November 17, 2015


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


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.

June 9, 2015

U.S.News and World Report released its 2015-2016 Best Children’s Hospitals list today, and Texas Children’s Hospital maintained the no. 4 spot among the 184 children’s hospitals surveyed by the publication. Also, Texas Children’s once again is listed on the Honor Roll, which recognizes hospitals with top 10 rankings in at least three specialties.

“We are thrilled that U.S.News continually recognizes our hospital as one of the best children’s hospitals in the country,” said Texas Children’s President and CEO Mark A. Wallace. “These rankings reflect what we all already know, that the trajectory of Texas Children’s is incredible. In our relatively short 60 year history we have achieved amazing feats. Through the commitment and enthusiasm our staff and employees display each and every day for our mission, we have become, and will continue to be, one of the preeminent resources for health and hope to all children and their families.”

U.S. News surveyed 184 pediatric centers to obtain clinical data in 10 specialties and asked 150 pediatric specialists in each specialty where they would send the sickest children. This year, specialty certified physicians were able to participate in Doximity in addition to the sampling of 150 specialty certified physicians.

These rankings are the result of a methodology that weighs a combination of outcome and care-related measures such as nursing care, advanced technology, credentialing, outcomes, best practices, infection prevention, and reputation, among other factors.

There were 83 hospitals that ranked in at least one specialty, and 12 hospitals were named to the honor roll, listed below:

Ranking Hospital Points Specialties in top 10
1 Boston Children’s Hospital 20 10
2 Children’s Hospital of Philadelphia 19 10
3 Cincinnati Children’s Hospital Medical Center 15 10
4 Texas Children’s Hospital, Houston 12 6*
5 Children’s Hospital Colorado, Aurora 7 6
6 Seattle Children’s Hospital 7 5
7 Children’s Hospital Los Angeles 6 5
8 Children’s Hospital of Pittsburgh of UPMC 6 4
9 Nationwide Children’s Hospital, Columbus, Ohio 5 5
10 Children’s National Medical Center, Washington, D.C. 5 3
11 Ann and Robert H. Lurie Children’s Hospital of Chicago 3 3
11 Children’s Healthcare of Atlanta 3 3

The 12 children’s hospitals on the 2015-16 Honor Roll ranked at or near the top in three or more specialties. The order is by total points. A hospital that ranked among the highest 5 percent in a specialty received 2 points; a hospital that ranked in the next 5 percent got 1 point. Ties were broken by the number of specialties in which points were earned.

Texas Children’s, working closely with academic partner Baylor College of Medicine, continues to pioneer advancements in pediatric healthcare and earns the U.S.News honor roll distinction by being ranked among America’s best in:

  • #2 Cardiology & heart surgery
  • #2 Neurology & neurosurgery
  • #2 Pulmonology
  • #3 Urology
  • #4 Cancer
  • #4 Nephrology (kidney disorders)
  • #10 Diabetes & endocrinology
  • #11 Gastroenterology (digestive disorders)
  • #26 Neonatology
  • #26 Orthopedics

This year’s ranking demonstrates some significant gains among several Texas Children’s services. Here are a few highlights:

  • 7 services scored in the top 10*
  • 6 services were ranked among the top 5
  • 3 of the services among the top 5 now rank no. 2 in the nation
  • 7 of the 10 services maintained or increased their rank from 2014 (4 increased, 3 maintained)

* Note: Texas Children’s has services in the top 10 list in 7 categories. And of those, 6 are among the top 10 percent of all hospitals ranked.

“While we’re very proud of this achievement, we are never satisfied,” Wallace said. “We will continue to push ourselves and drive for even better results. Because ultimately, it’s not about a numerical ranking – it’s about delivering the best possible care and service to the patients and families who entrust us with their lives.”

The 2015-16 edition of Best Children’s Hospitals is available online at


Texas Children’s Pediatric Anesthesiologist and Baylor College of Medicine Associate Professor Dr. Olutoyin Olutoye recently received the college’s Rising Star Clinician award.

The award recognizes assistant and associate professors with at least five years of clinical service who have shown exemplary qualities of clinical excellence and expertise, consistent high level of patient care, professionalism, commendable leadership skills, and continuous service to our community.

Established by Baylor President, CEO and Executive Dean Dr. Paul Klotman, the award was presented to Olutoye at a May 14 ceremony.

“These awards are important to me personally, and they are also important to Baylor College of Medicine,” Klotman said. “At the end of the day, how we take care of patients is what differentiates us from others.”

Texas Children’s Anesthesiologist-in-Chief Dr. Dean Andropoulos said Olutoye is well deserving of the Rising Star Award seeing that she is an international authority on maternal-fetal anesthesia, and is our Texas Children’s leader of that service.

