DRISCOLL PULSE SUMMER EDITION 2024
In this issue:
Survey Results | Maternal Fetal Medicine | Gastroenterology joins ImproveCareNow
Welcome to the Driscoll PULSE!
In this Issue
In this issue of the PULSE, Driscoll is sharing what we are doing well at : adverse drug events catheter-associated urinary tract infections central line-associated bloodstream infections (CLABSIs) falls unplanned extubations
and where we need to improve: pressure injuries surgical site infections
Mary Dale Peterson, MD
I think it is important to be transparent with our results and continuously work on zero harm. That is why we post our findings in the hallways of our patient care areas so families can see the work we are doing to ensure the safety of their children.
Executive Vice President and Chief Operating Officer Driscoll Health System
I want to thank all of you who participated in our satisfaction survey last year - we really do value your feedback and use that to improve.
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Maternal Fetal Medicine
That is where the MFM program began- we set up clinics in Corpus Christi, Victoria, Laredo, Brownsville, Harlingen, and McAllen. Our MFMs had 30,000 visits last year. Is this making a difference? You bet it is!
Now, onto one of our main stories- our Maternal Fetal Medicine program. You might ask, “Why does a children’s hospital that doesn’t deliver babies have an MFM program?” It all started when Medicaid Managed Care expanded to the Nueces Service Area in 2006 and Dr. Ernie Buck and I asked ourselves, “what is it that we need to improve?” The answer- our high preterm birth rates which was around 15.1% at the time. We didn’t know how to improve it, but that was our goal. We asked the OBs what they thought. Their answer was that pregnant women needed better education around good nutrition in pregnancy and recognizing danger signs of preterm birth. With that, we got a grant and developed educational baby showers reaching thousands of pregnant women. Over a 3-year period, we did see some improvement and learned that we needed more “wrap-around” services like mental health treatments. We also began a deep dive on our data and abstracted every delivery for a year to see how the maternal condition and care affected the infant outcomes. We shared this in 2007 with the OB leaders in our community. At the time 20% of infants went to the NICU, 30% of inductions were not medically indicated, etc. This was the first time they had seen data like that, and everyone worked together to follow the ACOG guidelines more closely. However, in further discussions, I could see there was still a gap. OBs were dealing with very complicated pregnancies, and they had no maternal fetal medicine specialists in our area to ask for help. They worried about fetal demise or severe complications in the mom. Because Driscoll Health Plan was taking on full financial risk, I recommended to the Driscoll Hospital leadership that we needed MFMs in our region to lower these complications, improving the outcomes of infants (our mission) and save dollars (less risk for the health plan).
I credit the hard work of our OBs and MFMs. Thank you for what you do every day to improve infant outcomes and safe deliveries for mothers. While we have a lot to be proud of with our limited resources, there is more work to do as we still have some of our regions in South Texas lagging. In the Nueces Service Area, the preterm birth rates are down to 9.4%. Even though our maternal population has a diabetes rate of 25%, and high rates of high blood pressure, we in South Texas (includes Nueces and Hidalgo Service Areas) have the lowest maternal mortality and severe complications (49.3/10,000) in Texas (the highest is in the Dallas region at 70.5/10,000).
Together, we can continue to make a difference!
Mary Dale Peterson, MD Executive Vice President and Chief Operating Officer Driscoll Health System
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Ensuring Excellence Driscoll Strengthens Quality Care Efforts
Driscoll Children’s Hospital has long been committed to delivering the highest quality care through a strong focus on patient safety and continuous improvement. Over the past decade, the hospital’s Quality and Patient Safety department has become a cornerstone of this mission. The department’s efforts are closely aligned with the Solutions for Patient Safety (SPS) network, a collaborative of children’s hospitals dedicated to reducing hospital-acquired conditions (HACs) and medical errors. Driscoll emphasizes the prevention of harm through thorough investigation of unintended events and strict adherence to best practices and prevention bundles. The hospital’s participation in the SPS network allows us to benchmark our own performance against other leading children’s hospitals. Notably, Driscoll is performing below the network centerline (desired direction) in critical areas such as: � Adverse Drug Events � Catheter-Associated Urinary Tract Infections � Central Line-Associated Bloodstream Infections (CLABSIs) � Falls � Unplanned Extubations
However, the hospital recognizes that continuous improvement is necessary, especially in the face of challenges posed by an influx of newer, less experienced staff. The hospital has seen an increase in certain HACs, including Pressure Injuries and Surgical Site Infections, where it is currently above the SPS centerline (undesired direction). In response, active performance improvement teams are working diligently to enhance outcomes in these areas. Driscoll’s unique Micro-team model, which embeds Quality Coordinators in clinical areas, ensures that patient care is continuously monitored and improved. Additionally, the hospital’s robust infection prevention program and recent Joint Commission accreditations, including for the new Driscoll Children’s Hospital Rio Grande Valley, underscore its commitment to excellence. The introduction of the Quality Explorers Series in 2021 further illustrates Driscoll’s dedication to fostering a culture of continuous improvement. This intensive training program equips staff service with the skills to drive quality improvement projects, resulting in tangible enhancements in care and service delivery across the hospital.
