November 20, 2023

The Inpatient Rehabilitation Unit (IRU) gathered in November to cut the ribbon on their new space on 9 West Tower, adding four beds to the existing 12-bed unit on 12 West Tower. Created in 2012, the IRU provides comprehensive rehabilitation care with a family centered approach to improving functional independence and quality of life.

“The opening of these four additional beds is a milestone for us,” said Medical Director Dr. Christian Niedzwecki. “Each year, the rehabilitation needs of so many children go unserved, and today, Texas Children’s took a bold step forward in rectifying those gaps.”

Most IRU patients have acquired brain and spinal cord injuries, chronic disabilities or cerebral palsy. Thanks to a dedicated interdisciplinary team and access to a wide range of hospital services, we improve patients’ comfort and psychological well-being and provide strategies to navigate their return home.

“Expanding the IRU is a strategic initiative aimed at enhancing our capacity to provide comprehensive and high quality care, meet the growing demand for rehabilitation services and ensure patients receive the support they need for optimal recovery,” explained Assistant Clinical Director Anthony Bodnar.

“It’s truly inspiring to see our team interact with these patients, meeting them where they are and providing the level of compassion we’re known for at Texas Children’s.”

Click here to learn more about the IRU, and view the photo gallery above to see more from the ribbon-cutting event below.

August 9, 2016

81016smithvisit640On July 11, Executive Commissioner Charles Smith of the Texas Health and Human Services Commission (THHSC) met with executive leaders at Texas Children’s Hospital and toured several areas of the hospital’s medical center campus to learn more about how we strive to provide the best care to women and children in the Greater Houston community and throughout Texas.

In his new role as THHSC executive commissioner, Smith will oversee the operation of the state’s 58,000 employees across four health care agencies, including the Medicaid/CHIP division and many health care services that impact the care that children and women receive at Texas Children’s.

Dr. Mark Shen, who serves as the chairman of the Children’s Hospital Association of Texas board and is president of Dell Children’s Medical Center, along with Stacy Wilson, president of the Children’s Hospital Association of Texas, also joined the visit and highlighted the collaboration that occurs among all freestanding children’s hospitals in Texas.

Chief of Neonatology Dr. Gautham Suresh, Vice President of Nursing Judy Swanson and NICU Nursing Director Heather Cherry toured the group through the Level IV NICU where they met with several patient families and heard their touching stories. As the state of Texas undergoes its process to designate NICU levels of care, the tour allowed our subject matter experts to educate the commissioner regarding the extensive differences between a Level 1 and Level 4 NICU.

The group also met with Dr. Christian Niedzwecki, medical director of the inpatient rehabilitation unit, and Shelley Ellison, director of the Physical Medicine and Rehabilitation. During their tour of Texas Children’s Physical Medicine and Rehabilitation, the group discussed the concerns shared by physicians and patient families regarding Medicaid therapy rate cuts, which will impact this service line and the care provided to Texas Children’s patients with rehabilitation needs following a physical injury or medical condition.

April 14, 2015

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Shelley Ellison, director of Physical Medicine and Rehabilitation, was strapped inside an evacuation sled holding a doll, which represented a baby, and was evacuated from the Inpatient Rehabilitation Unit (IRU) down 12 flights of stairs and across a street to the Feigin Center for safety. It was just an exercise, but it was an exercise in preparedness.

The IRU practiced their vertical evacuation procedures to learn what it would take for the entire eight-bed unit to leave using the exit stairs in case of an emergency. This was the second time the team has taken part in this exercise that is required by the Commission on Accreditation of Rehabilitation Facilities (CARF), an international, independent, nonprofit accreditor of health and human services. The IRU received the highest level of CARF accreditation, last year. The Texas Children’s Hospital IRU is the only pediatric inpatient rehabilitation facility in the state of Texas, and one of only 31 worldwide with this accreditation.

These annual evacuation exercises, while required for CARF accreditation, are an excellent demonstration of preparedness and interdisciplinary teamwork.

“We want to demonstrate our proficiency in safely evacuating these patients who are “mobility impaired,” said Shelley Ellison, director of Physical Medicine and Rehabilitation. “The exercise goes beyond teaching us what needs to be done in an emergency; it gives our staff a sense of confidence in case they ever have to evacuate in a real scenario.”

The unit learned many lessons that are now being put into motion as they prepare for future exercises and education that is being presented to the staff.

See photographs from the evacuation drill below.

