July 23, 2020

Texas Children’s has transitioned the management of COVID-19 workforce testing to Epic which, through MyChart, allows Texas Children’s employees and Baylor faculty and staff to:

  • Access COVID-19 testing appointments that are scheduled via Employee Health
  • Receive secure and confidential COVID-19 test results
  • Quickly access return-to-work instructions

We encourage you to activate a MyChart account in the event that a COVID-19 test is needed. Follow the instructions below to set up your account. You can also learn more about MyChart here.

I am an employee or Baylor partner based at Texas Children’s How do I create a MyChart account?
Never been a patient at Texas Children’s  (e.g. Pavilion for Women)  

Employee Health will send an activation link to your new MyChart account via email or text at the time of COVID-19 test scheduling.

 
Was previously a patient without a MyChart account Select the “Adult Access” option on the homepage and submit a request. In the “Physician” field, please enter “Employee Health.”
Am a current patient without a MyChart account Select the “Adult Access” option on the homepage and submit a request. In the “Physician” field, please enter “Employee Health.”
Am a current patient with a MyChart account No action required

COVID-19 testing is provided at no cost to our workforce members. If you are currently experiencing symptoms of COVID-19 or have a known exposure in the community or at work, please contact Employee Health or Medical Staff Services (for Baylor medical staff).

July 21, 2020

As events continue to unfold around racial inequity in our community and across the country, Texas Children’s remains committed to supporting equality, justice, and respect, and The Black Lives Matter Movement.

Texas Children’s Psychology Section recently convened The Collaborative on Racial Equity and Inclusion for Black Youth (REI) to provide resources, information, and support to our patients, colleagues, and the broader community around this important mission. One aspect of REI is providing actions the Texas Children’s community can take. Every few weeks, the group will provide a set of “Take FIVE” actions on a particular topic related to battling racism and promoting equity, justice, and respect. Check back often to learn more ways to take action.

This week, REI is launching the program with a list of five TED Talks to watch on different aspects of racism: health disparities, parenting, systemic abuses of power, and engaging in anti-racism advocacy. The videos are between five and 20 minutes. Watch each video at your convenience and share with your communities.

Dr. David Williams, sociologist, talks about the impact of racism on health (2016)
How racism makes us sick

Dr. Beverly Daniel Tatum, psychologist, discusses parenting and addressing racism with kids (2017)
Addressing racism with kids

Mia Birdsong interviews Black Lives Matter founders, Alicia Garza, Patrisse Cullors, & Opal Tometi (2016)
Black Lives Matter founders

Baratunde Thurston, writer/comedian and activist, discusses changing systemic abuses of power and the phenomenon of white people calling/weaponizing police against people who are #LivingWhileBlack (2019)
How to deconstruct racism

Clint Smith III, artist and activist, speaks on parenting Black children (2015)
Parenting Black children

To learn more, check out this curated list of TED talks on racism and related topics.

To contact the Collaborative on Racial Equity and Inclusion for Black Youth (REI), email RacialEquityandInclusion@texaschildrens.org

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.

Texas Children’s Heart Center has once again been named the best place in the country for pediatric cardiology and heart surgery in the U.S. News and World Report 2020-2021 Best Children’s Hospitals rankings – the center’s fourth straight year at No. 1.

“We are incredibly proud to be named the best place in the country for children who are in need of pediatric cardiology and heart surgery,” said Chief of Pediatric Cardiology Dr. Daniel Penny. “Achieving this honor for the fourth consecutive year is a testament to our dedicated multidisciplinary team who works tirelessly to advance the field and provide the best care possible to our patients and their families. We don’t take this responsibility lightly, and these survey results only inspire us to work harder to be even better for our patients and each other every day.”

The U.S. News rankings use a well-accepted framework for evaluating quality of health care, which factors in patient outcomes, such as mortality and infection rates; available clinical resources, such as specialized clinics and programs and external accreditations; and compliance with best practices. Improved rankings demonstrate a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.

This past year, the Heart Center built on the successes of previously existing programs and continued to excel in their outcomes metrics. One of those metrics was related to the center’s heart transplant survival ratio, which earned a top score for its one-year heart transplant survival ratio. The Heart Center continues as one of the busiest programs utilizing ventricular assist devices to support hearts that might need transplantation.

“Leading the field in transplantation and ventricular assist devices is important to ensure that we can provide expert care for the sickest patients,” said Dr. Christopher Caldarone, chief of Congenital Heart Surgery. “We are proud of our teams that keep us at the forefront of medical care. This comes about by maintain a culture focused on continuous improvement. We constantly measure our performance and drive for better outcomes. Quite simply, we never rest.”

