October 24, 2014

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Texas Children’s had the opportunity Thursday to show the Centers for Disease Control and Prevention firsthand how prepared we are to handle a suspected Ebola patient.

Members of the CDC “Fast” team, which assesses readiness and provides feedback about any gaps in Ebola preparedness, visited both Main and West campuses. While there, the team met with various Texas Children’s leaders and employees who have been instrumental in putting together the organization’s Ebola readiness plan.

“We welcome CDC’s input and guidance as we develop an Ebola preparedness plan second to none in the nation,” said Texas Children’s Physician-In-Chief Dr. Mark W. Kline, who was chosen by Chief Executive Officer Mark A. Wallace to lead our Ebola planning efforts and to create a model of preparedness here at Texas Children’s.

Kline has convened a core team of medical and administrative leaders to develop, implement and maintain our plans and protocols as the situation continues to evolve. He meets with Wallace daily and his team has been working closely with Infection Control, Nursing, Pathology, Critical Care, Emergency Medicine and Communications.

Texas Children’s started working on its Ebola readiness plan months ago in response to the Ebola outbreak in West Africa. The plan was tested in September when a suspected Ebola case presented at Texas Children’s Hospital West Campus.

Staff handled the case confidently and proficiently, diligently screening the patient, which allowed for immediate isolation as outlined in our protocol for handling suspected cases of Ebola. The patient ended up testing negative for Ebola but positive for malaria.

Texas Children’s continues to screen patients for possible Ebola exposure. The organization also continues to train staff on how to respond to a suspected case of the virus.

“I am confident in our rigorous, ongoing preparation efforts,” Wallace said. “We have a responsibility to our patients to deliver the best possible care at all times, but we also are intensely focused on keeping you – our physicians, staff and employees – safe.”

 

Return to Ebola Response site.

October 21, 2014

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Bright red signs asking patients if they have traveled to West Africa in the past 21 days were posted around Texas Children’s Hospital more than a month ago when the Ebola outbreak overseas continued to escalate.

A few weeks later, Thomas Duncan was diagnosed with Ebola at a Dallas hospital and later died. Duncan contracted the virus in Libera, one of three West African countries where Ebola has spread rapidly and killed thousands. Two of the nurses who cared for Duncan caught the infection and are being treated at hospitals in Georgia and Maryland.

No one has been diagnosed with Ebola in Houston, but Texas Children’s has been preparing for months in the event we receive such a patient. One of the first steps in that process is screening.

Staff in the Emergency Centers at both Main and West campuses and entry areas in the Pavilion for Woman are actively screening all patients for possible Ebola exposure.

Anyone who has traveled to Liberia, Sierra Leone, and Guinea in West Africa within the past 21 days is considered at risk and is immediately isolated. After isolation procedures are initiated, additional screening occurs and Infection Control is notified. The patient must be cleared by Infection Control to be removed from isolation.

Any patient with suspected Ebola will immediately be isolated in a pre-designated room, Infection Control will be notified, and additional screening will occur. Once deemed appropriate, the patient will be transported to a pre-designated room where they will remain until their treatment is completed.

At the West Campus, the patient will be transported to the Pediatric Intensive Care Unit and cared for by the nurses and physicians there. At the Main Campus, the patient will be transported to the pediatric care unit and cared for by nurses and physicians from the PICU. Since patients will only be placed and cared for in these units, other units do not need to designate isolated space for Ebola patients or receive extensive training.

All patients transported to Texas Children’s by the Houston Fire Department paramedics are screened prior to arrival in the Emergency Center.

Our clinics in the Critical Care Center and at the West Campus, pediatric and OB/GYN practices, urgent care centers and other community centers are being educated and informed on proper screening protocols and isolation methods should a suspected case of Ebola present at one of their locations. However, the care of that patient would not take place within these facilities.

