Optimization – Page 18 – Texas Children's News

March 1, 2016

Bench 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.

February 2

Texas Children’s, Rice University team up to develop new way to repair birth defect

Bioengineers at Texas Children’s Hospital and Rice University have won a National Institutes of Health grant to develop a new generation of patches to repair the damaged hearts of infants. The $1.9 million, 5-year grant will allow Jeffrey Jacot and his team to take the next steps in a long-running drive to improve the survival rates of such infants, many of whom are diagnosed in utero and require surgery soon after birth.

February 2

Department of State Health Services to award Texas Children’s $1 million grant for SIU

Texas Children’s is set to receive a $1 million grant from the Texas Department of State Health Services (DSHS) to put toward its newly constructed Special Isolation Unit at Texas Children’s Hospital West Campus. The funds, to be delivered during the next five years, will specifically go toward Ebola preparedness activities that bolster employee safety and quality of care.

February 2

Texas Children’s convenes task force, urges employees to educate themselves on Zika

In light of the multiple confirmed cases of Zika infection in Texas due to foreign travel, Texas Children’s leaders encourage employees, particularly pregnant women, to refrain from traveling to areas where the outbreak is growing and to follow precautionary measures to protect themselves from Zika exposure. Since the mosquito-carrying virus has been known to increase the risk of microcephaly, a neurological fetal birth defect, Texas Children’s recently convened a task force to develop management and research strategies based on screening criteria outlined by the Centers for Disease Control for pregnant women who may have been exposed to the Zika virus.

February 2 Kline: Children deserve access to best care

Many patients have been left scrambling to find a new medical home when a number of insurance companies decided not to provide in-network coverage for many hospitals in the Texas Medical Center, including Texas Children’s Hospital. Physician-in-Chief Dr. Mark W. Kline talks about how all children deserve access to the best care.

February 2

Zoghbi to receive medal for pioneering advancements in neuroscience research

Dr. Huda Zoghbi, director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s, will receive the 2016 Jessie Stevenson Kovalenko Medal from the National Academy of Science in April for her achievements in neuroscience, which includes unlocking the genetic and molecular mysteries behind rare neurological disorders.

February 2

Clinical Research Center presents research award to Dr. Anvari

The Clinical Research Center will present the Clinical Research Award for First Quarter 2016 to Dr. Sara Anvari, physician, Allergy and Immunology. Dr. Anvari is a dedicated clinical scientist for the food allergy research trials at Texas Children’s Hospital.

February 9

Three NRI researchers recognized for their contributions to neuroscience research

Drs. Michael Wangler and Shinya Yamamoto recently obtained a research grant from the Simon’s Foundation for Autism Research Initiative (SFARI) to advance their study on autism spectrum disorders. Their study titled, “In vivo functional analysis of autism candidate genes” is one of five projects selected for research funding by the SFARI. Dr. Andrea Ballabio, founder and director of the Telethon Institute of Genetics and Medicine (TIGEM), Italy, professor at Baylor and faculty member at the NRI, has been selected to receive the 2016 Louis-Jeantet Prize for Medicine. He will share this award with biochemist John Diffley, associate research director at the Francis Crick Institute, United Kingdom.

February 16

Study finds premature infants benefit from exclusive human milk-based diet

A recent Baylor College of Medicine study led by Texas Children’s neonatologist Dr. Amy Hair, and published in the journal Breastfeeding Medicine, found that premature infants weighing less than 1,250 grams at birth showed improved outcomes after being fed a human milk-based diet.

February 16

Mata twins celebrate one-year anniversary after historic separation

A year after being separated in a marathon surgery at Texas Children’s Hospital, formerly conjoined twins Knatalye and Adeline Mata are healthy, lively toddlers. Several members of our medical staff involved in the girls’ care got to see how much they have grown and how far they have come during a recent visit to Texas Children’s for their follow-up appointments with pediatric subspecialists monitoring their health and development. Hear some of their reactions and see for yourself how much the girls have progressed.

