Over 300 miles away from Texas Children’s Hospital is the Vannie Cook Children’s Clinic. Located in McAllen, Texas, the facility is an extension of Texas Children’s Cancer and Hematology Centers, dedicated solely to pediatric cancer and blood disorders in the Rio Grande Valley.
The clinic opened in 2001, as a joint venture between a local foundation, the Vannie E. Cook Jr. Cancer Foundation, Baylor College of Medicine and Texas Children’s Hospital. Since then, more than 9,500 families have found the care they need right where they need it most – in their own backyard.
“Before we arrived, most of the local children with cancer and blood disorders had to travel several hours to and from San Antonio or Houston for treatment,” said the clinic’s medical director Dr. Juan Carlos Bernini. “This region didn’t have any pediatric cancer facilities, and there were no pediatric oncologists or hematologists regularly practicing close by.”
During the first year of operation, clinic staff expected to see about 100 patients. Instead, they saw more than 400. “It was obvious how critical our presence was, but the community thankfully trusted and bolstered our ability to serve them,” said Bernini.
Texas Children’s/Baylor College of Medicine physicians staff the clinic in the only comprehensive pediatric cancer and hematology center in South Texas.
“The clinic has grown from a small group of providers into a top-notch team of physicians, nurses, social workers, clinic technicians and administrative supporters, all committed to delivering the newest and most advanced therapies to our young patients,” Bernini said. “Our commitment to the patient and family starts at diagnosis and continues throughout treatment and beyond. Most importantly, we’re able to forge exciting paths for long-term survivorship with our patients every day.”
The outpatient clinic is comprised of over 10,000 square feet of space with two waiting rooms, seven exam rooms, two procedure rooms, two phlebotomy stations, two laboratories and a large infusion suite divided into areas for toddlers, young children and adolescents, respectively.
In addition to offering diagnostic and cancer treatment services, the clinic offers a long term survivor program which follows childhood cancer survivors through adulthood, and a research program that offers participation in epidemiology studies and clinical trials.
As a member of the Children’s Oncology Group (COG), we are able to provide local children with critical access to clinical trials. This is particularly important since a large portion of the population that we treat is Hispanic, a population that is generally under-represented in clinical trials.
Leaders with the Vannie Cook Children’s Clinic and its partners are always evaluating the services provided at the clinic and are constantly striving to deliver the best care possible to the children served in the Rio Grande Valley.
Dr. David Poplack, associate director of the Cancer and Hematology Centers and director of Global HOPE, helped pave the way for the partnership between Texas Children’s and the Vannie Cook Foundation. He has always said that supporting the clinic was and continues to be the right thing to do.
“At Texas Children’s we believe our responsibility to care for children doesn’t begin and end with those who are able to come to us for help,” Poplack said. “We have an obligation to identify and address critical gaps in coverage whether they are near or far.”
November 12, 2018
Eighteen-year-old Angeles Vasquez was anxious and scared. For months, a painful wound had lingered on her right ankle. No matter what remedy she and her family tried, it just wouldn’t heal. Unable to find answers or relief elsewhere, they turned to Texas Children’s Hospital and our new pediatric Wound Care Clinic, a new initiative spearheaded by Chief of Plastic Surgery Dr. Edward Buchanan and Director of Surgical Advanced Practice Providers Ryan Krasnosky.
“Dr. Buchanan and Ryan were awesome,” Vasquez said “They gave me the medications I needed and taught me how to properly clean and care for the wound. It’s finally healing and they’re still checking in with me all the time to make sure I’m okay.”
The new Texas Children’s Wound Care Clinic – one of only a few in the country, and the first and only one of its kind in Texas – is a comprehensive center where patients can have a variety of wounds evaluated and treated by an experienced, multidisciplinary team of dedicated medical, surgical, nursing and advanced practice providers.
The team uses evidence-based, standardized treatment protocols – which are under constant scientific scrutiny – to develop individualized treatment plans for each patient. These care plans take into account factors such as wound origin and location, as well as patient and family lifestyle, to determine the best approach to maintenance and to prevent future wounds. Additionally, data from each case is carefully analyzed with the dual goals of improving clinical processes and ensuring care protocols provide the best possible outcomes.
