Texas Children’s Hospital is committed to creating the best possible experience for our patients and their families. A significant part of this experience, that perhaps at times goes unnoticed, is our linen services. Linen forms an integral part of the services we provide – from clinical visits, to emergency visits or long stays.
Effective Friday, May 4, Texas Children’s will partner with a new linen vendor, Texas Textile Services. With more than fifteen years of experience and a state-of-the-art facility, Texas Textile has worked with various prestigious health care organizations throughout the Houston area.
On January 13, Texas Children’s successfully performed its fourth conjoined twins separation, giving identical twin girls Anna Grace and Hope Elizabeth Richards a chance at a normal life.
The 7-hour procedure was performed by a multidisciplinary team of nearly 75 surgeons, anesthesiologists, cardiologists and nurses from eight specialties. Click here to see a list of surgeons, clinicians and nurses in the operating room during the milestone procedure, and here to view a photo gallery documenting the twins’ journey the day of their separation.
“The success of this incredibly complex surgery was the result of our dedicated team members’ hard work throughout the last year,” said Surgeon-in-Chief and Chief of Plastic Surgery Dr. Larry Hollier. “Through simulations and countless planning meetings, we were able to prepare for situations that could arise during the separation. We are thrilled with the outcome and look forward to continuing to care for Anna and Hope as they recover.”
The girls were born on December 29, 2016, at Texas Children’s Pavilion for Women to their parents Jill and Michael, and two older brothers Collin and Seth. Weighing a combined 9 lbs. 12 oz. and delivered via Caesarean-section at 35 weeks and five days gestation, Anna and Hope were conjoined at their chest and abdomen, through the length of their torso and shared the chest wall, pericardial sac (the lining of the heart), diaphragm and liver. In addition, they had a large blood vessel connecting their hearts.
The Richards family, from north Texas, learned Jill was carrying conjoined twins during a routine ultrasound. The family was then referred to Texas Children’s Fetal Center, where they underwent extensive prenatal imaging, multidisciplinary consultation and development of plans to achieve a safe delivery and postnatal care. They temporarily relocated to Houston in order to deliver at Texas Children’s and be close to the girls during their hospital stay. For the past year, Anna and Hope have been cared for by a team of specialists in the level IV and level II neonatal intensive care unit (NICU).
Planning and preparation
During much of that time, medical staff prepared for the separation, using extensive imaging with ultrasound, echocardiography, CAT scans, magnetic resonance (MRI) and even a virtual 3-D model of the girls’ anatomy. Closer to the surgery date, almost 50 medical personnel involved in the procedure participated in a lengthy simulation of the separation.
“These are the kind of procedures you plan for the worst and hope for the best,” said Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Oluyinka Olutoye. “We were blessed that this was the best case scenario. Everything went very well. The procedure was as well as we could have hoped.”
The Richards family is grateful to Texas Children’s for the care provided to their daughters since they found out they were expecting conjoined twins.
“We’ve thought about and prayed for this day for almost two years,” said the girls’ mom, Jill Richards. “It’s an indescribable feeling to look at our girls in two separate beds. We couldn’t be more thankful to the entire team at Texas Children’s for making this dream come true.”
Anna and Hope are recovering in the CVICU and expect to be released to a regular room soon. Both girls will face additional surgeries in the future to ensure their chest walls are stabilized. Otherwise, doctors expect them to lead normal lives.
“What we try to do here at Texas Children Hospital is essentially provide our patients with as normal of a life as we can,” said Pediatric Plastic Surgeon Dr. Edward Buchanan. “I think in this case with these two little girls we were able to achieve that.”
A history of success
The Richards separation is the fourth conjoined twins separation performed at Texas Children’s. The first pioneering procedure occurred February 16, 1965, when a team of surgeons separated 9-week-old conjoined twins Kimberly and Karen Webber. The Webber twins were connected at the liver and pericardium. The second separation happened on June 9, 1992, when Texas Children’s surgeons successfully separated Tiesha and Iesha Turner, who were 1 year old and shared a sternum, liver, entwined intestines and fused organs.
