September 26, 2018

 

As the largest children’s hospital in one of the fastest growing cities in the country, Texas Children’s high-quality care is always in high demand. However, due to high volume, getting patients and referring providers the answers and access they need in a timely fashion can be a challenge, which is why improving access has been a key focus at Texas Children’s in recent months.

Since the March 2018 launch of the Patient Access Initiative, several key improvements have been made to streamline processes for patients, including standardized clinic sessions and enhanced implementation of MyChart. On September 5, the Department of Surgery took a major step in improving access for referring providers with the launch of 1-855-TCH-KIDS, Texas Children’s new Provider Priority Line, available 24/7 exclusively for referring physicians and advanced practice providers.

“The Provider Priority Line creates a pathway for referring providers to have easier access to Texas Children’s surgeons for questions about patients,” said Dr. Sohail Shah, surgical director of Perioperative Services at Texas Children’s. “We want to make ourselves available to referring providers to assist them in the care of children across the state of Texas, and ultimately the region.”

Previously, if a referring provider had a question for a Texas Children’s surgeon, the communication pathway might route them across numerous Texas Children’s campuses, offices, clinics, and health and specialty care centers. This fragmented approach had the potential to result in multiple call transfers, which could contribute to delayed response times. Now providers can simply call the Provider Priority Line and reach on-call attending surgeons for specialties including Neurosurgery, Ophthalmology, Orthopedics, Otolaryngology, Pediatric Surgery, Plastic Surgery and Urology.

Department of Surgery leadership partnered with Texas Children’s Mission Control and Telecommunications Services to develop the line’s efficient communication flow.

  • When a referring physician calls the line, the call is triaged through Mission Control.
  • Mission Control gathers patient information, and determines the specialty area needed and whether the call is urgent or non-urgent.
  • The call is routed to the on-call attending surgeon at the Texas Children’s campus nearest to the referring provider’s location.
  • The attending surgeon calls Mission Control and is connected to the referring provider on a recorded line, which closes the communication loop.

Early metrics have shown rapid connection times between providers and on-call specialty surgeons, with responses for urgent calls occurring in 15 minutes or less. Initial referring provider reactions have been overwhelmingly positive.

“An early call we received was from a physician at a regional emergency center who had a question about a 14-year-old patient,” Shah said. “He was pleased to be able to speak directly with a pediatric surgeon and relay a care plan to the family immediately afterward. He said the usual course of action would have required an opinion from a local adult surgeon, which often led to a delay in definitive care.”

The Provider Priority Line will not only create easier access to Texas Children’s pediatric surgical expertise, it will also make interactions with providers more customer focused.

“Dr. Shah and his team, in collaboration with Mission Control, have developed a system that delivers an enhanced level of service for our referring providers, who very much appreciate help and advice when seeing pediatric patients who are dealing with complex problems,” said Texas Children’s Surgeon-in-Chief Dr. Larry Hollier. “As the largest children’s hospital in the country with the largest number of surgeons and operations, we should be able to provide them with the help they expect from us. With the Provider Priority Line, we can show them we’re committed to meeting and exceeding their expectations.”

In the near term, the service will be promoted to referring providers across the region with the ultimate goal of routing all such referring provider calls through the Provider Priority Line for a more streamlined experience. The long-term goal will be to extend the service to emergency centers and urgent care facilities as well. And in addition to 1-855-TCH-KIDS, there is also a local number available: 832-TCH-KIDS.

Learn more about how Texas Children’s is improving access.

September 10, 2018

What happens when 32 specialties at Wallace Tower, 16 specialties at Texas Children’s Hospital The Woodlands, and 51 Texas Children’s Pediatrics practices take part in their own “Shoot for the Stars” MyChart challenge? It means more patients and their families are signing up for My Chart, the hospital’s online patient portal.

Due to the tremendous success of the 5-week MyChart Madness Challenge in March – which generated close to 2,000 same-day MyChart activations across the hospital system – clinical staff launched a second competition to add to these successes, while engaging their teams around Texas Children’s Patient Access Initiative.

MyChart Instant Activation is one component of the Patient Access Initiative, which essentially pushes a text or email notification to patient families that allows them to sign up for a MyChart account via phone instead of having to use a computer to sign up. Patients are then able to access their personal health information, communicate directly with their care team at any time, and schedule their clinic appointments online.

The Shoot for the Stars My Chart Challenge began on July 23 and ended on August 31. The competition generated impressive results across the organization which has helped to improve access for our patients and their families.

