Texas Children’s Hospital recently hosted the 7th annual REACH (Research, Education and Awareness for Children with Hirschsprung Disease) Symposium. More than 60 parents and patients traveled from 10 states – including California, Colorado, Florida, Louisiana and Oregon – with additional families participating via livestream, making it the best-attended symposium in REACH’s history.
REACH is an international, parent-led non-profit organization committed to increasing awareness, promoting education, connecting families and supporting research initiatives for Hirschsprung disease, which is a congenital condition of the colon. Patients born with Hirshsprung disease have severe colon motility issues due to absence of nerve cells in the affected segments of the colon. These children suffer from intestinal obstruction, colon infections and fecal incontinence. REACH contacted Texas Children’s more than a year ago to discuss holding the symposium, due to the hospital’s outstanding reputation in the field of colorectal surgery, and specifically for its work with Hirschsprung disease patients.
In addition to hosting and organizing the event, Texas Children’s was able to put forth its expert multidisciplinary team, which cares for patients with this disease.
Dr. Danielle Hsu and Dr. Kristy Rialon gave presentations on the surgical management of Hirschsprung disease. Dr. Danita Czyzewski from Psychology discussed how parents and children might better cope with this condition. Talks from Jasia Correa and Simone Romero highlighted Texas Children’s Pediatric Pelvic Floor Physical Therapy Program. Dr. Amaka Akalonu gave a lecture titled, “When Things Don’t Go as Planned: Motility and Sphincter Issues.” And Akalonu’s colleague and fellow gastroenterology motility expert, Dr. Bruno Chumpitazi, participated in a physician panel discussion, moderated by Dr. Timothy Lee, pediatric surgeon and Texas Children’s Colorectal and Pelvic Health Program director.
In addition to participating in presentations and discussions, attendees also got a firsthand look at some of Texas Children’s world-class facilities, including Lester and Sue Smith Legacy Tower and Mission Control, and had the opportunity to interact with our Disney displays.
Colorectal and Pelvic Health at Texas Children’s
A highly skilled, multidisciplinary team of specialists at Texas Children’s Hospital offers the full spectrum of care for congenital disorders of the colorectal and urogenital systems in Texas Children’s Colorectal and Pelvic Health Program.
Regardless of the disorder, the team works together to develop a customized approach to care for these complex, and often sensitive, medical conditions. Specialists collaborate to identify the patient’s specific issues and determine the best path to a positive outcome and improved quality of life, whether through surgery, medication or some combination of treatments. Additionally, the team has focused on improving patient care through clinical research and development of best practice pathways to standardize and streamline clinical care for this complex patient population.
“This hallmark of the program is providing multidisciplinary collaborative care,” said Lee. “Even though these conditions aren’t common, we’ve seen more and more of them at Texas Children’s as our patient volume has grown. Parents can be confident when they come to us that they will be receiving truly comprehensive, collaborative care delivered by experts who have been treating these kinds of patients for years.”
The Pavilion for Women recently held a two-day conference focused on obstetric critical care. With increasing focus on maternal morbidity and mortality the need to expand and elevate the care provided by physicians and nurses is paramount. This unique conference affords the opportunity to participate in skill simulation and expert presentations. Additionally, CMEs and CNEs were awarded upon receiving a successful pass rate of the post-test administered.
Attended by more than 100 people across Texas, and 12 midwives visiting the Pavilion for Women from Hong Kong, the conference covered physiologic changes during pregnancy, specific obstetric medical conditions and appropriate treatment; maternal cardiovascular resuscitation and airway management of critically ill pregnant patients; as well as appropriate steps in fetal assessment, delivery, and neonatal management.
The conference was held October 4 and 5, and was formatted as a series of presentations and skill stations to provide knowledge and guidance for decision-making, and limited practice in some clinical procedures and scenarios. Positively received by attendees, the conference enables the Pavilion for Women as a Level IV Maternal Care Designated facility to determine what educational needs exist across the state and provide additional education to help improve quality outcomes for women.
October 3, 2019
Mark A. Wallace is not your typical CEO. Along with leading the serious and important work in the C-suite and executive board room, the longstanding president and chief executive officer of Texas Children’s Hospital more often than not is connecting with front-line staff and employees, as well as patients and families, to see how Texas Children’s can better serve those in need of exceptional pediatric care.
On any given day, Wallace can be seen walking the halls of Texas Children’s Hospital in the Medical Center wearing a suit, one of his signature ties and his megawatt smile. His booming made-for-radio voice can be heard from quite a distance greeting passersby with a robust “Good Morning!” or “What a great day to be at Texas Children’s!”
