July 1, 2019

Since implementing Texas Children’s Patient Access Initiative, Texas Children’s continues to make great strides to ensure our patients and their families get in the door easier to access our high quality services.

One of the many impactful changes benefitting patient families has been their ability to easily and quickly schedule their appointments online as a result of new features the organization has implemented. To date, more than 10,000 appointments have been scheduled online via MyChart and DocASAP.

In May 2018, Texas Children’s launched direct scheduling that allows current patients to schedule return appointments online through MyChart. Since its implementation, over 7,909 visits have been scheduled online and many patients and their families describe the scheduling process as “easy and convenient.”

“I was surprised that Texas Children’s now offers this option,” wrote a Texas Children’s family. “It was very convenient and the process for scheduling appointments was very simple and streamlined.”

In addition to direct scheduling via MyChart, over 2,814 appointments have been made via DocASAP, Texas Children’s online scheduling partner, since November 2018. Offered in both English and Spanish, this online scheduling tool is available to new patients, current patients, and referred patients at Texas Children’s three hospital campuses including our specialty care locations in Houston and Austin, and Texas Children’s Pavilion for Women.

“I am excited about the progress we’ve made to better serve our patients and their families,” said Sarah Ringold, assistant director of Perioperative Business Operations at Texas Children’s and project manager for the online scheduling team for Patient Access. “It is amazing to be able to offer families the flexibility of scheduling online, and to continue to improve the online scheduling tool to make it more and more effective for our patients.”

Other patient access milestones

Texas Children’s implemented other enhancements to improve patient access across the system. Below is an update on where we are today:

  • MyChart activations: Texas Children’s continues to see an increase in the number of patients signing up for MyChart. In October 2017, the organization had approximately 61 percent of distinct patients sign up for MyChart. As a result of system wide efforts to raise patient awareness and engagement, we have now exceeded over 74 percent activation rate for MyChart throughout the system as of June 2019.
  • Electronic Waitlist: Since implementing this MyChart feature that automatically sends texts and email notifications when appointments become available sooner, 3,794 patients have accepted an appointment on average 39 days earlier than their prior appointment. The total patient volume includes Texas Children’s Pediatrics (TCP), all subspecialties, sleep studies and therapies. Due to its success, TCPs in Austin and College Station will go live with this convenient electronic tool by the end of the summer.
  • Referrals: The referrals team continues to work through enhancements to the referral process in an effort to improve patient access. In April and May 2019, Texas Children’s received over 6,000 referrals from external providers that were processed through the central transcription team – the highest number of referrals from external providers to date. In addition, TCP surgical referrals and medicine referrals referred to Texas Children’s specialties also reached their highest levels at 91 percent and 87 percent, respectively. Current initiatives are in process to increase scheduling conversion and appointment capture rates for various specialties.
About Texas Children’s Patient Access Initiative

Launched in August 2017, Texas Children’s Patient Access Initiative is an on-going, collaborative effort to improve patient access across the organization. Since then, Texas Children’s has made significant progress to ensure patients easily and conveniently get in the door so we can provide the care they need, when they need it.

Click here for a list of other tools and features we’ve implemented across the system to improve access, care coordination and patient experience at Texas Children’s.

May 28, 2019

The National Institute of Health awarded a team of Texas Children’s scientists a $2.2 million grant in 2018 to study and develop computer and tissue-engineered models to predict the recurrence of congenital heart diseases. The study aims to change the way heart diseases are managed to improve the quality of life of children. Learn more by visiting our 2018 virtual Annual Report.

May 14, 2019

Not too long ago a child with hepatocellular carcinoma – a rare liver cancer – would have few options for treatment and even fewer chances of long term survival.

In most cases, these tumors are discovered so late that surgery and transplant are not viable options to save a young child’s life. Families could hope for recovery, but the odds would not support their optimism.

The good news is that today is a new day.

A multidisciplinary team, led by Dr. Kamlesh Kukreja, expert in Interventional Radiology; is successfully performing the Trans-Arterial Radioembolization procedure – called TARE – on children who have this rare disease.

“There are only three hospitals in the country performing TARE and we are one of them,” Kukreja said. “We are the only one in the state of Texas.”

He added that TARE has the potential to regress tumors and help patients live with their own liver or keep the tumor in control until a liver transplant is available. An additional advantage is that TARE is an outpatient procedure, which allows the child to recover at home.

How it all works

TARE is administered in two steps. Step one involves identifying the angiographic anatomy of the tumor mapping the vascular supply of the cancer to assess how much radiation it can handle, while still keeping the patient safe.

“Two to four weeks after this mapping, the patient returns for the radioactive chemical agent – called Yttrium-90 (Y90) – to be administered directly to the artery supplying the tumor,” Kukreja said. “This administration is targeted and direct, which allows for higher doses of radiation to be administered with minimal side effects; unlike systemic chemotherapy, which has been found to not work well in these cases.”

