May 4, 2020

When Kirsti Clifford found out she was pregnant with her second child, she was excited beyond belief. She was grateful to be giving her daughter a sibling and she was looking forward to pregnancy and delivery more so than with her first child because she knew what to expect. Then the pandemic happened and Clifford’s anxiety rose right along with it.

“There is so much unknown.” Clifford said. “I have felt much more uneasy this time and am trying to be really careful. I am limiting my exposure, social distancing and not going out unless I have to.”

To reduce the anxiety of expectant moms like Clifford, and to lower their risk of COVID-19 exposure and infection, Texas Children’s Pavilion for Women has opened a drive-through prenatal clinic at our Medical Center Campus.

A group of Texas Children’s obstetrics and gynecology physicians in consultation with the American College of Obstetrician Gynecologists (ACOG) came up with the idea while discussing how to adequately care for pregnant mothers while reducing their risk of contracting COVID-19 while traveling to hospitals or clinics for a prenatal exam.

“Providing access to prenatal health care while limiting exposure of both obstetric health care professionals and patients to COVID-19 is challenging,” said Dr. Mark Turrentine, a Texas Children’s obstetrician and gynecologist. “Although reductions in the frequency of prenatal visits and implementation of telehealth interventions provide some options, there still remains a need for patient–health care professional visits.”

The drive-through prenatal care clinic at Texas Children’s allows pregnant women who do not need to be seen in the clinic to remain in their vehicles while being assessed by a health care professional, thus reducing potential patient, health care professional, and staff exposure to COVID-19.

View photos of the drive-through clinic below.

The drive-through visits include key elements of a prenatal exam such as blood pressure measurements for evaluation for hypertensive disorders of pregnancy, fetal heart rate assessment, and selected ultrasound-based measurements or observations, as well as face-to-face patient–health care professional interaction.

“Patients using the drive-through clinic feel reassured that they can actually see a health care provider and hear their baby’s heartbeat without having to come into our facility and risk being exposed to the virus,” Turrentine said. “Our providers like it as well. They enjoy being able to provide patients with an option that might better suit their needs during these unprecedented times.”

Clifford said she used the drive-through clinic at the Medical Center Campus for her 30-week appointment because she didn’t want to take any unnecessary risks, and that it turned out to be a great decision. She said she got her blood pressure taken and that, more importantly, she got to hear her baby’s heartbeat.

“I appreciated the setup because we can still get some of the important monitoring that we need to feel reassured,” Clifford said. “It’s a creative solution that I would opt to use again.”

In conjunction with Turrentine and other Texas Children’s obstetrics and gynecology physician, Obstetrician and Gynecologist-in-Chief Dr. Michael A. Belfort recently published a paper about the drive-through prenatal clinic in Obstetrics & Gynecology, the official publication of ACOG. In that paper, Belfort said the drive-through model is projected to reduce the number of in-person clinic visits by 33 percent per patient compared with the traditional prenatal care paradigm, using equipment and supplies that most obstetric clinics in the United States can access.

“What we have seen so far at Texas Children’s is that the concept of a drive-through prenatal clinic works,” Belfort said. “They are reducing patient anxiety without compromising quality of care. It’s a win-win for everyone involved.”

Texas Children’s is also using drive-through capabilities for a variety of services including per-operative COVID-19 testing at all three of our hospital campuses and will expand these options as we continue to refine how we care for our patients.

If your working hours have been temporarily changed because of how our operations have been impacted by this pandemic, your Texas Children’s benefits coverage still remains the same.

Hit the “What’s New” button on the front page of the COVID-19 Resources site for the latest information and updates on available benefits and community resources, including your:

  • 403(b) Savings Plan
  • Dependent Care Flexible Savings Account
  • Health Care Flexible Spending and Reimbursement Accounts
  • COVID-19 Care and Coverage
  • Child Care
  • Dental Emergencies

You can also access your benefits online to review your elections 24/7 from any desktop or mobile device.

Texas Children’s Health Plan is continuing its pursuit of an accreditation from the National Committee for Quality Assurance (NCQA). This is the most widely-recognized accreditation program in the United States and going through the process demonstrates the health plan’s commitment to quality.

