Compassionate Care During a Difficult Time

Texas Health Fort Worth's Palliative Care Unit appeared in this week's Fort Worth Star-Telegram. The article focused on patient Lela Adams, a vivacious 80-year-old, who has lived her life to the fullest. She was recently diagnosed with a life-limiting illness and was among the first few patients in our palliative care unit.

Below is a link to the article for you to read more.

Palliative Care Article in Star-Telegram

Photo Credit: Ron T. Ennis and the Star-Telegram

Standing Down

All 20 patients are in good condition and three patients from this incidence have been treated and release.

We have received notification from the scene that we will not be receiving any more patients from the gas leak incident.

Continue to follow www.texashealthfortworth.blogspot daily for your latest health news and updates.

Update on Gas Smell

We now have 20 patients who are being triaged. We are preparing to receive more, although we have not received any notification that there will be more patients.

This is a good time to let you all know how Texas Health Fort Worth prepare for incidences like this. We perform disaster drills quarterly and use incidences like today to prepare and perfect our disaster plan.

Stay tuned for more information...

Gas Smell in Fort Worth

Many of you have heard that there has been a gas leak in Fort Worth.

At this time, we have received 3 patients from this incident. I will continue to update this as we receive more information.

Stay tuned for more.

The Electronic Age of Medicine

Last month I told you a little bit about myself and deferred talking about The Electronic Health Record because one of our employees had discussed it in an earlier entry. I thought now would be a good time to elaborate on it. Paul Palermo had discussed how hard it was to deploy this complex project and gave an example of how it helped one emergency room patient. I wanted to discuss a little more about our electronics in the hospital.

The structure of CareConnect (Electronic Health Record) facilitates the reliable retrieval of data. Its nature enables all the providers to access and review the notes of all the care givers. The entries of physicians, nurses, social workers, therapists, pharmacists, and others are all readily available and legible allowing a true team approach to the patient’s care. This information is readily available no matter where you are in the hospital. Additionally providers can access it remotely, thus a nurse’s phone call to a doctor allows that doctor to review the patient’s information while talking to the nurse. This greatly enhances the interchange. The physician can then enter any orders necessary and helps reduce possibility of an error caused by a verbal order.

As mentioned before CareConnect enables health care professionals to see the entire medical record of our patients, that is not only the data on the present admission, but the records of previous encounters. Thus we have an excellent baseline of the past medical history. We also are able to see encounters from other Texas Health Hospitals. This is a great advantage when patients are transferred from our sister facilities. The care of the patient can be seamless, and in fact the team can anticipate what will be needed before the patient physically arrives.

Because other hospitals in the area such as Parkland are Epic users soon we will be able to access the patient records from those encounters as well, thus minimizing the loss of information when patients utilize different facilities.. We are a participant in a Health Information Exchange in Fort Worth called SandLot. This allows us to see patient data, with their permission, from their doctor’s office. This too greatly enhances the flow of information and makes for more timely and efficient health care.

As we continue to use these products we will become more adept with them and will find more and more uses for the information within them, thereby enhancing the care of our patients.

- Harold Berenzweig, MD

The Steece Quads Flying High Above the Metroplex

Many of you know or may follow Suzanne Steece's blog. She is the "quad mom" who delivered at our hospital almost two years ago. Well, her family was chosen to be in our latest ad campaign. For those of you who do not know her story, here is a snapshot of her pregnancy and delivery.

Suzanne and her husband, Joe, prayed for one child - but were blessed with four! They struggled to conceive and took one round of clomid (a fertility medication) and got pregnant with quads. This was the shock of their life.

Suzanne is a nurse and knew that she had to find the hospital and physician that specialized in high-risk deliveries. After all, "things can happen in an instant" with pregnancy. So Suzanne and her husband decided to find a place that they trusted to deliver their babies - they chose Texas Health Fort Worth and Dr. Bannie Tabor to deliver their babies.

Suzanne carried her babies until she was 30 weeks pregnant - which is absolutely phenomenal! August of 2007 - the Steece quads made their grand entry into this world. They spent several weeks in our Level III neonatal ICU, and went home one at a time.

Phase II of the Steece Quad ad campaign is coming soon - so keep your eyes peeled for more...