Other notable initiatives include:

Public reporting of Heart Center outcomes
The Society of Thoracic Surgeons (STS) is a national leader in health care transparency and accountability and publishes outcomes from congenital heart surgery programs across the country. The members of the Heart Center strongly believe that transparent reporting of outcomes after congenital heart surgery is important to insure that patients and families are well-informed with accurate information to help make informed health care decisions. The STS database publishes risk-adjusted outcomes on its public website and the Heart Center at Texas Children’s Hospital has adjusted operative mortality rates that are among the best reported.

International collaboration to monitor outcomes in the catheterization laboratory
In partnership with clinical and physician leadership, the Heart Center’s Cardiac Catheterization Labs implemented processes to submit metrics on all catheterization procedures included in the American College of Cardiology’s IMPACT Registry®. This national register collects quality-focused data on the management and outcomes of pediatric and adult congenital heart disease (ACHD) patients who undergo diagnostic and interventional cardiac catheterization procedures. The registry also allows Heart Center leadership to compare performance against a national aggregate for quality improvement initiatives.

Expertise to provide care for every patient
The Heart Center provides excellent care for patients with all types of congenital heart disease. From simple to complex problems, the Heart Center has expertise in every field. We have specialists that can provide interventions for babies before they are born and throughout infancy, childhood, and all of adulthood. The Heart Center can provide expert care for all aspects of congenital heart disease.

Continued dedication to Adult Congenital Heart Disease Program
Texas Children’s ACHD Program allows patients with congenital heart disease to receive seamless continuity of care from birth throughout adulthood. As pediatric patients with congenital heart defects transition into adulthood, the program’s multidisciplinary team of experienced congenital heart disease specialists advises them on health and lifestyle choices for their adult needs, including physical challenges, exercise options and family planning. The program offers comprehensive medical and surgical care in collaboration with colleagues at Texas Children’s Pavilion for Women® and Texas Children’s Fetal Center®. The hospital’s ACHD Program is accredited by the Adult Congenital Heart Association (ACHA) and is one of only three accredited programs in Texas.

Learn more about the Heart Center, its services, and volume and outcomes.

Care coordination at Texas Children’s – an already challenging job – has become that much more challenging as COVID-19 cases surge in the Houston area. But in true #oneamazingteam fashion, the team of 52 has risen to the occasion and continues to support their multidisciplinary counterparts.

“The entire team is working remotely,” said Jennifer Thorpe, Director of Care Coordination at main campus. “However, with the help of technology and innovative leadership we are remaining successful.”

The department has two primary responsibilities – first, patient care coordination. This means to effectively prepare families for condition management outside of the inpatient setting. The team focuses on timely and safe discharges that prepare families for appropriate management of their conditions.

Secondly, the team is focused on Utilization Management, which is the evaluation of the medical necessity, appropriateness, and efficiency of the use of health care services, procedures, and facilities. In other words, how are services, procedures and facilities being used by a patient? And are these uses necessary, appropriate and efficient? The team focuses on centralized utilization reviews, length of stay management, payer relationships, daily review of observation patients, and authorizations.

“The ability to deliver exceptional care in an effective and cost-efficient way is always the first priority for Texas Children’s,” Thorpe said. “Care coordinators are at the heart of that priority and our resolve is stronger than ever.”

While Thorpe’s team serves main campus patients, there are care coordinators across the system including the health plan team lead by Ashley Simms, the West Campus team lead by Kara Abrameit and The Woodlands team led by Julie Barrett. They all work closely to support one another.

The Department of Care Coordination also has access care coordinators located in the emergency center at Main, West and Woodlands campuses. The access care coordinators focus on patient access at the point of entry, the review for appropriate status, the coordination of admissions, transfers, direct admissions activity at specific locations and partnering with interdisciplinary care teams.

Intended outcomes as defined by Care Coordination success measures are:

  • Decreased Emergency Center admissions for established patients with chronic conditions.
  • A decrease in duplication of efforts for the same patient across the system.
  • A tracking of referrals to community based organizations with appropriate follow up and gap closure.
  • The use of predictive analytics to decrease high cost care and unnecessary utilization of services based on what has happened to provide a best assessment of what will happen in the future.
  • Identification of off the scale “outliers” to rising risk conditions that drive cost and work across the system to close care gaps.
  • An increase in linkage to community based organizations for social determinants of health and tracking of ‘community’ data alongside clinical and claims data to measure intervention care impact on patients with chronic diseases.
  • Management of length of stay via the use of the 3M bi-directional interface.
  • The utilization of patient stratification to look for and intervene on high-risk or determined risk families.
Racial justice in health care

In addition to COVID-19, care coordinators are also positioned to respond to our society’s recent focus on racial and social justice. The Department of Care Coordination reports to Senior Vice President Tabitha Rice. Tabitha lives the core values of Texas Children’s and believes in racial, religious, and gender equality. This is evident in her ongoing efforts to champion change as well as the department’s response to identified socioeconomic barriers in vulnerable and underserved populations. As part of the department’s response, they have reignited efforts to adopt a new electronic platform called “Aunt Bertha,” which serves as a portal for valuable resources.

