August 4, 2020

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.

Preparing for a potential second wave

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.”

August 3, 2020

Members of the Child Life team have decorated sidewalks at the Medical Center Campus with inspiring chalk art. The art is meant to send positive vibes to anyone and everyone visiting or working in our facilities. Go check it out, and thanks Child Life!

July 28, 2020

When Nurmeen Khokhr called her pediatrician’s office to schedule a time to come in and get the vaccinations she needed before going off to college in the fall, she was pleased to hear she didn’t have to step out of her car.

A new program called Car Side Care is being piloted at Texas Children’s Pediatrics Cypresswood in Spring and allows patients nine and older to receive vaccinations from the comfort and safety of their vehicles. All patients have to do is make an appointment, answer a few screening questions, get their temperature taken and roll up their sleeves.

“We are providing the same high-quality care in parking spaces outside our practices as we provide inside our buildings,” said Assistant Vice President Sara Montenegro. “In doing so, we are helping reduce patients’ and staff members’ potential exposure to COVID-19.”

The idea for Car Side Care followed a national drop in the number of patients coming in to get their routine vaccinations. When asked, many patients and/or their family members sited fear of being exposed to the virus as their reason for delaying their shots.

Dr. Stanley Spinner, chief medical officer and vice president of Texas Children’s Pediatrics, said he doesn’t blame people for being cautious, but emphasized the importance of routine childhood vaccines does not lessen during a pandemic. In fact, Spinner said, children should be getting them now more than ever with back to school and flu season right around the corner.

“Vaccines are arguably the most effective public health measure we have next to clean water,” Spinner said. “They are that important, and with the pandemic, they are even more so. I would hate to see a child sick with both COVID-19 and something else like the flu.”

In addition to routine vaccinations, getting kids inoculated against the flu is one of the main drivers behind Car Side Care. Prior to the pandemic, patients needing a flu vaccine often would call their pediatrician’s office, make a nurse’s appointment, and drop by and get their vaccine. That won’t work today with COVID-19 when so many extra precautions are necessary to limit exposure.

“Our offices are very cautious about safety precautions, and with that, needed creative solutions to see hundreds of children for flu vaccine and childhood immunizations quickly, without needing to come in our facilities,” Montenegro said. “Care Side Care is a perfect way to handle this and to hopefully remain on top of the upcoming flu season by vaccinating as many children as possible.”

Car Side Care was launched as a pilot at Texas Children’s Pediatrics Cypresswood and has grown across more than 15 Texas Children’s Pediatrics sites, as we work closely with our landlords to allocate parking spaces to support this program.

Each location will designate four parking spots a couple of times a week to patients wanting to come by and get their vaccines. An appointment will be necessary as well as a COVID-19 screening. Patients and anyone else in the vehicle will be required to wear a mask. Clinicians will wear a mask, goggles and a protective gown. The program has also been expanded from caring for older children to caring fo children of any age over the past two months.

“Texas Children’s Pediatrics has done a very good job at continually finding ways to provide the care our kids need in the safest possible environment,” Spinner said. “Our families seem very happy with the modifications we’ve made thus far and they seem pleased with our commitment to maintain the quality of care we’ve always provided.”

Khokhr said she was very pleased with her Car Side Care experience. It was convenient and gave her the sense of safety she needed to get the shots required by her school.

“I’m glad Texas Children’s Pediatrics is doing this,” she said. “I think it will help ease the nerves of a lot of patients who want to come in and get their vaccines.”

Diana Lopez shares her role as a clinical product evaluation coordinator in Supply Chain, and how she and her team collaborate to ensure the organization has adequate supplies to support daily operations during COVID-19. Read more

July 27, 2020

As we near the end of summer and schools share their plans for reopening, there are, undoubtedly, many questions parents and caregivers have due to COVID-19’s impact on our communities. There are certainly no easy, one-size-fits-all answers to these questions. After all, we are facing an unprecedented situation. Both the American Academy of Pediatrics (AAP) and Centers for Disease Control and Prevention (CDC) have published guidance documents addressing safety measures that schools and parents can practice to mitigate risk. These measures do just that – mitigate – but they cannot eliminate all risk of acquiring COVID-19.

Dr. Galit Holzmann, associate director of Infection Prevention at Texas Children’s Hospital West Campus, addresses many top-of-mind questions in a blog found here. These and many others are common questions and considerations for parents and caregivers of school-aged children. There is understandable uncertainty for parents regarding whether schools will or should physically open, and whether they should send their children to school if/when physical reopening occurs.

Ultimately, the decision of whether to send a child back to school will be a personal one for each family, incorporating the overall physical and emotional health of the child, presence of high-risk underlying medical conditions in household members, the ability to learn virtually, the extent of community spread, the family structure and finances, and parent’s/child’s comfort level.

