2022 was a year of change exemplified in our shift from constant crisis to managing a slowing pandemic, with information that continued to shift as we increased our knowledge and battled misinformation. It was a year of change as we responded to another horrific crisis in our community, this time in Uvalde – and we joined the wider community in helping as best we could, not only in the medical needs of the moment, but in the long aftermath of healing that continues, and will continue. In the midst of crisis upon crisis we continued to erect a Women’s & Children’s Hospital that would provide the best care possible. With each year we change and with each year we grow better as a team, as a system, and as a community. We invite you to scroll through this journey with us.
Our mission is to improve the good health of the community through high quality compassionate patient care, innovation, education and discovery.
We fulfill this mission through a set of core values.
Our patient care will be:
As we continue this legacy of service to our growing community and region, we embrace a bold vision:
We are leading the way to be one of the nation’s most trusted health institutions.
"This is going to be a game changer for the community," Hernández said during the signing ceremony at the Texas A&M – San Antonio campus.
The affiliation followed University Health's purchase of 68 acres at the west entry to the campus where University Health is scheduled to open Vida, its multi-specialty health care center, and its Institute of Public Health in 2026. Next door, University Health's full-service Palo Alto Hospital with 166 initial beds is expected to admit its first patients in 2027.
Bexar County commissioners allocated $40 million in federal American Rescue Plan Act money for the Public Health Institute. The Texas A&M System Board of Regents underscored its commitment to the partnership by approving funding to build a $45 million College of Education and Public Health facility at their San Antonio campus.
The partners envision a collaboration that will accelerate the training of health care professionals, expand medical research and provide needed care to southern Bexar County residents as well as those in South Texas. It also enhances the school's ability to educate the Latino community for high-quality, health care careers.
Chancellor John Sharp, chief executive for the Texas A&M University System, underscored the importance of the academic partnership in creating a health education pipeline that will provide trained professionals for the growing region.
"When it comes down to it, collaborations are important," said sharp. "University Health needs well-trained health care professionals. Texas A&M Health Science Center and Texas A&M University-San Antonio create them. This agreement formally recognized that and binds us, helping us each to better accomplish our shared missions of serving San Antonio," he said.
Texas A&M – San Antonio envisions benefitting the university, its students and University Health by growing in the following ways:
The partnership also supports University Health's commitment to provide pathways and opportunities for minority and low-income students to pursue careers in health care through Texas A&M – San Antonio's collaboration with the ASPIRE network of seven ISDs. The effort will educate and train future professionals in the fields of community health, environmental health and pre-clinical studies.
June 21, 2022 was a historic day for University Health and its expansion of service in Bexar County.
That was the day Bexar County Hospital District Board of Managers voted to approve a capital improvement program to construct two community hospitals and attached medical office buildings to offer high-quality care to residents living on the South Side and the communities along the I-35 corridor north of Loop 1604.
The approved plan included constructing Palo Alto Hospital on a 68-acre plot the health system had purchased across from the Texas A&M – San Antonio campus and Retama Hospital on land purchased next to the Retama equestrian racing complex. Both hospitals will include attached medical office buildings. These full-service, state of the art University Health hospitals will offer access to high-quality emergency care, labor & delivery, surgical care, and outpatient services closer to home. Patients needing higher-level care can be transferred to University Hospital or the Women's & Children's Hospital in the Medical Center.
"These two campuses will help University Health meet the future health needs of our rapidly growing population, ensuring residents can have access to high-quality care closer to their homes, in hospitals and clinics that are connected with the entire University Health network through one electronic health record," said George B. Hernández Jr., president and CEO of University Health.
Palo Alto Hospital and Retama Hospital will each include an emergency room for adults and children, labor and delivery suites, a neonatal intensive care unit (NICU), operating rooms, and spacious inpatient hospital rooms. The adjoining medical office buildings will provide much-needed access to family medicine and a wide range of specialists. Both hospitals will have four floors and 166 beds, which will help alleviate the demand on University Hospital and allow us to better to meet the needs of people who require specialized care and more complex surgical procedures at our South Texas Medical Center campus.
San Antonio's Marmo Mok Architecture has partnered with Earl Swensson Associates from Nashville, Tennessee to design the hospitals and medical offices. Construction is expected to begin in 2024 and to be completed by 2027. The total anticipated cost is $1.5 billion, and the plan requires no increase in the tax rate.
The large Palo Alto Hospital campus will also be home to University Health's Institute for Public Health. Established in 2022, the institute represents University Health's commitment to promoting health, preventing disease and prolonging life in our community through programs service and partnerships. This building will include primary care services, wellness and preventive health education and programs, as well as spaces for community partners to help University Health advance this critically important mission.
After a patient leaves the hospital, their healing journey continues. And after our patients are discharged, University Health continues to keep their best interests in mind. To this end, University Health established a joint venture with PAM Health in February 2022 to improve access to inpatient rehabilitation services after patients leave our facilities.
"In addition to their national reputation for quality, PAM Health's commitment to restoring hope and supporting optimal recovery from injury and illness aligns perfectly with our mission as the region's premier Level I trauma center and comprehensive stroke center," said George B. Hernández Jr., president and CEO of University Health.
The joint venture allows patients discharged from University Hospital to more easily transition to the high-quality, comprehensive care offered at one of three PAM Health rehabilitation hospitals in San Antonio: Warm Springs Rehabilitation Hospital of San Antonio, Warm Springs Rehabilitation Hospital Westover Hills and Warm Springs Rehabilitation Hospital Northeast San Antonio. The Reeves Rehabilitation Center at University Hospital will remain at the hospital to care for patients who need rehab care as well as acute care services.
"We want to help our patients transition smoothly to the next level of care," said Ted Day, executive vice president for strategic planning and business development at University Health. "The PAM Health inpatient rehabilitation hospitals will allow discharged patients to receive ongoing care closer to home."
With locations throughout the San Antonio region and beyond., PAM Health offers University Health patients' high-quality rehabilitation options in convenient locations," said Anthony Misitano, president and CEO of PAM Health. "We recognize the importance of family and friend play in patient's recovery. When they can get that care closer to home, it's a win-win for everyone."
This clinic, located at 1256 Pinn Road, is adjacent to the Anson Jones Middle School in the NISD school district. It is named for a nurse who worked almost 50 years for the school district and was its first health services director.
The clinic provides immunizations, well-child checkups, medication prescriptions, physical exams and primary care for students, school staff and families on San Antonio’s West Side who must otherwise travel for health services.
“The idea of the school-based clinics is to provide a medical home and health care for students in the neighborhoods where students and their families live and grow,” said Valerie Maldonado, University Health director of health care services. “If we make children healthier, we improve their ability to learn.”
NISD Superintendent Dr. Brian Woods said having medical care near the school will keep students in class and go a long way toward improving academic success.
“What this will do is provide high-quality and close neighborhood access to health care,” Wood said. “This is an area where it’s not the easiest thing to find, and that lack of access contributes to attendance problems. So, one of the things we are trying to do is solve that problem.”
In another West Side neighborhood, University Health opened the Kennedy Clinic at 1831 S. General McMullen Street. The medical team at Kennedy provides adult and pediatric primary care services as well as prenatal and pregnancy care.
A hospital that serves the community should be built, as much as possible, by the community it serves, and those providing services should include all ethnicities, genders and areas of the community. That foundational principal guided University Health’s Supplier Diversity department as a new leadership team exceeded goals in 2022.
The department greatly increased the annual percentage of University Health services provided by local companies and raised the participation of SMWVBE–certified vendors. SMWVBE stands for Small, Minority, Women, and Veteran Owned Business Enterprises, and is an industry standard for recognizing diversity and inclusion.
In 2022, the Suppler Diversity department doubled the annual health system spending for SMWVBE vendors to $56.6 million and also increased spending with not-for-profit partners.
The achievements didn’t happen by accident. The team worked to educate community businesses about working with University Health by hosting or participating in almost 50 public events. Supplier Diversity Manager Latifah Jackson said they mentored at least 148 potential vendors, walking them through the application process.
“I got a lot of powerful feedback from vendors who said our outreach demonstrated how much University Health cares,” said Jackson.
"This is going to be a game changer for the community," Hernández said during the signing ceremony at the Texas A&M – San Antonio campus.
The affiliation followed University Health's purchase of 68 acres at the west entry to the campus where University Health is scheduled to open Vida, its multi-specialty health care center, and its Institute of Public Health in 2026. Next door, University Health's full-service Palo Alto Hospital with 166 initial beds is expected to admit its first patients in 2027.
Bexar County commissioners allocated $40 million in federal American Rescue Plan Act money for the Public Health Institute. The Texas A&M System Board of Regents underscored its commitment to the partnership by approving funding to build a $45 million College of Education and Public Health facility at their San Antonio campus.
The partners envision a collaboration that will accelerate the training of health care professionals, expand medical research and provide needed care to southern Bexar County residents as well as those in South Texas. It also enhances the school's ability to educate the Latino community for high-quality, health care careers.
Chancellor John Sharp, chief executive for the Texas A&M University System, underscored the importance of the academic partnership in creating a health education pipeline that will provide trained professionals for the growing region.
"When it comes down to it, collaborations are important," said sharp. "University Health needs well-trained health care professionals. Texas A&M Health Science Center and Texas A&M University-San Antonio create them. This agreement formally recognized that and binds us, helping us each to better accomplish our shared missions of serving San Antonio," he said.
