December 16, 2014

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Six hundred and fifty inpatient beds make up the Texas Children’s Hospital system. On any given day, hundreds of patients come through the hospital doors at Main Campus and West Campus. Whether they walk through our doors on their own, or are transferred from another hospital, these patients require the care of Texas Children’s Hospital specialists.

“Census is patient activity and patient volume across the system,” said Texas Children’s Hospital West Campus President Michelle Riley-Brown. “A high census is an indication that our patient volume is exceeding our capacity to care for patients.”

Reaching that capacity means there are no rooms left to admit new patients. In November, 101 patients had to be turned away. The patients were denied a transfer from another institution because Texas Children’s Hospital was above census.

“We have to always remember that when people come to us, they are bringing their children who are ill for care,” said Surgeon-in-Chief Dr. Charles D. Fraser, Jr. “We have to put ourselves in their position, and respond.”

During the past several months, Texas Children’s Hospital has experienced numerous high census days and on many occasions, the patient volume has exceeded the number of available beds.

“Teams across both campuses are on daily conference calls managing patient flow, management, and so on. Making sure patients get to the right place at the right time,” Riley-Brown said. “It’s managing patients, it’s patient flow, it’s room facilitation, room management and bed control.”

While cold and flu season brings its own challenges to the hospital census, a high census has begun to be the norm for Texas Children’s Hospital. While a high census stresses the system, it’s an opportunity for the staff to show support for one another.

“It is especially important now to work as a team and to make sure we are helping each other,” Riley-Brown said. “It’s always important that everyone is taking care of themselves and of each other to make sure we can do our best to take care of the patients.”

“This is the norm for us now as an organization and we should embrace it and be extremely proud of it,” Fraser said. “It’s unbelievable what we get to do. It’s an unbelievable opportunity, it’s an unbelievable responsibility. These folks have entrusted their children to us. We should feel blessed because of that.”

In response to the increasing number of children seeking our care, the organization has already begun plans to expand capacity at Main Campus through CareFirst and the building of a new hospital in The Woodlands to provide care for many patients in their own community. For more on those initiatives, read here.

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What do Community Coffee, Microsoft and Stryker have in common? All three strategic business partners – and several others – helped us save about $25 million in operational costs.

Delivering on the Vision (DOTV) Non-Labor Initiative was more than just a cost-savings expedition. It prompted us to think like a system and ask ourselves, “What can we do differently to maximize efficiency across the organization?”

In July 2012, Texas Children’s launched DOTV and partnered with Huron Healthcare consultants to identify cost savings opportunities across the organization. They examined several non-labor areas including billing and collection processes, vendor contracting, physician services and clinical care coordination. Fifty-eight initiatives were identified, which yielded $18 million in potential savings and revenue opportunities.

During the second phase – which began in September 2013 – Texas Children’s implemented Huron’s cost-saving strategies systemwide. But, our efforts didn’t stop there. Three non-labor solution teams – administrative support, clinical coordination, and hospital-based services – were tasked with identifying more opportunities to grow our hospital’s savings strategically year-over-year.

“We engaged our employees at every level of the organization to pitch their cost-savings ideas,” said Texas Children’s Revenue Cycle Director Carrie Rys, who was the co-leader of the Administrative Support Solutions Team. “Our three teams generated $5 million in potential savings.”

The DOTV Initiative uncovered 91 cost-savings ideas amounting to potentially $25 million.

“We negotiated and leveraged our vendor relationships to maximize the full value of every contract,” said Texas Children’s Vice President Diane Scardino, who co-led the DOTV Non-Labor Solutions Team. “When we asked the right questions, we discovered bigger savings and revenue opportunities.”

“One of our pathology frontline managers picked up on a workflow that had left out the billing on a pathology test that had existed for years,” said Texas Children’s Pathology Director Ann O’Connell. “After updating the workflow, more than $1 million in annual gross patient revenue is now generated.”