Wallace Tower and The Woodlands

Over the course of five weeks, Wallace Tower generated a total of 979 same-day MyChart activations. Of the 32 participating clinics at Wallace Tower, the neurology team won with 204 same-day activations. Over the course of four weeks, The Woodlands campus generated 100 same-day activations with Dermatology winning the challenge.

Texas Children’s Pediatrics

Texas Children’s Pediatrics (TCP) conducted their own competition which began on July 23 and ended on September 2. TCP generated a total of 11,206 My Chart activations. Several practices won weekly and overall raffles including TCP Baytown, Cy-Fair, Lakewood, Pasadena, PMG and Sterling Ridge.

Texas Children’s Pediatrics also conducted a creative competition where each TCP practice designed a creative campaign to display the benefits of MyChart and encourage MyChart activation.

Here are the top three creative campaign winners:

  • TCP Pasadena – “MyChart is Out of this World”
  • TCP Heights – “Be Incredible…Sign Up for MyChart
  • TCP Rayford – “MyChart-Land”

Click here to view all of the MyChart campaign posters.

Patient access: Opening the door at Texas Children’s

Since launching this initiative in March, Texas Children’s has seen significant improvements in patient access across the hospital system. Several enhancements were implemented in waves across specialties which included:

  • Standard clinic sessions: After evaluating 944 provider templates, extra slots were found where physicians could see patients for a duration of four hours. By standardizing clinic sessions for all specialties across Texas Children’s, over 53,000 new appointments have been added to the system.
  • MyChart activation: In October 2017, the organization had less than 8,000 monthly MyChart activations. To date, we have now exceeded over 60 percent activation for MyChart throughout the system.
  • Direct scheduling: More than 100 patients have used this online feature that allows current patients to quickly and easily schedule appointments online on MyChart.
  • Electronic waitlist: This MyChart feature automatically offers up available appointments to patients desiring a sooner appointment. Since its implementation, over 300 patients have accepted an appointment on average 52 days earlier than their prior appointment.

Click here to watch this video that highlights our patient access journey and our recent accomplishments.

July 3, 2018

“Thanks to online scheduling, it’s super easy to make appointments through MyChart now,” wrote a Texas Children’s family. “The past several times we’ve been here, we have been in and out in less than 45 minutes with the same level of quality and care. It seems like they heard our concerns loud and clear, and it shows that they care.”

This touching comment from a patient family in our Texas Children’s Pediatrics Cinco Ranch location is one of several inspiring patient testimonials that demonstrate our continued commitment to improving patient access.

Several months ago, Texas Children’s Access and Patient Scheduling Task Force conducted a baseline assessment of the hospital’s current landscape which revealed several opportunities to improve access for our patients. The Task Force proposed more than 30 recommendations and prioritized which ones would be implemented first.

Since implementing these solutions in four waves across different specialties throughout the system – the first wave went live on March 1 and the fourth wave went live on June 1 – patient families have noticed a positive difference.

Below are several impressive results during the implementation of Waves 1 to 4:

Increase appointment capacity: After evaluating 944 provider templates, we found extra slots where physicians could see patients for a duration of four hours. By standardizing clinic sessions for all specialties, over 53,000 new appointments were added to the system annually, 44 percent of those offering availability for new patients.

MyChart activation: Since launching MyChart Madness in March, Texas Children’s has seen a significant increase in MyChart activation rates. In October 2017, we had less than 8,000 monthly activations compared to over 18,000 in March. To date, Texas Children’s has a total of 72,006 same-day MyChart activations. A similar competition will be launched in July to ensure we’re getting as many patients to sign up on MyChart as possible by the end of FY18.

Online scheduling: More than 100 patients have already used this online feature to schedule their appointments. Six specialties have gone live with online scheduling for MyChart users. Nine more specialties will go live on July 23 and by September all specialties will offer online scheduling. Texas Children’s has partnered with a vendor to set up an online scheduling infrastructure for new patients who do not have a MyChart account.

Fast Pass Waitlist: Since implementing an electronic waitlist in MyChart that automatically offers up available appointments to patients desiring a sooner appointment, over 200 patients have accepted. On average, patients are getting into earlier appointments 60 days faster. So far, 16 specialties have gone live with this new feature.

One of these patients who benefitted from the electronic waitlist feature on MyChart was 10-year-old Aiden Blancas whose mother was able to get him into a dermatology appointment a lot sooner than expected.

