November 19, 2018

After the grand opening over two months ago, Texas Children’s 12th urgent care clinic, the second of which is located near a Texas Children’s Emergency Center has exceeded expectations.

“We are thrilled with the strong start our West Campus Urgent Care has had so far,” Director of Business Operations for the Urgent Care, Roula Smith said. “It definitely reaffirms that this was the right decision for our patients, as we provide the right care, at the right place, at the right time, at the right cost.”

On September 11, located next to the Texas Children’s Hospital West Campus Emergency Center, the clinic opened to help manage the Emergency Center’s low-acuity patient population and to serve patients and families in the West Houston area.

From opening through the end of October, the clinic has seen nearly 3,000 patients. Approximately one third of the patients are Texas Children’s Health Plan (TCHP) members. This helps TCHP members have access to the same high quality care but in a more cost effective environment. More than half of the patients seen at Texas Children’s Urgent Care West Campus have been self-select patients, who are not presenting via the Emergency Center but arrive to the clinic voluntarily.

This collaboration with the Emergency Center offers a quicker and less expensive option for low-acuity patients. The number of patients that leave the Emergency Center without being seen has been reduced by 80 percent during operating hours.

“In addition to being a win for our patients, it is a win for the Texas Children’s system as a whole,” Smith said. “We know that our colleagues in the Emergency Center are able to take care of higher acuity patients and our TCHP members are receiving care in the right environment for their needs.”

Prior to the clinic opening, the “Save My Spot” feature launched which allows patient families to reserve a time slot at the clinic from the comfort of their own home. This feature is live and wait times are also posted on the website so families know how long it will be before they are seen. Nearly 200 families have used this feature so far and the average cycle time for clinic visits is approximately an hour.

“Urgent care has been the perfect addition to the West Campus,” Assistant Vice President at West Campus Sara Montenegro said. “We have the full spectrum of care available – primary care, specialty care, urgent care, emergent care, surgery, and inpatient care, available in close proximity to each other now, and we are seeing very strong patient arrivals in our Urgent Care & Emergency Center, with this new addition. We knew this was a need in the community, and it is exceeding expectations!”

For more information about Texas Children’s Urgent Care and its locations, click here.

The shuttle commute for employees at the Medical Center campus continues to be quicker and easier following the addition of three new shuttles earlier this spring. We are now operating 12 shuttles, which are helping reduce midday wait times at the circulator stops. According to Facilities Operations, wait times have been cut in half since the addition of the shuttles.

“Midday traveling between the Meyer Building and the Medical Center Campus is a very busy time,” Facilities Operations Assistant Director Michael Jackson said. “So, decreasing wait times for midday riders is a very big win.”

Most recently, two loaner shuttles were replaced with two new Texas Children’s-branded shuttles in bright orange and hot pink, which are diesel-fueled and have front entry and rear exits, vinyl seats, and audio-visual monitors. They’re also equipped with Double Map shuttle tracking, which, once active, will allow employees to locate and track the shuttle using a mobile phone app.

“Our goal is to improve the shuttle experience for employees by decreasing wait times and increasing the frequency of shuttles in the rotation to and from destinations,” Jackson said, adding that the number of employees riding the shuttles continues to increase. “The frequency between shuttles is now averaging five minutes with a shuttle round trip averaging 20 minutes. We are receiving no calls of negative effects on ridership at this time.”

Another operational change made was allowing the shuttle supervisor, who has primarily been stationed at the Garage 19 stop, to move to the Feigin stop during peak evening times to monitor shuttle frequency, ridership, and most importantly, communicate to riders when the next shuttle will arrive.

“We believe informing riders of the shuttle arrival status helps ease anxiety and set expectations,” Facilities Operations Manager Samuel Hines said. “With more staff parking at the Meyer South surface lots, we have asked our shuttle drivers to stop there on the return trip back to Garage 19 in the evenings. This will shorten the walk to their vehicles at night and during inclement weather.”

The enhancements Facilities Operations continues to implement for employees also help provide a better experience for patient families. Jackson says that the additional shuttles are expected to improve patient and family experience by opening up parking spaces at the hospital, as staff continue parking in their assigned garages and ride the shuttle.

The Facilities Operations team is excited about the new additions, and they are looking forward to continuing to make employees’ commute throughout the Medical Center a safe and efficient one.

