October 6, 2015

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10715SafetyCoachinside640With 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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10715AndrewJea175Dr. Andrew Jea, Fellowship Program Director, Director of Educational Programs for the Division of Pediatric Neurosurgery, and Associate Professor of Neurological Surgery at Baylor College of Medicine, was recently appointed to the college’s Medical School Curriculum Committee.

The committee oversees the medical education program as a whole and has responsibility for the overall design, management, integration, evaluation and enhancement of a coherent and coordinated medical curriculum.

“I am honored to have been selected to serve on such a prestigious committee,” Jea said. “I look forward to playing a role in shaping the medical curriculum at Baylor College of Medicine.”

Jea earned his medical degree from the University of Miami School of Medicine. He completed an internship at the school, and completed his residency and spine fellowship there. Before joining Texas Children’s, he finished a second fellowship in pediatric neurosurgery at the University of Toronto and the Hospital for Sick Children.

Jea’s awards in the field of medical education include three Fulbright & Jaworski Faculty Excellence Awards in Teaching, and Evaluation, Educational Leadership, and Development of Enduring Educational Materials, respectively. He is the recipient of successive annual Baylor College of Medicine Department of Neurosurgery teaching awards since 2010, including Teach of the Year honors in 2012. Jea was also named the Texas Children’s Hospital Department of Surgery Faculty Research Mentor Award in 2012. Moreover, he was recently elected a Senator to the inaugural Baylor College of Medicine Faculty Senate.

Jea’s clinical interests center around the surgical treatment of spine and spinal cord disorders, including scoliosis, kyphosis, spondylolisthesis, trauma, and tumors, in the pediatric and young adult age groups. His laboratory interests involve the use of nanotechnology to effect neuronal regeneration in the setting of spinal cord injury. These interests have led to numerous grants, presentations, and publications, as well as a lasting collaborative relationship with nanotechnology scientists at Rice University.

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bench-and-beside-Header2Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your submissions and feedback.

10615PaintingGroup300September 2

Pulmonary hypertension team hosts the painting party, proceeds benefit PHA

Physicians and staff with Texas Children’s Pulmonary Hypertension Program hosted a tile painting party on August 22 where patients transformed ceramic tiles into colorful pieces of art. The event benefited the Pulmonary Hypertension Association. Read more

September 9

Texas Children’s Hospital West Campus expands urology services

Urology services at Texas Children’s Hospital West Campus have been extended to meet the needs of patients in Houston and its surrounding area. Read more

September 9

Dormans sets sights high for future of Orthopedics Department

Chief of Orthopedics Dr. John Dormans joined Texas Children’s three months ago and has already developed a plan to make the Texas Children’s Orthopedics Department one of the top programs in the world. His plan focuses on three main areas – recruitment, operations and facilities, and reputation and expertise. Read more

10615drhairaward300September 9

Hair receives 2015 Clinical Faculty of the Year Award

Dr. Amy Hair, a neonatologist and director of neonatal nutrition at Texas Children’s, recently received the Baylor College of Medicine’s 2015 Clinical Faculty of the Year Award for demonstrating “exemplary performance of activities that are above and beyond the scope of assigned responsibilities.” Read more

September 9

New program offers emotional healing for parents of special-needs children

Texas Children’s Geneticist Dr. Christian Schaaf and his colleagues developed a support program that helps parents cope with the emotional challenges of caring for children with developmental disabilities by learning to let go of things they cannot control. Read more

September 15

Clinical Research Center/Research Resources Office presents research award to Dr. Wenderfer

The Clinical Research Center/Research Resources Office presented the Clinical Research Award for Third Quarter 2015 to Dr. Scott Wenderfer, Department of Pediatrics-Renal, Baylor College of Medicine. Wenderfer’s research activities focus on Inflammatory Kidney Diseases and Lupus Nephritis. Read more

10615summercamps300September 15

Texas Children’s patients, staff create shared memories at Camp Spike N Wave, Camp Periwinkle

Every summer, Texas Children’s staff and their patients make the 90-mile trek to Camp for All, a 100-acre, barrier-free recreational facility where children with complex medical conditions experience the thrill of camping just like other kids their age. More than 185 children with epilepsy attend Camp Spike N Wave and roughly 185 patients from Texas Children’s Cancer Center go to Camp Periwinkle. Read more

