April 8, 2016

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The United States Agency for International Development (USAID) has awarded a $69.8 million grant to the Baylor College of Medicine Children’s Foundation–Malawi (Baylor–Malawi), an affiliate of the Baylor College of Medicine International Pediatrics AIDS Initiative at Texas Children’s Hospital, to support and expand HIV/AIDS programs in Southern Africa. The grant, through the USAID Regional HIV-AIDS Program, will fund a dynamic and innovative project called Technical Support to PEPFAR Programs in the Southern Africa Region, or TSP. Designed by the Baylor-Malawi team, TSP is a collaborative program that includes ICAP at Columbia University and Baylor College of Medicine Children’s Foundations in Botswana, Swaziland, Lesotho and Angola.

“While Southern Africa remains the epicenter of the HIV/AIDS epidemic, recent progress toward global elimination goals provides an impetus for coordinated, regional efforts,” said Dr. Saeed Ahmed, assistant professor of pediatrics with BIPAI who will lead TSP. “The program will address challenges related to HIV care and treatment, including pediatric and adolescent care, HIV prevention from mother to child and the unique gender aspects of the epidemic, providing a common regional platform for dissemination and rapid adoption of best practices.”

In support of the primary goal to reduce the impact of HIV/AIDS in Southern Africa, TSP objectives are to:
Improve clinical and other technical outcomes of partner programs in the region by providing mission programs with technical support and short- and medium-term program assistance and capacity building toward sustainability;

Improve and rapidly expand pediatric and adolescent treatment services in the region by providing technical assistance in the short and medium term and longterm program support;

Implement PEPFAR programs directly, in close cooperation with USAID.

The TSP will provide a wealth of technical expertise, Ahmed said, including human resource capacity, physical infrastructure, existing networking and program implementation experience, bringing together formally the unique and complementary strengths of the Baylor network and ICAP at Columbia University. The Baylor foundations are the leading providers of pediatric and adolescent HIV care and treatment in their respective countries with Centers of Excellence anchoring broad networks of satellite clinics. ICAP, the second-largest PEPFAR implementing program, offers incredible geographic scope and technical, programmatic and monitoring and evaluation expertise. Combined, the Baylor network and ICAP have managed more than $1 billion in funding over the past 5 years, and are implementing more than 50 U.S. Government supported initiatives.

To provide assistance to regional HIV/AIDS programs, Baylor-Malawi and its partners have organized a ‘Dream Team’ of experts who will provide the technical advising backbone of the program. Through its implementing partners, the Dream Team will have access to an extensive network of more than 1,500 people, including doctors, nurses, social workers, counselors, community health workers and volunteers, and pharmacists to provideHIV/AIDS program assistance and implementation.

“The high-quality assistance and program implementation provided by this project will strengthen the efforts in the region to achieve the UNAIDS 90-90-90 benchmarks, which call for 90 percent of HIV-infected individuals to know their status; 90 percent of patients who know their status to be started on and adherent to anti-retroviral therapy; and 90 percent of patients on ART to be viral suppressed by 2020” said Dr. Mark Kline, physician-in-chief, Texas Children’s Hospital and chairman of the department of pediatrics, Baylor College of Medicine.

Women and children are a special focus on the TSP program. It aims to achieve elimination of mother-to-child transmission, doubling of the number of children on anti-retroviral therapy and, through the DREAMS Initiative, assisting partners in developing interventions to address gender-based violence and reduce new HIV infections in adolescent girls and young women. DREAMS, or Determined, Resilient, AIDS-free, Mentored and Safe Women, is a PEPFAR program to reduce HIV infections among girls and young women in sub-Saharan Africa.

“This award is a true testament to the BIPAI Network’s ability and capacity as a global leader in pediatric HIV/AIDS and tuberculosis. Baylor–Malawi continues to excel in innovative program development,” said Michael Mizwa, chairman, Baylor–Malawi Board of Directors, chief operating office/senior vice president of BIPAI and director of global health at Texas Children’s Hospital.

“With the resources from this award, I am pleased that Baylor Malawi will lead a consortium that leverages the extensive expertise that is in the BIPAI network with its partners ICAP and regional ministries of health to accelerate the region’s advances to the 90-90-90 targets,” said Dr. Peter Kazembe, executive director of Baylor College of Medicine Children’s Foundation–Malawi.

December 15, 2015

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Dr. David Poplack, director of Texas Children’s Cancer and Hematology Centers, and numerous members of his medical staff helped write the recently published, 7th edition of the textbook, Principles and Practice in Pediatric Oncology, the leading textbook in the field.

This thoroughly updated edition contains 54 chapters, more than 1,300 pages, and is the most comprehensive resource on the biology and genetics of specific childhood cancers including recent advances in the diagnosis, multimodal treatment and long-term management of cancer in young patients.

“Since the first edition was published 26 years ago, the biology and treatment of pediatric cancers have become increasingly more complex, which has made it more challenging to produce a textbook of this magnitude,” Poplack said. “There was immense collaboration involved to bring this exciting project to fruition.”

Besides being used by all medical schools, pediatric oncologists and institutions pursuing pediatric oncology research around the world, this textbook also provides helpful information geared specifically to caregivers and families of children with cancer, which adds to the unique quality of the book.

“This resource guide also comes in an e-book format,” Poplack said. “We will have periodic updates on the major chapters that will be available electronically to subscribers.”

Click here for more information about this textbook.

December 8, 2015

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

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

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

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

December 1, 2015

On November 14, hundreds of families from around the country traveled to Houston to attend Texas Children’s Fetal Center family reunion. Since its inaugural event in 2007, the reunion provided an opportunity for physicians and staff to reunite with patient families who received life-saving medical and surgical care at our fetal center.

