September 4, 2019

Texas Children’s is known for implementing the latest technology to increase the quality of care for our patients. At an open house, The Woodlands campus recently celebrated the Radiology Department upon receiving two new, hi-tech MRI scanners that will expand the range of exams that are performed.

“We feel that we owe it to our patients to deliver the best possible care and with that it includes getting the best possible diagnoses and having the best possible equipment,” Assistant Director of Radiology Traci Foster said. “We are extremely excited about what this means for The Woodlands campus, and Texas Children’s as a whole.”

The celebration began in the second floor conference room at The Woodlands campus, as members of the radiology department and hospital leaders mingled and enjoyed complimentary breakfast. Foster then opened a small program by welcoming everyone and thanking many others for their part in this accomplishment. Three MRI technologists, Dionne Dowdy, Hollis Marshall, and Mark Caspari, were awarded the Texas Children’s – The Woodlands Radiology Promise award for Quality Improvement for their collective efforts in successfully transitioning the Radiology Department to the new MRI platform.

“I have been here 22 years and I am really excited about receiving these new scanners and the success of the radiology department as a whole,” Dowdy said. “I look forward to working with these machines and expanding the scope for what we can do for our patients.”

The primary benefit of the new scanners are to provide the best possible quality MR imaging, particularly for neurologic imaging of the brain and spine. The implementation of these machines is a part of a cutting edge platform by our vendor partner, Siemens.

“Texas Children’s for years has set standards for pediatric care in Texas and the country,” Vice President of Sales for Siemens Healthcare Matt Hoffman. “We are excited to be working with you all to be a part of providing high-quality care to children.”

The multinational manufacturing company provided the campus with both the 3T Vida scanner and the 1.5T Sola scanner. Both scanners represent the latest technology on their newest platform, and are amongst the first of its kind in any pediatric facility worldwide.

“Texas Children’s has a commitment to the highest quality and the highest safety for patients, and we are extremely proud of being a part of something so groundbreaking in radiology,” Dr. Victor Seghers, Chief of Community Radiology, said. “These new Siemens MRI magnets represent yet another tangible delivery of our CEO Mark Wallace’s promise to The Woodlands community that children will receive the best care, close to home.”

Following the program, everyone proceeded to Radiology on the first floor as seventeen-year-old patient, Ashia Smith cut the ribbon commemorating this momentous event, just before her scheduled MRI exam.

“We have improved our ability to diagnose disease and ultimately treat our patients due to the investment in this new technology,” Seghers added. “Our patients are also reporting improved convenience and satisfaction related to faster imaging time acquisition and the quieter environment in the new MR scanners.”

From an imaging perspective, these new scanners will help ensure that The Woodlands campus can perform all types of MRI exams onsite as opposed to sending patients to the Medical Center campus.

“The future looks terrific. We have a solid partnership with our vendor and a brand new cutting edge platform,” Seghers said, “that can benefit from further improvements and enhancements to both hardware and software over the next 10 years. This is important in light of our clinical and academic/research mission to the patients in The Woodlands and the North Houston metro region.”

Texas Children’s will continue pioneering pediatric radiology technology as we look forward to the arrival of the Kinetic Sensor later this year. This is an integral part and one of the key features of Siemens Healthineers BioMatrix technology and of the new 1.5 Sola and of the 3T Vida systems. It is the first ever in-bore, real-time patient viewing system, allowing close patient monitoring and prospective motion correction for neurological MRI exams, and will be the first in the country.

To learn more about Texas Children’s radiology services, click here.

Every year, more than 25,000 patients come to Texas Children’s for the expert care we provide in neurology, neurosurgery, neurophysiology and genetics. They come from across the nation and around the world with neurologic conditions ranging from common to rare to unknown because few places offer the full continuum of care that Texas Children’s provides.

It was fitting, then, that Texas Children’s was recently recognized for its commitment to excellence and comprehensive, high-quality care, once again being named No. 3 in the nation for pediatric neurology and neurosurgery by U.S. News & World Report.

“We are incredibly proud to be ranked once again among the best locations in the nation for pediatric neurology and neurosurgery,” said Texas Children’s Chief of Neurology and Development Neuroscience Dr. Gary Clark. “Our desire is always to provide the very best care for our patients. That is what drives everything we do and what has gotten us where we are today. We’re committed to providing outstanding neurological and neurosurgical care, to conducting groundbreaking research, and to becoming the best program in the nation.”

