March 18, 2019

 

As part of Texas Children’s Care Coordination Initiative – and in an effort to ensure better care and communication between providers and their patients – MyChart is now available in Spanish.

“By having our patient portal available in Spanish, we want to ensure that we are providing information to families in a language they understand,” said Dr. Heidi Schwarzwald, executive sponsor of MyChart Spanish and Chief Medical Officer Pediatrics of Texas Children’s Health Plan. “Patients and providers can now use the same great functionality in MyChart to transmit messages and health information faster and more efficiently in whichever language our patient families are most comfortable with.”

Before or after patients log on to MyChart at mychart.texaschildrens.org, they can click on the “En Español” button and the MyChart patient portal switches to Spanish. From there, patient families can obtain their after visit summaries and immunization records electronically, reducing phone calls and delays. They can also request medication refills and other services. All of the main features from MyChart English are now in Spanish except for certain titles or sections, such as medication names.

Within MyChart, patient and families can also send and receive open messages. Care team members have three tools to translate Spanish messages from MyChart. Messages can be translated by Spanish-speaking staff who have been validated by Language Services or through a translation software, Systran. Staff can also send MyChart messages for translation to the Language Services team via Epic Inbasket. Each clinic has established their workflow on who and how incoming messages will be translated and can then respond to the concern or request using the current workflow for English messages.

“While over 60 percent of Texas Children’s patients use MyChart, only 27 percent of Spanish-speaking patients had accessed the MyChart patient portal which meant providers had to use different modalities to contact these families,” Schwarzwald said. “Now with the launch of MyChart Spanish, we hope this new communication tool will encourage more Spanish-speaking families to engage with us via MyChart.”

From Texas Children’s operations teams that provided the guidance for needed features to the technical teams that helped implement the new functionality to the Language Services department that provided translations for content, the MyChart Spanish rollout has been a huge team effort across the board.

Language Services provided all of the content and document translations that populated the server files for the Spanish MyChart implementation. This included everything from minor phrases and alert messages to full multi-page, terms of service and important FAQ translations. All of the patient-facing files and content needed to be translated and included in the Spanish MyChart build on the web servers.

“We provided knowledge and expertise to ensure the accuracy and reliability of the translation software and we’ve been working to create and build the software’s dictionary, which establishes the benchmark for accurate translation,” said Alma Sanchez, manager of Language Services. “Our team will continue to enhance the dictionary and translation memory to enable quick and complete responses to our patients.”

The soft launch of MyChart Spanish will give staff the opportunity to test the system and workflow processes before actively marketing this new service to our Spanish-speaking patients and families.

“We’re excited to roll out MyChart Spanish for our multilingual patients, families and staff that interact with Texas Children’s for their patient experiences,” said Colleen Julien, Epic Patient Engagement manager for Texas Children’s Information Services. “We are appreciative of the Care Coordination initiative and Dr. Schwarzwald’s leadership. This project has been on our road map for many years and the project took off when Care Coordination made it an operational priority to offer MyChart in Spanish.”

Click here to read the MyChart Spanish FAQs. For more information about MyChart, visit texaschildrens.org/mychart.

March 5, 2019

When opportunities arise, Texas Children’s Emergency Management plans functional active shooter exercises on our campuses. Thanks to the leadership and staff of the Texas Children’s Health Plan, or the first time on February 27, the exercise was geared toward those who work in an office environment rather than a clinical space.

The purpose of these exercises is to test Texas Children’s emergency notification procedures, staff training for response to an active shooter (Run, Hide, Fight), and to give our law enforcement partners a chance to practice their tactical response to an active shooter. Holding this training in an administrative rather than a clinical setting provided an excellent opportunity to test the “Run, Hide, Fight” training and a different environment.

The most important aspect of the exercise is the difference in an administrative setting versus a healthcare setting. Hospitals have multiple patient rooms and storage rooms for other medical purposes, whereas, in most office buildings there are large open areas that have cubicles. When the staff practice the “Run, Hide, Fight” method, most people’s first thought is to hide under a cubicle desk.

