The Pediatric Intensive Care Unit (PICU) at Texas Children’s Hospital West Campus is celebrating more than just its 5th anniversary this week. The unit will mark the milestone without having any hospital-acquired infections, a significant achievement for the unit’s staff and a huge win for the patients treated there.
“It’s an amazing accomplishment to have gone this long without any hospital acquired infections,” medical director of the PICU at Texas Children’s Hospital West Campus Matthew Pesek said. “Limiting hospital acquired infections is a major hospital initiative, and it’s something we take tremendous pride in achieving.”
Pesek said nurses, physicians and the leadership team all played a part in the unit’s success. The PICU care team does weekly quality rounds, along with continuous monitoring and documenting to ensure compliance with best practices and quality bundles; care tactics that significantly improve patient outcomes.
“Infection prevention is at the forefront of everything the team does,” Pesek said. “They work to ensure central lines are kept clean, and nurses work collaboratively with physicians to determine if a line is absolutely necessary.”
The PICU nurses also are trained to place ultrasound-guided IVs in patients who are difficult to access. This new technique provides nurses with easier access and reduces the number of days a patient has a central line and the patient’s exposure to possible infection.
“I am so proud of our team and what we have achieved together,” assistant clinical director of the PICU at Texas Children’s Hospital West Campus Karen Sripan said. “It feels really great to know that, since we’ve been open, not only has our team provided great care, but our patients and the community have responded positively. Our Press Ganey scores were 100 percent for our hospital rating this past month, which is validation that we are doing an outstanding job.”
Since opening five years ago, West Campus’ PICU has grown to meet the evolving needs of patients in the community and beyond. Partially funded by a generous $1 million donation from the Lauren and Lara Camillo Family Trusts, the unit opened its doors in 2014 on the second floor of the hospital with eight beds. Three years later, the unit was moved to the fourth floor of the hospital and more than doubled in size, expanding to 22 beds.
“The acuity of our practice has just changed dramatically over the course of five years,” Pesek said. “We are taking care of patients who nobody dreamed would even be within our scope. The ability to manage critically ill patients in the community, to the highest quality, is a testament to the hard work and dedication of our team.”
September 19, 2017
Since the topping out celebration of Texas Children’s Legacy Tower nearly seven month ago, significant construction milestones have been reached inside the tower’s 400-foot-tall structure at Texas Children’s Medical Center campus.
Carefully designed to promote the safest possible environment to care for our most critically ill patients and their families, construction is underway on the patient care rooms in the cardiovascular intensive care unit (CVICU), pediatric intensive care unit (PICU) and the progressive care unit (PCU). Last year, a series of patient care simulations were conducted to identify and eliminate any latent safety defects in the final design of the critical care tower before actual construction began.
Based on helpful feedback from our providers and patient families, the size of the critical care rooms inside the Legacy Tower will be between 350 to 450 square feet – three times the size of the hospital’s current ICU rooms. The rooms will feature a dedicated family space, a bathroom and shower, and care teams will have enhanced visibility and monitoring between patient rooms and into the patient rooms from the nurses’ work stations. The ICU rooms also will be equipped with state-of-the-art technology including a boom that will provide gas, power and data from the ceiling.
“Booms allow us to position the patient almost anywhere in the 360-degree circle,” said Chief of Critical Care Medicine Dr. Lara Shekerdemian. “This means that we can use some very state-of-the-art equipment for mounting all of the pumps, monitors and ventilators at the patient’s bedside while keeping the equipment off the floor.”
The Legacy Tower’s high intensity operating rooms and intraoperative state-of-the-art MRI suite also will provide dedicated subspecialty care for surgical patients.
“Our pediatric surgical patients are different than other ICU patients,” said Texas Children’s Chief of Plastic Surgery Dr. Larry Hollier. “For the first time, we’re going to have them in a setting where the care is designed specifically for that surgical patient, and that’s going to be located one floor above the operating rooms. The new tower will help us increase our OR capacity so we are not turning patients away from receiving critical care.”
The Legacy Tower will open in two phases. The first phase will occur in May 2018 when the PICU, PCU, operating rooms and Radiology open. A few months later, the Heart Center will move into the new tower in August 2018.
The 25-floor Legacy Tower will house 126 beds for pediatric and cardiovascular intensive care, six new operating rooms (ORs) with the latest technology to complement the hospital’s existing 19 ORs, and will be the new home of Texas Children’s Heart Center, including the outpatient clinic, four cardiovascular ORs and four catheterization labs. This vertical expansion will help reinvest in the programs needed to provide the highest level of care to our most critically ill patients.
