October 29, 2019

Your name, title and department. How long have you worked here?
My name is Mark Mazziotti and I’m an Associate Professor of Surgery and Pediatrics, and I work in the Division of Pediatric Surgery. I’ve been on staff at Texas Children’s since 2001 and joined the Baylor Faculty in 2006.

Tell us how you found out you won a super star award.
I was finishing clinic and the clinic staff told me that Jag Grooms, our office administrator, wanted to talk to me about a new hire in the conference room at the end of the hall. I thought that was strange but didn’t think twice and walked into a surprise. The staff, Jag, and my administrative assistant Vanessa Mose, presented me with the award.

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?
It is a great honor to even be considered for an award that is based on the core values of Texas Children’s Hospital. I’ve been fortunate to work at one of the best children’s hospitals in the world over the past 18 years. The amazing clinical volume and the ability to attract patients from all over the United States has helped me fulfill my career goals. Although I perform the full complement of procedures of a pediatric surgeon, I focus on correcting chest wall deformities. I’ve had the privilege of treating patients from 4 different countries and ten different states. I also have the opportunity to teach medical students, residents, and fellows and this is incredibly rewarding.

What do you think makes someone at Texas Children’s a super star?
To me, a Super Star always goes the extra mile and makes sure that they excel at their craft. For me, I want to make the patient experience special. I gladly add patients to my clinical schedule so they don’t have to make a second trip to the hospital. Patients and their families are anxious and need their health care problems addressed and resolved. As a surgeon, I deal with very anxious patients and parents and it’s my job to inform them, care for them, and do my best to get them back to their usual activities.

What is your motivation for going above and beyond every day at work?
I have always had a motivation to excel at everything I do. It is an inherent motivation, but also one instilled by my parents to be the best that I can be, as well as to seek to help others. I think what helps me the most is to put myself in the shoes of those I care for – when that occurs, you almost don’t require motivation.

What is the best thing about working at Texas Children’s?
Without a doubt, I would have to say the people. No matter what their level of experience or their role, it’s clear that we all pull together and have common goals. It’s no wonder that Texas Children’s Hospital is always among the best places to work.

What does it mean to you that everyone at Texas Children’s is considered a leader? What is your leadership definition?
In my opinion, it means that everyone at Texas Children’s should strive to lead by example. The definition of a leader is someone that motivates and inspires others around them. I believe the best leaders influence the actions of others by demonstrating qualities such as compassion, patience, honesty, integrity, decision-making capabilities, good communication skills and accountability.

Anything else you want to share?
I love art and art history. I have over one hundred published medical illustrations and I enjoy oil painting. I have historically painted a canvas for our graduating fellow, although for the past two years I have created movies.

The Scoliosis Research Society (SRS) – the premier international society dedicated to the research and treatment of spinal deformities – recently honored Texas Children’s Chief of Orthopedics Dr. Brian Smith at the society’s 54th Annual Meeting, held in Montréal, Canada.

Smith received the Russell A. Hibbs Clinical Research Award, presented annually by the SRS for the meeting’s best clinical research paper. The title of the paper was “Using Proximal Humerus Ossification and Cobb Angle to Predict Progression to a Surgical Range in Adolescent Idiopathic Scoliosis Patients.”

The Hibbs Award is one of four main awards given by the SRS for basic and clinical research, and all are named for pioneers in scoliosis surgery. The SRS Program Committee selected nominees from submitted abstracts. Nominees were then invited to submit full manuscripts for review. The winners were selected based on a popular vote by meeting attendees and by committee scoring.

“I am very grateful to receive the 2019 Hibbs Award and to represent Texas Children’s Hospital in front of my peers in the SRS,” said Smith. “I would like to congratulate all my colleagues who did so much to make this happen, and I am looking forward to more research on this topic with my team at Texas Children’s.”

The paper was the result of collaborative research led by Smith and conducted with a team of experts at Yale School of Medicine. The team developed a classification system to assess skeletal maturity by analyzing proximal humerus ossification (the development of the bone of the upper arm) as seen on scoliosis patient X-rays. The study found that not only can skeletal development and maturity be reliably assessed using this system, but also that the system can be used in conjunction with other established methods to predict peak height velocity (the period when a child experiences their maximum upward growth) and the percentage of growth remaining with high accuracy. Coupled with scoliosis curve size, the system could be used as a means of predicting the risk of the patient’s potential curve progression to a surgical range during their remaining growth.

