November 5, 2019

Thank you for making Texas Children’s a Best Place to Work in Houston! According to the Houston Business Journal, we rank No. 5 among companies with more than 1,000 employees. Our Catalyst Leadership Award winners and Human Resources team members accepted the Houston Business Journal award on October 31. Read more

October 7, 2019

 

Texas Children’s Orthopedics Department jumped five spots from No. 15 to No. 10 in this year’s U.S. News and World Report survey.

The team worked quickly, relentlessly and collaboratively to achieve this ranking, a first for the Orthopedics department at Texas Children’s.

Service chief Dr. Brian Smith expressed his sentiments with the ranking, “The Orthopedics Division is thrilled and honored to be recognized as one of the top 10 Orthopaedic programs in the country. This is a tribute to our entire team of physicians, physician’s assistants, nurses and staff whose primary goal every day is to provide the best musculoskeletal care possible to our patients and families.”

But seriously, how did they move so far so fast?

Specifically, the Orthopedics Department accomplished four big wins for patients:

  • Gait Lab accreditation: Dr. Jeffery Shilt, chief surgical officer in The Woodlands, led efforts to ensure that our Gait Lab was accredited as a clinical motion laboratory. The Texas Children’s Hospital Gait Lab received this accreditation in record time after opening, providing exceptional care to patients with movement disorders.
  • Continuing education: 100 percent of nurse practitioners and physician assistants received pediatric orthopedic surgery related continuing education units. Janai’ Buxton, manager of Advanced Practice Providers in Orthopedics is proud of this dedication to education, saying, “Such education ensures our APPs are providing the very best current, evidence-based care for patients.”
  • Scoliosis outcomes: The spine surgery team implemented several changes, including a multi-disciplinary meeting, to reduce unplanned readmissions and reoperations for complex scoliosis surgery patients.
  • Gap closures: The team worked together to close out 90 percent of gaps related to the department structure.
Deserved recognition

The dedication and leadership of Dr. Larry Hollier, surgeon-in-chief, Dr. David Wesson, interim chief of Orthopedics, and Rachel Warfield, Director of Surgical Ambulatory Services, helped the team accomplish this ranking. Additional recognition goes to the many physician champions who led efforts to improve quality as well as the data team led by Ken Kocab and Debasis Dash.

The Orthopedics department sees this accomplishment as a testament to all the hard work that has been done to improve patient quality and access to care over the past several years.

September 30, 2019

To be ranked among the best children’s hospital services in the nation by U.S. News and World Report is a big deal. But when you talk to leaders within the Diabetes & Endocrinology service you get the sense that high performance is simply who they are.

“We are extremely proud of the recognition because it speaks to how hard we work,” said Curtis Yee, practice administrator of the Diabetes and Endocrinology section. “But we also recognize that we still have a lot of work left to do for our patients and families.”

This year the service ranked at No. 8.

What makes a high performing team?
Ryan Breaux, U.S. News and World Report service team lead, said the heart and soul of the program’s success is the quality infrastructure of the Diabetes Care Process Team which is comprised of approximately 150 people.

“A strong team is motivated to improve outcomes for our patients. That’s the core of our work every single day and it shines through,” Breaux said. “I also give a lot of credit to Dr. Rona Sonabend who has been instrumental in building the culture of this service.”

The Diabetes care process team includes providers, nurses, diabetes educators, dietitians, social workers, data technicians, and psychologists.

U.S. News recognized several big wins for patients and families:

  • An increase in percentage of patients with Diabetes who have LDL cholesterol less than 130, which is tied directly to the physical health of patients within the service.
  • A significant increase in patient encounters with a nutritionist, certified dietitian educator, social worker, and/or a psychologist for patients with Diabetes – a marker that captures how much emphasis is placed on the overall health and well-being of patients with diabetes
  • Increased dialated retinal or non-mydriatic camera examinations in the diabetes clinics to ensure that the eye health of patients with diabetes is regularly monitored.
  • Closed out all structural related metrics in an effort to guarantee that the service has the structural and procedural framework to keep performing at the highest level possible.
September 23, 2019

Premature infants and sick infants often need the kind of medical attention and care only found in a newborn intensive care unit like Texas Children’s Hospital Newborn Center.