February 16

Heart Center launches series of educational animated videos

Featuring an armadillo, a bison and robot-like caregivers called Blings, a series of animated videos created by Texas Children’s Heart Center aims to help educate patients and their families about various heart conditions and treatment options. Six of the videos were unveiled at a February 15 red carpet premier and can be accessed on the Texas Children’s website at http://www.texaschildrens.org/hearteducation.

February 23

CVICU physician performs CPR, saves man’s life during spin class

When Dr. Natasha Afonso clipped in to a bike for a spin class on a recent Thursday evening, she didn’t know the skills she uses each day to treat patients in the CVICU would mean the difference between life and death for a fellow rider. Toward the end of the 45-minute, high-intensity class, Afonso heard 50-year-old Scott Corron collapse and fall off his bicycle. Because he wasn’t breathing and had no pulse, Afonso immediately started CPR, an action that ultimately saved Corron’s life.

February 23

New in situ simulation program enhances role clarity in high-risk emergencies

Texas Children’s Simulation Center recently launched the first-ever Neonatal Comprehensive In Situ Simulation Program for NICU providers at the Pavilion for Women. The program focuses on improving crisis resource management skills, one of which is role clarity, to ensure all code team members know each other’s specific roles when delivering care to patients during high-risk medical emergencies.

February 23

Texas Children’s helps develop nation’s first hospital-based rapid test for the Zika virus

Pathologists and clinical laboratory scientists at Texas Children’s Hospital and Houston Methodist Hospital developed the nation’s first hospital-based rapid test for the Zika virus in a matter of weeks as part of the L.E. and Virginia Simmons Collaborative in Virus Detection and Surveillance. Pathologist-in-Chief Dr. James Versalovic and Dr. James Dunn, director of medical microbiology and virology, led Texas Children’s Zika test development team. The new diagnostic test identifies virus-specific RNA sequences to detect the virus and can distinguish Zika virus from other virus infections like Dengue, West Nile or Chikunguny.

February 23

Blaney receives Pioneer Award for contributions in pediatric neuro-oncology The Children’s Brain Tumor Foundation honored Dr. Susan Blaney with the Pioneer Award for Pediatric Neuro-Oncology, celebrating her 25 years of dedication to the search for new and better treatments for children with brain and spinal cord tumors. Blaney’s extensive experience in clinical translational research focuses on developing new treatment strategies for children with brain tumors and other refractory cancers. Blaney has been instrumental in developing more new agent clinical trials than anyone in the field of pediatric oncology.

February 23

Dietrich voted president-elect of North American Society for Pediatric and Adolescent Gynecology

Chief of Pediatric and Adolescent Gynecology Dr. Jennifer Dietrich has been voted president-elect of the North American Society for Pediatric and Adolescent Gynecology. Her tenure as president-elect begins in April. She will be voted in as president in April 2017.

February 23

Texas Children’s Health Plan Center for Children and Women earns accolades for CenteringPregnancy® program Texas Children’s Health Plan’s Center for Children and Women has earned site approval for its CenteringPregnancy® program. The Centering Healthcare Institute (CHI) has awarded both the Southwest and Greenspoint locations the official designation for closely following the CenteringPregnancy® model.

February 23, 2016

Pathologists and clinical laboratory scientists at Texas Children’s and Houston Methodist Hospital developed the nation’s first hospital-based rapid test for the Zika virus in a matter of weeks as part of the L.E. and Virginia Simmons Collaborative in Virus Detection and Surveillance.

This collaborative program was established to facilitate rapid development of tests for virus detection in a large metropolitan area. These tests are customized to each hospital’s diagnostic laboratory and designed to provide results within several hours. Before the Zika test was developed, physicians faced the possibility of long delays of testing in local and state public health laboratories and the Centers for Disease Control (CDC).

Texas Children’s Pathologist-in-Chief Dr. James Versalovic and Dr. James Dunn, director of medical microbiology and virology, led Texas Children’s team tasked with developing a rapid test for Zika virus.

Transmitted primarily through mosquito bites, Zika is a flavivirus that contains RNA as its genetic material. This new diagnostic test identifies virus-specific RNA sequences to detect Zika virus and can distinguish Zika virus from other virus infections like Dengue, West Nile or Chikungunya. Every viral particle contains genes in its RNA and these RNA sequences are directly detected on blood, amniotic fluid, urine and spinal fluid.

