November 4, 2014

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Texas Children’s cares for some of the country’s most critically ill patients, and safe, quality care for every patient is the most important responsibility of each staff member and employee here. Equipping our staff and employees with the knowledge and tools to take preventive action is key to creating an environment of safe patient care.

In an effort to illuminate the importance of everyone’s role, each month we will share patient safety stories that help heighten staff and employee alertness and accountability and, ultimately, reduce harm. This month’s story is a reminder that being familiar with your surroundings and knowing what to do in an urgent situation can help improve the outcome.

When congenital heart disease patient Emily came to the hospital for diagnostic testing, her family and the diagnostic team expected a routine clinical visit like she’d had many times before. But this visit ended differently. During testing, Emily’s condition began to deteriorate unexpectedly. The diagnostic team rarely treated acute patients and was not accustomed to calling for help. Their unfamiliarity with emergency protocol delayed a call to *9999, and once the response team arrived, there was additional delay in finding the code cart.*

Actions everyone can take:

  1. Know how to get help in an emergency. If you don’t know, ask your leader today.
  2. Know your surroundings and the location of emergency equipment. Some areas have code carts, automatic electronic defibrillators, panic buttons and other emergency equipment. Make sure you know what emergency support is available in your area, where it is and when it should be used.
  3. Be alert. Don’t take routine situations for granted, even if it’s something you’ve done many, many times before.

*Patient safety stories are based on events at Texas Children’s Hospital. Patient names and some of the circumstances of the event may have been changed to protect patient privacy.

For the latest quality and safety information, visit the Patient Safety website on Connect.

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Recently the Department of Pediatrics at Baylor College of Medicine and Texas Children’s Hospital reached a milestone with the hiring of its 1,000th faculty member. Today, more than 1,011 physicians make up that faculty and while the numbers are impressive, the story behind the numbers is what makes this department truly impressive. The latest milestone is part of a continuation of growth the department has seen over the years, more than doubling in size since 2007.

“Being the first in history means we cover the waterfront,” said Physician-in-Chief Dr. Mark W. Kline. “Texas Children’s forte is taking care of kids with the most complex medical conditions. We have expertise in every conceivable area no matter how complex or serious a child’s illness.”

In the past few years, the organization has added more than 100 new physicians a year across all subspecialties at Main Campus with a much bigger footprint across the community including West Campus, health centers, The Center for Children and Women, newborn units across the community that are staffed by Texas Children’s physicians and our latest partnership with Children’s Hospital of San Antonio.

“It’s a great story of our capacity and expertise,” said Kline. “We are less siloed and leave a mark across a broad geographical area.”

Kline said the vast expertise of the department means a capacity to deliver on every area of the Texas Children’s mission including patient care, education, research and service while driving innovation in health care. Amongst the goals of the department is educating young doctors who are the future of pediatric health care. Last year 40 new pediatric residents began their careers at Texas Children’s, this year that number has grown to 43 and it’s a program that continues to distinguish itself amongst others in the nation. Not only is it the largest program offered, the program includes a general pediatrics track, a global health track as well as the newest addition for 2015 applicants, the pediatrician-scientist training and development program. The program is intended for those with an interest in becoming a physician-scientist.

“I tell applicants it doesn’t matter where your interests gravitate throughout your residency, we have someone who can mentor you in that area,” said Kline. “This is a program to broaden horizons.”

Having the largest faculty and expertise in every recognized subspecialty gives Kline and other leaders the opportunity to recruit the best and brightest faculty. While leading growth has come easy, managing growth while preserving the cultural values of the institution presents a bigger challenge.

“The way we’ve ensured our culture remains strong is having a mix of new talent along with those who have been engrained in the culture for years,” said Kline. “We are creating that same mix at the leadership level to preserve our culture while continuing our growth.”

Kline recently created a new leadership structure with Dr. Susan Blaney, Dr. Sheldon Kaplan and Dr. Gordon Schutze appointed to new executive vice chair positions allowing the strengthening of the leadership structure with broader representation.

Kline said he doesn’t see a plateau in sight and hopes the growth will continue as the hospital continues its efforts to offer the best care at Main Campus, expands its services at West Campus and soon begins its latest venture in The Woodlands.

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Dr. Paul Checchia, medical director of the pediatric cardiovascular intensive care unit, has extensive experience with respiratory syncytial virus (RSV) in various clinical, research and academic settings. In response to the recent Ebola outbreak in West Africa and the handful of cases that have been treated here in the United States, Checchia wrote the following story in an effort to refocus people’s attention to RSV and influenza – two viruses he says are much bigger threats in the United States than Ebola.

11414pchecchia150During the past couple of months we all have seen our fair share of news coverage on Ebola. From turning on your television to walking into a pediatrician’s office and being asked questions about recent travel, the topic is everywhere. It’s not uncommon that with the surplus of information out there, it can begin to cause some anxiety.

While the likelihood of an Ebola outbreak is extremely low, it is still important to stay informed. And at Texas Children’s Hospital we want the community to know that we are fully prepared if an Ebola case were to appear in Houston.