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Your Feedback is Important and Part of Our Mission!
2023 Engagement Survey Results
Engagement Survey Results Snapshot
Driscoll’s Engagement Score and Respondent Distribution
91
st
59%
Strengths
Overall, I am satisfied with the expertise of Driscoll Children’s medical staff. (Highest scoring survey item, 94% favorable) Overall, I am satisfied with the performance of Driscoll Children’s hospitalists. (Highest scoring survey item, 94% favorable) Driscoll Children’s administration is responsive to feedback from physicians. (Highest scoring vs. benchmark, +.46 above Nat’l Ref Phys Avg) Overall, I believe my patients feel highly satisfied with the care they receive from this hospital. (+.38 above Nat’l Ref Phys Avg) Driscoll treats physicians with respect. (+.38 above Nat’l Ref Phys Avg)
Percentile Rank vs. Nat’l Referring Physician Avg 2023 22% Response Rate
37%
1% 3%
Areas We’re Improving Driscoll is using the survey results to further improve areas of patient care and confidence in Driscoll. Some steps being taken include…
Driscoll’s work wouldn’t be possible without physicians who trust our commitment to high-quality pediatric healthcare.
Aggressive approaches to Society for Patient Safety (SPS) measures like extensive efforts around Central Line Associated Bloodstream Infections (CLABSI) as well as Pressure Injury Prevention, and critical review of diagnostic errors to build a better safety net. Recruitment of more Maternal Fetal Medicine specialists to adequately service the South Texas Region and build out of bed space and hiring of staff and physicians to open additional ICU beds.
Our latest engagement survey of referring physicians shows that trust is stronger than ever, with 94% of referring physicians saying they were satisfied with the expertise of Driscoll’s medical staff and the performance of the hospital. Referring physicians also believed Driscoll is responsive to their feedback, something we are extremely proud of. Referring physicians graded our responsiveness 46% above the national reference or average.
Driscoll will continue to build trust and improve off that feedback, its part of our mission!
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Care Every Step of the Way Driscoll’s Maternal Fetal Medicine Department
Maternal fetal medicine (MFM) specialists play a crucial role in ensuring the health and well-being of both mother and baby during high-risk pregnancies. These specialists are obstetricians with additional training in managing complex pregnancy conditions. Driscoll’s MFM department was established in 2008 and now consists of 6 full-time board-certified maternal fetal medicine specialists, 3 nurse practitioners and a dedicated, skilled team of registered nurses and ultrasound specialists. Together, this multidisciplinary team ensures that high-risk pregnancies are managed with the highest level of care, combining expertise, compassion, and advanced medical technology to achieve the best possible outcomes for the mothers and babies of South Texas. The department provides services at several locations in South Texas, including: Corpus Christi, Brownsville, Harlingen, Laredo, McAllen, and Victoria. The goal of Driscoll’s Maternal Fetal Medicine department is to provide state-of-the-art maternal care, fetal diagnosis and treatment for the women of South Texas. The department diagnoses and treats common maternal medical conditions, like diabetes, and helps address pregnancy complications and fetal conditions.
The map below highlights the success of working closely with the regional obstetricians in our efforts to decrease severe maternal morbidity in South Texas.
Severe Maternal Morbidity (SMM) Rates in South Texas are the LOWEST in the State
56.5
70.5
53.3
55.1
59.1
69.8
54.4
49.3
Rate of delivery hospitalizations involving SMM in Texas per 10,000 delivery hospitalizations, by public health region, 2016-2020.