“Current systems that relied on X-ray imaging of the pelvis on scoliosis films to help determine skeletal maturation have not provided an accurate means of assessment for children with scoliosis,” Smith said. “This method has the potential to help us better define a patient’s maturity, which will help guide treatment choices and minimize cost and inconvenience of additional imaging to assess maturity.

Learn more about Texas Children’s Orthopedics Program, ranked in the top 10 nationally by U.S. News & World Report.

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.

Texas Children’s has received the 2019 “Most Wired” designation for outstanding healthcare-based technology from the College of Healthcare Information Management Executives (CHIME).

The annual Most Wired survey recognizes hospitals and health systems nationwide for information technology (IT) initiatives in the areas of infrastructure, business and administrative management, clinical quality and safety, and clinical integration. For the first time, CHIME introduced separate surveys for domestic, ambulatory and international healthcare. Texas Children’s earned Most Wired in the domestic and ambulatory surveys. We did not participate in the international survey.

“Earning Most Wired designation reflects the partnership of the Information Services team and our many clinical and operational partners at Texas Children’s,” said Myra Davis, senior vice president of Information Services. “One of our strategic goals is to leverage technology and digital platforms to revolutionize the way we provide care to our patients and manage our business enterprises.”

Texas Children’s has earned Most Wired recognition in 2013, 2014, 2016, 2017, 2018 and now in 2019. This year’s survey incorporated an improved certification system that allows participating organizations to better benchmark their level of adoption and outcomes achieved. This year, participants were certified at a level between one and 10 that represents their respective achievements, allowing organizations to clearly benchmark against a defined worldwide industry standard.

Texas Children’s achieved Most Wired Certified Level 8. Organizations certified as levels seven and eight met the criteria for being designated as Most Wired. These organizations have deployed technologies and strategies to help them analyze their data and are starting to achieve meaningful clinical and efficiency outcomes. Some of these organizations, such as Texas Children’s, are experimenting with more advanced technologies, like telehealth, that expand access to care.

Some of Texas Children’s notable IS achievements include:

Successful Epic system upgrade – IS successfully upgraded Texas Children’s Epic electronic health record. The upgrade is important because it touches users and patients throughout the organization. It provides a robust platform to support patient engagement and care team enablement to influence positive patient outcomes through quality, safety and operational efficiencies. Some highlights include:

  • Renal – EpicCare Dialysis (Nephrology) integrates outpatient dialysis treatment and therapy plan data; extracting clinical information and demographic data and submits directly to CrownWeb/CMS, provides new specialty plans of care activity for required monthly, annual and unstable reviews, and creates a ‘snappy’ new dialysis snapshot report available by default to clinicians.
  • MyChart – Texas Children’s newly redesigned patient portal has expanded functionality to include subspecialty self-scheduling, quick and easy account (instant) activation, guest bill pay, pre-appointment check-in, waitlist for sooner appointments, and the ability for patients to share the information in their MyChart accounts with other medical providers via Share Everywhere.
  • Beacon – Epic’s module to manage oncology care allows providers to create a patient’s treatment plan that carries over to every oncology appointment. Treatment plans are created from standardized protocols, which are templates that promote standardized documentation and treatment for similar diagnoses.

More Epic benefits to come – In addition to improvements and new features, the recent Epic upgrade set the stage to launch additional application features:

  • Beaker – Epic’s new pathology information module manages lab orders and results, specimen collection, workflows, testing and reporting.
  • Cupid – Epic’s new cardiovascular information module provides order entry, scheduling, procedure documentation and structured reporting for diagnostic cardiology procedures.
  • Alaris Smart Pump – A communication interface between patient IV pumps and Epic that allows staff to focus on patient care rather than manual data entry. The system also promotes patient safety by decreasing the risk of IV medication errors.
  • Tapestry Program – Implementation of Epic Tapestry, CRM and Healthy Planet modules to replace several disparate systems at Texas Children’s Health Plan in order to improve Health Plan operational efficiency and improve care of its members.