September 29

Dormans presides over 50th annual meeting of SRS

Dr. John Dormans, chief of Orthopedics at Texas Children’s Hospital, completed his year as president of the Scoliosis Research Society (SRS) at the 50th anniversary meeting in Minneapolis September 30 to October 3 and presented one of six special lectures titled, “Neural Complications in Spinal Deformity: Detection and Avoidance.” Read more

September 29

Dr. Swathi Bataji joins Pediatric Surgery

Dr. Swathi Balaji has joined the Pediatric Surgery Research Laboratory at Texas Children’s Hospital. Balaji also has been appointed assistant professor in the Department of Surgery at Baylor College of Medicine. Read more

September 29

ICD-10 debut: New coding system launchess at Texas Children’s October 1

On October 1, Texas Children’s and other hospitals around the world switched to the ICD-10 coding system that will allow greater detail and precision in reporting patients’ diagnoses and procedures. For more than a year, Texas Children’s ICD-10 preparedness teams worked diligently to ensure all employees were prepared for the mandatory October 1 conversion. Read more

10615PICS300September 29

Heart Center physicians perform two cases broadcasted to live audience

Heart Center physicians performed two pediatric interventional cardiac care cases for the Pediatric and Adult Interventional Cardiac Symposium. The cases, which were performed at the Main Campus, were transmitted live to the conference in Las Vegas, Nevada via satellite. Read more

September 29, 2015

93015ICD10640On Thursday, October 1, Texas Children’s will join other hospitals across the world and switch from ICD-9 to the expanded ICD-10 code sets to report patients’ diagnoses and procedures.

The ICD-10 system will allow greater detail and precision in describing patient care and acuity. This increased level of detail will improve our clinical providers’ ability to track data, enhance the measurement of care quality and safety, refine the claims reimbursement process and ultimately, improve clinical, financial and administrative performances.

For more than a year, Texas Children’s ICD-10 preparedness teams have worked diligently to ensure all employees are prepared for the mandatory October 1 conversion. As of today, 100 percent of our clinicians, nurses and nonclinical support staff have reached full compliance with the required training and education necessary to ensure organization-wide readiness.

While previous ICD-10 delays prompted some organizations to pause during their preparations, Texas Children’s has continued forward with technical application remediation, provider training and education to all impacted service areas.

“We would not be able to achieve this level of preparedness without the tremendous support we received from leaders across our organization,” said Texas Children’s Director of Health Information Management Austin Frazier. “Your commitment and the support from our executive team helped us achieve this milestone as we transition to this important shift in health care. Thank you!”

As we start the final countdown to ICD-10, here are some helpful resources to consider:

1. Where do I go for additional information on ICD-10?

Below are links to a quick fact sheet and helpful sites with basic information on ICD-10 to see how this change will impact your own medical record documentation:

ICD-10 Video

ICD-10 Fact Sheet

ICD-10 Industry Updates

ICD-10 Myths and Facts

2. What if I have technical issues on or after October 1 related to ICD-10?

Contact the IS Help Desk at Ext. 4-3512 for all system related questions and concerns. Clinicians can contact the 4 Epic team for support

3. Is there a crosswalk tool to assist me?

Yes. Revenue Cycle has developed a tool for quick code translation to support the organization. Those users who will be heavily impacted will be able to reference this SharePoint site directly.

4. Who should I contact if I have additional questions about ICD-10?

For other questions or concerns, email Frazier or call him at Ext. 4-1605.

Physicians from around the world attending the Pediatric and Adult Interventional Cardiac Symposium in Las Vegas, Nevada were invited to watch two live cardiac catheterization cases performed by the Texas Children’s Heart Center team. The cases, which were performed at the Main Campus, were transmitted live to the conference via satellite. The purpose of these cases is to showcase the surgical techniques of the different hospitals and encourage greater collaboration. Texas Children’s was among nine hospitals from around the world chosen to participate in these live cases.

The conference, held in Las Vegas, focuses on opportunities for greater integration between congenital heart and adult structural heart disease specialists. Texas Children’s Heart Center is ranked #2 nationally in cardiology and heart surgery by U.S. News & World Report.

