October 7, 2019

Every year from October 6 to 12, the American Academy of Physician Assistants (PAs) honors the 50-plus-year history of the PA profession, and the immeasurable contributions to health care made by PAs during that time, with a week-long celebration – National PA Week.

Texas Children’s will again be celebrating amazing PAs across the system with events and festivities throughout the week. These include:

Tuesday, October 8

  • Taco Tuesday at each of our three Texas Children’s Hospital campuses

Wednesday, October 9

  • West Campus main lobby: Poster display, games, crafts, and a chance to meet and thank PAs
  • Texas Medical Center campus, Pavilion for Women 4th-floor conference rooms: “Get It Poppin’” Snack Break

Thursday, October 10

  • Texas Medical Center campus, Auxiliary Bridge: Poster displays, games, crafts and photos

Friday, October 11

  • The Woodlands main lobby: Poster displays, games, crafts, and a chance to meet and thank PAs
Helping lead the way in health care

Over the past half century, health care delivery has changed dramatically, with emphasis no longer solely placed on the expertise of a doctor, but rather on a team of caregivers. And because of the rising demand for health care, combined with the ongoing shortage of physicians in the United States, advanced practice providers (APPs) – PAs and nurse practitioners – have become major, even indispensable, players on that team.

APPs work in most areas of medicine, from primary care, to the emergency room, to surgical subspecialties. While they do not replace a physician, they work collaboratively on the care team and perform many of the duties a doctor might, including performing minor procedures, providing routine diagnoses, delivering health care education, assisting in the operating room and writing prescriptions.

“Because of the high demand for health care, it is widely accepted that much of that work couldn’t be accomplished without the partnership of PAs and nurse practitioners,” said Veronica Victorian, assistant director of Quality and Safety. “The collaborative relationship with the physician, and the increased opportunities and diverse responsibilities, also often mean a more autonomous role for PAs, in both the clinic and surgical settings.”

It’s then perhaps unsurprising that there has been a proliferation of APPs across the Texas Children’s system over the past few years.

“When I arrived at Texas Children’s in 2011, we had fewer than five PAs,” said Ryan Krasnosky, director of APPs at Texas Children’s. “The Department of Surgery alone now has more than 130 PAs.”

In fact, surgical PAs currently outnumber surgeons at Texas Children’s, an intentional part of the department’s strategy for growth. The Department of Surgery, moreover, is an excellent example of how PAs have added immense value that has led to improved patient access and the development of several key initiatives.

“There is no way that the Department Surgery can hire enough surgeons to keep up with the clinical demand of our rapidly growing city,” said Texas Children’s Surgeon-in-Chief Dr. Larry Hollier. “No one comes close to our surgical volume – 40,000 surgeries a year across every possible subspecialty. We rely on our PA partners to provide access at all of our locations throughout Greater Houston, so that patients and their families can be seen wherever and whenever they need help.”

PAs, along with nurse practitioners, have also proven to be key administrative leaders for the Department of Surgery, driving several critical initiatives around safety and quality, and have also been at the forefront of efforts to expand access to care in Houston, in Texas and across the southeastern United States.

“Saturday clinics, remote appointments via telemedicine and after-hours clinics have all largely been accomplished thanks to APPs, and we feel like we’re only scratching the surface,” said Kris Marsack, director of Surgical APPs.

Training the next generation of leaders

As the PA profession has evolved, so has the way Texas Children’s trains providers. One example is the Surgery Physician Assistant Fellowship, which was created in 2013 and was the first of its kind in the country.

You can watch this video to learn more about the fellowship.

“Pediatric surgery is not covered in most PA schools,” said Hollier. “We thought it would be a wonderful opportunity to take PA graduates and expose them to the broad diversity of pediatric surgery that exists here.”

During the intensive one-year program, fellows are fully immersed in the culture at Texas Children’s as they rotate through each surgical subspecialty service, including:

  • Congential heart
  • General pediatrics
  • Hand/microsurgery
  • Neuro
  • Ophthalmology
  • Orthopedic
  • Oto
  • Plastic/reconstructive
  • Surgical ICU
  • Surgical hospitalist
  • Trauma
  • Urology

The program also includes dedicated research time and suture, cadaver, and simulation labs. Training is provided in clinics, on the surgical floors and in the operating room, and involve pre-, intra- and post-operative care. Fellows can also participate in and help lead several community service initiatives, including the Family Fun Runs at Texas Children’s Hospital campuses in The Woodlands and Katy, the annual APP backpack drive.

