In keeping with Texas Children’s pledge to support you in every aspect of your well-being, we’ve compiled resources to help keep your families healthy and strong. This handy guide covers various topics such as parenting resources, tips for physical activity, nutrition, stress management and much more. Read More
As work life began to change for many Texas Children’s employees, the introduction of the Labor Pool system has brought new opportunities. Employees who normally serve in administrative or office roles have been able to interface with patients and families in a new way.
Kathleen Wood, director of Business Services with Texas Children’s Physicians Services Organization, manages the Labor Pool operation at the Medical Center. She said that although providing new insights and perspectives to employees was not an initial primary goal of the program, it has been a joy to see this emerge as an outcome.
“I understand this benefit in a very personal way,” Wood said. “In the past, while working in Revenue Cycle, I also volunteered in patient transportation at West Campus Radiology. That time spent on the front lines reaffirms the purpose of the organization and the importance of what we all do.”
Barbara Shreffler, manager of Research in the Office of Philanthropy, has spent the last two months managing several screening locations across main campus including Feigin, West Tower, Abercrombie and MPERT.
Shreffler said the work is challenging, but equally rewarding. “How else would I get to know emergency room nurses, pharmacists and other clinical professionals?,” said Shreffler, whose full-time job doesn’t require her to go into a patient care area. “I can honestly say that I have made new friends and I really do think that this experience will make me a better member of the philanthropy team.”
She went on to say that she has a reinvigorated enthusiasm to do more for Texas Children’s. “This Labor Pool role has made me more knowledgeable and more passionate about my work.”
Shreffler is not alone in how she feels. Elizabeth More, who works as a physician liaison in the Fetal Center, joined Labor Pool in April and became a team lead for screening at Legacy Tower and the Pavilion for Women.
“In my current role, I establish relationships with referring providers and their staff. My hope is that by building these trusting relationships with potential and/or referring providers, they will refer their patients to us for evaluations and interventions,” More said. “However, it is very rare that I have any interactions with the patients that they refer to us. My Labor Pool assignment has opened my eyes to see things from our families’ perspective.”
Some employees have an opportunity to work in a variety of roles. Diane Ramirez, a medical interpreter, has worked several positions for labor pool with the most recent one being as an elevator ambassador.
“This position, in particular, gave me a better sense of understanding on how the patients and their families feel nowadays when they visit our facilities,” Ramirez said. “Labor pool assignments gave me the opportunity to empathize with our visitors and take pride in our role in the community during these difficult times.
Some employees are not only gaining new insights but also new career skills. Kelley Hernandez, a senior coordinator in the Office of Philanthropy, began as a team lead for the screening areas in March and became a Labor Pool coordinator just last week.
“Serving in the Labor Pool has been such an incredible opportunity,” Hernandez said. “In my full-time role, I do a lot of data entry and spreadsheet manipulation. As part of Labor Pool I’ve been able to strengthen my decision making skills and critical thinking skills. No two days are alike! When I first started I was only lead over one location, and a few months after taking on this role I was covering four locations. I enjoy that every day is a new challenge and I wake up looking forward to what the day will bring.”
Labor Pool shifts are still available all across our organization. To sign up, click here.
One in four youth in the U.S. have a diagnosable mental health disorder that often is a direct response to what is happening in their lives. The COVID-19 pandemic, along with many other societal factors, have affected all of us, but for children who already suffer from anxiety or depression, the emotional impact can be severely magnified.
Many pediatricians are seeing more children and adolescents with mental health problems, and they are playing an increasingly significant role in the diagnosis and treatment of mental illness in young people. While numerous surveys of pediatricians indicate they feel they lack the necessary training and skill to manage their patients’ mild to moderate mental health care disorders, a new program at Texas Children’s is providing the support they need.
On May 18, Texas launched the Child Psychiatry Access Network (CPAN), a new statewide pediatric mental health initiative that Texas Children’s and Baylor College of Medicine are partnering on for our region. This state-funded program provides pediatricians, family physicians and other health care providers direct and immediate access to a pediatric mental health specialist to help them manage their patients’ mental health care needs more effectively.
