Recognition – Page 113 – Texas Children's News

December 8, 2015

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Texas Children’s Hospital West Campus has been recognized as a Top Children’s Hospital by the Leapfrog Group for the third consecutive year. The Leapfrog Group is an organization that provides the only national, public comparison of hospitals across safety, quality and efficiency dimensions. Texas Children’s Hospital West Campus is honored among an elite group of only 12 children’s hospitals and is the only children’s hospital in Houston to be recognized with this prestigious distinction.

“It is an honor to again be recognized as a top performing children’s hospital,” said Chanda Cashen Chacón, president of Texas Children’s Hospital West Campus. “Our physicians, nurses and employees constantly strive to provide high quality care for our patients while keeping their safety our top priority.”

This year’s list includes 12 Top Children’s Hospitals, 62 Top Urban Hospitals and 24 Top Rural Hospitals. The selection is based on the results of The Leapfrog Group’s annual hospital survey, which measures hospitals’ performance on patient safety and quality, focusing on three critical areas of hospital care: how patients fare, resource use and management structures established to prevent errors. Performance across many areas of hospital care is considered in establishing the qualifications for the award, including survival rates for high-risk procedures and a hospital’s ability to prevent medication errors.

The Leapfrog Group was founded to work for improvements in health care safety, quality and affordability. The annual survey is the only voluntary effort of its kind. The Top Hospitals will be honored at Leapfrog’s Annual Meeting on December 2 in Washington D.C., which gathers key decision-makers from Leapfrog’s network of purchaser members, industry partners, health care stakeholders and national collaborators. For more information, or to see a complete list of The Leapfrog Group’s 2015 Top Hospitals, visit www.leapfronggroup.org/news.

December 7, 2015

Bench and Bedside is a digest of the previous month’s stories about the clinical and academic activities of our physicians and scientists. We welcome your submissions and feedback.

November 3

West Campus gastroenterology team grows

Three pediatric gastroenterologists recently joined the pediatric gastroenterology team at the West Campus. The additional physicians brings the team to a total of four full-time gastroenterologists at the West Houston hospital. More

November 3

Two neurologists, pharmacist receive AES Young Investigator Award

Texas Children’s neurologists Drs. Sunita Misra and Dana Marafie and Clinical Pharmacy Specialist Dr. Mindl Messinger will be presented with the 2015 Young Investigator Award at the upcoming American Epilepsy Society’s Annual Meeting. More

November 10

Texas Children’s participates in largest study on teen weight-loss surgery

The results of research Texas Children’s Hospital participated in were recently published in the New England Journal of Medicine and show teen weight-loss surgery demonstrates the reversal of type 2 diabetes and significant weight loss. More

November 10

Watcher program improves safety across organization

A new program has significantly decreased codes in acute care areas by heightening the awareness of patients in need of extra attention and improving communication amongst caregivers about those who may quickly decompensate. More

November 17

Preidis receives 2-year NASPGHAN research grant for microbiome nutrition study

Dr. Geoffrey Preidis, a pediatric gastroenterology fellow at Texas Children’s and Baylor College of Medicine, received the 2016 Young Investigator Development Award from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Foundation and Nestlé Nutrition Institute. More

November 17

Lam recognized with Baylor Rising Star Award

Dr. Sandi Lam, co-director of the Texas Children’s Hospital Craniofacial Surgery Program, was recognized at a recent Baylor College of Medicine Neurosurgery Grand Rounds with the inaugural Rising Star in Resident Education award. The award is given to a neurosurgery junior faculty member who demonstrates excellence in teaching. More

November 17

Dr. Huynh-Tran joins Department of Surgery

The Department of Surgery is pleased to announce the appointment of Dr. Amy Huynh-Tran to the Division of Dental Surgery. Huynh-Tran also has been appointed as an assistant professor in the Dental Department at Baylor College of Medicine. Huynh-Tran will see patients in the Dental Clinic at the main campus of Texas Children’s. More

November 17

Drs. Chandy, Musso awarded Master Teacher Certificates

Otolaryngologists Drs. Binoy Chandy and MaryFrances Musso recently received the Baylor College of Medicine Master Teacher Certificate and presented at the Baylor College of Medicine Academy of Distinguished Educators. The Master Teacher Certificate is awarded by the Master Teachers Fellowship Program at Baylor. More

November 17

Pediatric Anesthesiology promotes two high-level faculty, creates new division

The Department of Pediatric Anesthesiology recently made some significant organizational changes, promoting two faculty members to Associate Anesthesiologist-in-Chief and creating a new division dedicated to non-operating room anesthesia. More