Wallace welcomes with energy and fervor all new Texas Children’s employees at several pep rallies throughout the year. He humbly thanks those who have served the organization for 15 years or more at an annual employee recognition ceremony. And, in 2015, he set out to reach every employee across the organization – first with seven hospital-based events, dubbed the One Mission, One Culture, One Amazing Team Event, and then on a whirlwind, 73-stop One Amazing Team bus tour.
In addition to all of this, Wallace has what many CEOs lack today – staying power. Celebrating his 30th year at the helm of Texas Children’s Hospital on October 4, he is the longest serving CEO in the Texas Medical Center. According to a recent study by Equilar, an executive data solutions company, his service to Texas Children’s is pretty extraordinary, considering the average tenure of a CEO at a large U.S. company is a mere five years.
Texas Children’s Board of Trustees Chairman Michael Linn said Wallace’s tenure is exceptional, but not surprising for two main reasons – Mark Wallace is an extremely successful businessman, and he cares deeply about the mission of Texas Children’s.
“Mark sees everyone at Texas Children’s as one big family taking care of other families,” Linn said. “In his heart, he really believes he’s doing what God wants him to do.”
“Mark also cares about our debt rating and our bottom line,” Linn said. “He understands that if we don’t have the financial wherewithal we cannot treat our patients.”
Bigger and better
When Wallace began his journey with Texas Children’s Hospital on October 4, 1989, as a bright and ambitious 36-year-old, Texas Children’s was still in its infancy. The one-building hospital was just 35 years old, a baby compared to other leading children’s hospitals in the nation, some of which have been around for more than a century.
Having just separated from St. Luke’s Medical Center, Texas Children’s Hospital, and its then 1,400 employees, were in desperate need of a leader who could help shape the growth of the organization and distinguish it from its counterparts.
Wallace, who came to Texas Children’s from Houston Methodist Hospital where he had been senior vice president, took this charge to heart and has never looked back.
“When Mark came to tell me he was leaving and that he’d been recruited to Texas Children’s, I actually tried to talk him out of it,” said Larry Mathis, former president and chief executive officer of Methodist Hospital. “I thought Mark had the talent to do something bigger and better. But, as it turned out, he went to Texas Children’s and made it bigger and better.”
During the first 10 years of his career at Texas Children’s, Wallace strengthened the organization’s position as a leader in children’s health care, taking on milestone cases, opening the first Texas Children’s Pediatrics practice and the first Texas Children’s Specialty Care Clinic. He also established Texas Children’s Health Plan, the nation’s first and now largest, pediatric health maintenance organization.
Renovations of the hospital’s original building, the Abercrombie Building, were completed during this time, and construction of what is now the Mark A. Wallace Tower and West Tower began. These two additions made Texas Children’s the largest freestanding pediatric hospital in the United States, a title Texas Children’s still holds today.
Best in nation
During his second and third decades at the helm of Texas Children’s, Wallace’s momentum, passion and dedication to the organization has continued to grow, and has spread to those around him. His vision and energy motivate people to invest in what has become one of the best pediatric health care organizations in the nation.
One of Wallace’s biggest fans is Executive Vice President Michelle Riley-Brown, who joined Texas Children’s in 1999 as an administrative fellow and steadily rose through the ranks to her current position. Over the years, Riley-Brown has seen Wallace’s leadership style grow into what it is today – strong, effective and visionary.
“Mr. Wallace is the quintessential leader,” Riley-Brown said. “He knows what’s best for Texas Children’s, and he knows how to get everyone on board to get it done.”
Riley-Brown has worked closely with Wallace to expand the reach of Texas Children’s into the greater-Houston area and beyond. She helped open the system’s two community hospitals – Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands – and grow the system’s network of Specialty Care Centers, Texas Children’s Pediatrics practices and Urgent Care Centers. Riley-Brown currently is leading Texas Children’s expansion into Austin, where the organization has opened a Specialty Care Center, an Urgent Care Center and a handful of primary care practices.
“I am grateful for the opportunity to work under Mark’s leadership,” Riley-Brown said. “It has been a joy and privilege to implement his vision of expanding care into the community, and I look forward to all that is to come.”
Other major milestones under Wallace’s leadership include the expansion of the Feigin Center and the construction of Texas Children’s Pavilion for Women and the Jan and Dan Duncan Neurological Research Institute. Two Centers for Women and Children have opened their doors, and a network of Urgent Care practices have been established. Most recently, Texas Children’s built and opened the Lester and Sue Smith Legacy Tower, Texas Children’s new home for heart, intensive care and surgery.