Other impressive ways we Delivered on the Vision include:

  • Microsoft License Optimization: We assigned shared clinical workstations a device license instead of a per user license (as we have more clinical users – physicians, nurses, clinicians – than devices), which saved the hospital $857,000. Also, we were able to negotiate lower costs for our annual support benefits equal to $100,000 in savings.
  • 340B Drug Purchasing: When we purchased medications at the 340B discounted price for our Medicaid patients, we saved $10.3 million for Texas Children’s Main and West Campus in FY14.
  • Surgery: We restructured our Stryker contract so that anytime a new product/service line was added, all previous lines received a savings percentage to ensure we were duly compensated each time their business increased. Additionally, implants around spine surgeries were negotiated with three vendors to meet the physician preference needs of spine surgeons across two service lines – Orthopedics and Neuroscience. We used a benchmark tool and leveraged the support of our surgeons to negotiate more than $1 million in annualized savings.
  • X-ray services: When we purchased five digital X-ray machines in bulk this year, we saved more than $200,000. We leveraged the buying power of a system by aggregating our purchases to drive price concessions from two vendor partners.
  • Community Coffee: Being alert of contract errors helped us trim our expenses. When an administrative employee asked why it was more expensive to buy Sweet N’ Low at the contracted price versus buying it in bulk at the store, our Supply Chain team found Community Coffee had not adjusted its rates appropriately, which resulted in a $58,000 rebate check.
  • Pest Control: We saved $6,727 by streamlining the hospital’s pest control services to one vendor at a reduced cost, which made the process of ordering and tracking supplies easier and more efficient.

“We have a lot of negotiation power that we don’t always use,” said Chanda Cashen Chacón, vice president of Women’s Services at Texas Children’s Pavilion for Women. “When we think like a system, we achieve better and bigger results.”

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Texas Children’s Hospital recently celebrated the 30th anniversary of its heart transplant program. Since its inception in 1984, Texas Children’s Heart Center has performed more than 300 heart transplants, making the program one of the most active and largest in the nation.

A team of experts – including heart transplant surgeons, pediatric cardiologists, transplant coordinators and dietitians, child life specialists, social workers, pharmacists, physical and occupational therapists, infectious diseases experts, immunology physicians and dedicated nurses – focuses on each aspect of the patient’s care. The team’s experience, compassion and access to state-of-the-art facilities helps children in need of heart transplants survive and thrive.

“The true results of our team’s exceptional work over the past 30 years can be seen in the hundreds of success stories of our patient families,” said Texas Children’s Heart Failure, Cardiomyopathy and Cardiac Transplantation Medical Director Dr. Jeff Dreyer. “As one of the largest programs in the nation, our experience in treating patients with heart failure is leading the way in positive outcomes.”

The multidisciplinary team at Texas Children’s has transplanted hearts in newborns to young adults from across the United States. Due to the transplant team’s unique expertise, Texas Children’s Heart Transplant Program sees some of the rarest and most complex cases, resulting in the best possible outcome for each child.

“Texas Children’s has been a pioneer in all aspects of pediatric cardiovascular surgery, and our heart transplant program is a shining example of this,” said Heart and Lung Transplant Program Surgical Director Dr. Jeffrey Heinle. “Over the past 30 years, Texas Children’s has consistently led innovations in this field, bringing hope to children and adolescents from all over in need of a heart transplant.”

Texas Children’s Heart Center is on the cutting-edge of ventricular assist device (VAD) placement, which provides circulatory support until a transplant can be received. The center offers the best VAD tailored to each child’s size, diagnosis and needs for both short- and long-term assistance.

Texas Children’s Heart Center is ranked No. 2 nationally in cardiology and heart surgery by U.S. News & World Report.

To learn more about Texas Children’s Heart Transplant Program, click here.

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No parent ever wants to hear their child will need to have surgery – whether it’s a routine procedure that only takes minutes or it’s something more serious. That’s why the Department of Surgery goes out of its way to make the surgical experience at Texas Children’s a good one for patients as well as their families.

The department’s most recent effort to ensure a positive surgical experience is had by all is a video for parents that talks about what to expect when their child has surgery at Texas Children’s. The video, available in English and Spanish, covers eating and drinking instructions, what to bring to the hospital and what parents will experience while their child is in surgery.

After doing more than 25,000 surgical procedures each year, we know parents need to be prepped for surgery just as much as their children do. We hope this video helps parents who are going through that process.