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MFM Services & Conditions
Our Services NONINVASIVE TESTING Genetic screening Genetic counseling
Conditions & Complications
Fetal Conditions
Diabetes
Multiple gestations Fetal growth abnormalities Suspected fetal anomalies Fetal congenital cardiac defects Fetal abdominal wall defects
Hypertensive disorders Cardiac disease Renal disease Thyroid disease
Preconceptual counseling Detailed fetal anatomy survey
Doppler studies
Cervical length ultrasound
Antenatal testing Fetal cardiac echocardiography
Infectious diseases Preterm labor including cervical insufficiency and premature rupture of membranes
Fetal neural tube defects Fetal anemia
INVASIVE TESTING AND FETAL PROCEDURES Amniocentesis Chorionic villus sampling Fetal blood sampling
Placental abnormalities Recurrent pregnancy loss
Intrauterine infections Genetic disorders, such as Down syndrome
Intrauterine fetal transfusion
Fetal shunt placement
After a mother is referred by an obstetrician, the department evaluates and then engages in further specialty evaluations leading to advice and plans for successful management of identified problems. In the case of a complex surgical or congenital heart defect, collaboration is planned with the primary obstetrician, a pediatric surgeon or a fetal cardiology team, a transport team, and/or the pediatric cardiovascular surgery team. The team seeks to make the process as smooth as possible for the family. Regular meetings are held to discuss high-risk patients, ranging from sonograms to upcoming deliveries where infants will need immediate care. “These meetings are designed to ensure a collaborative approach for management, delivery, and postpartum care,” explained Dr. Javier Castillo, Driscoll Medical Director of Maternal Fetal Medicine. To make parents feel more comfortable and informed, families are given tours of Driscoll facilities, including the Neonatal Intensive Care Unit and Pediatric Intensive Cardiac Unit weeks in advance of the big day.
Babies with congenital heart defects receive especially watchful oversight throughout this entire process and are discussed with the heart team. “We routinely present a fetus with a new congenital defect to our maternal fetal medicine conference and develop a comprehensive plan throughout their pregnancy and delivery,” Castillo said. “After our maternal fetal medicine specialist counsels the patient, we then refer the patient to our pediatric surgical or pediatric cardiology teams for collaborative management.” With best-in-class care and a multidisciplinary approach, Driscoll’s Maternal Fetal Medicine department ensures care every step of the way for patients.
Scan QR Code To learn more about Driscoll’s MFM Department
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Meet our MFM Specialists
Dr. Javier Castillo
Dr. Violetta Lozovyy
Dr. Carlos Carreno
Dr. Anna Nutter
Dr. Franklyn Christensen
Dr. John Visintine
Locations Driscoll Maternal Fetal Medicine
Brownsville Specialty Center 5500 N. Expressway 77, Ste 201
Harlingen Specialty Center
McAllen Specialty Center 1120 East Ridge Rd, Ste 220 McAllen, TX 78503 Phone: (956) 632-8350 Fax: (361) 808-2719 Victoria Specialty Center 106 Springwood Dr., Ste 200 Victoria, TX 77904 Phone: (361) 694-6054 Fax: (361) 808-2718
802 S. Loop 499, Ste 4 Harlingen, TX 78550 Phone: (956) 421-1730 Fax: (361) 808-2720
Brownsville, TX 78526 Phone: (956) 698-8670 Fax: (361) 808-2762
Corpus Christi Bay Area Hospital 7121 SPID, Ste 118
Laredo Maternal Fetal Medicine Clinic 7210 McPherson Rd #104 Laredo, TX 78041 Phone: (956) 764-7000 Fax (956) 764-7070 | (361) 808-2138
Corpus Christi, TX 78412 Phone: (361) 694-6054 Fax: (361) 808-2718
CHRISTUS Spohn - South Hospital 5920 Saratoga Blvd, Ste 635 Corpus Christi, TX 78414 Phone: (361) 694-1590 | (361) 808-2718 Fax: (361) 651-1239
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GIHH Corner Engaging South Texas communities in healthcare research by providing access to clinical studies through strategic partnerships.
Since 2018, the Texas A&M and Driscoll Children’s Hospital Global Institute for Hispanic Health (GIHH) has been connecting researchers and clinicians, providing access to clinical trials for the South Texas community and promoting collaborative research, education, and outreach to eliminate health disparities. Our clinical trials provide families with access to cutting-edge investigational therapies in multiple pediatric subspecialties for kids with limited or no treatment options. Promoting equitable representation of Hispanic communities in clinical trials is just one way the GIHH is working to reduce disparities in health outcomes.
Mark Your Calendar & Register Now!
Study Now Enrolling New Participants Tirzepatide in Adolescents with Obesity and Weight-Related
Saturday, October 26, 2024 9:30AM - 2PM
Comorbidities (SURMOUNT-ADOLESCENTS-2). Principal Investigator: Ana Maria Paez, MD
Driscoll and Texas A&M Corpus Christi are sponsoring the 2 nd Annual Health Sciences and Technology Research Symposium on the beautiful campus of Texas A&M Corpus Christi. Join us to discover innovations in health and build bridges between academia, the community, and clinical care. Keynote Speaker: Dr. Joseph McCormick Epidemiologist & Global Health Leader
To learn more or to schedule a pre-screening appointment, interested families may contact:
Jennifer Cantu, RN | Clinical Research Nurse (361) 694-4455 | jennifer.cantu@dchstx.org
General study information: trials.lilly.com/en-US/trial/494896
Scan QR Code or Check Website for Updates
Registration deadline is October 11 th .