The U.S. News rankings use an approach that analyzes quality of health care and patient outcomes data from thousands of medical institutions across the country. This includes measuring specialized clinics and programs, external accreditations, and compliance with best practices. A ranking among the top hospitals in a specialty area indicates a commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.

One recent example was when survey data revealed gaps specific to neurosurgical shunts. Teams were able to review and analyze the data and swiftly close the gaps.

“We are always striving for excellence, so we take the U.S. News rankings very seriously,” said Chief of Neurosurgery Dr. Howard Weiner. “The rankings are just one measure of the trajectory of the Neuroscience Center as a whole. When I first arrived three years ago, the goals were to be the destination for high-quality, innovative and attentive care; to train the leaders in the field; and to lead in the investigation of neurologic conditions. We’re meeting those goals, but what’s key to our success is the ability for everyone – in Neurosurgery and our amazing colleagues in Neurology – to work together for our patients. That’s the driving principle behind Neuroscience at Texas Children’s.”

Big wins for patients and families

This year, Neurology and Neurosurgery built on successful existing programs and also implemented new initiatives to improve monitoring capabilities, reduce occurrences of infection and improve the overall quality of care.

  • Saw significant decreases in unplanned returns to OR for craniotomy and in readmissions for Chiari decompression

The surgical advanced practice provider team implemented a post-discharge call system to assess patients for signs of infection, increases in pain or other possible complications. This system allowed the surgical team to determine if a clinic visit was appropriate, and it helped decrease the number of 30-day unplanned returns to the OR for craniotomy patients and the number of Chiari decompressions patients readmitted within 30 days of surgery.

  • Increased monitoring for epilepsy patients who received surgical resection or laser ablation

To ensure patients always receive the highest possible level of care, Texas Children’s has always been committed to recruiting and retaining the best and brightest. The addition of six new epileptologists helped greatly improve monitoring capabilities. This past year, at least 50 percent of epilepsy patients who received surgical resection or laser ablation surgery received intraoperative electrocorticography and/or extra-operative monitoring.

  • Significantly decreased percentage of surgical site infections (SSIs) for ventricular shunt surgeries

Dr. William Whitehead has been leading efforts to identify opportunities to reduce SSIs for shunt-related procedures. One key strategy was improved compliance with a bundle of evidence-based surgical protocols, which include the administration of pre-operative antibiotics, appropriate hair removal and proper scrubbing of the surgical site. Adherence to these protocols contributed to a significant decrease in the percentage of SSIs for ventricular shunt surgeries.

  • Decreased the complication rate for epilepsy surgical procedures

An expansion in Texas Children’s Epilepsy program has led to an increase in neuro-diagnostic monitoring volumes that eclipses other institutions. With the addition of new team members (i.e., six new epileptologists) and the opening of a dedicated neuro-intensive care unit this past year – one of the first of its kind in the country – Texas Children’s provides the safest and most effective environment for the care of children with seizure activity.

Learn more about Texas Children’s Neuroscience Center.

August 26, 2019

When the results of the 2019 U.S. News & World Report survey of Best Children’s Hospitals poured in on June 18, Nephrology patiently waited to find out if they would again be named among the best in the nation.

For the first time, Texas Children’s is ranked in the top 10 in each of the U.S. News & World Report-recognized pediatric sub-specialties. Nephrology, moved up a spot from last year, ranking No. 2.

“We were all very pleased,” Chief of Renal Services Dr. Michael Braun said. “The entire multidisciplinary team has a tremendous focus on making sure we deliver the best and safest care possible, and so seeing that reflected in our U.S. News & World Report rankings is wonderful.”

The U.S. News rankings uses an approach that analyzes quality of health care and patient outcomes data from thousands of medical institutions across the country. This includes measuring specialized clinics and programs, external accreditations and compliance with best practices. Improved rankings determine a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.

“We are excited because it validates what we already know about the program,” Renal Programs Manager Helen Currier said. “Our goals haven’t changed, and we are going to continue to provide outstanding care to patients with kidney disease in a safe and family-centered context.”

Big wins for patients and families

This past year, Nephrology exceeded their yearly goals and executed additional initiatives to increase transparency, reduce risk of infection, and improve the quality of care.

  • Significant decrease in hemodialysis catheter associated blood stream infections (BSI)

Hemodialysis catheter associated BSIs are complications that can result in hospitalization and possibly death. Minimum standards are set by the federal government, as a result metrics are analyzed monthly to identify improvements at a system level. Minimizing these infections is an example of our commitment to providing the best possible care for our hemodialysis patients.