Texas A&M – San Antonio envisions benefitting the university, its students and University Health by growing in the following ways:
The partnership also supports University Health's commitment to provide pathways and opportunities for minority and low-income students to pursue careers in health care through Texas A&M – San Antonio's collaboration with the ASPIRE network of seven ISDs. The effort will educate and train future professionals in the fields of community health, environmental health and pre-clinical studies.
June 21, 2022 was a historic day for University Health and its expansion of service in Bexar County.
That was the day Bexar County Hospital District Board of Managers voted to approve a capital improvement program to construct two community hospitals and attached medical office buildings to offer high-quality care to residents living on the South Side and the communities along the I-35 corridor north of Loop 1604.
The approved plan included constructing Palo Alto Hospital on a 68-acre plot the health system had purchased across from the Texas A&M – San Antonio campus and Retama Hospital on land purchased next to the Retama equestrian racing complex. Both hospitals will include attached medical office buildings. These full-service, state of the art University Health hospitals will offer access to high-quality emergency care, labor & delivery, surgical care, and outpatient services closer to home. Patients needing higher-level care can be transferred to University Hospital or the Women's & Children's Hospital in the Medical Center.
"These two campuses will help University Health meet the future health needs of our rapidly growing population, ensuring residents can have access to high-quality care closer to their homes, in hospitals and clinics that are connected with the entire University Health network through one electronic health record," said George B. Hernández Jr., president and CEO of University Health.
Palo Alto Hospital and Retama Hospital will each include an emergency room for adults and children, labor and delivery suites, a neonatal intensive care unit (NICU), operating rooms, and spacious inpatient hospital rooms. The adjoining medical office buildings will provide much-needed access to family medicine and a wide range of specialists. Both hospitals will have four floors and 166 beds, which will help alleviate the demand on University Hospital and allow us to better to meet the needs of people who require specialized care and more complex surgical procedures at our South Texas Medical Center campus.
San Antonio's Marmo Mok Architecture has partnered with Earl Swensson Associates from Nashville, Tennessee to design the hospitals and medical offices. Construction is expected to begin in 2024 and to be completed by 2027. The total anticipated cost is $1.5 billion, and the plan requires no increase in the tax rate.
The large Palo Alto Hospital campus will also be home to University Health's Institute for Public Health. Established in 2022, the institute represents University Health's commitment to promoting health, preventing disease and prolonging life in our community through programs service and partnerships. This building will include primary care services, wellness and preventive health education and programs, as well as spaces for community partners to help University Health advance this critically important mission.
After a patient leaves the hospital, their healing journey continues. And after our patients are discharged, University Health continues to keep their best interests in mind. To this end, University Health established a joint venture with PAM Health in February 2022 to improve access to inpatient rehabilitation services after patients leave our facilities.
"In addition to their national reputation for quality, PAM Health's commitment to restoring hope and supporting optimal recovery from injury and illness aligns perfectly with our mission as the region's premier Level I trauma center and comprehensive stroke center," said George B. Hernández Jr., president and CEO of University Health.
The joint venture allows patients discharged from University Hospital to more easily transition to the high-quality, comprehensive care offered at one of three PAM Health rehabilitation hospitals in San Antonio: Warm Springs Rehabilitation Hospital of San Antonio, Warm Springs Rehabilitation Hospital Westover Hills and Warm Springs Rehabilitation Hospital Northeast San Antonio. The Reeves Rehabilitation Center at University Hospital will remain at the hospital to care for patients who need rehab care as well as acute care services.
"We want to help our patients transition smoothly to the next level of care," said Ted Day, executive vice president for strategic planning and business development at University Health. "The PAM Health inpatient rehabilitation hospitals will allow discharged patients to receive ongoing care closer to home."
With locations throughout the San Antonio region and beyond., PAM Health offers University Health patients' high-quality rehabilitation options in convenient locations," said Anthony Misitano, president and CEO of PAM Health. "We recognize the importance of family and friend play in patient's recovery. When they can get that care closer to home, it's a win-win for everyone."
This clinic, located at 1256 Pinn Road, is adjacent to the Anson Jones Middle School in the NISD school district. It is named for a nurse who worked almost 50 years for the school district and was its first health services director.
The clinic provides immunizations, well-child checkups, medication prescriptions, physical exams and primary care for students, school staff and families on San Antonio’s West Side who must otherwise travel for health services.
“The idea of the school-based clinics is to provide a medical home and health care for students in the neighborhoods where students and their families live and grow,” said Valerie Maldonado, University Health director of health care services. “If we make children healthier, we improve their ability to learn.”
NISD Superintendent Dr. Brian Woods said having medical care near the school will keep students in class and go a long way toward improving academic success.
“What this will do is provide high-quality and close neighborhood access to health care,” Wood said. “This is an area where it’s not the easiest thing to find, and that lack of access contributes to attendance problems. So, one of the things we are trying to do is solve that problem.”
In another West Side neighborhood, University Health opened the Kennedy Clinic at 1831 S. General McMullen Street. The medical team at Kennedy provides adult and pediatric primary care services as well as prenatal and pregnancy care.
A hospital that serves the community should be built, as much as possible, by the community it serves, and those providing services should include all ethnicities, genders and areas of the community. That foundational principal guided University Health’s Supplier Diversity department as a new leadership team exceeded goals in 2022.
The department greatly increased the annual percentage of University Health services provided by local companies and raised the participation of SMWVBE–certified vendors. SMWVBE stands for Small, Minority, Women, and Veteran Owned Business Enterprises, and is an industry standard for recognizing diversity and inclusion.
In 2022, the Suppler Diversity department doubled the annual health system spending for SMWVBE vendors to $56.6 million and also increased spending with not-for-profit partners.
The achievements didn’t happen by accident. The team worked to educate community businesses about working with University Health by hosting or participating in almost 50 public events. Supplier Diversity Manager Latifah Jackson said they mentored at least 148 potential vendors, walking them through the application process.
“I got a lot of powerful feedback from vendors who said our outreach demonstrated how much University Health cares,” said Jackson.
The Public Health Division would later grow to become the Institute for Public Health.
Born out of the last public health emergency, the Institute for Public Health will help University Health provide resources and education to help break the cycle of chronic disease impacting far too many families in our community.
"There are many things we learned as the result of the COVID-19 pandemic. One of those is that health care organizations here and across the country must take a leadership role upstream in prevention - to help prevent illness, not just treat it." said University Health President and CEO George B. Hernández Jr. "At University Health, we were already moving in this direction. In fact, 10 years prior to the pandemic, we hired Dr. Bryan Alsip as our chief medical officer. Dr. Alsip is board certified in public health and general preventive medicine."
University Health already had multiple ways to connect patients to preventive health services and resources. The new institute allows its team to take these efforts to the next level and integrate new tools available through Epic, our electronic health records system. Compass Rose, for instance, helps connect patients to needed resources outside University Health for common barriers known as nonmedical drivers of health. These barriers include food insecurity, a lack of stable housing and lack of transportation. Addressing these are crucial to a person's ability to take care of themselves and their families. Compass Rose doesn't just generate a list of resources for people; it allows us to follow up on these connections to make sure they are happening in an effective way.
"Gathering and sharing the data on health, health care access and nonmedical drivers of health will provide us, our partners and the people themselves with the means for improving lifespans, opportunity and quality of life," said Dr. Roberto Villareal, University Health senior vice president and chief public health innovation and equity officer. "This is the natural expansion of our mission to provide high-quality, compassionate care and be wise in the use of resources."
At the official launch of the public health division, then Bexar County Judge Nelson W. Wolff said University Health is uniquely positioned to establish the institute.
"With more than 9,000 employees, a state-of-the-art hospital, 25 outpatient centers, telemedicine, Hospital at Home, digital patient medical records the teaching program for UT Health, and a women's and children's hospital," Wolff said, "they bring a unique perspective to public health."
As the only locally owned health system in Bexar County, the sole Level I adult and pediatric trauma center for a 22-county area of South Texas, and the region's academic medical center through its affiliation with UT Health San Antonio, University Health has a deep and long-standing commitment to public health programs and research. Additionally, University Health has long been an essential partner with the city, the county and other health organizations during natural disasters and public health emergencies.
"We have learned a great deal about the important role of public health experts during a worldwide pandemic and the significant responsibility University Health has to serve this community in times of uncertainty," Hernandez said.
The Essential Public Health Services as defined by the Center for Disease Control and Prevention served as a framework to align existing functions, develop new services and establish priorities. This list describes the activities that the institute will lead to improve health and remove barriers that result in health inequities. The essential public health services are:
The programs and initiatives of the Institute for Public Health seek to be innovative, transparent and transformative, particularly in the areas of public health emergency response, addressing health disparities and equity.
Several current community-based initiatives and systems serve as a solid foundation for the new institute. University Health's initial efforts concentrated on linking existing public health-related functions such as:
As the division grew into an Institute, Carol Huber was named deputy chief public health and equity officer. "This new institute will serve as a hub for University Health, so we can collaborate with key partners without duplicating services," said Huber. "It will also help us identify goals and gaps, as welll as emerging threats and opportunities."
In January 2022, with two years of battling COVID-19 behind us and pandemic fatigue settling heavily on providers and the public alike, University Health staff readied for another wave - this one caused by a variant called Omicron.