“There is a huge need for this kind of care in Houston and across the United States,” said Buchanan. “We want to lead the way in pediatric wound care on the national level, developing scientifically supported protocols that become the standard of pediatric wound care. With our clinical volume and our dedication to treating these patients, we’re strategically positioned to accomplish this goal.”
Experts in the Wound Care Clinic currently see patients from across the Texas Children’s system at our Texas Medical Center campus, providing high-quality care for a wide range of conditions, including:
Deep pressure wounds and ulcers
Fragile skin and other skin issues
Gastrostomy or other tube issues
Soft tissue infections
Thermal skin injuries (that do not meet criteria for burn transfer)
Wounds in babies with congenital anomalies
“These wounds are often complex and can take quite some time to heal,” said Surgeon-in-Chief Dr. Larry Hollier. “It’s wonderful for a patient to be able to see a team that has all the expertise and products available to heal these wounds in a timely fashion. Additionally, we have the ability to perform minor procedures to speed along the healing and are also able to directly schedule surgeries from the clinic if necessary.”
Still in its beginning phase, the clinic is currently held one day a week. However, in the months since the clinic’s opening, there has been a rapid increase in patient volume, and preliminary plans are already being made for expansion to West Campus and The Woodlands.
“The growth in volume is a testament to the high-quality care our patients are receiving,” Krasnosky said. “Families have been extremely pleased with the care we’re providing and they’ve voiced their appreciation for having a consistent ‘home’ for wound care.”
As the clinic grows, teams will continue to analyze data and lessons learned in order to further standardize clinical processes and care protocols. Long-term goals include the introduction of same-day surgical interventions, for wounds that require more invasive treatment. There are also plans for the integration of a comprehensive research component, with a basic science emphasis on wound healing and clinical research efforts focused on developing evidence-based wound care guidelines, as well as the creation of novel wound treatments and care assessment tools.
In the meantime, clinic care teams are laser-focused on providing the best possible wound care and improving outcomes for every patient who comes to us.
“The Wound Care Clinic is open to any and all wounds that practitioners need assistance with,” Buchanan said. “We hope to get involved early in the care of pediatric wounds within the Texas Children’s system, so as to decrease the time to healing and improve the quality of life of our patients. As our clinic expands, our capacity will expand, and we will be able to provide services to all patient populations. No wound is too trivial or small for an evaluation.”
November 6, 2018
A team of Texas Children’s surgeons, anesthesiologists and perioperative staff recently traveled to Malawi and Uganda to provide surgical care for children with cancer and congenital anomalies as part of Texas Children’s Cancer and Hematology Centers’ Global HOPE program. This was one of the first coordinated trips under the new Division of Global Surgery.
Dr. Jed Nuchtern, chief of Global Surgery, Dr. Bindi Naik-Mathuria, pediatric surgeon and Trauma medical director, Dr. Titi Aina, pediatric anesthesiologist, and operating room nurse Anita Hadley worked alongside local surgical teams to provide much-needed surgical care for area children, many of whom had been waiting months for experienced doctors and nurses who could treat their conditions. The team helped complete more than 30 operations, including 10 nephrectomies for Wilm’s tumor, the most common form of pediatric kidney cancer, effectively providing a cure for these children.
“I am so proud to be able to share the talents of our surgical teams by going abroad,” said Nuchtern. “Not only are we able to treat these children who are in great need of surgery, but we are also able to educate the doctors and surgical teams from these countries. The collaborative efforts of Surgery, Anesthesia and the Cancer Center continue, as future trips have already been planned, and we will add to our traveling surgical teams as the Division of Global Surgery grows.”
The Division of Global Surgery, created this past August, expands Texas Children’s ability to help children and women across the globe in low-resource countries and offers pediatric surgery education by providing hands-on instruction and necessary supplies. To build capacity, preliminary Global Surgery efforts are focused on surgical care for pediatric cancer patients and leverage resources, infrastructure and successful global medical programs already in place in sub-Saharan. These include Baylor International Pediatric AIDS Initiative (BIPAI) Network, Global HOPE and existing efforts by Texas Children’s Department of Ob/Gyn. Long-term goals for the division include a surgical facility for women and children in Lilongwe, Malawi; expansion of care capacity in Central America; and, ultimately, recognition for Texas Children’s as a leader in global surgical outreach.