Since its inception, the fellowship has grown to include eight providers, and is a valuable pipeline for talent and a unique training opportunity for providers who want to join the Department of Surgery team at Texas Children’s.

“We aim to retain every fellow and we are thrilled to see the number of applicants rise each year,” said Jackie Broda, PA-C and clinical lead of PA Fellowships.

Learn more about the Surgery Physician Assistant Fellowship.

September 30, 2019

Texas Children’s Hospital has announced the two new leaders of the Adult Congenital Heart Disease (ACHD) Program at Texas Children’s Heart Center® – esteemed cardiologist, Dr. Peter Ermis, as medical director and Dr. Edward Hickey, a recognized cardiovascular surgeon, as surgical director. Beginning on October 1, they will together guide the largest ACHD program in the state.

Texas Children’s is ranked No. 1 in the nation for pediatric cardiology and heart surgery by U.S. News & World Report, but for years the hospital has also offered expert care for adults with congenital heart disease. Texas Children’s ACHD Program allows patients with congenital heart disease to receive seamless continuity of care from birth throughout adulthood. As pediatric patients with congenital heart defects transition into adulthood, the program’s multidisciplinary team of experienced congenital heart disease specialists advises them on health and lifestyle choices for their adult needs, including physical challenges, exercise options and family planning. The program offers comprehensive medical and surgical care in collaboration with colleagues at Texas Children’s Pavilion for Women® and Texas Children’s Fetal Center®. The hospital’s ACHD Program is accredited by the Adult Congenital Heart Association (ACHA) and is one of only three accredited programs in Texas.

Ermis, a native Houstonian and dedicated member of Texas Children’s ACHD Program team since 2014, also serves as assistant professor at Baylor College of Medicine, Texas Children’s academic partner.

“I’m honored to take on a leadership role in the program where I began my cardiology career,” said Ermis. “As this population of patients grows, it is even more important they are cared for by congenital heart disease specialists who recognize their specific needs as they transition to and live through adulthood. Our team is revolutionizing the way we care for these patients, and I look forward to continuing to do so in partnership with Dr. Hickey.”

Ermis received his undergraduate degree at Rice University. He earned his medical degree from the University of Texas Health Science Center at San Antonio, and went on to complete his residency and pediatric and adult cardiology fellowship at Baylor. He is board certified in pediatric cardiology, adult cardiology and adult congenital heart disease. Ermis is a fellow in the American College of Cardiology and a member of the American Academy of Pediatrics, Texas Heart Institute Cardiac Society and the International Society on Adult Congenital Heart Disease.

Hickey, a proven leader in cardiovascular surgery, most recently served as associate professor of cardiac surgery at the University of Toronto and cardiac surgeon and chief of the ACHD program at The Hospital for Sick Children. In addition to his leadership role, he will also perform congenital heart surgeries and serve as associate professor of surgery at Baylor.

“I’m thrilled to join Texas Children’s and lead the ACHD Program alongside Dr. Ermis,” said Hickey. “Treating these unique patients requires dedication from an entire team, and it is evident Texas Children’s is paving the way in this field. I’m looking forward to joining this innovative and collaborative group as we continue to develop tailored approaches for our patients.”

Hickey received a Bachelor of Medicine degree from the University of Southampton in the U.K., where he also completed his general surgery residency. He went on to complete higher surgical training in cardiothoracic surgery and simultaneously earned his Doctorate of Medicine research thesis from Oregon Health & Science University and the University of Southampton, respectively. Later, he received the John Kirklin Fellowship from the Congenital Heart Surgeons’ Society, University of Toronto and spent two years at The Hospital for Sick Children in Toronto. He then pursued residency training in Cardiovascular Surgery at the University of Toronto, followed by a clinical fellowship in congenital heart surgery.

Learn more about Texas Children’s ACHD Program.