Disney Team of Heroes – IS worked with the Walt Disney Co. to ensure the installation of equipment related to the Disney Team of Heroes Program. Texas Children’s is the first hospital to work with Disney on this comprehensive new initiative that will enhance the patient and family experience at children’s hospitals across the globe through a unique combination of reimagined spaces, personalized moments and engaging content, all featuring Disney’s beloved characters and themes.

Improved access to care – IS improved the patient experience by enhancing access to care by:

  • Patient scheduling – IS partnered with clinicians, schedulers and the Epic & Revenue Cycle team to generate a questionnaire template to guide scheduling staff when making appointments. The result is a consistent process that improves the patient experience and promotes access to care.
  • Wait times – IS updated the Texas Children’s Urgent Care website to display location wait times, which allows patients to make an informed decision and potentially save time, improving patient satisfaction.

Spanish language version of MyChart – The Epic Patient Engagement team introduced a Spanish language version of the MyChart patient portal for Texas Children’s multilingual patients, families and staff.

Texas Children’s Hospital was recently honored with the 2019 Sepsis Heroes Award presented by the Sepsis Alliance at the organization’s eighth annual Sepsis Heroes gala on September 12.

Sepsis Alliance, the nation’s leading sepsis organization, recognized Texas Children’s for its continued support and instrumental efforts in raising sepsis awareness and improving treatment for sepsis – the body’s life-threatening response to infection that affects 1.7 million children and adults each year.

‘We are incredibly honored to receive this prestigious award in recognition of our efforts on sepsis quality improvement initiatives at Texas Children’s,” said Dr. Lauren Hess, director of Simulation for Pediatric Hospital Medicine. “Our continued investment in innovative processes, decision support and analytics has helped our care teams across the organization significantly improve pediatric sepsis care and outcomes.”

During the awards gala, Sepsis Alliance recognized Texas Children’s for several notable achievements, including the successful development and implementation of a pediatric sepsis algorithm to improve the timely diagnosis of sepsis. The computerized algorithm records data such as a patient’s heart rate, blood pressure, skin appearance, temperature, respiratory rate, and other risk factors like diagnosis and/or high-risk medical treatment like chemotherapy, to calculate a risk score and generate a sepsis alert.

“The algorithm automatically calculates the sepsis score each time a patient’s chart is opened or a pertinent data element is filed,” said Texas Children’s Quality Safety Specialist Terri Brown. “If the sepsis score reaches eight or higher, the score is pushed to clinicians in the form of an alert, leading to the early detection and timely care of sepsis, which significantly improves a patient’s chance of recovery.”

Click here to read an article about Texas Children’s sepsis algorithm and the collaboration that went into creating and implementing this electronic screening tool which was featured in the journal Health Affairs.

Other notable recognitions

Texas Children’s was also the recipient of a Health Catalyst award for data utilization at the 2019 HAS conference and a finalist for the clinical achievement award in recognition of our sepsis quality improvement efforts.

Since improving access to meaningful data and analytics among clinicians and staff is key to improving patient care and outcomes, Texas Children’s established the structural foundation to make this possible, and to ensure timely, accurate data drives new care interventions for the treatment of pediatric sepsis.

To obtain information necessary to drive sepsis improvements, Texas Children’s improved data collection and sharing throughout the organization. Several sepsis quality improvement milestones included:

  • Developing a pediatric sepsis analytics accelerator to monitor, improve sepsis performance. Leveraging the use of Texas Children’s Health Catalyst Analytics Platform, clinicians can use the analytics accelerator to evaluate outcome measures including the number of children with sepsis, the number of sepsis encounters, and sepsis mortality. Clinicians also use this tool to evaluate the impact of their interventions on patient outcomes and gain insight into actionable improvement opportunities.
  • Improving team structures that oversee quality improvement and analytics work related to sepsis. Enhanced workflows were implemented to facilitate escalation of concern about sepsis. Sepsis huddles became more routine following a sepsis alert to ensure staff had the latest information on the patient’s condition, and to determine if additional interventions or monitoring were required for the patient.

Click here to read a Health Catalyst article highlighting Texas Children’s data analytics efforts to reduce sepsis mortality.

Your name, title and department. How long have you worked here?
My name is Lorenzo Benavides, Social Worker, Patient and Family Services. I have worked here for two years.