Led by interventional cardiologist Dr. Henri Justino, The Charles E. Mullins Cardiac Catheterization Laboratories at Texas Children’s Hospital include three dedicated labs and a team of five dedicated interventional cardiologists. In 2014, the team performed more than 1,150 cardiac catheterization procedures and more than 98 percent of cases occurred without complication.

“We are thrilled to showcase Texas Children’s specialized pediatric interventional cardiac care on an international level,” Justino said. “Our team performed two procedures on patients with extremely complex cardiovascular malformations which will further highlight the depth and breadth of minimally invasive transcatheter treatments we provide to our patients every day.”

Justino was joined by Dr. Athar Qureshi, associate director of the Mullins Catheterization Laboratories at Texas Children’s along with the team. The first case involved a patient with Abernethy malformation with portopulmonary hypertension. The team plans a percutaneous splenic vein puncture, splenoportography and possible placement of an additional device in the large congenital portosystemic shunt. The second case features a patient who has pulmonary vein stenosis due to Cri-du-Chat syndrome, a chromosomal condition that results when a piece of chromosome 5 is missing. The team plans balloon dilation and/or stenting of the right pulmonary vein stents with possible intentional stent fracture.

September 22, 2015

For Aleida Stark, RN, each time a new patient receives their diagnosis at Texas Children’s Cancer and Hematology Centers, she begins a new puzzle. The care that is required for patients in the very complex world of hematology and oncology requires a massive amount of coordination. That work is taken on by nurse coordinators who serve as the point of contacts for families, patients and providers. The nurses in this role are constantly moving around the puzzle pieces to ensure everything fits.

“As nurse coordinators, we’re in charge of making sure the families understand their diagnosis,” Stark said. “Our job is to empower the patients and families and educate them to recognize events that need to be reported back to their care providers.”

Stark works closely with Dr. Donald Mahoney, director of Texas Children’s Hematology Center.

“We deal with very complicated problems here and these problems are not simply managed with a brief office visit,” Mahoney said. “It requires extended care support and that’s where the nurse coordinator fits the critical role.”

The role is one that has been present for adult cancer and hematology patients for years, but Texas Children’s is the first to create a role to this extent for the pediatric Hematology and Oncology patient population. Denise Tanner-Brown, clinical director of the Cancer and Hematology Center said the role has recently been reshaped to more closely align with the patients’ and providers’ needs and is growing with seven new positions added in the hematology/oncology and bone marrow transplant outpatient areas with recruitment currently underway.

“Cancer and Hematology care is so complex and our patients touch so many different services in the organization and many times they felt lost in a big and complex system,” Tanner-Brown said. “Our patients needed a central person to help them along the way that’s what they have found in our nurse coordinators.”

The nurse coordinator is with the patient throughout their care at Texas Children’s. From their outpatient clinic visits to any time they are admitted to the hospital or visit the Emergency Center, their nurse coordinator is there to ensure continuum and coordination of care. For the nurses in this role, the relationships are unlike any other area of care.

“There is a different level of satisfaction in this role because you see the entire continuum of care,” Tanner-Brown said. “In this role, you experience the successes, challenges and emotional roller coasters along with the families throughout the months or years they are in our care.”

Tanner-Brown said the right person for this position must be compassionate as they deal with patients in the most vulnerable moments of their lives and must be self-motivated with a great sense of collaboration.

For those interested in applying, contact Debora Harris, assistant director of Bone Marrow Transplant Clinic or Judy Holloway, assistant director of Hematology/Oncology Clinic.

September 9, 2015

91015JohnDormansortho640Chief of Orthopedics Dr. John Dormans is an eternal optimist, skilled orthopedic surgeon and strategic leader, a combination of which are destined to prove great things for Texas Children’s.

Since joining the organization three months ago, Dormans has developed a plan to make Texas Children’s Orthopedics one of the top programs in the world.

“Texas Children’s is the place to be,” Dormans said. “It’s the largest children’s hospital in North America and is located in one of the fastest growing metropolitan areas in the country; the potential here is just immense.”

To harness that potential, Dormans is focusing his efforts on three main areas – recruitment, operations and facilities, and reputation and expertise.