“My son’s original appointment date was scheduled for September 4, but when I got an electronic notice via MyChart asking me if I wanted to accept an appointment in June, I accepted it,” said Monica Blancas. “While we usually go to the medical center for appointments, I didn’t mind driving a little further for my son’s appointment in Katy if it meant that I could get him in to see a doctor a lot sooner than originally scheduled.”

While improving patient access at Texas Children’s continues to remain a priority, more system-wide solutions are being considered that will further enhance patient access across the hospital system.

“Since implementing our patient access initiative, we have made significant progress to ensure our patients get into our system according to their urgency and timeline,” said Texas Children’s Assistant Vice President Carrie Rys. “We plan to continue these efforts into the next fiscal year with additional goals aimed at improving patient access.”

June 5, 2018

In an effort to better serve patients seeking care at one of 10 Texas Children’s Urgent Care sites, wait times for each location have been posted on the Urgent Care website.

“Our goal is to be completely transparent to our families as to how long it takes for them to be seen,” said Melissa Fischer, director of community and business development for Urgent Care and Texas Children’s Pediatrics. “For families that live in between two locations, we believe that posting wait times will help our families choose which site to visit.”

The information also will help manage expectations around wait times, which average about 17 minutes from check-in to being taken to a patient room. Patients spend about 60 minutes from check-in to check-out.

The wait time feature on the Urgent Care website is automatically updated every five minutes based on the number of providers who are seeing patients and the number of patients who have checked in.

The feature was piloted at Texas Children’s Urgent Care Pearland and was then implemented in Austin. As of May, online wait times are available for all Urgent Care locations.

Save My Spot is also available to patients and families visiting one of our Urgent Care locations, allowing them to reserve a time slot from the comfort of their own home. All the patient family member has to do is pre-register online and the check-in process is expedited. Their personal information is also pre-populated which makes the process easier for existing patients.

“Patients and their families now look for ease and convenience in every aspect of their lives,” said Roula Smith, director of Urgent Care business operations. “You are able to save a spot at places like the DMV and restaurants, why not at Urgent Care?”

Smith added that, Save My Spot allows Urgent Cares to stay competitive as well as evenly distribute patients throughout the day to be more efficient overall.

Save My Spot also was piloted at the Pearland location, and is now available at all Urgent Care locations. More than 600 patients have used the feature to date.

Welcome, an electronic check-in process, is another feature that has been created to expedite the registration process. Check-in is done on an electronic tablet, making the experience paperless. This feature is expected to be rolled out to all Urgent Care locations soon.

Texas Children’s Urgent Care was launched in 2014 and currently has 10 locations, all of which are staffed by board certified pediatricians who diagnose and treat a wide variety of ailments, illnesses and conditions, including: asthma, strep throat, fever, minor burns, influenza, ear infections, allergic reactions and more. Procedures provided include: antibiotic injections, breathing treatments, fracture care and splinting, IV (intravenous) fluids, lab services, laceration repair and X-rays onsite.

For more information about Texas Children’s Urgent Care and its locations, click here.

May 8, 2018

From our three hospital campuses to our health centers, urgent care and pediatric practices, Texas Children’s continues to focus its efforts on enhancing patient access. Since implementing solutions for the first two waves of specialties over the last two months, patient families are noticing a positive difference.

For Christina Williams, being able to schedule her 13-year-old son’s clinical appointment 21 days sooner than the originally scheduled appointment has been nothing but a game changer for her.

“I scheduled my son for an appointment in April to see an allergist at Texas Children’s Health Center in Sugar Land,” Williams said. “When I logged on to MyChart, I received an instant notification about an available opening in the Wallace Tower clinic and I quickly accepted it. This process is quick, easy and convenient, and it’s great knowing that I can be notified on MyChart as soon as an opening becomes available.”

First launched on March 19 with two subspecialties – Allergy and Immunology, and Baylor College of Medicine OB/GYN – MyChart’s electronic waitlist feature automatically offers patients and their families on the waitlist earlier appointments once their MyChart account has been activated.

Since the new feature went live for these two subspecialties in mid-March, there have been multiple offers accepted to help families get earlier clinical appointments. Below are the results as of April 30:

  • Combined acceptance rate of 8.2 percent for Allergy and Immunology, and Baylor OB/GYN with average day improvement of 56 days
  • Acceptance rate of 7.4 percent for Allergy and Immunology with average day improvement of 54 days
  • Acceptance rate of 10.7 percent for Baylor OB/GYN with average day improvement of 64 days.