Currently, only registered patients at Texas Children’s or Houston Methodist hospitals can receive the test but the labs will consider referral testing from other hospitals and clinics in the future.

The test will be initially offered to patients with a positive travel history and symptoms consistent with acute Zika virus infection such as a rash, arthralgias or fever, or asymptomatic pregnant women with a positive travel history to any of the affected countries. The World Health Organization has advised pregnant women to consult their doctors before traveling to places with Zika virus outbreaks and consider delaying travel. The CDC issued similar guidelines to pregnant women last month.

“With travel-related cases of the Zika virus becoming more prevalent in the U.S. coupled with the looming increase in mosquito exposure during spring and summer months, we must be prepared for a surge of Zika testing demand,” Versalovic said. “We must provide answers for anxious mothers-to-be and families who may experience signs and symptoms or may simply have a travel history to these endemic areas.”

Click here for more information about the Zika virus and what Texas Children’s maternal fetal task force is doing to develop strategies based on CDC screening guidelines for pregnant women who may have been exposed to the Zika virus.

The neonatal team at Texas Children’s Pavilion for Women is always prepared for special deliveries – taking care of newborns is what they’re trained to do. But earlier this month, the neonatal intensive care unit (NICU) received a special delivery that wasn’t quite what you’d expect.

Texas Children’s Simulation Center hosted an open house to introduce Tory, a high-fidelity infant mannequin, and the newest addition to the first-ever Neonatal Comprehensive In Situ Simulation Program launched at the Pavilion for Women’s Newborn Center. The simulation equipment and supplies were purchased with a generous $200,000 grant from the M.D. Anderson Foundation, which will also support an in situ simulation program for the Emergency Center and Critical Care, as well as one for the NICU in West Tower once a dedicated space for simulation has been identified.

“We’re grateful to our Newborn Center leadership for dedicating a simulation room at the Pavilion,” said Dr. Jennifer Arnold, medical director of the Simulation Center. “Now, our NICU providers can train in their actual practice environments during regular workdays to enhance individual and team performance – particularly in high-risk situations – and improve patient outcomes and safety.”

The in situ simulation program focuses on improving crisis resource management skills, one of which is role clarity. During a code, the potential for confusion and chaos can easily set in as responders attempt to care for a patient in a high-risk medical emergency. Clinicians responding to a code may not always be sure of their roles or the roles of their team members when they arrive, and that’s when in situ simulation training becomes crucial to patient safety and care.

“First, we conducted tests to determine the necessary roles in a crisis, whether it’s a resuscitation or a code,” said Dr. Mona Khattab, one of the in situ simulation program directors for the NICU. “By having the necessary personnel at the code, we alleviate staff overcrowding and ensure optimal efficiency and clear communication are achieved while delivering lifesaving treatment to our NICU patients.”

Inside the simulation room, colored labels – red, yellow and green – are affixed to the floor that encircle the bedside. These labels identify the specific roles of each of the code response participants and directs them to their position on the floor during a medical emergency.

The red team consisting of clinicians and nurses stand in the innermost circle closest to the bedside where they provide direct patient care.
The yellow team is positioned behind the red team. They support patient care providers by documenting the code, handing over equipment, managing the ventilator and medication and blood prep drawers, and providing mentorship and consultations to the team leader as needed.
The green team stands in the back of the room near the code cart and provides overall code and room support to ensure everything is running seamlessly.

“When a text message page is sent, the unit reports to the simulation room as if it were an actual page in the unit to respond to a code,” said Kellie Kainer, assistant director of Nursing for the NICU at the Pavilion for Women. “We give them a brief history of the patient and alert them to the code.”

The in situ simulations will occur every Thursday and last 10 minutes followed by 20 minutes of debriefing. The NICU teams alternate every week and are selected based on their current assignment and the flow of the unit on that particular day.

“We’re focusing on one specific patient case so that everyone gets exposure to that case,” said Dr. Leigh Ann Cates, a neonatal nurse practitioner and a program director for the in situ simulation program. “As our program expands, we hope it will become a model for in situ simulations in other units of the hospital.”

