December 2, 2019

On November 14, hundreds of Texas Children’s Hospital friends and supporters gathered at the Westin Galleria Hotel for this year’s The Forum Luncheon, which highlighted the astounding work of the Trauma and Grief (TAG) Center at Texas Children’s.

The program was emceed by Physician-in-Chief Dr. Mark Kline and featured Dr. Julie Kaplow, the TAG Center’s founding director and the Shannon and Mark A. Wallace Chair in Pediatric Behavioral Health, who spoke about the challenges created by trauma and grief in the lives of children and the community, and about the TAG Center’s efforts to meet those challenges head on.

Trauma- and grief-informed care

The TAG Center at Texas Children’s uses evidence-based practice to provide care for patients, from 7 to 21 years old, and their families who have experienced trauma or grief. Under Kaplow’s leadership, the center uses a scientist-practitioner model with three primary aims:

  • Provide evidence-based assessments and interventions for youth who have experienced traumas and/or losses
  • Conduct research on adaptive and maladaptive responses to trauma and loss, as well as treatment effectiveness
  • Provide training and professional education in trauma- and grief-informed assessment and interventions using best-practice teaching methods

The TAG Center’s impact on the community was immediate. Less than a month after Kaplow started at Texas Children’s in 2017, Houston experienced Hurricane Harvey, one of the most devastating storms in the nation’s history. To help support the most vulnerable populations, and to serve the mental health needs of children affected by the hurricane and flooding, the TAG Center launched the Harvey Resiliency and Recovery Program. Another of the program’s primary goals was to equip the community to provide the same services, primarily in schools.

The TAG Center increased access to in-house services by partnering with Lyft to bring families to the hospital and by paying for parking. Generous philanthropy also made it possible to deploy mental health clinicians on one of Texas Children’s Mobile Clinics, making much-needed mental health care available to many immigrant families in areas of Houston where they otherwise would not have had access.

In the two year’s since Harvey, the storm’s affects are still being felt and the TAG Center is now seeing more children exhibiting mental health symptoms that require treatment.

Nine short months after Harvey, Greater Houston was struck with another horrible tragedy – The Santa Fe school shooting.

In the immediate aftermath, the TAG team went out and provided immediate support for students and teachers, which included education about the symptoms people might be experiencing, normalizing those symptoms, and helping identify children who might be in need of a higher level of care. The center also held community meetings to educate people about possible triggers of trauma and loss in the weeks and months following.

In a commitment to the long-term recovery from this devastating tragedy, the TAG Center partnered with other organizations to launch the Santa Fe Resiliency Center. There are now four TAG Center clinicians providing trauma- and grief-informed assessment and treatment to the many students, teachers and families who continue to need help.

One of those students – 17-year-old Reagan Gaona – was present at the event and spoke to the audience about her experience of losing her boyfriend in the shooting and the terrible pain, depression and anxiety that followed. It was after meeting with Marisa Nowitz, a TAG Center clinician, that Reagan was able to begin coping. She began to use writing as a tool to let her feelings out and to help remember memories of her boyfriend. Other exercises, she said, helped her deal with anger and to appreciate things in life more.

“If it weren’t for the TAG Center, I don’t know where I’d be,” Reagan said. “I really hope that after today, people will see what the TAG Center is capable of doing for people like me and why it’s so important. If it weren’t for the TAG Center and Marisa coming to Santa Fe, I don’t know where I’d be.”

Learn more about the Trauma and Grief Center at Texas Children’s.

November 26, 2019

On his blog, Mark Wallace concludes his Leadership Maxim series with his fifth guest blogger, Shannon Holland, who writes about Maxim No. 5: The key characteristics to look for when selecting people are a winning attitude and a strong work ethic.

By commenting on Holland’s blog you can secure a chance to score a spot at a Houston Texans event.

The Corporate Communications team will randomly select people from the comments to attend a private event with the Houston Texans, including a behind-the-scenes tour of NRG Stadium, an autograph session with two Houston Texans football players and photos with Texans cheerleaders. The event will be held on Tuesday, December 3. Read more

 

An unprecedented future and unlimited possibilities were the talk of this year’s Health Plan Town Hall, hosted at the Bayou City Event Center on November 1.

The strong tone of optimism and opportunity was only made stronger by the event’s inclusion of Mark Wallace’s 30th anniversary celebration. Wallace, who is the president and chief executive officer of the Texas Children’s system, opened the event with an organizational overview and closed the event following a special film that documents his life and leadership.

