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.”

For many Texas Children’s employees, gone are the days of the morning commute.

Our efforts to fight COVID-19 through the practice of social distancing has required more than 1,000 staffers – and counting – to work from home. But what does it take to make this work?

Teresa Tonthat, assistant vice president for Information Services, says there are multiple factors to consider. Her department has spent the past few weeks ensuring that employees who are asked to work remotely can do so in a seamless way.

This includes assessing the current technologies, equipment requirements, and available network capacity to effectively support these employees; all while continuing to serve our patients and caregivers.

The good news is that we now have a well-defined plan in place.

Be prepared for bumps in the road, this is GLOBAL.

However, digital technology is never 100 percent available – even on the best days.

“As millions of people and organizations shift to remote working, our internet networks will be tested. We are experiencing a mass human behavior change across the globe,” Tonthat said. “The internet’s infrastructure will be strained and will be felt in the networks inside employee’s homes, and the internet services (i.e., Comcast, AT&T, and Verizon) that these networks rely on.”

Many remote workers will share the same internet connections throughout the day with household members. Household members could be using data-intensive applications and that surge in internet access could strain home networks.

Overall, as entities around the globe are moving to remote work environments to promote social distancing, local commercial and residential internet and telecommunication infrastructures (i.e., WebEx, Zoom, Teams, Video, etc.) are seeing increased traffic load. While our cloud telecommunication vendors are doing their best to increase capacity to mitigate availability issues, our local internet service providers may also experience issues with the high demand…
Just last week, virtual cloud platform vendors such as WebEx and Teams reported infrastructure capacity issues. Many organizations across the nation felt the disruption to virtual online meetings. And this is just the beginning.

How to stay as productive as possible
  • Call your internet service provider to make sure you have enough bandwidth to support your work responsibilities.
  • Consider all the people in your home who will need internet. Under normal conditions, a basic plan may do the trick. However, it’s important to keep in mind additional users such as other adults who may be working from home or children who may now be enrolled in online schooling.
  • Communicate with your manager if you are having trouble. You can’t work remotely if your internet isn’t working. Let your manager know if you are experiencing trouble so that arrangements can be made for you to come into the office and work in an way that adheres to social distancing guidelines.
  • Limit calls to the HelpDesk. Texas Children’s IS Help Desk can support system related connectivity issues, but cannot support issues related to your home internet provider.

For additional questions, please contact your manager or supervisor for support and guidance.

Elex Sanchez draws on his more than 25 years in the hospitality industry to bring the same level of customer service, attention to detail and visitor experience standards to our pediatric patients and their families.

Sanchez and his team start every shift with a huddle to discuss the day’s tasks and calisthenics to warm up for the physical demands of the job. Members of the team include floor care techs, unit support assistance, recycling techs, and lead techs who manage small, tactical groups like operating room (OR) technicians focused on daily terminal cleans in the OR. A terminal clean is a very deep, detailed cleaning process with special disinfectants requiring a certain amount of “kill time” to work properly.

Right now, as the spread of a global pandemic is knocking on our doors, the Environmental Services team is working hard to keep it at bay. This Texas Children’s team is well stocked and has proactively worked with vendors to secure a surplus of cleaning supplies, as an additional layer of readiness should it become difficulty to procure such items in the future.

Texas Children’s Environmental Services also employs five ultra violet light disinfection systems for ORs, isolation units or any other potentially contaminated areas in the hospital. First, the techs clean the room and then bring in the robot system to shine ultraviolet light from multiple, flexible arms. The whole process takes about 50 minutes. Texas Children’s has had five systems in place for about six months, and is in the process of procuring seven more units.

The team has also increased cleaning schedules and now completes 12 cleanings per day over three shifts in public spaces and restrooms, and also completes four to six cleaning rounds in lobbies and waiting rooms.

“We call ourselves ‘warriors for infection control.’ Essentially, we are infection control and our teams are on the front lines every day ensuring our patients and staff have a safe, sanitized and sparkling clean environment,” said Sanchez.

March 3, 2020

Sudden cardiac arrest can happen to anyone, anywhere, any time – and it often happens with little to no warning. More than 200,000 cardiac arrests occur in hospitals each year in the United States. To keep employees better prepared to perform cardiopulmonary resuscitation (CPR) and contribute to improved patient outcomes, Texas Children’s recently launched a new Nursing initiative that takes CPR training to the next level.

