August 30, 2022

The Quality, Clinical, and Information Services (IS) teams who were among the international winners of the Healthcare Information and Management Systems Society (HIMSS) 2022 Davies Award of Excellence are sharing highlights from their case studies presented at HIMSS’ virtual site visit in July. Excerpts from their work shows how the technologies they have pioneered are helping to identify opportunities for collaboration with clinical teams across Texas Children’s to drive improvements in the delivery of our patient care and outcomes.

Pediatric Palliative Care: Optimizing the Electronic Medical Record (EMR) to Improve End-of-Life Care in Children

  • Dr. Jessica Casas, Assistant Professor of Pediatrics, Division of Palliative Care
  • Amy Jeppesen, Systems Analyst Lead, Information Services

Challenge: As an international referral center for patients with the most complex illnesses, Texas Children’s Hospital treats diverse and complex patients of all ages. Being a busy center comes with challenges, including the need to provide goal-concordant care to a wide variety of patients in all stages of the disease process. This is particularly important for seriously ill children.

Approach: The Pediatric Advanced Care team (PACT) partnered with Epic Informatics/IS and Quality Outcomes & Analytics to improve the quality of care for these seriously ill children, including end-of-life care, to ensure delivery of goal-concordant care every time for every patient. PACT led focus groups with stakeholders across the institution to learn about their needs and questions regarding caring for children at end of life. Evidence shows that end-of-life care outcomes are strongly related to communication between clinicians and patients.

Using stakeholder input, the team engineered the electronic medical record (EMR) to create a novel navigator that consolidates all end-of-life care activities: consents, advance directives, autopsy, organ donation, keepsakes, spiritual rites and bereavement. The team then carefully guided EMR users through the end-of-life navigator workflow.

Outcome: This EMR optimization minimizes unnecessary variation in end-of-life care, improves communication between teams and is improving appropriate post-mortem care. The new process elevates the care that seriously ill children receive to mirror the institution’s standards of excellence.

COVID-19 Vaccine Tracking with Integrated Medication Management Technology

  • Gee Mathen, Director, Clinical Application & Technical Pharmacy Services, Financial Services
  • Shawn Mathew, Informaticist, Clinical Pharmacy

Challenge: In 2020, the SARS-COV-2 pandemic brought about rapid mobilization of vaccine research, production and implementation, with Federal and state regulations mandating accuracy of vaccine inventory for institutional allocations.

Approach: The Texas Children’s Pharmacy Informatics team developed new and repurposed existing technological solutions to track procurement, distribution, administration, and vaccine waste. The team created a PowerApp named COVID19VaccTrac to track vaccine movement in the system through procurement, distribution, preparation, and waste.

Additionally, Codonics® Safe Label Systems® were repurposed from the operating room to the pharmacy to prepare color-coded vaccine doses. Complexities associated with multiple formulations for different age groups, dose types and manufacturers benefited from the color-coded design to safely administrator vaccines. Lastly, Epic© was used to document administrations for patients. Medication management technology captured data in each step of the medication use process. Data from multiple sources was integrated to provide real-time insights into inventory and patient vaccination statuses to drive decision-making by leadership for resource allocation.

Outcome: Collaboration with multiple disciplines and swift development of innovative technological solutions ultimately provided efficiency and a paramount level of care for our patients.

Improving High Blood Pressure Recognition in Pediatric Primary Care

  • Dr. Justin Zachariah, Associate Professor in Pediatrics (Cardiology), Baylor College of Medicine; Co-Chair of Research Operations, Texas Children’s Heart Center
  • Dr. Scott Watson, Pediatric Physician, Texas Children’s Pediatrics; Associate Medical Director of Clinical Informatics

Challenge: Pediatric Hypertension is often missed in primary care due to the complexity of evaluating normal blood pressure ranges for children at different ages.

Approach: Texas Children’s Preventive Cardiology and Texas Children’s Pediatrics leadership developed a plan to improve initial measurement accuracy and increase primary care recognition of high blood pressure during clinic visits. The project involved multi-step decision support tools to automate recommendation for manual blood pressure confirmation by staff members, allow for easier review and classification of blood pressure readings by physicians, and encourage American Academy of Pediatrics (AAP) guideline recommended initial evaluation steps for confirmed elevated readings.

Outcome: Initial data from our go-live showed clear improvement in recognition and referral rates for many previously unrecognized cases of elevated blood pressure.

Read more on Connect about HIMSS’ Davies Award and the award announcement.

Every two seconds, someone needs a blood transfusion. On Wednesday, September 7, everyone on our One Amazing Team will have an opportunity to be a hero by helping to support the need for blood in health care operations across our community. Wednesday’s Gulf Coast Regional Blood Center (GCRBC) drive will be in the Feigin Tower, first-floor conference center. Donors should make an appointment by registering here. Walk-ins are accepted based on availability in the schedule, although appointments are preferred.