The Standardized Care to Improve Outcomes in Pediatric End-stage Renal Disease (SCOPE) collaborative focuses on infections prevention in pediatric peritoneal dialysis and hemodialysis patients using large-scale collaboration to identify and spread effective interventions across pediatric care settings. Adopting and following SCOPE played a large role in this big win as well.

  • Increased number of full-time equivalents (FTEs) Psychologist/Psychiatrist dedicated to the care of pediatric maintenance dialysis patients in Pediatric Nephrology Program

FTEs are licensed, doctoral psychologists or psychiatrists who work more than 30 hours per week. The burden of illness is the highest among all pediatric chronic illnesses, Texas Children’s Hospital has led the nation as a proponent of integrated mental health support to patients, and families with end-stage renal disease (ESRD).

  • GRAFT Survival rate of 1 year kidney transplant

Graft survival is an estimate of the probability of the transplant functioning at a finite time after transplantation. According to the National Center for Biotechnology Information, outcomes after pediatric kidney transplantation in the United States have improved over time, independent of changes in recipient, donor, and transplant characteristics.

Not only is the first year that Texas Children’s Hospital leads the nation in the number of pediatric kidney transplants, but we also celebrated the 500th kidney transplant done at Texas Children’s Hospital. This is not only reflected in our U.S. News ranking, but has been a major impact on the well-being of our patients. Texas Children’s transplant team as a whole goes above and beyond to provide high quality care to our patients. Last year, they received a glowing review from the Centers for Medicare and Medicaid Services recertification evaluation team. More specifically, the fantastic work that the kidney transplant team has done is reflected in this esteemed honor in the U.S. News & World Report survey.

  • Improvement in Children under 5 years of age receiving hemodialysis

Dr. Braun attributes this improvement in outcomes in large part to the impressive work of Dr. Michael Belfort and the Fetal Center in developing an outstanding maternal fetal medicine program. Texas Children’s Fetal Center is one of the nation’s leaders in the diagnosis and treatment of abnormalities in unborn and newborn infants, allowing us the ability to care for a child even before birth which directly impacts their quality of care later in life.

Click here to learn more about our Kidney (Renal) department at Texas Children’s Hospital.

A group of 25 Texas Children’s ventricular assist device (VAD) patients of all ages and more than 100 other guests, including families, caregivers and guest speakers, recently attended the second annual VAD celebration – “A Night with VAD Superstars.”

There was plenty of food, a visit from Child Life Specialist Adair Galanski with Bailey – the dedicated therapy dog for Lester and Sue Smith Legacy Tower – and games and activities provided by Physical Therapy, Occupational Therapy and Child Life.

The evening was emceed by Barbara Elias, VAD coordinator and the event’s founder, who started the celebration as a way to honor patients currently on heart pump or circulatory support, or those patients who have previously been on support but have had their pump removed or received a transplant. The VAD celebration also honors families and caregivers and has quickly become an outlet for information exchange and networking.

“Device patients are a special group that lead challenging lives, and their families and caregivers are with them every step of the way for what is sometimes a very long journey,” said Elias. “This event serves many purposes: It provides a forum for families to meet one another, share their experiences and build a community. It allows parents of children with VADs to meet other children or adults who have lived through the experience and persevered. And it gives caregivers – especially those from the ICU, who have seen these patients at their worst – an opportunity to see these patients living their lives and doing well.”

The evening’s speakers included Dr. William Dreyer, Texas Children’s medical director of Heart Failure, Cardiomyopathy and Cardiac Transplant; Dr. Lara Shekerdemian, chief of Critical Care; and Texas Children’s heart surgeon Dr. Iki Adachi. Attendees also heard from special guest speaker Dr. Richard Wampler, the inventor of Medtronic’s HeartWare® HVAD pump, a device frequently used in Texas Children’s patients. In turn, the event gave Wampler an opportunity to see firsthand how his invention has positively affected the lives of so many children at Texas Children’s.

“This event was testimony to what our VAD program has accomplished over the last decade,” said Adachi. “There is no doubt that VAD support has provided our patients with a chance for life. It was a pleasure seeing and sharing the happiness generated by such life-saving therapies with patients, families and medical colleagues.”

The VAD program’s expertise was on display in the evening’s two special patient honorees, Eugene Carrette and Jameson Finney. Eugene, who is from Belgium, was the smallest and youngest patient to receive a VAD since the beginning of the program. Thanks to the expert care he received at Texas Children’s, he has been able to travel with his family to Europe recently, a phenomenal feat for a young VAD patient. Jameson Finney earned the nickname “Daredevil” for living life to the fullest while on a device, running, golfing and riding bikes until receiving a heart transplant in 2018. Both the VAD implantation and the transplant were performed by Adachi. Jameson has been doing well since his transplant and continues to lead an active life.