Recruitment

Including Dormans, five new people have joined the Orthopedics Department this summer. Dormans came to Texas Children’s from Children’s Hospital of Philadelphia (CHOP), where he was the hospital’s chief of orthopedic surgery from 1996 to 2014. During his time with CHOP, Dormans focused his clinical work on pediatric spinal deformity and musculoskeletal tumors while providing the leadership to grow the number of specialized and outreach clinics and make CHOP the No. 1 ranked orthopedic program in the country, according to U.S. News & World Report. He also was president of CHOP’s medical staff for three years and presided over five international surgical organizations.

“Dr. Dormans comes to us with an incredible track record of success,” said Surgeon-in-Chief Dr. Charles D. Fraser Jr. “His knowledge, leadership and accomplishments make him an exceptional asset to Texas Children’s and we are confident in his ability to lead our Division of Orthopedics into an exciting new chapter.”

In addition to Dormans, a new pediatric orthopedic surgeon, Dr. Dorothy Harris, has joined the team, as well as two clinical fellows and one research fellow. Harris recently completed her fellowship in pediatric orthopedics and scoliosis at Texas Children’s Hospital and Baylor College of Medicine. Her major areas of interest include orthopedic trauma/fractures, cerebral palsy, and limb deformities.

Next summer, Dormans anticipates hiring up to eight new orthosurgeons at Main Campus and corresponding support for Texas Children’s Hospitals The Woodlands and Texas Children’s Hospital West Campus.

Some of those hires will be “super stars” in the orthopedics field, Dormans said, adding that 20 pediatric orthopedic surgeons have formally expressed interest in working with Texas Children’s Orthopedics, some of whom are among the top orthopedic surgeons in the country.

“I think we’re on the radar,” Dormans said. “We’ve attracted a lot of interest.”

A more robust staff will allow the Orthopedics Department to accommodate the requests it currently gets from patients and families across the region, throughout the United States and across the globe, Dormans said. It also will position the department for tremendous growth in both its general practice and sub specialty areas.

Operations and Facilities

A key ingredient to that growth is gaining more access to existing clinical space and operating rooms on Main Campus.

“We are bursting at the seams on Main Campus,” Dormans said about available clinical and operating room space at Main Campus. “Our only escape valve for surgical cases currently is at West Campus.”

Texas Children’s Hospital The Woodlands and the Care First initiative – which will reinvestment in the programs our most critically ill patients need – will help. In addition, leadership is acutely in tune with Dormans’ needs and is doing everything they can to meet them.

“The leadership at this organization is phenomenal,” Dormans said. “They are all over everything, listening, trying to prioritize and implement and execute to get things done.”

Operationally, Dormans said he is making several changes that will help make the department run more efficiently and become more competitive. The department will have dedicated surgical schedulers, which will free up some of the clinical staff’s time, for example. And, an additional six nurse practitioners, physician assistants and advanced practice providers will make the department’s outpatient visit process run more smoothly.

Another aspect of operations Dormans said he is focusing on is technology and getting the latest and greatest tools to aid his staff in doing the best they can to help the patients who seek expertise from his department. One such piece of equipment is a device called an EOS system that will bring state-of-the-art low X-ray dose imaging for patients with scoliosis and leg length issues. The machine will be in place later this month and is part of a joint capital project between the departments of Radiology and Orthopedics.

“There are a lot of exciting things coming to fruition and many more to come,” Dormans said.

Reputation and Expertise

All orthopedic departments are different in what services they choose to offer and specialize in. Some organizations dedicate all of their time and resources to specialty services while others only offer general services. Dormans said he wants Texas Children’s to offer the best of both.

“It’s like a football team,” he said. “You want a diverse lineup of players.”

Within his department, those players not only include medical and support staff but researchers and educators as well. Recently, the department has started journal clubs, revamped the conference schedule and collaborated with Brenden Lee, the No. 1 funded musculoskeletal researcher in the world, to create a basic science research program in orthopedics.

Ultimately, Dormans said he wants people to identify Texas Children’s as the place to go to find answers to all of their pediatric musculoskeletal problems.

With more than 20 physicians and advanced practice providers treating everything from minor fractures to complex disorders, the department is on the right track, but, “the sky is the limit,” Dormans said.