February 16, 2016

21716WCtwitter640Texas Children’s Hospital West Campus is on Twitter @TexasChildrensWest. Follow them today to connect with the West Campus community and to receive the latest news and updates about greater Houston’s first suburban hospital designed exclusively for children.

For more information about West Campus, go to http://www.texaschildrens.org/departments/texas-childrens-hospital-west-campus.

January 26, 2016

12716telehealth640For epilepsy patients who receive primary care at The Center for Women and Children in Greenspoint, heading to their neurology appointment just got a lot easier. Instead of making the 20-mile trek to the Texas Medical Center, patients can “see” their neurologist without leaving their primary care clinic.

Texas Children’s Division of Neurology and The Center in Greenspoint recently launched Telehealth, an interactive telecommunications system that uses real-time video technology to create a communication link among the primary care physician (PCP), specialist and family during a patient visit. Implementing this new technology has enhanced access to patient care and facilitated the coordination of care for Greenspoint patients enrolled in Texas Children’s Health Plan.

“Even though our patients live in urban areas, access to care can still be challenging,” said Dr. Heidi Schwarzwald, a Texas Children’s pediatrician at The Center in Greenspoint. “The struggle getting to and navigating through the medical center could lead to missed appointments, poor medication adherence and increased emergency room visits, all of which telehealth aims to resolve.”

So, how does a telehealth visit work?

After a patient checks into the clinic, the patient is directed to a room just like any other visit except the neurologist is seen on a video screen. At the end of the visit, the PCP enters the room and performs the physical exam while the neurologist observes remotely from a telehealth room at main campus. Together, the PCP, family member and neurologist develop the care plan for the patient which is then printed out for the family. Medication adjustments and prescriptions are completed and sent to the in-house pharmacy at The Center. If lab work is needed, blood tests are drawn at the clinic and the results are both visible to the PCP and the neurologist via the shared electronic medical record. The neurologist bills for the office visit the same as any other office visit but a modifier is applied to distinguish the visit as telehealth. The PCP bills a facility fee but not an office visit.

Besides enhancing patient care access, Dr. Gary Clark, Texas Children’s chief of Neurology and Developmental Neuroscience, says Telehealth serves a much larger purpose than just visiting with a patient over the video system.

“Through Telehealth, we’re impacting patient care and improving outcomes by offering an educational and supportive environment for our patients,” Clark said. “By including an educational component in the telehealth visit, the neurologist and PCP are helping to co-educate patients on the importance of taking their seizure medication, thereby reducing unnecessary hospital admissions and emergency room visits.”

Since Texas Children’s Health Plan covers more than 390,000 lives spread throughout Harris and Jefferson counties, many of the patients do not live near the medical center, which is why The Center in Greenspoint was selected as the first launch site for the telehealth initiative.

Future plans are underway to expand the telehealth service to patient families at The Center for Children and Women Southwest, who are also members of Texas Children’s Health Plan.

December 22, 2015

122315PCICS640Intensivists, cardiologists, cardiovascular surgeons, nurses, and outcomes and quality experts from Texas Children’s Heart Center and Baylor College of Medicine served as presenters and moderators during the Pediatric Cardiac Intensive Care Society (PCICS) 11th International Meeting held December 9 through 11 in Houston.

Nearly 300 cardiovascular experts from 13 countries met during the two-day multidisciplinary, interactive conference, which includes cutting-edge research presentations and panel discussions. PCICS is an international professional forum for promoting excellence in pediatric cardiac critical care medicine. Through programs, meetings and educational curriculums, the society has a large role in vital research and training that will improve the level of care of pediatric patients with congenital heart disease and acquired cardiovascular disease.

“I’m thrilled so many of our leading Heart Center experts presented and moderated at this year’s conference in front of an international audience,” said Dr. Paul Checchia, medical director of the Cardiovascular Intensive Care Unit (CVICU) at Texas Children’s and president of the PCICS.

