The gift we give every day

Last week, as I was thinking about my Christmas message to you, I of course thought about all the things the season typically means – family, beloved traditions, lots of good food and opening that perfect gift. But over the last few weeks, I’ve been thinking a lot about gifts much greater than anything that fits beneath a tree. In particular, I thought about what a gift it is for us to be able to be here for children when they need us. This time last year, we couldn’t always do that.

Like most years around this time, our patient volume was high, but last year we reached historic highs – at or beyond our 650-bed capacity throughout November and December. On many days we reached a point when we simply had to deny children the opportunity to receive care at Texas Children’s. In fact, in November 2014 we denied 101 hospital transfers.

Denying a patient who is being transferred from another hospital is heartbreaking. These are not low-acuity patients who walk into our Emergency Center with mom. When another hospital attempts to transfer a child to Texas Children’s, that facility has assessed that the patient is so critically ill that he or she needs the comprehensive care that only Texas Children’s can provide. Having to say no to children who needed us last year is not something any of us want to see happen again.

That is why we launched the Promise Campaign to build a new community hospital in The Woodlands and a new tower here in the Texas Medical Center. But the children who need us now cannot wait until that new space is available. We need to be prepared for the high-volume season that is now upon us. And that’s where all of you play such an important role. Our leaders, physicians, nurses and staff have been working intently and strategically for months. We assessed our previous approach to patient flow decision-making, and we created a new structure.

We now have rotating teams of operational leaders and physicians focused on patient volume every day. We created a “real-time demand and capacity” process to manage patient census, so that we assess patient flow at three pivotal points daily and can more accurately forecast bed capacity. We’ve increased acute care capacity at the Main Campus and at the West Campus, and perhaps most impactful is that we’ve shifted the way we think. For example, we no longer approach the PICUs at the Main Campus and the West Campus as separate units – we think systematically about these units and consider the total capacity between them when we make decisions about the best place to send a child for care.

We’ve created interdisciplinary roles dedicated to patient flow, and our executives, physicians and unit leaders are rounding and asking front-line staff, “How are things? What do you need?” And we’re making sure the support is where it’s needed, when it’s needed. This focus and teamwork is what allowed us to continue receiving patients last week when we peaked at a census of 691. We were still able to say yes to families and children who needed us when others shut their doors due to lack of capacity.

This is huge, and it’s important. And in many cases, it’s crucial. What you are doing, what you are dedicated to accomplishing, is working – and because of the effort everyone is making together, we can care for these children at Texas Children’s. For many of these families, there is no greater gift than the moment they learn we have a bed available for their child.

I truly wish that no child ever has to be in the hospital during the holidays, but my greater hope is that if they do, Texas Children’s can be there to care for them and ensure the best possible outcome so that they can see a better Christmas next year. That is our gift – during the holidays and every day. Thank you for all you’re doing to ensure we can continue to offer that gift.

I wish you all happy holidays and a merry Christmas.