October 23, 2018
On October 19, Texas Children’s leaders cut the ribbon to our health system’s newest addition – Texas Children’s Specialty Care Austin.
The clinic, at 8611 N. Mopac Expressway, Suite 300, officially opens Thursday, October 25, and will offer services in cardiology, and ophthalmology. Pulmonology services will begin in mid-November and Allergy and Immunology will begin in December. Scheduling for cardiology, ophthalmology, and pulmonary is now open, and schedules for Allergy & Immunology services will open in November.
“Our goal is to supplement the great health care options already available to Austin-area families and improve access to specialty care in a convenient location,” Executive Vice President Michelle Riley-Brown said.
The 26,000 square foot clinic has 30 exam rooms including five eye lanes. This exam area is the comprehensive site where patients have their vision checked and ophthalmic professionals conduct exams and meet with patients. Each specialty has two to four dedicated rooms depending on the number of providers. There is an additional 26,000 square feet of shell space on the second floor available for future expansion.
Outpatient Radiology services are available for internal and external patients. For cardiology, EKGs are available to record heart activity, echocardiogram to capture images of the heart, and a portable device called holter monitors that also measures and records heart activity. There is also a pulmonary diagnostic laboratory available to perform a number of pulmonary tests such as spirometry, bronchodilator response evaluations and oxygen saturation.
“We have recruited the best and brightest,” Physician-in-Chief Dr. Mark W. Kline said. “We did it at West Campus, The Woodlands and we are doing it again here in Austin.”
Staff at the clinic provide specialized clinical and diagnostic care. Several specialties expected to be provided at the clinic in the future are:
Allergy & Immunology
“At Texas Children’s, we are extremely proud to be in Austin,” Vice President Ivett Shah said. “Being here is an extension of our mission — so that we can provide the very best care to even more children who need it. We are honored to have everyone respond so positively and we are so grateful to be here, serving you.”
Click here to visit the website for more information, or call 737-220-8200 to schedule an appointment.
October 16, 2018
Sweeping views of the Houston skyline from high atop the Lester and Sue Smith Legacy Tower were the backdrop for a special ceremony to formally dedicate the 23rd floor as the Direct Energy Patient Floor. The floor will serve as the new home of the Heart Center’s Cardiac Patient Care Unit.
Texas Children’s and Direct Energy executives, as well as physicians, staff and volunteers celebrated the milestone alongside U.S. Representatives Sheila Jackson Lee and Al Green, and State Representative Sarah Davis. A bright orange ribbon cutting ceremony followed remarks from Texas Children’s President and CEO Mark Wallace, Manu Asthana, president of Direct Energy Home, and Chief of Pediatric Cardiology Dr. Daniel Penny.
“This facility, with all its new technologies, is something that we’ve all accomplished together,” Penny said. “But the point of all this technology is to shorten these children’s hospital stays, to reduce the number of operations they need, and to give them back their childhood. Direct Energy has been with us from the start and has helped us see it through. And we owe them a heartfelt thank you.”
Following the ribbon cutting, the festivities continued as Direct Energy volunteers visited patient rooms with the Direct Energy Fun Cart, which is full of toys and activities for patients and their families to enjoy during their hospital stay.
In 2015, Direct Energy committed $5 million to Promise: The Campaign for Texas Children’s Hospital to support the expansion of the Heart Center. It is the largest corporate gift ever made to a Texas Children’s campaign priority. With Direct Energy’s generous support, Texas Children’s is able to provide highly specialized care to even more children who come to the hospital for help – and particularly to those who are the most critically ill and have the most complex cardiac conditions.
Last week was monumental for Texas Children’s with the move of our No. 1 ranked Heart Center into the new state-of-the-art Legacy Tower. The milestone came just months after the historic May 22 move of our pediatric intensive care and progressive care units into the spacious, high-tech tower adjacent to the Texas Children’s Pavilion for Women and across the street from Mark Wallace Tower.
