COVID-19: Innovation Under Pressure

The onset of the COVID-19 pandemic forced health care institutions to change the way they deliver care and innovate new ways to meet the unusual demands created in a space of social distancing, masks and PPE shortages. Le Bonheur providers and Associates used new tactics to ensure the safest care for children in need.

Tech Talk

Telehealth services inside and outside the hospital allow continuity of care

Pediatric Pulmonologist Tonia Gardner, MD, is one of many providers at Le Bonheur who complete more than 2,400 telehealth visits each week in an effort to limit unnecessary exposure. Telehealth allows children not to miss critical appointments while providing the safest possible environment for patients and providers.

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22-month-old Mary Kate Webb participates in telehealth physical and speech therapy with Le Bonheur therapists.

She has Wolf-Hirschhorn syndrome and suffers developmental delays from her diagnosis. Missing therapy appointments would put her at risk for falling behind. Within days of the first reports of COVID-19 in Tennessee, therapists were able to expand telehealth services to ensure that children like Mary Kate don’t miss vital therapy sessions and can continue their progress.

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Parties, concerts and game shows are just a handful of activities that the Child Life team provides on a daily basis to help bring a bit of normalcy to the hospital setting. But the implementation of social distancing and need to avoid unnecessary exposure has changed their approach. Le Bonheur’s Child Life team has looked to technology to help them provide normalcy for children during COVID-19, moving in-person programming to the hospital’s closed-circuit TV channel, creating a virtual Easter egg hunt and providing interaction with special visitors via video chat.

Caring for the Community

Community-based health workers meet vital needs during COVID-19

Children living with chronic conditions like diabetes and asthma were on the minds of Le Bonheur’s community health workers when COVID-19 emerged. Their concern: would children already living with food insecurity have access to the nutrition they needed to stay healthy during a pandemic? Access to nutritious food can mean the difference between children staying safe at home and having to
be hospitalized. Community health workers have made no-contact deliveries of food and necessary supplies to famiies – more than 300 and growing – and children like Carter Evans.

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COVID-19 has intensified an urgent need for support for many expecting mothers in the Memphis area.
A Le Bonheur community outreach program, Nurse-Family Partnership (NFP) is stepping in to help hundreds of new and expecting moms and their babies. Community Health Nurse Beth Pletz is able to continue providing medical and social support to new moms like Dominique Jones and bring her vital food and supplies. Partnerships with organizations like Slingshot Memphis also allow the NFP team to use impact funds to provide support for clients’ utility bills as many have lost jobs but still have bills accruing.

Procuring PPE

New PPE construction and reprocessing techniques mitigate shortages

At the onset of the outbreak, Le Bonheur leaders took a proactive approach to calculate PPE stockpiles and how long it would last. Face shields were identified as a critical need. Le Bonheur Chief Medical Officer Barry Gilmore, MD, and Surgeon-in-Chief Trey Eubanks, MD, partnered with University of Memphis Mechanical Engineering Assistant Professor Ebrahim Asadi,PhD, who runs a 3D printing lab. The U of M converted its lab to create face shield frames 24 hours a day. The U of M made its first delivery of 50 new face shields, which can be easily cleaned and reused, to Le Bonheur at the end of March.

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N95 respirators have been in short supply since the beginning of the COVID19 pandemic. Medical Director of Infection Prevention Nick Hysmith, MD, and Manager of Infection Prevention Don Guimera knew that drastic measures were needed to optimize and maintain a consistent supply of disinfected N95s. Working with the Methodist Healthcare system, Guimera and Hysmith created a hospital workflow process for the decontamination and reuse of N95 masks using hydrogen peroxide vapor in line with the Centers for Disease Control and Prevention guidelines.