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#SRHaccess Facebook LIVE Recap: What is a teaching hospital?

#SRHaccess Facebook LIVE Recap: What is a teaching hospital?

by | Nov 8, 2017 | Research & Innovation

On this week’s Facebook live, Chief of Staff Emeritus Tony Herring, M.D. joined us to discuss what it means to be a teaching hospital and the history of our institution educating the doctors of the future. Below is the recap of the conversation.

Watch this Facebook live. 

What is a teaching hospital?

  • A hospital that teaches and educates students in medicine – including medical students, residents, fellows, nursing students, psychology fellows. As a teaching hospital, Scottish Rite Hospital provides residents and fellows the opportunity to work closely with the staff when treating the patients.
  • Medical students: most of their time is in the classroom – students observe, practice medicine under supervision of the staff to become a doctor.
    • Residency: After graduating from medical school, the individual goes into residency. The residents of the University of Texas Southwestern Medical Center join our team for six months for their pediatric orthopedic rotation.
    • Fellowship: After completing a residency, an individual is now a doctor. A fellowship provides training in a subspecialty, like pediatric orthopedic surgery.
    • The hospital has several fellowships. The Dorothy & Bryant Edwards Fellowship welcomes five new fellows to train at Scottish Rite Hospital for a year. Fellows work alongside and learn from our world-renowned staff in all areas of pediatric orthopedic surgery.
  • The hospital also has programs for all levels of medical training: nursing students, physical therapy students, psychologists, etc.

Historical timeline of Scottish Rite Hospital being a teaching hospital:

  • Residents from UTSW trained at our hospital since the Department of Orthopaedics started at that institution decades ago.
  • In the early 1980s, Scottish Rite Hospital established a pediatric orthopedic fellowship program to allow orthopedic surgeons to receive specialized training. Since its inception, the fellowship program has grown to be one of the finest programs in the country.
  • The first class of fellows had a total of three – today, the Dorothy & Bryant Edwards Fellowship is offered to five individuals each year.

How does being a teaching hospital impact patient care?

  • The staff surgeon is responsible for everything that happens – controls the operations and care of the child.
  • Decision making – children’s orthopedics is complicated and each case requires an individualized treatment plan.
  • Every Monday night, the medical staff and the trainees gather to discuss the surgical cases scheduled for that week. Residents and fellows can collaborate and work with the staff to determine the best possible treatment plan for each child. This not only teaches the trainees, but also allows our doctors to continue their education.

Research as a key component to training:

  • The hospital is privileged to conduct research through UTSW. The goal of the hospital’s research is to find better ways to manage problems and determine the best possible treatments for the various conditions.
  • Our doctors travel the world to present current research and are changing medical practice on a global scale.
  • Residents and fellows choose the area of research they would like to study. The research work from the trainees enhances their education while also bringing better care to our patients.

“We wrote the book on pediatric orthopedics – literally.” 

  • Our doctors are currently working on the next volume of Tachjian’s Pediatric Orthopaedics: From the Texas Scottish Rite Hospital for Children.
  • The book is revised and updated every five years.
  • People around the world refer to it as the ‘go-to’ for pediatric orthopedics.
  • Videos of cases and surgeries are made to along with the textbook for people to reference and learn from throughout their education.
  • One of the very few medical textbooks written from one institution.
  • Each time the book must be revised, it continues our doctors’ education when they are rewriting their respective sections. This ultimately brings the best care back to our patients.

Then and now regarding the hospital’s fellowship program:

  • As it was then and is now, the patients always come first.
  • The impact of our doctors is now worldwide. Staff present research and lead educational sessions both nationally and internationally to share how Scottish Rite Hospital cares for children.
  • We have a responsibility to continue researching and teaching medical professionals to bring the best care to children now and into the future.
Improving Care with Patient Reported Outcome Measures

Improving Care with Patient Reported Outcome Measures

by | Nov 1, 2017 | Research & Innovation

The goals for providers at Scottish Rite Hospital are to understand symptoms and concerns, develop the best action plan for treatment and to ensure that treatment is effective. We use standard questionnaires, called patient reported outcome measures (PROM), as tools to help us accomplish these goals. Patients are asked to complete these during or just before clinic visits or procedures. They are asked to complete them on an iPad, tablet or on paper. The completed questionnaires may be used for treatment decisions as well as research. Staff orthopedist Henry Ellis, M.D. says, “PROMs are valuable communication tools that can help improve patient satisfaction, symptom management and enhance the quality of care for our patients.”

Below are common questions patients and their families have about the ’WHAT’, ‘WHY’ and ‘HOW’ in regards to these PROMs.