Checchia, who also serves as a professor of pediatrics-critical care and cardiology at Baylor, and Dr. Lara Shekerdemian, chief of critical care medicine at Texas Children’s and professor of pediatrics-critical care and cardiology at Baylor, were program directors of the meeting. The 11 Texas Children’s Heart Center experts who presented or moderated throughout the meeting include:

  • Dr. Patricia Bastero, pediatric intensive care physician at Texas Children’s and associate professor of pediatrics-critical care at Baylor, presented: Lessons Learned from Simulation: How to Keep a Safe Environment for Real Life Event Debriefings.
  • Kathleen Carberry, director of the Texas Children’s Hospital Outcomes and Impact Service, moderated: Wave the Magic Wand: What do Bedside Nurses Need to Create a Safer Culture?
  • Dr. Charles D. Fraser Jr., surgeon-in-chief and chief of congenital heart surgery at Texas Children’s and professor of surgery and chief of the division of congenital heart surgery at Baylor, moderated: The Risks We Used to Take: Panel of Innovators.
  • Trudy Leidich, director of quality and safety at Texas Children’s, presented: Reassurance vs. Criminal Charges, How Do We Handle/Talk About Errors?
  • Dr. Carlos Mery, congenital heart surgeon at Texas Children’s and assistant professor of surgery-congenital heart surgery at Baylor, presented: Congenital Heart Disease in Mexico: Building Programs and Changing Paradigms.
  • Dr. Jack Price, pediatric cardiologist at Texas Children’s and associate professor of pediatrics-cardiology at Baylor, presented: Candidate Selection: Different Views from Across the Spectrum – Medical.
  • Dr. Craig Rusin, cardiology research core, physiological signal processing and algorithm development at Texas Children’s and assistant professor of pediatrics-cardiology at Baylor, presented: Capturing Data in CVICU: When is Enough, Enough?
  • Kerry Sembera, CVICU nurse at Texas Children’s, served on the panel: Wave the Magic Wand: What do Bedside Nurses Need to Create a Safer Culture? and presented: Improving Patient Outcomes: Just in Time!
  • Shekerdemian moderated: The Future is Now: Updates on Trials and Research and present: PHN/NIH Update.
  • Dr. James Thomas, pediatric intensive care physician at Texas Children’s and professor of pediatrics-critical care at Baylor, presented: Ethics in ECMO: How to Handle Difficult Cases.
  • Dr. Eric Williams, medical director of quality at Texas Children’s and associate professor of pediatrics-critical care at Baylor, presented: Being Resilient: The Cardiac ICU as a Complex Socio-Technical System.
September 22, 2015

92315EpicRover640More than 1 million patients are harmed each year in the United States because of medical errors. One of the most common, yet preventable medical errors involves the administration of medication.

Providing medicine to patients is more than just handing out pills or delivering drugs through an IV line. It’s a complex, multi-step process that involves meticulously checking and re-verifying that the medicine being prescribed, transcribed, dispensed and administered is going to the right patient every time.

As part of our commitment to patient safety, Texas Children’s has already begun implementing Epic Rover, a mobile software application that uses barcode technology designed to prevent medication errors and improve the quality and safety of medication administration.

Epic Rover is an extension of the electronic medication administration record (MAR) within Epic. Once this software is downloaded to an iPod Touch equipped with a scanner or sled, nurses and respiratory therapists scan the barcode on the patient’s wristband and the barcode on the prescribed medication at the patient’s bedside. The medication documentation then flows real-time into the MAR in Epic.

Bar Code Medication Administration (BCMA) helps our clinical staff verify the administration of medication more efficiently by assuring that the “five rights” are confirmed – right patient, right medication, right dose, right time and right route of administration.

“Medication scanning creates a significantly safer process and improves compliance with industry standards and regulations,” said Texas Children’s Clinical Informatics Director Jennifer Sanders. “It’s a safety measure for our patients and provides an additional safety net for our frontline nurses and clinical staff who are the last line of defense to prevent medication errors.”

