June 20, 2017

As the Department of Surgery continues to expand in the community at Texas Children’s Hospital West Campus and Texas Children’s Hospital The Woodlands, ongoing training is needed to be able to offer high-level surgical procedures.

Otolaryngologists Dr. Deidre Larrier and Dr. Mary Frances Musso have been leading that charge when it comes to training operating room staff in the removal of aerodigestive foreign bodies – obstructions in the esophagus and/or trachea.

Such obstructions can be emergent, and require rapid response using specialized equipment. During a four-year period between 2011 and 2015, there were 556 obstruction cases, 64 of which occurred at West Campus.

“The instruments used in obstruction procedures are very specific and are not used in general surgical procedures,” Larrier said. “Thus the need for supplemental training for our OR support staff.”

Led by Larrier, the training is for OR nurses and scrub technicians. The half-day course includes a lecture, hands-on skills lab, and in-situ simulation.

Musso is taking the Texas Children’s Hospital simulation instructor course this summer, which will allow her to enhance her mentoring skills during these sessions. Larrier is already an instructor and was instrumental in helping establish simulation education at the hospital. She leads the otolaryngology simulation sessions for not only OR staff but also residents, fellows, and mid-level providers. She recently led a training for Advanced Practice Providers on tonsillectomy surgery and the complications that can occur following such procedures.

“Dr. Larrier’s training of OR staff in the removal of aerodigestive foreign bodies and esophageal obstructions was very well received here in the Woodlands,” said Dr. Charles Hughes, a member of the otolaryngology team in The Woodlands. “Both Ramon Enad and Tom Cunningham, our OR staff leads, felt it was extremely beneficial for staff, in that these procedures are high risk and infrequent.”

Musso said, West Campus staff is very appreciative of the training and that it has helped improve their skills using this specialized equipment and treating these patients. “We plan to repeat this training session annually at West Campus to maintain the staff’s skill level.”

Larrier said she will gladly continue such training, something she views as a testament to how much the surgical capability at West Campus and in The Woodlands has grown.

May 9, 2017

Texas Children’s recently received an impressive report card from The Joint Commission with surveyors commending the hospital for demonstrating several best practices.

“Our survey results are a great indication that we are meeting the expectation of quality care for our patients,” said Texas Children’s President and CEO Mark A. Wallace. “This should only propel us to continue our focus on providing safe, quality care every single day for every one of our patients.”

Every three years, Texas Children’s undergoes an accreditation process to ensure our delivery of high-quality patient care. On May 1, the Joint Commission survey team arrived at Texas Children’s for a 5-day unannounced survey. The surveyors consisted of an administrator, a pediatrician and ambulatory specialist, four pediatric and OB/GYN nurses, and a life safety engineer.

What Joint Commission noted

The survey is intended to assess the organization’s compliance in patient care areas that contribute to positive outcomes and to measure and improve performance. The Joint Commission team was very impressed with our improved outcomes in asthma, diabetes, radiology efficiency and flow, patient flow and surgical complications.

The team also identified several best practices observed during the survey including:

  • Time out processes across the system
  • NICU infection control practices
  • Error prevention technology in the anesthesia and pharmacy areas
  • Critical lab documentation
  • Simulation of new buildings and processes for latent safety threats

“The Joint Commission survey team visited several Texas Children’s facilities to evaluate patient care processes through on-site observations, staff interviews and tracer methodology,” said Texas Children’s Quality and Safety Director Elaine Whaley. “This year, Joint Commission implemented a new survey methodology called Survey Analysis for Evaluating Risk (SAFER), a matrix that uses a color-coded grid to evaluate the likelihood of harm to our patients, staff and visitors based on the number of occurrences.”

The surveyors were impressed with the knowledge and confidence exhibited by staff and faculty who participated in the tracer interviews. They complimented them on their ability to navigate Epic and explain the continuum of care, and they were impressed by our staff’s ability to talk about quality projects and outcomes.

How we prepared for the survey

Preparing for regulatory surveys is an ongoing process underscored by Texas Children’s daily focus on patient safety and high quality programs. Texas Children’s uses a consultant on an ongoing basis to review our processes and evaluate our survey readiness. The information provided by the consultant helps the organization fine tune.

