January 24, 2017

12517Barcodemilk640On January 17, Texas Children’s implemented barcode scanning for breast milk to reduce administration errors system-wide by ensuring that the correct breast milk is delivered to the right baby every time.

“Since 80 percent of breast milk orders originate in the NICU, we implemented barcode scanning in our Newborn Center last September as part of a pilot project which produced amazing results,” said Texas Children’s Patient Care Services and Clinical Informatics Director Jennifer Sanders. “We are excited to deliver this functionality across our Medical Center campus, the Pavilion for Women and West Campus.”

Using the same barcode scanning system to prevent medication administration errors, the Positive Patient Identification (PPID) process incorporates Epic Rover, a mobile software application that uses barcode technology to positively match breast milk orders to the right patient, subsequently reducing the potential risk of adverse patient safety events during the milk handling process.

Once Epic Rover is downloaded to an iPod Touch equipped with a scanner or sled, a nurse scans the barcode on the patient’s wristband and the barcode on the breast milk container at the patient’s bedside instead of having to manually check it prior to a feeding. The milk order documentation then flows real-time from Epic Rover into Epic, which also documents any supplements added to the breast milk.

“Since using Epic Rover in our Newborn Center, our compliance rates have consistently soared above the 95 percent goal,” said Texas Children’s Clinical Informatics Manager Erin Davies. “We have avoided documented near misses where Epic Rover detected the wrong breast milk with the wrong baby, which demonstrates the tremendous impact barcode scanning has on ensuring the safety of our patients.”

The successful implementation of Epic Rover at Texas Children’s involved the collaboration of several departments including Clinical Informatics, Information Services, Food and Nutrition Services, Milk Bank, Pharmacy, Nursing, and the Nursing Professional Development team that helped apply PPID safety protocols to breast milk.

Barcode scanning for breast milk will also go live at Texas Children’s Hospital The Woodlands when the facility opens this spring.

January 17, 2017

11817POSNA640The Texas Children’s Hospital Division of Orthopedic Surgery recently hosted the second annual meeting of the Children’s Orthopedics Trauma and Infection Consortium for Evidence Based Study (CORTICES).

Organized by local hosts Dr. Scott Rosenfeld and Dr. Jaclyn Hill, the January 8-9 meeting was attended by about 20 physicians and investigators from peer hospitals across the country. Supported in part by a Texas Children’s Hospital Auxiliary Research Grant for the study of regional variations in pediatric musculoskeletal infections, the group met to discuss preliminary data that has been collected from nearly 15,000 pediatric patients around the country. Additionally, the group began plans for future research projects in the field of pediatric musculoskeletal trauma and infection.

The Texas Children’s Hospital Orthopedic Surgery and Sports Medicine Programs focus on the study and treatment of musculoskeletal conditions in order to advance knowledge, prevent disease, improve health and ensure the highest level of individualized care for patients from newborns to young adults. With more than 30 Pediatric Orthopedic Surgeons and Advanced Practice Providers, Texas Children’s Orthopedics is recognized as a leader in research, teaching, and the clinical care of children not only across Houston, Texas but around the world.

January 10, 2017

11117wayfinding640As part of Texas Children’s continuing efforts to improve wayfinding across our entire system, one of our top destinations in West Tower has been updated.

The West Tower Level 3 destination for Surgery Reception and the PASS Clinic is just beyond the elevator banks. The blue wall that has been used as a directional landmark for many years has now been painted purple to match West Tower’s newly assigned wayfinding color.

In May, each building on Main Campus was assigned a color to add a layer of identification to our locations, allowing employees, patients and families to be able to easily discern between buildings not only by name, but also by color.

Pavilion for Women = Turquoise
Pediatric Tower = Yellow
West Tower = Purple
Abercrombie Building = Green
Feigin Tower = Blue
Clinical Care Tower = Orange

These colors are being added to the ongoing wayfinding signage as these changes and improvements continue to be implemented.

For more information about our wayfinding efforts, click here. To view a color-coded map of Texas Children’s Hospital, click here.

December 20, 2016

122116pathologyvietnaminsideSince 2005, the Department of Pathology & Immunology at Baylor and the Department of Pathology at Texas Children’s Hospital have played an important role in global health initiatives, first in Africa and later extending their outreach to Southeast Asia.

The Global Pathology Program at Texas Children’s launched a collaboration with the Vietnam Vascular Anomalies Center in Ho Chi Minh City in 2013, focusing on improving medical care for people in Vietnam through diagnostic pathology.

“One of our major goals is to improve medical care for the people in Vietnam by raising the standard of practice of pathologists who provide diagnostic workup for patients,” said Dr. Thuy Phung, associate director of Global Pathology at Texas Children’s and assistant professor of pathology & immunology at Baylor College of Medicine. “This includes improving physician training and pathology laboratory practice.”

Participants of the Global Pathology Program and the Vietnam Vascular Anomalies Center returned to Vietnam earlier this year for their sixth annual trip, accompanied by a team of more than 30 physicians, medical residents and students from the United States, South Korea and Thailand. Together they held a three-day CME conference in dermatology and skin and gynecologic pathology to train more than 90 pathologists on developing more accurate diagnosis.

