August 20, 2019

Texas Children’s Hospital recently celebrated a well-deserved milestone after being named No. 2 in the nation for Gastroenterology and GI surgery by U.S. News & World Report.

“Our team was delighted by this year’s ranking of No. 2 nationally,” said Dr. Benjamin Shneider, Chief of Gastroenterology, Hepatology and Nutrition. “I am particularly proud of the achievements our team has made in improving outcomes for the children and families who entrust us with their care.”

The U.S. News rankings uses a methodology that weighs a combination of factors including patient outcomes, quality of health, available clinical resources like specialized clinics and external accreditations, and compliance with best practices. Improved rankings show a health care organization’s commitment to providing high-quality care and identifying gaps where improvements are needed.

Big wins for patients and families

Building on the successes of previously existing programs, the Gastroenterology, Hepatology and Nutrition team, in collaboration with Pediatric Surgery and Liver Transplantation, continues to make great strides in patient care and outcomes which were recently noted in the U.S. News rankings:

  • Achieved successful Kasai procedures in infants with biliary atresia. The most common reason for pediatric liver transplantation is biliary atresia (BA), which occurs in infancy. Within weeks, the liver suffers from extensive scarring that eventually leads to end-stage liver disease. One way to slow disease progression is with an operation called the Kasai procedure. Kasai procedures performed earlier have the best chances of delaying or preventing the need for a liver transplant.

In the U.S. News rankings, Texas Children’s scored the highest score for success after the Kasai operation. The score reflects the world-class care given to patients with biliary atresia cared for at Texas Children’s Hospital. Texas Children’s provides comprehensive care to infants with BA and their families, including aggressive nutritional support, social work services, nursing expertise, and attention by leading pediatric surgeons, hepatologists and transplant surgeons.

BA research at Texas Children’s Hospital, led by Dr. Sanjiv Harpavat, is laying the foundation for a uniform way to detect infants with biliary atresia earlier, to ensure they receive the Kasai procedure at a young age. Texas Children’s researchers have developed a newborn screening tool, which they have implemented in nurseries around the city. This has led to earlier referrals and helped fuel the improved outcomes with the Kasai procedure. Texas Children’s researchers are now working to implement this early screening program across Texas and nationwide, to ensure that all infants with biliary atresia can receive an early Kasai procedure, delaying liver transplantation and potentially avoiding the need for liver transplantation.

  • Improved three-year survival for children undergoing liver transplantation. Texas Children’s has one of the largest and most successful pediatric liver transplant programs in the country. “Our team’s multi-disciplinary approach to pre and post-transplant care, further development of our Liver ICU, surgical innovations, and the incredible teamwork and dedication of our entire liver transplant teams, including our inpatient and outpatient nursing and support staff, have only enhanced our outcomes year after year,” said Dr. Daniel Leung, Director of Hepatology and Liver Transplant Medicine. Texas Children’s three-year liver transplant survival exceeds 92 percent and post-liver transplant length of stay is four days shorter than other high volume peer programs. Additionally, our one-year liver transplant survival exceeds 95 percent.
  • Improved prednisone-free remission rates in children with Inflammatory Bowel Disease (IBD). Since steroids carry significant side effects for children, steroid-free remission is a commonly used outcome measure of clinical care quality in Inflammatory Bowel Disease. To meet this metric, an automated mechanism was implemented in the electronic medical record (EMR) system, which alerts physicians about their patients’ steroid use, thereby focusing attention on the on-going need and appropriateness of steroid use for each patient in a real-time fashion. As part of a hospital supported effort, Texas Children’s also is part of the International Improve Care Now (ICN) registry of pediatric IBD patients, which allows GI physicians to closely monitor the hospital’s active patient cohort and improve their clinical care. Steroid free remission indicates optimal medical management and decreased potential for IBD-related complications in children suffering from these disorders. It is a big win towards improved quality of life for our patients.
  • Implemented successful community support groups

Our community hospital system at Texas Children’s has provided tremendous support to engage our children and families contending with IBD in the form of monthly Family Support Group meetings. These meetings create an outstanding venue for patient and family education, and enables parents to actively influence the care of their child. These interactions have helped to improve patient satisfaction and quality of life in children with IBD. Texas Children’s offers similar support programs for liver transplantation and intestinal failure.

Click here to learn more about our Gastroenterology, Hepatology and Nutrition Service at Texas Children’s Hospital.