“We ride the shuttles frequently, and we meet with the shuttle transportation company every two weeks to address any issue and pitch ideas,” Jackson said. ”Just being present, available, fostering that communication, and definitely being transparent is going to be the key to improving Texas Children’s transportation and parking as a whole.”

For more information, call the 24/7 shuttle hotline, ext. 4-2666.

Parking update

The Texas Children’s Parking Task Force is listening to your feedback about employee parking and shuttle experiences, and we are trying to create solutions to ease the frustrations that come with working and navigating in the world’s largest medical complex.

What has the Parking Task Force accomplished recently?

We are excited to share with you new developments and improvements made over the past few months. Click here for more details.

Where can I find more parking information?

The Benefits website is the best and most readily available resource for everything employees want to know about parking and commuting at Texas Children’s – one of the last institutions in the Medical Center to offer paid, off-campus parking as a benefit to our employees. Simply click on Parking at the top right corner of the Benefits homepage (next to Important Resources) for direct access to all things parking.

Under the “Locations & Commuter Options” section on the site, we have included new information about TMC parking at Garage 19, Meyer North, Meyer South as well as Smith Lands East and West. You can also find more information online about weekend and after-hours access to different garages, security services and no-cost METRO bus and rail passes.

How can we keep up with what the Parking Task Force is doing?

Communicating with our Texas Children’s employees and leveraging your feedback are major priorities for the Task Force. Be sure to look for future updates about the group’s activities and accomplishments on Connect.

I want to share my comments or concerns with the Parking Task Force. How do I get in touch?

The Parking Task Force maintains and monitors a dedicated email inbox every day to give our employees a place to share their parking and shuttle comments and suggestions directly with the team. Send your thoughts and feedback to tchparkingtaskforce@texaschildrens.org.

On November 10, nearly 100 people gathered at the Meyer Building for Texas Children’s first ever Microtia Awareness Day, sponsored by the Division of Otolaryngology’s Microtia Clinic.

The event featured educational talks and Q&A sessions offered by experts across numerous Texas Children’s specialties and subspecialties, including Pediatric Otolaryngology, Speech and Language Pathology, Audiology and Anaplastology. There was also a full slate of games and activities for children, such as face-painting, a bean bag toss, Hula-Hooping and mini bowling, as well as a step-and-repeat for photos.

For patients and families alike, it was a wonderful new opportunity to meet with members of the multidisciplinary care team in Texas Children’s Microtia and Atresia Program, and to interact with other families who have been affected by these rare conditions.

“The event was extremely well received,” said Allison Haggerty, senior speech-language pathologist at Texas Children’s Hospital The Woodlands. “It was incredible to hear families say how they no longer felt like the ‘only ones,’ as they met so many others in similar situations.”

Microtia is a rare congenital malformation of the ear, occurring in about one in 10,000 births. Typically, the condition affects only one ear and the severity of symptoms can vary widely. In less severe cases, the ear might be slightly smaller than normal. However, in the most severe cases, the ear may be completely absent. Because the external and internal structures of the ear are so developmentally linked, children with microtia may also experience atresia – an absence or underdevelopment of the ear canal and middle ear structures. Atresia can potentially cause hearing loss and speech difficulties, which can in turn contribute to poor academic performance.

The effects of these conditions on physical appearance and on speech, hearing and learning, especially during crucial early developmental years, could potentially have a lasting negative impact on self-esteem and overall quality of life.

To meet the complex needs of patients with microtia and atresia, Texas Children’s has built the only comprehensive program in the state that offers the full spectrum of care, from reconstruction of the outer ear, to complex repair of aural atresia, to hearing aids or implants for appropriate candidates.

“With our program, we have created a one-stop shop where families have access to care for children of all ages – and our demand is high,” said Dr. Rodrigo Silva, director of Texas Children’s Ear and Hearing Center. “These conditions may be rare, but because of Houston’s size and diversity we see a very large number of patients each year.”

The Microtia and Atresia Program offers families a multidisciplinary approach to care that includes audiology, with experts trained in age-appropriate hearing testing and solutions; speech and language pathology; and surgical interventions to address cosmetic needs and hearing loss. The event gave Texas Children’s caregivers an opportunity to share the many ways we can help.