Through the Eyes of an Administrative Resident

It’s been approximately 2 months since I put on the Texas Health Harris Methodist Hospital Fort Worth badge. I have previously introduced myself as one of two residents here at THFW, and will continue to try and bring a broad perspective to the blog. For those unfamiliar with a healthcare administrative residency, it’s a year long process to dive deeply into the facility and system. Administrative residencies and fellowships are offered across the United States by hospitals and healthcare systems alike. Basic requirements typically include completion of the didactic portion of a Masters in Healthcare Administration, Health Services Administration, or Business. The remaining requirements vary.
The objective is to allow recent graduates to broaden their perspective of healthcare and develop a better understanding for the variety of roles and responsibilities. Texas Health Resources believes education is highly important and structures their process on a two year continuum. The first year allows the resident to “get their hands dirty” and actively participate in various departments and roles, generally at either Texas Health Dallas or Texas Health Fort Worth hospitals. As the rotations occur, small projects are performed to grasp both the clinical and administrative requirements to ensure quality health care occurs. The fellowship is for individuals who have completed in exemplary fashion their administrative residency. It is designed with an intense focus on projects to help fellows gain experience specific to their areas of interest and identify future career options. Fellows are usually placed in our mid-sized hospitals such as Texas Health Plano or Southwest.

I have completed several rotations including radiology, cardiology, engineering and transportation. As I continue my residency and complete rotations, I hope to be considered for a fellowship and will begin to think of a potential projects that will utilize not only the knowledge I have gained but the relationships built from an extraordinary opportunity to work hand in hand with the THR family. For more information about the residency/fellowship programs, please see the “Administrative Fellowship Program” page in the jobs section of http://www.texashealth.org/.

- Melissa

Have Heart Failure? Read On...

Recently the Center for Medicare and Medicaid Services released its comparison of readmission rates for patients suffering from pneumonia, congestive heart failure, or a myocardial infarction (heart attack). Texas Health Harris Methodist Hospital Fort Worth was deemed “better than the national rate” for re-admissions for patients with Heart Failure.

You can review any hospital’s results across a number of clinical indicators at http://www.hospitalcompare.hhs.gov/. This same website also will show the results of patient surveys that consider the environment of the hospital as well as how the needs of the patients are met. The clinical indicators and the comfort indicators, when taken together, allow someone who is not familiar with hospital settings to compare hospitals and hopefully result in informed decisions concerning future hospital choices.

The readmission rates for Heart Failure are based on many variables that begin with the initial management of the patient in the Emergency Department, and do not end until the patient is discharged to a stable environment with an appropriate plan that covers, among other things: diet, exercise, medications, physician followup, and general information about congestive heart failure. It takes a complete team of health care workers, from the physician to the dietitian to ensure that once a patient is well enough to go home, they don’t suffer a relapse and find themselves back in our hospital.

Hats off to the medical and hospital staff of Texas Health Harris Methodist Hospital Fort Worth! Great job!

- Joe Prosser, M.D. , Chief Quality Officer

A Warm Bright Smile

It is Hugh Gittens, lead chef at Texas Health Fort Worth, again. I wanted to share a story that has inspired me - and I hope it will inspire you.
In 1984 Mr. Tekle & Mrs. Kudusan Hagos arrived in Fort Worth, Texas from Eretria, East Africa; where Mr. Hagos was a pharmacist. Immediately after arriving Mr. Hagos began life here in Fort Worth working at Kentucky Fried Chicken while attending UTA, earning a degree in biochemistry and later on computer science. They instilled their hard work and values in their son, Isaac Hagos (Pictured Above), who was born in the United States in 1988. He works at our hospital as a host, serving healing meals to patients with a warm bright smile. Isaac is known for his courtesy, compassion and attentiveness towards patients. Isaac acknowledges that this is the first job that he has had, where the culture “feels sincere”. That feeling translates to his commitment to a patient first attitude. Isaac is known as the young man with the warm smile and sense of purpose in our Heart Center Isaac is currently attending Tarrant County Community College and plans to transfer to UTA to complete his degree in criminal justice. In the meantime, he plans to continue ensuring that healing meals are served on his watch.

Below are pictures of Isaac's co-workers living out their mission to provide healthy and tasty food for our patients. Did you know that they prepare more than 1600 patient meals a day?

If you have met a Faith Community Nurse...

I’m often asked the question what exactly is a Faith Community Nurse (FCN) and what do they do? It’s easy to answer the first part: A Faith Community Nurse is a registered nurse who has completed specialized training with the curriculum developed by the International Parish Nurse Resource it. Faith Community Nurses are a recognized as a nursing sub specialty by the American Nurses Association.

The second part is more complex because each one’s practice is different.