November 17

Passionate confrontations subject of annual McNamara Grand Rounds

Speaking to a packed auditorium, visiting physician Dr. Chris Feudtner shared his insight on speaking to parents of critically ill children with compassion during the annual McNamara Grand Rounds. More

November 24

Stein elected president of the American Academy of Pediatrics

Dr. Fernando Stein, medical director of the Progressive Care Unit, has been elected President of the American Academy of Pediatrics (AAP). This is the first time in the AAP’s 85-year history that a Texas pediatrician has been elected to the post. As AAP president, Stein will represent all pediatricians and subspecialists across the U.S. and serve as Texas Children’s voice on national issues impacting the health and safety of the millions of patients and families we serve. More

November 24

Ribbon cutting held for special isolation unit at West Campus

More than 70 people from across the organization, city and state attended the Special Isolation Unit ribbon cutting and open house last week at Texas Children’s Hospital West Campus. Attendees got a close-up look of the state-of-the-art facility, which allows Texas Children’s to care for children with highly contagious infectious diseases. More

November 17, 2015

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The Epilepsy Monitoring Unit (EMU) had one hospital-acquired pressure ulcer (HAPU) in a period of 892 days, which translates to 647 days and 244 days without a HAPU occurrence. These notable milestones demonstrate the value of teamwork and commitment to cultivating an environment of safe patient care.

When epilepsy patients are admitted to the EMU for an electroencephalography (EEG) study, electrodes are attached to their scalp, forehead and cheeks. These electrodes, which enable the recording of brain wave activity to diagnose seizures and other neurological disorders, can lead to skin breakdown at the electrode sites resulting in a pressure ulcer.

“Before revising our quality improvement practices for HAPU prevention, 10 percent of our EMU patients developed a HAPU, averaging three or four occurrences per month,” Texas Children’s Clinical Specialist Joellan Mullen said. “Today, we have brought our HAPU incidence rate to zero.”

In an effort to reach this milestone, EMU nurses, technicians, physicians and physician assistants collaborated to develop techniques to enhance skin care management and pressure ulcer prevention. These best practices were published in the 2014 issue of the Journal of Pediatric Nursing co-authored by Mullen and Texas Children’s EMU/EEG Clinical Manager Wendy Morton.

Several improvements were implemented to reduce HAPUs:

Patients were prepped with a less abrasive solution to remove oils from the skin before electrodes were placed on the scalp and forehead
Disposable electrodes were used to reduce the potential risk of infection instead of using the same electrodes for patients following equipment disinfection
Crib mattresses were replaced with pressure-reducing cushions to distribute weight evenly
A breathable, fishnet dressing was wrapped around the electrodes on a patient’s head to prevent moisture and pressure on the scalp. Prior to this change, the entire head was wrapped tightly in gauze which increased the potential of skin breakdown at the electrode sites.
Wireless technology was implemented to allow greater mobility for patients. Instead of being tethered to the wall, the electrodes are hooked up to a small monitor that patients wear as a backpack so they can move freely in the unit instead of being confined to the bed.
Nurses performed skin assessments for pressure ulcers twice per shift – before the electrodes were placed on the patient and after they were removed.

Additionally, the Skin Champions Program helped staff significantly reduce the occurrence of pressure ulcers in the EMU and in high acuity areas of the hospital like the intensive care and cardiovascular units.

Two skin champions were chosen from each unit to serve as coaches and ensure compliance with proven pressure ulcer prevention strategies. While all EMU staff members are trained in HAPU prevention, skin champions undergo more intensive training and must attend monthly educational sessions with a certified wound-ostomy nurse.

“Ensuring our nurses and technicians are equipped with the knowledge and tools to take preventive action are key to creating a harm-free environment for our EMU patients,” Mullen said. “I am proud of our team for helping us achieve this milestone.”

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Dr. Daniel Yoshor, chief of the Department of Neurosurgery at Baylor, presented Lam with the award. “Dr. Lam is a dynamic and natural teacher and has quickly made her mark in resident and medical student education in neurosurgery at Baylor,” he said.

His award-winning study titled, “Glycan metabolism shapes the undernourished intestinal microbiome and influences weight gain,” explores the mechanisms by which undernutrition alters the bacterial balance in the gut microbiome and how this imbalance may impact weight gain potential in children with poor nutritional status.

Dysbiosis refers to disturbances in the bacterial composition of the gut microbiome. Intestinal bacteria transform glycans, non-digestible complex sugars, into short chain fatty acids that provide energy to epithelial cells lining the digestive tract. There are two types of glycans in the intestine – N-glycans derived from diet and O-glycans produced by the host that comprise intestinal mucus.