“That is not the safest place during an active shooter situation,” manager of Texas Children’s Emergency Management Aaron Freedkin said. “They need to find another place, either leave the floor or find a room that they can lock or block the door with furniture. That’s preferable to just hiding under a desk.”

The exercise included 175 participants, 14 logistical volunteers, 32 observers and 48 law enforcement officers such as: UT Police, Bellaire Police, Houston Police Department, Precinct 5 Constables Office, and Pasadena Police Department SWAT. Having multiple agencies involved in simulating an active shooter incident response creates an environment that is as realistic as possible and allows law enforcement agencies to practice their skills in a new environment. A secondary benefit is having the opportunity to train in the office setting, which would be valuable in the event of a real active shooter incident. It is a chance for them to train together with other agencies and get exposed to different training aspects that ultimately have the same basic goals and mission.

“We are excited to partner with these law enforcement agencies,” Freedkin said. “They get many opportunities to practice in empty buildings with law enforcement participants. This exercise will give them all a chance to practice their building clearing and searches with the unpredictability of non-law enforcement officers playing the role of victims and so there is definitely something in it for everyone participating.”

After the participants arrived, they were put through a safety briefing with Texas Children’s Hospital Emergency Management, followed by further orientation with The University of Texas Police Department, and “Run, Hide, Fight” training provided by Texas Children’s Security. During these exercises blank ammunition was used to simulate gunfire to increase realism while maintaining safety.

Law enforcement was staged on the 13th floor and the exercise began as they proceeded down the stairwell. Meanwhile, there is a person on the 12th floor acting as the aggressor toward employees. The challenge then comes as the aggressor engages in a discussion with the employee that may result in them not thinking immediately about, “Run, Hide, Fight.” After the exercise is reset and begins a second time, there is quicker movement of people because they have had time to immediately think about it and learn from their initial mistakes.

“It is always interesting to observe an exercise such as this because people react in unexpected ways such as seeking shelter and protection in places that are not ideal,” Freedkin said. “That is one of the reasons we conduct this training so that people have an opportunity in advance to consider their training and what their reaction should be.”

There were three sessions and all were structured the same way. Between the first evolution and second evolution of each session, a portion of the scenario changed. A debrief discussion was later held and everyone was able to reflect on their reactions.

“The exercise went extremely well and was well received by the exercise participants and senior leadership who were present,” Freedkin said. “For future exercises, we are working with our law enforcement partners to add additional elements of realism to the exercise while still maintaining the safety of our participants.”

The Emergency Management Team looks forward to providing more trainings geared toward the administration staff throughout the system, and wants people to know if an opportunity comes up to participate in an active shooter exercise like this, staff should take advantage of it. The more realistic your training experience the better you’re going to react in an actual incident.

February 25, 2019

An energetic crew of 30 health-conscious Texas Children’s employees, some of their friends and one enthusiastic Heart Center patient mom recently teamed up to put a whole new spin on celebrating Heart Month.

The multidisciplinary group of physicians, nurses, physical and occupational therapists, and nutritionists from our cardiac intensive care unit (CICU), along with several employees from other critical care medicine (CCM)-related departments and services, met at RIDE indoor cycling studio in Houston Heights to sweat for a cause, raising money for Texas Children’s CICU and CCM patients and their families in a charity spin class.

“An event like this shows you the kind of amazing people we have at Texas Children’s,” said Dr. Paul Checchia, medical director of the Cardiac Intensive Care Unit. “Not only does it reflect their dedication to our patients, to give up their personal time – and their sweat – to benefit children with heart disease, but it also shows their dedication to the team, to each other and to their own heart health.”

The idea first came to Dr. Patricia Bastero, Texas Children’s medical director of Simulation for Critical Care Medicine, after the CICU team held two previous spin runs together.

“Lots of us love spin – it gives you strength and cardio, it’s great for you,” she said. “But it’s also a great way to bond with friends. I thought, ‘Why not take it a step further and do it to benefit our families?’ So we started to spread the word through email, on Facebook and with custom-made flyers, and I want to thank Pamela Biggs for all the work she did in helping us to keep people informed about the event.”