August 20, 2019

Back-to-school is a time full of anticipation as students get ready to learn new things and make new friends. However, it can also be a time of stress and anxiety for families who can’t afford back-to-school supplies.

To help ensure Houston-area students have the materials they need to start the year successfully, advanced practice providers (APPs) in the Department of Surgery APP Community Outreach Committee collected more than 50 backpacks filled with school supplies from across the three Texas Children’s Hospital campuses. The backpacks were donated at YMCA of Greater Houston locations and The Woodlands Family YMCA at Branch Crossing as part of YMCA Operation Backpack.

This was the fourth year APPs participated in the backpack drive, one of two major charitable initiatives held by the committee each year in which APPs from all Texas Children’s Hospital locations join forces for a common cause – to give back to the community. The other larger annual initiative is a food collection drive in January that benefits Houston Food Bank and Montgomery County Food Bank.

“Each campus participates in numerous events throughout the year, but we wanted to find a couple of opportunities to give back during the year when everyone can be involved,” said Jackie Broda, PA-C in Pediatric Urology and Clinical Lead of the Community Outreach Committee. “Going back to school is obviously a big thing for all our patients. So the backpack drive allows us to help kids get started back to school on the right foot.”

Supplies for each donation included:

  • 1 new backpack
  • 1 package of pens
  • 1 package of #2 pencils
  • 1 pencil sharpener
  • 1 eraser
  • 1 24-pack of crayons or 8-pack of markers or colored pencils
  • 1 package ruled loose leaf 8.5 x 11 paper (wide ruled)
  • 1 12” ruler
  • 1 pair of child safety scissors
  • 2 pocket folders
  • 2 spiral notebooks (100 sheets each)
  • 1 glue bottle or glue stick
  • 1 composition notebook

The backpack drive and food drive are just a part of the busy annual calendar of charitable initiatives and community events that APPs take part in every year at each Texas Children’s Hospital campus. Committee members take an active role in organizing and also volunteer at these events, which include the annual Family Fun Runs, Camp For All 2 U, Teddy Bear Clinics and many, many more – and all in addition to the amazing care and support they provide for patients and families every day.

“It’s a source of pride that everyone comes together for these incredible causes, but it’s awe-inspiring how much everyone is willing to give back on top of all the amazing work they do helping our patients,” Broda said.

Department of Surgery APP Community Outreach Committee 2019 Backpack Drive

Clinical Lead: Jackie Guarino Broda, PA-C

Texas Children’s Hospital – Texas Medical Center campus
Lead: Marielle Faraone, PA-C
Co-project Leaders: Marielle Faraone, PA-C and Madison Fitzgerald, PA-C
Donated: 14 backpacks

Texas Children’s Hospital West Campus
Lead and Project Leader: Anna Shafer, PA-C
Donated: 12 backpacks

Texas Children’s Hospital The Woodlands
Lead: Stephanie McGee, PA-C
Co-project Leaders: Alaina Dozar, NP and Jill Goeltz, PA-C
Donated: 28 backpacks

June 24, 2019

After nearly 30 years at Texas Children’s, Xavier George is just as devoted to patient care as he was when he first stepped foot in the hospital. As a patient care assistant (PCA) George is the first person to see the patients in the post anesthesia care unit (PACU) at the Medical Center Campus. The majority of his time at Texas Children’s he has been the comforting part of the patient’s experience, easing any apprehensions they may have before procedures.

“It’s so fantastic to work for Texas Children’s,” George said. “All of my hard worker and the reasons that I continue to come to work, day after day and year after year, is for the children.”

George’s compassion and experience with the children helps decrease anxiety of the parents and guardians as well.

“We have been coming here for two years now and every time we come, Xavier is kind, compassionate, friendly, and upbeat,” the parent of a patient said. “I cannot say enough nice things about him, he’s so great!”

George has the ability to work in many roles in PACU. He is able to work the waiting room and pre-op and PACU secretary. His flexibility makes it so much easier for everyone on the department to do their job.

“Xavier demonstrates teamwork and compassion towards coworker’s on a daily basis,” Perioperative Nursing Manager Beth Jones said. “He works well with the pre-op team to ensure positive experience for our patients. He steps in wherever he is needed to ensure a positive work environment. He will do all of this with a positive attitude. It is great having him on my team.”