“We don’t have to perform CPR too often, but unfortunately, when we have to provide this life-saving procedure, we have to do it well,” said Nursing Professional Development Specialist Gayle Young. “Through this initiative, resuscitation skills are accessed and reinforced to give staff the added confidence they need to achieve and maintain high quality CPR performance in the event of a cardiac emergency.”

Resuscitation Quality Improvement, (RQI), the American Heart Association’s gold standard for Basic Life Support (BLS) training, is a quarterly training program at Texas Children’s that offers real-time visual and audio feedback on compressions and ventilations to support the mastery of high quality CPR skills. Unlike conventional CPR classes – where an instructor provides his or her own personal feedback – RQI uses computer-based eSimulation technology that evaluates performance quality and solicits objective feedback in the form of positive reinforcement or suggestions for improvement.

“Being able to see the actual outcome of our compressions is amazing,” said Cardiac ICU Education Coordinator Shannon Cummings. “You can see if you’re under or over inflating, if you’re going too deep or too shallow, or if you’re not allowing for recoil and letting the chest expand. The program walks you through the steps, and tells you when to adjust your compressions, so you can perform CPR effectively.”

This program, administered by Texas Children’s Nursing Professional Development (NPD) Team, consists of online learning modules and skills assessments that are completed quarterly instead of once every two years. As part of this quarterly training, on-campus simulation stations will be equipped with adult and infant manikins, and a computer that connects to the CPR training materials.

After successfully completing the RQI training curriculum, staff are issued an RQI e-Credential card that must be renewed quarterly and a BLS e-Card that is renewable every two years. Additionally, staff can keep track of their completion and expiration via HealthStream.

“Studies have shown that CPR skills can decay within three to six months after initial hands-on training,” said Nursing Professional Development Assistant Director Angie Rangel. “The only way to master basic life-saving skills is through regular, measured and frequent practice. Through quarterly drills, we’re reinforcing the confidence and competence staff need to perform high quality CPR. At the end of the day, it’s all about improving outcomes. And with RQI, we are really moving towards great patient outcomes.”

Several nurses and direct patient care providers, as well as Child Life staff, participated in the soft launch of the RQI program on February 4, and these participants already see the benefits this program offers.

“In Child Life, a lot of times we’re doing one-on-one activities where there’s no medical staff around our patients in the room,” said Child Life Specialist Danielle Coleman. “So just in case something unexpected happens with a code, we can be the first responders and help that child out and be there for support.”

“I think this program is great, and will help refresh our skills more frequently than once every two years,” said Pavilion for Women Ambulatory Education Coordinator Leslie Williams. “We’ll be more comfortable with performing the resuscitation skills and it’s just better for the patients and the families.”

The NPD team has already identified 75 “super users” from Texas Children’s Medical Center Campus, Texas Children’s Hospital West Campus, Texas Children’s Hospital The Woodlands, and several Specialty Care Centers to be early adopters of RQI before the program is rolled out in phases across the system.

Click here to access the NPD website to learn more about RQI Training at Texas Children’s Hospital.

February 24, 2020

US House Representative Dan Crenshaw visited Texas Children’s Hospital last week to learn about our organization and get an up-close view of our operations.

Crenshaw, who represents Texas’ second congressional district, had the opportunity to meet with executive vice presidents, Michelle Riley-Brown, Dan DiPrisco, Mark Mullarkey, and Weldon Gage where they spoke candidly about access to care and Texas Children’s role working with Medicaid and Medicaid populations. They also discussed our efforts to support innovative research and our focus on medical residency and training programs.

“It’s important that our elected representatives have an opportunity to see Texas Children’s first-hand,” said Rosie Valadez McStay, assistant vice president for Governmental Relations and Community Benefits. “We are an organization that is so greatly impacted by their work. To that end, touring our patient care areas to see how care is provided, and meeting with our clinical leaders and administrators, provides them the opportunity to learn how their legislative decisions effect our patients and families. Our hope is that these experiences assist them in making informed and insightful health policy decisions.”

Rep. Crenshaw’s afternoon tour featured visits to:

  • Texas Children’s Legacy Tower Mission Control
  • Texas Children’s Heart Center
  • Texas Children’s Neurology Center
  • Texas Children’s Cancer and Hematology Centers

To learn more about Crenshaw’s life, work and service in the United States military visit: https://crenshaw.house.gov/about/

February 10, 2020

We all know it when we see it.