All of this and more has earned Texas Children’s a top spot in the U.S. News & World Report Best Children’s Hospital ranking for more than a decade. This year, Texas Children’s was ranked No. 3 in the nation among all children’s hospitals, a ranking no other pediatric hospital in the state has ever achieved. In addition, Texas Children’s ranked in the top 10 in each of the U.S. News & World Report-recognized pediatric sub-specialties.
“I’m sure Mark is very pleased with how a tiny children’s hospital in 1989 has turned into one of the best children’s hospital in the world,” said Susan Stock, Wallace’s long-trusted executive assistant. “He sees that his determination and dedication has paid off in a big way.”
And, that determination and dedication isn’t waning, said Stock, who started working in the president and chief executive officer’s office a few months before Wallace arrived at Texas Children’s.
“I believe that even after being such an excellent leader for so many years, he’s still finding ways to make Texas Children’s even better,” Stock said.
More to come
The pace Wallace has kept all these years isn’t slowing. The tenured Texas Children’s leader has paved the way for continued growth with the purchase of the Baylor and O’Quinn Towers and expansion into the Austin, Beaumont and Tyler markets.
In the capital city, Texas Children’s is continuing to grow its outpatient strategy at a steady pace, and the Texas Children’s Health Plan has a growing membership in Beaumont and Tyler as the result of being chosen in 2016 as one of three managed care organizations to offer the STAR Kids plan, which covers children with complex medical needs.
Texas Children’s Emergency Center at the Texas Medical Center Campus is being renovated and expanded, and the list goes on. With Wallace in the driver’s seat, growth and change is inevitable. It’s part of what makes him a great leader. The one thing that doesn’t change with him though is his ability to connect with the people he serves.
Even though the number of employees at Texas Children’s has grown to 15,000, and the number of patient encounters reached 4.3 million last year, Wallace still finds time to walk the halls of the system’s ever-growing facilities, show up at pep rallies and other celebrations, and share his ongoing vision for the organization. In short, he still cares passionately about Texas Children’s and its mission to care for sick children and women.
“As the need for affordable, quality health care grows for our country, I believe Mark’s motivation grows to meet those needs,” said Shannon Wallace, Mark Wallace’s wife of 16 years. “He is incredibly gifted at finding solutions for problems, especially when those problems affect our most vulnerable citizens.
“I am overwhelmed but not surprised by Mark’s accomplishments,” Shannon added. “I have never known a more authentic, compassionate, capable person in my life.”
October 1, 2019
Texas Children’s is one of the best in the country at taking care of our patients. But we are constantly striving to be better in the coordination of that care.
So what exactly does that mean? It means that although several providers may be involved in a patient’s treatment, they each deliver care as if they are part of one big picture.
This effort – Care Coordination – is an organizational priority and is in full swing at Texas Children’s.
Many Texas Children’s patients, especially those who are medically complex, use several aspects of our services; several times throughout the year. We can take care of these families as if each one of their visits are individual occurrences; or we can actually coordinate their care so that it is more comprehensive, less frustrating and enhances value for us as an organization.
What does UNcoordinated care look like?
Before recent efforts began there were many more cases of uncoordinated care, which caused a great deal of frustration for our families.
Uncoordinated care means that patients may receive multiple phone calls with inconsistent information, they may be asked the same question when they show up in different areas of the organization, and certain duties may be duplicated by employees.
Tabitha Rice, senior vice president and administrative lead of the Care Coordination project, said she is proud of the work that has been done so far to rectify these issues. The project is already yielding measurable results. “However, high performance is in our blood at Texas Children’s and so we never want to stop getting better,” Rice said. “Care coordination is about quality and safety first. Secondly, it’s about enhancing the experience for our patients, providers and staff.”
The Care Coordination effort involves all three of our hospitals, Texas Children’s Pediatrics, Texas Children’s Health Plan, The Centers for Children and Women and all of our partners. It is a true system-wide effort.
When care coordination is done right, we …
Have a shared care plan that forces us to think through responsibilities and potential problems ahead of time.
Communicate with patients by explaining treatments, procedures and necessary follow-up actions.
Communicate between providers and care givers by telling all the details of the patients’ story when performing a hand-off.
Transition a patient efficiently between areas within our system or between their stages of care.
Organize a patient’s care for their convenience by taking into consideration things like scheduling, transportation, supplies, medication, etc.
Use community resources effectively.
Both clinical and non-clinical employees have a role in this work. Care Coordination is a priority for the system and for thousands of members of our One Amazing Team.
A shining example of Care Coordination
Deanna Courts, Texas Children’s Health Plan service coordinator, and her work with member Mark Bowden is a shining example of exceptional care coordination.