Texas Children’s has one of the nation’s largest, busiest and highest-acuity critical care services. Each year more than 6,000 children are admitted to our intensive care units, including approximately 800 children with heart disease admitted to our CICU, the majority of whom have undergone heart surgery. Understandably, because of the complex nature of these cases, critical care treatment can be stressful for patient and family. It can also mean lengthy stays or lots of travel to the hospital, which can add up.

The funds raised through the charity spin class will help defray some of those costs incurred during hospital visits, such as parking or gas.

“An event like this not only raises much-needed funds to support out families, but it’s an incredible team-building event,” said Dr. Lara Shekerdemian, Texas Children’s chief of Critical Care. “We are lucky to have ICU and Heart Center teams whose commitment to our patients extends beyond the doors of the ICU. Excellent teamwork outside leads to even better teamwork and patient care in our ICUs.”

The event was so popular that there are already plans for future charity spin classes. Bastero also hopes it inspires other groups in the hospital to host similar events, both for our patients’ health and their own.

“There are so many groups across the hospital that do similar things for patients and their families, but every little bit helps,” she said. “When many people join together for a common purpose, we can make a bigger difference.”

Learn more about the CICU and critical care services at Texas Children’s Hospital.

When Nicole Tenney took her daughter Aubree home from the hospital in August of 2017, the last thing on her mind was how often she would talk to her newborn and how she would make connections with her through speech.

All the new mom could think about was whether she was going to be able to make it through the day without having to call one of the many clinicians she and her daughter had gotten to know during their 136-day stay in the Neonatal Intensive Care Unit at Texas Children’s Hospital’s Medical Center Campus.

“Aubree was born at 24 weeks gestation and overcame several challenges while at Texas Children’s,” Nicole said. “But she still had a long way to go, and I was willing to do anything to help keep her moving forward.”

So, when Aubree’s physicians, nurses and therapists with the SOAR Program, also known as the High-Risk Neonatal Follow Up Clinic, at Texas Children’s Hospital The Woodlands suggested that Nicole also participate in the hospital’s upWORDS Program, she jumped at the opportunity.

Developed in association with the LENA Research Foundation and generously supported by Kohl’s Care, Episcopal Health Foundation, Ed Rachel and the Powell Foundation, upWORDS gives parents the knowledge of how to improve the quantity and quality of language spoken with their child and educates them on the long-term impact language can have on their child’s success in life. The program includes group classes where parents learn to use the LENA System™ to monitor their home language environment and are taught simple techniques to increase interactive talk with their child.

To measure a participant’s home language environment, the LENA System™ uses a small recorder that fits inside a vest worn by the child. The recorder measures the amount of words a family speaks to their child and how much their child responds in return. The recording is then translated into data that the parents can use to see how much they are talking to their child and identify opportunities to increase the level of spoken interaction they have with their baby.

Texas Children’s via its Section of Public Health and Primary Care launched the upWORDS program in June 2016 as a pilot program at Texas Children’s Hospital West Campus in partnership with the Section of Public Health and Primary Care and Speech Therapy department at West Campus. Since then, 502 families have participated in the program, which is now being offered at 10 locations across the Greater Houston Area.

Late last year, Texas Children’s extended the program to NICU parents via two sets of classes at Texas Children’s Hospital The Woodlands. The classes are supported by the SOAR Program and several of the therapy teams in The Woodlands. About dozen family members – including Nicole and Aubree – attended the classes, graduating from the program on February 14.

“The biggest thing I learned was to give Aubree a chance to respond to me however she could,” Nicole said. “This and many of the other tips I learned really helped. Aubree’s development in speech increased by seven months during the time we were in upWORDS.”

Maura Dugan, manager of the Section of Public Health and Child Abuse Pediatrics, said some parents in the NICU classes increased the number of words spoken to their children by 25,000, and that 84 percent of upWORDS participants who graduated from upWORDS classes last year reported they spoke more to their children, and 79 percent reported an increase in the number of conversational turns or instances of back and forth verbal exchanges between them and their children.

