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.

Dr. Jordan Orange has been selected to receive a 2017 Michael E. DeBakey, M.D., Excellence in Research Award, a prestigious honor given annually to Baylor College of Medicine faculty who have made the most significant published scientific contribution to clinical or basic biomedical research during the past three years.

Orange’s peers – Drs. Emily Mace, Lisa Forbes and Tiphanie Vogel – nominated him for the award in honor of his work as a distinguished pediatrician-scientist who has made seminal contributions to the fields of clinical immunology, basic immunology and cell biology.

Specifically, they highlighted three papers that represent the breadth, caliber and recent impact of Orange’s work as chief of the Section of Immunology, Allergy and Rheumatology and director of the Center for Human Immunobiology. These papers were published in Nature Genetics, the Journal of Clinical Investigation and the Journal of Cell Biology and are described in greater detail below.

“Dr. Orange orchestrates a vibrant and successful clinical and basic research program applying cutting-edge cell biology to questions of important clinical relevance,” Mace said. “In addition to being a pioneer in the field of NK cell deficiency and an international authority in the study and treatment of primary immunodeficiency, he is also a world’s expert in the field of highly quantitative imaging, including super-resolution and total internal reflection microscopy.”

Mace added that Orange’s scientific accomplishments are paralleled only by his success as a leader and mentor.

“His scientific vision and innovation are combined with tireless dedication to both teaching and learning,” she said. “We all are honored to count him as a colleague.”

Orange will be presented with the DeBakey, M.D., Excellence in Research Award on May 15. To learn more about the award, click here. To learn more about the scientific research that garnered Orange the DeBakey award, see below.

Nature Genetics – Through collaboration with the Baylor Hopkins Center for Mendelian Genomics, Orange has become a leader in the discovery of novel monogenic causes of primary immunodeficiency. The discovery of COPA syndrome (Watkin et al., Nature Genetics 2015) was the result of a multi-institute collaboration led by Orange. This rare, autosomal dominant autoimmune syndrome leads to arthritis and interstitial lung disease and was identified through whole exome sequencing of affected patients and their unaffected family members. This genetic discovery was validated in Orange’s laboratory by identifying the mechanism of disease through modeling of the impacted pathway. This work was also recognized with the Lee C. Howley Sr. prize for the most outstanding paper of the year by the Arthritis Foundation in 2015.

Journal of Clinical Investigation – NK cells are innate lymphocytes that eliminate infected or diseased cells. The field of primary NK cell deficiency (NKD) is one in which Orange has been a pioneer; he penned one of the first descriptions of NKD in 2003. While rare, NKD is severe and frequently fatal. To date, four monogenic causes of isolated NKD have been published, two of these from Orange’s group. Most recently, Orange led an international team that discovered biallelic mutations in the transcription factor IRF8 are a novel cause of NKD. This paper, published in the Journal of Clinical Investigation in 2017 (Mace et al.), ended a decade-long quest to solve the original published case of NKD. Again, modeling of patient mutations in the Orange laboratory using cutting-edge cell biology revealed the mechanism of impaired NK cell development in a cohort of patients from unrelated families.

Cell Biology – As NK cells lie at the heart of Orange’s research, it is not surprising that understanding NK cell function has been a cornerstone of his basic science program. He has led the field of NK cell biology by using highly quantitative microscopy and image analysis to deeply probe their function. In the January 2017 issue of the Journal of Cell Biology, Hsu et al. describe the purpose of NK cell lytic granule convergence, a mechanism by which NK cells direct their potent cytolytic machinery to prevent damage to bystander cells. This finding, which has important clinical implications for the field of immunotherapy, featured the application of novel technology to mimic an NK cell microenvironment. This work was showcased on the cover of the journal and merited an editorial from the well-known cell biologist Dr. Ira Mellman, as well as a feature on the journal’s weekly podcast.

April 26, 2017

Jennifer Abernathy, February 2017 Employee

Jennifer Abernathy of Endocrine and Diabetes clinic, is the latest Texas Children’s Super Star employee. “A super star is someone who is able to bring a smile to BOTH patients and co-workers.” Read more of her interview below and find out how you can nominate a Super Star.

Your name, title, and department. How long have you worked here?
Jennifer Abernathy, Clinical Program Coordinator, Endocrine & Diabetes clinic. I have worked here for almost two years.