WHAT

What are patient reported outcome measures (PROMs)?
These are standard questionnaires that have been developed by medical experts and research teams across the country. Patients are asked to respond to these at various points throughout treatment. They help the health care team provide appropriate care based on the patient’s physical abilities, goals and emotions. The answers to these questionnaires, along with other information, can help us determine the effectiveness of the treatment.

WHY

Why do providers ask their patients to complete the PROM before they meet?
It is important to establish a baseline of how a patient is feeling and what they can do so we can easily identify changes over time.

Why do we use PROMs instead of just asking the questions during the appointment?
There are a few reasons questions may be asked in the form of a PROM instead of during the clinical visit. These forms are used at many hospitals outside of Scottish Rite Hospital and have been designed based on the patient’s age. The questions are asked in a very consistent format at all sites so the results can be compared across the larger populations. PROMs are a place for the patient to document their opinions, feelings and function, which are combined with the discussions with your provider to make the best treatment plan for you.

HOW

How do doctors know what questionnaires to use?
For specific conditions, there are series of questions that have been shown in previous research studies to effectively track improvement in the patient’s ability to function in day-to-day activities. A patient with a shoulder problem will be asked to answer different questions than a patient with a knee problem.

Filling out PROMs seems to make a visit take longer. How is Scottish Rite Hospital taking that into consideration?
Scottish Rite Hospital is very excited to be using electronic software designed for use by our patients. Although not all forms are available electronically just yet, teams of clinicians and researchers are working to get questionnaires available in electronic formats to be answered on an IPad or tablet. With the use of electronic systems, some of the PROMs can be combined to remove all duplicate questions. This will reduce the number of questions patients must complete. After a patient enters answers electronically, the software scores and organizes the answers so the results are available to the provider right away. Additionally, the electronic software systems allow us to send follow-up forms to patients electronically, in many cases, eliminating this step in the office.

How do PROMs help our researchers?
For studies that evaluate treatment options or outcomes, changes in symptoms and function can be measured in many ways. We can measure changes in bone length, joint angles or even tissue healing using advanced imaging techniques. The PROM provides a standardized and objective way for the patient to report progress and allows our team to track how our patients are improving over time. This information can improve the health and satisfaction of our patients, help identify the most effective treatments and ensure we are providing the best care we can.

Learn more about research conducted at Scottish Rite Hospital.

A Wise Approach: Frisco Style

A Wise Approach: Frisco Style

by | Nov 1, 2017 | Press Coverage, Research & Innovation

When Dr. Carol Wise looks at the thousands of specimen tubes that reside in the laboratory she oversees at Texas Scottish Rite Hospital for Children in Dallas, she sees not only vials filled with important DNA samples, but also the patients and families behind them. People who generously and, quite literally, gave of themselves in hopes of helping further advancements in science and medicine that may someday work to cure others. “That tube is a little tube of gold,” says Dr. Wise, 54, who is the hospital’s director of molecular genetics and basic science. “People have heard me say our freezer is Fort Knox, and every time you hold a tube, that is somebody who was kind enough to give us a sample, or somebody who might have been suffering quite a bit.”  

Read the full article here to learn more about Dr. Carol Wise and her groundbreaking research career at Scottish Rite Hospital. 

Inaugural Marybeth Ezaki/Peter Carter Visiting Professorship in Hand Surgery Hosted at Scottish Rite Hospital

Inaugural Marybeth Ezaki/Peter Carter Visiting Professorship in Hand Surgery Hosted at Scottish Rite Hospital

by | Oct 19, 2017 | Research & Innovation

Scottish Rite Hospital is hosting the inaugural Marybeth Ezaki/Peter Carter Visiting Professorship in Hand Surgery, October 20 and 21. It was established to honor Marybeth Ezaki, M.D. and Peter Carter, M.D., both world-renowned pediatric orthopedic hand surgeons. This two-day conference includes presentations and lectures from the visiting professor, hospital staff, and former trainees on the latest research and treatments for pediatric upper extremity patients.

Ezaki served as the director of hand services, and Charles E. Seay, Jr. Hand Center during her time at Scottish Rite Hospital. She celebrated her retirement in 2015, however she continues as a consultant on the hand team. Carter was a key member of the hospital’s hand team as an inventor and researcher to provide the best care to his young patients. Although he retired in 2007, Carter continues to be a strong influence through the hospital’s fellowship program.

Director of the Center for Excellence in Hand Disorders, Scott Oishi, M.D., F.A.C.S., is excited about this educational course and the opportunity to learn from various medical professionals from around the country. “We are delighted to host a conference specific to the treatment of pediatric hand differences,” says Oishi. “Ezaki and Carter contributed tremendously to our hand program here at the hospital. We look forward to the success of this first meeting, and those in the years to come to continue our mission of cultivating collaboration, research, and education to better patient care.”