Named No. 7 in the nation by U.S. News & World Report 2019-2020 Best Children’s Hospitals rankings, The Neonatal Intensive Care Unit (NICU) at Texas Children’s Hospital is designated by the Texas Department of State Health Services as a level IV NICU, the highest level of care available for premature and critically-ill newborns.

More than 1,800 infants are cared for each year in the Texas Children’s Neonatal Intensive Care Unit (NICU), making us one of the largest, most experienced NICUs in the country. We provide all services that critically ill or premature babies might need, including on-site neonatologists available 24/7, the highest level of respiratory support, advanced imaging, pediatric surgery, pediatric anesthesiology and more.

Texas Children’s NICU is led by a multidisciplinary team of neonatal experts – physicians and nurses who are internationally known for their level of experience and knowledge in the care of premature and critically ill infants. They serve on committees and consortiums that set the standard of care for newborn care nationally and conduct research on a range of topics in perinatal and newborn medicine.

“I am extremely excited that our neonatal team has been named again as one of the best in the nation,” said Chief of Neonatology Dr. Gautham Suresh. “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.”

Texas Children’s Newborn Center is continuously ranked by U.S. News as one of the best places in the nation to receive pediatric care. The rankings use a well-accepted framework for evaluating quality of health care, which factors in patient outcomes, such as mortality and infection rates; available clinical resources; and compliance with best practices. Improved rankings demonstrate a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.

Big wins for patients and families

This past year, the Newborn Center built on its legacy of success and implemented new initiatives to increase transparency, reduce risk of infection and improve the quality of care. Here are some of the center’s big wins for patients and families:

Increased the number of infants discharged drinking their mother’s milk.
Studies have found that when infants receive their mother’s milk at discharge they are more likely to breastfeed and/or breast milk feed for longer. To encourage this behavior, the Keeping Abreast Quality Improvement work group was formed to identify areas for improvement involving human milk feeding and direct breastfeeding in the Newborn Center. From this group, two sub-groups were formed to optimize colostrum for oral care and infant-driven feeding. Colostrum is the first fluid produced by the breast after birth and is rich in nutrients, immune and growth factors. The work of these groups helped increase by 15 percent the number of infants discharged drinking their mother’s milk. This year, 1,024 infants were discharged drinking their mother’s milk compared with 894 last year. A bar coding system for correct breast milk identification also was implemented. The system decreases the likelihood of milk misappropriation.

Achieved a less-than-24-hour turnaround time for urine organic acid and amino acid on-site analysis. The 24-hour turnaround time on urine organic acid and amino acid tests has important implications for newborns. These tests help clinicians diagnose newborns with inborn errors of metabolism, a group of disorders caused by defects in pathways that are crucial for metabolizing food and turning it into a source of energy. Prompt diagnosis of these conditions is important as it allows us to start targeted treatments and initiate dietary changes without significant delay. Rather than presuming the diagnosis and implementing generalized treatment plans, we are able to customize specific treatment plans based on the diagnosis and counsel families accordingly.

Emergent neonatal transports were dispatched within 30 minutes of being requested.
This improvement was made by strengthening partnerships between neonatal nurse practitioners and members of the Neonatology and Transport service team. To ensure the neonatal nurse practitioners were able to respond to the transport team when a transport request was made, a float neonatal nurse practitioner was scheduled and dedicated to such requests. When a float neonatal nurse practitioner was not available, the neonatal nurse practitioners on the floor were empowered to provide a short, succinct checkout to the neonatologist or fellow neonatal nurse practitioner to ensure a timely dispatch time.

Increased the number of registered nurses with neonatal intensive care certification.
The number of registered nurses with neonatal intensive care certification increased 14 percent in 2019 compared with 2018. Our rate of 55 percent is higher than the required certification rate of 51 percent prescribed by Magnet. As noted by the American Nurses Credentialing Center (ANCC), certification affirms advanced knowledge, skill, and practice to meet the challenges of modern nursing. Increasing/maintaining our certification rate is important because research findings have demonstrated a relationship between higher rates of nursing specialty certification and lower rates of negative patient outcomes, such as falls, hospital acquired pressure injuries, select hospital acquired infection rates and failure to rescue and death.

All attending physician extenders participated in a competency simulation for an infrequently performed procedure (chest tube placement) in the past 24 months.
It’s important that all health care providers in the Neonatal Intensive Care Unit are competent in performing key life-saving procedures. Some of these procedures are used rarely, therefore we provide refresher courses and measure each provider’s competency in performing these procedures using hi-fidelity simulation. This allows our providers to feel confident in their skills and be ready to perform them when necessary.