As for visitors to our hospital, we are not actively screening them for travels to the affected regions in Africa, but they all are screened on a routine basis for signs and symptoms of any infectious disease. This screening occurs before visitors are allowed entry into the inpatient units. The screening includes questions about symptoms such as fever, cough, runny nose, and vomiting.

Remember, Ebola is only contagious when a patient is showing symptoms. Because symptoms associated with the virus are severe, it is highly unlikely that someone with Ebola would be visiting another patient in the hospital.

Because this is a rapidly evolving situation, all screening practices are routinely reviewed and will change if necessary.

For more information about the organization’s Ebola preparations please click on the “Ebola Response” logo on the Connect intranet site and on the parallel external Connect news site at texaschildrensnews.org, which is accessible from any computer or mobile device at any time.

If you have questions about our plan or about Ebola, please email them to connectnews@texaschildrens.org. The communications team will route questions to Dr. Kline and the leaders of our response and readiness team to get answers and provide updated information to our organization.

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Annual benefits enrollment is right around the corner, but now is the time to learn about your options so you can make the best decision for you and your family.

Enrollment this year will be from Thursday, October 30, through Friday, November 14.

A newsletter highlighting your benefit options and some changes for 2015 will be mailed to your home later this week. The newsletter also will provide information on tools that can help make the enrollment process simple and successful.

“Now is the time to learn more about your benefits and make your best choices for 2015,” said Jim Cuva, assistant director of Human Resources. “We have some great tools and resources available this year to help our employees have a successful enrollment.”

What’s new?

Here’s a quick preview of some of the main changes to next year’s benefits package:

Medical and Prescription Drug Coverage

  • Additional Plan Option: Texas Children’s is excited to introduce the Consumer Plus Plan (CPP), a consumer-directed health plan that includes a health reimbursement account (HRA) funded by Texas Children’s.
  • Increased EPO Expenses: An annual deductible will be introduced for both individual and family coverage under the EPO, and your coinsurance for services will now be 10 percent.
  • Prescription Drug Coinsurance: Coinsurance will now apply to brand-name prescription drugs purchased under the EPO and PPO plans. All three plans will have a copay for generic drugs.
  • Premium Changes: Although some employees with children will see a slight reduction in cost, most employee premiums will increase for the EPO and PPO plans. This increase reflects higher trends in medical and prescription drug costs.

Dental Plans

  • Reduced Dental Premiums: Dental rates will decrease by 5 percent in 2015, regardless of the plan or coverage tier you select.
  • Discounted Orthodontia: Discounted orthodontia will now be available onsite from Dr. John Wirthlin, including traditional braces and Invisalign for adults. These services will be available to all employees, regardless of whether they enroll in dental plan coverage.

Eligible Dependents

  • Domestic partners and their children will be eligible for coverage under our benefits plans.
  • This coverage includes both same-sex and opposite-sex partners, whether under legally married or common-law relationships.

Education and Information

  • Texas Children’s will be rolling out a new benefits website soon. Check your newsletter for details.
  • All benefits information will be posted on the new website. No benefits guides will be mailed to employees’ homes.
  • On the website, you’ll have access to Decision Direct, an interactive tool that can help you decide which plan works best for you and your family.

There will be several opportunities during the upcoming weeks to ask questions about the 2015 benefits package and to enroll in whatever plan you choose. Representatives from benefits vendors and Human Resources will be on hand during this year’s Benefits and Wellness Fair from 7 a.m. to 4 p.m. Thursday, October 30, on The Auxiliary Bridge. Human Resources representatives also will be visiting various departments throughout the organization and will have information and enrollment booths set up in high-traffic areas throughout the enrollment period.

Remember, if you want to change plans or coverage levels, or if you want to participate in the Flexible Spending Account, you’ll need to elect your benefits during annual enrollment, which is October 30 through November 14. If you don’t actively enroll during that time, your current medical, dental and other benefits will automatically carry over next year. Flexible Spending Account participation does not carry over from one year to the next, so you will need to reenroll.

During the past few weeks, you have heard from various leaders across the organization as to why they want you to get your flu shot. Now, it’s time to hear from your colleagues in other parts of the organization.