The hospital is honored to host this year’s visiting professor, Stéhpane Guéro, M.D. Guéro currently works at the Institut Français de la Main in Paris and specializes in plastic and reconstructive surgery. He is a member of several medical societies and has been published in well-known orthopedic journals.

The Marybeth Ezaki/Peter Carter Visiting Professorship is another element of the hospital’s continued efforts to excel in patient care, research, and education. It is a privilege to honor two world-renowned hand surgeons through this conference to enhance our mission of providing the best possible care to children, both here and around the world.

Hospital Staff Attend 33rd Annual Orthopaedic Trauma Association Meeting

Hospital Staff Attend 33rd Annual Orthopaedic Trauma Association Meeting

by | Oct 12, 2017 | Research & Innovation

Orthopedic staff from Scottish Rite Hospital are attending the 33rd annual Orthopaedic Trauma Association (OTA) meeting in Vancouver, British Columbia. Established in 1985, OTA now has over 2,000 members, including medical professionals in all areas of the world. Members gather each year to share the latest research and collaborate with fellow colleagues to bring better care to the injured patient.

At this year’s meeting, 950 abstracts were submitted, with just over 250 being accepted for presentation. Scottish Rite Hospital is being represented by several orthopedic staff and past fellows, with four projects selected for presentation. The research being presented from the hospital:

  • Is Less More? Assessing the Value of Early Clinical and Radiographic Follow-Up for Operative Supracondylar Humerus Fractures
  • The Utility of Intra-Operative Arthrogram in the Management of Pediatric Lateral Condyle Fractures of the Humerus
  • Does Delay to Surgery in Type III Supracondylar Humerus Fractures Lead to Longer Surgical Times and More Difficult Reductions?
  • Does a delay in treatment of displaced pediatric lateral condyle fractures increase the risk of complications?

In addition to scientific presentations, hospital faculty work closely with the OTA to assure ongoing education of colleagues and trainees in the discipline of pediatric orthopedic trauma management. Assistant Chief of Staff Philip L. Wilson, M.D. and staff orthopedists Anthony I. Riccio. M.D. and Lane Wimberly, M.D. continue to direct the pediatric module at the annual OTA Comprehensive Resident Fracture Course. Staff orthopedist Christine Ho, M.D. also serves as faculty for a newly developed trauma symposium for advance practice nurses and physician assistants.

As members of the Orthopaedic Trauma Association, our doctors can be a part of a world-wide medical community that is dedicated to advancing the treatment and prevention of musculoskeletal injuries. Scottish Rite Hospital is honored to have the opportunity to present the most recent research on a global stage to ultimately bring better care back to our patients and children everywhere.

DNA Samples from Scottish Rite Hospital’s Biobank of AIS Patients Selected for Analysis

DNA Samples from Scottish Rite Hospital’s Biobank of AIS Patients Selected for Analysis

by | Sep 7, 2017 | Research & Innovation

Director of Molecular Genetics and Basic Science Carol Wise, Ph.D. and Assistant Director of Molecular Genetics Jonathan Rios, Ph.D. are in Rockville, Maryland attending the inaugural Kids First Program annual meeting held at Johns Hopkins University- Montgomery County Campus. Rios was awarded a grant through the Gabriella Miller Kids First Pediatric Research Program to fund his project, “Genomics of Orthopaedic Disease (GOOD for Kids), which utilizes next-generation genomic technologies to discover the genetic causes of adolescent idiopathic scoliosis (AIS). DNA samples from Scottish Rite Hospital’s biobank of AIS patients and families have recently been selected for analysis.  

The Gabriella Miller Kids First Pediatric Research Program was established as a resource for researchers everywhere to access a vast amount of genetic data from children diagnosed with cancer and other birth defects. The purpose of this program is to create a large data set of sequenced DNA from thousands of individuals to understand pediatric diseases and ultimately find the cause. In 2014, the Gabriella Miller Kids First Research Act was signed into law authorizing to support a fund specifically for pediatric research.
The Kids First Program is at the forefront of innovation. Along with federal support, our team at Scottish Rite Hospital is an integral part of this national project and is conducting ongoing research to understand the causes of various pediatric diseases. 

Carol Wise, Ph.D., and Jonathan Rios, Ph.D., are professors at the University of Texas Southwestern Medical Center (UTSW). Dr. Wise is a Professor in the McDermott Center for Human Growth and Development, Pediatrics, and Orthopedic Surgery and Dr. Rios is an Associate Professor of Pediatrics and Orthopedic Surgery.