“The fact that we are continuing our process in the face of COVID-19 demonstrates the high level of commitment we have to our members,” said Emmalou Torres Cabrera, Director of Quality Management at Texas Children’s Health Plan. “The quality of our care isn’t wavering due to this pandemic. In fact, we are working to ensure that we raise the bar even more so.”

The first big milestone in the process was completed on April 14 with the submission of 262 documents. The next step is preparing for the file review that surveyors will focus on during the virtual audit, which replaces the onsite visit on June 1 and June 2.

Cabrera extends appreciation to everyone involved in the process, with special recognition to Quality Improvement Specialists Rosendo Cardoso Gonzalez, Jeremiah Judkins and Joshua Fernelius.

NCQA surveyors will ensure that the health plan is meeting quality standards in the following areas:

  • Quality Management and Improvement
  • Population Health Management
  • Network Management
  • Utilization Management
  • Credentialing and Re-credentialing
  • Members’ Rights and Responsibilities
  • Member Connections

For more information about the National Committee Quality for Assurance, visit NCQA.org

April 27, 2020

 

With the global pandemic resulting in a rapid increase to the nation’s unemployment rate, more Americans may now qualify for Medicaid — a government-funded health insurance program that provides coverage for low-income children, pregnant women, and disabled adults in Texas.

Texas Children’s Health Plan serves children and women in the Medicaid program, therefore, an increase in Medicaid recipients will likely result in an increase in Texas Children’s Health Plan members.

And we are ready to serve.

”We are closely collaborating with the state of Texas as we collectively respond to the evolving COVID crisis,” said Johnna Carlson, director of Government Programs. “We are anticipating a surge and know we will have the ability to serve these new members well.”

Why is it important that the health plan is ready?

Texas Children’s Health Plan is a health plan much like Blue Cross Blue Shield, United Healthcare, Cigna or many others. The difference is that it manages the health care of low-income families who receive government-funded insurance.

Even outside of a pandemic, health plan employees are skilled at caring for families that are living through challenging and stressful life circumstances. “This is what we do,” Carlson said. “We care for the families that need us most. We answer the call all of the time – but especially in times like these.”

The Texas Health and Human Services Commission has indicated that it saw a 47 percent increase in Medicaid application submissions in March 2020 compared to March 2019. While not all applicants may qualify for Medicaid coverage, we can expect to see an ongoing increase in Medicaid applications in the coming months.

What does the national picture look like for the low-income?

Health Management Associates, an independent firm that is consulting with health plans across the country, recently published some high-level observations and predictions:

  • The number of people receiving health insurance coverage from an employer could decline by 12 to 35 million, including both workers and family members.
  • Medicaid enrollment could increase from 71 million to 82-94 million.
  • Medicaid enrollment could grow by 5 million regardless of the number of people who lose their jobs.
  • Uninsured numbers could increase to 40 million.

Based on these and other projections there will be a national need for affordable and quality health care; and Texas Children’s Health Plan will be positioned to meet the need. If you or anyone you know would like more information about Texas Children’s Health Plan, visit texaschildrenshealthplan.org.

April 14, 2020

Since the COVID-19 pandemic began, Texas Children’s leaders have been working tirelessly to keep us informed about COVID-19 and the organization’s response to this historic and unprecedented event.

From timely global e-mail communications to implementing various precautionary measures – including employee/patient screening, employee/patient testing algorithms, quarantine and masking protocols, and social distancing – our COVID-19 response has focused on protecting the health and safety of our patients, employees and staff while ensuring Texas Children’s facilities have sufficient resources to support patient care and operations.

“Our preparation for COVID-19 began back in January when we started screening all patients arriving for appointments,” said Chief Nursing Officer Mary Jo Andre. “We activated our Incident Command Center on March 12. This was a critical step in our response to this rapidly evolving health situation, as our command structure provides the support that is necessary to not only manage operations today, but also to proactively forecast needs and plan accordingly for the future.”

The Incident Command structure consists of eight subcommand centers. These include Logistics, Operations, Planning, Finance/Human Resources, and four other subcommand centers that cover Texas Children’s Hospital West Campus, Texas Children’s Hospital The Woodlands, Texas Children’s Pediatrics and Urgent Care, and Texas Children’s Health Plan. Each of these teams provide guidance for the organization’s response to COVID-19.