Record of Success

Kukreja has successfully performed TARE on two patients to date with one patient showing a clear regression in the growth of the tumor allowing complete surgical resection.

Although Texas Children’s is one of the pioneers of TARE in pediatrics, it’s important to note that TARE is a frontline therapy at adult hospitals for patients with the most common type of liver cancer. Accumulating evidence from studies with adult liver cancer suggests that TARE is a promising strategy which may benefit children as well.

The people that make It possible

“We are very proud of what we have been able to accomplish so far and the way we have raised the standard of care for our patient families,” Dr. Kukreja added. “We are also proud that a multidisciplinary team has made this possible.”

The decision to use this approach is first made by a multidisciplinary team involving:

Dr. Prakash Masand, Radiology
Dr. Andras Heczey, Oncology
Dr. Sanjeev Vasudevan, Pediatric Surgery
Dr. John Goss, Transplant surgery

The hands-on clinical teams at Texas Children’s include interventional radiology, nuclear medicine, radiation safety, anesthesia and Dr. Armeen Mahvash, associate professor at M. D. Anderson Cancer Center.

To Learn More

If you know a patient who could benefit from this treatment, please reach out to the department of Interventional Radiology at 832-824-5565 or liver tumor team at https://www.texaschildrens.org/departments/liver-tumor-program. Dr. Kukreja can be reached at kukukrej@texaschildrens.org/kukreja@bcm.edu.

April 29, 2019

On April 26, superheroes of all sizes assembled on The Auxiliary Bridge to celebrate National Pediatric Transplant Week, observed each year during the last full week of National Donate Life Month in April.

The event, hosted by Texas Children’s Transplant Services, marked the end of a week that focuses on the powerful message of ending the pediatric transplant waiting list. There were plenty of fun activities for children, including karaoke, hula-hooping, coloring and crafts, a photo wall, and a visit from Elsa, one of Texas Children’s three therapy dogs. There were also educational materials available on organ donation and transplantation.

The event also honored real-life superheroes – the donor families whose children have saved and healed lives through organ, eye and tissue donation.

The gift of an organ transplant comes to one family as another family is enduring the most difficult time of their lives. The team in Transplant Services works hand in hand with Texas Children’s Spiritual Care Department during these times to provide donor families with compassionate support, to honor the choice to donate an organ, and to honor the legacy of the patient.

There are several ways we recognize the legacies of these children and their families, including:

  • The observance of moments of honor, small ceremonies during which the gift of the organ donation is acknowledged and celebrated through readings and a blessing or prayer
  • Flag ceremonies, at which a Donate Life Flag is displayed and family, Texas Children’s staff and chaplains, and our LifeGift partners gather to tell stories about the patient, let the family touch the flag, share a group reading, and then the flag is then passed around the unit to be signed with messages of support and recognition from Transplant Services staff
  • National Donor Sabbath, an annual three-day observance where members of local faith communities participate in services and programs to honor donor families and to educate the public about the need for lifesaving transplants

In addition to these heartfelt moments of acknowledgement and remembrance, Texas Children’s Hospital has begun a new tradition to honor our donor families.

As the sun went down on April 22, Lester and Sue Smith Legacy Tower was illuminated in green and white. The tower was lit each evening for the rest of the week, both in commemoration of National Donate Life Month and Pediatric Transplant Week, and also as a tribute to our donor families. Going forward, the lighting of the tower will serve as yet another way Texas Children’s acknowledges them.

“Nothing we do would be possible without our donor families, and we wanted to find another way to honor them,” said Dr. John Goss, medical director of Transplant Services. “Now when people see Lester and Sue Smith Legacy Tower lit in green and white, they will know there’s a hero here at Texas Children’s who has just given the gift of life.”

About Transplant Services at Texas Children’s

Transplant Services at Texas Children’s was the nation’s largest pediatric transplant program in 2018, performing a remarkable 107 solid organ transplants including the highest volumes of pediatric liver, lung and kidney transplants.

Transplant Services provides a comprehensive, multidisciplinary approach to care through all aspects of the transplant process, from initial referral to hospitalization and outpatient management. Our team of experts includes physicians and surgical advanced practice providers, transplant coordinators, pediatric ventricular assist device coordinators, perfusionists, child life specialists, dieticians, social workers, financial counselors, pharmacists, inpatient and outpatient nursing and support staff, Perioperative Services, physical and occupational therapists, Radiology, Pathology, our LifeGift partners, and many others.

Our depth of skill and service enables us to offer world-class care for patients, from newborns to young adults, in need of heart, kidney, liver and lung transplants. That expertise has allowed us to successfully treat some cases that other national and international programs might consider untreatable.

