December 20, 2016

122116physiciansurveyinside640Texas Children’s shined in a recent survey conducted by the Harris County Medical Society to determine physicians’ perspectives and satisfaction in their relationships with local hospitals. More than 2,000 physicians took the survey, providing results for 30 hospitals in the Greater Houston area.

When asked to rate their overall satisfaction with each of those hospitals, 87 percent rated Texas Children’s Hospital West Campus at the top of their satisfaction list. Texas Children’s Hospital medical center campus was next with 83 percent of physicians giving the hospital high satisfaction marks.

Reputation is another area where the Texas Children’s system stood apart from the rest. When asked how physicians rated the overall reputation of each health system represented in the survey, 91 percent placed Texas Children’s at the helm.

“The results of this survey are incredible and speak to the superb quality of work we do across our entire system each and every day,” said President and CEO Mark A. Wallace. “They also are a testament to the relationships we have built and continue to strengthen with physicians in Houston and beyond.”

The purpose of the survey, according to Harris County Medical Society President Dr. Kimberly Monday, is to identify areas of strength and areas of opportunity for improvement in physician/hospital relationships that will create the opportunity for further discussion and will ultimately enhance collective efforts to improve patient care in the Houston area.

“These results will give physicians and hospital leaders a clear picture of the areas where the most work needs to be done,” Monday said. “These issues are too important to the quality of care we deliver to our patients to be dismissed, and we want to show hospital administrators that physicians are eager to work with them to make meaningful improvements to hospital practices and policies.”

Monday added that the impetus for the study was the decision on behalf of the federal government to tie Medicare payments to long-term patient outcomes instead of process. As physicians and hospitals become financially tied to actual outcomes, she said, doctors must know which hospitals provide a culture of quality and safety.

Conducted from May 8 to June 20, the Harris County Medical Society survey asked questions regarding:

  • Safety of medical care
  • Relationships between hospital administration and physicians
  • Hospital policies affecting care
  • Medical staff issues and bylaws
  • Electronic medical records

Texas Children’s system, Texas Children’s Hospital and Texas Children’s Hospital West Campus led several categories in the survey as well and made the top 5 or top 10 list in many others, including leadership and leadership training opportunities, adequate nursing staff and quality of support staff.

“It’s good to hear our partnering physicians view us in such a positive light,” said Matt Schaefer, West Campus president. “Those relationships are extremely important to what we do, which is ensuring the best medical care to our patients and their families.”

Click the links below to view the results of the survey:

2016 Harris County Medical Society physician survey – Texas Children’s Hospital
2016 Harris County Medical Society physician survey – Texas Children’s Hospital West Campus
2016 Harris County Medical Society physician satisfaction survey

November 29, 2016

113016surgicaloncologyinside250Texas Children’s Cancer Center is renowned for extraordinary care and outcomes and is ranked No. 2 in the nation by U.S. News & World Report. An important part of the program’s success is the multidisciplinary care children here receive – particularly in the area of surgical oncology. Many solid tumors – such as liver tumors, bone tumors, neuroblastomas and sarcomas – require complete surgical removal. Chemotherapy and radiation may be used to shrink the size of the tumor or to keep it from coming back after surgery, but surgical removal is a critical step for children with these cancers. In these cases, oncologists and surgical oncologists must work together to carefully plot the course of treatment and time the surgery just right to give young patients the very best chance at a cancer-free life.

Patient diagnosed with hepatoblastoma

In September 2015, Dr. Maria Garcia Fernandez, a pediatric infectious disease specialist, and Dr. Fernando Padilla, a family practitioner, discovered a mass in their 17-month-old baby Victoria’s abdomen. Fearing the worst, they immediately contacted the Solid Tumor Program at Texas Children’s Hospital, where Victoria was promptly evaluated and diagnosed with stage 3 hepatoblastoma.

Hepatoblastoma is a relatively rare type of childhood cancer, with approximately 200 cases diagnosed per year in the country. Usually occurring in children under the age of 5, there are often no initial symptoms other than the mass.