Before Epic Rover, our nurses and respiratory therapists manually conducted the “five rights” checks. With BCMA, the entire process is done electronically. However, clinical staff must still rely on their critical thinking and judgment to ensure medication ordered by the physician matches the medication prepared and dispensed in the pharmacy before it is administered to the patient.

To help primary users adjust to the BCMA system, the Epic Rover rollout will be implemented in phases over a 9-week period with the completion of the final rollout phase on Saturday, November 21.

Epic Rover rollout schedule:

Dates          Weeks                  Grouping
9/22/15        1 and 2         PFW, Respiratory Therapy
10/6/15        3                   West Campus: 3W, PICU, EC, PACU, 5W/SIU
10/13/15      4                   Main: All EC areas, Floats
10/20/15      5                   9WT, 10WT, 11WT, 12WT, IRU
10/27/15      6                   PRCU, BMT, 14WT
11/3/15        7                   6N, 7N, 7S
11/10/15      8                   NICU 2, NICU 4, PFW NICU
11/17/15      9                   PICU, CVICU, 15WT

Mandatory training will include a Health Stream module, an Epic video and a 90-minute hands-on classroom training session. All staff must complete training before the go-live.

“Our goal is to reach 90 percent compliance in 90 days,” said Texas Children’s Clinical Informatics Supervisor Erin Davies. “We’re confident we will reach this goal because our clinical staff is committed to creating an environment of safe patient care.”

The implementation of Epic Rover would not be possible without the collaboration from several departments including Clinical Informatics, Information Services, Pharmacy, Respiratory Care, Nursing and the Nursing Professional Development team who helped create the training curriculum.

July 21, 2015

72215HHconference640On July 11, Texas Children’s Hospital and Hope for Hypothalamic Hamartomas hosted an educational conference to empower patients and their families affected by a rare and often devastating brain condition.

Hypothalamic Hamartoma (HH) is a noncancerous tumor of the hypothalamus that causes uncontrollable seizures, early puberty, hormonal imbalances and cognitive and behavioral problems. Seizures usually begin in infancy, most often as frequent, uncontrollable laughing spells (gelastic seizure), before different types of seizures emerge.

Texas Children’s neuroscience team along with Dr. Daniel Curry, Texas Children’s director of pediatric surgical epilepsy and functional neurosurgery, and Dr. Angus Wilfong, medical director of Texas Children’s Comprehensive Epilepsy Program, helped organize the HH Family Conference which featured insightful presentations from 11 experts from across the country who specialize in the diagnosis and treatment of neurological diseases.

The conference provided valuable information about exciting research on the horizon and potential new treatments for HH patients, with the hopes of empowering families and caregivers to make educated treatment decisions for their loved ones.

Several guest speakers from Texas Children’s included Drs. Wilfong, Maria Grosch, Marcia Komlos-Kukreja, Michael Quach, Varina Wolf, and Curry, who delivered a presentation on laser ablation technology, a surgical procedure he and Wilfong helped pioneer to treat seizures in children with epilepsy and HH.

Ranked no. 2 in neurology and neurosurgery by U.S. News & World Report, Texas Children’s is the first hospital in the world to use this real-time MRI-guided thermal imaging and laser technology to destroy brain lesions that cause epilepsy and uncontrollable seizures. Unlike a craniotomy – which removes a larger area of skull bone – the MRI-guided laser probe uses a much smaller pathway through the brain to reach a lesion. This minimally invasive surgery has resulted in promising outcomes for HH patients, with 78 percent of them being able to live seizure-free.

“Several of our families have been treated by this new laser ablation surgical procedure that Drs. Curry and Wilfong have worked hard to perfect on our high-risk patients,” said Lisa Soeby, president of Hope for Hypothalamic Hamartomas. “We are thankful for their dedication and passion for what they do and look forward to partnering with Texas Children’s Hospital in the future.”

In addition to providing informative sessions, the HH Family Conference also offered opportunities for families to meet others like them, who are impacted by this rare but treatable condition.