Dugan said the NICU classes in particular have been a huge success as the majority of the participants are dealing with a lot of issues and greatly needed the support of experts as well as other parents who are going through similar things.

Led by upWORDS Health Educator Jennifer Howell and Listening and Spoken Language Therapist Allison Haggerty, the NICU classes not only teach parents and caregivers the importance of early talk and turn taking, but how to implement talking tips into their everyday routine like singing, pausing and chatting while out and about with their baby.

“With the help of staff and each other, parents work through some of the challenges they face in everyday life,” Dugan said. “And, each week they get to watch their children interact and achieve various milestones.”

Dr. Candice Allen, medical director of the SOAR Program, has helped get the upWORDS NICU class started and said they are a great addition to the services her team already provides families who are transitioning from the NICU to home.

“The more support we can give these parents and babies the better,” she said. “We want them to go on to lead healthy and productive lives, and language is a big part of that.”

To learn more about or register for the upWORDS program at Texas Children’s, click here.

Experts from Texas Children’s Hospital are regularly invited to give lectures and presentations at national and international conferences, where they share their knowledge and experiences caring for some of the rarest and most complex pediatric medical conditions. Now a new video series from Texas Children’s Service Line Marketing provides direct access to those experts.

Medically Speaking features some of the brightest minds from several Texas Children’s specialty and subspecialty areas. The series is meant to be a helpful educational resource for parents and a convenient way for physicians and other caregivers to stay up-to-date on the latest in pediatric medicine. Viewers can watch talks on a variety of interesting topics, including advancements in surgery, breakthroughs in research, new clinical trials, and novel and back-practice treatments for specific conditions.

In this episode, you’ll hear from Texas Children’s ophthalmologist Dr. Madhuri Chilakapati speaking about strabismus, an eye muscle imbalance commonly known as crossed eyes, lazy eyes or wandering eyes. During the talk, Madhuri reviews the different types of strabismus, shares common pain points from parents and ways to offer better support, and shares possible treatment options.

Be on the lookout for more Medically Speaking episodes on Connect, or view additional episodes now.

Learn more about the services provided and conditions treated by Texas Children’s Division of Ophthalmology.

PLEASE NOTE:
This presentation is not intended to present medical advice or individual treatment recommendations, and does not supplant the practitioner’s independent clinical judgment. Practitioners are advised to consider the management of each patient in view of the clinical information. All content is shared for informational purposes only, and reflects the thoughts and opinions of the original author. No physician-patient relationship is being created by the use of this presentation. The presentation sets out recommendations based upon similar circumstances and is provided as an educational tool. The presenters are not attorneys, and to the extent this presentation provides commentary on current laws and regulations affecting health care activities, it is not intended as legal advice.

To better understand the impact of parental incarceration in Harris County, Texas Children’s Section of Public Health Pediatrics recently led a needs assessment of children of incarcerated parents.

The year-long study was funded by Texas Medical Center’s Health Policy Institute and involved Baylor College of Medicine, the University of Texas Medical Branch at Galveston, and the Harris County Sheriff’s Office.

“We wanted to better understand the needs of children with incarcerated parents in Harris County Jail as well identify opportunities to support these children,” said Nancy Correa, senior community initiatives coordinator for Texas Children’s Section of Public Health and Primary Care. “Parental incarceration as an adverse childhood experience has been largely overlooked and not well-studied, which is significant considering the United States has the highest incarceration rate in the world and The Annie E. Casey Foundation estimates 5.1 million American children have a parent in jail or prison during their childhood.”

After conducting interviews with inmates and caregivers of children that have parents in Harris County Jail, researchers found that seven percent of all Harris County children have a parent who spends time in the county jail each year, half of inmates have at least one child under the age of 18, and 61 percent of incarcerated parents provided all or most of the financial support for their children before being jailed.

“If the person who is incarcerated is the breadwinner, lots of family needs all of a sudden become really critical,” said Dr. Chris Greeley, the section chief of Public Health and Primary Care. “Sometimes people will get incarcerated for something relatively minor, and they can’t afford to pay bond. Because of that, a kid’s life is irrevocably altered.”