The Incident Command Center is co-chaired by Andre, Interim Physician-in-Chief and Pathologist-in-Chief Dr. James Versalovic and Executive Vice President Mark Mullarkey. This team works closely with our eight large subcommand centers dealing with a variety of issues related to supplies, remote access, visitor and patient screening, patient placement, shuttle service, dining services, adult care services, community services and response, and a command focused primarily on supporting our employees and staff.

In collaboration with our partners from Infection Control, the Special Isolation Unit, Nursing, Pathology, Critical Care, Emergency Medicine, Obstetrics and Gynecology, Supply Chain, and other areas critical to system wide planning, the command centers also work with our Human Resources and Corporate Communications teams to ensure timely information is communicated to our employees and staff.

“We attend conference calls throughout the day with many leaders representing diverse areas of the organization to help us reassess and strategize our needs around COVID-19,” Mullarkey said. “The pandemic is a dynamic situation with rapidly changing information and new developments are constantly coming to light. As this situation unfolds, we have been adjusting our response protocols as needed and reporting out to system leadership via weekly Shared Leadership teleconferences.”

While ensuring the health and safety of our employees, patients and families remain the highest priority, communication and transparency have played a pivotal role in our response to COVID-19. As decisions are made in the Incident Command Center, employees and staff can always stay informed through global e-mail communications and by visiting Texas Children’s COVID-19 Resources webpage. Employees can also visit Texas Children’s Coronavirus Connect page for updated information.

Versalovic says the organization will continue to work together one day at a time to respond to the challenges ahead, and for as long as this pandemic lasts, we will come out of it stronger than ever.

“Texas Children’s is a sturdy and resilient organization,” Versalovic said. “While we have weathered many catastrophic storms together, we will get through this COVID-19 pandemic together. We are grateful to our entire team for leading tirelessly and for their strength and resilience they have shown every step of the way.”

April 7, 2020

While Texas Children’s employees work locally to keep COVID-19 at bay, members of our system’s global health team are working just as hard to keep the disease from spreading in areas that are far more vulnerable to the pandemic.

“Low- and middle-income countries in places like Africa and Latin America are already stressed and strained with weak health systems and vulnerable populations,” said Dr. Heather Haq, Chief Medical Officer for the Baylor College of Medicine International Pediatric Aids Initiative (BIPAI) at Texas Children’s Hospital. “We will see devastating effects if COVID-19 becomes widespread in these areas.”

BIPAI at Texas Children’s Hospital is one of the largest global maternal and child health programs in the world with a presence across sub-Saharan Africa as well as Latin America and Romania. Our mission in these countries is the same as it is here in the United States – to care for sick children and women, and to educate more people to do the same.

Tremendous progress has been made in these communities over the years in the areas of HIV/AIDS cancer, tuberculosis, malaria, sickle cell disease and malnutrition; however much work needs to be done to ensure that COVID-19 does not undo these gains. Although the disease has yet to reach these areas in full force, it’s coming, and Texas Children’s and Baylor are standing ready to help fight its effects. Partnerships forged between Texas Children’s, government officials and local leaders are already helping forge a productive path forward in the face of this global crisis.

“We are extremely thankful for the continued commitment Texas Children’s and Baylor have to their global partners,” said Dr. Mogomotsi Matshaba, Executive Director of BIPAI’s operations in Botswana. “We need your expertise, guidance, moral support and financial assistance to get through this trying time.”

BIPAI at Texas Children’s Hospital is working around the clock to provide technical assistance and resources to help our global partners prepare for and respond to COVID-19 while maintaining access to essential services like continued access to antiretroviral therapy for people living with HIV. The BIPAI network holds daily calls to discuss strategies to protect the health care workforce, contain the spread of COVID-19, and continue to serve patients. In addition, they hold weekly video conferences focused on pertinent clinical information on COVID-19 and have established a COVID-19 resource library for global sites.

Texas Children’s and Baylor also are participating at national levels with local and regional leaders to shape policies aimed at curbing the impact of COVID-19 and protecting the work that’s already been done to strengthen their nations’ health care systems.