The third conjoined twins separation happened nearly three years ago on Feb. 17, 2015, when a team of more than 40 clinicians from seven specialties separated 10-month old Knatalye Hope and Adeline Faith Mata during a marathon 26-hour surgery. The twins were connected from the chest to the pelvis and shared a chest wall, pericardial sac, diaphragm, liver, intestinal tract, urinary system and reproductive organs. Today, Knatalye and Adeline are almost 4 years old and are doing very well, walking, talking, even learning how to ride a bike.
Since Texas Children’s opened its doors in 1954, multiple sets of conjoined twins have been referred to the hospital for consideration. However, in many of these cases, separation was not medically possible. Olutoye, who has participated in five conjoined twins’ separation surgeries, two at Texas Children’s Hospital and three at the Children’s Hospital of Philadelphia, said he and a team of experts from various specialties look at every case very closely and consider many factors before deciding how to move forward.
“Separating conjoined twins takes a tremendous commitment,” Olutoye said. “We all are privileged and honored to be part of each and every case, especially the ones where we can help.”
February 6, 2018
Texas Children’s Pediatrics acquired its first practice site in 1995. Two decades later, 50 more have been added and as of December 2017, all practices, hold the highest Patient Centered Medical Home (PCMH) recognition from the National Committee for Quality Assurance (NCQA).
NCQA Recognition Programs allow employers, patients and consumers to make quality informed health care decisions. This prestigious distinction celebrates patient care organizations that have demonstrated a strong commitment to improving quality care for their patients.
“NCQA has become the gold standard for quality of care amongst primary care physicians around the country,” said Dr. Stanley Spinner, Texas Children’s Pediatrics chief medical officer and vice president.
All 51 of the Texas Children’s Pediatrics practice sites submitted documented evidence to demonstrate data requirements for the distinction. All clinics are structured to follow the six required PCMH 2014 Standards:
Patient Centered Access
Team Based Care
Population Health Management
Care Management and Support
Care Coordination and Care Transitions
Performance Measurement and Quality Improvement
“Achieving this high level of quality of care has led to improved outcomes, often at a lower cost,” Spinner said. “Texas Children’s Pediatrics is extremely proud of the work that has been done throughout all levels of our organization during the past three years. This offers us a distinct advantage in our current managed care market.”
To date, Texas Children’s Pediatrics has achieved three successful cycles of PCMH Level III recognition, signifying organizational commitment to excellence by working together at every level across the system.
“This is an opportunity for our organization to show and prove that we only want the best care for our patients and their families,” said Natasha Fields, Texas Children’s Pediatrics Nanes Practice Manager. “Moving forward I believe it will continue to display our dedication, passion and integrity for all. It’s a special occasion and we all should celebrate.”
December 12, 2017
A lot happens behind the scenes before patients are wheeled into the operating room at Texas Children’s Hospital to undergo surgery. Technicians disinfect the OR from top to bottom and a team of people with the Sterile Processing Department clean, prepare, assemble and sterilize surgical instruments for patient care.
At Texas Children’s Main OR in the Medical Center, the sterile processing team handles instruments for close to 80 procedures a day Monday through Friday and around 15 procedures on the weekends. The procedures can require anywhere from two to 12 sets of instruments each with a numerous amount of single instruments.
The team processes more than 17,000 instruments a day. To be able to handle this and keep up with the demands there are 3,200 plus sets of instruments. Sterilization of the instrument sets can be accomplished by steam, hydrogen peroxide, or ethylene oxide. Each requires special quality assurance monitoring and designated time for completion.
There are also operating rooms designated for cardiovascular cases, at Wallace Tower, Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands that have their own sterile processing areas.
Click here to watch Channel 11 KHOU’s story about Texas Children’s sterile processing team.