The event concluded with a special moment of sharing and reflection. During this emotional and cathartic time of testimony, patients, families and caregivers who wished had the opportunity to share their stories and to speak frankly about living with a VAD. Many also thanked the experts at Texas Children’s for the care they received and how it has empowered them to live their lives.

“The event was extremely well received and was powerful for everyone in attendance,” said Elias. “I would like to thank Dr. Adachi, Dr. Hari Tunuguntla, my partner, VAD coordinator Jason McMullen, RN, the Heart Center Social Committee, and therapies including Physical and Occupational Therapy and Child Life, whose efforts allowed the event to occur.”

Texas Children’s Heart Center® was recently named the No. 1 pediatric heart center in the country for a third straight year by U.S. News & World Report. The VAD program is part of the Heart Failure Program and is one of the busiest pediatric programs in the country. There are currently 15 VAD patients in the program. Seven of those are full-time students.

Learn more about the Heart Center and its recent U.S. News ranking.

Karl Douglas, an imaging services technician in the Radiology department at Texas Children’s, recently received the Edward B. Singleton Staff Recipient Award. This prestigious award acknowledges individuals within Radiology whose outstanding leadership and/or contribution to the mission of the department has a significant and positive impact on advancing patient care, education, research or Texas Children’s core values.

Douglas began his career at Texas Children’s in 2003 and transferred to the Radiology department in 2010 as a technician assistant. For the past six years, he has been working in the imaging library helping our physicians and patient families obtain the images they need for patient care.

His colleagues describe Douglas as a person who goes above and beyond for patients and their families, as well as other departments, campuses and referring facilities. On several occasions, Douglas has been known to come into work early to lend a helping hand to his co-workers. His colleagues describe Douglas as a team player, and always finds a way to keep a smile on his face when handling difficult requests.

The Edward B. Singleton award was named in memory of Dr. Singleton, an early pioneer in radiology and long-time physician at Texas Children’s.

August 20, 2019

Texas Children’s Hospital recently celebrated a well-deserved milestone after being named No. 2 in the nation for Gastroenterology and GI surgery by U.S. News & World Report.

“Our team was delighted by this year’s ranking of No. 2 nationally,” said Dr. Benjamin Shneider, Chief of Gastroenterology, Hepatology and Nutrition. “I am particularly proud of the achievements our team has made in improving outcomes for the children and families who entrust us with their care.”

The U.S. News rankings uses a methodology that weighs a combination of factors including patient outcomes, quality of health, available clinical resources like specialized clinics and external accreditations, and compliance with best practices. Improved rankings show a health care organization’s commitment to providing high-quality care and identifying gaps where improvements are needed.

Big wins for patients and families

Building on the successes of previously existing programs, the Gastroenterology, Hepatology and Nutrition team, in collaboration with Pediatric Surgery and Liver Transplantation, continues to make great strides in patient care and outcomes which were recently noted in the U.S. News rankings:

  • Achieved successful Kasai procedures in infants with biliary atresia. The most common reason for pediatric liver transplantation is biliary atresia (BA), which occurs in infancy. Within weeks, the liver suffers from extensive scarring that eventually leads to end-stage liver disease. One way to slow disease progression is with an operation called the Kasai procedure. Kasai procedures performed earlier have the best chances of delaying or preventing the need for a liver transplant.

In the U.S. News rankings, Texas Children’s scored the highest score for success after the Kasai operation. The score reflects the world-class care given to patients with biliary atresia cared for at Texas Children’s Hospital. Texas Children’s provides comprehensive care to infants with BA and their families, including aggressive nutritional support, social work services, nursing expertise, and attention by leading pediatric surgeons, hepatologists and transplant surgeons.

BA research at Texas Children’s Hospital, led by Dr. Sanjiv Harpavat, is laying the foundation for a uniform way to detect infants with biliary atresia earlier, to ensure they receive the Kasai procedure at a young age. Texas Children’s researchers have developed a newborn screening tool, which they have implemented in nurseries around the city. This has led to earlier referrals and helped fuel the improved outcomes with the Kasai procedure. Texas Children’s researchers are now working to implement this early screening program across Texas and nationwide, to ensure that all infants with biliary atresia can receive an early Kasai procedure, delaying liver transplantation and potentially avoiding the need for liver transplantation.

