December 14, 2020

We heard you, Texas Children’s!

After inviting our team members to participate in the first Amplify Unity pulse survey on diversity and inclusion, more than 2,500 of you raised your voices to share how we can cultivate more open and honest conversations that build trust, respect and understanding.

Based on your votes and the algorithm used by the Waggl pulse survey platform, the top survey responses called out a need for the organization to “increase diverse representation” and “enable equality of opportunity.” You want to “include everyone in the dialogue” and provide “more education on effective communication,” particularly how to handle crucial conversations. You want to see the hiring and promotion of leaders who are “comfortable discussing diversity and inclusion,” and you want us to recognize the “value in diversity of thought” by “listening to a variety of employees” and encouraging participation from those who don’t usually contribute to conversations.

Now, we’re turning your candid and honest feedback into meaningful action that will expand our commitment to diversity, equity and inclusion – moving all of us forward in the ongoing journey to ensure a workplace where every team member can feel they are valued and belong. Here’s where we plan to focus our efforts in 2021:

  • Building on Our Culture of Inclusion and Belonging
  • Helping You Navigate Difficult Conversations
  • Overcoming Our Unconscious Biases
  • Developing Our Leaders

For details on each area of focus and a full summary of the Amplify Unity pulse survey results, click here or tap the image above.

By participating in the first Amplify Unity pulse survey, our team members showed how much can be learned when we listen to each other and welcome the unique perspectives that make our organization so strong.

Look for additional updates and information about Texas Children’s ongoing movement to support diversity, equity and inclusion among our workforce throughout the coming year.

As we all gear up for 2021, excitement is building about the new Epic Tapestry health care management system. This year has brought significant progress in the project; with testing, communication and training as the focuses going forward.

“In a normal year, we would be proud of the work that’s taken place,” said Richelle Fleischer, senior vice president. “But the fact that we hit project milestones amid a leadership change, a global pandemic, hurricane preparations and so much more is truly remarkable. We can all agree that 2020 has been one for the books and to see Tapestry team members persevere is commendable.”

John Turner, assistant vice president for Information Services, says the project is on track and scheduled to go live in June of 2021. He urges employees to stay engaged. “We are in the homestretch of our roll-out and it’s more important ever that all teams tune into communications and receive the proper training,” he said. “Articles, videos, emails and virtual training sessions will be plentiful next year. Let’s get excited, engaged and trained.”

Employee communications will continue in January. Watch Connect, your inbox and the upcoming Sharepoint site to stay informed. In the meantime, view the series of stories that are linked below.

In pursuit of a healthier planet – Care Coordination (Healthy Planet Module)
https://texaschildrensnews.org/in-pursuit-of-a-healthier-planet/

Being a member is about to get even better – Member Services
https://texaschildrensnews.org/being-a-member-is-about-to-get-even-better/

The Money Matters of Epic Tapestry – Finance & Claims
https://texaschildrensnews.org/the-money-matters-of-epic-tapestry/

An improved provider experience is on the way – Provider Relations
https://texaschildrensnews.org/an-improved-provider-experience-is-on-the-way/

The story you are about to read is part of an ongoing series about Texas Children’s efforts to care for women and children around the globe. The series highlights Texas Children’s efforts in Malawi, one of the 17 countries we currently serve. Today’s story focuses on the care of expectant mothers in Malawi via a unique private-partnership between Texas Children’s, Baylor College of Medicine Children’s Foundation-Malawi and the Ministry of Health of Malawi.

Eneless Janlathanle lives about 12 miles from the nearest hospital in Lilongwe, Malawi. That might not seem far, but it is quite a way when you don’t have reliable transportation. This barrier to health care is what led Eneless to deliver her second child at home, an experience she said she does not want to repeat if she had another child.

“My delivery at home was hard,” Eneless said. “I knew I couldn’t do that again.”

Due to the growth and success of the Area 25 Health Center – a unique public/private-partnership between Texas Children’s, Baylor College of Medicine Children’s Foundation-Malawi and the Ministry of Health of Malawi – Eneless didn’t have to deliver her third child at home. Instead, she spent two-plus weeks at the center’s maternal waiting home and gave birth to her child in the nearby labor and delivery ward.