We continued to produce informative Q&A videos to share with media and the public, answering question after question - new questions about Omicron and familiar ones about vaccine safety - anything that might help people understand how to protect themselves and others in a landscape where misinformation grew more hydra-headed with every new variant.
COVID-19 Q&As: BA.2, Reproductive Health, and cloth masks
We had two major advantages: a successful mass vaccination campaign of more than 611,000 COVID-19 shots by the end of 2022, primarily through our site at the Wonderland of the Americas mall; and the fact that a large percentage of the population had already survived at least one episode of COVID-19.
These facts combined to boost the community's ability to fight the disease, but Omicron brought a new onslaught. Once again, people became very sick in large numbers in what would be the last big wave of hospitalizations of the pandemic.
Food insecurity skyrocketed as the pandemic spread throughout the country. To assist those most in need in the San Antonio area, Community First Health Plans, a nonprofit health plan established by University Health, developed a food pantry initiative that touched more than 25,000 people—both donors and recipients—throughout 2022.
These small, freestanding food pantries (similar to a Little Free Library, but larger) are stocked with nonperishable foods as well as school supplies, personal hygiene products, small clothing items like socks, and more. Six pantries were installed in locations around the San Antonio in 2021, and 30 more were installed in 2022. Community First partners with schools, churches, businesses and other organizations to reach anyone in need of food, particularly women and children. Because no one works at these pantries, they offer more privacy for recipients, breaking down barriers such as shame and stigma that can prevent people from getting the food they need.
"We want it to be free of judgment, so if you need food, you can get it," said Brennan Loy, Community First public relations coordinator. Community First keeps the food pantries in good repair and restocks monthly, while members of the host organization and people in the community provide donations.
In addition to the hosts, other organizations, like University Health, have adopted food pantries, collected donations and ensured they remain well supplied. Loy encourages more organizations to adopt a food pantry: "We want to install more, but we want to make sure the ones we have are receiving enough donations. We don't want them sitting there empty."
University Health's NurseLink department adopted the Big Brothers Big Sisters pantry at 10843 Gulfdale Street. Registration access specialist Margarita Barbosa, who organizes the donations delivered to the pantry, said it's important for her department to assist the community it serves.
Amy Hogan, LVN, service coordinator at Community First, along with Tracy Whitehurst, LVN, and the rest of Team 2 in Population Health Management, adopted the food pantry at Woodlawn Hills Elementary School. "We realize the dire need for basic food resources, and this is a tiny way we can help ease that burden," Hogan said. "We always add a few fun items in there as well. I add chocolate because life needs a bit of sunshine."
Having been a volunteer checking the pantries every month, Loy said he gets satisfaction knowing that he's helping people in need. "It's a lot of work, a lot of driving, but being a volunteer felt good knowing those resources were going out into the community," he said. "And seeing everyone in our organization contributing during quarterly donation drives is a morale booster."
Loy said that Community First has started installing food pantries in surrounding counties. "Sometimes people want to give back, but they don't know how," he said. "We've provided an easy and direct way for people to give back to the community."
Domestic violence is an unsettling public health issue. In Bexar County, 15 % of adults admitted to witnessing family violence in 2022 and more than 22,550 individuals reported incidents to law enforcement. Acts of violence included physical, emotional, financial and sexual abuse. Community leaders are coming together to protect families from the devastating effects of domestic violence.
Funded by University Health and operated by the Southwest Texas Regional Advisory Council (STRAC), the Domestic Violence Navigation Line helps bridge the gap between law enforcement and service organizations ready to help victims get access to needed services. The navigation line supported more than 1,600 victims from October 2021 through December 2022. This is significant because 24% of the calls involved individuals at high risk for serious injury or death from intimate partner violence. The support following an emergent incident can mean the difference between life and death, particularly for vulnerable children and older adults.
Bexar County sheriffs use the navigation line to locate immediate resources to help domestic violence victims. The navigation line helps victims connect with resources for immediate shelter, financial and housing support, legal assistance, food access and other vital services. Metro Health provides case management services from teams specializing in high-risk scenarios to ensure people get the resources they need through the network of services available. It is important that people do not get lost in the process. This integrated approach connects victims and their families with tools to be safe, healthy and protected.
University Health stands ready to respond to the community’s health needs. This commitment to health pushes us to do more because we know that adults and children impacted by intimate partner violence have poorer health outcomes. These adverse childhood events can even lead to increased rates of chronic diseases as adults, like high blood pressure and heart disease. Depression, post-traumatic stress disorder and suicide occur in those experiencing domestic violence in greater numbers compared to those individuals who live in homes free of violence.
“University Health is committed to caring for the people in our community, including those impacted by family violence, neglect and abuse. It’s a public health issue and we want to be part of the solution,” said Dr. Sally Taylor, senior vice president and chief of behavioral health with University Health. “Family violence is complex and it often takes multiple organizations working together to prevent and stop violence that occurs in the home. It is why our support of the navigation line makes perfect sense; it is another way we care for the people in our community.”
The need for preventative and support services for family violence survivors remains high in San Antonio. The implementation of the Domestic Violence Navigation Line brings us one step closer to bridging the gap between people and the life-saving services available for those impacted by the family violence crisis.
A grant to University Health’s CareLink program helped ensure families in Bexar Country were aware of the change and took action to support them through the renewal process.
CareLink team members put University Health’s values of being attentive, kind and helpful into action as they committed to helping those families most at risk of losing health care coverage.
The team made phone calls, participated in community events and visited CareLink members in the community to ensure families had the resources they needed. Staff helped people navigate the health care coverage application process through both virtual and in-person sessions offered in multiple languages. The team took initiative to identify its members whose coverage would be lapsing soon and proactively contacted those individuals to notify of them of the need to renew due to the end of continuous coverage – undoubtedly protecting many families from a lapse in vital access to health care.
“We did not want to see any family miss the opportunity to renew their health coverage. Connecting Kids to Coverage helped us continue providing these essential services and ensured families would be successful in accessing the health care coverage they needed,” Rogers said.
The 2022 grant marked the second time University Health’s CareLink program received funding from Connecting Kids to Coverage. Since 2009, Connecting Kids to Coverage has awarded approximately $270.9 million to programs across the country that help reduce the number of children who are eligible for Medicaid and CHIP but are not yet enrolled.
New COVID-19 variants were contributing to a wave of positive cases just as children began returning to school after summer break. The popular drive-thru vaccination events held in six locations across the city helped take the flu vaccine out to the people rather than asking the people to come to us. The University Health team used their experience from the last two years to operate safely and effectively, directly protecting more than 2,500 Bexar County residents from the flu through vaccination events in September and October. It is another example of how University Health took action to provide access to care throughout our community when residents needed it.
“The focus on COVID-19, Mpox and other respiratory viruses may have distracted some from the flu but the risk of complications from the virus remained, particularly for young children, the elderly and immunocompromised,” said Dr. Jason Bowling, hospital epidemiologist with University Health and associate professor of infectious diseases with UT Health San Antonio. “Vaccination remained the best way for people to avoid severe complications from the flu.”
National Seat Check Saturday is an annual reminder for parents to ensure their children are safe in their car and booster seats. University Health's injury prevention team helped families do just that during their car seat inspection event Saturday, September 24th, 2022.
"Most parents think their kids are in the right seats and that the seats are installed the right way," said Jennifer Northway, director of injury prevention with University Health, "but the reality is that nearly half of car seats are installed incorrectly, leaving kids vulnerable to injury during a vehicle accident."
Certified technicians confirmed that children were in the proper car or booster seat according to their age, weight and height. Sometimes, it was determined that a seat was not appropriate. Those families left the event with new seats and confidence knowing the seat's installation met recommended safety standards.
University Health's partners, including Toyota, TxDOT, Bexar County ESD #2 and Southside ISD helped make the event a success. The team cited 44 instances of improper use. Common issues included harnesses not fitting children correctly, incorrect installation methods, not adhering to manufacturer instructions and non-approved accessories used.
"Using age-and size-appropriate car seats and installing them correctly are the best ways to reduce crash fatalities among children," Northway said.
The Public Health Division would later grow to become the Institute for Public Health.
Born out of the last public health emergency, the Institute for Public Health will help University Health provide resources and education to help break the cycle of chronic disease impacting far too many families in our community.
"There are many things we learned as the result of the COVID-19 pandemic. One of those is that health care organizations here and across the country must take a leadership role upstream in prevention - to help prevent illness, not just treat it." said University Health President and CEO George B. Hernández Jr. "At University Health, we were already moving in this direction. In fact, 10 years prior to the pandemic, we hired Dr. Bryan Alsip as our chief medical officer. Dr. Alsip is board certified in public health and general preventive medicine."
University Health already had multiple ways to connect patients to preventive health services and resources. The new institute allows its team to take these efforts to the next level and integrate new tools available through Epic, our electronic health records system. Compass Rose, for instance, helps connect patients to needed resources outside University Health for common barriers known as nonmedical drivers of health. These barriers include food insecurity, a lack of stable housing and lack of transportation. Addressing these are crucial to a person's ability to take care of themselves and their families. Compass Rose doesn't just generate a list of resources for people; it allows us to follow up on these connections to make sure they are happening in an effective way.
"Gathering and sharing the data on health, health care access and nonmedical drivers of health will provide us, our partners and the people themselves with the means for improving lifespans, opportunity and quality of life," said Dr. Roberto Villareal, University Health senior vice president and chief public health innovation and equity officer. "This is the natural expansion of our mission to provide high-quality, compassionate care and be wise in the use of resources."