Since most bacteria metabolize only a small subset of glycans, the limited availability of key glycans could induce dysbiosis, which may impair weight gain by causing microbes to compete with the host for nutrients, transform fewer luminal contents into bioavailable energy or induce epithelial cell gene expression changes that decrease nutrient uptake.

To explore these possibilities, Preidis and his research team established a model of protein-energy undernutrition in neonatal mice. The undernourished microbiome in mice contained fewer N-glycans and fewer bacteria that metabolize N-glycans compared to the control group. The undernourished microbiome also was enriched with a plethora of Akkermansia muciniphila, a bacterium that lives and feeds on O-glycans in the intestinal mucus lining and is found in smaller quantities in obese humans and obese mice.

Preidis and his team hypothesize that loss of dietary N-glycan energy sources in the calorie-restricted diet causes a bloom of microbes including A. muciniphila that feed on mucus layer O-glycans. The resulting dysbiosis in the undernourished intestinal microbiome thins the mucus, decreases expression of epithelial cell genes that drive nutrient uptake and impairs weight gain.

“Uncovering the mechanisms by which dysbiosis contributes to poor nutrition – and can possibly be corrected – has enormous potential to improve global child health,” Preidis said. “Our long-term objective is to improve our understanding of how the microbiome contributes to metabolism and which microbes are potentially harmful or beneficial to weight gain and growth. This knowledge will enable us to develop therapies that target the microbiome to promote rapid recovery following periods of undernutrition and weight loss.”

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Otolaryngologists Drs. Binoy Chandy and MaryFrances Musso recently received the Baylor College of Medicine Master Teacher Certificate and presented at the Baylor College of Medicine Academy of Distinguished Educators. The Master Teacher Certificate is awarded by the Master Teachers Fellowship Program at Baylor.

Chandy presented on “Spaced Education in Difficult to Teach Topics: Professionalism,” looking at teaching small amounts over a period of time rather than routine lectures in hard to teach topics such as professionalism.

Musso discussed a pilot study she led using a video to educate parents of patients scheduled for an adenotonsillectomy. Parents were asked to rate the effectiveness of the video before and after surgery. This project’s main goal was to increase educational resources available to patients and families and have them be better prepared for postoperative care.

November 10, 2015

Michael Cothran from the Office of Development is the latest Texas Children’s Super Star leader. “We are fortunate to have a work culture that encourages and supports employees at every level,” Cothran said. “I’ve always challenged myself and others to explore new ideas, processes and tools.” Read more of Cothran’s interview, and find out how you can nominate a Super Star.

Q&A: Michael Cothran, July – September 2015 Leader

Your name, title and department. How long have you worked here?
Michael Cothran, Development Manager, Texas Children’s Hospital Office of Development. I have been an employee at Texas Children’s Hospital since 2007.

What month are you Super Star for?
July – September 2015

Tell us how you found out you won a super star award.
I thought I was going to a staff meeting but all of my coworkers had gathered to congratulate me on the award. The Office of Development runs at a pretty fast pace so I really appreciated everyone taking a few minutes out of their day to celebrate.

What does it mean to be recognized for the hard work you do? How has the organization helped you achieve your personal and professional goals?
It really makes that hard work even more meaningful. We are fortunate to have a work culture that encourages and supports employees at every level. I’ve always challenged myself and others to explore new ideas, processes and tools. These efforts have consistently been supported by the organization, and I believe we have grown stronger as a result.

What do you think makes someone at Texas Children’s a super star?
There really isn’t one simple recipe. When I look around at the most successful people in our organization, I see a variety of traits and characteristics. Key among them are selflessness, enthusiasm, confidence and integrity.

What is your motivation for going above and beyond every day at work?
In my role in the Office of Development, I have the opportunity to interact with many of the top leaders at Texas Children’s Hospital. I’m always impressed by the scope of the vision that they share. While there are needs that must be answered today, there is always an eye toward tomorrow. Knowing that Texas Children’s has great plans for the future is a strong motivator.

What is the best thing about working at Texas Children’s?
The mission is very clear. It feels good to do purposeful work that will have a lasting impact.

What does it mean to you that everyone at Texas Children’s is considered a leader? What is your leadership definition?
We are all in a unique position to proactively influence the path that we are traveling. I think this is key to the ongoing success of Texas Children’s.
I believe that leadership is the ability to understand the need for transformation or preservation and then to actively support the pursuit of either.

Anything else you want to share?
I’d simply like to thank those who nominated and selected me for this award. It is a true honor.

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