Mark Mullarkey, president of Texas Children’s Health Plan, presented a “state of the health plan” to his nearly 900 employees who were enthusiastic and energized about the year ahead.

Fiscal Year 2019 accomplishments included …

  • People and Structure: The Health Plan opened over 100 incremental positions and better leveraged the subject matter expertise of 18 senior leaders.
  • Stronger Connection to the System: The Health Plan strengthened its connection to the Texas Children’s system and became an even more integral part of our One Amazing Team.
  • Focus: Health Plan leaders rallied around four key priorities to drive process improvement and operational excellence – Customer Obsession, Membership Growth, Effective and Efficient Operations, Highest Quality Care in a Cost Effective Manner.

In 2020, the focus will be on …

  • Continued intensity on the four key priorities listed above.
  • Assisting the Health and Human Services Commission (our state funding agency) as they attempt to reach the goals outlined in their new “Blueprint for a Healthy Texas.”

Links to visit:
The top10 things you should know about The Health Plan
HHSC’s Blueprint for a Healthy Texas
All about Mr. Wallace’s 30th anniversary and his legacy as the leader of our organization

A year’s worth of planning and preparation came to fruition last month as Texas Children’s Hospital hosted the 24th Annual Society of Pediatric Liver Transplantation (SPLIT) Conference, bringing together experts from more than 40 national and international liver transplant centers.

The two-day event, designed for health care professionals involved in the care of pediatric liver transplant patients, featured speaker presentations, panel discussions, and case and poster presentations. Major discussion session topics included:

  • Unique Transplant Considerations
  • A Village Approach to Liver Intensive Care
  • Surgical and Interventional Considerations
  • The Many Faces of Rejection
  • Advocacy

Texas Children’s multidisciplinary approach to liver transplant care was on display throughout. Of the 36 presenters who spoke, 15 were from Texas Children’s and academic affiliate Baylor College of Medicine. This year’s SPLIT meeting also boasted the best attendance ever, with 236 attendees, which included physicians, surgeons, advanced practice providers, trainees, data and transplant coordinators, dietitians and social workers.

The event was spearheaded by Dr. Daniel Leung, Texas Children’s Director of Pediatric Hepatology and Liver Transplant Medicine, and the event’s Continuing Medical Education (CME) Activity Director; and Melissa Nugent, education coordinator for Transplant Services, who was the event organizer and the meeting’s Nurse Planner for Continuing Nursing Education. Thanks in large part to the planning committee, the conference was such a success that it won Texas Children’s award for Best CME Course.

The planning committed included:

  • Dr. John Goss, Medical Director of Transplant Services
  • Diesa Samp, Director of Transplant Services
  • Julie Economides, RN, SPLIT data coordinator at Texas Children’s

“It was an honor to be selected to host this year’s SPLIT Conference,” said Leung. “We not only showcased the breadth of our subspecialty expertise – including ICU, infectious diseases, immunology, interventional radiology, transfusion medicine, nephrology and others – all dedicated to pre- and post-lever transplant care at Texas Children’s, but we also continue to lead the country by example in how we collaborate and learn from one another. I am truly grateful for our special team of surgeons, hepatologists, coordinators, nurses, pharmacists, dietitians and social workers. It really does take a village.”

About SPLIT
The Society of Pediatric Liver Transplantation is a unique multidisciplinary, multicenter consortium focused on optimizing outcomes pediatric liver transplantation through research, advocacy, and dissemination of best practice in this field. SPLIT is the only such academic body dedicated to pediatric liver transplantation.

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, dietitians, 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.

November 19, 2019

Norma Terrazas shares her excitement with colleagues as they prepare to move acute care services from the old Abercrombie Building into 15 West Tower – the former home of Texas Children’s Heart Center — on November 20. Read more

November 18, 2019

On his blog, Mark Wallace continues his Leadership Maxim series with his fourth guest blogger, Kristi Lemmert, who writes about Maxim No. 4: We all should have our own definition of leadership.

By commenting on Lemmert’s blog – and the next blog in the Leadership Maxim series – you can secure a chance to score a spot at a Houston Texans event.

Throughout November, the Corporate Communications team will randomly select 100 people from the comments to attend a private event with the Houston Texans, including a behind-the-scenes tour of NRG Stadium, an autograph session with two Houston Texans football players and photos with Texans cheerleaders. The event will be held on Tuesday, December 3. Read more

During the final week of October, Texas Children’s Hospital hosted visitors from around the world for a very special Rett Syndrome Symposium and Workshop.