The remaining Wave 1 specialties along with Wave 2 will go live with this new feature on May 21. These subspecialties are Orthopedics, Rheumatology, Nephrology, Neurology, Adolescent/Sports Medicine, Dermatology, Gastroenterology, Pediatric Gynecology, Ophthalmology, Orthodontics, Plastic Surgery, Urology and Cardiology.

MyChart Instant Activation

While the nation was glued to the NCAA’s March Madness college basketball tournament, Texas Children’s remained focused on scoring patient access points during MyChart Madness.

On March 19, clinic staff at Mark Wallace Tower participated in a collaborative, 5-week MyChart Madness competition to increase MyChart activation rates across the hospital system, resulting in more patients and their families taking advantage of the benefits of this online patient portal.

MyChart Instant Activation essentially pushes a text or email notification to patient families that allows them to sign up for a MyChart account via phone instead of having to use a computer to sign up.

“Out of the 32 participating clinics at Wallace Tower, a total of 1,096 same-day activations were generated as a result of MyChart Madness,” said Rachel Norman Brock, manager of Ambulatory Clinics at Texas Children’s. “The Urology team was the winner of the MyChart Madness competition with 118 same-day activations.”

During the first week of instant activation across the Texas Children’s hospital system, there were 3,492 same-day activations, almost half of which resulted from instant activation. To date, Texas Children’s has a total of 6,974 same-day activations thanks to our collaborative team efforts to enhance patient access.

Other strategies to improve patient access

Championed by administrative and physician leaders from medical, surgical, and women’s service lines, the Improved Capacity & Improved Utilization workgroup has been focused on ensuring that providers have appointments in their schedules for our patients when it is most convenient for them to be seen.

By first evaluating appointment templates and aligning provider schedules to a standard four-hour clinic session definition to ensure patients receive the service and availability they need, the organization was able to add over 36,000 new patient appointments annually into the system through Waves 1, 2 and 3 of the project. The team looks forward to additional slots as Wave 4 goes live on June 1.

“To date, the workgroup has partnered with 28 specialties and over 600+ providers to create increased appointment availability, particularly for new patients that are currently facing long waits to be seen in our clinics,” said Grace Karon, project manager for Ambulatory Services at Texas Children’s. “With these new appointment slots, the team is proud to be helping our patients access the care that they need.”

March 29, 2018

While the nation is glued to their TVs watching the NCAA’s “March Madness” college basketball tournament, Texas Children’s is focused on scoring patient access points during MyChart Madness.

On March 19, Texas Children’s launched MyChart Instant Activation and Fast Pass as part of the hospital’s system-wide initiative to improve patient access. MyChart is an online patient portal where patient families can schedule clinic appointments, communicate with their health care providers and access their health records at any time.

“When we implemented MyChart in 2010, one of our goals was to enable parents to become active participants in their child’s health care,” said Julie McGuire, director, Enterprise Systems Clinical, at Texas Children’s. “Through these recent enhancements to MyChart, we are continuing to cultivate a positive experience for our patients, children and women, and their families, while delivering the highest level of care possible.”

MyChart Instant Activation

MyChart Instant Activation essentially pushes out a text or email notification to Texas Children’s patient families that allows them to sign up for a MyChart account. Instead of having to use a computer to sign up, families who receive the invitation can now use a smart phone to activate their MyChart account and download the MyChart mobile app. Clinic staff at Texas Children’s Pediatrics (TCP) and Mark Wallace Tower have seized on the excitement of this new notification tool – and the current excitement around the college basketball tournament – by joining in a collaborative MyChart Madness competition. Other campuses like Texas Children’s Hospital West Campus have been successful in implementing MyChart Mondays where patients and their families can register on the spot.

“Our employees and staff have embraced this friendly and collaborative competition which has had a positive impact on patient access,” said Rachel Norman Brock, manager of Ambulatory Clinics at Texas Children’s. “Instant Activation provides the organization with another way to increase MyChart activation rates across the hospital system, resulting in more patients and their families taking advantage of the benefits of this online patient portal.”

The MyChart Madness teams are grouped in regions – Midwest, West, East and South – and the winner of the entire bracket receives a prize. MyChart Madness originated with TCP. TCP staff and employees launched the push to increase activations on March 1, and within just three weeks, the practices activated 9,003 new MyChart accounts. TCP’s success in promoting MyChart activations across its 51 practices inspired leaders across the organization.