The people who excel at everything they do. The organizations that achieve all parts of their mission. The companies that deliver great service without fail. But do we understand what it takes?

I’ve been alive long enough to know that “high quality” doesn’t just happen. But I was reminded of this recently when I sat down to talk with three members of the Quality Team at Texas Children’s Health Plan.

After a conversation with quality improvement specialists Rosendo Cardoso Gonzalez, Jeremiah Judkins and Joshua Fernelius, it all came back to me. High quality requires the right people, planning, oversight and accountability. Becoming the best is never an accident.

For this reason, improving quality is – literally – a full-time job for this team.

We started our talk with acknowledging the health plan’s upcoming accreditation survey from the National Committee for Quality Assurance (NCQA). They explained to me that although our survey takes place in mid-April, the results are the sum of what we do every single day.

Here is a look inside our conversation:

How would you describe your roles at Texas Children’s Health Plan?
All: We are the team that serves as a resource to the entire health plan. We support leaders and front-line staff in a shared responsibility to achieve national HEDIS (Healthcare Effectiveness Data and Information Set) goals.

What is the most challenging part of the work that you do?

Rosendo – “Ro”: It’s a lot of work, but that’s why we are here. It’s also challenging because most issues are complex and don’t just involve one department. Making sure that multiple departments are on the same page can be difficult.

Jeremiah – “JJ”: Encouraging employees to use us a resource. Our job is to come in and rethink processes, systems and methods. Just because we’ve been doing something one way doesn’t mean we will keep doing it that way. But like Ro said, that’s why we are here – as a resource to help facilitate the changes.

Joshua – “Josh”: Fostering change in the organization. Lasting and sustainable change is never easy, however it’s important that we evolve for the sake of our members. They deserve for us to operate effectively at the highest level of care.

What is the most rewarding part of the work that you do?

Rosendo: It’s extremely rewarding when everyone comes together and focuses on reaching for the same goals. It’s also rewarding when we can maximize each other’s strengths to solve problems.

Jeremiah: I love Texas Children’s. I have a personal connection because my six-year-old daughter has had a health condition since she was in-utero. Texas Children’s helped save her life. I want to be part of ensuring that this organization is always operating at the highest level it possibly can.

Joshua: I have been invested in public health for many years. It truly is my passion. I enjoy the opportunity to positively impact the lives of more 400,000 health plan members each and every day. Your work seems to focus on the big picture, but what do you do on a daily basis to improve quality?

All: We run the daily operations briefing, which is the glue that holds The Health Plan together. The “DOB” offers a way to uncover organizational issues and bring barriers to the forefront. If we have more visibility into our challenges, we can solve them effectively.

***

Rosendo, Jeremiah and Joshua report to Yahaira Colorado, manager for Quality & Outcomes Management. Colorado’s team, together with Natasha Pierce – manager of Credentialing – and her team, are preparing The Health Plan to gain its NCQA accreditation this summer. For more information on NCQA, visit https://texaschildrensnews.org/strive-for-five-strive-for-five/

To learn more about “Hayes on The Health Plan” and to learn basic information about Texas Children’s Health Plan visit https://texaschildrensnews.org/hayes-on-the-health-plan/.

February 3, 2020

Baylor College of Medicine Obstetrics & Gynecology Grand Rounds will host a talk on Women: The journey is far from over from 8 a.m. to 9 a.m. Wednesday, February 19 in Texas Children’s auditorium, B1 level of Texas Children’s Abercrombie Building.

Dr. James Dornan – chair of Health and Life Sciences at University of Ulster in Ireland, and retired chair of Fetal Medicine at Queen’s University of Belfast in the United Kingdom – will be giving the talk with the aim of increasing clinicians’ knowledge and skills related to the latest scientific advances and translational efforts, as well as the unique ethical challenges, in Obstetrics and Gynecology.

Objectives: Explain that women’s rights are human rights and that human rights are women’s rights.
Illustrate that religions are not to blame, but the men who run them are.
Explain that Native American Indians are correct when they said life is out of balance.

Target audience: OB/GYN Faculty, fellows, residents, and medical students.

Educational methods: Educational methods will include lectures, case presentations, literature review, and panel discussion.

Activity evaluation: Participants will be asked to complete a session evaluation.

Accreditation/Credit Designation: Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.