In preparation for this training, all clinicians within the Newborn Center complete an online pre-simulation course through Healthstream. The Simulation Center developed a series of powerpoint presentations covering crisis resource management skills, an orientation to simulation, and what to expect during simulation such as a confidential and psychologically safe learning environment.

February 16, 2016

A year ago, Knatalye and Adeline Mata lay on an operating table at Texas Children’s Hospital conjoined from the chest to the pelvis. For the next 26 hours, a team of surgeons and support staff separated the girls in an historic and intricate procedure meticulously choreographed to ensure that each step of the process would lead to and support the steps to come. Throughout the procedure, the Mata family stood by, waiting and praying for good news.

Just before 10 a.m. on February 18, 2015 the family counted their prayers as answered when they saw their girls, apart for the first time in adjacent rooms in the Pediatric Intensive Care Unit, where they were cared for by a team of specialized nurses. Since then, the almost 2-year-old twins have been discharged from the hospital and are living relatively normal lives in Littlefield, Texas with their parents Elysse and John Eric, 6-year-old brother Azariah and 5-month-old sister, Mia.

“The girls are both doing awesome,” said Dr. Darrell Cass, one of the lead surgeons in the separation case. “Neither have experienced any complications and both are making steady progress.”

Knatalye is beginning to walk, talk and eat by mouth. Adeline is meeting milestones as well. Her lungs are continuing to improve and she is slowly being weaned from ventilator support. Both girls are still undergoing physical and occupational therapy.

Several members of the medical staff involved in the girl’s care got to see how much Adeline and Knatalye have grown and how far they’ve come during a recent visit the Mata family made to Texas Children’s for follow-up appointments with pediatric subspecialists monitoring the twins’ health and development.

Aimee Renaudin, one of Adeline and Knatalye’s primary nurses in the Neonatal Intensive Care Unit, said she is amazed that the girls are doing so well.

“You would never know how they started off their lives together,” she said. “Elysee and Eric have taken such good care of them.”

Dr. Oluyinka Olutoye, the other lead surgeon in the separation case, said it’s a blessing to see how far Adeline and Knatalye have come.

“It’s always a joy to see the changes that have gone on,” he said. “They’ve gone from just being little babies to now trying to walk and talk and interact with you.”

John Eric said his daughters have far exceeded his expectations and that he and Elysee are enjoying being able to care for the girls at home.

“It’s nice to be able to have all of us together and to be able to wake up and know that they’re there,” Elysee said. “It’s fun to be able to be mom and dad, which we didn’t get to do for the first 10 months of their lives.”

The Mata family will return to Texas Children’s this summer for a checkup. During that visit, surgeons will operate on Knatalye, removing the metal struts used to stabilize her rib cage and to close her chest wall.

To read more about their journey click here. See photos from the Mata family’s latest visit to Texas Children’s below.

An armadillo with thick, long eyelashes whistles as she notices a problem with the blood flow in a child’s heart. Almost immediately an army of robot-like caregivers race into the hospital room and fix the problem.

No, this is not your typical medical setting. This is an imaginary world made to help children with heart problems better understand their diagnosis and potential treatment options. Created by a team led by Chief of Cardiology Dr. Daniel Penny, the series of almost 40 animated videos features Ruby, an armadillo; Beau, a bison; and a group of caregivers called Blings.

Ruby and Beau’s role in the videos is to identify the problem with a child’s heart, call in the Blings for help and explain – in very simple terms – what’s happening and how it’s affecting the patient. The Blings fix whatever is wrong while hopping in and out of colorful cars and using a cadre of MacGyver-like tools.

“The aim of our project is to improve the health literacy of the children and parents who come to us with heart disease,” Penny said. “If we can empower them through information, we can likely improve their treatment outcome and overall quality of life.”

To effectively communicate complex issues such as ventricular septal defect and patent ductus arteriosis, Penny is working with Michael Liddy, a friend and Australian animator, to script the 4- to 7-minute videos and create their characters, sound effects and musical score, all of which are done very intentionally and with the young age of the viewer in mind.