At the official launch of the public health division, then Bexar County Judge Nelson W. Wolff said University Health is uniquely positioned to establish the institute.
"With more than 9,000 employees, a state-of-the-art hospital, 25 outpatient centers, telemedicine, Hospital at Home, digital patient medical records the teaching program for UT Health, and a women's and children's hospital," Wolff said, "they bring a unique perspective to public health."
As the only locally owned health system in Bexar County, the sole Level I adult and pediatric trauma center for a 22-county area of South Texas, and the region's academic medical center through its affiliation with UT Health San Antonio, University Health has a deep and long-standing commitment to public health programs and research. Additionally, University Health has long been an essential partner with the city, the county and other health organizations during natural disasters and public health emergencies.
"We have learned a great deal about the important role of public health experts during a worldwide pandemic and the significant responsibility University Health has to serve this community in times of uncertainty," Hernandez said.
The Essential Public Health Services as defined by the Center for Disease Control and Prevention served as a framework to align existing functions, develop new services and establish priorities. This list describes the activities that the institute will lead to improve health and remove barriers that result in health inequities. The essential public health services are:
The programs and initiatives of the Institute for Public Health seek to be innovative, transparent and transformative, particularly in the areas of public health emergency response, addressing health disparities and equity.
Several current community-based initiatives and systems serve as a solid foundation for the new institute. University Health's initial efforts concentrated on linking existing public health-related functions such as:
As the division grew into an Institute, Carol Huber was named deputy chief public health and equity officer. "This new institute will serve as a hub for University Health, so we can collaborate with key partners without duplicating services," said Huber. "It will also help us identify goals and gaps, as welll as emerging threats and opportunities."
In January 2022, with two years of battling COVID-19 behind us and pandemic fatigue settling heavily on providers and the public alike, University Health staff readied for another wave - this one caused by a variant called Omicron.
We continued to produce informative Q&A videos to share with media and the public, answering question after question - new questions about Omicron and familiar ones about vaccine safety - anything that might help people understand how to protect themselves and others in a landscape where misinformation grew more hydra-headed with every new variant.
COVID-19 Q&As: BA.2, Reproductive Health, and cloth masks
We had two major advantages: a successful mass vaccination campaign of more than 611,000 COVID-19 shots by the end of 2022, primarily through our site at the Wonderland of the Americas mall; and the fact that a large percentage of the population had already survived at least one episode of COVID-19.
These facts combined to boost the community's ability to fight the disease, but Omicron brought a new onslaught. Once again, people became very sick in large numbers in what would be the last big wave of hospitalizations of the pandemic.
Food insecurity skyrocketed as the pandemic spread throughout the country. To assist those most in need in the San Antonio area, Community First Health Plans, a nonprofit health plan established by University Health, developed a food pantry initiative that touched more than 25,000 people—both donors and recipients—throughout 2022.
These small, freestanding food pantries (similar to a Little Free Library, but larger) are stocked with nonperishable foods as well as school supplies, personal hygiene products, small clothing items like socks, and more. Six pantries were installed in locations around the San Antonio in 2021, and 30 more were installed in 2022. Community First partners with schools, churches, businesses and other organizations to reach anyone in need of food, particularly women and children. Because no one works at these pantries, they offer more privacy for recipients, breaking down barriers such as shame and stigma that can prevent people from getting the food they need.
"We want it to be free of judgment, so if you need food, you can get it," said Brennan Loy, Community First public relations coordinator. Community First keeps the food pantries in good repair and restocks monthly, while members of the host organization and people in the community provide donations.
In addition to the hosts, other organizations, like University Health, have adopted food pantries, collected donations and ensured they remain well supplied. Loy encourages more organizations to adopt a food pantry: "We want to install more, but we want to make sure the ones we have are receiving enough donations. We don't want them sitting there empty."
University Health's NurseLink department adopted the Big Brothers Big Sisters pantry at 10843 Gulfdale Street. Registration access specialist Margarita Barbosa, who organizes the donations delivered to the pantry, said it's important for her department to assist the community it serves.
Amy Hogan, LVN, service coordinator at Community First, along with Tracy Whitehurst, LVN, and the rest of Team 2 in Population Health Management, adopted the food pantry at Woodlawn Hills Elementary School. "We realize the dire need for basic food resources, and this is a tiny way we can help ease that burden," Hogan said. "We always add a few fun items in there as well. I add chocolate because life needs a bit of sunshine."
Having been a volunteer checking the pantries every month, Loy said he gets satisfaction knowing that he's helping people in need. "It's a lot of work, a lot of driving, but being a volunteer felt good knowing those resources were going out into the community," he said. "And seeing everyone in our organization contributing during quarterly donation drives is a morale booster."
Loy said that Community First has started installing food pantries in surrounding counties. "Sometimes people want to give back, but they don't know how," he said. "We've provided an easy and direct way for people to give back to the community."
Domestic violence is an unsettling public health issue. In Bexar County, 15 % of adults admitted to witnessing family violence in 2022 and more than 22,550 individuals reported incidents to law enforcement. Acts of violence included physical, emotional, financial and sexual abuse. Community leaders are coming together to protect families from the devastating effects of domestic violence.
Funded by University Health and operated by the Southwest Texas Regional Advisory Council (STRAC), the Domestic Violence Navigation Line helps bridge the gap between law enforcement and service organizations ready to help victims get access to needed services. The navigation line supported more than 1,600 victims from October 2021 through December 2022. This is significant because 24% of the calls involved individuals at high risk for serious injury or death from intimate partner violence. The support following an emergent incident can mean the difference between life and death, particularly for vulnerable children and older adults.
Bexar County sheriffs use the navigation line to locate immediate resources to help domestic violence victims. The navigation line helps victims connect with resources for immediate shelter, financial and housing support, legal assistance, food access and other vital services. Metro Health provides case management services from teams specializing in high-risk scenarios to ensure people get the resources they need through the network of services available. It is important that people do not get lost in the process. This integrated approach connects victims and their families with tools to be safe, healthy and protected.
University Health stands ready to respond to the community’s health needs. This commitment to health pushes us to do more because we know that adults and children impacted by intimate partner violence have poorer health outcomes. These adverse childhood events can even lead to increased rates of chronic diseases as adults, like high blood pressure and heart disease. Depression, post-traumatic stress disorder and suicide occur in those experiencing domestic violence in greater numbers compared to those individuals who live in homes free of violence.
“University Health is committed to caring for the people in our community, including those impacted by family violence, neglect and abuse. It’s a public health issue and we want to be part of the solution,” said Dr. Sally Taylor, senior vice president and chief of behavioral health with University Health. “Family violence is complex and it often takes multiple organizations working together to prevent and stop violence that occurs in the home. It is why our support of the navigation line makes perfect sense; it is another way we care for the people in our community.”
The need for preventative and support services for family violence survivors remains high in San Antonio. The implementation of the Domestic Violence Navigation Line brings us one step closer to bridging the gap between people and the life-saving services available for those impacted by the family violence crisis.
A grant to University Health’s CareLink program helped ensure families in Bexar Country were aware of the change and took action to support them through the renewal process.
CareLink team members put University Health’s values of being attentive, kind and helpful into action as they committed to helping those families most at risk of losing health care coverage.
The team made phone calls, participated in community events and visited CareLink members in the community to ensure families had the resources they needed. Staff helped people navigate the health care coverage application process through both virtual and in-person sessions offered in multiple languages. The team took initiative to identify its members whose coverage would be lapsing soon and proactively contacted those individuals to notify of them of the need to renew due to the end of continuous coverage – undoubtedly protecting many families from a lapse in vital access to health care.
“We did not want to see any family miss the opportunity to renew their health coverage. Connecting Kids to Coverage helped us continue providing these essential services and ensured families would be successful in accessing the health care coverage they needed,” Rogers said.
The 2022 grant marked the second time University Health’s CareLink program received funding from Connecting Kids to Coverage. Since 2009, Connecting Kids to Coverage has awarded approximately $270.9 million to programs across the country that help reduce the number of children who are eligible for Medicaid and CHIP but are not yet enrolled.
New COVID-19 variants were contributing to a wave of positive cases just as children began returning to school after summer break. The popular drive-thru vaccination events held in six locations across the city helped take the flu vaccine out to the people rather than asking the people to come to us. The University Health team used their experience from the last two years to operate safely and effectively, directly protecting more than 2,500 Bexar County residents from the flu through vaccination events in September and October. It is another example of how University Health took action to provide access to care throughout our community when residents needed it.
“The focus on COVID-19, Mpox and other respiratory viruses may have distracted some from the flu but the risk of complications from the virus remained, particularly for young children, the elderly and immunocompromised,” said Dr. Jason Bowling, hospital epidemiologist with University Health and associate professor of infectious diseases with UT Health San Antonio. “Vaccination remained the best way for people to avoid severe complications from the flu.”
National Seat Check Saturday is an annual reminder for parents to ensure their children are safe in their car and booster seats. University Health's injury prevention team helped families do just that during their car seat inspection event Saturday, September 24th, 2022.
"Most parents think their kids are in the right seats and that the seats are installed the right way," said Jennifer Northway, director of injury prevention with University Health, "but the reality is that nearly half of car seats are installed incorrectly, leaving kids vulnerable to injury during a vehicle accident."