Since March 6, Texas Children’s Supply Chain Team has worked hard to ensure the organization has enough supplies to care for our patients during the COVID-19 pandemic. Now, four months later, Texas Children’s is still going strong.

With the increasing demand for N-95 masks and other personal protective equipment (PPE), the hospital’s PPE supply has grown significantly since the COVID-19 pandemic began. In early March, Texas Children’s had 10,000 N-95 masks on hand. As of July 22, the organization has 521,000 N-95 masks, which is the largest supply of masks in the Texas Medical Center. The Supply Chain also secured 3 million procedure masks and 1.2 million isolation gowns.

Much of this success is credited to the Supply Chain’s multi-tiered strategy for acquiring products. Texas Children’s obtains PPE in many different ways. The organization can source it through our Group Purchasing Organization (GPO), which most hospitals in the country do, or it can go out into the marketplace to secure aggressive deals.

“Prior to the COVID-19 pandemic, Texas Children’s primarily acquired N-95 masks from a single company,” said Bert Gumeringer, Texas Children’s senior vice president for Facilities Operations. “Since the pandemic, we are now sourcing PPE from three different U.S. suppliers, which has eliminated our need to purchase PPE product from China. If one of our suppliers can’t provide us with PPE, we have two other resources to meet our needs.”

Gumeringer and other leaders meet at least twice a week to discuss PPE and stay abreast of new developments in the global market. They meet daily with our PPE suppliers to discuss plant status, FDA approvals and incoming shipments. Despite rumors of PPE shortages swirling on social media, Gumeringer says there is no shortage.

“There is PPE out there if you know how to acquire it,” Gumeringer said. “Our Supply Chain team is doing an excellent job of helping us acquire product so we can support patient care. We have a good system in place.”

While Supply Chain continues to grow our PPE inventory, Dr. Judith Campbell says it is important for employees and staff to be mindful of their use of PPE and engage in conservation practices as much as possible. Many organizations like Texas Children’s are using a lot of PPE , especially N-95 masks.

“We are using 2,500 N-95 masks per day, which is the highest usage rate in the Texas Medical Center,” said Campbell, medical director of Infection Control and Prevention at Texas Children’s. “To conserve our supply, we encourage our staff to use a clean procedure mask over their N-95 when an N-95 mask is recommended, for example, when seeing a patient under investigation (PUI) for COVID-19.  After evaluating the PUI, remove the outer procedure mask, to extend the use of the N-95 mask.”

Campbell says if we all do our part, we can conserve the N-95 masks and other PPE supplies that we do have, which will help us in the months ahead during this pandemic.

Click here for PPE guidelines on the extended use of N-95 masks in certain patient care locations.

July 20, 2020

Heather Washington, a nurse in the cardiac intensive care unit (CICU) at Texas Children’s Lester and Sue Smith Legacy Tower, says one thing she enjoys most about being a nurse is seeing her patients making progress during their stay in the CICU and the excitement on their faces when it is time to go home.

While she finds these moments incredibly rewarding, she says some days on the unit can take a mental and emotional toll – like when it comes to sharing not so good news with her patients and their families.

“Each day, we are dealing with new circumstances and new challenges,” Washington said. “It is easy to get caught up in the emotions and sometimes you need to step away for a moment to collect yourself.”

With the recent opening of 39 respite rooms across the system, Washington and other frontline medical staff now have a quiet place where they can remove their face masks and other personal protective equipment and take a moment to relax and decompress so they can provide the best possible care to their patients.

“In response to the additional stress on frontline staff due to the COVID-19 pandemic, our leaders worked together to identify underused spaces that could be easily converted into respite rooms,” said Tarra Kerr, director of Nursing at the Emergency Center at Texas Children’s Medical Center Campus. “We collaborated with Employee Health and our Facilities and Operations teams to prepare these rooms for self-care purposes.”

The respite rooms – 31 at the Medical Center Campus, four at West Campus and four at The Woodlands Campus – are equipped with a recliner, lamp, end table and chair. The rooms also include self-care supplies like essential oils for aromatherapy, coloring books, a massage chair, yoga mats, stress balls, and guides on stretching techniques and how to manage stress in order to achieve optimal relaxation.

“It’s really nice to have respite rooms available for staff who need them,” Washington said. “I can come into the room and relax, look outside the window, and pretend to be somewhere else for at least a few minutes.”

To maintain social distancing practices, the respite rooms can be assessed only by one person at a time. Disinfectant wipes are located in each respite room. Users are required to wipe down all of the furniture in the room before another person uses the room. Wellness Ambassadors will be assigned to the respite areas to ensure the rooms are cleaned and to make sure supplies are restocked as needed.

Click here for a list of the respite locations across the system.