Learn more about Transplant Services at Texas Children’s Hospital.

April 22, 2019

Disney Magic has officially arrived at Texas Children’s Hospital.

Invited guests from The Walt Disney Company, media outlets and health care organizations across the country joined Texas Children’s clinical and executive leadership to celebrate the launch of the Disney Team of Heroes pilot. Texas Children’s is the first hospital to work with Disney on this comprehensive new initiative that will enhance the patient and family experience at children’s hospitals across the globe through a unique combination of reimagined spaces, personalized moments and engaging content, all featuring Disney’s beloved characters and themes.

Watch the video to see how all these elements came together over the past three weeks.

“Disney’s commitment to bringing comfort and inspiration to children doesn’t stop at the gates of Disneyland or Walt Disney World, and we are so grateful Disney is bringing those values to us in this way,” said Texas Children’s Surgeon-in-Chief Dr. Larry Hollier. “The magic and joy we have all experienced at a Disney park is now apparent as you walk throughout our hospital, and I am looking forward to seeing how this special partnership enhances the patient and family experience.”

Texas Children’s relationship with The Walt Disney Company dates back to 1952 when Walt Disney himself gifted the hospital with an illustration depicting his vision for the hospital’s campus at the time. The partnership was further solidified in 2018 when Texas Children’s was chosen as the pilot hospital for this transformative, five-year commitment to the patient experience from The Walt Disney Company.

The Disney Team of Heroes launch was the culmination of a year of hard work and collaboration between a group of more than 80 Disney team members, including Disney’s famed Imagineers, and a dedicated team of Texas Children’s employees and caregivers.

“As the name itself implies, at Disney we know that if you want something to be timeless, and touch the hearts of millions, it requires a talented team to bring it all to life,” said Elissa Margolis, Senior Vice President of Enterprise Social Responsibility at The Walt Disney Company. “We could not have done this without all the guidance, partnership and collaboration from doctors, nurses, hospital administrators, child life specialists, creative teams, tech leaders and also, importantly, parents.”

Guests at the event got a first look at new Disney Team of Heroes experiences on a tour of Lester and Sue Smith Legacy Tower. These elements included the stunning Magic Mural, which allows patients and families to interact with characters and environments; mesmerizing Magic Windows, where favorite characters pop in for a brief visit before taking off again; captivating Magic Portals, seek-and-find activities that provide distraction while waiting for an appointment to begin; and Disney Products and Hospital Gowns, which help brighten patient rooms and bring familiarity into hospital stays. Additionally, Texas Children’s employees system-wide received themed Disney Team of Heroes Employee Badges featuring Disney characters. The badges will create opportunities to engage patients, and fellow employees, in a fun new way.

Stay tuned for a more in-depth look at the new Disney Team of Heroes elements on our Corporate Communications Instagram, @oneamazingteam. Learn more about Texas Children’s partnership with Disney, and check Connect frequently for more exciting updates.

April 9, 2019

Texas Children’s Heart Center was once again the site of a groundbreaking novel treatment that gives experts in our new catheterization laboratories yet another method at their disposal in the treatment of complex heart conditions.

Dr. Henri Justino, co-director of the center’s cardiac catheterization labs and director of cardiac innovation, recently developed and performed a first-of-its-kind procedure in which a young patient’s lung veins were reached directly through the chest wall.

Hope for Bronx

Three-year-old Bronx Delarosa was born with total anomalous pulmonary venous return, a critical heart defect that causes oxygen-rich blood returning from the lungs to be pumped into the right atrium instead of the left atrium, as it normally should. There, the oxygen-rich blood mixes with oxygen-poor blood, which means the body doesn’t get the oxygen it needs.

At just 8 days old, Bronx underwent a surgery to repair the defect that was initially thought to be a success. However, following a second surgery, doctors told his parents he’d developed a secondary condition – pulmonary vein stenosis, a condition that caused severe narrowing in his surgically repaired veins. The Delarosas were heartbroken when they learned there was nothing else that could be done for Bronx in their hometown.

To give their son a fighting chance, they turned to Texas Children’s Hospital.

Breaking new ground

Justino performed Bronx’s first catheterization procedure in February 2018, during which he placed a metal stent in the blocked upper vein in Bronx’s right lung. However, he was unable to relieve the blockage in the lower vein.

After a personal friend underwent a lung biopsy, where a tissue sample was taken directly through the chest wall, Justino wondered if a similar approach could be applied in cases like Bronx’s – entering the veins of the lungs through the chest.

After thorough research, Justino decided to move forward with the unique approach to relieve the blockage in Bronx’s right lung.