We are always in the process of opening new studies, both clinical trials and investigator- initiated, or grant-funded observational studies. gihh.tamu.edu/clinical-trials
Registration is FREE and CME/CNE credits will be offered. tamucc.edu/research/hstr- symposium
Poster and Case Report abstract submissions are due by September 30 th .
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Driscoll’s Gastroenterology Department Joins ImproveCareNow Network
In an exciting development for pediatric healthcare, Driscoll’s Gastroenterology department has joined the prestigious ImproveCareNow Network. This collaboration marks a significant step forward in the care and treatment of children with inflammatory bowel disease (IBD), a chronic condition that can have a profound impact on young patients and their families. About the ImproveCareNow Network ImproveCareNow is an innovative, clinician-driven network that aims to transform the health, care, and costs for all children and adolescents with IBD. By fostering a collaborative environment, the network leverages shared knowledge, data, and best practices to improve outcomes for pediatric patients. Since its inception in 2007, ImproveCareNow has grown to include over 100 participating centers across the United States and internationally, creating a powerful community of healthcare professionals dedicated to continuous improvement in IBD care.
What This Means for Driscoll Children’s Hospital Joining the ImproveCareNow Network enables Driscoll’s Gastroenterology department to access a wealth of resources and support that will enhance the quality of care provided to its patients. This includes:
Data Sharing and Analytics
Patient and Family Engagement
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3
The network’s robust data-sharing platform allows participating centers to contribute and access real-time data on patient outcomes. This data-driven approach facilitates the identification of trends, effectiveness of treatments, and areas needing improvement.
The network’s robust data-sharing platform allows participating centers to contribute and access real-time data on patient outcomes. This data-driven approach facilitates the identification of trends, effectiveness of treatments, and areas needing improvement.
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4
Collaborative Learning
Quality Improvement Initiatives
Through regular meetings, webinars, and collaborative projects, healthcare providers at Driscoll can learn from their peers nationwide. This shared learning environment encourages the adoption of best practices and innovative treatment methods.
Participation in the network involves engagement in quality improvement (QI) initiatives aimed at enhancing various aspects of patient care. This includes initiatives to reduce hospital readmissions, improve medication management, and ensure timely and accurate diagnoses.
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Meet our Gastroenterology Specialists
Dr. Valentine Enemuo
Dr. Ashok Jain
Dr. Asha Sukumaran Nair
can expect to see a series of enhancements in their care experience. From more personalized treatment plans to access to the latest research and clinical trials, the benefits of this partnership are vast and far-reaching. This collaboration exemplifies Driscoll Children’s Hospital’s commitment to excellence in pediatric healthcare and its dedication to staying at the forefront of medical advancements. By leveraging the collective expertise of the ImproveCareNow Network, Driscoll is set to make a lasting impact on the lives of children with IBD, offering hope and improved health outcomes for the future. Driscoll Gastroenterology department’s membership in the ImproveCareNow Network heralds a new era of collaboration and innovation in the treatment of pediatric IBD. This partnership underscores the hospital’s unwavering commitment to providing the highest quality of care to its patients and their families, ensuring that every child with IBD has the opportunity to lead a healthier, happier life.
The Impact on Pediatric IBD Care IBD, which includes Crohn’s disease and ulcerative colitis, affects approximately 80,000 children in the United States. The chronic nature of these conditions requires ongoing medical management and can significantly affect a child’s quality of life. By joining the ImproveCareNow Network, Driscoll Children’s Hospital Gastroenterology is poised to make substantial improvements in the care of these young patients. Dr. Valentine Enemuo, Pediatric Gastroenterologist at Driscoll Children’s Hospital, expressed his enthusiasm about this new partnership: “Joining ImproveCareNow represents a tremendous opportunity for us to elevate the standard of care for our patients with IBD. The collaborative nature of the network means we can share our experiences and learn from others, ultimately providing the best possible outcomes for our patients.” Looking Ahead As Driscoll’s Gastroenterology department integrates into the ImproveCareNow Network, patients and families
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Residents present projects at 2024 Driscoll Annual Pediatric Conference
At Driscoll’s 31 st Annual Pediatric Conference, pediatrics residents at Driscoll Children’s Hospital highlighted their scholarly work aimed at improving patient care. This included a mix of quality improvement projects, research and case reports of rare diseases. Local and regional pediatricians and allied professionals meet the resident session at the Graduate Medical Education Center during the conference, conversing with DCH faculty and residents with a high level of interaction and interest in the numerous works displayed. The session was well-received, and there are plans to continue this tradition annually to showcase the diverse and complex cases managed at Driscoll Children’s Hospital. This initiative aims to foster collaboration and knowledge-sharing among healthcare providers in the community, ultimately enhancing patient care.