“Hepatoblastomas tend to present very large, because the liver is tucked under the ribs so the mass is hard to feel,” said Dr. Sanjeev Vasudevan, Victoria’s surgical oncologist specializing in liver surgery. “You have to remove the side of the liver that the tumor inhabits without damaging the normal side and still get the tumor completely out.”

The stakes for this type of surgery couldn’t be higher.

“If you attempt to remove the mass and wind up leaving some of it behind, the prognosis for the child becomes much more serious,” Vasudevan said. “Basically, if you can’t guarantee a negative-margin resection, it’s safer to skip the attempt and go straight to liver transplantation.”

Aggressive chemotherapy treatment

At the time of diagnosis, Victoria’s tumor was 6 cm in diameter and covered both sides of her liver. She had to undergo an aggressive regimen of chemotherapy to see if resection would be an option, or if transplant would be required.

“We were devastated,” Fernandez said. “We didn’t know if the chemotherapy would work, what kind of toll it would take on her, or if she’d have to have a transplant and deal with that her whole life. But, what we did know was that Texas Children’s was the best possible place for us to be. They had the numbers. They had the best track record for treating this type of cancer, whether it’s from an oncology perspective or surgery or transplant or intensive care.”

Only a handful of major centers in the country are equipped to take a case like Victoria’s. Of the 200 cases diagnosed in the U.S. annually, Texas Children’s treats approximately 10 percent of them.

“In addition to a strong cancer program, you need to have pediatric ICUs and intensivists, surgical expertise, anesthesia and pain services, all for children under the age of 5 – and enough volume to do it well and have good outcomes,” Vasudevan said.

Victoria underwent four intense cycles of chemotherapy. Each time, she was admitted back to the hospital for about a week, fighting fever, neutropenia and RSV. Knowing that four cycles was probably as much as the petite toddler could take, Victoria’s physicians were hoping to take her for surgery after one or two rounds. After the third cycle, she was placed on the transplant list briefly before scans finally showed a glimmer of hope. Victoria underwent a fourth cycle and was scanned again, and the team was delighted to find a margin of healthy tissue that made surgery possible.

“This entire team of oncologists, radiologists, pathologists, surgeons and transplant surgeons met so many times and discussed her case, all diligently trying to figure out what was best for Victoria,” Fernandez said. “It showed tremendous perseverance and dedication, and I will never forget that as long as I live.”

Surgical tumor removal

On January 6, 2016, Victoria went in for surgery, and she didn’t come out for more than nine hours. The vicinity of the tumor to the main portal vein, the primary blood supply to the liver, was close and required special attention to ensure that the tumor was completely removed.

“When operating on the liver, there is a high risk of disrupting the blood vessels and the bile ducts,” Vasudevan said. “What makes it really complicated is the fact that the liver is brown and completely opaque, and you can’t see the tumor. You rely on ultrasound guidance and external cues, the rest is up to feel and experience.”

Victoria’s procedure went smoothly. Vasudevan removed the tumor and the left lobe and was able to preserve about 60 percent of her liver.

There is a 30 percent chance of liver insufficiency post surgery, but after four or five days, the liver begins to regenerate and compensate for its loss. Victoria was stable and extubated by the next morning, and she went on to have two more cycles of chemotherapy to ensure no microscopic seeding had occurred. She has since celebrated her second birthday and returned to her normal, vibrant self.

Although Victoria is still checked regularly for signs of recurrence, overall her prognosis is excellent. She has an approximately 90 percent chance of an event-free, five-year survival.

“This is exactly why I got into this field,” Vasudevan said. “It’s an amazingly rewarding thing to do. Cancer is so devastating, in general, and to see a small 1- or 2-year-old child robbed of her whole life…that’s motivation enough for me.”

For more information about our Surgical Oncology Program, click here.

November 8, 2016

11916drhollierpressganeyinside640Improving the experience for every patient and family who comes to Texas Children’s Hospital for surgery is a top priority for Dr. Larry Hollier, associate surgeon-in-chief for clinical affairs and chief of plastic surgery at Texas Children’s. Over the past two years, he has led the charge at the hospital to ensure every family feels there is no better place for their children to receive surgical care.