When 19-year-old Isabella Williams found out she was going to meet not one but 10 Houston Texans cheerleaders, her face lit up like a lightbulb.

“She LOVES to cheer,” said Child Life Specialist Natalie Juneau. “This is a perfect event for her.”

The event Juneau had the privilege of inviting Williams and other patients to on August 13, was the fourth Houston Texans Jr. Cheer Mini Camp. Held in a conference room on the fourth floor of the Pavilion for Women, the event brings the Texans Junior Cheerleader Program to children who wouldn’t be able to participate otherwise.

“This is one of my favorite events,” Texans cheerleader Shakila said. “I love being able to make the kids smile.”

View photos from the event below.

Shakila and her colleagues – Amanda, Ashley, Briana, Gabrielle, Kristin, Lainey, Natalie, Taryn and Taylor – spent about an hour with Isabella and several other Texas Children’s patients. The cheerleaders performed for them, did an arts and crafts project with them, signed autographs, posed for pictures, and handed out lots of goodies, including Junior Cheerleader T-Shirts, insulated water bottles and bright red pom-poms.

At one point during the event, the patients were divided into three teams with the cheerleaders – Liberty White, Battle Red and Deep Steel Blue –and asked to come up with their own group cheer and perform it for everyone in the room. Excitement filled the room as the patients cheered for their hometown NFL team.

“We are so glad to be here today,” Taryn said. “We can’t wait to get to know you and for you to get to know us.”

For 9-year-old Luci Warren, the visit from the cheerleaders was a bright spot on what could have been a pretty dull birthday spent in the hospital.

“I got very excited when I found out I was going to meet them,” Luci said.

Luci’s father, Rob Warren, said being able to attend the event was a pleasant surprise, especially since it fell around his daughter’s special day.

Following the event, the cheerleaders visited patients on the 11th floor of West Tower. These patients were unable to make it to the event at the Pavilion for Women and enjoyed seeing a friendly face.

The Houston Texans Jr. Cheer Mini Camp is made possible due to an ongoing partnership Texas Children’s has with the Texans to inspire children to lead healthier, more active lives through camps, programs and events all year long. Texas Children’s works alongside the Texans through community engagement and education programs to give Houston-area kids the tools necessary to make healthy choices throughout their lives.

There’s no greater responsibility than raising a child. Who should do that alone?

If you asked Adrian McKinney, manager of Texas Children’s Nurse Family Partnership (NFP), she’d say no one. Thanks to McKinney and her team, more than 625 first-time mothers and 487 children have benefited from personalized nursing support since 2009.

That’s 10 years of taking pre-natal and post-partum care directly into the home of Texas Children’s Health Plan members. Certainly something worth celebrating.

“We couldn’t be more pleased about the success we’ve had as a team,” McKinney said. “Our mothers are all entering one of the most challenging times in life and if we can help make preventative health care a priority before their children are born then we’ve already won.”

And that is ultimately the focus of the program. Much like a strong pre-school experience is important to the educational life of a child, so is a good prenatal experience. If the seeds for success are planted early there is time to yield an incredible result.

Rachael Mumbach knows this personally. Mumbach is currently enrolled in the NFP program and calls it an answered prayer. She is mom to little Alaina, who will be two-years-old in December.

“As a first-time mom you get so much inconsistent information about how to handle your pregnancy and raise your children. Your mom and grandmother will tell you one thing. Your boss and your friends will tell you something different,” she said. “They all mean well, but you don’t really know what’s right and what’s wrong.”

Mumbach’s nursing partner, Savanah Ryan, has been an NFP nurse for six years and thoroughly enjoys her work. “Every day looks completely different,” she said. “We are on the road, in homes and providing that hands-on support that our moms need. It’s a joy.”

More than mom
Although moms are the primary focus of the program’s coaching model, McKinney says other family members can also be involved in the sessions. “Dads, grandparents, friends and others who will be part of the child’s support system can absolutely take part in the sessions. We want to make sure that as many people as possible are informed and prepared for the baby’s arrival.”

Who teaches what?
McKinney’s team of nurses conduct weekly and semi-monthly sessions. They teach on topics such as maternal health, sexual health, depression, anxiety, drug use, general child development, parenting and more. Nurses on the team are:

  • Savannah Ryan
  • Galynn Jackson
  • Natalie Nichols
  • Jeanette De Leon
  • Erika Dunn

A big congratulations to the entire team on their 10-year anniversary and successful outcomes for moms.