September 17, 2019

The Urology Division at Texas Children’s Hospital offers the most advanced surgical care for routine urological needs as well as complex genitourinary problems related to congenital birth defects, trauma and a range of other medical conditions. Our urologists have experience successfully carrying out to most extreme procedures on the most delicate patients. Those success rates are evident through nation-wide recognition.

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 and this year Urology ranked No. 6.

“Now is the time to show that we can elevate to an even higher level of patient care and do even better than we already have,” Urology Chief of Service Dr. Paul Austin said. “We have to strive to be on the cutting edge of advancement and I envision our reputation factor only increasing further in urology.”

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’re not going to slow down when it comes to advancing in the areas where we have room for improvement,” Urology Physician Dr. Nicolette Janzen said. “We are going to continue to work toward providing the best care for our patients.”

Big wins for patients and families

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

  • Exceed threshold for Percent revision surgery for pyeloplasty
    Pyeloplasty is the surgical reconstruction of a portion of urinary drainage system. This is a procedure that has a national average success rate of over 90 percent. Our Urology team is trained to successfully carry out various approaches to pyeloplasty including robotic-assisted laparoscopic and open. Having this broad range of skill for this procedure ensures the ability to tailor the approach for every patient from babies to teenagers.
  • Significantly decreased unplanned hospital admissions for a urologic issue within 30 days of inpatient urological surgery
    A patient may be re-admitted to the hospital for a urologic issue subsequent to a surgical procedure. Urology has been able to minimize this by analyzing the data from previously re-admitted patients, determining areas for improvement, and applying these improvements to future patients. One successful initiative has been the implementation of “Enhanced Recovery After Surgery” (ERAS). These are protocols for perioperative care pathways provided to advance practice providers (APP), physicians, and nurses as they work together to care for our patients. Lastly, making sure the patient families are educated on how to maintain the child’s health at home helps prevent re-admission.
  • Increased patient volume seen by a pediatric urologist in your Oncofertility program
    Texas Children’s Cancer Center is one of the busiest centers nationally and is on the cutting edge of therapies for cancer patients. An important consideration as patients undergo chemotherapy and radiation therapy for various cancers is fertility preservation. Our urologists are committed to this endeavor. Through our partnership with Baylor College of Medicine (BCM), patients have access to extensive resources for fertility preservation and appropriate counseling. According to Janzen, improving the communication between all services involved with these families has helped to improve access to fertility preservation services.
  • Have closed out 70 percent of gaps
    Gap closure is the result of successful yearly strategies that improves quality outcomes. One of those objectives focuses on preventing infections, more specifically as it relates to Catheter Associated Urinary Tract Infection. Urology’s prevention of gaps in care is a combined effort with the hospital’s system-wide infection control initiatives as we work tirelessly to provide high quality care to our patients.

Click here to learn more about our Urology services at Texas Children’s Hospital.

September 10, 2019

Texas Children’s Cancer and Hematology Centers is one of the largest cancer and blood disorder centers in the country, diagnosing more than 4,000 new patients a year. Over the past decade, patients from all over the world have traveled to Texas Children’s because they know we are a leader in family-centered care and provide personalized, comprehensive services that address both the physical and emotional aspects of the disease.

Named No. 3 in the nation by U.S. News & World Report 2019-2020 Best Children’s Hospitals rankings, Texas Children’s Cancer Center comprises a multidisciplinary team of dedicated and compassionate physicians, advanced practice providers, nurses, child life specialists, social workers and other subspecialists who care for the physical, emotional and psychosocial needs of young patients.

Our world-renowned staff of nearly 200 faculty and more than 1,000 employees have pioneered many of the now standard protocols for treating and curing pediatric cancer and blood disorders. In addition, we provide a full range of pediatric subspecialty care available in-house 24 hours a day and treat all pediatric cancer and blood disorders, even the rarest disorders.

In addition to providing world-class, comprehensive patient care, our hematologist/oncologists are leading the way in advancing pediatric cancer and hematology research. The Cancer and Hematology Centers have 47 laboratories and more than 350 people who are engaged in research to help revolutionize cutting-edge therapies for treating and ultimately curing all childhood cancers and blood disorders.