“The results we get from area tracers during the preparation process provide information we need to develop and implement an organization-wide readiness education program,” said Danyalle Evans, Texas Children’s assistant director, System Accreditation and Readiness. “We regularly evaluate our internal processes against regulatory guidelines to identify opportunities for improvement. Regulatory surveys are valuable evaluation tools, but we have a deliberate focus on the quality and safety of our patients’ care every day.”

The Joint Commission accredits and certifies more than 20,500 health care organizations and programs in the United States. Approximately 77 percent of the nation’s hospitals are accredited by The Joint Commission.

Each year, Texas Children’s produces an annual report spotlighting the breadth, depth and growth of our organization. The report typically is in the form of a book that is mailed out to tens of thousands of our health care peers, government and community leaders, donors and other internal and external constituents.

This year we have a new way to share our experiences that will reach you and anyone with whom you wish to share it – the Texas Children’s Hospital online Annual Report. The report went live this week and is a dynamic representation of our growth and success in 2016.

Throughout the site, you will find articles, pictures, videos and graphics that highlight our patients, staff and growth. You also can hear directly from our President and CEO Mark Wallace in a video address about our year and what’s to come.

Each section of the site – news, notes and numbers – gives you an opportunity to experience how and why Texas Children’s health care system continues to get bigger and even better.

“At Texas Children’s, we are so passionate about our work and our mission that it is easy to get swept up in the incredible pace at which we move, build and expand,” Wallace said. “We get a lot done in the span of one short year, and 2016 was no different.”

Read all about it at texaschildrensannualreport.org. Share the link to the online report with friends and colleagues, and encourage them to do the same.

May 4, 2017

With the help of physicians in interventional radiology, anesthesiology and pathology at Texas Children’s Hospital, children in Vietnam suffering from severe and debilitating vascular anomalies are getting the help they desperately need.

At the beginning of the year, a medical team from Texas Children’s traveled to the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, Vietnam to examine and treat patients with vascular anomalies as well as to train medical staff at the University Hospital to perform certain life-altering procedures on their own.

The effort is an extension of the active collaboration between the Vietnam Vascular Anomalies Center (VAC) based in Ho Chi Minh City and the Global Pathology program at Texas Children’s Hospital, launched in 2013 by Dr. Thuy Phung, a pathologist and associate director of Texas Children’s Global Pathology. Global Pathology is based in the Department of Pathology, under the leadership of Texas Children’s Pathologist-in-Chief Dr. James Versalovic.

The Vietnam VAC was established in 2009 by Phung and a team of physicians at Harvard Medical School and Ho Chi Minh City. Its mission is to provide safe and effective humanitarian medical care for underserved Vietnamese children with vascular and pigmented birthmarks, and to promote active collaboration between Vietnamese and U.S. physicians to improve the health of these children.

“We have been thinking about and working on the formation of an interventional radiology team that can work with the Vietnam VAC for some time and feel that our initial efforts have been extremely successful,” Phung said. “The techniques that we are teaching physicians in Vietnam can make a huge difference in the lives of children with vascular anomalies.”

During the team’s week-long visit to Ho Chi Minh City in January, members worked with and trained a local clinical team led by Dr. Tran Quoc Tuan, an interventional neuroradiologist at the University of Medicine and Pharmacy Hospital. Together, they evaluated and consulted on 38 adult and pediatric patients, providing recommendations on how to best manage their vascular anomalies. Of those patients, the clinical team selected 13 to treat using techniques such as embolization, which involves the injection of special medications into abnormal blood vessels under ultrasound and X-ray.

These treatments are common across the globe but can only be appropriately performed by highly trained medical professionals and require an experienced support team, such as a pediatric anesthesiologist, interventional radiologist, interventional radiology nurse practitioner and interventional radiology technologist proficient in the procedures. Texas Children’s brought all of the above to the Vietnam VAC, enabling several children, including a young boy whose vascular lesion was impeding his ability to breathe, to get the appropriate treatment and go home with a chance at a drastically improved life.

“This partnership has enabled us to train our clinical colleagues in Ho Chi Minh City to independently handle vascular anomaly patients and act as a referral center for the country,” said Texas Children’s interventional radiologist Dr. Sheena Pimpalwar. “Due to a large population of children in Vietnam who are affected by vascular anomalies and our ability to treat them in a multi-disciplinary fashion, this program has huge potential for growth.”