Certified technicians confirmed that children were in the proper car or booster seat according to their age, weight and height. Sometimes, it was determined that a seat was not appropriate. Those families left the event with new seats and confidence knowing the seat's installation met recommended safety standards.
University Health's partners, including Toyota, TxDOT, Bexar County ESD #2 and Southside ISD helped make the event a success. The team cited 44 instances of improper use. Common issues included harnesses not fitting children correctly, incorrect installation methods, not adhering to manufacturer instructions and non-approved accessories used.
"Using age-and size-appropriate car seats and installing them correctly are the best ways to reduce crash fatalities among children," Northway said.
Around noon on Tuesday, May 24, the pagers for University Hospital’s Level 1 trauma team sounded with an alarming message. Eighty miles away, a teenage gunman had entered Robb Elementary in Uvalde. Adults and children were wounded. Emergency responders were rushing at least two of the injured to University Hospital, and there could be more.
Without hesitation, the trauma staff put their training into action and readied about a dozen resuscitation and operating rooms with transfusion, blood bank and anesthesia specialists. They positioned equipment and prepared to treat a large number of severely injured patients.
“When severely injured patients come to our trauma center, the entire team shows up. We are like a launched missile,” said Dr. Lillian Liao, pediatric trauma medical director. “We have one target, and that’s to save the patients’ lives. We are focused on our professional task, and we compartmentalize our personal feelings.”
About an hour after the page, the first patient arrived by air. A second landed an hour after that, and two more shooting victims arrived by ground transportation later in the day. The trauma team zeroed in on treating the injuries of the three children and one adult, though there was disappointment and sadness as they understood they would not have the chance to save additional lives – 19 children and two teachers had not survived.
“After a while you start realizing why they aren’t coming, and the reality sets in,” trauma nurse Colleen Davis recalled during one of the many media stories that documented the Uvalde heroics. “It follows you for the rest of the day and for days after.”
For some of the trauma team, the Uvalde shooting triggered a flashback to another mass shooting. Five years earlier, the same pagers had notified them that nine adults and children were headed to University Hospital from a mass shooting at the Sutherland Springs First Baptist Church. The trauma team had learned a great deal from treating those severely wounded patients and had since worked to prevent other deaths from traumatic bleeding.
University Hospital’s trauma staff had helped launch the American College of Surgeons’ Stop the Bleed training across South Texas, teaching community members from all walks of life how to prevent injured people from bleeding to death while they wait for emergency help to arrive.
Its trauma surgeons had also participated in the American College of Surgeons’ Firearm Strategy Team called FAST. The ACS group brainstormed and found consensus around a set of recommendations to address the firearm public health crisis in a nonpartisan way. Their aim was to better understand and address the root causes of violence and make firearm ownership as safe as possible. The tragedy in Uvalde provided an important platform to advance the group’s common-sense recommendations, which included background checks for those purchasing firearms, formal firearm training for new gun owners, safe storage of firearms, and a more lengthy approval process for individuals seeking to purchase semi-automatic rifles like those used in Uvalde and Sutherland Springs.
Importantly, University Hospital’s trauma doctors had also worked with the South Texas Blood and Tissue Center and the Southwest Texas Regional Advisory Council, STRAC, to develop the most advanced program in the country to place cold-stored whole blood on ambulances and emergency aircraft so that patients with severe blood loss could get whole blood in the field, before reaching the trauma center. One of the Uvalde patients received whole blood at the scene, which may have kept her alive.
That child, 10-year-old Mayah Zamora, spent 66 days at University Hospital after arriving in critical condition. On July 29, hospital employees lined the hallway, cheering and applauding as the petite, brown-eyed girl with braids left their round-the-clock care, handing roses to her medical team as she departed.
University Health posted a video of Mayah’s departure on social media that was shared around the world. It said: “She is our hero and we can’t wait to see all she accomplishes in the future.”
Mayah had stolen the hearts of many hospital employees who cared for her. She became a symbol of resilience and survival against staggering odds, and a testament to the determination of a trauma team who save the lives of those critically injured in unspeakable tragedies.
University Health received reports of the mass shooting in Uvalde on May 24, 2022. The trauma team swung into action to care for the injured, and the public relations team readied for an onslaught of media inquiries.
As the only Level I trauma center in South Texas for both adult and pediatric patients, University Health has more experience with needless tragedy than anyone could want – and specifically with mass shootings. Our trauma team cared for four patients who survived the shooting that took the lives of 19 children and two adults. At the same time, our communications team began fielding hundreds of phone calls, text messages and emails from local, national and international media outlets, as well as from terrified and desperate family members. The requests would pour in nonstop for weeks.
Understandably, many initial interview requests dealt with the immediate horror of the situation, what kinds of injuries these AR-15-type rifles caused, and how health care providers coped with the shock and grief of treating wartime injuries in children’s bodies. Our providers did their best to address these painful questions, but the appetite for them did not abate.
So the public relations team pivoted. By the second week, the team was reframing firearm violence as a public health crisis and redirecting the conversation to “What can be done to prevent this in the future?”
We met with media representatives to discuss their interview goals and determined if each interview was appropriate. We strategized to find an available health care provider with the right voice for each interview.
Physicians provided a clear framework of actionable firearm violence prevention recommendations, developed in part by trauma surgeon leader Dr. Ronald Stewart in his role as a member of the American College of Surgeons. The public relations team disseminated the content to all national networks and media outlets, including The New York Times podcast The Daily, and we let media know that was what our experts were prepared to discuss. We pushed hard to change the national conversation, and the media – hungry for a new approach to an old problem – gladly accepted our information.
Not long afterward, Congress passed the Bipartisan Safer Communities Act – the first step in national bipartisan action on firearm safety in decades.
Impact:
I haven't slept well since May 24th. I was asked to write this piece, and I've had a hard time putting my thoughts together. I've lost count of the number of times reporters and others have asked me how it feels to care for victims of another mass shooting - the second mass, terroristic type shooting in less than five years, and I've lost count of the number of times people have asked me how I am doing? I understand people care and want to understand the impact to people like me, and also the impact these tragedies have on truly innocent human beings. I answer those questions pretty much the same way. I deflect the question, and answer, Yes - it takes a heavy toll on health care professionals - it takes a heavy toll on me, but nowhere close to the toll that it took on those who never made it to the Trauma Center and their loved ones. Our focus must be on those survivors and those innocent victims. Our focus must be centered on preventing other children and other families from experiencing this unfathomable suffering.
I have been doing this work for almost 40 years. It is not the late nights, the 24-hour+ in-house call, or the fatigue of this high intensity work that weigh on me or gets me down. The greatest toll on me and I believe on my fellow team members comes from witnessing the type of horrific injuries we saw on the patients we received from the Uvalde school shooting last month and the Sutherland Springs church shooting in 2017. The toll is worse because I know by working together these tragedies are preventable.
We are responsible - we are all responsible. I am not sleeping well, but from my vantage, no one else should be sleeping well either, because we collectively are responsible for not coming together across ridiculous, man-made divisions to work together to effectively put an end to this particular type of American/Texan Violence. I believe we all own the culture of violence, and the mass murder of innocent children and innocent teachers is the natural consequence of decisions made by us Texans, enacted through our elected officials. I think some of them seem to sleep well, because rather than taking responsibility for their own decisions, they blame the "other side." This is the worst form of self-deception, and it leads to some horrific natural consequences.
So how are we, the average Texans, responsible? When faced with a complex problem like firearm - related violence, we make one of two irresponsible choices. We retreat to our social media bubble or our own social bubble where everyone agrees with us, and where the other "side" is stupid, wrong, the enemy, and their opinions are worthless. We seem to love it when those beliefs are reinforced by elected officials. This way of thinking is irresponsible, because to solve a complex problem requires all of us working together. The second irresponsible approach is to simply throw up our hands and tell ourselves, "This is just too complicated and there is simply nothing we can do that would make a difference," so let's get back on TikTok or some other diversion.
There is responsible, very viable and very healthy third approach. We can choose to learn from these horrific tragedies, and we can use our own unique skills, working with each other to create solutions to these difficult problems. We can also send a clear message to our elected leaders that we expect them to find common ground and take commons sense actions to reduce firearm injuries and deaths, while also working to preserve or enhance personal liberty. This approach does not require a restriction of freedom (we would actually be freer), and it does not infringe on second amendment rights. It does require us to lay aside partisan politics for the sake of our children and grandchildren. Our children's future is literally at stake. This is not an exaggeration.
Fortunately, a lot of groundwork is already done. The American College of Surgeons (ACS) Committe on Trauma established the Firearm Strategy Team (FAST) in 2017 and formed the Improving Social Determinants to Attenuate Violence (ISAVE) workgroup in 2018. I was part of these teams who met for multiple years using a consensus-based process. One group consisted of passionate firearm owners and the other included medical and violence prevention professionals.
These workgroups found consensus grounded on the reality that firearm ownership is a constitutionally protected right and that we also have epidemic of violence and firearm-related injury, death and disability in the United States. These diverse teams agreed that we can address this epidemic of violence, while simultaneously making firearm ownership as safe as reasonably possible (for those who own a firearm, and for those who do not). These teams made relevant, nuanced and expert recommendations on what we could do to reduce firearm-related violence in the U.S.
You can find the full list of these recommendations on the ACS website.