Tell us how you found out you won a super star award.
I was told by my leadership that I needed to give a presentation about a Texas Children’s Hospital event that happened earlier that month. I was nervous to present about this event as it was heavy in areas that were outside of my expertise. My manager also gave me an incredibly short window to present on such a complicated issue. I ran through the first few slides and was then eventually surprised by a new slide in my presentation that read “Congrats! You won the Super Star award!” In the moment, the audience (which I then came to realize was composed by the wonderful people I work with every day) all stood up and congratulated me. It was truly an amazing and wonderful experience to say the least.

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?
It is a very humbling experience. I work with wonderful, intelligent, and compassionate people at Texas Children’s Hospital who all do amazing, wonderful work for our patients. The core values and culture of Texas Children’s Hospital have helped me become a more confident leader, team-player, and has refreshed my understanding of what providing world-class service to others looks like.

What do you think makes someone at Texas Children’s a super star?
I believe working tirelessly for others, always being open to feedback, and above-all knowing the value of collaborating with other people and disciplines, makes someone a super star.

What is your motivation for going above and beyond every day at work?
The profession of social work, by nature, is consistently involved in the most dire and vulnerable psychosocial cases. We can help one family with acquiring the most basic access to necessities, help another family address concerns and fears, advocate for a vulnerable child, and also provide comfort to another family for the loss of a different child, all in one day. I, like many other social workers, are motivated by knowing that our work is important and meaningful, and can sometimes positively change lives.

What is the best thing about working at Texas Children’s?
By far, the best thing about Texas Children’s Hospital is the culture and level of respect we all have for one another’s profession. It is such a unique and unifying feeling to be able to walk down the hall and be greeted by a friendly smile or nod from attendings, residents, nurses, care managers, directors, child life, janitorial staff, etc. It makes me feel that we are all part of a team that truly believes in doing better for our patients.

What does it mean to you that everyone at Texas Children’s is considered a leader? What is your leadership definition?
I believe that it pushes us to become better overall. My definition of leadership is to consistently find ways to improve yourself and your profession, while also finding the beauty and joy of where you currently are. I believe that that we all have room to grow and glow, and I find that everlasting mission wonderful because it keeps life fun and challenging.

Anything else you want to share?
I want to recognize the daily hard work of my fellow social workers, the nurses on 11 West Tower, the nursing leadership, the 11 West Tower care managers, child life, activity coordinator, PCAs, unit secretary, the floor’s PA-c, all the medical teams, and all the hospital directors/assistant directors that consistently work hard for our patients and families. You guys truly make work a fun and joyful place to be.

Texas Children’s Hospital was recently re-verified as a Level 1 pediatric trauma center by the American College of Surgeons and the Texas Department of State and Health Services.

During the re-verification process, the American College of Surgeons evaluated whether Texas Children’s Hospital met specific criteria. The evaluation included a lengthy and thorough questionnaire, patient care review, and an on-site visit.

The evaluation found no deficiencies and listed multiple strengths, including the excellent multidisciplinary efforts, leadership, quality improvement, and commitment to research by the hospital and its staff.

Selected comments from the reviewers are below:

  • The hospital administration’s commitment to provide the facilities and support for the trauma program is outstanding. Texas Children’s Hospital clearly demonstrates leadership in both the state and regional trauma system development. The comradery and commitment of everyone associated with the trauma program is outstanding. The Trauma Program has an outstanding trauma registry validation process. The addition of an outreach and education coordinator has markedly impacted this service in only a few years. The trauma prevention manager is a strength for the program and brings extensive experience, productivity, and energy to the program. The hospital’s collaborative efforts internally and with the other Level I pediatric trauma centers in combined prevention efforts is excellent.
  • The commitment of the Pediatric Emergency Medicine physicians to the trauma program is outstanding and there is a notable culture of cooperation, trust, and respect between the emergency medicine physicians and the trauma service.
  • The hospital has many outstanding resources including a technologically advanced Mission Control Center, an extensive child abuse program and resources, and the commitment of the trauma floor to provide dedicated trauma nurses and rooms. The commitment of the PICU physicians to the trauma program and their relationship with trauma related services is also outstanding.

The trauma center is led by Dr. Bindi Naik-Mathuria, medical director and Christi Reeves, the director of trauma services.