During her stay, Eneless ate food from the center’s permaculture garden and learned how to grow and cook similar food when she returned to her village. The 24 year old also took perinatal classes to better learn how to take care of herself and her baby. The experience, Eneless said, was wonderful.

“I was comfortable and well taken care of,” she said. “I also gained a lot of knowledge that I could take back home.”

A paradigm shift

Women like Eneless and their children are disproportionately affected by lack of access to health care services, particularly in resource limited settings. Malawian women have some of the worst odds with 675 deaths per 100,000 live births – among the highest maternal mortality ratios in the world. By contrast, the ratio for US women is 14 deaths per 100,000 live births.

To improve these odds, the Global Women’s Health program has invested a lot of time and effort into expanding the quality and quantity of services offered at Area 25 Health Center, significantly alleviating the burden of increasing demand for maternal and neonatal services at Kamuzu Central Hospital (Lilongwe’s referral hospital) and Bwaila Maternity Hospital, the largest maternity unit in the region with 17,500 plus deliveries per year.

With the help of generous donors, a maternal waiting home, a four-room operating theater and most recently a new maternity ward have been built to help clinicians, midwives and non-medical staff better serve the women and children of Malawi.

“When we first became involved, there were about 1,800 deliveries a year at Area 25,” said Dr. Jeffrey Wilkinson, vice chair of Global Health and professor, OB-GYN and director of the Global Women’s Health Program, public-private partnership that has invested a lot of time and effort into expanding the quality and quantity of services offered at Area 25 Health Center. “Now there are more than 6,500, the same amount of babies born per year at the Pavilion for Women.”

The bulk of that growth began a little more than a year ago when a four-room operating theater opened at Area 25, providing a safe haven to pregnant women and newborns in need of surgical care. Prior to the opening of this theater, women who needed a cesarean delivery and babies with even minor neonatal issues were referred to Kamuzu Central Hospital or Bwaila Maternity Hospital. The theater at Area 25 has helped alleviate the pressure on those hospitals and has given women and babies another chance to receive the care they need.

Dr. Ibe Iwuh, one of the OB-GYNs at the health center, said when coordinated efforts began, more than 20 percent of their patients who needed surgical intervention were referred to a hospital with an operating theater and that about half the time, their babies didn’t survive because the referral either happened too late or there was another delay in intervention.

“Since we started operating here, we have seen significant reduction in those numbers and the overburdening that happens at the referral unit,” Iwuh said. “So, it’s no question the theater has supported and greatly improved the quality of health care we provide.”

A safe haven

The maternal waiting home has made a significant impact on patient outcomes as well. Built in 2013 with the help of a Bill and Melinda Gates Foundation grant, the red building with green trim can house almost 40 women who are in the latter stages of pregnancy and either need or want to be close to a medical community prior to going into labor to avoid a secondary delay in accessing maternal care.

During their time at the home, women learn how to take care of their babies and themselves after pregnancy. They learn about family planning, nutrition and hygiene. They also are taught income generating skills such as sewing, knitting and gardening.

The women are encouraged to take the knowledge and skills back to their communities where they can share it with community members. These programs are unique to Area 25 Health Center and are focused on sustaining a woman and baby’s health beyond the health care setting.

“It’s not easy to take care of a baby, especially in our setup where resources are so limited,” said Ruth Moyo, manager of the waiting home. “Teaching them how to take care of their baby, the importance of vaccines and family planning, and the dangers of pregnancy, is like preventing maternal and neonatal death. It’s also empowering them to be more self-sufficient when they leave and go back home.”

Surrounding the maternity waiting home, is a diverse and vibrant permaculture garden packed with healthy fruits, vegetables and herbs. Cultivated and designed by Afshan Omar and her team, the garden has grown steadily in the two years it has served the community. What started out as a few small beds is now a lush mandala-shaped ever-expanding edible landscape filled with food that women at Area 25 Health Center can learn to cook, eat, grow and cultivate on their properties.

“Permaculture is a design system using sustainable agricultural methods that mimic patterns of natural ecosystems,” said Omar, a native Malawian who oversees the permaculture and environmental program at Area 25 Health Center. “In a country where the majority of people are small scale farmers with a limited range of healthy and diverse crops, the garden provides a unique opportunity to teach healthy crop cultivation, while inspiring an improved quality of a life for the patients to take home.”

