October 6, 2015

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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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September 29, 2015

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.

93015JohnDormans175Dr. John Dormans, chief of Orthopedics at Texas Children’s Hospital, will complete his year as president of the Scoliosis Research Society (SRS) at the 50th anniversary meeting in Minneapolis September 30 to October 3. In his presidential address, he will discuss how the SRS has grown since its creation in 1966 to become the preeminent spinal surgical professional organization internationally with more than 1,200 members from more than 50 countries and how the accomplishments of the past five decades will impact the future of spinal deformity education, research and treatment.

Dormans will also present one of six special lectures titled, “Neural Complications in Spinal Deformity: Detection and Avoidance,” describing the status of neurological monitoring and the methods that are the most effective at preventing neurological deficits. This is a special session on scientific work that has changed the practice of spinal deformity surgery over the past 15 years. He will also discuss his ongoing scientific research focus to promote safety, quality and value in spinal deformity surgery.

In reflecting on his year as president, Dormans said, “This anniversary is a reminder of what the SRS has contributed in the past five decades and the society’s ability to impact the future of spinal deformity education, research and treatment.” He noted that during the past 10 years, the SRS has funded 84 grants totaling more than $3.5 million. In addition, each year the SRS sponsors two international meetings, seven worldwide courses, traveling fellowships and hundreds of educational, research and advocacy initiatives.

In speaking about his role as outgoing president, Dormans said the SRS has gained recognition as the world’s premier spine society.

“Most importantly, the success of the SRS is primarily because of the commitment of its members,” he said. “The consistency with which members care deeply about the SRS mission and are willing to translate that dedication into participation is remarkable. I have no doubt that the SRS will continue to flourish, and as I wrap up this year, I am very proud to have played a role in that process.”

93015SWATHIBALAJI175The Department of Surgery is pleased to announce that Dr. Swathi Balaji has joined the Pediatric Surgery Research Laboratory at Texas Children’s Hospital. Balaji has also been appointed assistant professor in the Department of Surgery at Baylor College of Medicine.

“We are excited to welcome Dr. Balaji to the Texas Children’s Division of Pediatric Surgery,” said Dr. Jed Nuchtern, chief of the Division of Pediatric Surgery.

“Dr. Balaji’s recruitment represents a further commitment to develop a world-class research effort within the Department of Surgery,” Nuchtern said. “She has had significant scientific success by melding her bioengineering background with her interest in regenerative medicine to push the translational envelope.”

Nuchtern said the goal of her research is to understand the underlying mechanisms of how the fetus heals without scarring to achieve postnatal regenerative tissue repair in various organ systems. Balaji will be joining the Laboratory for Regenerative Tissue Repair, which is directed by surgeon-scientist Dr. Sundeep Keswani.

Balaji was most recently a postdoctoral research associate in the Division of Pediatric, General, Thoracic and Fetal Surgery at Cincinnati Children’s Hospital Medical Center. She received her doctorate degree in biomedical engineering from the University of Cincinnati and did her postdoctoral training at Cincinnati Children’s Hospital Medical Center.

September 22, 2015

92315EpicRover640More than 1 million patients are harmed each year in the United States because of medical errors. One of the most common, yet preventable medical errors involves the administration of medication.

Providing medicine to patients is more than just handing out pills or delivering drugs through an IV line. It’s a complex, multi-step process that involves meticulously checking and re-verifying that the medicine being prescribed, transcribed, dispensed and administered is going to the right patient every time.

As part of our commitment to patient safety, Texas Children’s has already begun implementing Epic Rover, a mobile software application that uses barcode technology designed to prevent medication errors and improve the quality and safety of medication administration.

Epic Rover is an extension of the electronic medication administration record (MAR) within Epic. Once this software is downloaded to an iPod Touch equipped with a scanner or sled, nurses and respiratory therapists scan the barcode on the patient’s wristband and the barcode on the prescribed medication at the patient’s bedside. The medication documentation then flows real-time into the MAR in Epic.

Bar Code Medication Administration (BCMA) helps our clinical staff verify the administration of medication more efficiently by assuring that the “five rights” are confirmed – right patient, right medication, right dose, right time and right route of administration.

“Medication scanning creates a significantly safer process and improves compliance with industry standards and regulations,” said Texas Children’s Clinical Informatics Director Jennifer Sanders. “It’s a safety measure for our patients and provides an additional safety net for our frontline nurses and clinical staff who are the last line of defense to prevent medication errors.”

Before Epic Rover, our nurses and respiratory therapists manually conducted the “five rights” checks. With BCMA, the entire process is done electronically. However, clinical staff must still rely on their critical thinking and judgment to ensure medication ordered by the physician matches the medication prepared and dispensed in the pharmacy before it is administered to the patient.

To help primary users adjust to the BCMA system, the Epic Rover rollout will be implemented in phases over a 9-week period with the completion of the final rollout phase on Saturday, November 21.

Epic Rover rollout schedule:

Dates          Weeks                  Grouping
9/22/15        1 and 2         PFW, Respiratory Therapy
10/6/15        3                   West Campus: 3W, PICU, EC, PACU, 5W/SIU
10/13/15      4                   Main: All EC areas, Floats
10/20/15      5                   9WT, 10WT, 11WT, 12WT, IRU
10/27/15      6                   PRCU, BMT, 14WT
11/3/15        7                   6N, 7N, 7S
11/10/15      8                   NICU 2, NICU 4, PFW NICU
11/17/15      9                   PICU, CVICU, 15WT

Mandatory training will include a Health Stream module, an Epic video and a 90-minute hands-on classroom training session. All staff must complete training before the go-live.

“Our goal is to reach 90 percent compliance in 90 days,” said Texas Children’s Clinical Informatics Supervisor Erin Davies. “We’re confident we will reach this goal because our clinical staff is committed to creating an environment of safe patient care.”

The implementation of Epic Rover would not be possible without the collaboration from several departments including Clinical Informatics, Information Services, Pharmacy, Respiratory Care, Nursing and the Nursing Professional Development team who helped create the training curriculum.

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.