I applaud Republican Sen. John Cornyn from Texas and Democratic Sen. Chris Murphy from Connecticut for their leadership and courage, and for working together in a bipartisan way. The passing of their Bipartisan Safer Communities Act is an important step forward toward a healthier future. But we cannot stop there. We absolutely need more bipartisan and nonpartisan efforts to address this complex public health crisis.
Our patient and our children demand our action. The deaths and injuries of the innocent demand we work together to make a real difference.
On May 24, 2022, a gunman armed with an AR-15-style rifle shot 19 students and two adults at Robb Elementary School in Uvalde, Texas.
In the first awful wave of the crisis, the staff and physicians at University Hospital's Level I trauma center got ready for the children ... but most of the children never came.
So many of the Level I trauma center nurses, techs, surgeons, anesthesiologists and others who were trained to make small bodies whole never got the chance to even try.
University Hospital ended up receiving four patients from the mass shooting and was able to help all of them.
But within a day, University Health also had sent a team of nurses to Uvalde Memorial Hospital, providing support to the staff here. They were joined in the following days by staff from Methodist Baptist and Christus Santa Rosa health systems.
Southwest Texas Regional Advisory Council (STRAC) coordinated the effort.
STRAC had already exercised/implemented its acute response strike teams to the scene.
"On that day, STRAC played a very significant role in all the things a rural hospital needed," said Adam Apolinar, CEO of Uvalde Memorial, who in May 2022 was emergency department executive director.
Now it stood up a longer mission, calling in San Antonio-area hospitals to support Uvalde Memorial, where every employee had suffered in some way from the shock and loss, said Sondie Epley, University Health assistant director of trauma services.
Epley made sure the University Health team deployed smoothly, setting up the proper credentialing so they could legally access resources and provide car in another hospital. The first team of three, Rhiannon Rasmussen, Becky Ramer and Will Herrera, left for Uvalde on the afternoon of the 25th.
Apolinar said the deployment was "seamless."
"You would have thought those nurses had been working here for years," he said. "They understood the situation, and the emotions that were going through my team - and they understood the time it took to process that."
That began a cycle of University Health nurses helping staff Uvalde Memorial for many weeks. Some were able to go to Uvalde once or twice, some went back as many as 14 times. The University Health team gave many hours of support over many shifts.
The original idea was to give the Uvalde hospital staff a break from the pressures of their work so they could deal with terrible losses in their community.
But like the University Health teams who had waited in agony that first day, the Uvalde Memorial Staff wanted to deal with their losses by showing up and performing their mission.
"They had trouble getting their staff not to come in," Epley said. "They needed to be with each other."
"It was literally the entire hospital staff that was affected," said Rhiannon Rasmussen, University Health assistant director of emergency services.
Multiple employees had children who attended Robb Elementary. They had stories - one picked up their child from school and took them home, then came to work. Another had gone to Robb Elementary and watched their child run with other evacuating children out of the building to board a bus. Once they knew their child was safe, the parent was able to leave the school and go to the hospital in hopes of helping others.
But everyone knew someone.
"It was somebody's cousin, or someone they'd been working with for 20 years who lost someone," Rasmussen said.
The University Health team was in awe of the strength they found in Uvalde.
"It is hard to work here," Epley said of the Level I trauma center at University Hospital. "You see a lot of stuff. But can you imagine you roll up to an accident and you know the person?"
Almost every person who comes to the local emergency room in a rural hospital is known in the community. Almost every wounded and dying individual has a personal connection to the care team there. The connection heightens the pain and the loss, and it takes a toll, even in normal circumstances.
"That's how committed they are to their community," Epley said. "They live there, they work there, they take care of that community."
"It also means that those community need didn't stop," Rasmussen said, "even as the caregivers were reeling from the horrific event." Heart attacks, asthma attacks, broken arms, all kinds of emergencies continued to come into Uvalde Memorial from that city and the small towns that depend upon it.
That's where the supporting team from the San Antonio hospitals came in.
Picking up shifts or picking up after massive amounts of donated food that people sent to the hospital, listening to agonizing experiences or talking through mundane issues like workflows, taking over care so the Uvalde teams could debrief, anything that needed doing, the volunteers did.
And in helping, we helped ourselves.
"I needed to hear from them that they were glad that we were there and that we were helping them," Rasmussen said. "Being able to tell them, 'It's okay, we're here to take that on for you.'"
Around noon on Tuesday, May 24, the pagers for University Hospital’s Level 1 trauma team sounded with an alarming message. Eighty miles away, a teenage gunman had entered Robb Elementary in Uvalde. Adults and children were wounded. Emergency responders were rushing at least two of the injured to University Hospital, and there could be more.
Without hesitation, the trauma staff put their training into action and readied about a dozen resuscitation and operating rooms with transfusion, blood bank and anesthesia specialists. They positioned equipment and prepared to treat a large number of severely injured patients.
“When severely injured patients come to our trauma center, the entire team shows up. We are like a launched missile,” said Dr. Lillian Liao, pediatric trauma medical director. “We have one target, and that’s to save the patients’ lives. We are focused on our professional task, and we compartmentalize our personal feelings.”
About an hour after the page, the first patient arrived by air. A second landed an hour after that, and two more shooting victims arrived by ground transportation later in the day. The trauma team zeroed in on treating the injuries of the three children and one adult, though there was disappointment and sadness as they understood they would not have the chance to save additional lives – 19 children and two teachers had not survived.
“After a while you start realizing why they aren’t coming, and the reality sets in,” trauma nurse Colleen Davis recalled during one of the many media stories that documented the Uvalde heroics. “It follows you for the rest of the day and for days after.”
For some of the trauma team, the Uvalde shooting triggered a flashback to another mass shooting. Five years earlier, the same pagers had notified them that nine adults and children were headed to University Hospital from a mass shooting at the Sutherland Springs First Baptist Church. The trauma team had learned a great deal from treating those severely wounded patients and had since worked to prevent other deaths from traumatic bleeding.
University Hospital’s trauma staff had helped launch the American College of Surgeons’ Stop the Bleed training across South Texas, teaching community members from all walks of life how to prevent injured people from bleeding to death while they wait for emergency help to arrive.
Its trauma surgeons had also participated in the American College of Surgeons’ Firearm Strategy Team called FAST. The ACS group brainstormed and found consensus around a set of recommendations to address the firearm public health crisis in a nonpartisan way. Their aim was to better understand and address the root causes of violence and make firearm ownership as safe as possible. The tragedy in Uvalde provided an important platform to advance the group’s common-sense recommendations, which included background checks for those purchasing firearms, formal firearm training for new gun owners, safe storage of firearms, and a more lengthy approval process for individuals seeking to purchase semi-automatic rifles like those used in Uvalde and Sutherland Springs.
Importantly, University Hospital’s trauma doctors had also worked with the South Texas Blood and Tissue Center and the Southwest Texas Regional Advisory Council, STRAC, to develop the most advanced program in the country to place cold-stored whole blood on ambulances and emergency aircraft so that patients with severe blood loss could get whole blood in the field, before reaching the trauma center. One of the Uvalde patients received whole blood at the scene, which may have kept her alive.
That child, 10-year-old Mayah Zamora, spent 66 days at University Hospital after arriving in critical condition. On July 29, hospital employees lined the hallway, cheering and applauding as the petite, brown-eyed girl with braids left their round-the-clock care, handing roses to her medical team as she departed.
University Health posted a video of Mayah’s departure on social media that was shared around the world. It said: “She is our hero and we can’t wait to see all she accomplishes in the future.”
Mayah had stolen the hearts of many hospital employees who cared for her. She became a symbol of resilience and survival against staggering odds, and a testament to the determination of a trauma team who save the lives of those critically injured in unspeakable tragedies.
University Health received reports of the mass shooting in Uvalde on May 24, 2022. The trauma team swung into action to care for the injured, and the public relations team readied for an onslaught of media inquiries.
As the only Level I trauma center in South Texas for both adult and pediatric patients, University Health has more experience with needless tragedy than anyone could want – and specifically with mass shootings. Our trauma team cared for four patients who survived the shooting that took the lives of 19 children and two adults. At the same time, our communications team began fielding hundreds of phone calls, text messages and emails from local, national and international media outlets, as well as from terrified and desperate family members. The requests would pour in nonstop for weeks.
Understandably, many initial interview requests dealt with the immediate horror of the situation, what kinds of injuries these AR-15-type rifles caused, and how health care providers coped with the shock and grief of treating wartime injuries in children’s bodies. Our providers did their best to address these painful questions, but the appetite for them did not abate.
So the public relations team pivoted. By the second week, the team was reframing firearm violence as a public health crisis and redirecting the conversation to “What can be done to prevent this in the future?”
We met with media representatives to discuss their interview goals and determined if each interview was appropriate. We strategized to find an available health care provider with the right voice for each interview.
Physicians provided a clear framework of actionable firearm violence prevention recommendations, developed in part by trauma surgeon leader Dr. Ronald Stewart in his role as a member of the American College of Surgeons. The public relations team disseminated the content to all national networks and media outlets, including The New York Times podcast The Daily, and we let media know that was what our experts were prepared to discuss. We pushed hard to change the national conversation, and the media – hungry for a new approach to an old problem – gladly accepted our information.
Not long afterward, Congress passed the Bipartisan Safer Communities Act – the first step in national bipartisan action on firearm safety in decades.