“We wanted to highlight our capabilities and let families know that we offer individualized treatment paths for each child we see,” said Texas Children’s pediatric otolaryngologist Dr. Yi-Chun Liu. “Whether the child needs a reconstruction surgery of the ear or ear canal, a hearing aid or implant, speech and language therapy, or some combination of all of these, we’re committed to providing them with the best possible care.”

At the end of the event, parents were given survey cards that asked for suggestions about the kinds of information regarding microtia and atresia that families might find most helpful when starting their care journey. There was also a section for feedback and comments.

Judging by some of the responses …

It was spectacular!”

We absolutely loved the event.”

It was so nice to meet other families with microtia.”

I want to thank you all for everything. I learned a lot.”

… the event was a success.

“We’ve already had requests to make it an annual event,” said Jessie Marcet-Gonzalez, CPNP, with the Division of Otolaryngology. “We had so many volunteers who helped make this day special for our families and in letting them know that we really care.”

Learn more about Texas Children’s Microtia and Atresia Program.

The neonatal intensive care unit (NICU) at Texas Children’s Pavilion for Women celebrated babies this past week in recognition of Prematurity Awareness Month. Infants on the unit received superhero capes, created by FirstMemories Texas, an all-volunteer organization dedicated to teaching families whose infants are in the NICU and CVICU at Texas Children’s Hospital how to celebrate, honor and tell their children’s stories through photography and album making.

One family got three capes – one for each of their triplet sons, Barrett, Calvin and Jacob. The brothers were born on November 1 at 34 weeks gestation and have been in the NICU ever since. All three babies are healthy but need some extra attention and care before going home.

Dara Miller, the boys’ mother, said the care she and her boys have received at the Pavilion for Women has been incredible and that everyone they have encountered has been professional, compassionate and kind.

“We have had complete confidence in everyone who has taken care of us,” Miller said. “Everyone has always kept us informed and made us feel like we are in the best possible hands.”

The day her boys received their black and yellow batman capes was icing on the cake and ended up sparking a milestone moment. Until that day, she had never held her boys together, only separately. Joined by her husband, Mason, and 2-year-old daughter, June, Miller held her babies donned in capes big enough to cover almost their entire body and grinned widely.

“In that moment, we all came together as a family,” she said. “Until then, something felt incomplete.”

Kellie Kainer, assistant clinical director of nursing for the NICU, said comments like Miller’s and special events like the one with the capes bring smiles to her and her staff as well. Knowing that patients and their families are comfortable with the care they receive is huge.

“Everyone in the NICU has a passion for what they do,” she said. “We truly love caring for some of Texas Children’s most fragile patients.”

Texas Children’s Hospital, together with Texas Children’s Pavilion for Women, house the nation’s largest level IV NICU, the highest level of care available for premature and critically-ill newborns. Babies born prematurely require round-the-clock care and often need access to highly specialized services to have the most optimal outcomes. Complications from premature birth (before 37 weeks gestation) are the #1 cause of death of babies in the United States and 1 in 10 babies in the U.S. are born too soon.

November 13, 2018

Over the next couple of weeks, we will highlight some of this year’s Caught You Caring Award winners and how they go above and beyond for their patients and colleagues.

Caught You Caring is a recognition program offered to patients and families, as well as staff, to recognize employees who have gone above and beyond their role to provide compassion and kindness to another person. This could be in the care of a patient, service to a family, or in support of a coworker. Launched in 2015 in ambulatory surgery, the now system-wide program has recognized many employees, including the eight listed below who were honored by the program this year.

To thank this year’s winners for their compassion and dedication to the Texas Children’s mission, they will head to NRG Stadium on December 9 to watch the Houston Texans play the Indianapolis Colts. The Texans-Colts game is sponsored by Texas Children’s Hospital and celebrates the National Football League’s Play 60 campaign, which encourages children to be active 60 minutes a day to help decrease childhood obesity.

The tickets to the game are one of the benefits of Texas Children’s Hospital being the official children’s hospital of the Houston Texans football team. The goal of Texas Children’s and the Texans partnership is to inspire children to lead healthier, more active lives.

Experience Consultant with Family and Patient Services Lorianne Classen said being able to reward our Caught You Caring recipients in this way is truly amazing.

“Recognizing people for their hard work goes a long way when it comes to creating a positive work environment,” she said. “So many members of our Texas Children’s family go above and beyond each and every day for our patients, families and colleagues, and we appreciate that very much.”