Bronx was taken to the catheterization lab where the team performed a CT scan to identify the exact location where the blocked vein was sufficiently far apart from artery, yet close enough to the chest wall, to allow a needle to enter the vein directly between the ribs. Justino and his team also generated a 3-D computerized model to pinpoint the exact location where the needle would enter Bronx’s chest. To ensure the utmost accuracy, a laser crosshair was beamed on his chest at the entry point.

Justino carefully made his way into Bronx’s lung and placed a tiny catheter, the thickness of a raw spaghetti noodle. He then used a special wire to deliver radiofrequency energy to get across the blocked vein and into the heart. From there, the wire was threaded down through Bronx’s leg. This allowed a stent to be placed in the blocked vein via a catheter in the leg.

Bronx recovered well and a follow-up echocardiogram proved the experimental approach was a success. The first-of-its-kind procedure, which lasted more than eight hours, was performed in one of the Heart Center’s new state-of-the-art, 1,000-square-foot cardiac catheterization labs, which Justino helped design with this type of procedure in mind.

“We are proud that Dr. Justino was able to develop this completely novel procedure for Bronx,” said Texas Children’s Chief of Pediatric Cardiology Dr. Daniel Penny. “Pulmonary vein stenosis in children is an extremely difficult problem to treat and tests the limits of our abilities to innovate. We see this new procedure as another advancement in the treatment of these children, which will be applied more widely in the future and help us improve the care we offer for complex cardiac conditions.”

Learn more about Texas Children’s Heart Center, ranked No. 1 in the nation by U.S. News & World Report.

December 11, 2018

A little over a year ago, Larissa Fletcher took a huge leap of faith and walked into Texas Children’s Family Fertility Center to carry out the plan she and husband made years earlier on the darkest day of their lives.

On that dark day, Larissa and her late husband John Fletcher learned he had stage four esophageal cancer, and would, at best, live another year. Knowing they wanted to give their then 1-year-old daughter, Emma, a sibling, the couple decided to freeze John’s sperm and store it at the Fertility Center’s state-of-the-art in vitro fertilization (IVF) lab until Larissa was ready to try to have another child.

Shortly after that day came, Larissa watched her embryologist zoom her microscope in on what would become the now 4-month-old Elliana “Ellie” Joy Fletcher. Using a leading-edge embryo monitoring system called the EmbryoScope, Larissa also was able to watch a video of Ellie from when she was just a few cells all the way up to the time she was ready to be transferred into her mother’s belly to develop and grow for the next nine months.

“I was in awe of all of it,” Larissa said of the video. “In that moment, everything became very real for me.”

Texas Children’s Family Fertility Center’s three EmbryoScopes bring to life what reproductive endocrinology specialists see under a microscope and then describe to their patients. The technology, which provides continuous time-lapse imaging of embryos as they grow, also enables specialists to identify the healthiest embryo to transfer to the patient, for improved IVF success rates.

Dr. Richard Cochran, the Family Fertility Center’s Laboratory Director, said he and his colleagues in the lab are looking at whether the EmbryoScope can also help improve patient outcomes. The technology, he said, allows clinicians to see how an embryo divides, which in turn gives them the opportunity to see certain abnormalities.

“Sometimes embryos will divide, and then the cells will remerge, and then re-divide,” Cochran said. “That’s very abnormal, and that’s something we would not see in a traditional incubator setting.”

In such a setting, clinicians typically look at an embryo two days after fertilization is attempted, again a day or two later and so on. What happens in-between observations isn’t captured, and could be an important predictor of developmental abnormalities. For similar logistical reasons, the EmbryoScope already has proven to be helpful at enabling specialists to identify the healthiest embryo to transfer to a patient.

“In the vast majority of laboratories, embryos are put in traditional incubators where you have to take them out and expose them to room temperatures to see them,” said Texas Children’s Chief of Reproductive Medicine Dr. William Gibbons. “With the EmbryoScope, handling of the embryos is minimized and visibility is 24/7, enabling us to ensue embryos are growing and reach the appropriate stages at the appropriate times before transplantation.”

Texas Children’s Family Fertility Center is the only location in Texas other than Dallas that is using the EmbryoScope. The center has been using the technology since it opened in 2014 and currently has three. One of the scopes is dedicated to research while the other two are for clinical use.

Larissa, a former Fertility Center patient and a pediatrician with the Texas Children Newborn Center, said her experience at the center was extraordinary from beginning to beautiful end.

“When I was eight weeks pregnant and had to move my pregnancy care from the Family Fertility Center to a traditional OBGYN, it was bittersweet,” she said. “The people there were like my second family.”

To learn more about the EmbryoScope and how clinicians with the Texas Children’s Fertility Center uses the technology, click here.

Texas Children’s Family Fertility Center has earned national and international recognition for advancing the understanding and treatment of reproductive disorders. Our reproductive endocrinology specialists are proud of the impact we have made on the lives of our patients, women and families across the globe. To learn more about our Fertility Center, click here.