Using the new technology of telepathology, participants were able to view digitalized images of stained tissue sections on their own computer monitor as if they were viewing through a microscope. Telepathology gives pathologists from anywhere in the world the opportunity to connect with one another through the internet to show and share pathology cases for diagnostic consultation, teaching and training. The consultation can take the form of a live videoconference, webcast or one-on-one discussion.

“Logistically, how this works is when pathologists in Vietnam have difficult skin biopsies, and they want my input as an experienced skin pathologist, they scan the tissue glass slides and send me the digital files,” Phung said. “With the digital files, I am able to view the slide image and move the virtual slide around to see different areas of the tissue. This imaging technology allows me to digitally view tissue in any way I want so that I can make the correct histologic diagnosis for the patient.”

Through telepathology, Phung has been able to provide expert consultation to pathologists in Vietnam in real time with high accuracy. She holds weekly live videoconferencing with Vietnamese pathologists to view the cases together.

“We view the digital images together and discuss the cases, and I share my opinion of each case,” she said. “Each week, we do this for about one hour, and usually look at 10 to 12 tissue biopsies that pose diagnostic dilemmas for the Vietnamese pathologists.”

Phung and her team have been holding weekly video meetings for a year and have broadened their training with pathologists in Ho Chi Minh City to include pathologists in other major cities in Vietnam such as Hanoi, Hue and Danang. “By conducting live telepathology, we not only provide correct tissue diagnosis in real time for patients in Vietnam, but equally important, we can use this approach to enhance the training of Vietnamese pathologists in diagnostic skin pathology,” she said.

“My hope is that they will become experts themselves in the future and be able to help even more patients than I can do myself here in the U.S.” said Phung.

There are now six Vietnamese pathologists who regularly participate in telepathology with Phung, and she believes their efforts will provide them the knowledge base to be experts in skin pathology in their own right.

“I like to think of this as innovation in global medical education involving virtual and interactive learning that has been enabled by today’s state-of-the-art technology in telemedicine and digital pathology,” she said. “This is a way to practically apply advanced technology and medical expertise that we have here at Baylor and Texas Children’s to help improve medical diagnosis and medical education in other countries, no matter where in the world.”

Currently, the Global Pathology team and the Vietnam Vascular Anomalies Center are working on expanding their work to Can Tho and Da Nang, two major provinces in Vietnam.

December 13, 2016

“We’re on the eighteenth floor of the CVICU and watching the tower every single day make so much progress so quickly, makes us want it right now,” said Jessica Gaustad, a cardiology nurse at Texas Children’s Heart Center.

Like Gaustad and so many other Texas Children’s employees, it’s hard not to notice the incredible progress that’s been made on Texas Children’s Pediatric Tower. As each day passes, the tower is getting taller and taller. Since construction work began one year ago, 16 floors have been built on the existing 6-floor base next to Texas Children’s Pavilion for Women. Three more floors are being built to complete the external structure of the 19-floor vertical expansion of the pediatric tower.

To see how far we’ve come along, you don’t have to look very far. This time lapse video highlighting the pediatric tower construction also includes animation of the different critical care services that will be housed in the tower once the approximately 640,000-square foot structure is completed in August 2018.

Texas Children’s Heart Center will have eight dedicated floors in the new tower to house the Heart Center outpatient clinic, catheterization lab, cardiovascular intensive care unit, a cardiovascular operating room and cardiology acute care beds. Also, the tower will be home to a new Pediatric Intensive Care Unit that will span four floors and open with 84 beds, including neuro ICU rooms, surgical ICU rooms and a progressive care unit.

Additional features of the tower include a total of 10 operating rooms, one radiology suite, faculty offices and a helistop on the roof of the tower to transport high acuity patients to Texas Children’s.

Earlier this year, a series of pre-construction simulation activities led by Dr. Jennifer Arnold’s simulation team were conducted to ensure the final interior layout of the pediatric tower would be designed in a way that promotes the safest possible environments to care for critically ill patients and their families.

“We were able to tweak a lot of things from how we envisioned beds being situated in a room to where the code carts are going to be located to even simple things like clock placement,” Gaustad said. “Families were also a big part of this process as well. Their feedback was incorporated into the final design decisions.”

As for the design theme and colors, the pediatric tower’s public spaces will embody the Beauty of Texas. Floors will have different colors for wayfinding. Floor patterns will depict trails and streams. Curving walls and ceilings will mimic canyons, skies and clouds.

While much progress still needs to be made in anticipation of the August 2018 opening, Texas Children’s will host a topping out celebration on February 9, 2017, to mark the construction milestone of completing the tower’s external structure.

“There’s going to be a time before you know it, that we’re going to have space to accommodate families,” said NICU nurse Nicole Leathers. “We’re going to have space to make the patient family experience more comfortable and will have more space to deliver the best care to our critically ill patients.”