All six of the people below received their seasonal flu vaccine the first day it was offered at Texas Children’s. Listen to their stories to find out why they got the flu shot and why they think you should too.

Elizabeth Rincones, a patient care assistant with Texas Children’s Hospital, said she got the flu vaccine to protect herself and the children here at the hospital.

“We take care of kids every day, and if we are exposed to the flu, we could potentially expose them,” she said. “So, I think it’s very important to get the flu shot every year.”

Paige Simmons, a development associate with Texas Children’s, is pregnant with her first child and said she got the influenza vaccine to protect herself and her baby. Simmons urged other pregnant women to do the same.

“Definitely be vaccinated,” she said. “Little babies, they can’t handle it (the flu), so we need to watch out for them.”

Richard Lion is a fellow with Pediatric ICU Services and works with some of the sickest patients in the hospital. He said he got his flu shot because he didn’t want to put his patients at an increased risk of getting an infection that can be deadly to those with compromised immune systems.

“It’s well known that influenza is a terrible thing for them to experience,” Lion said. “Therefore, you can’t take any chances of putting them at risk.”

Clara Diaz, a patient care assistant who works with children who have pulmonary issues, said she gets the flu vaccine because she herself is at high risk of suffering complications from the infection.

“I already have asthma, so this lets me go,” Diaz said. “I can keep on working without stopping the work flow.”

Sarah Koohmaraie, a transplant coordinator, said she gets the flu shot every year to protect herself, her patients and her dad, who is a transplant recipient.

“I can’t think of anything more important,” she said of getting the vaccine. “The flu doesn’t discriminate, it gets everyone. So, the more people who get vaccines the better.”

Melvin Sergeant, a staff technician in Radiology, said he gets the flu shot because he knows firsthand what it’s like to have the infection.

“I’ve had the flu twice and I was hospitalized for it,” Sergeant said. “So, now I protect myself.”

Sergeant said other Texas Children’s employees should do the same.

“Please take the flu shot,” he said. “It will help you, plus it’s free.”

Employee Health is administering free seasonal influenza vaccinations to all Texas Children’s employees, Baylor College of Medicine employees working in Texas Children’s facilities, Texas Children’s medical staff and volunteers. Leaders from Texas Children’s Pediatrics, Texas Children’s Health Centers and The Center for Women and Children will inform their staff about seasonal flu vaccination details.

Click here to view vaccination schedules for both Main and West Campuses on Connect. Employee Health strongly encourages you to get your vaccine at one of the times listed on the schedule. If you are unable to do so, please schedule an appointment to get the flu vaccine at the Employee Health Clinic after Wednesday, October 1.

And, remember, getting an annual flu shot is part of Texas Children’s P3 incentive plan, which is an important component of the total rewards you receive at Texas Children’s Hospital. As part of P3, we are striving for at least 90 percent of our staff to get vaccinated by Monday, December 1. As of October 21, almost 65 percent of employees had gotten a flu shot.

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Texas Children’s is all about improving patient outcomes. Every day, we’re creating a healthier future for children through excellence in patient care, education and research.

A perfect example of this is Texas Children’s Neuroscience Center, where neurologists and neurosurgeons partner with researchers from the Jan and Dan Neurological Research Institute (NRI) to improve the lives of children with brain disorders.

A video spotlight of the Neuroscience Center features powerful testimonials from patients and experts in the field. Dr. Gary Clark, chief of Neurology; Dr. Thomas Luerssen, chief of Neurosurgery; Dr. Huda Zoghbi, director of the NRI; and Dr. Anne Anderson, medical director of the Epilepsy Monitoring Unit; share their team’s contributions to the Neuroscience Center, which have led to incredible advances in the way we diagnose and treat neurological disease and improve patient outcomes.

Children receive comprehensive, multidisciplinary care from a diverse team of specialists at the Neuroscience Center. On average, more than 30,000 clinic visits and 900 surgeries are performed at our facility each year.