What month are you Super Star for?
February 2017

Tell us how you found out you won the super star award?
One of the providers asked me to assist her with a meeting. When I walked in, I saw everyone was already seated in the room with a big smile on their faces!

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?
I was so honored to be recognized by my department. I got a little teary-eyed during the speeches! My practice administrator, manager, and several of the physicians have approached me throughout the months to offer support and advice on achieving my goals. For example, because of their support, I was able to create a poster for presentation at last year’s national pediatric endocrine nursing society conference. In addition, they encouraged me to go back to school for my master’s degree in nursing administration. I will begin later this year!

What do you think makes someone at Texas Children’s a super star?
Patients need to feel that we are listening and genuinely want to help them. Co-workers need to feel that we really treasure them and share a team spirit. I think a super star is someone who is able to bring a smile to BOTH patients and co-workers.

What is your motivation for going above and beyond every day at work?
I see the struggles of families trying to manage difficult health issues. Every interaction, whether it is a clinic visit, a visit at the bedside, or a phone call is my chance to let the family know that I am here to support them. So many parents are appreciative about being able to share their burden, even for a little while.

What is the best thing about working at Texas Children’s?
The endocrine and diabetes department has so many great people with big hearts and they are truly passionate about their patients! My department is the absolute best, hands down!

What does it mean to you that everyone at Texas Children’s is considered a leader? What is your leadership definition?
My definition of a leader who someone who inspires others to follow his or her example. Everyone at Texas Children’s is a leader because we all can inspire others in so many different ways – to be more kind to co-workers, to be more smart with our resources, to be a better patient advocate, to be mindful of our health, etc. The ways to inspire others is endless!

Texas Children’s neuroradiologist Dr. Michael Paldino received the 2017 Lucien Levy Best Research Article by the American Journal of Neuroradiology (AJNR).

In his article titled, “Brain Network Architecture and Global Intelligence in Children with Focal Epilepsy,” Paldino and his colleagues Drs. Wei Zhang and David Chu are working to translate quantitative imaging techniques for mapping the network of the human brain into clinical tools that will someday improve the care of children with epilepsy. Their work is helping to advance the mission of Texas Children’s as we lead with cutting-edge technology in the global community. Paldino is the first neuroradiologist at Texas Children’s to receive this prestigious award.

This award is named for the late AJNR senior editor who championed its establishment and recognizes the best original research paper accepted in 2016. Paldino’s award-winning paper was published electronically on October 13, 2016, and appeared in the February print issue.

Seven surgeons in the Texas Children’s Hospital Department of Surgery received Faculty Awards for Excellence in Patient Care from Baylor College of Medicine. The awardees will be formally recognized at the Baylor Annual Education Awards Ceremony on Thursday, May 18.

There are three categories of awards to recognize clinical excellence: Early Career, Star Award for mid-career faculty and Master Clinician for senior faculty members. The Early Career and Star Awards replaced the Rising Star Awards, which were given in previous years.

“I am immensely proud of the clinical expertise and accomplishments of our surgeons at Texas Children’s – including those who received recognition this year and those who will be honored in upcoming years,” said Dr. Charles D. Fraser, Jr., Texas Children’s surgeon-in-chief.

Early Career Awards

Four Texas Children’s surgeons received Early Career Awards: Dr. Carlos Mery from Congenital Heart Surgery; Dr. Laura Monson from Plastic Surgery; Dr. Bindi Naik-Mathuria from Pediatric Surgery; and Dr. Julina Ongkasuwan from Otolaryngology.

Early Career Award recipients are full-time instructors or assistant professors who spend at least 50 percent of their time engaged in patient care and have been in clinical practice as a Baylor faculty member for between two and five years.

The review committee examines applications for clinical excellence and expertise, a consistently high quality of patient care, professionalism and communication, leadership potential, the ability to work effectively with faculty, staff, students and administrators, and continuous service to the Baylor community.

Star Awards

Star Awards were given to Dr. Jeffrey Heinle from Congenital Heart Surgery, Dr. Chester Koh from Urology and Dr. Allen Milewicz from Pediatric Surgery.

Star Award recipients are full-time assistant professors, associate professors or professors engaged in patient care for at least 50 percent of their time, who have at least six years of clinical service as a Baylor faculty member. Faculty members who have transferred from other institutions and have comparable years of service are eligible for the award after three years as Baylor faculty members.