“We want our pediatricians to feel more comfortable managing the mental health care needs of their patients,” said Jennifer Evans, assistant director of the Meyer Center for Developmental Pediatrics and the Psychiatry Service at Texas Children’s and associate program director for the Central Operational Support Hub (COSH) for the Texas Child Mental Health Care Consortium that oversees the state implementation of CPAN. “Pediatricians at our TCPs and The Centers for Children and Women can collaborate directly with our CPAN team about their patient’s plan of care instead of having to refer their patient to our child psychiatry clinic where they would be placed on a lengthy waitlist.”
When a pediatrician calls the CPAN hotline (1-888-901-CPAN Monday – Friday from 8-5 excluding holidays) to reach the Baylor hub, a Texas Children’s behavioral specialist, licensed counselor or licensed clinical social worker will answer the phone. Depending on the patient’s needs, they will connect the pediatrician to a Texas Children’s psychiatrist who can provide real time consultation on various mental health issues. For instance, if there is a question about a patient’s medication, they can advise whether to adjust the medication dosage. The CPAN team can also help pediatricians develop a behavioral or safety plan for patients with depression or suicidal tendencies, and other mental health disorders. Pediatricians can also call the CPAN hotline to access educational resource materials on mental health.
“Through CPAN, our pediatricians are given the knowledge, skill, training, and support they need to address and treat mild to moderate mental illness,” said Dr. Laurel Williams, medical director for COSH and Division Head of the Child and Adolescent Psychiatry Division at the Menninger Department of Psychiatry. “If we can collaborate more directly with our PCPs, our psychiatry team will have greater access for youth and families that need more regular, intensive specialty care.”
Baylor College of Medicine is one of 11 centers participating in the CPAN initiative. Each Department of Psychiatry across the state of Texas has a region that they are responsible for supporting. Baylor and Texas Children’s are providing support to the seven counties in the Greater Houston area. However, there are times when our CPAN team has provided mental health consultation and training to pediatricians in other parts of the state including El Paso.
Along with the CPAN initiative, Texas Children’s psychiatrists also provide mental health care support to patients and children in the community in other ways. Through a 4-year grant from the Substance Abuse and Mental Health Services (SAMHSA), our teams at Texas Children’s and Health and Human Services are able to provide more comprehensive evidence informed treatments for youth with serious mental health disorders (SMD) like bipolar and psychosis. The grant provides assistance in building infrastructure that can be maintained beyond the life of the grant through cultivating collaborations and coalitions across important teams that assist children with SMD.
“We transfer 6 to 7 kids per week to inpatient units and these are mainly bipolar patients who are having a really hard time,” Evans said. “SAMHSA has changed the dynamic of care for these patients. Instead of sending them to the hospital, we can have intensive services in the home. It’s like an intensive outpatient service in your home.”
As part of the Texas Child Health Access Through Telemedicine (TCHATT) program, our psychiatric team is also collaborating with various independent school districts – Houston, Spring, Conroe, Pasadena, Center for Success Charter School and Sheldon – to provide in-school behavioral telemedicine care to at-risk children and adolescents that include free comprehensive assessments and up to four clinical sessions either with a physician or a therapist.
“Through our CPAN, TCHATT and SAMHSA partnerships, our psychiatry section will be able to grow by three physicians and over 10 licensed therapists allowing our team to provide these new services without taking away from our current services,” Williams said. “In collaboration with Dr. Kirti Saxena, our interim chief of psychiatry at Texas Children’s, we have six physicians, along with our child psychiatry fellows, social work interns and trainees who will spend a portion of their time working on these programs to ensure every child gets the care they need.”
Five years ago, Texas Children’s Special Isolation Unit (SIU) opened at Texas Children’s Hospital West Campus to provide safe, effective care to patients with highly contagious infectious diseases. The decision to build the SIU came shortly after an unprecedented Ebola outbreak, resulting in the realization that Texas Children’s must always be prepared as an organization to handle any emerging infections that come our way.
