Texas Children’s Hospital, saving children and mothers through innovation
Texas Children’s Hospital is a not-for-profit organization, with nearly 1,000 beds spread over three hospitals in Houston. The staff sees more than 21,000 hospital admissions and 150,000 emergency room visits each year. The hospital system has been recognized as one of the best children’s hospitals in the United States.
The system’s team approach to sepsis care has resulted in a drop in sepsis mortality over the past two years among both mothers and children. One of the key tools in improving sepsis care was the development of a computerized algorithm to help identify and diagnose sepsis early. This algorithm runs in the background, covering nearly all patients in the facility.
Charles G. Macias, MD, Chief Clinical Systems Integration Officer and Co-Chairman of the Improving Pediatric Sepsis Outcomes of the Children’s Hospital Association, is part of the team that made this improvement in sepsis care possible. Dr. Macias still regularly works in the emergency room and sees sepsis patients. “It’s a huge advancement for medicine that we don’t have to rely on late outcomes, but we have predictive models that can identify children at risk,” he explained. “This is early in the course and prevents resource consumption, both for the parents in personal time, as well as for the healthcare system.”
Other improvements include sepsis huddles and decreasing the time between an order for antibiotics and administering the medications. Antibiotic orders are now highlighted and prioritized when they are transmitted to the pharmacy. Another key change was the implementation of antibiotic champions. The pharmacy contacts the designated person when the antibiotic is ready and the champion retrieves it. In 2016, it took about 72 minutes from the order to administration. With the new process, this time has dropped to 52 minutes.
Earlier this year, the hospital opened a maternal intensive care unit (ICU). The hospital dedicated 4-bed unit cares for high-risk pregnant and postpartum women with a variety of medical problems, including sepsis. Traditional ICUs are equipped to care for these severe illnesses, but not necessarily the added needs of pregnant or post-partum women.
To recognize the organization’s dedication in improving sepsis identification and management in both mothers and children, Sepsis Alliance is proud to honor the staff at Texas Children’s Hospital with a 2019 Sepsis Heroes Award. Dr. Macias will accept the award on behalf of Texas Children’s Hospital.
“This [award] is an absolute validation to the hundreds of people who have engaged with dedicating all the time and effort voluntarily to support this work that is a recognition for all of them that these things matter,” Dr. Macias said. “I think the most astounding thing about all of the work that we’re doing is that it has ramifications to other diseases and other processes. So, improving antibiotic timeliness doesn’t just apply to sepsis, right? It gave us an opportunity to understand how we could be better, more timely, more efficient, more effective in other areas as well. And so, it’s the learning that we have done through the sepsis work has allowed us to optimize other the management of other diseases.”