May 28, 2019

Whether it is ensuring that families are well informed and comfortable, or walking into a room with enthusiasm willing to help her co-workers when necessary, at the crack of dawn in the Surgery Department at The Woodlands campus, patients and employees count on Jennifer Grubbs to make their day.

Grubbs started her journey here at Texas Children’s in 2015, in the Emergency Center at Texas Children’s West Campus, and then moved to The Woodlands just in time for the hospital’s opening as a Post Anesthesia Care Unit (PACU) charge nurse. She later moved into her current role as the Patient and Family Liaison nurse that requires her to be knowledgeable, compassionate, and have the ability to communicate effectively. Grubbs exemplifies these characteristics daily which is why she was nominated by for the Caught You Caring (CYC) award by her leaders.

“She is so straight forward and concise when giving parents information about the surgery process, while also maintaining a profound sense of compassion and courtesy for their child,” Nursing Manager of Perioperative Services, Betty Smith said. “Her passion for her job is palpable and I have no doubt she will continue to provide amazing, well-rounded care to patients and families in day surgery.”

Grubbs’ flexibility to charge in the PACU, work in pre-op, or even work in the PACU as a nurse when needed on top of her duties as Patient and Family Liaison., shows her commitment to the department as well as our patients. She also serves as the chair of her unit’s Patient Experience committee.

“I really enjoy the patient experience role that I have,” Grubbs said. “I love working at Texas Children’s as a whole. There are so many opportunities for growth and the support by management here is immeasurable. Everyone is open to communication, there’s honest feedback, and it feels like a family, especially working in a community setting.”

Smith recalled a time when a PACU patient had a prescription for a medication that their local pharmacy could not fill, and Jennifer took the initiative to call several locations in the area repeatedly until she was able to find a pharmacy that carried the prescription. Something that may seem small to one person ultimately removed an immense amount of stress off of the patient’s parent. This particular occurrence is an example of her willingness to go above and beyond.

“However she can assist patients, she does,” Smith said. “Often as I prepare patients for surgery I hear her clarifying any misconceptions, addressing any fears, and comforting them every step of the way. That amongst many other things is why she is so deserving of this award.”

Grubbs’ sense of urgency that she has gained in the emergency room, combined with her compassion and patience from her PACU experience, allows her to be able to communicate with all family’s that walk in to any surgery situation.

“I am honored to be recognized for what I do every day,” Grubbs said. “It’s what I love to do, just connect with families and try to ease any anxieties they may have, and make a positive impact with every encounter I can have.”

The latest in cutting-edge research from across Texas Children’s Department of Surgery was recently on display at the 10th annual Edmond T. Gonzales, Jr. Surgical Research Day. The event is an important forum for surgical faculty, post-graduate trainees, nursing personnel and operating room staff to showcase their academic efforts in an encouraging environment.

More than 120 abstracts covering a broad spectrum of research topics, from basic science to clinical and outcomes research, were submitted for consideration. Of those, 14 were chosen for oral presentation.

The day kicked off with a keynote address from Dr. Adil Haider, Dean of Aga Khan University Medical College in Karachi, Pakistan and formerly of Johns Hopkins University and the Boston-based Center for Surgery and Public Health, a joint initiative between Harvard University and the Brigham and Women’s Hospital. He is regarded as one of the foremost experts on healthcare inequities in the United States, with projects focused on describing and mitigating unequal outcomes based on gender, race, sexual orientation, ethnicity, age and socioeconomic status. Dr. Haider spoke to the audience about his groundbreaking work in trauma disparities research, a field that he has helped establish by uncovering racial disparities after traumatic injury.

2019 Awards

Dr. Emily Steen was awarded the 2019 Samuel Stal Research Award. Over the past two years, Dr. Steen has been conducting basic science research in the Laboratory for Regenerative Tissue Repair under Dr. Sundeep Keswani, surgical director of basic science research at Texas Children’s Hospital. Dr. Steen’s work has focused on pediatric and fetal surgery, wound healing and fibrosis.

Texas Children’s Chief of Plastic Surgery Dr. Edward Buchanan received the 2019 Research Mentor Award. He was nominated by Dr. Kelly Schultz, a recent Baylor College of Medicine graduate.