Patients like 17-year old Ellie – whose battled seizures since she was a year old – came to the Neuroscience Center after exhausting all avenues. Today, her future is bright.

102214neuroscienceinside640“When I was younger, I was not able to go out and do things on my own, like walk a dog or go to school,” said Ellie. “The seizures used to be daily, sometimes four or five times a day. Texas Children’s has given me my life back.”

Ellie’s story is one of many success stories emerging from the Neuroscience Center, where our team of experts use a multidisciplinary approach to improve patient outcomes.

“We coordinate multiple specialties to treat children with neurological disorders in a profoundly different way,” said Dr. Clark.

Neurologists collaborate with neurosurgeons to deliver complete care in more than 12 pediatric specialty clinics, including our recently expanded Epilepsy Monitoring Unit, which closely monitors and treats patients with epileptic seizures.

The Neuroscience Center brings together a diverse group of pediatric specialists representing different areas of expertise:

  • Neurology
  • Neurosurgery
  • Neurophysiology
  • Neurological Critical Care
  • Genetics

“From diagnosis to treatment – whether it involves surgery, inpatient rehabilitation or access to a clinical trial – patients receive the full complement of services in one location,” said Dr. Luerssen.

However, the Neuroscience Center would not be this successful without the support of the NRI at Texas Children’s. Under the leadership of Dr. Zoghbi, scientists work tirelessly each day to uncover the genetic mutations responsible for a number of rare neurological disorders.

“Without research, it’s almost impossible to understand these devastating disorders,” said Zoghbi. “The NRI is the home of many physicians and physician-scientists who study brain disorders, in the hope of developing new therapies to improve the quality of life for our patients.”

Click here to learn more about the NRI. Click here to visit the Neuroscience Center website.

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By Lori Armstrong

As a nursing community, our thoughts are with both Nina Pham and Amber Vinson, the two nurses in Dallas who contracted Ebola after caring for a patient who died from this disease after returning from Liberia. These two new cases are the first confirmed transmissions of Ebola in the United States.

Nurses play such a critical role in the care of every patient. The treatment provided in situations such as these highlights the amazing work of nurses and the inseparable link between outstanding nursing care and patient care outcomes.

Ebola is a serious illness, and as a nurse myself, I understand and share the concerns that nurses and health care providers across the country have about Ebola. Texas Children’s is committed to providing the very best care to patients with suspected or confirmed Ebola while ensuring the safety of our caregivers. Nursing leaders are partnering with Infection Control and our physician colleagues to ensure the best protocols and procedures are in place, and I am confident that Texas Children’s Hospital is prepared.

Since suspected Ebola patients will be cared for by the nurses and physicians in the Emergency Centers, Pediatric ICUs, the Women’s Assessment Center, and in the Labor and Delivery Unit, it is unlikely that many of you will come in contact with an Ebola patient at the hospital. However, for those who may care for these patients, extensive training is being provided. We are so thankful to our dedicated colleagues in these areas for their participation in all the training and preparation that is ongoing.

We will support and protect our health care team

While caring for our patients remains our focus at Texas Children’s, we are also intensely focused on protecting our physicians, nurses and staff. Keeping each one of you safe as you care for these patients means that we will provide you with state-of-the-art personal protective equipment (PPE), extensive training and education in the use of PPE, and ongoing communication.

Personal protective equipment such as impervious jumpsuits or gowns, gloves, eye protection, facemasks and shoe covers are readily available and frontline employees are being trained on the proper use of this isolation equipment. We will use PPE practice drills as well as simulation to ensure competency of all employees who will be providing direct care to these patients.

Education and communication is of utmost importance, and we are doing everything possible to stay up to date with the latest information and share it with those who will be directly responsible for these patients’ care. As new information becomes available, leaders will work to quickly understand any new recommendations, make changes and communicate those changes to you.

