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Issue 12013

In Brief

Hospital granted Magnet® status for third consecutive time

Texas Children’s Hospital for the third consecutive time has been granted Magnet® status, a national designation from the American Nurses Credentialing Center (ANCC) that recognizes health care organizations for quality patient care, nursing excellence and innovations in professional nursing practice.

First recognized in 2003 and again in 2007, Texas Children’s is one of only six freestanding children’s hospitals in the nation to earn Magnet status and is one of fewer than 7 percent of United States health care organizations to hold this designation.

“This designation reflects our dedication to supporting our nursing staff with the resources and tools they need to deliver the highest level of care to our patients and their families and to continuously demonstrate leadership in initiatives that improve patient outcomes,” said Lori Armstrong, MSN, RN, senior vice president and chief nursing officer at Texas Children’s Hospital.

The Magnet Recognition Program® has become the gold standard for nursing excellence. It is achieved through a rigorous application and review process that demands widespread participation from leadership and staff and includes a site visit by Magnet appraisers. Hospitals must reapply for Magnet status every four years.

Unprecedented study demonstrates Berlin Heart device as lifesaving “bridge” for young children

A tiny heart pump that maintains blood flow in babies and small children with serious heart failure proved effective and lifesaving in a pioneering study involving 17 institutions led by Texas Children’s Hospital and Baylor College of Medicine (BCM). A report on this study appeared in the August issue of the New England Journal of Medicine.

The study looked at the safety and probable benefit of the Berlin Heart EXCOR® Pediatric Ventricular Assist Device (VAD), the only VAD available for babies and children. Patients who received the Berlin Heart lived longer on the device and were more likely to receive a transplant or recover heart function than children who were maintained on more traditional support using extracorporeal membrane oxygenation (ECMO), according to the study’s results.

“This study is now the gold standard for VAD therapies in children. Everything going forward will be compared to this,” said Charles D. Fraser, Jr., M.D., Texas Children’s surgeon-in-chief and chief of congenital heart surgery and Baylor College of Medicine professor of surgery.

Fraser and his colleagues in the United States and Canada compared the outcomes for 48 children (infants to 16 years) who received the device between 2007 and 2010 to matched patients in a national registry of patients supported by ECMO. They divided the patients who received the German-manufactured heart assist device into two groups based on their body size.

The Berlin Heart EXCOR® Pediatric VAD was approved by the U.S. Food and Drug Administration (FDA) for use in children in 2011. FDA approval allows the device to be used as a bridge to transplantation. The Berlin Heart has been used in approximately 1,000 children worldwide.

Cancer Center opens world’s first pediatric lymphoma research center

Texas Children’s Cancer Center recently opened the Fayez Sarofim Lymphoma Center, the first and only center in the world dedicated specifically to the research, care and treatment of children with lymphoma. This innovative research center was made possible by a generous gift of $10 million to Texas Children’s Hospital.

Cancer remains the leading cause of non-accidental death in children, and lymphomas are the third most common malignancy in childhood. Modern therapies to treat children with lymphomas primarily involve chemotherapy, which is occasionally supplemented with radiation treatment.

Although the outlook for children with lymphoma has generally improved in recent years, substantial challenges still exist. The launch of the new center addresses those challenges. There, researchers will conduct breakthrough laboratory investigations on the biology of lymphomas, use the information gained from laboratory and basic research to develop new diagnostic approaches, and identify novel therapeutic targets and new approaches to therapy.

“Our researchers have already developed effective cell-based therapies that have demonstrated extremely exciting clinical results, and we are also evaluating new chemotherapeutic agents with significant clinical promise,” said Catherine Bollard, MBChB, M.D., Fayez Sarofim Lymphoma Center director and Baylor College of Medicine associate professor for cell and gene therapy.

The new center will become the leading site for the development of new diagnostic and therapeutic approaches for the treatment of childhood lymphoma and the focal point for childhood lymphoma research. Advances made at the center will impact patients at Texas Children’s Cancer Center, as well as children throughout the U.S. and around the world.

Multidisciplinary effort to save babies’ hearts before birth brings families hope

The team at Texas Children’s Fetal Center, a national leader for treating fetal anomalies, has successfully completed two in utero fetal cardiac interventions to treat hypoplastic left heart syndrome (HLHS), a congenital heart defect that is one of the most complex heart defects to treat.

The first center in the Southwest to create a program to treat this defect in utero, Texas Children’s Fetal Center and Heart Center can offer this procedure to future parents looking for hope for their unborn babies with HLHS.

