the coronavirus.

But despite the uncertainty and daily disruptions caused by the COVID-19 pandemic, this health crisis has prompted our physicians, nurses and other patient care staff to explore innovative, non-traditional approaches to patient care processes – like e-rounding – to enhance the provider/patient experience.

Daily patient rounding has been around for centuries, and is an important part of the patient care process. Before COVID-19, a group of multidisciplinary staff would gather in or outside a patient room to discuss the patient’s condition and plan of care with the patient’s family, taking into account the experience, concerns, questions and needs of the patient. Through this multidisciplinary, family-centered approach, each team member would then contribute their expertise to support the best possible care/outcomes for the patient.

To adapt to COVID-19 and to ensure social distancing practices are followed, our critical care teams began conducting patient e-rounding in April, which has been a beneficial change from the norm.

“E-rounding has been a big change for us,” said Dr. Jordana Goldman, attending physician in Critical Care. “Rounds are as old as time in medicine and so it takes a little bit of practice to get use to it. But once you get the flow of it, it really works well. Our physician and nursing leaders, and the e-Health and IS teams have been very supportive in helping us leverage new technology to make e-rounding possible.”

Through the VidyoConnect platform, virtual “rooms” are created that are then available for all rounding team members to join. During e-rounding, an attending physician, bedside nurse and family member, can be outside the patient’s room in front of a computer screen while maintaining social distancing, and can communicate virtually with remote team members including our consultants, the provider team (consisting of APPs, fellows and residents) dietitian, pharmacy, Respiratory Therapy support and other members.

“We facilitated the implementation of e-rounding by working with Dr. Goldman and Dr. Aarti Bavare to integrate their ideal workflow using the software and hardware that we already had available,” said Dr. Robert Ball, medical director of e-Health. “It was the team work of Information Services, e-Health and the physician champions that made it a reality. When you have amazing innovators in every corner of our organization working together to enhance this process, there are no obstacles that cannot be overcome.”

Since e-rounding was first introduced in the PICU and CICU in April, e-rounding has expanded to other parts of the hospital including the acute care cardiology floor. PHM has been working on the acute care side on a version of e-rounds to help with the education of the residents and medical students. Plans are underway to expand e-rounding capabilities to the Pavilion for Women and NICUs with the option of e-rounding being made available to all inpatient areas at our three hospital campuses in the coming weeks.

Our e-Health teams are also working on the ability to leverage VidyoConnect to communicate with families in a HIPAA compliant way so they can join rounds when they are not able to be at the bedside.

“The disruption of COVID-19 has allowed us to take a closer look at our rounding practices and see how we can improve them for our patients, team, learners and consultants,” Goldman said. “This is a very new process for us, but our team’s willingness to engage in this novel approach has been pretty phenomenal.”

It’s Cultural Competency Week at Texas Children’s Health Plan – a celebration of the cultural differences that exists among the organization’s more than 900 employees, 11,000 providers and 480,000 members.

In celebration, employees will participate in team discussions, have a chance to win prizes by answering a question of the day and learn more about the 15 national cultural competency standards through a state-mandated training course. The course – available until September 30 – is focused on understanding the diversity that exists in people of different races, languages, genders, socioeconomic statuses and beliefs.

“There is no time like the present to pause and celebrate diversity,” said Johnna Carlson, director of Government Programs. “The Health Plan is so excited to be a leader in this conversation. Our entire mission is to serve those who need us – regardless of who they are, what they look like, or what language they speak. This week is simply a highlight on the way we do our jobs each day.”

Although there are 15 national standards around cultural competency, these are rooted in one principal standard, which is to provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.

This is the standard of highest priority that employees are expected to uphold.

“For me, coming to a country that is so diverse, certainly took me out of my comfort zone and has been such a positive experience,” said Donna Jackson, senior administrative assistant. “To learn and participate in a new cultural experience has made me more open minded and accepting. In general, this makes The Health Plan a more pleasurable work environment.”

Jackson adds that understanding one another’s differences breaks down barriers and makes people feel heard and therefore valued. “As we learn more and become advocates for each other, our children also get to reap the benefits. I truly believe that history will show Texas Children’s will be a better organization because of our focus on cultural competency.”

Watch Connect in the coming weeks to learn more about the national standards. All Health Plan employees are required to take the Cultural Competency training course in HealthStream by Wednesday, September 30.

 

Texas Children’s medical staff is sharing a collection of wellness tips covering a variety of topics in hopes it will help those working so hard for our patients and families during the pandemic. Read more

You are not alone 

The following passage was written by Texas Children’s Chaplain James Denham. 

I watched a mother hold her baby for the first time last week, after some time waiting for this moment. It was absolutely mesmerizing and stirred something deep in my soul. Have you ever had something take your breath away and stop you in your tracks?  I hope so. It’s kind of beyond words.

Let me tell why this particular circumstance was so amazing to me. This mother, courageous and resilient, held her son and spoke to him words he had never heard – “No tenga miedo. (Don’t be afraid). No tenga miedo. (Don’t be afraid). Estoy aquí. (I am here little one.).”  Wow!  Her grip on her child was firm and the look, the maternal strength she imparted through her stare, spoke volumes. Even as I write this, I have goosebumps and am misty eyed because it is so beautiful.  As a parent, I longed to speak those words to my son and for my mom to speak them to me as soon as possible.

They mean even more to me this week.  A pandemic with a novel virus, a society desperate for equality and justice, a heated presidential election, and now two tropical storms in the Gulf of Mexico?  Yes, this mother’s words ring true: “So not be afraid. I am here with you.”