But one thing I can’t help but ask myself is: With so many people worried about the spread of Ebola, why aren’t they also taking every precaution necessary to protect themselves against other diseases? For instance, why are individuals not having the same reaction to the flu as they are with Ebola?

The flu is a preventable disease that affects hundreds of thousands of individuals every year. According to the Centers for Disease Control and Prevention, an average of more than 200,000 people in the United States are hospitalized each year from the flu, with up to 49,000 dying from it. Yet many people are still refusing to get vaccinated. In fact, less than half of the U.S. population receives the flu vaccine each year. The CDC also reports that only 45 percent of children ages 6 months to 17 years got the influenza vaccination during the past 12 months. Only 26 percent of adults 18-49 years of age received theirs.

And what about respiratory syncytial virus (RSV)? While there isn’t a vaccine for RSV, there are many ways in which parents and Texas Children’s employees can actively protect infants and children from contracting this respiratory virus, including, washing your hands and making sure anyone in contact with your infant does the same. It’s also important to keep infants and children away from others who are sick, especially with cold or flu-like symptoms (which is why a flu shot is important for all family members and health care workers). While RSV is not as deadly as the flu, it can spread very rapidly among children. So what’s most important to remember about RSV is that is can be prevented.

As many communities are taking precautions to protect themselves and their families from Ebola, let’s not forget about these other diseases that are affecting so many of us every year. The flu and RSV have regularly impacted our community in more devastating ways than Ebola has. It is important that we not ignore these much greater health threats in the U.S.

So please get vaccinated: Everyone 6 months or older is recommended for flu vaccination. It’s the best way to protect yourself and others.

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic.

Remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3, we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1.

October 28, 2014

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The flu vaccine protects pregnant women, their unborn babies and the baby after birth.

These are just a few of the reasons it is so important for pregnant women to get a flu vaccine.

Dr. Michael A. Belfort, obstetrician and gynecologist-in-chief of Texas Children’s Hospital, tells you more about how serious the flu can be for pregnant women and why they should get vaccinated against the potentially life-threatening infection.

“Pregnancy is a state where there are adjustments in the mother’s immune system that can make certain infections more serious during pregnancy than they would be outside of pregnancy,” Belfort said. “The flu is one of those illnesses that can be a lot worse in pregnancy than outside of pregnancy.”

Pregnant woman with the flu also have a greater chance for serious problems for their unborn baby, including premature labor and delivery, according to the Centers for Disease Control and Prevention.

“So, it is absolutely vital for all pregnant women to get the flu vaccine,” Belfort said.

The shot has proven to be safe for pregnant women and their babies with millions of expecting mothers receiving the vaccine during previous years.

Getting the shot is the first and most important step in protecting against flu, according to the CDC. Given during pregnancy, the shot has been shown to protect both the mother and her baby (up to 6 months old) from the flu.

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules on Connect for both Main and West Campuses. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic.

And, remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3 , we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1.

October 24, 2014

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Texas Children’s had the opportunity Thursday to show the Centers for Disease Control and Prevention firsthand how prepared we are to handle a suspected Ebola patient.

Members of the CDC “Fast” team, which assesses readiness and provides feedback about any gaps in Ebola preparedness, visited both Main and West campuses. While there, the team met with various Texas Children’s leaders and employees who have been instrumental in putting together the organization’s Ebola readiness plan.

“We welcome CDC’s input and guidance as we develop an Ebola preparedness plan second to none in the nation,” said Texas Children’s Physician-In-Chief Dr. Mark W. Kline, who was chosen by Chief Executive Officer Mark A. Wallace to lead our Ebola planning efforts and to create a model of preparedness here at Texas Children’s.

Kline has convened a core team of medical and administrative leaders to develop, implement and maintain our plans and protocols as the situation continues to evolve. He meets with Wallace daily and his team has been working closely with Infection Control, Nursing, Pathology, Critical Care, Emergency Medicine and Communications.

Texas Children’s started working on its Ebola readiness plan months ago in response to the Ebola outbreak in West Africa. The plan was tested in September when a suspected Ebola case presented at Texas Children’s Hospital West Campus.

Staff handled the case confidently and proficiently, diligently screening the patient, which allowed for immediate isolation as outlined in our protocol for handling suspected cases of Ebola. The patient ended up testing negative for Ebola but positive for malaria.

Texas Children’s continues to screen patients for possible Ebola exposure. The organization also continues to train staff on how to respond to a suspected case of the virus.

“I am confident in our rigorous, ongoing preparation efforts,” Wallace said. “We have a responsibility to our patients to deliver the best possible care at all times, but we also are intensely focused on keeping you – our physicians, staff and employees – safe.”

 

Return to Ebola Response site.

October 21, 2014

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Bright red signs asking patients if they have traveled to West Africa in the past 21 days were posted around Texas Children’s Hospital more than a month ago when the Ebola outbreak overseas continued to escalate.

