Leadership – Page 83 – Texas Children's News

October 13, 2015

Pastel paint, shiny floors and spacious rooms equipped with the latest scientific and technological approaches to biocontainment are just a few of the features of the soon-to-be-finished Special Isolation Unit at Texas Children’s Hospital West Campus. The 8-bed unit designed for children with highly contagious infectious diseases is part of an 18-bed expansion of the hospital’s Acute Care Unit, which will open in mid-October.

“We are very excited about this state-of-the-art facility opening and serving our community’s most fragile patients,” said West Campus President Chanda Cashen Chacón. “The unit allows Texas Children’s to effectively and safely provide the best possible care to a patient who has a highly communicable disease while ensuring the health and safety of our team and other patients and families throughout the hospital.”

The decision to build a special isolation unit came last year after an unprecedented Ebola outbreak, resulting in the realization that we must be prepared to handle emerging infections as an institution. As a result, the state and the Centers for Disease Control and Prevention designated Texas Children’s Hospital as one of several pediatric Ebola treatment centers countrywide.

Texas Children’s Special Isolation Unit is the only one of its kind in Texas and the southwest region, and is among the few in the United States designated just for children. Located on the fifth floor of West Campus, the unit will be fully equipped to care for any infant or child with a serious communicable disease, with all of the measures available to assure safety of the health care team, other patients and their families.

Each of the patient rooms, for example, has an antechamber, where doctors and nurses will put on personal protective gear. After treating a child inside the room, they will leave through a separate door and enter a third room, where they will take off the gear. Nurses will observe the entire time through large glass windows.

The unit also will have its own biosafety Level 3 laboratory, which allows for safe, on-site rapid identification of both usual and unusual pathogens. There’s also a separate medical waste room, where carts of used clothing and equipment can be wheeled inside 6-foot autoclaves.

Some of the unit’s additional features include:

Negative pressure rooms and isolated air handling
High-protocol workflows designed around a “clean-to-dirty” workflow
Observation windows into patient rooms to limit staff exposure
Specialized technology and communication devices to communicate as a team
Staff locker room where caretakers will show before leaving the unit after each shift
Child life play room for patient siblings and young visitors

In addition to a state-of-the-art facility, children coming to the Special Isolation Unit will receive top notch care from a team of highly-trained nurses and doctors. At least six members of the team, called the Special Response Team, will be assigned to each child, and one of them will act as a family liaison.

Children being treated in the unit will be able to use tablet computers to talk with their families via video chat, and will be able to see them through the large windows. To make the unit’s patients feel as comfortable as possible, a special doll is being developed that will wear a mini-version of the personal protective equipment the doctors and nurses wear.

The goal there, said Special Isolation Unit Assistant Director Dr. Judith Campbell, is to soothe even the youngest children, and help them understand: “Yes, we’re dressed up a little differently, but their little doll has similar attire on.”

The specialized unit will be led by Dr. Gordon Schutze, who will serve as medical director, as well as Campbell and Dr. Amy Arrington, who will be the unit’s associate medical directors. Sondra Morris will lead the team’s nursing staff. The unit will be run by a Special Response Team comprised of physicians, nurses, medical technologists and environmental service technicians who have been trained in infection control, hospital epidemiology and management of infectious diseases in the critical care setting.

“The team has completed up to 24 hours of specialized training to date to be ready to care for these patients safely,” Arrington said. “Additional training will be ongoing.”

When the Special Isolation Unit isn’t activated, it will be used as a new acute care unit for West Campus. Morris will lead the area when the Special Isolation Unit isn’t being used.

For more information about the Special Isolation Unit and the infectious diseases that might be treated there read this blog written by Campbell.

The finishing touches are being put on Texas Children’s Special Isolation Unit, an 8-bed unit designed for children with highly contagious infectious diseases. View the unit that is scheduled to open in mid-October.

Thousands of Texas Children’s employees have armed themselves against the upcoming flu season by taking advantage of the free flu vaccines that are being offered by Employee Health. It’s not too late for you to do the same.

Free flu shots are still being offered to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers at various events across the organization and at the Employee Health Clinic.

Staff Nurse Sarah Vining got her flu shot the second day it was being offered on The Auxiliary Bridge and said she gets the annual vaccine to protect herself, her family and the patients she serves against a potentially fatal infection.

“It’s important for our families and our patients, as well as our own families at home, to stay healthy and make sure that we’re in our best condition to take care of our patients,” Vining said. “So, get your flu shot!”