“Texas Children’s Cancer and Hematology Centers, world renowned for its clinical care, research and education, offers innovative therapies for all forms of childhood cancer and blood disorders,” said Dr. Susan Blaney, director of Texas Children’s Cancer and Hematology Centers. “In addition, physicians-scientists at Texas Children’s Cancer and Hematology Centers are working relentlessly to improve the outcome for all patients afflicted with these diseases and to develop and perfect new treatment approaches that emanate from some of their most extraordinary scientific insights and discoveries.”

All of this and more is why Texas Children’s Cancer Center is continuously ranked by U.S. News as one of the best places in the nation to receive pediatric care. The rankings use a well-accepted framework for evaluating quality of health care, which factors in patient outcomes, such as mortality and infection rates; available clinical resources, such as specialized clinics and programs and external accreditations; and compliance with best practices. Improved rankings demonstrate a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.

Big wins for patients and families

This past year, the Cancer Center built on its legacy of success and implemented new initiatives to increase transparency, reduce risk of infection and improve the quality of care. Here are some of the center’s big wins for patients and families:

  • Made significant improvements to reduce Central line-associated bloodstream infection rate

Texas Children’s Cancer and Hematology Centers’ leadership team identified high-risk central line-associated bloodstream infection (CLABSI) patients and increased rounding with the Centers’ infection control medical director, infection control practitioner and leadership team. Beginning in 2019, the Clinical Operations Team also partnered with nursing, pharmacy and physicians within the Centers, as well as with other departments, including but not limited to, Pediatric Surgery, Infectious Disease, Interventional Radiology and Anesthesia to develop a standardized central line placement and removal practice to decrease variations in line placement and care. These efforts have facilitated a reduction in Texas Children’s Cancer and Hematology Centers CLABSI rates from 1.31 in 2018 to 0.82 in 2019. Leaders anticipate the rate will lower next year.

  • Implemented computerized provider order entry system for chemotherapy orders

In partnership with Information Services, Texas Children’s Cancer and Hematology Centers implemented Epic Beacon, which is the oncology module in Epic that allows physicians to input orders for services, such as chemotherapy, electronically. Adopting such technology is considered best practice as it provides clarity and automated calculations to enhance safety. It also allows these orders to be created and queued up in advance of patient visits for cancer treatment, which should improve patient satisfaction by decreasing wait times.

  • Increased the percentage of patients who received intravenous treatment of antibiotics within an hour of initial triage

The Texas Children’s Cancer Center maintained >95 percent compliance the administration of intravenous antibiotics within an hour of initial triage for oncology patients who were seen in the Texas Children’s Emergency Center and Texas Children’s Cancer Center’s Urgent Care Bay across Texas Children’s three hospital campuses. The Centers’ data tracking over the past year improved greatly due to the strong work of Warren Boudreau, director of Quality Outcomes and Impact Service, and his team. In partnership and collaboration with the Emergency Department, the Centers were able to decrease its antibiotic administration time by an average of 20 minutes. This timely administration of antibiotics in our pediatric patient population is a national standard for decreasing the incidence of sepsis, morbidity and mortality.

  • Increased five-year survival of patient with neuroblastoma

Neuroblastoma is one of the most common solid tumors in children, and approximately 700 patients are diagnosed each year in the United States. Texas Children’s Cancer Center cares for patients of all ages diagnosed with neuroblastoma, which in the later stages is a highly aggressive tumor. For localized, low stage neuroblastoma Stage L1, the Center’s survival rate was 100 percent. For metastatic neuroblastoma, the survival rate was 53 percent, a 10 percent improvement from the previous year. Metaiodobenzylguanidine or MIBG therapy is likely a contributing factor to the Center’s increased success as well as the availability of varying molecular and targeted therapies, and new treatment protocols.

  • Closed out all structural related metrics

As described in the methodology section of U.S. News & World Report’s Best Children’s Hospitals’ publication, structure refers to hospital resources directly related to patient care and includes the ratio of nurses to patients, the presence of specialized clinics and programs and the certification by recognized external organizations. The Cancer and Hematology Centers were able to successfully demonstrate that each of these services were available, including molecular oncology/targeted therapy programs, an on-site inpatient pediatric rehabilitation unit with individualized dedicated cancer rehabilitation programming, participation in the Solutions for Patient Safety Hematology/Oncology CLABSI Working Group and maintenance of a quality committee with an identified medical director/leader.

September 4, 2019

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.