An additional bonus to the production of the videos, which is being funded by a grant from ExxonMobil, is the voices of Ruby and Beau are recorded at Texas Children’s Hospital by employees Hasti Taghi and Dr. Stuart Hall.

“We were very lucky to get the voices of Ruby and Beau in house,” Penny said. “They definitely add a special touch.”

To date, six of the videos in the series have been completed and were unveiled at a February 15 red carpet premier at Texas Children’s Pavilion for Women (click here to view a video). Doctors, patients and families across the organization and beyond can access the videos via Texas Children’s website at http://www.texaschildrens.org/hearteducation.

Penny and his team will continue to add to the animated series and work on another series of videos that educate patients on certain types of routine procedures done at the average heart center.

“We hope that having a program like this any child who enters a heart center will be able to get a feel for what they are going to experience,” Penny said.

February 9, 2016

Remember reading the official announcement of our CareFirst plans in November 2014? Well, as you can imagine, a lot has happened since then. After receiving the green light to proceed, Texas Children’s has made remarkable progress on the Pediatric Tower E vertical expansion project.

The first visible sign that construction has begun is the large crane that towers over the south end of Texas Children’s Pavilion for Women. Concrete slabs were removed to make room for the tower crane installation which was completed last December.

“We’re excited to see everything gradually come together,” said Jill Pearsall, Texas Children’s assistant vice president of Facilities Planning and Development. “The progress over the last two months is a direct result of the collaboration among our CareFirst executive leadership and project management teams, our design and construction contractors, and most importantly, our patients and their families.”

Perhaps one of the most significant milestones to date is the completion of the pre-construction simulation-based design tests on the proposed patient room layouts for the cardiovascular intensive care unit, pediatric intensive care unit and the progressive care unit.

In collaboration with Dr. Jennifer Arnold and her simulation team, the CareFirst Quality, Service and Safety Project Team led by Dr. Angelo Giardino, Trudy Leidich and Maria Happe, participated in 32 hours of simulated patient scenarios over a period of four days inside a large warehouse mock-up that resembled a critical care environment. A multidisciplinary team of intensivists, nurses, surgeons, anesthesiologists, respiratory therapists, patient families and other support staff, participated in the simulation and provided feedback to drive design of the space. During these simulations, 115 latent safety threats (LSTs) were identified. The LSTs were categorized based on Safe Hospital Design Principles outlined by the Agency for Healthcare Research and Quality and recommendations will be incorporated into the design.

“We have an opportunity to provide a new space that accommodates the needs of patients, families and clinicians,” said Happe, clinical senior project manager for CareFirst. “All patient rooms are configured to provide dedicated space for the patient, clinicians, all associated clinical equipment, as well as for the families, which helps to promote and enhance family engagement and patient and family-centered care. Simulation has allowed us to test these spaces prior to construction and has guided our design decisions.”

Other recent progress updates include:

The interior design concepts for the pediatric tower’s public spaces were fine-tuned with the Board of Trustees Building and Grounds Design Subcommittee on January 13. Once the design theme and colors have been finalized, this will provide architectural guidance to ensure a consistent look and feel throughout the building.
A pilot study to test the use of touch-screen activated information stations was launched on the first and third floors of the Clinical Care Center (CCC) for a 60-day assessment and feedback period. Survey input from patient families will be used to refine the hospital navigation tool before it is adapted to other Texas Children’s campuses, including Pediatric Tower E.
The technology team installed wireless access points for Voalte phones outside of the operating rooms (ORs). Tests are still ongoing to determine if wireless access points can be added in the OR suite to fully operationalize the Voalte phone roll-out in a manner that does not interfere with the communication of medical equipment in the OR. Additionally, the team will begin testing and reviewing a variety of other devices for CareFirst implementation.
The Pavilion Express Gift Shop closed to prepare for the installation of the tower’s elevator shafts. The gift shop will relocate to the first floor of the Pavilion for Women as a separate renovation project. The Pediatric Radiology department’s 3D lab moved from Building E 5 to the fourth floor of the CCC to make way for the upcoming construction activities.
Concrete pours to build the floors in the 25-story Pediatric Tower E will continue this month. From north to south, it will take roughly three concrete pours to create one floor.