To honor him for his work in improving the patient experience at Texas Children’s, Press Ganey, a leading provider of patient experience management solutions, presented Hollier with the 2016 Physician of the Year award at the annual Press Ganey National Client Conference.

Members of the Ambulatory Surgery Patient Experience Workgroup and leaders throughout Texas Children’s nominated him for the award.

“Dr. Hollier is very passionate about the patient experience, and he embraces all of the different touch points that comprise a patient and family’s care experience,” said Sarah Maytum, assistant vice president of patient and family services at Texas Children’s. “In leading the Ambulatory Surgery Team, he not only sought input from front line staff, he listened, acted on their input and empowered staff members to take ownership of project implementation.”

Hollier has been responsible for leading patient experience innovations within the Department of Surgery including: same-day surgery consultation appointments, standardized pre-surgery materials, the surgery greeter program, direct scheduling for Texas Children’s Pediatrics providers and for Texas Children’s Emergency Center; surgical patient ingress/egress patterns; and a physician communication course, called Breakthrough Communications, aimed at enhancing the conversation between patients, families and caregivers. He has also been instrumental in advancing the hospital’s expertise in caring for patients with a range of complex conditions while simultaneously becoming a leader in outcomes measurement and patient experience.

Recently, the Meds to Beds program, which delivers post-surgery medications to a patient’s bedside before discharge, was highlighted in NEJM Catalyst as a highly innovative program. Meds to Beds not only enhances the surgery experience for patients and families, but has also resulted in improved pharmacist and OR staff satisfaction.

“We in the Department of Surgery are extremely proud of the extraordinary work being done at Texas Children’s to optimize the care experience of our patients and their families,” said Dr. Charles D. Fraser Jr., Texas Children’s surgeon-in-chief. “Dr. Larry Hollier has been an outstanding and visionary leader for the surgery service in partnering with Sarah Maytum and the Patient Relations team. His recognition by Press Ganey is a testimony not only to his enormous contributions, but to the effective team spirit we are so proud of in the Texas Children’s Hospital family.”

Hollier holds the S. Baron Hardy Endowed Chair in Plastic Surgery at Texas Children’s and serves as professor and chief of Plastic Surgery at Baylor College of Medicine. In addition, he is chairman of the Medical Advisory Board of Smile Train, an international children’s charity that provides free cleft repair surgery and comprehensive cleft care worldwide, and serves on the board of the Duke Global Health Institute focusing efforts on reducing health disparities. Hollier has authored more than 190 articles for scholarly and professional publications, written 37 book chapters and sits on the editorial board of numerous journals. His surgical specialties include craniofacial conditions, cleft lip and palate, and microsurgical hand repair.

September 27, 2016

92716chroniclediabetesad250Texas Children’s is the honored sponsor for every Tuesday’s “Houston Legends” series. We will showcase the legendary care Texas Children’s has provided since 1954, and focus on milestone moments in our unique history. Also, a complementary website offers a more detailed look at our past, our story and our breakthroughs.

On the right is the Texas Children’s ad that is featured in this week’s Chronicle. Click the ad to visit our companion website at The website will change weekly to complement the newspaper ad, which will be published in section A of the Chronicle on Tuesdays for the next several weeks. We also will spotlight this special feature weekly on Connect, so stay tuned to learn and share our rich history.

September 20, 2016

Before Dr. Howard Weiner accepted his new position as chief of neurosurgery, he knew that Texas Children’s Hospital was the place he wanted to be.

“When I visited Texas Children’s, I was literally blown away by this place,” said Weiner, who also serves as professor of neurosurgery at Baylor College of Medicine. “Speaking with the people here, hearing about the vision, the leadership, the direction, it was very infectious. This was where I needed to be for the next 15, 20 years of my career to do the things that I wanted to accomplish in pediatric neurosurgery for our patients.”

Prior to joining Texas Children’s neurosurgery team, Weiner received his undergraduate degree from the University of Pennsylvania and his medical degree from Cornell University Medical College. During his residency, he was a Howard Hughes Medical Institute research fellow in the Department of Biochemistry at New York University. Following residency, Weiner was awarded the Van Wagenen Fellowship by the American Association of Neurological Surgeons to study brain development in Paris. He also completed a fellowship in pediatric neurosurgery at New York University Langone Medical Center, where his career continued for a total of nearly 27 years altogether.