Texas Children’s Special Isolation Unit at West Campus – the only one of its kind in Texas and among only a few in the United States – allows our teams to treat pediatric patients who are infected with highly contagious diseases in a state-of-the-art environment. The SIU is fully equipped with all of the latest scientific and technological approaches to biocontainment to assure the safety of the health care team, other patients and their families. The types of highly contagious pathogens that can be treated in the SIU include Ebola, influenza, measles and respiratory illnesses like MERS, SARS and RSV. Today, as many health care organizations face another global health pandemic, the SIU team at West Campus has been busy over the last several months providing care to COVID-19 adult and pediatric patients.
“As a virologist, I always thought in the back of my mind that we would possibly face a pandemic one day whether it be avian influenza or another coronavirus like SARS or MERS,” said Dr. Amy Arrington, medical director of the SIU at West Campus. “But I think until you’re really in that moment, it’s hard to imagine what responding to a pandemic like COVID-19 would be like for our team and the organization.”
Housed on the fifth floor of West Campus, the SIU has eight dedicated beds and up to 18 overflow beds on the fourth and fifth floors to care for COVID-19 patients, with the potential of expanding bed capacity as the need arises. The SIU is activated when patients meet a specific criteria, and in this case, are COVID-19 positive.
“We have nurses and doctors embedded in many clinical areas across our campuses who serve as clinician reservists on standby,” said Denise Tanner-Brown, Assistant Vice President of Nursing of Community and Ambulatory Nursing. “Once we activate them, they are pulled out of their home clinical areas to support the SIU.”
Since the pandemic began in early March, the West Campus SIU has been activated 12 times. The last time the SIU was activated was on May 30 and has remained open since then. As of July 31, 184 patients have been admitted to the SIU and 75 of those patients were admitted in June. West Campus has had 13 COVID-19 positive adult patients admitted to the SIU since it started taking care of adult COVID-19 patients on June 24. In May and June, the SIU saw a 48 percent increase in the average daily census.
Tanner-Brown says the SIU is on the downswing compared to previous months. Texas Children’s has seen a recent decline in COVID-19 admissions which demonstrate that masking protocols are working to curb the spread of the virus. However, the SIU team remains ready to care for increased patient volumes if warranted.
“When we began accepting adult patients in our SIU on June 24, we were a little worried about how they would perceive us as they came into a pediatric hospital setting for care,” Tanner-Brown said. “They have been more than grateful and extremely appreciative of our willingness to take good care of them.”
Since many of the adults who have COVID-19 or who required admission had some underlying disease presence, the SIU team collaborated with education coordinators from Houston Methodist West who provided guidance on general and COVID-19 specific care to ensure the best outcomes for these patients.
View a photo gallery of inside the SIU at West Campus below.
While some school districts are reopening campuses and others are sticking to virtual learning at least for the time being, Texas Children’s is ready and prepared to respond if the Houston area experiences another surge in COVID-19 cases after school starts and into the fall months during flu season.
“We are always in a constant state of readiness and we are not letting our guard down especially with the mounting uncertainty surrounding this unprecedented pandemic,” said Tanner-Brown. “As patient volumes decrease, we have a deactivation strategy where we can temporarily close down units. But we also have an activation strategy in place where we can turn it back on really quickly should the situation change. In general, many people are getting COVID fatigue, and may not feel the need to continue practicing social distancing or taking other safety precautions, so I anticipate that we may see more new cases emerge.”
For the 70 days and counting that the SIU at West Campus has been activated, the recent milestones achieved would not have been possible without the 100 percent collaboration from our team members across the system.
“I think as an organization, we have just really stepped up to the plate to provide good quality and safe care for these patients and our staff,” said Arrington. “It takes a huge village to put this together and to carry this out day after day. And it’s exhausting work, but it is work that is incredibly rewarding too.”