“It’s imperative we protect the gains we’ve made,” said Dr. Adeodata Kekitiinwa, BIPAI’s Executive Director in Uganda. “COVID-19 has the potential to wipe out years of work in areas where we are seeing significant gains.”

HIV/AIDS is one of the areas where great strides have been made. A setback such as the spread of COVID-19 – the effects of which are not yet known in people living with HIV – could be detrimental. In addition, children who need care for ailments such as malaria and malnutrition might not get the services they need if travel is restricted in countries or if resources are diverted to help those with COVID-19. Compounding the issue is that resources for critical care are already scarce in these areas. Uganda, for example, has only 55 ventilators for the entire country – that’s one ventilator per 1.3 million people. Other countries have even fewer.

“Unfortunately, the severe shortage of critical care means that many people in these settings who get sick with severe COVID-19 disease will die, until advances are made in treatments or a vaccine becomes available,” said Haq.

Phoebe Nyasulu, Executive Director of BIPAI’s operations in Malawi, said the severity of the situation means that COVID-19 has to be faced head-on and that it needs to be looked at from a global lens versus a country-by-country issue.

“With the help of BIPAI, Texas Children’s and Baylor College of Medicine, we are more confident we will be able to respond to COVID-19,” Nyasulu said. “We will get through this together.”

March 31, 2020

If you think it’s tough to get a hold of toilet paper and hand sanitizer for your house of four, just imagine doing it for a health care system that sees over 4,000 children and women daily. Shoring up supplies for a critical population like ours is no small feat. It takes strong leadership to think ahead, secure partnerships and ensure we are prepared with the right supplies to continue to deliver care to patients who need us.

While the global coronavirus pandemic has created numerous challenges for health care – and for many other industries across the U.S. and around the world – Texas Children’s Supply Chain Team is helping us lead the charge to ensure all of our patient care facilities maintain adequate supply during COVID-19.

“We continue to support our patient care activities across the system, and with more incoming shipments on the way, we will add to our current supply in the days and weeks ahead,” said Texas Children’s Senior Vice President for Facilities Operations Bert Gumeringer. “We are able to meet this goal through collaborative relationships that we have built with our supply chain and community partners.”

Early on in the hospital’s response to COVID-19, Texas Children’s Supply Chain Team focused its efforts on increasing the organization’s inventory of supplies that are maintained in our warehouse – these items include masks, gowns and hand sanitizer – all of which are in short supply across the country.

In addition to collaborating with our traditional supply chain partners, Texas Children’s has been working diligently to acquire products outside of the hospital’s normal channels, which has proven beneficial:

  • Hand sanitizer:  Our supply chain is looking to the distilling industry to source hand sanitizer. We are working with two different distillers to provide us product. Our first shipment arrived on March 26. Texas Children’s sourced the materials to one of the distillers who used the materials to manufacture the hand sanitizer exclusively for our hospital.
  • Personal Protective Equipment (PPE): We are working through very creative, safe alternatives to maintain appropriate supplies of PPE. For N95 masks, we have sourced product through the commercial construction market. This is not a traditional supply channel, but one the organization has tapped into. We continue to receive N95 masks through our normal supply channels, as well.
  • Protective masks for patients – We continue to work with our partners in the Texas Medical Center to shore up supplies. Houston Methodist Hospital donated 12,000 Teddy Bear masks for  patients who need to wear them, especially for our immunocompromised patient population.
  • Other supplies and products:  Our team has adopted an out of the box approach.  When the Houston Rodeo and Livestock Show shut down, we moved quickly to acquire their hand sanitizer and paper products.  We are also acquiring hand sanitizer from Minute Maid Park, toilet paper from the Westin Hotel, paper towels from a janitorial service and disinfectant from Home Depot.

While significant progress has been made to ensure Texas Children’s has adequate supplies to support daily operations, engaging in good conservation practices is equally important.

“We encourage our employees and staff to continue to wash their hands frequently with soap and water to help conserve our supply of hand sanitizer,” Gumeringer said. “It’s also important to keep calm. While we’ve been through catastrophic hurricanes and storms, we will get through COVID-19 together as well.”