Cook Children’s Expands to Better Respond to Future Viral Outbreaks

The need for a dedicated infectious diseases unit appeared on Cook Children’s radar several years ago when Ebola first made its way to U.S. shores. As the hospital prepared for potential patients, clinical staff identified a number of challenges and requirements for creating the safest environment possible to care for those with a highly infectious disease. The COVID-19 pandemic brought this need to the forefront again, and is the catalyst for a new Cook Children’s Health Foundation capital campaign called Protecting Your Tomorrows.

This campaign will help fund an expansion project that will ensure the precise combination of clinical facilities and operations are in place to treat the sickest children, while best protecting Cook Children’s staff and the community from the spread of infectious diseases.

The expansion will include the construction of a new 6-bed infectious diseases critical care unit (CCU) and a 24-hour solutions center with dedicated incident command space. An existing 20-bed unit will become a dedicated infectious diseases unit for the treatment of non-critical contagious patients such as those hospitalized for flu, COVID-19, respiratory syncytial virus (RSV) and other viruses. A 32-bed medical surgical unit will be added, and the hospital’s simulation lab will be relocated.

“I am beyond excited about the new infectious diseases critical care unit,” Mary Suzanne Whitworth, M.D., medical director of pediatric infectious diseases at Cook Children’s Medical Center, said. “It is humbling to work for a system like Cook Children’s that is always looking for the next thing needed to make pediatric health care better. After spending the last 25 years of my career here I must say, however, that I am not at all surprised that this is in the works. This is a system that never stops rising to the occasion.”

Family-Centered Safety

Since the start of the pandemic, much has been learned about how to maintain safety for staff and guests and expertly care for infectious disease patients now and in the future. These best practices and protocols will be standard design in the infectious diseases units, which will feature specialized air ventilation systems, dedicated areas to put on and take off personal protective equipment (PPE), technology that allows clinicians to closely monitor a patient without having to be directly at the bedside and other heightened protection measures to contain disease spread.

“These units will be used in an effort to place potentially contagious patients in one area,” said Dr. Whitworth. “The goal is to have everybody in one unit with every employee in that specific unit dedicated to being experts in proper PPE donning and doffing, patient and visitor flow and all of the aspects of interrupting the spread of an infectious disease.”

Maintaining a family-centered and supported environment also influenced the design of the new infectious diseases CCU. The decision to limit visitors to Cook Children’s Medical Center during the pandemic was a difficult one for everyone. While Cook Children’s patients have always been allowed at least one family member at their bedside during the outbreak, the spread of the virus demanded that administrators take steps to protect employees and vulnerable patients by restricting the visitation of others within the family unit.

“Segregating families is not who we are as an organization,” said Stan Davis, chief operating officer at Cook Children’s Medical Center. “We promote that when a child is sick and in our hospital, they need family at their bedside to help with treatment and healing. This unit allows our staff to feel comfortable that they’re in the right environment and have the right precautions to be comfortable treating patients, and it allows for our community to understand that in addition to having the best nurses, therapists and support folks in the world, we have the right environment to keep families together.”

Each of the new infectious diseases CCU rooms will have a private bathroom, an accommodation not available in the current critical care space used for contagious patients. This allows parents to stay in the room with their child as long as they would like and reduces the in and out traffic of a parent who may have the same illness as the child due to exposure. Dedicated entrances and exits to these units for staff and visitors will help protect the general hospital environment.

“Re-tooling to deal with the re-emergence of SARS which resulted in lots of health care worker deaths in Canada, for COVID-19 variants already circulating, for Middle East respiratory syndrome (MERS), for avian flu, for new and old world hemorrhagic fever viruses, or for bioterrorism-related infections like anthrax, is our responsibility,” said Marc Mazade, M.D., medical director of Cook Children’s infection prevention and control. “We’re looking forward to having the facility to do that better than ever.”

To open up space for the infectious diseases CCU, the Cook Children’s simulation lab will be relocated. The simulation lab is an educational space where staff practice using new technologies, innovations and research. Last year, Cook Children’s was the first freestanding children’s hospital in the world to receive full accreditation through the Society for Simulation in Healthcare. The relocated lab will allow for future expansion and growth of this program.

A new 32-bed medical surgical unit will be built to gain back beds repurposed for the infectious diseases unit and to expand Cook Children’s ability to meet the hospitalization needs of the growing communities it serves.

System-Wide Solutions

The design of the new 24-hour solutions center was inspired by lessons learned about system-wide coordination and cooperation throughout the pandemic. Members of all 14 of Cook Children’s Health Care System’s entities worked together in the medical center’s incident command center to coordinate a consistent response to COVID-19 across the entire organization. This consolidation and cooperation allowed Cook Children’s to be nimble, flexible and quick to the ever-changing environment.

The new solutions center will operate year-round under the same premise of consolidation, coordination and consistency. It will be a one-stop-shop for staff and guests of any one of Cook Children’s entities to report or request assistance with a facility or operations issue.

“The solutions center will be a single touch point for staff, patients and families in terms of who they contact for assistance with an operations issue at one of our facilities,” Davis said. The consolidation that will occur is that there will be a joint information system—a communication hub, if you will—that everyone in the system uses, and the issue will be triaged and assigned from there. It’s similar to what you see with a technology help desk.”

Inside the solutions center will be a dedicated incident command center equipped with meeting space that accommodates proper social distancing protocols and communication technology that supports real-time global health updates for rapid, informed decision-making. This is a much needed upgrade from the classroom that doubled as an incident command center during the height of the pandemic.

“We’ve learned with COVID-19 that hospitals can become overwhelmed rapidly,” Dr. Mazade said. “Planning for staff shortages, getting supplies, developing protocols, and getting our teams the most up-to-date information ASAP while combating misinformation is vital to everyone in the organization, to our community partners, and to our community. We need an up-to-date, world-class incident command station built for that.”

Construction for this expansion is currently underway and slated to be complete in 12 months. If you’d like to join the Protecting Your Tomorrows fundraising effort, contact Cook Children’s Health Foundation at 682-885-4105.