The Star Award committee bases decisions on similar criteria to the Early Career Awards adding the factors of local, regional or national reputation and clinical innovation.

“The dedication to their patients and families shines through for these Early Career and Star Award recipients,” said Dr. Larry Hollier, associate surgeon-in-chief for clinical affairs at Texas Children’s. “They set wonderful examples for their surgical teams, fellows and residents to follow.”

April 12, 2017

Dr. Wesley Lee, co-director of Texas Children’s Fetal Center and section chief for women’s and fetal imaging at Baylor College of Medicine, recently received the Presidential Recognition Award from the American Institute of Ultrasound in Medicine (AIUM) during its annual meeting last month.

Each year, AIUM President Dr. Beryl Benacerraf extends special recognition to individuals for outstanding contributions and service to the future of ultrasound in medicine. Lee was honored for his critical role in developing a national curriculum for OBGYN ultrasound training based on the participation of several professional societies including the American Congress of Obstetricians and Gynecologists, Society for Maternal-Fetal Medicine and the Council on Resident Education in Obstetrics and Gynecology.

Among his many accomplishments, Lee has authored 148 peer-reviewed articles and 20 book chapters pertaining to maternal-fetal medicine, prenatal detection of congenital anomalies, 3-/4-dimensional fetal sonography and fetal magnetic resonance imaging.

April 11, 2017

We’ve all heard the saying, “Hard work pays off.”

That old adage certainly rings true for Texas Children’s Newborn Center leadership and staff. On April 7, Texas Children’s neonatal intensive care unit (NICU) became the first hospital in the state to achieve Level IV NICU designation by the Texas Department of State Health Services.

“As a Level IV NICU, our neonatal team has the resources and expertise to deliver the highest level of care available for premature and critically ill newborns,” said Texas Children’s Chief of Neonatology Dr. Gautham Suresh. “This designation helps ensure our neonates, who require highly specialized resources and 24/7 multidisciplinary care, are treated in the right level of NICU to achieve the most optimal outcomes.”

The designation process comes as a result of legislation passed in 2013 requiring Texas to establish and implement neonatal and maternal level of care designations by March 1, 2018. Texas is one of the first states requiring NICUs to undergo a site visit to verify they meet the Neonatal Levels of Care classifications as defined in the Texas Administrative Code. Completing the designation process is a requirement in order to receive Medicaid reimbursement for neonatal services by September 1, 2018.

Reaching this milestone was no easy task. The process required tremendous collaboration among NICU leadership, staff and employees, as well as various support services that help the neonatal team care for these critically ill babies including pharmacy, respiratory, physical therapy, lactation, nutrition and social services.

“In June 2016, we started a weekly work group that included members from neonatology and various ancillary departments across the organization,” said Project Manager Sohail Azeem. “We led them through the Neonatal Level IV designation guidelines impacting each area and gathered all of the necessary materials and documentation to prepare for the 2-day site visit and for the application process that followed.”

Several key requirements for Level IV NICU designation included the development of a Quality Assessment and Performance Improvement (QAPI) committee and a program plan outlining the Newborn Center’s breadth and depth of services, policies, procedures and structure for prioritizing quality improvement initiatives. While the Newborn Center already had an active quality and safety program, it was incorporated into the QAPI program.

In addition to meeting these Level IV designation requirements, Texas Children’s also participated in a rigorous survey site visit conducted by the American Academy of Pediatrics NICU Verification Program in November 2016.

“The 2-day site visit included interviews with NICU nursing and physician leadership among others, as well as reviews of our policies, medical records and credentialing process,” said Newborn Center Director Heather Cherry. “Surveyors also toured all of our level NICUs and other hospital areas that support neonatal services.”

As the largest NICU in the nation, Texas Children’s is proud to receive this designation. As a Level IV NICU, Texas Children’s Newborn Center meets all level III capabilities plus has the ability to care for infants born earlier than 32 weeks gestation and weighing less than 1,500 grams, provide life support, perform advanced imaging including MRI and echocardiography and provide a full range of respiratory support, among many other criteria.

“A lot of hard work went into achieving our Level IV NICU designation and I am so proud that our teams pulled together,” said Newborn Center Vice President Judy Swanson. “This collaborative milestone solidifies our reputation in providing the highest level of neonatal care to our tiniest, most fragile patients and their families.”