Lessons learned
Once the drill began, each “patient” in the exercise was assessed for medical stability and was paired with two staff members deemed appropriate for the level of medical complexity for the entirety of the evacuation drill. In some cases, it was determined that the patient required extra medical equipment, so a third person was added to carry the equipment and perform “in transit emergent” procedures such as suctioning. From preforming this exercise twice, the team has determined that caregivers should be pre-assigned a patient for emergency evacuation procedures each shift in preparation for an emergency.

Evacuation from the 12th floor to the first and across a street to a pre-designated evacuation point is not an easy task, even given the EvacusledsTM that are designed for this specific instance. The sleds were difficult to maneuver down the narrow stairways, leading the two member teams to switch off their positions to share the burden of the weight.

Amy Puglia with Emergency Management said while the exercise isn’t being performed in every other unit, it helps our Emergency Management department determine the system-wide needs to best prepare for an emergency that would require a vertical evacuation.

“In these exercises we are demonstrating the plan and making sure the plan works,” Puglia said. “We have evacuation plans in place and these exercises are a way for us to ensure those plans are up to date and tested.”

A team effort
It took teams from across the organization including emergency management, security services and even the Houston Fire Department to pull off this exercise.

“To make this exercise successful, it took a lot of preparation and hard work on the part of many teams,” said Dr. Christian Niedzwecki, medical director of Inpatient Rehabilitation Unit. “It really is an indication that the caregivers of this institution are dedicated to ensuring the safety of our patients in an emergency.”

“All it takes is that one time,” Ellison said. “We hope it never happens, but we want to prepare in the event that it does. Catastrophic events have happened across the country and could happen anywhere.”

For Ellison, being on the evacuation sled gave a perspective of how the patients would feel in an emergency, giving another dimension to the emergency preparations.

Evacuation Drill Photo Gallery

August 7, 2014

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On the 12th floor of West Tower, in an eight-bed rehabilitation unit, the rehab team including therapists, nurses, neuropsychologists, child life specialists and physicians,  are helping children relearn how to do those things that we all take for granted; walk, talk, stand, eat, bathe and play. It’s the daily tasks that they once knew well but after being impacted by a disease or accident, these children must relearn the basics. Just two years after opening its doors, the unit has seen 262 patients many who, with intensive rehabilitation, progressed from little or no functional independence to actively participating in their lives outside of the hospital walls.

Watch a short video explaining why we opened the unit in May of 2012

Now, the unit is celebrating a major milestone after receiving the highest level of accreditation from the Commission on Accreditation of Rehabilitation Facilities (CARF). It is the only pediatric inpatient rehabilitation facility in the state of Texas and one of only 31 worldwide with this level of accreditation. CARF international is an independent, nonprofit accreditor of health and human services.

“We built this unit with the understanding that we wanted to be leaders in the pediatric rehabilitation community and we wanted to lead in the nation,” said Dr. Christian Niedzweicki, medical director of inpatient rehabilitation. “We wanted to be a center of national prominence and CARF is the gold standard.”

The CARF accreditation means the rehab program has demonstrated significant conformance with at least 1,500 standards signifying quality care for children with multiple disabilities in the inpatient rehab setting. The CARF accreditation survey team who conducted the survey  interviewed physicians, nurses, therapists, patients and patient families as well as system-wide organizational representatives to determine the level of care and service that was being provided.. Accreditation is predicated at least in part on how well the rehab program addresses the individual needs of the patients and families.   Texas Children’s inpatient rehabilitation team creates an individualized and family centered plan of care for each patient based on their needs and levels of disability and ability. The rehab team sets daily, weekly and discharge goals unique to each child and their levels of progress. The child’s every activity from waking up in the morning and brushing their teeth, eating breakfast, attending therapy sessions, school, playing and each step until bedtime is dedicated to their recovery.

“Our team is passionate and dedicated to helping each child and their family achieve the best possible outcome,” said Shelley Ellison, director of physical medicine and rehabilitation. The team members, including the patients and their families, work collaboratively to achieve the identified goals throughout the day and night through hands-on intervention as well as ongoing progressive education to patients, families and others.

The program’s newest recognition is just the beginning of an on-going process of continuous performance and quality improvement. Niedzwecki said most programs don’t attempt accreditation until they’ve been open for at least five years. The Texas Children’s Hospital rehab unit submitted their letter of intent to be surveyed for accreditation at just 18 months.  The rehab team works collaboratively to embrace the culture of ongoing improvement while striving to be the best in the country.

“We will continue to constantly reassess the input from our patients and their families to continue improvement,” said Niedzwecki. “This accreditation means we are doing what is right for the patient and are now recognized by an international accrediting organization that helps us become a leader in the field.”

Niedzwecki and Ellison both emphasize the commitment of the entire IRU team and numerous others across the organization that made this major accomplishment a possibility.