What’s in the shot?

The shot that is being offered to employees this year protects against four of the main flu viruses that research suggests will be the most common during the upcoming season.

Those viruses are:

Influenza A (H1N1)
Influenza A (H3N2)
Influenza B (Phuket)
Influenza B (Brisbane)

It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against the flu. That’s why the Centers for Disease Control and Prevention recommends people get vaccinated soon after the vaccine becomes available. However, as long as flu viruses are circulating in a community, it’s not too late to get vaccinated.

“Getting the flu shot is important,” said Staff Nurse Vincent Orion prior to getting his annual vaccine on The Auxiliary Bridge. “It’s protects everybody.”

How to get vaccinated

Click here to view the dates and locations for your vaccination. If you are unable to make one of these dates, please make an appointment at the Employee Health clinic, located on the fifth floor of the Abercrombie Building near the yellow elevators, after October 1. If you have questions, please call Employee Health at Ext. 4-2150. West Campus Employee Health is located on the campus’ second floor and can be reached at Ext. 7-1365.

Visitation restrictions

Based on the increasing incidence of respiratory illness, effective at 6 a.m. Thursday, October 15 Texas Children’s Hospital is instituting new visitation restrictions for the inpatient units and critical care areas. To read more about these restrictions please click here.

Do you have any unwanted, unused or expired medications lingering in your medicine cabinet? Old prescription and over-the-counter pills left around the house can become a health and safety hazard, especially for small children and pets who may accidently get ahold of them.

To ensure the safe disposal of these medications, Texas Children’s Pharmacy Department will host the Medication “Take Back” Program from 10 a.m. to 2 p.m. on Monday, October 19, at The Auxiliary Bridge. There will be drop-off boxes to safely dispose unwanted and expired medications.

“Medication safety has always been our priority,” said Brooke Bernhardt, assistant director of Clinical Services and Outcomes in the Department of Pharmacy. “Any time we can eliminate preventable harm, it’s a win-win situation for our employees, their families and the patients we serve.”

The Take Back Program coincides with National Pharmacy Week, and this year’s theme is “Be a Hero, Aim for Zero,” which reflects our Pharmacy Department’s commitment to eliminating medication errors.

The Auxiliary Bridge event will feature fun activities and prizes for the children geared towards medication safety and poison control, educational information about our Pharmacy Department and the research activities they are involved in, and a showcase of pharmacy technology that’s helping our staff eliminate medication administration errors.

As part of this year’s “Be a Hero, Aim for Zero” theme, two pharmacy employees will dress up as super heroes to greet patients and their families, and the children can get their pictures taken with them.

Anesthesiologist-in-Chief Dr. Dean Andropoulos and several members of his medical staff helped write and edit the recently published Anesthesia for Congenital Heart Disease, 3rd Edition. The textbook is the leading reference source for the field, and since the first edition was published in 2005, readership has increased significantly around the world.

The new edition contains 32 chapters, more than 800 pages, and for the first time is in full color. The book also comes with full electronic access to the text, which covers the entire field of anesthesia for congenital heart disease. New chapters addressing pulmonary hypertension and anesthetic neurotoxicity have been added and all chapters have been thoroughly updated.

“It was a privilege to be part of the creation of this very important text,” Andropoulos said. “It will be used by many for the betterment of this sector of our field.

Those in the Texas Children’s Anesthesiology Department who contributed to the effort include:

Dr. Dean Andropoulos – Editor-in-Chief
Dr. Stephen Stayer – Editor
Dr. Emad Mossad – Editor
Dr. Wanda Miller-Hance – Editor
Dr. Rahul Baijal
Dr. Ken Brady
Dr. Lisa Caplan
Dr. Blaine Easley
Dr. Pablo Motta
Dr. David Vener
Dr. Erin Gottlieb

October 6, 2015

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Texas Children’s Health Plan has been selected by the Texas Health and Human Services Commission as a health plan in the STAR Kids Program, a managed care program that provides health coverage to children and youth with special health care needs.

Beginning September 1, 2016, the STAR Kids program will be implemented to manage children with special health care needs. This move is expected to bring about 40,000 new members into the Health Plan. In anticipation, more than 400 new employees will be hired to manage these cases. The program will provide benefits such as prescription drugs, hospital care, primary and specialty care, preventive care, personal care services, private duty nursing and durable medical equipment and supplies.