Suzi is the FCN at St Barnabas United Methodist Church in Arlington. Some days she makes hospital visits. “I make hospital visits, mostly to the critically ill members. This has been very gratifying, as the families have seemed appreciative of the visit”. She also arranged for Consumer Credit Counseling to do a program at the church: Money $EN$E : Basic Financial Education for Money Matters classes were offered once a month for four weeks. Topics included: Money Matters: Setting Goals, Keeping Records, Saving; Credit Matters: Why Use It, Establishing Credit, Credit Reports; Identity Thief: Protecting Your Good Name, What to do if it Happens; Numbers You Show Know



The nurses at University Christian Church have regular office hours on Sunday and Wednesday. Members stop in and have their blood pressure checked, check their weight and often ask to have someone to listen to them and to pray with them.

Theses are only a few examples of what faith community nurses do in their congregations. Each Faith Community Nurse have input form their Pastor, needs assessment done by the congregation and with their health cabinet determines what their Faith Community Nursing Program will look like.

If you’ve seen one Faith Community Nurse you’ve seen one Faith Community Nurse. They are all unique and different.

- Paulette Golden, RN

Manager of Community Health

How do I contact?

I received this comment yesterday from one of our visitors in response to our post on waterbirth:

"This is very excited to hear! My family and I just moved here from Houston and are looking for a hospital that had a midwifery group. We have two boys right now who where both delivered at St. Luke's Episcopal in Houston by our midwife. We were worried that we shouldn't be able to find another similar group. How do I get in contact with one of the midwives to set up an appointment?"

Thank you for your post! We are glad to have you in Fort Worth! I wanted to share with you how you can contact the midwives on our medical staff - (817) 250-5820.

A Nurses Perspective

My name is Jennifer Nelson and I am a staff nurse at Texas Health Fort Worth in the new Palliative Care Unit and Chair of our Nursing Advisory Council. I am far from new to the Harris culture though! I have call our Emergency Department home for the last 3 ½ years. What an amazing journey it has been! Many of you have probably read and seen that we went through the re-certification process for Magnet. I was fortunate enough to get to play a small role in this process and I can’t say enough now about how glad I am that I was a part of that process!
The Magnet journey is just that- a journey. A very LONG journey. A little over a year ago when I was still an ER nurse I got asked to be a Magnet Champion. I thought… “Great another thing to do and what in the world is a Magnet Champion?” I understood fully what the Magnet culture of a hospital was about but was a little unclear as to what role I might play in this re-certification journey. I have worked all over the country and can say with 110% certainty that I have NEVER come across a hospital like THFW!! So I decided what the heck! I jumped on board to be a “Magnet Champion.”
As the months and days ticked away I grew in my role as a leader at Texas Health Fort Worth. I was elected vice chair of NAC and in turn that lead to me being chair. It exposed me to so much more of the Harris Hospital I had become a part of. The team work amongst the staff of various floors and departments was truly amazing! The support of the CNO Karen Robeano was phenomenal! There wasn’t a meeting that went by that I did not learn something new about the hospital and the amazing staff that make it tick. While completing my own journey through various councils and meeting there was always one constant variable at the center of each gathering…. the patient. I have never worked for a place that cared more about their patients and made sure that everything had positive effects and outcomes for the patient. It truly spoke to the model of care that had been developed.
So all that being said, in the end I was honored to help represent Texas Health Fort Worth to the 4 women, our Magnet Surveyors, from across the country who came to see and learn about our hospital. We are not perfect, but I work with some of the most amazing staff and administrators who make sure every day we get one step closer to being there!

A Life-Saving Gift

A few weeks ago three nursing residents and I were invited by Sarah Nicholas in our Transplant Program to observe a kidney transplant. I have wanted to see one for some time and this was a great opportunity for me to see how our medical team performs this unique procedure. From what I understand, the patient was suffering from end-stage renal disease that could not be treated with regular medical treatments. The transplant does not cure the patient, but does help her/him have a better quality of life. I did not observe the procurement, but was still moved by the generosity of the donor.
The procedure was performed by Dr. Hemangshu Podder and lasted over lasted over three hours. I was very excited to see a transplant and appreciate Sarah and Dr. Podder for allowing me to do so. I did have a little bit of a rough start early in the procedure. I have not gotten queasy during other surgeries I’ve observed, but seeing the insertion of the Foley catheter nearly sent me to the floor. I had to turn away at one point but was able to keep it together for the rest of the surgery. Dr. Podder and his team were great in answering my questions and explaining what they were doing and how they were doing it. Time went by quickly and I was amazed by how well the surgical team worked together in providing such a high level of care to our patient.
As an administrative resident, it is great opportunity to learn how our caregivers do their jobs. This provides me with an understanding of the challenges and issues they face so that I may better serve them as my own career progresses. I am very fortunate to have access to the outstanding group of caregivers we have here at Texas Health Harris Methodist Hospital Fort Worth.
I also have a greater appreciation for organ donors who make these types of procedure possible. According to the Donate Life Texas website, “there is a critical shortage of organs, tissues and eyes available for donation. There are more than 96,000 patients in the United States awaiting transplantation—more than 7,000 are Texans. Every 13 minutes, a new name is added to the national transplant waiting list. Every day, 17 people die waiting for a life-saving organ transplant.” These facts were brought to my attention during our Raise the Donate Life Flag event on April 1st this year. Hearing a testimonial from a family whose son was a donor inspired me to register to be an organ, tissue, and eye donor with the Donate Life Texas registry. Organ donors can save up to eight lives and improve the lives of fifty through tissue donation. For more information about becoming a registered donor, see the Glenda Dawson Donate Life Texas website at http://www.donatelifetexas.org/.