“What a great day it’s been for everyone at Texas Children’s as we’ve moved into the upper floors of Legacy Tower,” said Texas Children’s President and CEO Mark Wallace. “We’ve transferred a lot of patients today and everything has gone flawlessly. This remarkable new space will make a world of difference for the critically ill patients and families we serve.”
View photos below from the move and the events that followed.
Over the course of about eight hours on September 25, six specially-trained clinical teams comprised of more than 200 members transported 64 heart patients, some critically ill, safely to their new, state-of-the-art rooms in Legacy Tower. The patients ranged in age from 3 days to 22 years.
The following day, on September 26, 11-year-old Colin Rankin of Dallas, became the first patient to undergo a cardiac catheterization procedure and an intra-cath MRI in Legacy Tower at the Heart Center’s new Charles E. Mullins, M.D. Cardiac Catheterization Laboratories.
Moments before Colin’s procedure, performed by Dr. Athar Qureshi, a ribbon cutting ceremony was held to commemorate the opening of our four new catheterization labs and integrated MRI. Dr. Charles E. Mullins, the pioneering Texas Children’s physician and father of modern interventional pediatric cardiology for whom the suite of labs are named, was present at the ceremony and cut the ribbon along with Dr. Henri Justino, director of the Mullins Cardiac Catheterization Labs.
On September 27, Associate Chief of Congenital Heart Surgery Dr. Jeff Heinle cut the ribbon to officially open the Heart Center’s new cardiovascular operating rooms, and to usher in a new era of cardiac surgery at Texas Children’s. Later that morning, 4-year-old Rizan Merchant underwent the first surgical intervention in the expansive new space – a Fontan procedure, performed by Heinle.
And on October 1, patients received treatment for the first time in the new Legacy Tower Therapy Gym. The gym is a powerful resource to help children and parents learn and focus on what they can do, rather than what they can’t. Features include machines for building core strength and balance, exercise bikes, and a bathtub and set of stairs for parents to practice everyday tasks at home with their children.
A week before the move, patients and families entered the doors of the Heart Center’s new outpatient clinic for the first time. Situated on the 21st and 22nd floors of Legacy Tower, the clinic is designed top to bottom with Texas Children’s families in mind. The bright, welcoming space was specially configured to offer a more personal approach to care, and to handle high clinical volume. During the first afternoon clinic session, 25 patients were seen, and 18 outpatient echocardiograms and 18 outpatient ECGs were performed. To read more about the new Outpatient Clinic, click here.
Throughout the entire move and for days afterward, the Legacy Tower Go Live Support Center was set up on the fourth floor of the Pavilion for Women and comprised of hundreds of individuals from across the hospital system who focused on patient move tracking from West Tower to Legacy Tower. The team included support staff from Supply Chain, Security, BioMedical Engineering, Facilities Operations, Information Services, Pharmacy and Respiratory Care.
“We all are incredibly blessed by this space, but this move isn’t just about the building. It’s the people as well,” said Vice President Judy Swanson. “We have such a committed, amazing team, all of whom worked so hard to make this move happen and to make it special for our patients and families.”
Texas Children’s started planning for Legacy Tower more than five years ago as an effort to reinvest in the programs our most critically ill patients need. Demand for these services continues to grow – here in our community and far beyond Houston. And prior to Legacy Tower, our core areas – Critical Care, Emergency Center and ORS/PACU – were often at capacity.
As an organization, we needed to make changes that advance quality, service, safety and strategic growth. We needed to broaden our expertise and better coordinate care to improve the experiences of our patients and their families. And we needed to expand our access to make certain we do not have to turn children away when they need us most.
Legacy Tower is helping Texas Children’s accomplish all of this and more. The 640,000-square-feet of new space includes:
– 8 floors for Texas Children’s Heart Center
– 7 floors of intensive care patient rooms
– 1 radiology suite
– 6 high-intensity surgical operating rooms
– 4 cardiovascular operating rooms
– 2 intraprocedural MRIs
– 4 cardiac catheterization labs.
A helistop atop Legacy Tower is scheduled to open in November.