Every woman who leaves the center is given two seedlings, a fruit tree seedling and a bamboo seedling. During their stay at the maternal waiting home, they learn how to care for those seedlings and understand their importance in nature, while also growing and cooking the food they are fed from the permaculture garden. Taking this knowledge back home, gives the women at the waiting home a sense of achievement in learning the ability to create a productive and aesthetically green space within their homesteads.

Broadening their nutrition is important. Many women at the maternity home are used to eating a local dish called nsima, which is a blend of maize and water with beans or a type of tomato and onion relish. They are not used to eating different types of vegetables that are more nutritious for their bodies and the bodies of their children.

“Historically in Malawi, people ate a lot of sorghum, millet, cassava and sweet potato, but you don’t find that to be a normal part of the diet anymore,” Omar said. “We are trying to gradually reintroduce these things back into these women’s diets through gardening and cooking classes.”

Omar’s efforts are paying off. Throughout the week, women at the waiting home would walk into the outdoor kitchen and ask Omar how to cook a dish that was served the day before or they ask her how to cook something they’ve found interesting in the garden. More importantly, they clean their plates. They eat the colorful concoctions Omar has created and infused with her passion of connecting people and nature.

“It’s been very positive,” Omar said. “The partnership between Texas Children’s, Baylor and the Ministry of Health is a beautiful synergy that’s allowing an innovative model of care to prosper and grow.”

Model of care

The latest outcome of that partnership is a new nine-bay labor and delivery ward adjacent to the maternity home. The unit opened in May and is providing women a private place to give birth, and clinical workers more space to deliver the same amount of babies per year born at the Pavilion for Women.

Each room in the new labor and delivery ward is equipped with a swinging door that leads out to a nurses’ station. One of the nine rooms has a private bath and shower. The other eight rooms share four private baths and showers, each with a sliding door for easy access.

Prior to opening the new ward, women at Area 25 were delivering their babies in a six-bed labor and delivery ward on beds lined up in one room separated by curtains. Because of the cramped quarters, family members were not able to accompany or help their loves ones during delivery. The new ward has enough space for one family member to be in the room during delivery, an accommodation that is somewhat unique in health care facilities across Malawi and sub-Saharan Africa.

“This has been a transformational gift for the women and babies in this region,” Iwuh said. “It’s helped us not only provide high quality care, respectful care to women but also to demonstrate the potential between a public-private partnership between a US academic institution, a US health care organization, and the Malawi Ministry of Health.”

Dr. Chikondi Chiweza, one of the OB-GYNs at Area 25, said it’s very satisfying to see Area 25 become one of the busiest maternity wards in the area.

“Because of the waiting home, women who might have gone into labor far from a medical institution now have a safe place to wait during their last few weeks and days of pregnancy,” Chiweza said. “The operating theater has enabled us to take care of more complex patients, and the new maternity and labor ward will allow us to better meet the ever-growing demand of births and well-woman services.”

Wilkinson said he believes what’s being done at Area 25 Health Center is a model of care that is sustainable and will be employed in other area of the country. He said it falls right in line with Baylor and Texas Children’s goal of providing the highest quality of care to the women and children we treat through our Global Women’s Health program and its many partners.

“Texas Children’s Hospital and Baylor College of Medicine are working together to respond to the needs of underserved communities throughout the world through a network of health care professionals dedicated to providing the best clinical care and treatment available, building health care capacity through education, and advancing clinical discovery with cutting-edge research programs,” he said. “Texas Children’s Global Women’s Health is proud to partner with the Malawi Ministry of Health, University of Malawi College of Medicine, and many local and international partners. Our work is made possible by the generous support of donors hoping to make a change in the lives of women and children in resource limited settings.”

For more information about Area 25 Health Center, click here. To make a donation to Texas Children’s global health efforts, click here.