“Texas Children’s Health Plan is very proud to be involved in the STAR Kids program and be able to provide children with special health care needs the care they deserve,” said Christopher Born, president of Texas Children’s Health Plan. “The introduction of STAR Kids speaks to our commitment of providing excellent care to the members of our community.”

Children age 20 or younger who receive Supplemental Security Income Medicaid, are enrolled in the Medically Dependent Children Program or receive services through 1915(c) waiver programs will receive a variety of services through the STAR Kids program. Children, youth and their families will have the choice of STAR Kids health plans and will have the option to pick one that best suits their needs.

“The case managers we are able to hire will help these members through the process and through the system, removing barriers,” said Kristen Cover with the Health Plan. “The families are going to have experienced care managers, who are often nurses, to assist them and be a support system for the whole family. The parents are no longer the only ones managing their children’s cases.”

Born said over the last few years, he has met the Texas Department of Health and Human Services about finding a new way to care for these children.

“It was a letter from Representative John Zerwas to Texas Children’s President and CEO Mark A. Wallace that was really a catalyst for this new way of caring for medically complex kids,” Born said. “Mark was adamant that we needed to be leaders in finding a more coordinated way to care for these kids on disability-related Medicaid and that’s really where the ball started rolling.”

“This is a tremendous tribute to Texas Children’s and our capacity, our ability and our passion to care for all children in Texas,” Wallace said. “Not only does this extend the care to this new patient population with a new and improved paradigm to care for these children, creating a better model of care.”

Texas Children’s Health Plan is currently the largest Children’s Health Insurance Program (CHIP) and Medicaid HMO in the Harris and Jefferson service areas and provides coverage in more than 20 counties in the Houston metropolitan area. By approving Texas Children’s Health Plan to offer coverage in the Health and Human Services Commission Northeast Expansion Area, which includes 34 counties, 64,000 STAR Kids eligible members in the Northeast, Harris and Jefferson service areas will be able to choose Texas Children’s Health Plan as their new health plan starting September 2016.

Take a moment to read the blog post (below) from President and CEO Mark A. Wallace about the journey that helped us reach this milestone and why it’s so important to so many children.

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In just a little more than a year, Dr. Ellis Arjmand has turned Texas Children’s Division of Otolaryngology into the largest pediatric ear, nose and throat program in the country.

Prior to him coming aboard as Chief of Otolaryngology in August of 2014, the program had eight otolaryngologists providing services to the entire city of Houston and its surrounding area. Now, Texas Children’s Otolaryngology has 21 physicians stationed throughout the greater Houston community, including The Woodlands, Cy-Fair, Sugar Land, Clear Lake and West Campus.

“The idea is to be there in the community and to really be available,” Arjmand said. “We can’t expect all families to travel to the Main Campus.”

Having a more robust staff strategically positioned throughout the Houston already has paid off. Otolaryngology’s patient volume has increased more than 40 percent this year and that growth is expected to continue with the addition of even more faculty members.

All things to all people

Arjmand, who came to Texas Children’s from Cincinnati Children’s Hospital where he was director of their Ear and Hearing Center as well as their Pediatric Cochlear Implant Program, said he wants people to come to Texas Children’s Otolaryngology with both low and high complexity problems. That’s why he said he was very strategic when he was building his team of physicians.

“In the course of providing better access to our program, I wanted to develop our sub-specialty expertise as well,” he said. “I wanted our group of physicians practicing pediatric otolaryngology and to be involved in programs in designated areas.”

Four areas Arjmand said have great potential for growth are: airway reconstruction surgery, sleep medicine, vascular malformations and the treatment of hearing impairment, including cochlear implant surgery.

Arjmand himself is internationally known for his research on pediatric hearing loss. His clinical interests include pediatric ear disease, congenital and acquired hearing loss, airway disorders and health care quality improvement.

Of the division’s new hires, Dr. Deepak Mehta, recruited as the director of the Texas Children’s Aerodigestive Center, is nationally recognized for his expertise in complex airway surgery. Dr. Tara Rosenberg adds expertise in the treatment of vascular anomalies and the treatment of children with cleft lip and palate, and Dr. Danny Chelius, Jr. and Dr. Elton Lambert contribute to the program’s strength in the treatment of head and neck diseases. Dr. Carol Liu extends services at West Campus for children with ear disease and hearing loss, Dr. Tony Hughes will lead the otolaryngology program at The Woodlands and Dr. Shraddha Mukerji will focus on program expansion at West Campus.