“We’ve made incredible progress since the initial planning phase began for Pediatric Tower E,” said Texas Children’s Executive Vice President Mark Mullarkey. “This expansion will help us deliver on our promise to make Texas Children’s the best possible place to give and receive care.”

Click here to learn more about how the Pediatric Tower E project will help meet the growing needs of our critically ill patients.

February 8, 2016

Bench 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.

January 5

Zoghbi to receive Vanderbilt prize in Biomedical Science

Dr. Huda Zoghbi, professor of molecular and human genetics at Baylor College of Medicine, and director of the Jan and Dan Duncan Neurological Research Institute at Texas Children’s, will be honored with the 2015 Vanderbilt Prize in Biomedical Science. This award is given by the Vanderbilt University School of Medicine to recognize women scientists with a stellar record of research accomplishment who have also mentored other women in science. More

January 5

Second location of The Center for Children and Women celebrates milestone

Texas Children’s Health Plan recently celebrated the first anniversary of The Center for Children and Women in Southwest Houston. During the past 12 months, the Center has provided care to more than 5,800 patients, including 356 births, demonstrating The Center’s remarkable footprint in the community. More

January 12

Dr. Sanjeev Vasudevan selected for Baylor Young Alumni Award

Dr. Sanjeev Vasudevan will receive the 2016 Young Alumnus Award from the Baylor College of Medicine Alumni Association. Vasudevan is a pediatric surgeon and researcher specializing in pediatric cancers such as neuroblastoma, liver cancer, renal tumors and sarcomas. More

January 12

Harpavat receives ASSLD award for study on newborn screening tool to detect biliary atresia earlier

Dr. Sanjiv Harpavat, a pediatric gastroenterologist at Texas Children’s and Baylor College of Medicine, received the 2015 Jan Albrecht Clinical and Translational Research Award in Liver Diseases from the American Association for the Study of Liver Diseases (AASLD) Foundation. His study titled, “Assessment of a Novel Newborn Screening Tool for Biliary Atresia,” explores a new strategy to detect infants with biliary atresia earlier. More

January 12

Pediatric Surgeon Dr. Sundeep Keswani awarded visiting professorship

Dr. Sundeep Keswani, pediatric surgeon, was chosen by the Association for Academic Surgery to receive the 2016 International Visiting Professorship Award to attend the Columbia Surgical Association Congress in Bogota, Colombia, in August 2016. Keswani is the principal investigator for the Texas Children’s Laboratory for Regenerative Tissue Repair. More

January 12

Family Fertility Center advances innovative research to improve IVF process

From exploring the metabolic factors impacting egg quality to the genetics of embryo implantation, Family Fertility Center researchers at Texas Children’s Pavilion for Women are engaged in several fascinating studies to help infertile couples achieve successful pregnancy outcomes. Read about the various studies in progress. More

January 19

Three Texas Children’s Cancer Center researchers receive prestigious ASH awards

The American Society of Hematology (ASH) recognized three researchers from Texas Children’s Cancer Center and Baylor College of Medicine for their work in advancing our understanding of disease pathogenesis and exploring novel innovative approaches for the treatment of pediatric cancers. More

January 19

Texas Children’s uses advanced orthopedic imaging, less radiation exposure

Texas Children’s is the first pediatric hospital in the southwest to offer advanced orthopedic imaging that provides full body, 3-D views of a patient’s bone structure using less radiation. Because of the low radiation dose, EOS imaging is beneficial for orthopedic patients with scoliosis and other spinal deformities who require frequent imaging to monitor disease progression. More

January 26

Texas Children’s Hospital welcomes expert pediatric hand surgeon

Texas Children’s Hospital is excited to welcome Dr. William Pederson, a highly-regarded pediatric hand surgeon, to the Department of Surgery. Pederson, whose appointment was effective in January, also is a professor of surgery and pediatrics at Baylor College of Medicine. More

January 26

Texas Children’s Heart Center welcomes trio of cardiologists

Texas Children’s Heart Center has welcomed three new pediatric cardiologists to the team. Drs. Tobias Schlingmann, Betul Yilmaz and Justin Zachariah joined Texas Children’s in July. More

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