“She is widely recognized for her clinical excellence, leadership skills, compassion and bedside manner for these complicated patients,” Andropoulos said. “She also is the pediatric anesthesiology liaison to the Texas Children’s Hospital Global Surgery Service, and is a recognized authority in anesthesia service and education to developing countries.”

Olutoye, who directs Texas Children’s Hospital’s Fetal Anesthesiology Services, earned her medical degree from Obafemi Awolowo University Medical School. She completed an internship and two fellowships at the Medical College of Virginia, and a residency program at the Children’s Hospital of Philadelphia. Olutoye’s interests include the effect of drugs on the fetus and the fetal brain during Maternal-Fetal surgery as well as the effect of pediatric obesity on the efficacy of anesthesia drugs.

June 2, 2015


Stephen Davis, a pharmacy operations manager at Texas Children’s, recently received the 2015 Pharmacy Leadership Award from the Texas Society of Health-System Pharmacists (TSHP).

This prestigious award recognizes a pharmacist who demonstrates leadership and vision in advancing the practice and profession of pharmacy and improving patient care.

During his nearly five years of service at Texas Children’s, Davis collaborated with colleagues to improve processes and modify pharmacy workflows by successfully implementing the DoseEdge Pharmacy Workflow Manager for the Main Campus Central Pharmacy and pharmacy areas at Texas Children’s Pavilion for Women.

The DoseEdge system is a pharmacy workflow solution that interfaces with Texas Children’s EPIC system to automate the process of routing, preparing, inspecting, tracking and reporting IV and oral liquid doses. Since its implementation, Texas Children’s pharmacists have improved dose preparation safety, reduced medication waste and enhanced pharmacy productivity to ensure quality patient care.

In collaboration with the University of Houston College of Pharmacy, where he serves as an adjunct clinical professor, Davis is a program director for the concurrent Master of Science and Health System Pharmacy Administration residency at Texas Children’s.

May 27, 2015


Have you ever wanted the opportunity to share your perceptions about what it’s like to work at Texas Children’s? Have you ever wanted to share your candid thoughts and ideas about how we can be more efficient and effective as an organization?

If you answered yes, now is your chance to do so in a safe and confidential way. As part of Texas Children’s commitment to open dialogue with employees, we have launched the new Your Texas Children’s Experience survey to provide constructive feedback that will help us formally measure our performance, identify gaps and effectively plan/improve through this process.

“Your voice matters here at Texas Children’s,” said President and CEO Mark A. Wallace. “Recently, I have heard from some of you about concerns and challenges, and today, I want to hear from all of you through Your Texas Children’s Experience survey.”

Administered by Press Ganey from May 18 to Sunday, May 31, Your Texas Children’s Experience survey is confidential, anonymous and takes about 10 minutes to complete. To access the survey, refer to the personalized email with login information you have received from Press Ganey. If you did not get an email or want more information about the survey, contact Press Ganey at or call 800-849-2292, option 1.

Since 2003, the engagement survey has been a powerful way to measure how our organization has been upholding our core values. The survey also has served as a catalyst to affect positive changes around such issues as time off, attendance, holidays, benefit plans, the relocation of Employee Health to Main Campus and the addition of the Employee Medical Clinic.

Texas Children’s is aiming to meet or beat our last survey response rate of 83 percent for employees and 45 percent for physicians. Although your participation is voluntary, it is your opportunity to share your honest perceptions about how our organization is performing and positively impacting our culture as well as the experiences of your coworkers and our patient families.

“Response rates for previous surveys have shown that many of you do want to be heard and believe that getting involved is the right thing to do,” Wallace said. “In doing so, you are directly impacting the health of our Texas Children’s culture and our future.”

For more information regarding Your Texas Children’s Experience survey, we have included a brief overview for your reference. In addition, here are some helpful hints and reminders when taking the survey online:

  1. The survey takes about 10 minutes to complete and is accessible via any computer with internet access
  2. The survey is confidential and anonymous and is administered and analyzed solely by Press Ganey
  3. (Rule of 5) applies – This means that results for work units with fewer than five responses will be rolled up to the next level leader or integrated into a larger work unit
  4. Review the Definition of Terms on the instruction page
  5. Click Confidentiality Pledge in the top right corner to review the Press Ganey’s Pledge of Confidentiality
  6. Do NOT use forward & back navigation buttons in your browser; navigate using buttons on each screen of the survey (Back, Save Page & Continue)
  7. Review Answers before you submit your final answers
  8. Results are not final until you click Save Page & Continue after the close ended questions
  9. Open-ended comments are transcribed and themed by Press Ganey