Our preparedness has been tested

As mentioned, designated teams are in place and I am confident we are taking the right precautions to be prepared should an Ebola patient arrive at Texas Children’s. Two weeks ago when a patient who returned from Sierra Leone presented at our West Camus Emergency Center with a fever, the patient was immediately isolated and subsequently transferred to the PICU. The appropriate teams were notified and protocols were followed.

Our staff was ready and performed flawlessly. They were careful, deliberate and efficient, and the right care was provided. The patient was discharged several days later after a negative Ebola test. The entire leadership team and I are so proud of the way this team provided expert care and executed all of the appropriate protocols while supporting the patient, patient’s family and each other.

This is reassurance that we are well prepared to care for patients with Ebola.

We will keep you thoroughly informed

As professional nurses, I encourage all of you to stay up to date on the latest Ebola information we are sharing regarding our response and readiness.

Please check Connect regularly. You can also visit the external Connect news site at www.texaschildrensnews.org anytime. We also will continue posting information here on our Voice of Nursing blog. And as always, your nursing leaders and I are here to support each and every one of you and answer any questions you may have about our preparations.

The voice of nursing is especially critical during our preparation and planning for patients with Ebola. Therefore, your input, suggestions, questions and feedback are welcomed and appreciated. You will continue to play a vital role in the coming days, weeks and months.

I am honored to work among such compassionate, dedicated nurses. I have never been prouder of our team for taking such great measures to care for patients who need us most. You inspire me to be a better nurse and a better leader.

October 17, 2014

In a news conference held earlier today at the Capitol in Austin, Texas Governor Rick Perry announced initial recommendations for better containment and care of diagnosed Ebola patients in Texas.

Perry was advised by the 17-member Texas Task Force on Infectious Disease Preparedness and Response that he created earlier this month, days after the first case of Ebola was diagnosed in the U.S.

“One of the lessons learned over the last few weeks is the importance of having specialized facilities for bio containment and for training health care workers in order to manage the complex care required by patients with Ebola,” said task force member Dr. Peter Hotez who also is director of the Texas Children’s Center for Vaccine Development. “A key recommendation from the task force calls for the creation of such facilities.”

Perry’s task force recommended state designation of Ebola Treatment Centers equipped to treat and care for adult patients with confirmed Ebola. These state-designated Ebola treatment facilities would be equipped to provide highly specialized infectious disease care, including infection control and protection of health care workers, decontamination, waste management, complex early stage experimental therapies, and various coordination and communication capabilities with local, state and federal partners.

The group specifically recommended University of Texas Medical Branch/ Galveston National Laboratory (UTMB/GNL) for the treatment and care of adult patients with Ebola. UTMB/GNL is a leading resource for all aspects of high consequence infectious diseases like Ebola. In a statement released by UTMB on Thursday, the organization said it has the expertise to safely and effectively care for Ebola patient needs, and there already is a plan in place for staffing and fluid decontamination. UTMB also houses a qualified incinerator.

Additional recommendations from the task force include:

  • Establishment of two Ebola Treatment Centers in Texas
  • Establishment of specialized patient transport teams
  • Expanded training of infectious disease protocols for health care workers
  • More testing labs for infectious disease
  • Increased authority for Department of State Health Services chief to issue Enforceable Control Orders

The task force will have its first hearing on October 23 to focus on medical and public health preparedness for initial identification and isolation of patients with Ebola or similar high-consequence infectious diseases and will submit initial assessments and recommendations by December 1 for consideration by Governor Perry and the Texas Legislature.

To view details of the task force’s recommendations, please visit here.

The task force has not made recommendations for the care of pediatric patients or pregnant women, but Hotez said they are studying the matter and will have additional recommendations soon. In the meantime, Texas Children’s is maintaining its focus on the preparedness plans already in place.

“The recommendations for adult care do not impact our planning and preparation,” said Texas Children’s Physician-in-Chief Dr. Mark Kline. “We will continue to train and over prepare our health care team to confidently treat any patient who exhibits symptoms of any potentially contagious disease.”