“In addition to showing unparalleled commitment to his patients, Dr. Buchanan has been a strong mentor, sponsor and role model in clinical research throughout the entirety of my and many other students’ and residents’ medical careers,” said Schultz. “I’m grateful for the many hours Dr. Buchanan spent discussing research projects and imparting knowledge that would eventually pay off in the research I accomplished during medical school.”

Additionally, Dr. Yangyang Yu from Pediatric Surgery received the award for Best Poster, titled “Cost-Effectiveness Analysis of the Surgical Management of Infants Under 1 Year of Age with Feeding Difficulties.” And Dr. Candace Style won the award for Best Oral Presentation, titled “Citrulline Effectively Reduces the Rate and Severity of Necrotizing Enterocolitis Compared to Hydrogen Sulfide in the Premature Piglet Model.”

The event’s grand finale was the announcement of the 2019 Clayton Awards. This grant program, funded by the Department of Surgery, allows surgery researchers to generate the preliminary data necessary for National Institutes of Health (NIH) grant applications and other extramural funding. The recipients were:

Dr. Yi-Chun Liu, Otolaryngology
Evaluation of the benefit of bone conduction hearing device in children with unilateral congenital aural atresia

Michelle Roy, PA-C, Plastic Surgery
Cleft care instructional videos and their efficacy in postoperative outcomes

Dr. Guillermo Aldave, Neurosurgery
Pilot study of oncolytic adenovirus DNX-2401 for recurrent pediatric high grade tumors

Dr. Sarah Woodfield, Surgery
Profiling and modeling extracranial malignant rhabdoid tumors

May 14, 2019

The stars were out and all-smiles at the Smile Train 20th Anniversary Gala on May 2 in New York City.

The event, sponsored in part by Texas Children’s Hospital, honored the memory of Smile Train founder Charles B. Wang and served as the launch for a year of celebrations of impact across the globe. It featured a performance by Alexa Ray Joel and appearances by many special guests, including NBA legend, former Houston Rocket and Smile Train partner, Dikembe Mutumbo.

Smile Train also recognized three exceptional honorees for their support of the organization and its mission. These were Graham Elliot, the award-winning chef, restaurateur and television personality; Paula Shugart, President of The Miss Universe Organization; and the Chairman of Smile Train’s Medical Advisory Board, Texas Children’s Surgeon-in-Chief Dr. Larry Hollier.

“I would like to thank Charles Wang for the confidence he placed in me by naming me chair of the Medical Advisory Board,” Hollier said in his remarks. “It has been one of the biggest honors of my professional life.”

Smile Train is an international children’s charity and the largest surgical non-governmental organization in the world. Through its sustainable model, Smile Train empowers local medical professionals with training, funding and resources to provide free cleft lip and palate surgery and comprehensive care to children around the world.

A cleft occurs when certain body parts and structures do not fuse together during fetal development. Clefts can involve the lip and/or the roof of the mouth, which is made up of both hard and soft palate. If left untreated, the conditions can cause children to have difficulty eating, breathing, hearing and speaking. Many children with clefts live in isolation, and too many will never receive the reconstructive surgery they need.

Smile Train supervises the quality and safety of surgery on approximately 130,000 children every year and has provided surgery for approximately 1.6 million children in 85 countries over the past 20 years.

Cleft lip and palate care at Texas Children’s

Cleft repair surgery is safe, and the transformation is immediate. Texas Children’s Hospital specializes in the comprehensive care of patients born with these conditions at our Cleft Lip and Palate Clinic. Our multidisciplinary team has over 40 years of experience treating these particular issues, and each patient’s care is tailored to their specific needs.

The team consists of:

  • Pediatrician
  • Plastic surgeon
  • Pediatric dentist
  • Craniofacial orthodontist
  • Otolaryngologist or ear, nose and throat specialist (ENT)
  • Speech pathologist
  • Audiologist
  • Craniofacial nurse
  • Genetic counselor
  • Social worker
  • Nutritionist

Hear more about Texas Children’s world-class cleft lip and palate care from Chief of Plastic Surgery Dr. Edward Buchanan in this month’s featured “Medically Speaking” episode on Connect.