December 5, 2017
A little over a year ago, Texas Children’s Hospital The Woodlands Outpatient Building opened its doors to the Greater Houston area and beyond. Since then, the ever-growing team of providers and support staff have seen 50,000 plus patients in the outpatient areas and received numerous compliments from the patients and family members they serve.
“Our first year has been packed with many new and exciting opportunities,” said Julie Barrett, director of outpatient and clinical support services for the Outpatient Building. “We have grown substantially, adding new service lines, providers and staff, and we have established a culture that exemplifies our mission to provide the best possible care for our patients and their families.”
Designed with a “spirit of the woods” theme to incorporate the lush, woodsy landscape that surrounds it, the six-floor, 209,973-square-foot Outpatient Building opened in October 2016 housing almost 20 areas of specialized care including cardiology, sports medicine, neurology and hematology/oncology. A dedicated medical staff at the facility works in conjunction with the Texas Children’s system to provide top-notch medical care.
Connected to the almost year-old Texas Children’s Hospital The Woodlands on floors one and two, the Outpatient Building offers a fresh, new kid-friendly environment to families seeking the best pediatric care for their children. A state-of-the art sports physical therapy gym is on the first floor, check-in and check-out stations resembling a child’s club house are at the entrance of each clinic, and spacious exam rooms and provider work stations line many of the building’s halls.
Susan Niles, a senior athletic trainer with Sports Medicine, said the Outpatient Building’s Sports Medicine staff has grown substantially since it starting seeing patients a year ago, adding nurses, physical therapists, athletic trainers and a sports dietitian. Such growth has allowed the staff to provide quicker access to therapy services, Niles said. It also has provided opportunities for research.
“Using technology from the motion analysis lab, we have launched a research project that we hope will provide breakthrough information on concussions,” Niles said. “We are the only campus with a motion analysis lab and we are excited to use the technology for our patients.”
Ambulatory Services Therapy Manager Jay Mennel said another unique service offered in The Woodlands comes by way of an Alter-G treadmill, an anti-gravity treadmill utilized by sports therapy patients, he said. Such a specialized service combined with other specialty clinics led to the therapy staff completing more than 18,000 outpatient visits during the Outpatient Building’s first year in operation.
“We have some fantastic physicians and great senior leadership at The Woodlands, which has helped our department grow at an exceptional rate,” Mennel said. “We hope to continue to grow this next fiscal year.”
Heather Jordan, a staff nurse in Outpatient Surgical Services, Melanie Garcia, a medical assistant with Plastic Surgery, and Yvonne Barham a staff nurse with Diabetes and Endocrine, all said they have seen tremendous growth in their areas and that they have seen patients from all over Texas and surrounding states.
“Our patients have come from Nacogdoches, Lufkin, Bryan/College Station, Corpus Christi, Port Arthur, and Louisiana,” Barham said. “Many of the local residents have stated how happy they are to not have to travel for their regular office visits.”
Garcia agreed and said patient experience is something that everyone at The Woodlands Outpatient Building takes to heart. “We go above and beyond on a daily basis to make sure every patient feels special,” she said. “We are always improving, always compassionately serving each other and our patients.”
When asked what’s next, leaders, providers and staff point to continued growth and involvement in The Woodlands community.
“Now that we are here and have established workflows, processes and procedures, we can begin to work on things such as more access to patients and families, and staff being more involved in the community,” said Shawnda Kelley, ambulatory manager of various service lines at the Outpatient Building. “I am happy and proud to be a part of this new beginning and can’t wait to see what’s next.”
November 29, 2017
Information Services, the Cancer and Hematology Centers and Pharmacy recently partnered to successfully launch Epic Beacon, a new medical oncology module that gives physicians and other providers a better tool with which they can create personalized treatment plans and support care regimens based on standardized protocols. The outcome of such treatment plans and support care is a more efficient and effective way to follow each patient through outpatient doctor’s visits and inpatient hospital stays, easing the patient’s transition to lifetime, post-cancer care.