“I don’t know of any other children’s hospital in the country that has the type of experience that Texas Children’s has in bringing all of these elements together,” Hollier said. “With larger, more functional spaces, we will be able to provide patients and families with the best possible environment to receive care.”
July 18, 2017
Three years ago, Texas Children’s Hospital West Campus opened an eight-bed Pediatric Intensive Care Unit thanks to a generous $1 million donation by the Lauren and Lara Camillo family. This fall, the last chunk of a $50 million capital improvement effort will expand the unit to 22 beds.
Construction on the project hit a midway point this summer and is expected to be complete in October, providing Texas Children’s West Campus and the entire Texas Children’s system with an opportunity to serve more patients and families that need our care.
Initially, 16 of the beds will be used for intensive care and six will be for acute care. Two of the intensive care beds will have negative pressure and can be used for isolation. All of the beds provide more privacy for our patients and families, as well as better visibility and workflow for our nurses and other medical staff.
Located on the fourth floor of the hospital and painted in calming pastels, the unit expansion includes two large nursing stations advanced practice provider workspace, a simulation room, nutrition room, lactation room, call room and conference space.
The patient rooms are spacious and have a private bathroom and seating/sleep area for family. The rooms are lined with windows that face outside, letting in sunlight and allowing for great views of the hospital grounds and surrounding community. The rooms also include several windows that face nursing stations and adjoining rooms, giving medical staff ample visibility at all times.
Equipment in the rooms and on the floor is robust and includes two blood gas machines for respiratory therapy and additional nurse station monitors. In the future, some of the rooms will be able to offer patients who need dialysis the capability of doing so from the comfort of their beds.
Also in the future, six of the rooms will have the ability to be converted into Neonatal Intensive Care Unit rooms. As a result, the unit will incorporate NICU design features such as a family transition room, lactation room and separate entrances to the NICU section of the unit.
“The design of this unit is extremely family friendly,” said Erica Ventura, one of three patient care managers in the PICU. “From the patient rooms to the nursing stations, everything is being constructed with the patient and the medical staff in mind.”
Karen Sripan, assistant clinical director of the PICU, agreed and said the planning and design of the PICU expansion has been going on since March 2016 and was comprehensive.
“We were very thoughtful in our design and engaged staff throughout the entire process,” Sripan said. “We also were mindful of ensuring room design consistency with the Woodlands PICU so that the layout of the rooms are familiar to staff and providers working at both campuses.
PICU Medical Director Dr. Matthew Pesek said he is very excited about the expansion and working in a space that is so geared toward patients, families and medical staff.
“Our staff will have a lot more mobility due to the large size of the patient rooms and families will have a lot more privacy,” Pesek said. “These two things alone will go a long way.”
The PICU expansion is the last project funded by a $50 million capital improvement effort that aimed at growing West Campus’ capacity and capability. To date the following projects have been completed:
Additional office and administrative support space for dedicated physicians and providers
An 18-bed expansion of the hospital’s acute care capacity, including a special isolation unit designed for children with highly contagious infectious diseases
Conversion of offices within ambulatory clinics into additional exam rooms to increase outpatient subspecialty access
A dedicated suite for Interventional Radiology service
A new 14 exam room clinic for Neurology, Renal & Dermatology
“Since the hospital opened in 2010, West Campus has continued to grow along with its surrounding communities,” said West Campus Assistant Vice President Sara Montenegro. “Texas Children’s is committed to continuing this growth and support of our patients and families in West Houston.”
February 24, 2015
During the early morning hours of February 17, Elysse Mata sat holding her babies tightly, kissing them as tears ran down her face. She was saying goodbye to her girls, conjoined for the last time before undergoing a historical surgery that would offer them their first chance at separate lives.
“We’ve been waiting for this moment for a year,” Elysse said. “Ever since we found out the twins were conjoined, we’ve been praying and hoping this day would come.”
Conjoined twins Knatalye Hope and Adeline Faith Mata – known by their family simply as Hope and Faith – were born at Texas Children’s Pavilion for Women on April 11, 2014 via Caesarean-section at 31 weeks gestation after weeks of extensive prenatal imaging, multidisciplinary consultation and planning at Texas Children’s Fetal Center. The babies each weighed 3 pounds, 7 ounces.
Surgeons allowed the girls to grow and gain strength for 10 months before undertaking the difficult task of separating them. During that time our comprehensive team of surgeons, physicians, nurses and support staff prepared for the day that had finally arrived. The lead surgeons had met and thoughtfully examined every aspect of their procedure, the simulation staff prepared the team for complications, and Critical Care nurses were readying the PICU for the girls post-surgery.