Texas Children’s pediatric anesthesiologist Dr. Helena Karlberg emphasized the importance of having a multi-disciplinary approach available to patients at the Vietnam VAC and described the role of the anesthesiologist as one that includes early planning of airway management in patients undergoing procedures of the head and neck regions, and monitoring for, and treatment of any adverse effects by agents used during vascular anomaly care.

“These rather specialized procedures require a great deal of expertise,” Karlberg said. “I am grateful for the opportunity to share my knowledge and experience assisting and instructing others to develop their own skills in caring for this group of patients.”

To ensure that patients receive the highest quality treatment, the Texas Children’s Hospital medical team plans on traveling to Vietnam each year to treat patients and to continue training the medical staff at the Vietnam VAC. In the meantime, the Texas Children’s team will consult with physicians in Vietnam on patient management via email, telephone and video conference.

Members of the Texas Children’s Hospital medical team that recently traveled to Vietnam include:

  • Dr. Alex Chau, interventional radiologist
  • Heather Cleveland, advanced clinical specialist and interventional radiology technologist
  • Dr. Helena Karlberg, pediatric anesthesiologist
  • Dr. Thuy Phung, associate director of Texas Children’s Global Pathology
  • Dr. Sheena Pimpalwar, interventional radiologist
  • Holly Phan Tran, vascular anomalies nurse practitioner
May 3, 2017

As a health care system, Texas Children’s believes that a critical component to offering outstanding clinical care is measuring the results of the care we deliver and doing our best to provide our patients and families with the safest environment possible.

“By tracking what we do, we learn about what happens to our patients, and we also learn about our performance as a health care delivery organization,” said Chief Safety Officer Dr. Joan Shook. “We know we can always do better and must continue to strive toward excellence in health care delivery.”

With that in mind, Texas Children’s has created a dedicated safety and outcomes website that parents can access directly from the Texas Children’s main landing page. The information on this page is organized into the following nationally recognized categories of quality measures:

  • Safe: Avoiding harm to patients from the care that is intended to help them.
  • Effective: Providing services based on scientific knowledge. This category also measures the outcomes of the care we provide.
  • Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical decisions.
  • Timely: Reducing wait times and harmful delays for both those who receive and those who give care.
  • Efficient: Avoiding waste, including waste of equipment, supplies, ideas and energy.

When possible, the website shows how Texas Children’s compares to other children’s hospitals in the United States in these categories. Where no good comparisons are available, the website illustrates how Texas Children’s compares to our own performance in the past, and how we measure up to our own goals.

Some of the topics and data reported include: hand-hygiene compliance, catheter associated blood stream infections, surgical site infections, death and complications within 30 days of surgery, patient experience, third next available appointment, patients leaving emergency care and transfer denials. Additional measures will be added over time.

For each measure, information is provided that lays out what parents can do to help Texas Children’s deliver the highest quality pediatric care. The website also includes links to our health system’s evidence-based guidelines. A distinctive feature of the website is an email address for readers who want to provide input on what additional information they would like to know and ways we can improve our website.

“We invite you to check out how we are doing and to share our outcomes with patients and their families,” Shook said. “We believe our patients and families deserve the most complete and accurate information possible about how we are doing as a health care system.”

Texas Children’s Pavilion for Women also has launched a safety and outcomes website. Click here for more information.

April 18, 2017

Opening day at Texas Children’s Hospital The Woodlands on April 11 was full of excitement and appreciation for Texas Children’s newest full-service community hospital.

The day began at 7 a.m. with the first of more than 20 surgical cases and a succession of ribbon cuttings at the hospital’s main clinical areas. View a photo gallery of the day’s events below.

“This is the second community hospital for Texas Children’s and we are so excited,” said Michelle Riley-Brown, president of Texas Children’s Hospital The Woodlands. “This hospital will allow us to expand even more access to high-quality pediatric care in the community.”

Located off of I-45 in The Woodlands near CHI St. Luke’s and Methodist hospitals, Texas Children’s Hospital The Woodlands will serve children and families in the Woodlands, Kingwood, Conroe, Spring, Magnolia, Humble, Huntsville and beyond, and will build on a decade’s worth of relationships Texas Children’s has built in the community through our primary and sub-specialty care at Texas Children’s Pediatrics locations and the Texas Children’s Health Center The Woodlands.