Nearly 420 families attended the event at the Houston Zoo – some traveling from Iowa, Louisiana, parts of Texas, and Monterrey, Mexico. Guests enjoyed face painting, dancing, sunglass craft, an animal experience where they got a chance to pet furry creatures, and in true Texas fashion, rodeo clowns.

The reunion has become a cherished experience for Fetal Center staff and patient families. Since many of these families spend extended periods of time with staff from Texas Children’s Fetal Center and Newborn Center, a special bond is formed between these patient families and the team members who treated them.

“The nurses and staff of the Fetal Center are the first point of contact for these families as they seek answers at a very difficult time in their lives,” said Dr. Oluyinka Olutoye, co-director of Texas Children’s Fetal Center. “The nurturing and compassionate care offered by the fetal team helps get many of these families through the rough patches. The bonds formed in the midst of challenges and adversity are those that are the tightest, strongest and most enduring.”

In collaboration with our Maternal Fetal Medicine specialists, the Fetal Center specializes in cutting edge medical and surgical care for the sickest of fetuses and neonates. Despite the challenging work involved, seeing these children thrive and the gratitude expressed by their parents and families, is what matters the most.

“We are always eager to catch up with our patients,” said Dr. Darrell Cass, co-director of Texas Children’s Fetal Center. “To see how these children are developing and enjoying their childhood is incredibly gratifying, especially when I consider that these thriving kids were once very sick.”

Highlights from the Fetal Center reunion included speeches from Drs. Olutoye, Cass and OB/Gyn Chief Dr. Michael A. Belfort. Other Fetal Center team members in attendance included Drs. Rodrigo Ruano, Wesley Lee and Nancy Ayres.

November 17, 2015

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

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

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

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

Several improvements were implemented to reduce HAPUs:

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

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

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

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

November 10, 2015

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It’s called the “Watcher List” and simply put, it is for patients who need a little extra attention. Any physician, nurse or resident can place a patient on the Watcher List if they are concerned that patient may need a higher level of care. A patient on the list is given extra attention by care providers who have a plan in place should the patient’s condition deteriorate quickly.

“Generally the plan is to increase global awareness of these patients for an extra set of eyes,” said Chief Resident Tolulope Adebanjo. “Each week there is a safety resident who oversees the Watcher List for each unit ensuring the proper steps are taken to escalate care for a patient should it become needed.”

The program was enacted by the quality and safety team as a measure to increase patient safety. It began as a pilot program on a few units and expanded to a system-wide acute care initiative. Since going into effect, the number of codes on each floor have dramatically decreased. The new system allows for the rapid response team (RRT) to be called into action more quickly and efficiently before a patient decompensates.

“For our nurses, the Watcher List allows for peace of mind knowing the entire care team is aware of the patients who may require the most attention on the unit and that there is a plan to ensure the patient receives the appropriate care,” said Assistant Clinical Director of Inpatient Nursing Monica Simmons. “The nurses have the most interaction with the patients and play a key role in communicating with the care teams about each of these patients.”

“The key to good patient care is communication so the Watcher List is one way that we communicate our level of concern about patients,” said Chief Resident Kim Lehecka. “It’s a really systematic way to communicate concerns easily and efficiently while being able to quickly prioritize.”

Patients on the Watcher List have a greater chance of being moved to a higher acuity unit. The criteria for the list varies from floor-to-floor and may include abnormal vital signs, abnormal labs, a patient on high risk medication and a variety of other causes. The list is available for teams across the organization and helps coordination across units when a patient may need to be moved. Higher acuity units are in constant communication with the others on what the needs may be throughout any given day.

“It’s a common language,” Adebanjo said. “It’s a patient who needs to be frequently assessed with the potential to get really sick very quickly.”

The list allows a greater preparation for adverse events and a plan of action that could mean a better outcome. The charts on each patient shows the reasons they are on the Watcher List as well as the plans of action should the RRT need to be called. A patient is taken off of the list when their condition improves, but not without a conversation between a multidisciplinary team.

August 18, 2015

81915TexansJuniorCheer640Patients got a special treat last week when the Houston Texans cheerleaders paid them a visit and hosted a mini Jr. cheerleading camp at Texas Children’s Hospital.

“We are going to teach you to dance like we do during the games,” one of the cheerleaders told the crowd as her squad mates handed out fluffy red and white pom-poms. “Show me how to shake ’em.”

For the next hour, the cheerleaders worked with the patients on their dance routine, played games, signed autographs and posed for photos. Excitement filled the room as the patients showed spirit for their hometown NFL team.

“I loved it!” 8-year-old Zoe Rosales squealed. “I want to be a cheerleader and practice all the time at home.”

Following the camp, the cheerleaders visited heart patients, bringing along pom-poms and autographed posters. For cheerleader Ashley S., the August 10 visit was extremely meaningful since she used to be a patient at Texas Children’s Hospital.

Ashley was diagnosed with a potentially deadly disease nine years ago and stayed at Texas Children’s Hospital for four weeks. During her time at the hospital, she enjoyed Radio Lollipop, our fully-equipped, on-site radio station that broadcasts to patients’ rooms via Texas Children’s television system.

“The staff at Texas Children’s Hospital worked really hard to make me feel like I was more than just a patient,” Ashley said. “It’s a blessing to be able to give that experience back.”

Texas Children’s teamed up with the Houston Texans earlier this year to inspire children to lead healthier, more active lives through camps, programs and events all year long. We are working alongside the Texans through community engagement and education programs to give Houston-area kids the tools necessary to make healthy choices throughout their lives. Last week’s mini Jr. cheerleading camp is just one of many of the exciting events we’ll take part in throughout the year. Click here to learn about some of the other ones.