In those quiet, prayerful moments before the surgery, Elysse’s husband, John Eric, and their 5-year-old son, Azariah, were also near, kissing the girls’ foreheads and squeezing their tiny hands while they anxiously awaited the start of the surgery that would change the girls’ lives forever. A group of extended family, friends and a Texas Children’s Hospital chaplain joined the Matas for an emotional prayer.
Lead surgeon Dr. Darrell Cass entered the room, gave the family a hug, and with the help of supporting operating room staff, escorted the girls to Texas Children’s Operating Room 12. Members of the girls’ NICU care team, who had been by their sides for almost a year, lined the hallways in an emotional show of support.
Just after 7 a.m., Hope and Faith were wheeled into the operating room where a team of 12 surgeons from seven specialties, six anesthesiologists, eight highly trained nurses and support staff spent nearly 24 hours performing an operation that would eventually separate the twins.
During the first few hours of the procedure, Anesthesiologist Dr. Helana Karlberg and Surgical Nurse Audra Rushing prepped the girls for surgery. At 1:10 p.m., Chief of Plastic Surgery Dr. Larry Hollier made the first incision. For the next 18 hours, the surgical team worked in shifts to separate the twins, who shared a chest wall, pericardial sac (the lining of the heart), diaphragm, liver, intestines, bladder, uterus and pelvis.
As the surgeons continued the difficult task, family and friends gathered in a large, room praying and supporting the parents while they waited for updates from the surgical team.
“This is the (most difficult) feeling ever,” said John Eric Mata as he and Elysse waited for their first in-person update. “It’s giving me too much time to think. I’ll be a lot more comfortable when they say they are separated. I’m ready for that.”
At one point, the family was told there had been a rocky part in the procedure when the twin’s livers were being operated on. During that process, surgeons explained there was quite a bit of blood loss and that the anesthesiologists and cardiologist in the room had to keep up with that and maintain the girls’ blood pressure.
“At times it was difficult,” Hollier said. “But it was controlled very rapidly, allowing us to move on with the procedure.”
Hours later, Eric and Elysse heard the answer to months of prayers when Pediatric Surgeon Dr. Oluyinka Olutoye met them in a private consult room and delivered the good news – the twins had been successfully separated.
“This is the farthest they’ve been from each other,” Olutoye said when we greeted the family around 1 a.m. “They’re about 30 feet apart right now.”
They are two
Separate for the first time, the twins were taken to different operating rooms where surgeons continued to work on the girls’ critical organs. Just before 10 a.m., the surgery was complete, and the family visited their girls, apart for the first time in rooms next to each other in the PICU, where they are being cared for by a team of their NICU primary nurses and their new PICU nurses.
Elysse said she and her family are extremely grateful for the team that separated her babies, and the countless hours they put into understanding the girls’ condition, and how best to treat and care for them.
Cass and several of the other surgeons, including plastic surgeon Dr. Ed Buchanan, met the family in Adeline’s room to share in the family’s joy and relief. They gave the family a summary of the monumental procedure and explained what they should expect in the next few days.
“Thank you for your trust,” Cass said to the Mata family. “We are going to keep doing everything we can to get them through this. So far, so good.”
Hollier said that to the best we know this is the first time a case of this magnitude – conjoined twins connected at the chest, abdomen and pelvis – has ever been done.
“It could not have gone better,” he said. “It was phenomenal team work and great preparation on the part of the institution.”
Click on the photo to view a gallery showing the Mata’s journey to separation.
A dream realized
By late morning Wednesday, February 19, Elysse and John Eric were again with their babies, watching over their girls, now in two beds, in adjoining PICU rooms. It was a moment they had been waiting for since more than a year ago when a routine ultrasound revealed that Elysse was carrying conjoined twins. They traveled from their hometown of Lubbock to Texas Children’s Fetal Center, where the next chapter of their journey began.
Today, their family has a promising new chapter, thanks to the compassionate expertise of our physicians, nurses and countless staff and employees.
“We love them,” Elysse said of the girls’ medical team. “They mean the world to us, and they will forever hold a special place in our hearts.”