*****

The Bottom Line
  • Any first-time mother who is a member of Texas Children’s Health Plan and no more than 25 weeks pregnant may be eligible for NFP Services.
  • Anyone who is interested and thinks they may be eligible can contact Mary Perez at 832-828-1274, mmperez1@texaschildrens.org
  • Want more information about NFP? Visit nursefamilypartnership.org

As a member of Texas Children’s Kangaroo Crew, Shawnaka Holland shares how her colleague’s communication and leadership skills have impacted positive outcomes in the safe transport of critically ill patients to Texas Children’s. Read more

It’s that time of year again! As many people are preparing to send their children back to school, we asked employees how they prepare their household for the new school year.

Walking the halls of Texas Children’s you may see someone in a red vest offering assistance or providing some type of support. Those are our volunteers, who have played an important role in the organization’s success since day one.

This summer The Woodlands Campus adopted the junior volunteer program to offer opportunities to teenagers and provide more support for patient care.

The volunteer program began when Texas Children’s opened its doors in 1954. Over the years the program has expanded to over 800 diverse active Auxiliary members who support patients, families and hospital staff.

“The role of the volunteer has really changed over the decades,” Assistant Vice President, Clinical Support and Research Administration, Paige Schulz said. “One of the things that’s really significantly changed is originally it was only women that volunteered at Texas Children’s. And then that was from the ‘50s really until the ‘80s, and then men started volunteering a lot more with our organization.”

Click below to view a video about the system-wide junior volunteer program.

In 2017, West Campus began their junior volunteer program based off of several requests from the Katy community. As the campus grew over the years, so did the need for a program.

“The juniors make a big difference in the patient’s experience in the hospital,” West Campus Senior Volunteer Coordinator Nora Lopez said. “When the patient comes in and they go to visit the doctor, they are scared. So if they play with someone before they are seen by the doctor, or nurse, or prior to any procedure or surgery, the patient is most likely in a better mood. So it’s a win, win situation and it makes a big difference in the hospital.”

The Woodlands Volunteer Services Department selected 12 high school students with an interest in working in the healthcare field to engage in tasks that enhances patient experience, whether it is providing games for them to play, snacks like popcorn and tea, or just having someone to talk to their age.

“The best part is their energy. They bring an enormous amount of energy to the hospital and their energy is contagious and it’s been so wonderful to have that contagious positive energy around the hospital,” The Woodlands Senior Volunteer Coordinator Zett Small said. “We are grateful to have the best, brightest, and most talented kids volunteering with us.”

Anvi Sana is a 16-year-old aspiring pediatrician who has always dreamed of working at Texas Children’s. The summer junior volunteer opportunity at The Woodlands combined her love for kids and thirst for the knowledge of health care. Sana expressed how much of a learning experience volunteering was and why it is beneficial for someone her age.

“I think as a teenager it teaches you a lot about the different kinds of people that you’re going to run into in a hospital,” Sana said. “I think doing a program like this as a teenager kind of opens up your eyes to the number of different people that you’re going to see or come across when you’re working in a hospital.

Being a volunteer at Texas Children’s is not just a job it is an experience for all ages, and backgrounds with endless possibilities.

“What I like to say about the volunteers are that they are the heart and soul of this organization,” Schulz said. “I’m excited about just the opportunity for us to expand beyond what maybe is a traditional volunteer assignment.”

Click here for information about the volunteer program.

 

You don’t have to be a victim of one of the latest mass shootings to be affected by them. Just hearing the news about the incidents in El Paso, Texas, and Dayton, Ohio, can cause anxiety, fear and a host of other emotions. And, for people sending children back to school this month, there’s an even heightened sense of sensitivity to such tragic events.

Failing to recognize these feelings and how to cope with them can begin to negatively affect your life and possibly hinder your daily performance as a Texas Children’s employee, parent, spouse or friend. Director of Texas Children’s Trauma and Grief Center and Texas Children’s Chief of Psychology Dr. Julie Kaplow assures employees they are not alone if they feel this way and recommends several tips on how to deal with the after-effects of a large-scale violent event.

Can mass shootings like the ones that recently occurred in El Paso, Texas, and Dayton, Ohio, affect people who are not directly impacted, and if so, how?

Whenever a mass shooting occurs, there’s often this sense of mortality, where you recognize that these things can and do happen. For many people, these events can change your world view a little bit. Generally speaking, we walk around feeling fairly secure in our environment, almost like there’s an invisible shield surrounding and protecting us, and then when something tragic or terrifying happens, it makes people feel more on edge, more hypervigilant, more worried or anxious.