Each day the Blood Center must collect 1,000 units to meet the needs of patients in 170 hospitals in their service area. As one of the Blood Center’s largest hospital clients, our team’s Commit for Life donations will make a difference for our patient’s lives. As a “thank you” for helping to save lives, donors will receive Gulf Coast Regional Blood Center themed socks.

Based on CDC guidance, the Blood Center has several safety measures in place to protect donors from COVID, including increased sanitization and placing donor beds six feet apart to maintain social distancing.

For questions or assistance, contact Christina Gligorova with GCRBC at 832-602-9350.

“Working at Texas Children’s has always been my dream,” said Elizabeth Martinez. Learn how Elizabeth took her unique background and translated that into a passion for nursing in this week’s One Amazing Team spotlight. Read more

Check out this new Password Strength Meter to check the strength of your passwords. Read More

August 23, 2022

Finding the right words to say just got easier. Learn more about why perception around mental health matters and ways you can help reduce the stigma surrounding mental health. Read more

In collaboration with the Simulation Center, the Pavilion for Women team leverages simulation to improve outcomes. Read more

While human connection and bonding are crucial to the health, growth, and early development of children, babies in the Neonatal Intensive Care Unit (NICU) can have a hard time making that connection to caregivers. The NICU Little Listeners program was founded by Pediatrician Dr. Christina Wong a few years ago, as one of the ways to help encourage parent and baby bonding in the Texas Children’s NICU through verbal communication, such as reading and talking aloud.

“Because early reading is critical for language, speech, and brain development, one of my initial goals at Texas Children’s was to help build the Little Listeners program and library in our NICU,” shares Dr. Wong. “It’s understandable for parents to feel stressed while their baby is in the NICU. They can sometimes forget that there are things they can do to help normalize the experience, such as reading and talking to their baby. We wanted to establish a program to support them.”

Dr. Wong, along with Library Coordinator and Child Life team member Catherine Zdunkewicz, and the Newborn Center Child Life and Music Therapy team – Emma Page, Maribeth Vain, Olivia Priolo and Anna Boucher – have combined their passions for children and literacy to take the program to the next level by creating the NICU Little Listeners Reading Initiative.

The NICU Little Listeners Reading team strives to help normalize the experience for NICU babies by providing parents with educational classes and books they can read to their babies. They also encourage Nursing team members to speak to babies by their name and model good verbal communication and gentle touch stimulation for parents.

Little Listeners Read-A-Thon coming in September

The Little Listeners team is excited to launch their first major event at Texas Children’s – a Read-A-Thon where NICU families will receive a new book on each day during the week-long celebration September 19-23, in honor of National Literacy Month and NICU Awareness Month. All Texas Children’s team members are encouraged to participate – watch for more information!

How the Little Listeners Reading program works

Prior to the coronavirus pandemic, the NICU Little Listeners Reading team encouraged parents to borrow books from the Pi Beta Phi Book Nooks located throughout the NICU to read to their child in the NICU, and siblings during visits. Post-pandemic, the team shifted to donating books to every family who arrives at Texas Children’s NICU, allowing them to keep the book and build their child’s library at home.

Upon arrival, the team provides families with the book Read Baby, Every Day by pediatrician Dr. John Hutton, along with their admission packet. The team also donates educational books to NICU families such as Calm Baby, Gently and Sleep Baby, Safe and Snug, also by Dr. Hutton. The books, reviewed by parents and Texas Children’s CPR educators, help educate families about safe sleep and promote injury prevention. Because admission is often prolonged, The Newborn Center Child Life and Music Therapy Team gives more books to families bi-monthly, along with a bookmark featuring tips and benefits of reading to your baby. Families receive about six books throughout the year, available in both English and Spanish.

Zdunkewicz has purchased a remarkable 2,860 books for the CPR educational class and admission packets with funds donated by the Houston Pi Beta Phi Foundation. The Little Listeners Reading team has also purchased more than 1,200 books for bimonthly Little Listeners book distribution.

“What we’d like everyone to remember is that no baby is too small or too sick to benefit from being gently read to or talked to,” Dr. Wong shares. “No matter how scary the situation is, or how scared you are by the machines and everything else going on, you can still read and talk to them. Reading and talking to your baby are two of the best things you can do for them in life.”

Literacy awareness resources

You can learn more about Texas Children’s libraries and library resources on the Child Life Department webpage, and we encourage you to explore Read Aloud, a website dedicated to promoting the benefits of reading by providing fun educational tips, flyers and other tools for literacy advocates.