“A large number of racial minorities are included in groups that face socioeconomic issues,” Thorpe said. “When you are facing challenges with literacy, parenting, employment, or live in a food desert, this can affect your overall ability to stay healthy.”

With just a click of a button, Aunt Bertha would allow families to access social service information such as rental assistance, food assistance, mental health services and much more. Thorpe said there are discussions about how to integrate this platform with Epic and MyChart.

The future of care coordination

Prior to the COVID-19 pandemic, the department had excitedly partnered with Dr. Jennifer Sanders, Gail Vozzella and Dr. Michelle Lyn on the initial phases of the Care Coordination Center, a separate Texas Children’s facility that would serve as a care continuum hub between inpatient and outpatient. Phase one goals for the Care Coordination Center include:

  • All non-TCHP Tier 1 Star Kids patients discharged from an inpatient stay at the hospital will receive a standardized discharge follow-up phone call within 72 hours to ensure they understand their discharge instructions and follow-up visits.
  • Ensuring continuity of care across health care settings by establishing a standardized process to ensure appointments are made prior to discharge.
  • Centralizing the process of obtaining Durable Medical Equipment to meet the therapeutic benefits of patients in need and enhance provider satisfaction.
  • The aim of the Care Coordination Center is to offer one consistent place for patients, families, providers or designees to receive 24/7 high touch coordinated services for recipients of healthcare within the Texas Children’s system. Although the timeline for moving in has been adjusted, those plans are still in the works.

Thorpe reminds the organization that although there are teams 100 perent dedicated to this work, Care Coordination is ultimately the responsibility of both clinical and non-clinical employees throughout Texas Children’s.

When care coordination is done well, we are all adhering to the key elements:

  • Having a shared care plan that forces us to think through responsibilities and potential problems ahead of time.
  • Communicating with patients by explaining treatments, procedures and necessary follow-up actions.
  • Communicating between providers and care givers by telling all the details of the patients’ story when performing a hand-off.
  • Transitioning a patient efficiently between areas within our system or between their stages of care.
  • Organizing a patient’s care for their convenience by taking into consideration things like scheduling, transportation, supplies, medications, etc.
  • Using community resources effectively.

Multidisciplinary team members can access Spok to identify their unit’s assigned Care Coordinator each day. The Care Coordination team is available Monday through Friday 8 a.m. to 5 .m.p and on call until 11 p.m.

For more information about Care Coordination, read a story previously posted at: https://texaschildrensnews.org/coordinating-the-care-of-our-patients/

View team photos at the links below:

Care Coordination Leadership Team

Access Care Coordinators

Inpatient Care Coordinators

Utilization Management Care Coordinators

Greetings, team. My highest hopes are that everyone is staying safe as we continue to live within a new world order. My last edition of Hayes on the Health Plan was published in April when life with the coronavirus was brand new. In that post I wrote tips on how to work from home effectively.

Since then, my colleagues and I have written numerous articles about our organization’s efforts to adapt to life with the virus. We have also published stories about departments within Texas Children’s Health Plan that are exceeding expectations in phenomenal ways. Speaking of phenomenal, we think it’s pretty phenomenal that our newest department – only five months old when the virus hit – has continued to grow and thrive in spite of a global pandemic. Today, I want to introduce you to the newly created Department of Pharmacy.

Director Peter Peter recently took the time to answer a few of my questions. His answers give us an inside view into the work his department does to keep members healthy, operations efficient and costs manageable.

Q: What is the role of the Pharmacy Department at Texas Children’s Health Plan?
A: Director of Pharmacy is a new position, as my predecessor was overseeing both Quality and Pharmacy. Historically, pharmacy at the health plan was seen as a clinical role focusing on medication appeals and provider outreaches. Under my leadership, it is more of an operations role. My department is responsible for overseeing pharmacy benefits for all our members. We also oversee Navitus, our pharmacy benefits management company. In addition, we partner with the Medical Policy team to make sure that medications processed through medical benefits are configured in compliance with the Texas Medicaid Providers Policy Manual (TMPPM). In addition to clinical, there are significant compliance, quality, financial, advocacy, and innovation opportunities that exist within the Health Plan, Texas Children’s system and Texas Medicaid. The health plan is in a unique position because of its access to the hospital system, care coordinators, medical data, and community status compared to other managed care organizations.

