March 8, 2020

The Clinical Research Center/Research Resources Office presented the Clinical Research Award for First Quarter 2020 to Farida Lalani, senior assistant manager, Research Resources Office.

This award was established by the Clinical Research Center in collaboration with the Research Resources Office to recognize and honor individual contributions to protecting the best interest of the research subjects and compliance with applicable rules and regulations.

Lalani joined the Research Resources Office with Baylor College of Medicine as a Sr. Research Coordinator in 2013. During this time, she has gained significant experience in pediatric clinical research as she worked with sponsors, CROs and expert physicians on clinical trials in several therapeutic areas such as peanut and milk allergies, rheumatoid arthritis, infectious diseases, surgical pain management, congenital cardiac defects, and diabetes, among many others. She moved into a management role in 2017 and currently oversees the research coordination team along with the RRO nurse manager.

March 3, 2020

Sudden cardiac arrest can happen to anyone, anywhere, any time – and it often happens with little to no warning. More than 200,000 cardiac arrests occur in hospitals each year in the United States. To keep employees better prepared to perform cardiopulmonary resuscitation (CPR) and contribute to improved patient outcomes, Texas Children’s recently launched a new Nursing initiative that takes CPR training to the next level.

“We don’t have to perform CPR too often, but unfortunately, when we have to provide this life-saving procedure, we have to do it well,” said Nursing Professional Development Specialist Gayle Young. “Through this initiative, resuscitation skills are accessed and reinforced to give staff the added confidence they need to achieve and maintain high quality CPR performance in the event of a cardiac emergency.”

Resuscitation Quality Improvement, (RQI), the American Heart Association’s gold standard for Basic Life Support (BLS) training, is a quarterly training program at Texas Children’s that offers real-time visual and audio feedback on compressions and ventilations to support the mastery of high quality CPR skills. Unlike conventional CPR classes – where an instructor provides his or her own personal feedback – RQI uses computer-based eSimulation technology that evaluates performance quality and solicits objective feedback in the form of positive reinforcement or suggestions for improvement.

“Being able to see the actual outcome of our compressions is amazing,” said Cardiac ICU Education Coordinator Shannon Cummings. “You can see if you’re under or over inflating, if you’re going too deep or too shallow, or if you’re not allowing for recoil and letting the chest expand. The program walks you through the steps, and tells you when to adjust your compressions, so you can perform CPR effectively.”

This program, administered by Texas Children’s Nursing Professional Development (NPD) Team, consists of online learning modules and skills assessments that are completed quarterly instead of once every two years. As part of this quarterly training, on-campus simulation stations will be equipped with adult and infant manikins, and a computer that connects to the CPR training materials.

After successfully completing the RQI training curriculum, staff are issued an RQI e-Credential card that must be renewed quarterly and a BLS e-Card that is renewable every two years. Additionally, staff can keep track of their completion and expiration via HealthStream.

“Studies have shown that CPR skills can decay within three to six months after initial hands-on training,” said Nursing Professional Development Assistant Director Angie Rangel. “The only way to master basic life-saving skills is through regular, measured and frequent practice. Through quarterly drills, we’re reinforcing the confidence and competence staff need to perform high quality CPR. At the end of the day, it’s all about improving outcomes. And with RQI, we are really moving towards great patient outcomes.”

Several nurses and direct patient care providers, as well as Child Life staff, participated in the soft launch of the RQI program on February 4, and these participants already see the benefits this program offers.

“In Child Life, a lot of times we’re doing one-on-one activities where there’s no medical staff around our patients in the room,” said Child Life Specialist Danielle Coleman. “So just in case something unexpected happens with a code, we can be the first responders and help that child out and be there for support.”

“I think this program is great, and will help refresh our skills more frequently than once every two years,” said Pavilion for Women Ambulatory Education Coordinator Leslie Williams. “We’ll be more comfortable with performing the resuscitation skills and it’s just better for the patients and the families.”

The NPD team has already identified 75 “super users” from Texas Children’s Medical Center Campus, Texas Children’s Hospital West Campus, Texas Children’s Hospital The Woodlands, and several Specialty Care Centers to be early adopters of RQI before the program is rolled out in phases across the system.

Click here to access the NPD website to learn more about RQI Training at Texas Children’s Hospital.

On his blog this week, Mark Wallace addresses the Harvey Weinstein verdict and the power of the #MeToo movement. Read more

Maya Peterson, education coordinator in the PICU, was recently accepted into The Archer Fellowship Program in Washington, D.C. Maya shares her experience applying for this internship program and how this opportunity will benefit her in her current role at Texas Children’s. Read more

March 2, 2020

Not so long ago the Claims department at Texas Children’s Health Plan faced significant challenges. Those challenges led to unhappy providers and millions of dollars in state penalties. But in the last year April Riggs, director of Claims Administration – and her newly restructured team – have overseen a remarkable turnaround. The team is more efficient, providers are happier and within the last eight months, the department has incurred $0 in state penalties.

Remarkable is perhaps an understatement.

In record time, the team has:

  • Ensured that 98 percent of all claims are paid within 30 days.
    • They reduced the average time from 22 days to five days.
  • Reduced the amount of claims in cue.
    • The team had 80,000 claims in cue at their lowest performance level.
    • The goal was to be at less than 30,000 claims in cue, which they have achieved and sustained for 14 months.
  • Eliminated liquidated damages, which are non-compliance penalties issued by the state.
      • The department previously incurred $2 million in damages over a 21- month period.
  • For the past eight months, they have incurred NO new liquidated damages.
How did they do it?

“We coined our mission Mission Possible and we set some very straight forward goals,” said Riggs. “We knew that to be successful we had to define our mission, review historical practices and in no way could we return to business as usual.”