This installment of the “Take FIVE” series provided by the Psychology Section’s Collaborative on Racial Equity and Inclusion (REI) for Black Youth focuses on how to incorporate anti-racism into the holiday season. The holidays are an important time for families to establish traditions that can carry on for a lifetime, especially for children – what better opportunity is there to make anti-racism part of the foundation? Here are 5 actions you can take this holiday season:

1. Books always make a great gift idea for the children in your life! Consider books by Black authors – here are some ideas:

  • Black Is a Rainbow, Angela Joy
  • Parker Looks Up, Parker and Jessica Curry
  • Kamala & Maya’s Big Idea, Meena Harris
  • Brown Boy Joy, Dr. Thomishia Booker
  • Hair Love, Matthew A. Cherry
  • SULWE, Lupita Nyong’o
  • My Brother Charlie, Holly Robinson Peete & Ryan Elizabeth Peete
  • President of the Whole Fifth Grade, Sherri Winston
  • A Good Kind of Trouble, Lisa Moore Ramee
  • ABC I Love Me, Miriam Muhammad
  • The King of Kindergarten, Derrick Barnes
  • Saturday, Oge Mora
  • A is for Ambition: A Motivational Read for Future Go Getters, Antonio Hunter

2. As we outlined in our post on supporting Black-owned businesses, buying these books from Black-owned bookstores can make a big difference. Here are a few to check out:

3. Toys are fun for the holidays, too! Consider buying toys that represent Black children or are from Black-owned toy companies, such as:

4. The holidays aren’t all about consumerism – volunteering is an important holiday tradition for many families. Here are some local organizations with volunteer opportunities:

5. What is the holiday season without music? Enjoy some of our favorite holiday tunes by Black artists:

  • “The Christmas Song” (Chestnuts) by Nat King Cole
  • “Deck The Halls” by Pentatonix
  • This Christmas by Donny Hathaway
  • I Saw Mommy Kissing Santa Claus – Jackson 5
  • Santa Claus is Coming to Town – Jackson 5
  • Do you Hear What I Hear – Whitney Houston
December 8, 2020

Texas Children’s Team Members,

Many of you have already opted in to participate in Texas Children’s Phase 1 deployment of the COVID-19 vaccine. If you have not already, you can still opt in to receive the vaccine by filling out the questionnaire at the link below:

Click here to access the Opt-In Questionnaire
All information is kept strictly confidential and only accessed by Employee Health.

Although we are currently planning for supplies of the vaccine to be limited initially, Texas Children’s has designed an equitable allocation framework to assign team members into different distribution phases, based on recommendations from the National Academy of Medicine, as well as guidance from state and federal authorities. As part of this process, Employee Health will evaluate team members who opt in against multiple objective risk elements, all of which are rated equally and include a person’s risk of acquiring infection, risk of transmitting infection, risk of severe illness and death, and risk of an individual’s infection impacting Texas Children’s ability to provide care for our community.

Please note that the pace at which we advance through each phase will be contingent on when and how many doses of the vaccine Texas Children’s receives. To stay up to date on the latest information and timing, please check your email, Connect and our COVID-19 Vaccine website at texaschildrensbenefits.org/CovidVaccine. To view the email announcement sent earlier this week, please click here.

Thank you for your tireless leadership and your compassionate care of our patients, their families and one another throughout our COVID-19 response.

Dr. Julie Boom and Jermaine Monroe
Co-Chairs, COVID-19 Vaccine Task Force

December 7, 2020

Exciting changes are on the horizon for Texas Children’s with the arrival of a new software solution that will unify our Human Resources, Finance and Supply Chain Management systems and move them into the cloud.

Dubbed the Voyager project to reflect the bold adventure that awaits us over the next 22 months, and the courageous way our employees embrace freedom by fearlessly adopting innovative technology, the new software is developed by Oracle and will replace PeopleSoft. Implementation will occur in four waves, and the Oracle solution is currently on track to go live starting with Human Resources in July 2021.

The Voyager team officially kicked off the journey in September and has now transitioned into the Design Phase, which consists of a series of collaborative sessions that help identify how work will be organized in the future state for HR, Finance, Supply Chain and Information Services.

“In many ways our journey to the cloud is just getting started, but we have all the right people, plans and partners in place to achieve our ultimate vision,” said HR Director Josh O’Brien. “We want everyone to feel confident and empowered to use the new system and navigate the cloud.”