Impact:
I haven't slept well since May 24th. I was asked to write this piece, and I've had a hard time putting my thoughts together. I've lost count of the number of times reporters and others have asked me how it feels to care for victims of another mass shooting - the second mass, terroristic type shooting in less than five years, and I've lost count of the number of times people have asked me how I am doing? I understand people care and want to understand the impact to people like me, and also the impact these tragedies have on truly innocent human beings. I answer those questions pretty much the same way. I deflect the question, and answer, Yes - it takes a heavy toll on health care professionals - it takes a heavy toll on me, but nowhere close to the toll that it took on those who never made it to the Trauma Center and their loved ones. Our focus must be on those survivors and those innocent victims. Our focus must be centered on preventing other children and other families from experiencing this unfathomable suffering.
I have been doing this work for almost 40 years. It is not the late nights, the 24-hour+ in-house call, or the fatigue of this high intensity work that weigh on me or gets me down. The greatest toll on me and I believe on my fellow team members comes from witnessing the type of horrific injuries we saw on the patients we received from the Uvalde school shooting last month and the Sutherland Springs church shooting in 2017. The toll is worse because I know by working together these tragedies are preventable.
We are responsible - we are all responsible. I am not sleeping well, but from my vantage, no one else should be sleeping well either, because we collectively are responsible for not coming together across ridiculous, man-made divisions to work together to effectively put an end to this particular type of American/Texan Violence. I believe we all own the culture of violence, and the mass murder of innocent children and innocent teachers is the natural consequence of decisions made by us Texans, enacted through our elected officials. I think some of them seem to sleep well, because rather than taking responsibility for their own decisions, they blame the "other side." This is the worst form of self-deception, and it leads to some horrific natural consequences.
So how are we, the average Texans, responsible? When faced with a complex problem like firearm - related violence, we make one of two irresponsible choices. We retreat to our social media bubble or our own social bubble where everyone agrees with us, and where the other "side" is stupid, wrong, the enemy, and their opinions are worthless. We seem to love it when those beliefs are reinforced by elected officials. This way of thinking is irresponsible, because to solve a complex problem requires all of us working together. The second irresponsible approach is to simply throw up our hands and tell ourselves, "This is just too complicated and there is simply nothing we can do that would make a difference," so let's get back on TikTok or some other diversion.
There is responsible, very viable and very healthy third approach. We can choose to learn from these horrific tragedies, and we can use our own unique skills, working with each other to create solutions to these difficult problems. We can also send a clear message to our elected leaders that we expect them to find common ground and take commons sense actions to reduce firearm injuries and deaths, while also working to preserve or enhance personal liberty. This approach does not require a restriction of freedom (we would actually be freer), and it does not infringe on second amendment rights. It does require us to lay aside partisan politics for the sake of our children and grandchildren. Our children's future is literally at stake. This is not an exaggeration.
Fortunately, a lot of groundwork is already done. The American College of Surgeons (ACS) Committe on Trauma established the Firearm Strategy Team (FAST) in 2017 and formed the Improving Social Determinants to Attenuate Violence (ISAVE) workgroup in 2018. I was part of these teams who met for multiple years using a consensus-based process. One group consisted of passionate firearm owners and the other included medical and violence prevention professionals.
These workgroups found consensus grounded on the reality that firearm ownership is a constitutionally protected right and that we also have epidemic of violence and firearm-related injury, death and disability in the United States. These diverse teams agreed that we can address this epidemic of violence, while simultaneously making firearm ownership as safe as reasonably possible (for those who own a firearm, and for those who do not). These teams made relevant, nuanced and expert recommendations on what we could do to reduce firearm-related violence in the U.S.
You can find the full list of these recommendations on the ACS website.
I applaud Republican Sen. John Cornyn from Texas and Democratic Sen. Chris Murphy from Connecticut for their leadership and courage, and for working together in a bipartisan way. The passing of their Bipartisan Safer Communities Act is an important step forward toward a healthier future. But we cannot stop there. We absolutely need more bipartisan and nonpartisan efforts to address this complex public health crisis.
Our patient and our children demand our action. The deaths and injuries of the innocent demand we work together to make a real difference.
On May 24, 2022, a gunman armed with an AR-15-style rifle shot 19 students and two adults at Robb Elementary School in Uvalde, Texas.
In the first awful wave of the crisis, the staff and physicians at University Hospital's Level I trauma center got ready for the children ... but most of the children never came.
So many of the Level I trauma center nurses, techs, surgeons, anesthesiologists and others who were trained to make small bodies whole never got the chance to even try.
University Hospital ended up receiving four patients from the mass shooting and was able to help all of them.
But within a day, University Health also had sent a team of nurses to Uvalde Memorial Hospital, providing support to the staff here. They were joined in the following days by staff from Methodist Baptist and Christus Santa Rosa health systems.
Southwest Texas Regional Advisory Council (STRAC) coordinated the effort.
STRAC had already exercised/implemented its acute response strike teams to the scene.
"On that day, STRAC played a very significant role in all the things a rural hospital needed," said Adam Apolinar, CEO of Uvalde Memorial, who in May 2022 was emergency department executive director.
Now it stood up a longer mission, calling in San Antonio-area hospitals to support Uvalde Memorial, where every employee had suffered in some way from the shock and loss, said Sondie Epley, University Health assistant director of trauma services.
Epley made sure the University Health team deployed smoothly, setting up the proper credentialing so they could legally access resources and provide car in another hospital. The first team of three, Rhiannon Rasmussen, Becky Ramer and Will Herrera, left for Uvalde on the afternoon of the 25th.
Apolinar said the deployment was "seamless."
"You would have thought those nurses had been working here for years," he said. "They understood the situation, and the emotions that were going through my team - and they understood the time it took to process that."
That began a cycle of University Health nurses helping staff Uvalde Memorial for many weeks. Some were able to go to Uvalde once or twice, some went back as many as 14 times. The University Health team gave many hours of support over many shifts.
The original idea was to give the Uvalde hospital staff a break from the pressures of their work so they could deal with terrible losses in their community.
But like the University Health teams who had waited in agony that first day, the Uvalde Memorial Staff wanted to deal with their losses by showing up and performing their mission.
"They had trouble getting their staff not to come in," Epley said. "They needed to be with each other."
"It was literally the entire hospital staff that was affected," said Rhiannon Rasmussen, University Health assistant director of emergency services.
Multiple employees had children who attended Robb Elementary. They had stories - one picked up their child from school and took them home, then came to work. Another had gone to Robb Elementary and watched their child run with other evacuating children out of the building to board a bus. Once they knew their child was safe, the parent was able to leave the school and go to the hospital in hopes of helping others.
But everyone knew someone.
"It was somebody's cousin, or someone they'd been working with for 20 years who lost someone," Rasmussen said.
The University Health team was in awe of the strength they found in Uvalde.
"It is hard to work here," Epley said of the Level I trauma center at University Hospital. "You see a lot of stuff. But can you imagine you roll up to an accident and you know the person?"
Almost every person who comes to the local emergency room in a rural hospital is known in the community. Almost every wounded and dying individual has a personal connection to the care team there. The connection heightens the pain and the loss, and it takes a toll, even in normal circumstances.
"That's how committed they are to their community," Epley said. "They live there, they work there, they take care of that community."
"It also means that those community need didn't stop," Rasmussen said, "even as the caregivers were reeling from the horrific event." Heart attacks, asthma attacks, broken arms, all kinds of emergencies continued to come into Uvalde Memorial from that city and the small towns that depend upon it.
That's where the supporting team from the San Antonio hospitals came in.
Picking up shifts or picking up after massive amounts of donated food that people sent to the hospital, listening to agonizing experiences or talking through mundane issues like workflows, taking over care so the Uvalde teams could debrief, anything that needed doing, the volunteers did.
And in helping, we helped ourselves.
"I needed to hear from them that they were glad that we were there and that we were helping them," Rasmussen said. "Being able to tell them, 'It's okay, we're here to take that on for you.'"
Jesus Moreno, 67, has overcome many years of drug addiction and opened a church in El Paso for other drug-dependent people who wanted to become sober. He and his wife, Lydia Moreno, committed themselves to helping others who wanted to abandon drugs and lead healthier lives.
His many years of substance abuse had, however, badly damaged Moreno's body. He needed both a kidney and a liver transplant to survive.
At the Transplant Institute, Moreno joined the Donor Champion program, which helps patients tell their relatives, coworkers and network of friends about their need for new organs. For Dr. Elizabeth Thomas and the transplant team, Moreno's previous drug addiction was not a factor in considering him for receiving two new organs.
"In our work, that is all in the past" said Thomas, the surgical director for the Living Kidney Donor Program. "We want to know, who are you today? Will you take care of these organs? That's what is important to us. We believe in second chances," she said.
The Donor Champion program teaches patients like Moreno how to use social media and personal connections to share their stories without making others and themselves uncomfortable. Each patient identifies a champion who leads their outreach effort, which is often successful in identifying living donors who are willing to come forward and donate a portion of their liver or a kidney to others who need them to survive.
Waiting for new organs from deceased donors can take many painful years, and some patients do not survive. Organs from compatible living donors can often be transplanted within weeks, are typically healthier and the donors recover quickly and continue to lead full live.
Moreno did not have to wait long for his living donors to step forward.
Like Moreno, Susana Cordes and Michael Jimenez had battled drug addiction. They joined Moreno's church, embraced its spiritual message and credited their pastor with helping them overcome their drug use. Cordes immediately stepped forward to donate part of her liver, understanding her remaining liver would regenerate and again be a full-functioning organ. The portion she donated would also grow into a new liver for Moreno.