“Our goal in the Department of Surgery is to have our patients and their families prepared as well as possible for the surgical experience,” Chief of Plastic Surgery Dr. Larry Hollier said. “Setting appropriate expectations is crucial to patient satisfaction. This surgical video covers all important issues pertinent to the patient’s arrival, registration, surgery, and discharge.”

Other efforts the Department of Surgery has made to enhance the surgical experience for patients and families at Texas Children’s include:

  • Pre-surgery paperwork have been streamlined to lessen parent’s preparation load before they bring their child in for surgery.
  • A greeter program has been implemented to help patients and their families more easily find our surgical admission areas. Greeters wearing blue vests are positioned at various entrances of the West Tower, the Abercrombie Building and the Clinical Care Center to help guide surgical patients to such locations.
  • Colorful, kid-friendly animal signage has been posted inside and outside the elevators, lobby, hallways and connecting bridges at the Clinical Care Center and the West Tower to improve navigation to the surgical suites at those locations.

All of these efforts have been based on feedback from parents, something the Department of Surgery is always eager to hear. While taking care of our patients is our top priority, we like to take care of their parents too.

121714JoshObrien175Read the newest Super Star interview featuring Joshua O’Brien with Corporate Financial Planning below.

Q&A: Joshua O’Brien, September 2014 Employee

Your name, title and department. How long have you worked here?
Joshua O’Brien, Senior Financial Analyst for Corporate Financial Planning. I’ve worked at Texas Children’s Hospital for 8.5 years.

What month are you Super Star for?
September 2014

Tell us how you found out you won a super star award.
We were having our group luncheon to celebrate the completion of the FY’15 budget and as our Senior Vice President Alec King was congratulating our team, he announced that I had won the Super Star award. I was extremely surprised, and I felt so grateful that our entire team was there to celebrate it; it’s something that I’ll remember forever.

What does it mean to be recognized for the hard work you do?
It’s an honor to be recognized here at Texas Children’s. I feel like our team and all of the people I get a chance to work with are so knowledgeable and work so hard that I really owe this award to them.

What do you think makes someone at Texas Children’s a super star?
I think a super star employee is someone who shows they support their team through their commitment to work hard and efficiently. It’s also about being happy to be at Texas Children’s and showing that happiness to those around you. This award is given through the nominations of our peers, so it personally means a lot to know that those you work with value your efforts.

What is your motivation for going above and beyond every day at work?
Although I don’t have direct contact with our patients, knowing that my work providing data to make strategic decisions and meeting with areas to develop reporting tools that will impact their care, is so rewarding. Thinking of the big picture and remembering that every bit helps in taking care of our families is what keeps me positive and motivates me every day.

What is the best thing about working at Texas Children’s?
Texas Children’s has always been my second home, and the people in it have become a part of my family. I’ve grown up here, and all of my peers have done more than they will ever know to make me a better employee and a better person. Working at Texas Children’s as a new father has deepened my pride in the role I play in all the good that we do here. Getting to work with such wonderful people and knowing that we’re making a difference in people’s lives are what makes Texas Children’s the best.

Anything else you want to share?
I’d like to thank some of the wonderful people who have mentored me and helped me grow and progress in my career here at Texas Children’s, all the members of Corporate Financial Planning, Business Expense Administration, Accounts Payable, Pathology, Pharmacy, Family Advocacy, Information Services and the Clinical Care Center Food Court. Furthermore I’d like to thank Catherine Codispoti, Bill Little, Scott Martinez, Lisa Saenz and Aisha Jamal for all they’ve done for me here at Texas Children’s.

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Representatives from seven Houston area Chuy’s Mexican Food restaurants presented on December 9 a Vecta Distraction Station to Texas Children’s Hospital West Campus. The machine, which helps promote a calming and relaxing environment for patients, was purchased with $7,000 raised at participating restaurants.

The Vecta Distraction Station aids in normalizing the hospital setting and turns an unfamiliar environment into a friendly and inviting space. The machine moves from room to room and transforms the space with a bubble column, projector and fiber optics. Child life specialists use the machine as a distraction tool during procedures, to normalize the hospital setting and to build rapport with patients during hospital visits.