Texas Children’s wants to continue to recognize those who take great pride in the work they do and encourages patients, families and employees to catch someone who is making a difference. Caught You Caring boxes and cards can be found throughout the Texas Children’s system for patients and families to fill out and recognize staff. Employees can fill out a Caught You Caring form on Connect. Cards and online submissions will be distributed to leaders for staff recognition.

Click here to learn more about the Caught You Caring Program.

Click the links below to read more about this year’s Play 60 ticket recipients and how they were caught caring.

Rosie Alvarado
Hilda Andrade
Yaneth Arrue
Lisa Carr
Melanie Johnson
Krista Miller
Melissa Starner
Erick Talamantes

October 29, 2018

Texas Children’s Hospital West Campus recently received their largest book donation to date. The Cypress area of the Goddard Schools donated 15,000 books to the hospital library.

The Goddard Schools are a well-known early childhood education institutional system that uses the most current, academically endorsed teaching methods to ensure that the students enjoy learning while simultaneously receiving the skills they need for long-term success in school and in life.

“I work in the Child Life Department and we want to be able to use any resources and tools that can bring relaxation, or just a sense of normalcy to patients and families when they are in the hospital,” Library Coordinator, Brian Ballard said. “The Goddard Schools are preparing children all the time with knowledge, so they understand that something as small as donating these books can relieve stress, and be a useful distraction for patients while they are in the hospital or just visiting a doctor’s office.”

Since the donation is such a large amount, the books will be dispersed throughout the organization. The Medical Center Campus, West Campus, and the Woodlands Campus all have libraries that offers books, board games, puzzles and movies for patients and their families to enjoy. The library also houses medical and parenting resources, paperback fiction, magazines, foreign language books, computers and a fax machine.

The hospital libraries are monumental to our Child Life Department. Texas Children’s has enjoyed a long-standing relationship with the Houston Pi Beta Phi alumnae organization and shares a mutual commitment to literacy and education. The first Pi Beta Phi Patient/Family Library opened in 1984 at Texas Children’s Hospital, and in 2011, the Pi Beta Phi Patient/Family Library opened at the West Campus.

The library has also expanded to include Book Nooks, to provide books for patients and families in waiting rooms across the Texas Children’s Hospital system.

The importance of the library, for Ballard, goes back to his childhood as he remembers what it is like to be in and out of a children’s hospital.

“I don’t remember it feeling like I was in the hospital, I remember the activity rooms and the things that were going on in the hospital,” Ballard said. “So hopefully the library or these Book Nooks are going to be instilled in these patients as well, and they remember Texas Children’s Hospital as a positive experience, and the library as a large part of providing that to them and their families.”

Currently, there are more than 150 Pi Beta Phi Book Nooks located at Texas Children’s medical center campus, the West Campus, Texas Children’s Health Centers, Texas Children’s Urgent Care facilities, the Centers for Children and Women and in all the Texas Children’s Pediatrics practices throughout the Houston area.

Click here to learn more about Texas Children’s Hospital’s library. To donate, contact Brian Ballard at bsballar@texaschildrens.org.

October 23, 2018

The New England Journal of Medicine (NEJM), one of the nation’s most respected peer-reviewed medical journals, has released a new study highlighting the groundbreaking work being done by the Undiagnosed Diseases Network (UDN), an National Institutes of Health-funded research consortium that includes the Jan and Dan Duncan Neurological Research Institute (NRI) at Texas Children’s Hospital, Baylor College of Medicine, Stanford University and other institutions.

Identifying the genes responsible for rare or unknown disorders using traditional approaches is time-consuming work and can take years, or sometimes even decades. And though genetic sequencing is now a routine part of the care people receive for these types of disorders, many patients are still left without a diagnosis. According to the NEJM study, the collaborative UDN model may already be changing that paradigm.

The study reports that the UDN defined 31 entirely new syndromes, and of 382 completed evaluations, 132 patients received diagnoses, a rate of 35 percent – all in just 20 months. The study also found that of the new diagnoses, 37 percent led to non-therapeutic changes in care, such as narrowing of diagnostic testing, and an amazing 21 percent led to changes in therapies for patients.

“This is a major accomplishment in genomic medicine and a giant step forward for these patients and their families,” said Dr. Huda Zoghbi, director of the NRI.