A few weeks later, Thomas Duncan was diagnosed with Ebola at a Dallas hospital and later died. Duncan contracted the virus in Libera, one of three West African countries where Ebola has spread rapidly and killed thousands. Two of the nurses who cared for Duncan caught the infection and are being treated at hospitals in Georgia and Maryland.

No one has been diagnosed with Ebola in Houston, but Texas Children’s has been preparing for months in the event we receive such a patient. One of the first steps in that process is screening.

Staff in the Emergency Centers at both Main and West campuses and entry areas in the Pavilion for Woman are actively screening all patients for possible Ebola exposure.

Anyone who has traveled to Liberia, Sierra Leone, and Guinea in West Africa within the past 21 days is considered at risk and is immediately isolated. After isolation procedures are initiated, additional screening occurs and Infection Control is notified. The patient must be cleared by Infection Control to be removed from isolation.

Any patient with suspected Ebola will immediately be isolated in a pre-designated room, Infection Control will be notified, and additional screening will occur. Once deemed appropriate, the patient will be transported to a pre-designated room where they will remain until their treatment is completed.

At the West Campus, the patient will be transported to the Pediatric Intensive Care Unit and cared for by the nurses and physicians there. At the Main Campus, the patient will be transported to the pediatric care unit and cared for by nurses and physicians from the PICU. Since patients will only be placed and cared for in these units, other units do not need to designate isolated space for Ebola patients or receive extensive training.

All patients transported to Texas Children’s by the Houston Fire Department paramedics are screened prior to arrival in the Emergency Center.

Our clinics in the Critical Care Center and at the West Campus, pediatric and OB/GYN practices, urgent care centers and other community centers are being educated and informed on proper screening protocols and isolation methods should a suspected case of Ebola present at one of their locations. However, the care of that patient would not take place within these facilities.

As for visitors to our hospital, we are not actively screening them for travels to the affected regions in Africa, but they all are screened on a routine basis for signs and symptoms of any infectious disease. This screening occurs before visitors are allowed entry into the inpatient units. The screening includes questions about symptoms such as fever, cough, runny nose, and vomiting.

Remember, Ebola is only contagious when a patient is showing symptoms. Because symptoms associated with the virus are severe, it is highly unlikely that someone with Ebola would be visiting another patient in the hospital.

Because this is a rapidly evolving situation, all screening practices are routinely reviewed and will change if necessary.

For more information about the organization’s Ebola preparations please click on the “Ebola Response” logo on the Connect intranet site and on the parallel external Connect news site at texaschildrensnews.org, which is accessible from any computer or mobile device at any time.

If you have questions about our plan or about Ebola, please email them to connectnews@texaschildrens.org. The communications team will route questions to Dr. Kline and the leaders of our response and readiness team to get answers and provide updated information to our organization.

During the past few weeks, you have heard from various leaders across the organization as to why they want you to get your flu shot. Now, it’s time to hear from your colleagues in other parts of the organization.

All six of the people below received their seasonal flu vaccine the first day it was offered at Texas Children’s. Listen to their stories to find out why they got the flu shot and why they think you should too.

Elizabeth Rincones, a patient care assistant with Texas Children’s Hospital, said she got the flu vaccine to protect herself and the children here at the hospital.

“We take care of kids every day, and if we are exposed to the flu, we could potentially expose them,” she said. “So, I think it’s very important to get the flu shot every year.”

Paige Simmons, a development associate with Texas Children’s, is pregnant with her first child and said she got the influenza vaccine to protect herself and her baby. Simmons urged other pregnant women to do the same.

“Definitely be vaccinated,” she said. “Little babies, they can’t handle it (the flu), so we need to watch out for them.”

Richard Lion is a fellow with Pediatric ICU Services and works with some of the sickest patients in the hospital. He said he got his flu shot because he didn’t want to put his patients at an increased risk of getting an infection that can be deadly to those with compromised immune systems.

“It’s well known that influenza is a terrible thing for them to experience,” Lion said. “Therefore, you can’t take any chances of putting them at risk.”

Clara Diaz, a patient care assistant who works with children who have pulmonary issues, said she gets the flu vaccine because she herself is at high risk of suffering complications from the infection.

“I already have asthma, so this lets me go,” Diaz said. “I can keep on working without stopping the work flow.”

Sarah Koohmaraie, a transplant coordinator, said she gets the flu shot every year to protect herself, her patients and her dad, who is a transplant recipient.

“I can’t think of anything more important,” she said of getting the vaccine. “The flu doesn’t discriminate, it gets everyone. So, the more people who get vaccines the better.”

Melvin Sergeant, a staff technician in Radiology, said he gets the flu shot because he knows firsthand what it’s like to have the infection.

“I’ve had the flu twice and I was hospitalized for it,” Sergeant said. “So, now I protect myself.”

Sergeant said other Texas Children’s employees should do the same.

“Please take the flu shot,” he said. “It will help you, plus it’s free.”

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses on Connect. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic after Wednesday, October 1.

And, remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3, we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1. As of October 21, almost 65 percent of employees had gotten a flu shot.