- Scott

The Miracle of Breast Milk

My name is Fran Lynch, MD. I am a neonatologist in the Neonatal ICU at Texas Health Harris Methodist Fort Worth. On a daily basis, we take care of the smallest, sickest, and most vulnerable infants. There have been so many advances in medications and technology in the past 2 decades, and we are now able to help save babies born as much as 17 weeks before their due date. Despite all these advances, we are learning that one of the most potent medications available to us is not a medication at all--it's BREAST MILK.
Nature doesn't do anything by accident. Human milk is the ideal food for human babies. It contains not only all of the fat, protein, and calories that healthy babies need to grow, it also contains many antibodies and other substances that help baby fight off infection. In fact, healthy babies that are fed breast milk instead of formula for the first year of life have less frequent ear infections, bouts of diarrhea, and "snotty noses". Breast milk also helps protect against more serious infections like meningitis and pneumonia.
Decreased infections are not the only benefit of breastfeeding. Breastfed infants are less likely to develop asthma or allergies, especially if there is a family history of these problems. Some studies suggest that breastfeeding may help prevent obesity and diabetes later in life. Breastfed babies have been shown in some studies to score higher on IQ tests as adolescents. Breastfeeding your infant for a year could potentially make them smarter.
Breastfeeding has benefits for mom as well. Moms who breastfeed lose the "baby weight" faster than those who don't. Breastfeeding can also reduce mom's risk of breast cancer. Last, and probably most importantly, breastfeeding allows moms to bond with their babies in such a special, intimate way--it helps cement the mother-baby bond.
For the financially conscious, breastfeeding is a great deal. Breast milk is FREE, always available, and always the right temperature. You don't have to prepare it or clean plastic bottles after you are done.
I hope that I have convinced you to encourage any expectant moms you know to breastfeed their infants. Breastfeeding is the most special gift that a mom can give to her child. Though breastfeeding only lasts for a short time, the benefits last a lifetime.

Come Check on You in an Hour!

An old approach to meeting the needs of our patients has taken on new meaning. Patient Rounding has been considered a standard of nursing care for as long as I have been a nurse, 30+ years. Recent research has demonstrated that patient rounding done in a consistent standardized manner increases patient satisfaction and decreases falls and call light usage.

So what is so special about this “new” patient rounding? It is designed to increase our communication with our patients, demonstrate a higher level of caring and compassion, and helps us respond more quickly to the needs of our patients.

What are the components of patient rounding? First and most important is developing a relationship with the patient through introduction of the caregiver and a common understanding of what the patient wants and needs to achieve during the time they are working together. Whiteboards are often used in patient rooms to help communicate important information. They capture the caregivers’ names, how to reach them for any needs, the goals for the day, and other key information. These are all done in an effort to make the patient feel more comfortable in the foreign environment of a hospital.

Next comes the checking in frequently with our patients and we have designated hourly rounding so we can ensure that all needs are met as soon as possible. Rounding is not just to peek in on the patient but to check on their 1) Pain level, 2) Positioning and Comfort, 3) Toileting Needs, and 4) finally before the caregiver leaves the room they should ask the question, “Is there anything else I can do for you” and let them know when to expect another round. As we have been incorporating this approach into our nursing care we have found that rounding has made a positive change in our patient satisfaction. The rounds lead to better care because they build trust between patients and caregivers. Other benefits of rounding also exist. Hospitals have found that there are safety benefits as well. Units that adopted hourly rounding cut their patient fall rates in half and reduced the number of pressure sores developed by patients.
Our patients’ satisfaction is a top priority for us and hourly rounding is helping us meet and exceed our patient’s expectations.

- Karen Robeano
Vice President of Patient Care Services and Chief Nursing Officer