How can people constructively deal with their feelings and emotions surrounding tragic events such as the recent mass shootings?

Social support is probably the No. 1 protective factor in the aftermath of any sort of disaster, including man-made disasters or acts of violence. Being around friends and family, people who can support you, is critical after something like this. We also need to be aware of the fact that for those who have a history of trauma, even if the traumatic event occurred many years ago, violent and distressing events like this can be triggering, meaning that oftentimes, even the physiological reaction you have to a mass shooting can remind you of the same physiological reaction you had to another event that happened years ago. Recognizing that these events often have a psychological impact, even if you weren’t directly involved, is key. Also, recognizing what safety precautions and measures are in place in your work environment or in your neighborhood can be comforting and can help to alleviate feelings of distress.

Should parents talk to their children about such events, and if so, what is the best way to go about doing so?

The most important thing, when talking to children about these events, is to let them guide the conversation. Oftentimes parents either err on the side of not sharing at all, or give a little too much detail and information. If developmentally appropriate, you can introduce the topic by saying something like, “You may have heard about something upsetting that happened in El Paso. Do you have any questions for me about that?” Then, let the child guide the rest of the conversation, revealing what they need to know as opposed to information that might be too overwhelming. Throughout the conversation, keep in mind that children mainly need to feel that they are safe and secure, and that the adults in their lives are going to take care of them. Caregivers can also remind them that even though bad things happen, there are lots of helpers out there who are looking out for them and protecting them.

Since opening in 2017, you and your team with the Texas Children’s Trauma and Grief (TAG) Center have launched two high-profile programs to provide ongoing support and healing to families impacted by Hurricane Harvey and the Sante Fe school shooting tragedy. Will your team be going to El Paso?

We have reached out to the El Paso community and the individuals who are on the ground providing assistance there to let them know we are ready and willing to help when and if we’re needed. Right now, the El Paso community is in the critical incident stress management stage, and our TAG team typically becomes involved a bit later in the process, focusing primarily on mental health needs assessment, training/consultation to community providers, intervention planning, and/or longer term recovery among families who have been impacted. So, we are really looking at being able to help two to three months down the road.

What can people do if they feel like their feelings surrounding such events are becoming too much to handle?

If someone is starting to feel like their anxiety is infringing on their ability to function in daily life, for example if they’re having trouble getting out of bed in the morning, going to work, or if they’re afraid to leave the house, then they should reach out to a trained, trauma-informed therapist for an evaluation and possible treatment. Some other red flags to look for are: constantly being on edge, having nightmares, trouble sleeping, trouble eating, engaging in risk-taking behaviors such as drinking excessively, or other forms of substance abuse. Someone exhibiting any of these feelings or behaviors would likely benefit from an evaluation.

Texas Children’s Employee Assistance Program (EAP) team has completed trauma and grief training with Kaplow, and is currently working with the Trauma and Grief team to develop a grief support group for Texas Children’s employees. EAP Manager Allison Bell said the team regularly provides counseling services to employees and eligible dependents with both concerns.

“Along with stress, grief is one of the top reasons that employees come to EAP,” Bell said. “Texas Children’s staff have tough jobs that have difficult and sad endings at times, and the EAP is there to support them. We provide EAP support to individuals, as well as entire units after critical incidents.”

EAP developed and manages Texas Children’s Tandem Support Team, which is designed to help employees cope with serious patient-related events such as errors, unanticipated outcomes or even patient deaths. Trained peer volunteers on the support team are available 24 hours a day, seven days a week, to offer guidance and reassurance to colleagues dealing with the profound emotions of stress, fatigue and blame that often occur after difficult events.

With EAP Plus, an enhanced program launched in January, employees and their families also have round-the-clock access to a certified counselor and confident emotional support services in their community for grief in the workplace, stress reduction and many more concerns.

For more information about EAP resources or to receive assistance with managing trauma and grief, contact the team at 832-824-3327. Additional details about EAP Plus, the Tandem Support Team and other services and programs – including a helpful brochure on how to cope after a traumatic incident and support fellow team members who have been affected – are available on the EAP page on Connect.

“The best way to deliver on Texas Children’s mission to provide exemplary care is to ensure our employees have the resources and support they need to build rewarding careers and lead healthy lives,” said Vice President Jermaine Monroe. “EAP is an important part of our focus on the total well-being of our workforce, and living compassionately as an organization that truly cares for our people and their families.”