Arjmand said his team also works with other areas of the hospital – such as cardiovascular, plastic and fetal surgeries – and that these supportive relationships have room to grow as well.

Improving patient care

To further improve the patient care process and expand the clinical scope of his department, Arjmand has expanded his group of mid-level providers, including physician assistants, nurse practitioners and advanced practice providers. Members of the group provide inpatient care at Main and West campuses as well as respond to requests for inpatient and emergency consults.

“It’s been a huge change but has been very well received and has really improved our response time to consultations,” Arjmand said. “I think it’s working out really well.”

Another focus of Arjmand’s is the standardization of care and the measuring of outcomes. In addition to his role as chief, Arjmand is the surgical director of practice standards and faculty development for the Department of Surgery. In this role, he works with Dr. Charles Macias in the Evidence Based Outcomes Center and Kathy Carberry in the Department of Surgery’s Outcomes and Impact Center to ensure patients receive the same level of care no matter who they see and that their care is the best based on sound medical data.

“Variation in treatment should be based on the patient, not the doctor’s preferences,” Arjmand said. “This allows for better measurement of outcomes, which makes it possible for us to improve how we care for patients.”

Making Texas Children’s Otolaryngology the best in the county is Arjmand’s primary goal, and based on what he’s accomplished since joining Texas Children’s in August 2014, he’s well on his way to achieving success.

For more information about the Texas Children’s Otolaryngology’s new medical staff click on the names below. To learn more about the program as a whole, go to: http://www.texaschildrens.org/ENT/.

Dr. Daniel Chelius, Jr.

With football season in high gear, many of you will be anxiously glued to your electronic devices cheering on our Houston Texans and their new quarterback. But, what does football have to do with Texas Children’s safety coaches?

Well, have you ever had a coach who ignited your passion for a sport, motivated you to push forward to achieve a goal or helped you become a better team player? That’s exactly what Texas Children’s safety coaches are all about. Just like a football team works together to score a touchdown, safety coaches help us reach our organization-wide goal: scoring multiple touchdowns in the “zero patient harm” end zone.

Every Texas Children’s employee – regardless of their job title or position – plays an important role in cultivating a harm-free environment for our patients. While all employees are required to complete error prevention training, Texas Children’s Safety Coach Program takes that training to a whole new level.

Safety coaches consist of clinical and nonclinical frontline staff and providers who are trained to observe employee interactions and provide feedback that reinforces safety behaviors and skills taught in error prevention training. These safety behaviors include how to effectively communicate concerns requiring action, how to support a questioning attitude and how to use three-way communication to achieve greater clarity.

“While all of us have been trained to use error prevention tools, it takes more than a single training session to hardwire these safety behaviors into our culture,” said Texas Children’s Patient Safety Specialist Sharon Jacobson. “Our safety coaches help us integrate proven safety behaviors in our everyday work to ensure error prevention alertness and personal accountability are always top of mind.”

Here’s an example of a safety coach at work:

“A safety coach working in the operating room observes an anesthesiologist express a concern about the volume of medication in a syringe. Because the anesthesiologist voices her concern, the team pauses before giving medication to the patient. They discover the wrong calculation had been used to prepare the medication. An error has been prevented. The safety coach provides the anesthesiologist and the care team with positive feedback for fostering a questioning attitude and preventing a potentially harmful patient safety event.”

So, you might be wondering, “How do I become a safety coach?”

As part of the recruitment process, Texas Children’s Patient Safety Team reaches out to departmental leaders across the organization to determine who on their team would be an ideal candidate based on the responsibilities and attributes outlined in the safety coach application packet. Once the forms are filled out, signed by the applicants and approved by their manager, the Patient Safety Team selects the candidates for the training program.

Safety coaches are required to take a mandatory 3-hour training course that includes an overview of the skills taught in error prevention training, a discussion on the attributes that embody a good safety coach and video scenarios that help safety coaches identify good versus not so good coaching moments. Since the program’s launch in February, Texas Children’s has more than 60 safety coaches across the organization, who all serve on a strictly volunteer basis.

“We’ve completed training sessions at Main Campus and West Campus, and are looking to get our first physician group going this month,” said Texas Children’s Patient Safety Specialist Tiffany Wrenn. “As you can see, our safety coaches play a vital role in helping all of our employees become Safety Super Stars.”

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