Conjoined Twins Separation Surgical Team
Plastic Surgeon Dr. Ed Buchanan
Lead Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Darrell Cass
Chief of Pediatric Gynecology Dr. Jennifer Dietrich
Pediatric Urologist Dr. Patricio Gargollo
Transplant Services Surgeon Dr. John Goss
Anesthesiologist Dr. Kalyani Govindan
Chief of Plastic Surgery Dr. Larry Hollier
Lead Anesthesiologist Dr. Helena Karlberg
Plastic Surgeon Dr. David Khechoyan
Pediatric Urologist Dr. Chester Koh
Cardiovascular Surgeon Dr. Dean McKenzie
Pediatric Surgeon and Co-Director of Texas Children’s Fetal Center Dr. Oluyinka Olutoye
Each year, around 5,000 children are admitted to the Texas Children’s Hospital Pediatric Intensive Care Units. These are the patients who require the highest level of medical care. Until just a few months ago, a portion of our admissions were children who were transferred from West Campus because of their need for a higher level of care which was not yet available in the community hospital.
In March, partially funded by a generous $1million donation from the Lauren and Lara Camillo Family Trusts, West Campus opened an eight-bed PICU to meet the evolving needs of patients in the community. The family, who’s known in West Houston for their thriving business in homebuilding, Legend Homes, made the donation to create the much-needed intensive care unit which will help care for the growing number of cases being seen at West Campus. This was the second $1million donation from the family, who also donated to the construction of West Campus, said they are giving back to the community that has helped them thrive. Only a few months after opening, Chief of Critical Care Dr. Lara Shekerdemian said it is meeting a great need that has been present for a long time. Already, there has been a steady increase of patients using the West Campus PICU with an average daily census of anywhere between five and seven and an 80 percent occupancy just a few months into opening.
“We’re delivering the right care in the right location for all of our patients who require critical care,” said Shekerdemian.
The unit is staffed by intensive care physicians and advanced practice providers who are all on Faculty at Baylor College of Medicine, Section of Critical Care. All of our caregivers, including our nurses, have experience and training at main campus PICU. Some of the West Campus PICU nurses transitioned from Main Campus and others were recruited from other intensive care units. The new positions were met with enthusiasm and there was no lack of interested individuals who were excited about working in this new setting. Shekerdemian stresses the care at West Campus is equivalent to the main campus intensive care with the same guidelines and protocols, and a highly trained team of providers. The addition of the unit will impact the ability of the West Campus facility to perform more complex surgical procedures, and to admit more patients from the Emergency Center. The unit is not only helping the great need in West Houston, it ensures that we have more space to care for the sickest children across the City.
“We have had to turn down patients at Main Campus needing our critical care services as recently as last winter before the opening of the West Campus PICU,” said Shekerdemian. “This is something that we are very uncomfortable with; we feel a moral discomfort at having to deny admission to any child that’s critically ill.”
Dr. Moushumi Sur, medical director of the West Campus PICU, said this is a situation we hope to ease this winter, with a proposed plan to increase staffing and beds.
“The number of transfers from the Emergency Center at West Campus and from other hospitals in the area to the Main Campus ICU has decreased since we opened the new PICU,” said Sur. “We’ve made an impact in terms of taking care of patients at the same level in a community setting. This is exactly what we hoped.”
Dr. Shekerdemian said while the transfers have decreased, the Main Campus PICU has not seen a major decrease in patient volumes. In fact, she said a proportion of the patients in need of intensive care at West Campus are new to the Texas Children’s Hospital system. As for the build out of the unit at West, Dr. Sur said it’s a breath of fresh air.
“There is more natural light in the unit which helps overall morale not only for our staff but for the patients and their families,” said Sur. “The visibility is also improved and enhanced. The ability for the nurses to have their eyes on their patients even when they’re outside the room is extremely important.”
With an already busy West Campus PICU, the critical care team is planning for the future. Sur is on a committee for The Woodlands Campus to plan an intensive care unit, making sure the facility is built to support the opening of a PICU within the first few months of the campus’ opening.
February 18, 2014
A new eight-bed Pediatric Intensive Care Unit at West Campus is now open. The unit will allow the hospital to accommodate patients with higher acuity and meet the needs of the community. The PICU will be staffed 24/7 with experience, board-certified critical care physicians, PICU nurses and support staff.
“We want to provide a higher level of care here at West Campus after seeing the needs of the community,” said Shannon McCord, director of West Campus Patient Care Services. “This allows even more patients to receive their care closer to home.”
West Campus is now able to care for patients with conditions including but not limited to:
And neonates (<30 days) diagnosed with:
Patients in need of care that is outside of the scope of care for West Campus will still be transported to Main, but this new expansion will impact the ability of the West Campus facility to do more surgical procedures and admit more patients from the Emergency Center who before were triaged to Main Campus.