For Veronica Velez, an Orthopedic surgery coordinator, she envisions the many benefits the new tower will bring for many years to come.

“When I am a retired nurse and there’s a new generation of nurses working on those floors that are being built right now, they can say a lot of thought went into this and they did a great job.”

December 6, 2016

12716mechanicalleechpg640Have you ever swam in a lake or trudged through swampy waters? If so, you probably have encountered leeches during your outdoor adventures. These worms have been used in human medicine for centuries because of their anesthetic, anti-inflammatory and tissue healing properties.

Primarily used in plastic surgery to restore blood flow to reattached body parts, leeches are considered natural healers. While removing deoxygenated blood from damaged tissue, their saliva contains hirudin, an anti-blood clotting protein, that allows oxygenated blood to flow to the injured tissue until normal circulation can be restored.

While leech therapy has never been used in gynecology and is rarely used in pediatrics due to the psychological impact it may have on patients and parents, what if there was a way to develop a mechanical device that could perform the same functions as a traditional leech?

Dr. Julie Hakim, a pediatric and adolescent gynecology fellow at Texas Children’s and Baylor College of Medicine, proposed this idea to a group of biomedical engineering students at Texas A&M University (TAMU) who then developed a mechanical leech prototype for potential use in pediatric gynecological surgeries.

“In pediatric gynecology, we often perform vaginal reconstructive surgery for girls who are born with congenital abnormalities,” Hakim said. “A graft of tissue is taken from somewhere else on the patient’s body to line the new vaginal tract. However, there are times when the grafts fail or do not take because of poor blood circulation to that area. Developing a novel mechanism to promote graft and tissue flap survival by increasing neovascularization of the tissue would help in these type of surgeries.”

With support from the Denton Cooley Innovation Award, the mechanical leech project and design requirements were presented to TAMU students on their first day of Senior Design Course. Two teams totaling eight students met every week with Hakim via Skype to provide updates on their progress. They also met with Dr. Jennifer Dietrich, Texas Children’s chief of Pediatric and Adolescent Gynecology, to present their updates once per semester.

The head of the mechanical leech was created with a small, flat circular unit measuring 1×1 cm fitted with an array of microneedles underneath for leech saliva egress and blood extraction that interfaces with the tissue. The head contains an outer reservoir for leech saliva and an inner reservoir that collects the extracted blood.

The leech body contains pumps that control and monitor the outflow of leech saliva and the inflow of blood, saliva and blood reservoirs. A blue tooth chip inside the pumps’ electronic assembly communicates through an iPhone app that runs the mechanical leech. The motor’s speed and the flow rate of the fluids can be recorded in real time and adjusted remotely via the iPhone app. The outer shell of the leech body and the gear mechanisms are connected by standard medical tubing.

“The mechanical leech has the potential to reduce complications associated with the use of live leeches,” Hakim said. “Since uncontrolled amounts of leech saliva can cause prolonged bleeding, controlling how much leech saliva is placed into the tissue can reduce the risk of transfusion. This mechanical novel device can also help reduce infection since live leeches are known to harbor bacteria.”

The mechanical leech head and the outer shell of the leech body and the gear mechanisms were 3-D printed. The project’s next step is to refine and test the feasibility of the prototype.

“I think this innovation could be of tremendous importance to the field of pediatric gynecology as well as pediatric surgery in general,” Dietrich said. “I’m excited to see where the next phase of this project takes us as we explore new avenues for improving the care we provide to our patients.”

November 15, 2016

111616newpfwwebsite350In case you haven’t already noticed, the websites for Texas Children’s Hospital and Texas Children’s Pavilion for Women have a new look and feel.

Sporting bright colors, vibrant photographs and iconography, the websites have been redesigned to better reflect Texas Children’s branding and marketing materials. The websites also have been revamped to incorporate best practices and user study feedback.

New features of the websites include:

  • A new content management system that allows for quicker, more timely updates
  • Incorporated branding (pictures, colors, icons) to match Texas Children’s current marketing material
  • Reorganized navigation based on usage data/analytics so that visitors can easily find the most searched-after content
  • Revamped website search that provides more accurate results
  • Improved responsiveness on mobile/tablet devices
  • New online health libraries provides valuable information to current/prospective patients as well as assists with search results through Google, Bing and other search engines.

Both websites have seen tremendous traffic with the Texas Children’s Hospital website garnering almost 6 million page views this year from 1.3 million different users and the Pavilion for Women website receiving 1.2 million views from 411,000 users. In addition, statistics have shown improvement in the amount of page views, average load time and bounce rate.

Work on Texas Children’s websites will continue with a new face and feel for Texas Children’s Pediatrics and Texas Children’s Urgent Care coming soon. A new safety and outcomes page also will be unveiled, offering our patients and their families the most complete and accurate information possible about how we are doing as a health care system.

Click here to see the new look of the Texas Children’s Hospital website and here to get a feel for the new website for the Pavilion for Women.

The web team would like to hear your feedback and answer any questions you might have about our new websites. Please direct your comments to tmmorri1@texaschildrens.org.