Aimee Martin’s two-year-old daughter Hope is extremely social. She chats up anyone she sees whether they are a stranger or a friend, and she does so at close range. Telling her to keep her distance to protect herself and others from COVID-19 is something she has a hard time comprehending to say the least.
So, when a routine trip to the ophthalmologist popped up on Amiee’s calendar, she cringed because she knew Hope’s eyes would need to be dilated and that they would have to spend at least 30 minutes in the waiting room of Texas Children’s Ophthalmology Clinic.
“Sitting in the waiting room with Hope during a pandemic or not is a train wreck,” Amiee said. “She wants to hug and talk to everyone she sees.”
To help prevent situations such as these and ease people’s anxiety about coming to the hospital during a challenging time, a handful of departments, including Ophthalmology, are offering some of their services via Patient Express, a drive-thru service at Texas Children’s Hospital’s Medical Center Campus.
Set up near the ambulance bay at Wallace Tower, patients call about five minutes before arriving for their appointment, pull up and are seen by a clinician. To ensure everyone’s safety, all patients and family members are asked a series of COVID-19 screening questions, their temperatures are taken and they are required to wear a Texas Children’s-issued mask. Texas Children’s employees participating in Patient Express are required to wear personal protective equipment including a mask, gown, gloves and facial shield.
“It’s great to be part of a project that is good for everyone,” said Ophthalmology Clinic Supervisor Veronica Gonzalez. “I feel like we are taking an extra step to make everyone feel safe – staff, patients and family members.”
Gonzalez’s team is using Patient Express to treat otherwise healthy patients who need to come in for a routine eye exam that requires dilation. Before going into the clinic for their exam, patients get their eyes dilated car side at Patient Express. By the time they park and make their way up to the clinic, it’s about time for their appointment.
Most patients are in and out of the clinic in 30 minutes. Prior to using Patient Express, they would spend an hour to an hour and a half in the facility, half of which was spent in the waiting room during the dilation process.
“Patient Express is a much better alternative,” Martin said. “I appreciate Texas Children’s coming up with the idea and for making our safety and health a priority during such challenging times.”
The drive-through or car side concept began in May when Texas Children’s Pavilion for Women opened a drive-through prenatal clinic at our Medical Center Campus to reduce the anxiety of expectant moms and to lower their risk of COVID-19 exposure and infection.
The clinic, which was recently phased out due to an increase in telemedicine and in-person visits, allowed pregnant women who do not need to be seen in the clinic to remain in their vehicles while being assessed by a health care professional. The drive-through visits included key elements of a prenatal exam such as blood pressure measurements for evaluation for hypertensive disorders of pregnancy, fetal heart rate assessment, and selected ultrasound-based measurements or observations, as well as face-to-face patient-health care professional interaction.
In June, Texas Children’s Dermatology started offering drive-through service via Patient Express to patients who need basic dermatological treatments for conditions such as warts and/or molluscum. The service is being offered every two weeks and has been very successful with both patients and clinicians.
Ophthalmology offers dilating services via Patient Express daily. Pulmonology offers services every other week through Patient Express to cystic fibrosis patients who are undergoing eradication treatment for two types of bacteria they are susceptible to getting and possibly having complications from.
“There is no need to bring them on site and expose them if we don’t have to,” said Caroline Hanson, who manages the outpatient nursing team for Pulmonology. “Our parents have been very appreciative of our efforts to best care for them and their children.”
To help create a fun environment at Patient Express, Hanson said she plays kid-friendly music when appropriate and hands out stickers any time she can. She said her staff forms a special bond with their patients since they tend to come in frequently and that being able to serve them in this way has been very fulfilling.
Valdemar Garza, practice administrator for Ophthalmology, said he has been impressed with the success of the drive-through service and with the collaboration between several teams to make it happen.
“We received a lot of help from Pulmonology, Dermatology and Women’s Services to come up with our Patient Express plan,” Garza said. “I’m grateful to work for an organization that values such creativity and innovation. It goes a long way in forwarding patient care.”
Click here to watch a video of Patient Express when it began with Dermatology.