During a February 12 press conference, Harris County Sheriff Ed Gonzalez underscored the multiple hardships children of incarcerated individuals face.

“Children are traumatized by being separated from their parent,” Gonzalez said. “Sometimes they have to change homes and schools routinely. These children also suffer shame and feelings of isolation, and have urgent basic needs like food and emotional support.”

The Sheriff said his office’s goal is to make visitation at Harris County Jail – the largest jail in Texas and the third largest in the United States – more child-friendly by making the visitors’ lobbies more inviting, developing curricula and training deputies on interacting with children when they visit the jail.

Gonzalez said he also plans on reviewing his department’s policies and determining best practices for when deputies arrest a parent when a child is present. He also plans on updating the Harris County jail website to include information on community resources.

“Children of incarcerated parents have been overlooked,” Correa said. “They are the innocent and forgotten victims of crime in our community, but there are things we can do to help.”

February 18, 2019

During Heart Month we celebrate our patients and the miracles our experts perform every day providing heart care that’s the best in the nation. This year, we’re also celebrating a unified commitment to making our Heart Center even better.

Heart Center leadership, faculty and staff recently convened for the inaugural Heart Center Retreat. The event afforded the full, multidisciplinary team of surgeons, clinicians, intensivists, nurses, advanced practice providers, anesthesiologists, administrators and more the opportunity to collectively reflect on past successes, discuss areas of possible improvement, identify transformative goals, and actively plan for the future.

“If you believe some of the external ratings sources, our congenital heart disease program is one of the best in the country. Personally, I do not like to give external ratings much credence” said Dr. Christopher Caldarone, Texas Children’s chief of Congenital Heart Surgery. “A great program will hear such accolades and disregard them while searching for ways to get better. And that was the purpose of the Heart Center Retreat – to help us rise above the day-to-day and intensely focus our attention on ways to improve in terms of patient care, access, teaching, research, innovation, and quality of life for members of the Heart Center team.”

Following an introduction from President and CEO Mark Wallace, attendees heard several talks from Heart Center leadership on a variety of topics. These included reflections on the program’s growth in recent years, how the move into Lester and Sue Smith Legacy Tower has affected processes and outcomes, and what it means to be the No. 1 heart program in the nation. Attention then turned to ways to make the Heart Center even better, with talks outlining opportunities for advancement in innovation and research, plans for improved education and training, challenges posed by competition and strategies for staying ahead, and the need to relentlessly improve patient care, access and experience.

“To be our best we must do our jobs better than anyone, work together and always keep the patient top of mind,” said Dr. Daniel Penny, Texas Children’s chief of Pediatric Cardiology. “We believe that what will separate Texas Children’s Heart Center going forward is a unique combination of exceptional technical abilities coupled with a highly developed collaborative culture that is completely centered on our patients and their families.”

Following the talks, attendees split up into preselected breakout groups. The teams chose their groups based on the topic and were tasked with developing real-world strategies based on key Heart Center objectives. These included:

  • Establishing a comprehensive center for patients and families living with Fontan physiology across the lifespan
  • Developing a unified data platform to increase efficiency and improve quality control and research productivity
  • Creating an innovation fund with a streamlined application process to generate new ideas
  • Design a process that solicits, evaluates and prioritizes innovative projects
  • Improving satisfaction and efficiency in the management of new patients
  • Providing access to professional development for nursing and ancillary services

The breakout groups facilitated lively discussion and engagement. Each team was highly motivated and have since reported back to the Heart Center executive committee with proposals that include target objectives, and tactics and budgetary considerations for meeting those objectives.

Feedback from retreat participants has been positive and there are plans to make it an annual event. It’s yet another way the Heart Center has rallied around its ongoing mission to, as the leadership teams says, “get so far ahead no one can catch us.”

“Even though we’re a large, elite program, we must consistently take a critical and objective look at all aspects of our performance”, said Caldarone. “Our goal is be a large, comprehensive, and collaborative team that is nimble in our ability to mobilize expertise to meet the needs of every patient.”