The 550,000-square-foot facility offers:

  • services in more than 20 areas of specialty care
  • 32 acute care beds
  • four operating rooms
  • 12 radiology rooms with two MRIs
  • an emergency center with 25 patient rooms
  • a helipad
  • 1,000 free parking spaces
  • 28 critical care rooms (14 NICU and 14 PICU)
  • neurophysiology sleep lab
  • EEG laboratory
  • state-of-the-art infusion center
  • dining area
  • family library
  • chapel
  • playrooms on every floor

“Texas Children’s Hospital The Woodlands is really a comprehensive, standalone children’s hospital that’s part of a larger system that provides care across the spectrum,” said Dr. Charles Hankins, chief medical officer at the new hospital.

Designed with a “spirit of the woods” theme to incorporate the lush, woodsy landscape that surrounds it, Texas Children’s Hospital The Woodlands offers an open and inviting setting for patients, families and staff alike.

Just inside the main entrance is a grand staircase that simulates a tree house, giving the area a safe, central location for children and families visiting Texas Children’s Hospital The Woodlands. As you travel throughout the campus, there are images of leaves on the ceiling, rivers on the floor and trees and 1,700 pieces of art created by children in The Woodlands community on the walls.

“A lot of planning and thought went into the design of this facility,” said Trent Johnson, director of business operations and support services in The Woodlands. “It’s focused completely on our patients.”

By the end of opening day, staff at Texas Children’s Hospital The Woodlands had treated more than 150 children seeking care at the new facility.

Opening day volume included:

  • 23 surgical cases completed
  • 41 radiology procedures
  • 6 infusion cases
  • 31 pathology lab draws
  • 42 emergency center visits
  • 2 NICU admissions
  • 1 PICU admission
  • 3 acute care admissions

Rebecca Vadala is a resident of The Woodlands and the mother of two twin girls who were transferred on opening day from the NICU at Main Campus to the one in The Woodlands.

“It’s huge for us to be able to be so close to home,” Vadala said. “We’re just tremendously grateful to be the first patients here; it’s really an honor.”

April 11, 2017

The day many have been waiting and preparing for is finally here! Texas Children’s Hospital The Woodlands opened its doors to the public this morning marking another milestone in Texas Children’s history.

The 550,000-square-foot inpatient facility is the second community hospital in the Texas Children’s system and will serve patients and families in The Woodlands and beyond. The hospital has been in the making for several years and is the product of many long hours of dedicated planning and preparation.

One of the last preparatory acts occurred on April 7 when members of the hospital’s leadership team joined Texas Children’s chaplains and representatives from various congregations throughout The Woodlands community to bless the hospital and its staff.

Texas Children’s Chaplain Pam Krinock began the blessing and prayer walk at the main entrance of the hospital with a few words of thanks and appreciation for the new facility as well as a request of peace for those who enter the building seeking care.

“Doors are a powerful symbol,” Krinock said as water and oil, symbolizing comfort and healing, were sprinkled on the hospital’s two main glass sliding doors. “We pray they will be a sign of welcome and comfort for all who enter here.”

The group proceeded to the Emergency Center, Acute Care Unit, Pediatric Intensive Care Unit, Neonatal Intensive Care Unit and Operating Rooms, saying a prayer at each stop and blessing the areas and their staff with water and oil.

“We pray that comfort is provided to the families here, some of whom will be going through the toughest moments of their lives,” said Texas Children’s Chaplain Johnna Faber while the group was in the NICU. “We also pray for the staff who will hold and care for these children.”

The prayer walk ended in the hospital’s chapel, a serine, tucked away space highlighted by a floor to ceiling stained glass image of a lush forest dotted with deer and birds. Standing in front of the stained glass, four community clergyman representing the Christian, Jewish and Muslim faiths blessed the chapel with words of peace, comfort, healing and strength. Later that day, Texas Children’s chaplains blessed the hands of several staff members in the hospital lobby.

“It is very important what happened here today because anything that begins with God’s blessing, goes well,” said Rev. Jayaraj Jones of St. Anthony of Padua in The Woodlands.

Al Caberra, the Texas Children’s chaplain who will be providing spiritual care in The Woodlands, agreed and said he looks forward to working with community clergy to provide spiritual care to patients and their families.

“We consider you part of our community and an extension of our chaplaincy program,” he said. “We want you to always feel welcome here and know we are extremely grateful for the added peace and comfort you will bring.”

Stay tuned for full coverage of the first day at the new Texas Children’s Hospital The Woodlands.