Q: How big is the Pharmacy Department and what are the roles of the employees?
A: We are a team of two. I started as the Director of Pharmacy in October 2019. Jerry Wong is the Managed Care Pharmacist, and he started June 2020. I am looking to expand the department with several more employees. The specific roles are still being finalized, but will focus on data analysis, project management, interdepartmental coordination, auditing, and clinical program development. I’m also looking to consolidate some tasks that are currently being handled outside of the pharmacy department.

Q: How does the Pharmacy Department work with the Pharmacy Department at the hospital?
A: There are several opportunities to coordinate with our hospital and retail/specialty colleagues on various clinical and quality related projects. Examples include coordination of care, identifying system savings, and prescriber education. This is an area I am looking to sync with more after staffing up the pharmacy department at the health plan.

Q: What successes has the department had in recent months, weeks? Especially in light of the pandemic?
A: We were able to successfully lobby the state to make formulary changes when COVID-19 shut down Texas to allow members expanded access to medications. We also identified opportunities where members were taking a brand-drug when generic alternatives existed. We launched campaigns to notify prescribers of these opportunities, which have already resulted in significant savings for the system.

Q: What is the vision for the department and what is the greatest work ahead of the department?
A: Combining medical and pharmacy data is what Amazon, Walmart, CVS, and other health care organizations are racing to, but what the health plan already has in house. We are ahead in this regard. However, the greatest work ahead of us is focused on alternative payment models where pharmacies can encourage pharmacist-prescriber collaboration, improved care coordination, reduction in adverse medical outcomes, and overall savings. There are also significant opportunities to partner with the Texas Health and Human Services Commission to expand traditional “pharmacist” services and have them more involved as partners in the overall care of the member.

Q: Any fun facts or things that people would be surprised to know about this department?
A: The pharmacy department oversees pharmacy benefits for over 400,000 members enrolled in STAR, STAR Kids, and CHIP across Texas.

Music means something

The following passage was written by Texas Children’s Chaplain James Denham.

Every night I sing to my son.  Yes, he’s five years old, but until he expresses he’s done with it, he will just have hear me sing!  For almost every night of his life, he has heard the same song (“Jesus Loves You”) with the same lyrics.  The music has transformed for him from just lyrics and sounds to a comfort.  When he is stressed or has had a hard day, he might ask for the song, or I can feel his body become less tense as I sing it when he snuggles me.  Music means something.

Serving our hospital for more than eight years, I have watched countless mothers and fathers sing to their babies.  Humming favorite nursery rhymes with gentle expressions.  Tearful expressions of “Five Little Monkeys” from a mother embracing her baby boy.  Whisper singing a baby girl to sleep. Laughter filled songs with lyrics that bring smiles to anxious and worried toddlers.  I even saw an adult on a ventilator using rock n’ roll to drown out the hum of a hospital.  Music means something for each of them.

What does music mean exactly?  It means expression, it means hope, it means reassurance, it means joy, it means freedom, it means healing, it means release, it means “I can endure,” and it means worth and value to the listener.  It means many more things too.  Tony Sauza, a modern band director, said “Music makes us better humans and teaches us many lessons that transcend across to other areas of life. Music uplifts us and gives us hope when things get tough. Music comforts us during difficult times but also makes us move, dance, and celebrate togetherness. Music allows us to connect to our humanity in a way that nothing else can.”

Music transforms words and sounds into a language of the soul that connects us and lifts us.

Today, music gives me hope.  This pandemic is terrible, and it feels never ending, and I feel the heartbreak and stretching of all around me.  Yet still, lyrics of hope abound in the music we listen to.  I felt moved to tears just listening to a special version of “Lean On Me” by Bill Withers and hearing ‘I’ll help you carry on…”  Listening to “Higher” from DJ Khaled, John Legend and Nipsey Hussle, you feel empowered to persevere and overcome.  Hearing the strokes of a violin from the concertos of Tchaikovsy brings awe and wonder.  Maybe you feel overwhelmed by the sacred every time you sing “10,000 Reasons” or other gospel music.  Perhaps it’s Bruce Springsteen or Tom Petty’s “I Won’t Back Down” and your feel that jolt of energy.  This is the substance of perseverance and hope.  It is the substance that transcends the depths and uncertainties of a pandemic.

Music is the stuff of hope.  It’s the kind of thing we need when our bodies are wearied and frustrated and when our minds are stuck and when we need to feel connected and grounded in our lives.  Just like my son, and the myriad of patients who use music, it means something. It stirs what needs stirring.  It gives us what we need when we really need it. It names the things we need named. It makes us want to move when we feel stuck.  It speaks to our connection and our humanity.

What song has been giving you life during the last four months?  What lyrics are in your ears often and keep you going?  What music makes you want to dance in your car or brings a smile to your face?  Stop for five minutes today and listen to that song.  Or listen to a whole bunch of them.  Let it give you what you need to know that you will get through this, and that we will get through this!