“The building of Legacy Tower has been a long journey and has really shown Texas Children’s at its best,” said Executive Vice President Mark Mullarkey. “This effort is and has always been focused around our patients and families.”
For our clinical staff, Legacy Tower will give them a better place to do what they do best – treat some of our most critically ill patients. It also will position them to continue to provide some of the best pediatric care in the world.
“Everything we would ever want as a specialty is here,” said new Chief of Congenital Heart Surgery Dr. Christopher Caldarone. “We have new and innovative centers like the exercise center, the gym where we can show patients what they’re capable of doing rather than telling them what they can’t do.”
All of this sets Texas Children’s apart, Caldarone said, adding that the only way to stay ahead of everyone else is make sure we bring all the expertise available to bear to every decision for every baby in a timely manner.
“That’s no small feat,” he said. “I think that’s where we’re going to be able to set ourselves apart.”
Chief of Pediatric Cardiology Dr. Daniel Penny said everything about the new Heart Center is about reducing the impact of heart disease on children and on their families.
“Whether it’s the amazing new clinical technologies that we’ve built, our new magnet in the Cardiac Catheter Lab, right down to the tiny design features,” Penny said. “They were all done with one thing in mind and that is what was best for parents and their children.”
Dr. Lara Shekerdemian, service chief of Critical Care Services, said everyone is extremely excited about Legacy Tower, the additional capacity it provides and the overall better environment it has made available to patients, families and staff. Patient rooms, Shekerdemian noted, are twice the size of the old rooms in West Towers. Dedicated family space has been incorporated into the design of the building and each inpatient room has its own bathroom.
“It’s a bright, beautiful, spacious, quiet and peaceful environment,” she said. “It’s a huge change from what we had previously.”
The past few weeks have been a flurry of activity as phase II of the Legacy Tower move-in drew to a close. In the final push, we opened the Heart Center outpatient clinic, moved 65 cardiovascular acute care and cardiovascular intensive care unit patients from West Tower to Legacy Tower, and opened our new catheterization labs and cardiovascular operating rooms. We also celebrated another exciting opening – a third blood bank, located on the 16th floor of Legacy Tower.
“The new blood bank is another major milestone for Texas Children’s,” said Transfusion Safety Officer Nicole Crews, RN. “Ensuring potentially life-saving blood products are quickly and more easily accessible is key to the care of many patients in Legacy Tower. This new location will increase efficiency and ensure we have the right blood products available when they’re needed.”
In an emergency situation when a blood product is needed, time is of the essence. If blood is closer to the bedside, runners don’t have to go as far to travel. Now, with locations in Legacy Tower, the Pavilion for Women and Abercrombie Tower (servicing both West Tower and Mark Wallace Tower), transport times could be reduced to as little as 5 to 10 minutes, down from 20 to 30.
In addition to proximity convenience, Texas Children’s blood banks are committed to providing the safest and highest quality blood products for our patients.
“Due to our tremendous volume and the diverse needs of not only our patients, but of the departments and service areas that require blood, we have to make sure we always have the right blood products available,” Crews said. “We provide plasma, platelets, red blood cells and cryoprecipitate for everything from pre- and post-op procedures to PICU patients, who can need three to four transfusions a day.”
At Texas Children’s, we’re fortunate to have a blood bank at each of our three hospital campuses. Combined, between 2,400 and 2,800 products (units and aliquots) are issued every month across our campuses, making transfusions possible for more than 500 patients.
The transfusion process comprises several steps and touchpoints – including type/screen collection and processing – and must be completed with the utmost safety, and at the highest standards, to mitigate risk and provide the patient with the best possible care. The blood bank is committed to meeting and exceeding the highest safety standards for every patient and every transfusion. To ensure that high level of excellence, Crews teaches the Five Rights of safe transfusion practices:
Right blood product
“We want staff across the hospital to know that the new blood bank in Legacy Tower is open and fully operational,” said Crews. “Many months were spent planning, preparing and validating equipment to ensure the utmost service is provided, and Transfusion Medicine and blood bank personnel are ready and excited to continue to grow with Texas Children’s and our patients.”
Learn more about our blood bank locations and which one you should visit to pick up your patient’s blood.