Riggs immediately set her team on a course that consisted of:

  • Putting the right people in the right positions
  • Making data driven decisions
  • Implementing metrics that matter
  • Consistently monitoring productivity; and
  • Collaborating with key business partners

After all of these efforts were in place, she noticed a shift occurring within her team. “It was a pleasure to watch it happen. We became a team that could identify issues very early on and then move swiftly to identify solutions.”

And if that wasn’t enough, Riggs said her staff began daily briefings to review their work for the day, the week and even for the following week. “I believe Mr. Wallace calls that skating to where the puck is going to be,” she said.

Indeed it is.

Members of Texas Children’s plastic surgery team have given 6-year-old Elvina Kolevi a chance at a new life after treating injuries she sustained during a burn when she was 2 years old. Watch ABC 13’s story about the little girl’s transformation.

Texas Children’s Neurosciences Program is all about improving patient outcomes. Every day, our team of neurologists, neurosurgeons, geneticists, physician-scientists and researchers are working together tirelessly to pioneer innovative therapies to improve the lives of children with neurological disorders.

On February 21, neuroscience leadership at Texas Children’s together with faculty and staff convened for the inaugural Neurosciences Retreat at the Jan and Dan Duncan Neurological Research Institute (NRI). This informative and engaging event provided our multidisciplinary team of neurologists, neurosurgeons, clinicians, researchers, behavioral health experts, and more the opportunity to reflect on past successes, discuss areas of possible improvement, identify transformative goals and actively plan for the future.

After welcome remarks from Executive Vice President Dan DiPrisco, the retreat began with a moderated panel discussion with two patient families who shared their inspiring stories that brought them to Texas Children’s Hospital. One of the guests was Debbie Sukin, the daughter of the late Dr. Ralph D. Feigin.

Sukin’s two sons, 18-year-old Jacob and 15-year-old Eli, were born with neurological challenges. Jacob was diagnosed with Angelman’s syndrome and Eli was diagnosed with a very rare neurological disorder caused by a CASK gene mutation diagnosed through genome DNA sequencing at Texas Children’s Hospital and Baylor College of Medicine.

“Texas Children’s holds a very special place in my family’s heart,” Sukin said. “We always knew about the hospital’s focus on clinical care and research, and didn’t quite know at the time that it would be so beneficial and important to our family. We are very much involved, on both the basic science and clinical sides, and the multidisciplinary components that are necessary to care for a child with neurological issues.”

The Sukin family’s journey, like so many other patient family stories shared at the retreat, highlight our clinical and research partners’ collaborative efforts in advancing neuroscience research, ultimately leading to the development of novel treatments and discovery of cures for neurological disorders.

“We’re always striving to do things better, and I think this retreat is one step towards getting us there,” said Texas Children’s Chief of Neurosurgery Dr. Howard Weiner. “Everyone here is ready to embrace a new idea if it’s going to advance the field forward. The key to our success is the ability for everyone – in Neurosurgery and our amazing colleagues in Neurology and the NRI – to work together for our patients.”

Weiner, along with Dr. Gary Clark, chief of Neurology and Developmental Neuroscience, and Dr. Huda Zoghbi, director of the NRI, participated in a panel discussion that highlighted the organization’s bench-to-bedside achievements in neuroscience research and neurological care over the last 20 years, and outlined collaborative opportunities to accelerate innovation and research to improve patient outcomes.

“We’re entering the renaissance of neuroscience in pediatrics,” Clark said. “Neurology and neurosurgery are not the same programs they were five or 10 years ago. Neurological diseases that we thought for years were not treatable, have become approachable with new DNA therapies, enzyme replacement therapy to treat lysosomal disorders, and minimally-invasive surgical approaches like laser ablation, that was pioneered at Texas Children’s, and has yielded successful outcomes for treating epileptic seizures.”

The panel also discussed strategies to ensure a seamless flow from bench to bedside, that will help researchers accelerate the discovery behind the causes of neurological diseases so that effective therapeutic interventions can be developed to improve the quality of life and outcomes for patients.

“At the NRI, our teams have identified the causes of about 66 different neurological disorders, some degenerative, others developmental or psychiatric, and have identified the path for therapeutics,” Zoghbi said. “Together, with our collaborators and trainees, we are charting new paths towards viable therapies that will have an immeasurable impact on families suffering from unexplainable neurological diseases.”

After the panel discussions, attendees split up into pre-selected breakout groups. The teams chose their groups based on the topic, and were tasked with helping to establish neuroscience goals and collectively chart the path for treatments, discoveries and cures to be realized over the next five years

The breakout groups facilitated lively discussion and engagement around these topics:

  • Operational Excellence: Facilitating support for clinical care and research
  • Translating Discoveries to Therapies: Overcoming barriers in order to accelerate the translation of research discoveries into effective patient care and better outcomes.
  • Population Health: Strategizing on how to deliver better care to the large population of people with neurological diseases in Texas by preparing and empowering pediatricians to handle straightforward simple cases so Texas Children’s experts have band width to see more complex cases promptly.
  • Educating for the Future: Training the next generation of physicians, physician-scientists and scientists who will care for patients, enroll them in studies, push the research forward to discover new paths for interventions.
  • Research Funding: Increasing NIH funding to support the basic, clinical and training missions and to advance the agenda of discovery and therapeutics development.

“One of our goals coming into this retreat was to simply facilitate discussions,” said Senior Vice President Matthew Girotto. “We have world renowned clinical and research teams that, too often, do not connect with each other. By simply bringing everyone together, we were able to uncover several opportunities that could not only help accelerate discovery to improve patient care but also increase our collaboration with Texas Children’s Pediatrics in addressing many of the common neurological needs of children.”