  • Improved three-year survival for children undergoing liver transplantation. Texas Children’s has one of the largest and most successful pediatric liver transplant programs in the country. “Our team’s multi-disciplinary approach to pre and post-transplant care, further development of our Liver ICU, surgical innovations, and the incredible teamwork and dedication of our entire liver transplant teams, including our inpatient and outpatient nursing and support staff, have only enhanced our outcomes year after year,” said Dr. Daniel Leung, Director of Hepatology and Liver Transplant Medicine. Texas Children’s three-year liver transplant survival exceeds 92 percent and post-liver transplant length of stay is four days shorter than other high volume peer programs. Additionally, our one-year liver transplant survival exceeds 95 percent.
  • Improved prednisone-free remission rates in children with Inflammatory Bowel Disease (IBD). Since steroids carry significant side effects for children, steroid-free remission is a commonly used outcome measure of clinical care quality in Inflammatory Bowel Disease. To meet this metric, an automated mechanism was implemented in the electronic medical record (EMR) system, which alerts physicians about their patients’ steroid use, thereby focusing attention on the on-going need and appropriateness of steroid use for each patient in a real-time fashion. As part of a hospital supported effort, Texas Children’s also is part of the International Improve Care Now (ICN) registry of pediatric IBD patients, which allows GI physicians to closely monitor the hospital’s active patient cohort and improve their clinical care. Steroid free remission indicates optimal medical management and decreased potential for IBD-related complications in children suffering from these disorders. It is a big win towards improved quality of life for our patients.
  • Implemented successful community support groups

Our community hospital system at Texas Children’s has provided tremendous support to engage our children and families contending with IBD in the form of monthly Family Support Group meetings. These meetings create an outstanding venue for patient and family education, and enables parents to actively influence the care of their child. These interactions have helped to improve patient satisfaction and quality of life in children with IBD. Texas Children’s offers similar support programs for liver transplantation and intestinal failure.

Click here to learn more about our Gastroenterology, Hepatology and Nutrition Service at Texas Children’s Hospital.

There’s no greater responsibility than raising a child. Who should do that alone?

If you asked Adrian McKinney, manager of Texas Children’s Nurse Family Partnership (NFP), she’d say no one. Thanks to McKinney and her team, more than 625 first-time mothers and 487 children have benefited from personalized nursing support since 2009.

That’s 10 years of taking pre-natal and post-partum care directly into the home of Texas Children’s Health Plan members. Certainly something worth celebrating.

“We couldn’t be more pleased about the success we’ve had as a team,” McKinney said. “Our mothers are all entering one of the most challenging times in life and if we can help make preventative health care a priority before their children are born then we’ve already won.”

And that is ultimately the focus of the program. Much like a strong pre-school experience is important to the educational life of a child, so is a good prenatal experience. If the seeds for success are planted early there is time to yield an incredible result.

Rachael Mumbach knows this personally. Mumbach is currently enrolled in the NFP program and calls it an answered prayer. She is mom to little Alaina, who will be two-years-old in December.

“As a first-time mom you get so much inconsistent information about how to handle your pregnancy and raise your children. Your mom and grandmother will tell you one thing. Your boss and your friends will tell you something different,” she said. “They all mean well, but you don’t really know what’s right and what’s wrong.”

Mumbach’s nursing partner, Savanah Ryan, has been an NFP nurse for six years and thoroughly enjoys her work. “Every day looks completely different,” she said. “We are on the road, in homes and providing that hands-on support that our moms need. It’s a joy.”

More than mom
Although moms are the primary focus of the program’s coaching model, McKinney says other family members can also be involved in the sessions. “Dads, grandparents, friends and others who will be part of the child’s support system can absolutely take part in the sessions. We want to make sure that as many people as possible are informed and prepared for the baby’s arrival.”

Who teaches what?
McKinney’s team of nurses conduct weekly and semi-monthly sessions. They teach on topics such as maternal health, sexual health, depression, anxiety, drug use, general child development, parenting and more. Nurses on the team are:

  • Savannah Ryan
  • Galynn Jackson
  • Natalie Nichols
  • Jeanette De Leon
  • Erika Dunn

A big congratulations to the entire team on their 10-year anniversary and successful outcomes for moms.

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The Bottom Line
  • Any first-time mother who is a member of Texas Children’s Health Plan and no more than 25 weeks pregnant may be eligible for NFP Services.
  • Anyone who is interested and thinks they may be eligible can contact Mary Perez at 832-828-1274, mmperez1@texaschildrens.org
  • Want more information about NFP? Visit nursefamilypartnership.org