Who is here with us?  Why should we not afraid?  For many, the answer to both of these questions lies in our spirituality and the profound grounding of faith in a God or love or something sacred that tells us fear is not our first response, although it is normal.  That spirituality tells us to lean in with courage to that which is greater than us, yet often intangible.  Namely, peace, or love, or God’s presence, or hope found in our common humanity, or the transcendence of nature.  We may feel worried, but these things ground us in the face of hard things and speak to us, “Don’t be afraid, you are not alone.”

Also, we have each other. Just as this mother held her baby and spoke with the one voice her son knew best, we hear the voices of many we love whose presence instills the truth, which is that they are here. Our parents, our children, our faith communities, our coworkers, our families, our mentors – all of them stand holding us speaking profoundly, don’t be afraid for I am walking with you. They wear masks with us.  They listen to us. They wade through rains with us. They calm our anxieties. They order food for us. They pray with us. They dive through research for us. They are here with us.  They are like a mother holding her baby, guiding him through the hard and long times, saying “Don’t be afraid. I am here with you.”

Know that you are that presence to me.  Know that you are that presence to others.  Hold on and hold each other.  We will make it together.

August 19, 2020

Baylor College of Medicine International Pediatric AIDS Initiative (BIPAI) at Texas Children’s Hospital lost one of its founding members August 11 with the passing of Dr. Peter Nicholas Kazembe. He was the founding executive director of Baylor-Malawi and served as director until his retirement in 2018.

Kazembe, often considered the “grandfather of pediatrics” in Malawi, made monumental contributions to the health of children and families in Malawi and beyond over his decades-long career. He was instrumental in the development of pediatrics as a specialty in Malawi. His collaborations and mentorship impacted the careers of thousands of doctors and health professionals, who now provide stellar pediatric care throughout Africa and beyond.

“Dr. Kazembe was a dedicated husband, father, leader, advocate, mentor, clinician educator, teacher and friend,” said Michael Mizwa, BIPAI chief executive officer. “I’m deeply saddened by his loss but know his legacy will live on in the work of many.”

Click here to listen to some of Kazembe’s colleagues talk about his loss and the significant contributions he made to pediatric health care in Malawi.

Kazembe’s legacy includes pioneering Malawi’s pediatric HIV/AIDS care, treatment and prevention programming; developing the country’s first HIV treatment guidelines; providing mentorship and education to countless health professionals; and collaboration with pediatricians and child health advocates all over the world.

Under his leadership, Baylor College of Medicine Children’s Foundation-Malawi in a public private partnership with the Government of Malawi and Abbott Fund, built and operated the first stand-alone pediatric HIV clinic in Malawi and was the first non-government organization to provide antiretroviral therapy for children in Malawi, fast becoming the country’s largest provider of pediatric HIV care.

“The work and leadership of Dr. Kazembe has saved countless lives,” said Phoebe Nyasulu, executive director of BIPAI’s Center of Excellence (COE) in Malawi. “Without him, we wouldn’t be where we are today.”

Kazembe’s contributions span clinical care, research, advocacy, policy, and education – and cross pediatric HIV, tuberculosis, malaria, neonatology, maternal and child health. Throughout his career, he developed long-lasting partnerships and deep friendships around the world that have blossomed and prospered and will continue to benefit the people of Malawi for decades to come.

“Dr. Kazembe was instrumental in the start of every single Texas Children’s global health program in Malawi,” said Dr. Susan Torrey, vice chair of the Global Health Steering Committee. “His leadership and vision have enabled Texas Children’s to expand care in Malawi to include cancer, cardiology, surgery, maternal health and emergency medicine, his support of which was instrumental in the successful emergency medicine collaboration between Texas Children’s and other organizations.”

Dr. Jeff Wilkinson, vice chair of Global Women’s Health with Baylor College of Medicine and director of Texas Children’s Global Women’s Health Program, said the impact Dr. Kazembe made during his lifetime on the people of Malawi, especially mothers and children, is invaluable.

“Pediatric and maternal care has advanced by leaps and bounds because of Dr. Kazembe’s efforts,” Wilkinson said, adding that more than 6,000 babies are now born each year at Area 25 Health Center, a public-private partnership between Baylor, Texas Children’s and the Malawi Ministry of Health. “The impact of his knowledge and dedication to pediatric and maternal health care will be felt for generations to come.”

In honor of Kazembe’s work, he will be posthumously awarded the American Academy of Pediatrics 2020 Hillman-Olness Award for lifetime service and lasting contributions to global child health. The award will be presented on October 5.

Established in 2011 in honor of the late Liz Hillman, the late Donald Hillman, and Karen Olness, the award recognizes individuals who have devoted their careers to advancing global child health. Among the numerous enduring legacies from Kazembe’s expansive career are the long-standing international and inter-institutional partnerships and collaborations that he forged, all of which continue to benefit the people of Malawi.

His collaborations and mentorship undoubtedly impacted the careers of thousands of doctors and health professionals, including numerous Fellows of the American Academy of Pediatrics (FAAPs), who now provides stellar pediatric care all over Africa and the United States.

Ministry of Health Principal Secretary Dr. Charles Mwansambo said in The Nation, Malawi’s leading newspaper, that he will miss Kazembe at both national and personal levels.

“At a time when many Malawian doctors studying abroad, especially specialists, were opting to stay abroad and make money for themselves, Peter returned home to serve and save what he knew best: the children and his own countrymen. He was a passionate and selfless man.”

Anna Mandalakas, director of Texas Children’s Global Tuberculosis Program, said she is extremely fortunate to have known Kazembe and to have learned from the work he did that changed the lives of so many.

“I have been inspired not only by his work but by the kind, compassionate, and humorous person that he was,” Mandalakas said. “I have smiled so much thinking about him these past days.”