The UDN was established in 2014 with the mission of providing answers for the millions of patients and their families affected by mysterious and rare conditions, but who, after years of extensive testing, still hadn’t received a diagnosis.

The NRI and Baylor have been at the forefront of discovery in the UDN since its inception, jointly serving as one of seven original clinical sites, where doctors and health care providers, ranging from neurologists, immunologists, nephrologists, endocrinologists and geneticists, come together to help find the cause of participants’ symptoms. Baylor, one of the UDN’s two original sequencing cores, currently acts as the network’s sole DNA sequencing site. The NRI and Baylor were also selected to serve as the UDN’s first Model Organism Screening Center (MOSC), which was spearheaded by NRI investigators Drs. Hugo Bellen, Shinya Yamamoto and Michael Wangler.

“The UDN recognized that the resources we had in place and our high throughput made us the ideal candidate to serve as a MOSC site,” Bellen said. “Because of our success with model organisms and the appreciation physicians have for our work, there will likely be a proliferation of MOSC sites in the future.”

In-depth fruit fly studies at the MOSC have helped physicians and scientists identify genes responsible for rare and undiagnosed disorders, leading to the diagnosis of some of the UDN’s most difficult cases. This collaborative effort, which also includes the University of Oregon, has already directly influenced how clinicians care for patients – patients like Avery Reilly.

At only a few months old, Avery began showing signs of a neurologic condition. She could not sit until age 3 or crawl until age 5, and today she cannot walk or speak. An appointment with Texas Children’s neurologist Dr. Timothy Lotze revealed Avery had poor muscle tone, which was delaying milestones. That initial appointment led to years of doctor visits and countless tests, all of which failed to reveal the cause of Avery’s developmental and speech delays.

Then in 2014, the Reillys heard about the NRI’s involvement with the UDN and submitted Avery’s case. For the first time in years, the family had hope. Using exome sequencing, researchers discovered Avery had a new type of genetic mutation. Then a team at the MOSC, led by Wangler, studied the mutation in a fruit fly model to see how the genes were affected. At long last, the Reillys had a diagnosis. What’s more, the discovery of Avery’s mutation led to a change in her medications, which could help slow the progression of her disease.

“The fact that we are able to help the UDN accelerate science to find actionable changes in therapies is very exciting,” said Zoghbi. “Helping people, and working to solve severe medical problems through basic research, and through unfettered collaboration, is what our work is all about.”

The NEJM study is the first to provide a detailed description of the inner workings of the UDN. It presents an in-depth analysis of the referral and acceptance patterns, diagnoses, impact rates and follow-up scientific investigations of 1,519 cases that were referred to the UDN in the last two years.

As the study points out, the most unique feature, and perhaps the biggest contributor toward UDN’s success, is its model of multi-institutional collaborations. Teams of researchers and physicians from participating institutions all over the nation leverage their multidisciplinary expertise and resources to quickly find specific diagnoses for patients with extremely challenging clinical cases, with no additional cost to the patients.

In addition to the original clinical sites and sequencing cores, the UDN also included a coordinating center as part of its phase I deployment. In 2015, a web-based portal, the UDN Gateway, was launched for patients and families to participate in UDN. The network recently expanded its footprint from seven to 12 clinical sites and also added a central biorepository, a metabolomics core and a new MOSC site.

Though the UDN’s larger focus is currently gene discovery, it’s the work being done at the NRI and Baylor that will set up the network’s next evolution.

“Once a gene is discovered, it’s natural that the focus should shift to finding out what the genes do, what the molecular mechanisms are, if they’re linked to other diseases, or if they can be manipulated with drugs,” Bellen said. “That’s what we’re doing at the NRI and Baylor now, and that will be instrumental in the next phase for the UDN. When that time comes, we’ll be ahead of the curve.”

Learn more about the recent research breakthroughs and patient success stories from the UDN and MOSC.

About the New England Journal of Medicine
For over 200 years, the New England Journal of Medicine has rigorously vetted and compiled the latest medical research in support of physicians and their patients. From the first uses of anesthesia to the most recent cardiology and cancer treatments, the New England Journal of Medicine has helped generations of clinicians enhance their knowledge and improve patient care.

Today, with rigorously peer-reviewed research, topical reviews, interactive clinical content and cases, the New England Journal of Medicine is the trusted source for essential findings in medicine.