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Examples of Projects
Uncovering the Layers: Diagnostic Complexity of Eosinophilic Gastroenteritis Type: Case Report Focus: Diagnostic challenges and management Outcome: Better understanding of the disease’s presentation and treatment options A Rare Case of Neonatal Marfan Syndrome with Severe Early Onset Heart Failure and Gracile Boney Dysplasia Type: Case Report Focus: Rare disease presentation and management Outcome: Insights into early diagnosis and intervention strategies More Than Just “Kissing Disease”: A Rare and Uncommon Case of Genital Ulcers (Lipschutz Ulcers) Due to EBV Type: Case Report Focus: Rare presentation of Epstein-Barr Virus (EBV) Outcome: Increased awareness and diagnostic acumen for atypical EBV manifestations
Fill The Belly: “Start High and Go Fast”
Type: Quality Improvement Project
Focus: Standardizing inpatient management of patients with Eating Disorders (ED) Outcome: Improved consistency in treatment protocols and patient outcomes Risk Stratification of High-Risk Inter-Stage Monitoring Congenital Cardiac Defects Program Type: Research Work Focus: Identifying risk factors for hospitalization and ER visits, classifying patient risk categories to improve care quality Outcome: Enhanced monitoring and tailored interventions for high-risk cardiac patients to reduce morbidity and mortality
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Let’s Collaborate!
Driscoll Children’s Hospital is an accredited sponsor of American Board Of Pediatrics Maintenance of Certification Category 4 credits. We can help you create a project, help you join an ongoing project, or take credit for ongoing efforts within your practice.
Driscoll’s New Clinics and Physicians
Driscoll is experiencing significant growth with the opening of new clinics and the addition of specialized physicians across various Texas locations. In Corpus Christi, new facilities include a cardiology clinic and the Quick Care clinic on Morgan Ave, which operates extended hours for convenient access. The expansion into Edinburg, El Paso, and McAllen brings new specialties such as pulmonology, orthopedics, urology, and endocrinology, providing children with a broader range of healthcare services closer to home. This growth not only enhances patient access to high-quality care but also strengthens Driscoll’s commitment to serving the diverse health needs of South Texas communities.
Contact
Please call Dr. Abdullah Dalabih at (361) 694-5933 to discuss your ideas and projects.
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New Clinics
Corpus Christi Pediatric Cardiology - South
Rio Grande Valley Endocrinology Jose David Gamez, MD 1120 E. Ridge Rd. McAllen, TX 78503 (956) 688-1200 Orthopedics Manish Lambat, MD 2821 Michelangelo Dr., Suite 102 Edinburg, TX 78539 (956) 362-8205 Pulmonology Roberto Paul Ayres, MD 2821 Michelangelo Dr., Suite 303 Edinburg, TX 78539 (956) 362-8275 Urology Juan Pablo Corbetta, MD 2821 Michelangelo Dr., Suite 203 Edinburg, TX 78539 (956) 632-3030 Quick Care – Edinburg 2821 Michelangelo Dr., Suite 101 Edinburg, TX 78539 (956) 632-3000
Mehrdad Salamat, MD 5802 Saratoga Blvd. Corpus Christi, TX 78414 (361) 452-4404 Quick Care - Morgan Sarona Mathware, MD 2401 Morgan Ave. Corpus Christi, TX 78405 (361) 694-1570
Youth Wellness Institute A program offering guidance and support for making healthy lifestyle changes in children and teenagers. 3533 S. Alameda St.
Sloan Building, 4th floor Corpus Christi, TX 78411 (361) 694-4986
El Paso Pediatric Cardiology - El Paso Srinivasarao Badugu, MD Rini Sahewalla, MD 1810 Murchison Dr., Suite 230 El Paso, TX 79902 (915) 275-1510
Scan QR Code
Laredo Maternal Fetal Medicine New office location 7210 McPherson Rd., Suite 104 Laredo, TX 78041 (956) 764-7000
For a full physician directory and information about how to refer a patient.
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