Setting the vision

The change from the traditional PeopleSoft software to a cloud-based system at Texas Children’s has been years in the making. To achieve the vision for what the Oracle software solution should be for the organization and our workforce, the Voyager Leadership Team established four key objectives:

  • Engaging and empowering our employees with an improved, mobile-friendly user experience that provides convenient access to real-time data, and a more efficient system to help you reach your full potential.
  • Seamlessly integrating our systems and processes with increased access to information that was previously segmented into different systems, and reduced maintenance on concurrent systems and integrations.
  • Supporting adaptability and efficiency with thoughtful design that improves the accuracy and compliance our data, as well as the ease of learning and implementing new features and enhancements.
  • Keeping it simple by removing some manual touchpoints and processes, and introducing more harmonious and efficient processes for data entry.
Next stops on the journey

Once the Design Phase ends, and all the foundational information necessary for the move to the new cloud system has been gathered, Voyager’s focus will shift to system configuration.

As we continue the journey to go-live, the Voyager team will also provide ongoing communications and establish a community of Change Agents to increase awareness among all of our Texas Children’s team members, and build greater understanding about this big move to the new Oracle software solution.

Just over a month after federal agencies sounded the alarm about a wave of damaging ransomware attacks targeting health care systems across the country, Texas Children’s own network environment has remained secure from cyber threats thanks to a coordinated effort mounted and led by the Information Services (IS) team.

Even before this most recent ransomware threat emerged, Texas Children’s had taken a holistic approach to keeping our network safe – relying on the vigilance of our workforce, enhanced digital security capabilities, continuous proactive monitoring by the IS Security Operations Center, and unwavering executive support, according to Assistant Vice President Teresa Tonthat.

But as hospitals and medical facilities nationwide scrambled to protect their networks from disruption in the past few weeks, our IS team partnered with Operational Resilience to quickly initiate their well-established Incident Response Command structure. This kept our leaders informed about potential impacts to operations if a ransomware attack did occur.

IS also collaborated with colleagues throughout the Texas Medical Center to stay abreast of the rapidly evolving tactics that threat actors were using and measures to prevent them, and leveraged high-fidelity intelligence data about the ransomware threat from trusted partners.

“At the end of the day, our team is not only in the business of cybersecurity – we’re in the business of enabling patient care for children and women,” Tonthat said, acknowledging that Texas Children’s may fall victim to a cyberattack at any time and must always be prepared to maintain operations, with or without digital connectivity.

“When an attack does occur, we need to remain resilient and continue to provide safe, quality care.”

Taking action to secure our systems

Ransomware locks a computer system to prevent the owner or organization from accessing data until they pay a ransom. Federal authorities announced in late October that malicious groups in Eastern Europe were targeting the U.S. health care sector with attacks to produce data theft and disruption of health care services.

To secure Texas Children’s network amid this serious threat, IS worked diligently to enhance our security capabilities by confirming all access to web-based e-mail and file storage sites are blocked, implementing multi-factor authentication and password rotation of privileged accounts, hardening our data backup and restoration capabilities, creating access to Microsoft 365 in case of a disaster, and taking new steps to protect Epic – one of the organization’s most critical applications.

Two strategies were particularly effective and will continue to improve and enhance network security in the days and weeks ahead. The first involved upgrading our remote VPN technology to allow IS to validate security health of all devices connected to our network remotely.

The second strategy was the deployment of a button within Microsoft Outlook that allows any Texas Children’s team member to easily report suspicious or potentially dangerous email messages with a simple click of the mouse. IS provided instructions for the Phish Alert Button and details about which emails to report in a recent newsletter.

Making cybersecurity a priority

Promoting cybersecurity awareness among Texas Children’s workforce was a priority for IS well before the large-scale ransomware attacks began. Since 2017, the team has run a quarterly and occasionally monthly phishing campaign to remind our employees how important it is stay vigilant about potential threats.

In the campaign, IS sends a phishing simulation email that contains a link. The email is designed to look suspicious and raise red flags that should alert our workforce of the possibility of phishing, and prevent them from clicking the link as instructed.

In the most recent phishing campaign deployed in October, only 0.4% of more than 19,000 recipients clicked the link in the email – the lowest rate since the campaign began three years ago, when 18% of recipients clicked the link in the first phishing simulation email.

“We ask our workforce to embed security into their day-to-day practices, as we do with quality. Make it part of our DNA,” Tonthat said. “We need to remain vigilant and adopt smart cybersecurity practices in our personal lives, as well.”