July 7, 2015

7815RADIOLOGYREADING640It’s 9 a.m. and outside the new radiology reading room a group has gathered to talk through the day’s challenges and prepare for the day ahead. Yesterday, several patients cancelled appointments due to heavy rainfall, and today there will be more appointments than expected to make up for it. With a team there to talk through the situation and challenges, the problems are quickly resolved. Dr. Lane Donnelly, associate radiologist-in-chief, asks if the right amount of staff are here to take care of this higher demand. Next, he talks about any other concerns. One MRI machine is down, which may slow down the process, but an alternative plan has been put in place to move patients through the system as seamlessly as possible.

The morning huddle operation was brought to Texas Children’s by way of Donnelly who had devised similar processes in his previous roles at other institutions.

“It improves our coordination and ability to identify and track issues,” Donnelly said. “It builds in support by bringing everyone together to resolve issues efficiently.”

The daily readiness process takes place every morning within the Radiology Department to ensure that the hospital’s imaging services are ready for patients. Present for this meeting are radiologists, radiology nurses and techs, other support services staff, such as representatives from information services and biomed, along with leaders within the department. Each day the team discusses safety, methods, equipment, supplies and work staff adequacy. This process is made to ensure that every machine and every staff member is properly equipped and ready to handle various cases throughout the day in our diverse imaging facilities throughout the hospital and our community locations.

The huddle is also a communication vehicle to share lessons-learned and best practices.

“I think the sense of our team changes because of this new process,” Donnelly said. “The informal huddle allows for better collaboration.”

The huddles are held just outside a new ballroom style reading room built to bring together radiologists who were previously spread throughout the organization at various locations on Main Campus. Radiologist-in-Chief Dr. George Bisset said this new process is just one of the many ways this new expansion and the concentration of the radiology services have helped the team and its partners.

“The greatest thing that this new area provides is teamwork,” Bisset said. “It is also a positive move for our clinicians who can now visit our large reading room, which serves as a one-stop-shop to receive all information on imaging for their patients.”

Radiologists have better access to their leaders and to each other. Fellows and residents are given access to all areas of radiology and can be educated on rare cases when they arise, even if it’s not within the area of their current rotation.

June 30, 2015

7115shuttleupdate640Have you ever wondered if you have time to cross one more task off your to-do list before hopping on the shuttle? Better yet, have you debated whether you even have time to make the bus?

Answers to both of these questions and other shuttle-related quandaries now can be found online via your desktop or smartphone.

All six new Texas Children’s shuttles that hit the road June 29 are equipped with GPS technology, allowing riders to connect to an Internet link that will tell them where a bus is, when it’s going to arrive and how long it will be until the next stop.

You can access this information on your desktop here and on your smartphone here.

In addition to enhancing your riding experience, Director of Supply Chain Rick McFee said the GPS technology will give authorities the opportunity to monitor the shuttles’ movements and to adjust accordingly. As for now, however, all routes will stay the same.

Some additional features inside the shuttles include:

  • A comprehensive security system that will keep employees safe and will record how many people get on and off the shuttle.
  • Video capabilities will give Texas Children’s another avenue to share important information.
  • A voice announcement system will keep riders up to date about where the shuttle is and where it’s headed.
  • USB ports will be available for riders who need to charge their phone or other electronic devices.

The first thing people notice about the new shuttles is the outside of them, McFee said. All of the shuttles are painted in a bright, bold color and have a graphic design on the side. The designs are of either clouds, fish, flowers or blades of grass.

“The wraps share the excitement we all have to work for Texas Children’s Hospital,” McFee said. “They also share a bit of the spirit we have when it comes to healing sick children and taking care of women.”

A not-so-obvious feature the buses have is an environmentally-friendly fueling system. Instead of using diesel, the new shuttles are be fueled by propane. Switching to this much cleaner-burning gas will reduce our carbon footprint by 70 percent and make Texas Children’s Hospital the first hospital in the Medical Center to offer green-friendly shuttle service.

“Welcome aboard!” McFee said. “We are glad to have you on our new shuttles.”

Six additional new buses will hit the road later this summer.