During the first week of instant activation across the Texas Children’s hospital system, we had 3,492 same-day activations, almost half of which resulted from instant activation. This was a significant increase considering that a month ago, prior to the launch of MyChart instant activation, we had only 1,972 same-day activations.

Currently, several of our Texas Children’s Health Centers are doing an outstanding job of increasing MyChart activations. Cy-Fair Health Center achieved 100 percent same-day activations the week of March 11.

Fast Pass

Once families have activated a MyChart account, they have access to features like Fast Pass, which also recently launched with two subspecialties on March 19. Fast Pass creates an electronic waitlist, and automatically offers patients and their families on the waitlist sooner appointments. Patients also have the ability to add themselves to the waitlist via MyChart.

Just last week, a patient who had an April 12 appointment with Allergy/Immunology at the Sugar Land Health Center was seen 21 days sooner than originally scheduled when an opening became available at the Wallace Tower.

“Since Fast Pass went live, there have been seven Fast Pass offers accepted to help families get earlier appointments,” said Julie Barrett, director of Outpatient and Clinical Support Services at Texas Children’s. “We are so proud of our teams and their diligent work in helping us achieve these recent success stories on patient access.”

MyChart Instant Activation and Fast Pass are both tactics in Texas Children’s strategy to improve patient access. In just three short weeks since Texas Children’s launched the patient access initiative on March 1, the hospital has added 10,000 new patient appointments annually into the system. After evaluating appointment templates for over 200 providers, additional slots were found where physicians could see patients in four hour blocks.

“We must ensure that all patients have access to the amazing clinical programs offered at Texas Children’s,” said Texas Children’s Assistant Vice President Carrie Rys. “Our Patient Access Committee has identified many system-wide solutions that will enhance patient experience across the system. These will be implemented in phases over the next several months. Improving patient access at Texas Children’s is our focus and priority.”

March 6, 2018

As one of the top pediatric hospitals in the nation, many patients come to Texas Children’s to access the high quality care and services that our hospital provides to children and women. But often times, trying to schedule an appointment to get into our system can be frustrating for patients and their families.

That’s why Texas Children’s is hitting this challenge head on. Several months ago, the Texas Children’s Access and Patient Scheduling Task Force conducted a baseline assessment of the hospital’s current landscape which revealed several opportunities for the organization to improve access. The Task Force proposed more than 30 recommendations and prioritized which ones would be implemented first.

The first wave of specialties went live on March 1, aligning provider schedules to a standard four-hour clinic session definition to ensure patients receive the service and availability they need. Six specialties impacted during the first wave of operational improvements include: Allergy & Immunology, Rheumatology, Nephrology, Neurology, Orthopedics and Baylor College of Medicine’s Obstetrics/Gynecology. There will be three more waves launching from April to June to standardize clinic sessions for all of the specialties at the hospital.

“After we evaluated appointment templates for over 200 providers, we found additional slots where physicians could see patients for a duration of four hours,” said Texas Children’s Assistant Vice President Carrie Rys. “By making that recommended change, we were able to add about over 10,000 new patient appointments annually into the system.”

Last year, 20 percent of appointment slots were unfilled due to restrictive scheduling practices and last minute cancellations. The committee also identified more than 60 different referral processes throughout the system, which made it extremely cumbersome for patients and families to access our care.

With tremendous support from Texas Children’s leadership, the committee identified additional system wide recommendations that will be implemented in waves over the next several months including:

  • 72-hour flip: If an appointment slot for a specific patient type is not filled 72 hours out, the slot will open automatically to a broader group of patients to maintain flexibility and open schedules
  • Fast Pass: This new MyChart feature creates an electronic waitlist and automatically offers up cancelled appointments to patients desiring a sooner appointment.
  • Online scheduling: Since most families overwhelmingly prefer online scheduling, referral and scheduling processes will be streamlined and standardized across the system to enable online scheduling for new and existing patients across all specialties beginning later this year.
  • Future idea development: The committee is vetting additional recommendations including how to optimize space utilization, pursue a formalized escalation process and leverage telemedicine.

“Our objective is to lay a solid foundation and layer on additional patient access solutions once we have a sturdy infrastructure to build from,” said Texas Children’s Surgeon-in-Chief Dr. Larry Hollier and co-chair of the Access Executive Steering Committee. “Because we really care about our families, we have to pay attention to their needs and do more to help them out. We have to keep the doors open to our patients.”