“Previously, patients had limited options for their babies when they received an early diagnosis of HLHS during a routine ultrasound,” said Michael A. Belfort, M.D., Texas Children’s OB/GYN-in-chief and Baylor College of Medicine Department of Obstetrics and Gynecology chair.

“From this moment on, through the collaborative work of the Fetal and Heart Centers at Texas Children’s, we can offer more options to families who otherwise would have little hope.”

HLHS occurs in approximately 1 in 6,000 live births, when the left side of the fetus’s heart does not develop normally. Because most of the structures on the left side of the heart are too small and underdeveloped (hypoplastic), it is difficult for the heart to provide enough red blood flow for the body’s needs.

All children with HLHS will undergo at least three surgeries within the first three years of life. However, if diagnosed early using a fetal ultrasound, some fetuses may be a candidate for the new in utero catheterization procedure that will help treat HLHS and allow them to be more stable at birth before having to undergo their first heart surgery.

The Fetal Center at Texas Children’s Pavilion for Women is one of only a few centers in the world capable of performing this complex fetal intervention, as it involves a coordinated effort among a large, multidisciplinary team of fetal cardiologists, OB/GYNs, interventional cardiologists, congenital heart surgeons, fetal imaging experts, maternal and fetal anesthesiologists, and other clinical specialists.

Texas Children’s Pavilion for Women commences labor and delivery services at premier facility for women’s, fetal and newborn care

Last spring, Texas Children’s Hospital announced the start of labor and delivery services at its landmark new facility, Texas Children’s Pavilion for Women.

With the opening of the new hospital, Texas Children’s has fully expanded into obstetrical and gynecological care. The 15-story, $575-million state-of-the-art hospital is staffed, designed and equipped to be among the nation’s premier centers for women’s, fetal and newborn health. The hospital can accommodate 7,000 births annually and specializes in multiple births and high-risk pregnancies.

“The Pavilion for Women provides unprecedented access to leading experts offering the latest treatments and most advanced technologies in obstetrics, gynecology, maternal fetal medicine, fetal surgery and neonatal medicine,” said Michael A. Belfort, M.D., Texas Children’s OB/GYN-in-Chief and Baylor College of Medicine Department of Obstetrics and Gynecology chair. “This is a new paradigm for children’s hospitals, but one that is sure to become a model for care across the country.”

The Pavilion is designed to facilitate the practice of family-centered maternity care, an evidenced-based care model that involves the family throughout the birthing and postpartum care process and promotes better outcomes.

Outpatient and inpatient services for women and babies at the 1.3-million-square-foot Pavilion encompass the full continuum of care, including gynecology, fertility, obstetrics, maternal fetal medicine, fetal diagnostics and imaging, minimally invasive and open fetal surgery, women’s behavioral health, labor and delivery, and newborn care. As part of Texas Children’s, the Pavilion provides patients access to pediatric subspecialists in 40 specialty areas.

Three new physicians complement pediatric surgery team, expand depth and breadth of care

The Texas Children’s Hospital division of pediatric plastic surgery recently expanded its team with three new members, making it one of the nation’s largest full-time pediatric plastic surgery teams.

Cranio-maxillofacial surgeons David Khechoyan, M.D., and Laura Monson, M.D., and craniofacial orthodontist John Wirthlin, M.D., round out the Texas Children’s team, which provides sub-specialized, multidisciplinary and individualized care of all aspects of cleft lip and palate, orthognathic surgery, craniosynostosis, craniofacial microsomia, facial clefts, resonance disorders, and pediatric facial trauma.

Khechoyan’s clinical interests include all aspects of cleft lip and palate care, craniosynostosis, craniofacial microsomia and pediatric facial trauma, and his research involves critical examination and novel 3-D imaging analysis methods of surgical outcomes in craniosynostosis surgery. Monson’s clinical interests are craniosynostosis, comprehensive cleft care, vascular anomalies and ear reconstruction, and her research focus is on improving clinical outcomes in the cleft lip and palate population. Wirthlin’s speciality areas are pre-surgical infant orthodontics, craniofacial growth patterns of patients with cleft lip and palate, distraction osteogenesis, and combined orthodontic and orthognathic treatment planning.

The three complement a team that cares for thousands of patients each year who require specialized medical and surgical treatment for a diverse set of congenital and acquired craniofacial anomalies. In addition, the team offers special expertise in the treatment of congenital nevi, vascular anomalies and general pediatric plastic surgery.