“This initiative has changed how we deliver care to some of our sickest patients,” said Cancer Center Director Dr. David Poplack. “With Beacon, we are able to provide more tailored treatment, more efficiently and at a decreased risk to our patients who receive some of the strongest medications.”
During the 18-month implementation process, about 600 treatment protocols were made electronic via Epic Beacon, which is fully integrated with Epic’s pharmacy and electronic Medication Administration Records (MAR) products, allowing oncologists to better track medications that have been dispensed and administered, including medications ordered outside of an oncology treatment plan.
In addition, Beacon, which is being used system wide where oncology patients receive chemotherapy, features decision support that can suggest protocols as well as dose-specific medication modifications based on chart data. It also tailors plans at the patient level, so medication orders can be created and queued up in advance of patient visits for cancer treatment.
“Using Beacon has been a culture change for the Cancer Center but well worth it,” said Julie McGuire, director of Enterprise Systems for Information Services. “It has taken real dedication from all teams involved as well as a tremendous amount of physician and nurse engagement.”
Dr. ZoAnn Dreyer, an oncologist with the Cancer Center, said Epic Beacon’s buildout and go-live process was smooth and seamless.
“Even Epic’s own representative was impressed, saying it was the best he has ever seen,” Dryer said. “And it’s worked well in clinic so far for sure!”
Other first impressions of Epic Beacon have been positive as well:
“I’ve never seen a project with as much dedicated physician support and I think that was a HUGE part of this project’s success!”
– Drew Willert, Information Services
“The success of the go-live and Beacon’s functionality is a direct result of a multidisciplinary team that demonstrated resilience, excellence and commitment to the overall success of the project.”
– Denise Tanner-Brown, Cancer and Hematology Centers
“I am so proud of what WE have done. I am so humbled by all of the outpouring of support from operational, Epic and IS leaders, as well as end users on the front lines.”
– Dr. Marla Daves, Cancer and Hematology Centers
When Peggy Kellum called the Texas Children’s Office Move and Relocations Team (OMART), all she wanted was three filing cabinets moved from one side of a room to another.
“I thought they were going to tell me no, but they did it,” said Kellum, an administrative assistant with the Department of Pathology. “I was so impressed by their willingness to go above and beyond.”
OMART was created less than a year ago to handle small jobs like the one Kellum requested as well as larger office moves and relocations. In the past, Texas Children’s has outsourced such jobs, but as the organization has grown, so have the requests and in turn the cost of such services. In addition, efficiencies initially seen by outsourcing have been replaced with extended turnaround periods for surveying, quoting, scheduling and completing the requested task.
“We were given the opportunity to improve the cost and delivery of this service and I believe we have found a solution that works for everyone involved,” said Dan Samora, director of Facilities, Planning & Development. “We’ve received positive feedback from many of our clients and we are providing a cost savings to the organization.”
Since launching the three-person OMART team in April, OMART has fulfilled more than 200 requests, with an average turnaround time of five and a half days from when the initial request was made. The team’s work has saved Texas Children’s an estimated $100,000 and has the potential of saving more if the team grows and expands to areas of the system outside of the Medical Center.
Currently, OMART has the capacity to fill requests from the Abercrombie Building, Feigin Tower, the NRI, Pavilion for Women, Meyer Building, Wallace Tower and West Tower. The team will cover Legacy Tower when it opens and will look at the possibility of expanding to West Campus, The Woodlands and beyond in the future.
OMART also would like to take on larger jobs when capable. Such jobs, as well as capital projects, are still supported by outside vendors.
“We have hit the ground running and are off to a really good start,” said Patrick Hatcher, manager of the Facilities Logistics Program. “We are getting things done more efficiently and effectively, and are looking forward to growing and serving even more of the Texas Children’s system.”