For more than two years Courts went above and beyond to assist Mark as he battled ADHD, bipolar disorder and a cancerous tumor.
With Courts leading the way, the entire Texas Children’s system had a role in providing Bowden and his family with diagnostics, chemotherapy, food assistance, psychiatric support, social support and anything else needed to work through this trying time in life.
Today, this young man is now a cancer-free, high school graduate. Thanks to our one amazing team he is currently enrolled in college at Lamar University and doing well.
Tell us your story
Do you or someone you work with coordinate care well? Tell us how by sending a note to firstname.lastname@example.org. We want to hear from you!
September 25, 2019
Recently, several executives, physician leaders, and Revenue Cycle team members gathered at the John P. McGovern Campus to celebrate the 10th anniversary of the Texas Children’s Physician Service Organization (TCPSO). The TCPSO manages payor contracting and revenue cycle functions of our physician group.
“The TCPSO is the core body that represents our physicians, and having that within Texas Children’s allows us as hospital leaders to partner with our physician leaders,” said Executive Vice President Dan DiPrisco, who served as one of the first directors of the TCPSO until 2014.
For the past 60 years, Texas Children’s Hospital has had an affiliation with Baylor College of Medicine, serving as the primary pediatric training site for Baylor’s physicians. Prior to 2009, Texas Children’s funded the physician group, while Baylor provided the governance, including billing and contracting.
As Texas Children’s began to expand rapidly, developing strategies for sustainable long-term growth was critical. Subsequently, Texas Children’s and Baylor developed an operating agreement to create an employment structure for physicians and allow contracting and revenue cycle operations to function under the Texas Children’s umbrella.
“When it comes to learning all the ins and outs of how to sustain the TCPSO structurally as an organization, it was important to define roles and create a productive team of leaders, which we will continue to refine and expand over the years,” DiPrisco said.
On July 1, 2009, 145 Baylor employees in the revenue cycle and contracting area transitioned from Baylor to employment at Texas Children’s, forming the TCPSO. Ten years later, 54 were present for the festive anniversary celebration, which included cake and a commemorative pin for the “original” TCPSO staff.
“There was a strategic vision 10 years ago, and it’s hard to imagine the growth of Texas Children’s without the TCPSO,” said Pathologist-in-Chief Dr. Jim Versalovic. “As we look ahead to the next 10 years, we know that we have learned many lessons, and we have certainly demonstrated that the TCPSO can be a very effective platform for the growth, management, and connecting the clinical practice with the business.”
Versalovic was among the first physician leaders to transition to Texas Children’s when the TCPSO was formed, and he served as a TCPSO board member. He has been a part of the organization’s evolution over the past 10 years, and emphasized that the TCPSO has established itself as a core entity of Texas Children’s and, through strategic planning, has significantly advanced during that time.
In the TCPSO’s first decade, its growth has mirrored that of the hospital. Within the first year, professional billing was managed for 655 physicians, comprising 32 pediatric and adult specialties. Within 10 years, the number of physicians has grown to more than 1,800 billable providers and 45 specialties. Net patient revenue had grown 151 percent to $282 million annually in 2019. And August 2019 alone was the organization’s highest cash collections month ever, at just over $26 million.
As Texas Children’s expands into further markets and continues to provide high quality care to patients and their families around the globe, the TCPSO will be right there as well, providing the revenue cycle support and collections.
“The level of collaboration between the TCPSO and the Baylor physicians on payor contracting and revenue cycle functions has never been stronger,” said Richelle Fleischer, President of the TCPSO and Senior Vice President of Revenue Cycle. “Everyone is excited about what we will accomplish together over the next 10 years!”
September 23, 2019
Just a few months after being named the No. 1 destination in the country for pediatric cardiology and cardiac surgery for the third straight year, Texas Children’s Heart Center® is celebrating another milestone.
One year ago, on September 25, the Heart Center made the historic move into its new home in Lester and Sue Smith Legacy Tower.
The entire day was a carefully orchestrated ballet of coordination.
“The move to the Heart Center was the culmination of two years of preparation and was a momentous day for us all,” said Chief of Critical Care Dr. Lara Shekerdemian. “There were lots of moving parts all working together in concert, which was incredible. The entire day was a testament to collaboration and great planning.”
Six specially trained teams made up of more than 200 members transported 64 heart patients, some critically ill, safely to their new, state-of-the-art rooms. The patients ranged in age from 3 days to 22 years. As units in the new tower prepared for patients’ arrival, team members in a command center were monitoring patients’ conditions, making sure facilities were ready, and stationing support teams along the travel routes in case of emergency.