This week on Mark Wallace’s blog, he reflects on the many accomplishments of Texas Children’s Pediatrics in celebration of the group’s 25th anniversary. Read more
Twenty-five years ago, Texas Children’s launched what is now the largest pediatric network in the nation with more than 250 board-certified pediatricians and more than 60 practices throughout the greater Houston area, College Station and in Austin. The group cares for over 400,000 patients and completes more than a million visits each year.
The physician network was formed in 1995 under the guidance of Dr. Ralph Feigin with the acquisition of the Ashford practice in west Houston owned and operated by four brothers – Drs. Paul, Morris, Ben and Harry Rosenthal. Because of its success, more and more pediatricians joined the group, making it what it is today.
In addition to its ever-growing primary care network, Texas Children’s Pediatrics operates 11 urgent care centers in the greater Houston area and one in Austin. The group also includes the Community Cares Program that provides trusted, high-quality pediatric medical services at designated locations to children who otherwise would seek care from emergency rooms or possibly go without care or treatment due to low family incomes and/or lack of health insurance.
Texas Children’s Pediatrics has consistently adapted to the needs of patients and their families while continuing to provide high-quality care. In celebration of the group’s 25 years of service, Texas Children’s Pediatrics President Kay Tittle answered a few questions about the group’s beginnings, present challenges amid the pandemic and future success.
Why, 25 years ago, did Texas Children’s start offering primary care services to patients and families across the greater Houston area and beyond?
Texas Children’s Pediatrics was part of Texas Children’s President and CEO Mark Wallace’s vision of what Texas Children’s needed to thrive in the changing environment in the 1990s. Many community pediatricians had reached out to Texas Children’s to ask for help as they were struggling to manage the increased complexities of running a practice. Managed care in particular was a large challenge for the practices as they worked to understand the changes in insurance coverage.
How did the group grow and become such a success?
Our focus has always been to provide the support needed to help physicians, advanced practice providers and staff provide the highest quality of care possible. We do this by providing physicians with administrative, financial and management expertise. Our reputation for providing such support helped us grow 25 years ago and continues to help us flourish today.
What are some of the things Texas Children’s Pediatrics has had to do over the years to maintain quality of care while also meeting the ever-growing and changing demands of patients and families?
In 2011, we made the decision to pursue National Committee for Quality Assurance (NCQA) recognition as a patient-centered medical home. This program focuses on how practices use data to improve the care they provide. The program provided the structure to help us maintain our focus on quality care and patient needs. We have been recognized every three years since as a Level III patient-centered medical home by NCQA, which is the highest recognition the organization gives out.
How has the COVID-19 pandemic changed the way Texas Children’s Pediatrics and Texas Children’s Urgent Care delivers care?
The pandemic has changed many things in our organization. Our focus has been to provide safe care and a safe environment for our patients as well as our staff while meeting the changing needs of our patients and families. We have received a positive response to changes such as Precheck-in using MyChart, waiting in one’s vehicle instead of our waiting rooms, being taken to an exam room as quickly as possible after arriving, scheduling well visits in the morning and sick visits in the afternoon, and car side immunizations. We were also able to quickly incorporate a telemedicine program with support from across the system. More than 20 percent of our encounters are now completed via telemedicine, which has helped meet the needs of patients and families in so many ways. The comments on our Press Ganey surveys are good reminders of the challenges our families are facing, and what we as an organization need to focus on to help them receive the right care, at the right time and at the right place.
What are some of the things the group will need to do in the future to remain successful?
We will need to continue to adapt to the needs of our patients and families as well as to the health care industry as a whole. We want to continue to lead the change and innovation necessary to grow and provide the highest quality of care no matter the circumstances.
In looking back and ahead, what are some of your most memorable moments as president?
Our team has created many great memories over the past 25 years. I think the move to an electronic medical record was notable and most exciting when paper charts were no longer needed. It has also been great fun to grow in Austin and College Station over the past few years. They are both exciting areas. As we look ahead, I look forward to making more great memories with the team.