With nearly three decades of experience in the field, Weiner shares his enthusiasm for the future of Texas Children’s neurosurgery program and the opportunity to work alongside a neurosurgery team that he describes as an “incredible team of innovators.”

“If you take every one on the faculty in neurosurgery here at Texas Children’s, everyone is driving their individual sub-specialty area,” Weiner said. “We are using minimally invasive approaches, like laser ablation, to treat epileptic brain lesions and brain tumors. Our teams are developing new techniques in fetal surgery to treat hydrocephalus and we are leading the way in defining neurosurgical clinical outcomes and best practices that are essential to growing a successful craniofacial surgery program to serve our patients and their families at Texas Children’s for many years to come.”

Weiner’s plan is to continue transforming Texas Children’s into the premier pediatric neurosurgical program in the country by providing innovative, high-quality patient care and focusing on multidisciplinary collaboration and teamwork. While overseeing the growth of Texas Children’s neurosurgery program, he is cultivating a rich environment for faculty members to develop their subspecialty interest and propel their clinical and scientific discoveries to the next level.

“We are well on our way as a division of neurosurgery and as an institution to be the destination for high-quality, world-class innovative and especially attentive care for children,” Weiner said. “That is really my vision for neurosurgery. We will be the leaders in training the next generation of leaders in our field.”

Ranked No. 2 nationally in neurology and neurosurgery by U.S. News & World Report, Texas Children’s neurosurgery program is among the largest and most experienced pediatric neurosurgery units in the U.S., performing more than 950 surgeries annually for a broad range of pediatric neurosurgical disorders.

For more information about Texas Children’s neurosurgery program, click here.

August 23, 2016

82416thorasicsurgeryinside640Texas Children’s Hospital’s congenital heart surgery program recently earned a three star rating from the Society of Thoracic Surgeons (STS), the highest possible distinction.

Star ratings are based on the STS Congenital Heart Surgery Database (CHSD) mortality risk model. One hundred and seventeen congenital heart surgery programs nationwide participated in the Spring 2016 STS CHSD Feedback Report. Texas Children’s is among only eight hospitals in the U.S. to earn a three star rating.

“We are honored to be recognized for our outcomes, which are among the best in the nation,” said Dr. Charles D. Fraser Jr., surgeon-in-chief and chief of congenital heart surgery. “Since 1995, our congenital heart surgery program has carefully tracked patient outcomes and continues to be committed to transparency. Information about our performance is a driver of innovation and critical to elevating the quality of care we provide to our patients every day.”

Texas Children’s Heart Center is comprised of an expert team of congenital heart surgeons, pediatric cardiologists, pediatric cardiovascular anesthesiologists and pediatric critical care physicians, among others. In 2015, Texas Children’s congenital heart surgery program’s overall risk-adjusted mortality rate was 1.6 percent, well below the STS national benchmark of 2.9 percent. Outcomes for atrial septal defect repairs, ventricular septal defect repairs, atrioventricular canal repairs, tetralogy of Fallot repairs and arterial switch operations were also below STS national benchmarks last year.

Texas Children’s is ranked No. 2 nationally in cardiology and heart surgery by U.S. News & World Report. To learn more about Texas Children’s Heart Center outcomes visit the website. For more information about STS Congenital Heart Surgery Public Reporting click here.

August 9, 2016

81016ChronicleAdUrology250.pgTexas Children’s is the honored sponsor for every Tuesday’s “Houston Legends” series. We will showcase the legendary care Texas Children’s has provided since 1954, and focus on milestone moments in our unique history. Also, a complementary website offers a more detailed look at our past, our story and our breakthroughs.

On the right is the Texas Children’s ad that is featured in this week’s Chronicle. Click the ad to visit our companion website at The website will change weekly to complement the newspaper ad, which will be published in section A of the Chronicle on Tuesdays for the next several weeks. We also will spotlight this special feature weekly on Connect, so stay tuned to learn and share our rich history.