“We are so appreciative of the continued support from our local Chuy’s restaurants,” said Katy Williford, child life specialist at Texas Children’s Hospital West Campus. “This donation will impact many patients and families who walk through our doors and will make their stay a little bit brighter.”

December 9, 2014

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Texas Children’s announced on December 4 our plan to build an eight-bed special isolation unit at Texas Children’s Hospital West Campus. This unit will be designed for children with highly contagious infectious diseases, such as pandemic influenza, enterovirus D68, Ebola, and many others. Additionally, we announced the state’s designation of our organization as a pediatric Ebola treatment center.

About the isolation unit

This new isolation unit at Texas Children’s will be similar to the four other biocontainment units in the country. Such units are equipped and staffed to care for patients with contagious infectious diseases.

“We will build a state-of-the-art isolation unit designed and staffed to provide the highest quality care and treatment for infants and children with serious or life-threatening infectious diseases of public health significance, always with the greatest possible margin of safety,” said Texas Children’s Physician-in-Chief Dr. Mark W. Kline. “We believe this will be an indispensable resource to our local community, Texas and the nation.”

This new unit will incorporate all of the latest scientific and technological approaches to biocontainment, including negative air pressure, laminar air flow, high-efficiency particulate air (HEPA) filtration, separate ventilation, anterooms, biosafety cabinets, a point-of-care laboratory, special security access, autoclaves and incinerators. There will be two levels of protection from airborne particles, as well as a comprehensive waste management plan, among other safety features.

It will be fully equipped to care for any infant or child with a serious communicable disease, with all of the measures available to assure safety of the health care team, other patients and their families. A point-of-care biosafety level 3 laboratory will enable the care team to monitor the progress of patients and perform rapid detection methods to identify unusual pathogens. Housed at Texas Children’s Hospital West Campus, the unit is anticipated to have capacity for eight patients, all in private rooms.

This specialized unit will be led by Dr. Gordon Schutze, who will serve as medical director, as well as Dr. Judith Campbell and Dr. Amy Arrington, who will be the unit’s associate medical directors. It will be staffed by an elite team of experienced critical care and infectious disease nurses and physicians, all of whom will have successfully completed an intensive advanced certification course and practicum in infection control, hospital epidemiology and management of infectious diseases in the critical care setting. The staff will maintain their certification through participation in ongoing educational activities.

Kline said Texas Children’s is working with the Centers for Disease Control and Prevention to design, build, equip and staff the unit, which is expected to be operational within nine months and cost approximately $16 million to build.

“I could not be more impressed with Texas Children’s desire to run towards issues of critical importance to the health and well-being of the children of Texas and our nation,” said Dr. Brett Giroir, director of the Texas Task Force on Infectious Disease Preparedness and Response and chief executive officer of the Texas A&M Health Science Center.

Caring for potential Ebola patients

Since the summer, Texas Children’s has been implementing a detailed plan to identify, isolate and treat suspected cases of Ebola, if necessary. As a result, following a visit from the CDC, the State of Texas designated Texas Children’s as a pediatric Ebola treatment center.

As part of the hospital’s preparation, specific protocols were developed outlining steps staff would take if and when a patient with Ebola symptoms arrived at a Texas Children’s facility. Additionally, in order to decrease the risk of exposure and provide the complex care required, the hospital identified specific areas and units responsible for caring for any patient with Ebola. The health care workers in those areas have received intense, ongoing training and simulation to help them prepare.

“This unit is part of the hospital’s long-term vision to care for children with the most serious and complex medical conditions,” said Michelle Riley-Brown, president of Texas Children’s Hospital West Campus. “Our leadership’s decision to build this new isolation unit at West Campus speaks volumes about our staff and employees’ skill, expertise and experience here. Our agility and responsiveness were tested just a few months ago when we had a patient with suspected Ebola under investigation. Our handling of that case demonstrated our competency here at West Campus, and it boosted the entire organization’s confidence in the readiness across the system.”

West Campus staff and employess helped lead the way for the organization to refine our protocols for care, and now Texas Children’s will lead the way for centers across the country. If you have questions about the unit or an interest in being trained to be part of the care team that will staff this unit, please contact your leader for more information.

Return to Ebola Response site.