The two-day event was momentous for many reasons. It was the inaugural meeting held in the stunning new Auditorium and Conference Center at the Jan and Dan Duncan Neurological Research Institute (Duncan NRI) at Texas Children’s Hospital. It fortuitously coincided with Rett Syndrome Awareness Month. And the symposium also marked the 20th anniversary of the discovery of the underlying cause of Rett syndrome. In 2000, NRI director Dr. Huda Zoghbi’s research team made the pioneering discovery that loss-of-function mutations in methyl-CpG binding protein, MECP2, were the underlying cause of Rett syndrome.

Rett syndrome is a rare neurological disorder that primarily affects young girls between 6 months and 2 years of age. The children appear to hit normal developmental milestones until, inexplicably, their motor, cognitive and social skills start to rapidly deteriorate. Most patients develop autistic features, breathing difficulties, dementia, growth abnormalities, epilepsy and scoliosis.

The symposium opened with a warm welcome from co-organizers Dr. Adrian Bird – Buchanan Professor of Genetics and Welcome Trust Center for Cell biology at the University of Edinburgh, UK – and Zoghbi, who is also a professor at Baylor College of Medicine and Howard Hughes Medical Institute investigator.

“The purpose of this event was to bring together researchers who work on Rett syndrome and leaders from related areas of neuroscience working in academia, industry and government, to think deeply and spark new ideas,” said Zoghbi. “The hope is that out of the work and discussions that happened here, in five years, when we’re marking the 25th anniversary of the gene discovery of Rett syndrome, we’ll also be celebrating new treatments for people with Rett syndrome.”

The international symposium was sponsored by Rettsyndrome.org (formerly the International Rett Syndrome Foundation) and the Rett Syndrome Research Trust. The multidisciplinary group of attendees included scientists, physicians, members of the lay public, and representatives from the National Institutes of Health, the pharmaceutical industry, and several foundations, all brought together to look at Rett syndrome with a fresh, new perspective.

On the first day of the symposium, presentation topics ranged from clinical observations of MECP2 disorders like Rett and MECP2 duplication syndrome to pathogenesis (progression or development) of Rett syndrome, to discussions on neuronal circuit alterations and therapeutics. Texas Children’s pediatric neurologist Dr. Bernhard Suter spoke about MECP2 duplication syndrome, which typically affects male patients and causes symptoms such as hypotonia, motor delays, intellectual disabilities, gastrointestinal issues and epilepsy.

Following a day of stellar research presentations, the investigators split into three working groups that focused on Molecular Pathogenesis, Therapeutic Approaches and Young Investigators. The groups discussed the information presented over the course of the day and their vision for the future of Rett syndrome research. This included the systemic and technical challenges that currently exist, and the group brainstormed ways to overcome those. The next morning, key points from these discussions were shared with the audience.

  • Rett syndrome is a particularly challenging disorder to correct. The levels of MECP2 protein in the neurons need to be precisely regulated because too much MECP2 protein causes a different neurological condition, the MECP2 duplication syndrome. Despite these challenges, research in Rett syndrome is advancing at a rapid pace, having moved from gene discovery to promising clinical trials in under 20 years.
  • Gene therapy offers exciting opportunities to develop treatment for Rett syndrome and is an area of active research. However, there are challenges to overcome including controlling the level and distribution of the delivered gene.
  • While the ultimate long-term goal of researchers is to find a lasting cure using gene therapy, clinicians in the audience weighed in on the benefits of also developing short-term strategies to treat specific behavioral or motor issues and/or how to delay the age of symptom onset. This would be a huge step forward for patients, their families and caregivers who cope with this debilitating condition on a daily basis. Participants in the discussion also drew parallels to the field of breast cancer, where non-targeted treatment modalities serve as the workhorses to treat the majority of patients.
  • There is a dire need to develop early screening/diagnostic methods for Rett syndrome among newborns. Early diagnosis, in combination with specialized therapies – such as neuromodulation physical therapy, speech therapy or psychotherapy may provide maximal improvements in the quality of life of the patients.
  • Building collaborations between academia and industry, with a focus on multidisciplinary team science and data-sharing, is critical to facilitate the development of superior reagents (i.e., better viral vectors for gene therapy), biomarkers (i.e., meaningful measures of clinical outcomes) and therapies. Moreover, there was a general agreement that close partnerships between various key stakeholders, such as scientists, physicians, pharma/biotech industry, families, caregivers and advocacy groups, are crucial for developing effective therapies.

Learn more about Texas Children’s research efforts at the Jan and Dan Duncan Neurological Research Institute and world-class clinical expertise provided at the Rett Center.