“Fortunately, we had experience since we had moved the pediatric and the transitional intensive care units over to the new building in the months prior to the Heart Center move,” said Maria Happe, Texas Children’s nurse practitioner and clinical project manager for Lester and Sue Smith Legacy Tower. “There was a lot of excitement and tons of activity in each unit as we were getting patients, parents and teams ready to move.”
The new Heart Center was designed from top to bottom with families in mind. One of the most important difference-makers that Heart Center staff and employees are quick to point out is the ability for families to stay together while a child receives care.
“Being able to have parents in the rooms with their children, for them to be able to comfortably stay in the space, has been a huge improvement, said Carmen Watrin, director of nursing for inpatient units. “It’s also made families essentially a part of the care team, which has been phenomenal. The families are so grateful.”
The new space also increased desperately needed care capacity. During one especially difficult period in 2013, spatial constraints rendered Texas Children’s incapable of accepting additional transports of critically ill children. We were simply too full. This prompted the historical expansion of critical, surgical and emergency care capacity that included the construction of Lester and Sue Smith Legacy Tower.
“We never want to be in a position where we say no to a family or to a child,” said Chief of Cardiovascular Anesthesiology Dr. Emad Mossad. “This new setting has given us the privilege, and the space and resources, to be able to serve as many patients as come our way. It’s been a great thing to move to a new space, a new place, a fresh start, and to have the capacity to be able to say yes to families who are seeking our help.”
In addition to new space, the Heart Center has been on a mission to ensure that it has the staff needed to deliver the highest possible level of care. One example has been the onboarding of over one hundred new nurses to ensure that nurse-to-patient ratios are always at the optimum level. There’s also no substitution for experience, especially in health care, which is why in the months leading up to the Heart Center move, cardiac intensive care unit (CICU) leadership worked not only to recruit the best nurses, but also to retain them. As a result, the number of CICU nurses with greater than two years’ experience has increased over the past year, which helps improve the overall quality of the team.
Eyes on the future
With a year now in the books, the No. 1 heart center in the country is focused on continuing to deliver the best care, but also to improving wherever possible and to growing as a team.
“I’m looking forward to further consolidating the concept of a heart center as something that we all are part of,” said Chief of Congenital Heart Surgery Dr. Christopher Caldarone. “We all have allegiances to many things – to our community, to our families, to our homes, to the hospital, to our academic department. Over the next year, we want to continue creating a culture here in the Heart Center where people feel like they are truly a part of this big team.”
Additionally, the Heart Center is looking forward to growing care capabilities, including an expansion of the Adult Congenital Heart Disease (ACHD) program. Over the course of the next year, the Heart Center will develop a dedicated center for adults with congenital heart disease, where they will be treated by specialists who recognize and understand their unique needs.
“This expansion will be a huge statement by Texas Children’s Hospital,” said Chief of Pediatric Cardiology Dr. Daniel Penny. “There should never be an expiry date on the care of children with congenital heart disease as they transition to adulthood. Our ACHD team already provides amazing care, but with this expansion, all aspects of care for adults with congenital heart disease will be available on one dedicated unit. It’s an exciting time at Texas Children’s Heart Center.”
The Texas Children’s footprint continues to expand in the capital. On September 16, Texas Children’s Pediatrics Dawson & Ramirez Pediatrics located at 1111 W 34th suite 102 Austin, TX 78705, opened its doors and became the fourth location in the city.
Drs. Thomas Dawson, Jaime Ramirez and Britni LeBoeuf lead the Practice’s care team, and are dedicated to understanding the importance of a parent feeling completely comfortable with a child’s primary care physician. These board-certified, expert pediatricians have extensive training in children’s health care, and will focus on maintaining Texas Children’s mission of providing high quality care in the Austin community.
“I’m excited to welcome Drs. Dawson, Ramirez and LeBoeuf, as well as their amazing team, to our TCP family,” Kay Tittle, president of Texas Children’s Pediatrics, said. “We know the value pediatricians bring to the community. They are more than doctors – they are partners in your child’s health.”
Texas Children’s Pediatrics locations provide full-service pediatric care for children of all ages including, among other offerings, prenatal counseling; newborn and infant care; well and sick child visits; immunizations; and hearing and vision screenings; as well as camp, school and sports physicals.
In 2018, Texas Children’s expanded its pediatric health care offerings into the Austin community. The first Texas Children’s Pediatrics practice in Austin, Texas Children’s Pediatrics Austin Pediatrics at 5625 Eiger Road, suite 225 opened on June 18.