Cordes was a good biological match for her pastor. Michael Jimenez, who stepped forward to donate one of his kidneys, was not. He agreed, however, to donate to another patient in return for that patient's living donor providing a kidney to Moreno. With compatible donors approved for both the liver and kidney transplants, Moreno medical team scheduled two surgeries, several days apart.
The more complex liver transplant came first because there was a potential for excessive bleeding and complications.
"We don't want to transplant a kidney into a less than stable patient," Thomas explained.
That surgery on September 27th went smoothly. Two days later, Jimenez donated his kidney to a recipient he didn't know. and the transplant team gave Moreno a new, functioning kidney from a separate donor.
The second transplant and Moreno's recovery also went beautifully.
"I never lost my strength because I always had hope that gift of life was going to come," said Moreno, who believes his faith in God led to his two "miracle" donors.
Every living organ donation that saves a life is precious, but the transplant team was especially moved by the love and devotion that prompted these donors to step forward.
"It is a beautiful cycle of life," Thomas said. "Mr. Moreno had beaten his drug addiction. He helped save them from their addictions, then they saved him from organ failure."
"It shows we are all deserving of a second chance," she said.
In developing new, high-tech ways to help children manage their diabetes and teaching high-risk adults how to prevent it altogether, researchers at University Health's Texas Diabetes Institute are fighting diabetes on every level and in every possible way.
Diabetes is common and increasing in Bexar County, and worldwide. Complications from the condition are also on the rise.
The condition occurs when blood glucose levels in the body are too high.
Type 2 diabetes is the most common and is closely tied to lifestyle, although it can have a genetic component. A poor diet high in saturated fats and carbohydrates, excess weight and lack of physical exercise can lead to Type 2 diabetes. While it typically occurs in adults, more children are being diagnosed with it.
Type 1 diabetes occurs when the pancreas stops making insulin. Without insulin, glucose cannot get into a person's cells, and this causes blood glucose levels to rise to an abnormal range. Patients must meticulously measure the carbohydrates in their food and monitor their glucose level to determine what does of insulin to take every day to keep their blood glucose in a safe range. It is an autoimmune condition, usually diagnosed in children and young adults, but it can appear at any age.
Compared to other available artificial pancreas technologies, the bionic pancreas requires minimal user input and provides more automation because the device's algorithms continually adjust insulin doses automatically based on the users' needs. Users initialize the bionic pancreas by entering only their body weight into the device's dosing software at the time of first use.
"The bionic pancreas offers a turnkey solution to diabetes management," said Rabab Jafri, MD, pediatric endocrinologist at the Texas Diabetes Institute and in the UT Health San Antonio Division of Pediatric Endocrinology and Diabetes.
The 13-week trial, conducted at University Health, UT Health San Antonio and 15 other clinical sites across the United States, enrolled 326 participants ages 6 to 79 years who had type 1 diabetes and had been using insulin for at least one year. Participants were randomly assigned to either a treatment group using the bionic pancreas device or a standard-of-care control group using their personal pre-study insulin delivery method. All participants in the control group were provided with a continuous glucose monitor, and nearly one-third of the control group were using commercially available artificial pancreas technology during the study.
An A1C test measures a patient's average blood sugar level over the last three months. A normal A1C is below 5.7% and 5.7% to 6.4% is considered prediabetes. A patient receives a diabetes diagnosis when their A1C reaches 6.5% and above.
In participants using the bionic pancreas, their A1C improved from 7.9% to 7.3%, yet remained unchanged among the standard-of-care control group. The bionic pancreas group participants spent 11% more time, approximately 2.5 hours per day, within the targeted blood glucose range compared to the control group. These results were similar in youth and adult participants, and improvements in blood glucose control were greatest among participants who had higher blood glucose levels at the beginning of the study.
"Every dose of insulin is determined by the bionic pancreas during its wear. The dosing cycle is 288 times a day (every five minutes)," Jafri said. "The improved glycemic control achieved with less effort are great steps forward and should help many children for whom this mode of therapy will be suitable. Improved blood sugar control results in a decrease in the long-term complications of Type 1 diabetes, which is especially important for children who may develop these complications at a relatively young age if their diabetes is not well controlled."
"Prediabetes is a condition in which the blood sugar numbers are not withing normal range. The numbers have not crossed into diabetes range," said Dr. Albert Chavez-Velazquez, endocrinologist and diabetes researcher at University Health Texas Diabetes Institute. "If left untreated, prediabetes can progress to a Type 2 diabetes diagnosis."
We know 1 in 3 adults worldwide may have prediabetes. The statistic may be higher in Bexar County. Of those with prediabetes, 80% are unaware that they have it. "Prediabetes is a warning. Patients should take aggressive action to lower their blood glucose levels. Once a patient's A1C reaches 6.5%, then they cross into diabetes range. A clinical diabetes diagnosis never goes away," said Chavez-Velazquez.
The prediabetes study underway at the Texas Diabetes Institute is trying to identify the best ways to help patients avoid a Type 2 diabetes diagnosis.
Study participants are seeing results. After two years, study participant Martha Hutchinson has lost 30 pounds and her A1C is no longer in the prediabetes range. Lifestyle changes, like regularly sleeping at least 8 hours a night, regular exercise and eating a healthy diet have helped improve her blood glucose level.
"The earlier the treatment begins, the higher the chances to send the prediabetes into remission and prevent complications," said Chavez-Velazquez.
In November, University Health’s Neonatal Nutrition & Bone Institute released the surprising findings of a five-year study comparing the body compositions of 48 low-birthweight, premature babies fed breast milk from their mothers to those fed human breast milk from a donor.
Previous studies had shown babies fed human milk from donors didn’t grow as quickly or develop as well as those with a diet of their mother’s milk. However, this study, printed in Pediatric Research, was believed to be the first to document differences in infants fed exclusive diets of human milk, as opposed to some percentage of formula derived from cow’s milk. The results demonstrated important differences from previous research and prompted a reexamination of the most effective diet for premature babies. It offered an especially hopeful option for mothers who could not produce enough of their own milk for their premature babies.
“We were surprised but pleased that we saw no differences in body composition for babies that received maternal milk and donor milk. That really goes to show that a human milk diet for these babies – particularly with our protocol – mimics the same body composition,” said Rachel Jacob, a dietician and manager of clinical nutrition who helped author the study.
The all-important “protocol,” essential to making donor milk just as nutritious as mother’s milk, was the addition of macronutrients which can be lost when donor milk is pasteurized. Those carbohydrates, proteins and fats are essential for helping a preterm baby add weight, avoid sickness and develop neurologically. When the neonatal team added the right combination of nutrients to the donor milk, preterm infants experienced the same vital growth and development as babies fed their mother’s milk.
A healing diet fueled by science and passion
“We will calculate exactly how many calories, how much protein, how much of everything is in that donor human milk,” explained Dr. Cynthia Blanco, a nationally recognized neonatologist who leads University Health’s infant nutrition program. She’s one of just six members of the American Academy of Pediatrics nutrition committee and the only neonatologist in the group.
Her research into improving infant nutrition, especially for babies born early, began more than 20 years ago, when she began working at University Health.
“I just felt that nobody was looking, in particular, at the nutrition for preterm babies. And since one of the most important things for a preterm baby in the last trimester is to grow – and they grow really, really rapidly in the last trimester – I felt somebody should focus on how to get the nutrients from the womb to babies to maximize their potential and long-term health.”
Groundbreaking discoveries
Since then, Blanco and a team from University Health and UT Health San Antonio have helped advance the field of infant nutrition with numerous studies, including one in 2018 that led the U.S. Food and Drug Administration in 2018 to approve a treatment for premature babies with a life-threatening liver condition.
The researchers documented an astounding reduction in infant deaths for the critically ill babies fed Omegaven, a fish oil-based solution. According to Blanco, the survival rate of the infants went from 10% to more than 90%.
Years of research add up
Each year the team builds upon what it’s previously learned and looks for even better methods to adapt nutrition and strengthen babies born with weaknesses.
The published study of an exclusive human milk diet for preterm babies was one of just several research projects conducted by the team this year. Another research project published in the Journal of Pediatrics, measured the effects of a human milk diet fed to 107 newborns with one instead of two pumping heart chambers, or ventricles. The single-ventricle condition would likely require multiple surgeries for the infants, so they needed to be as strong as possible to survive the procedures.
“If they don't grow well between their surgeries, they have a higher chance of dying. So it is extremely important for us to get them to grow for the next surgery. And we were able to get them to grow better with all human milk that had higher caloric concentration they were able to tolerate. So, likely they will have better survival because of that,” said Blanco.
The team is also looking at how to boost the health of newborns with a variety of congenital heart conditions. Once again it appears these babies often suffer from poor growth and difficulty in metabolizing food. They need a special feeding strategy that identifies the best way to deliver nutrition, the amount of food each baby can tolerate and a plan to customize and supplement their feeding.
A future based on research
Dr. Blanco sees the future of University Health’s infant nutrition program framed by this long history of progress through research. Some studies result in baby steps, others in giant strides. Collectively they have led to a sea change in our understanding of how nutrition can transform the health of sick and premature infants.
During the past 40 years, medical advances have resulted in preemies surviving with increasingly less time in the womb. That has resulted in evolving medical needs.
“What we're doing in the field of neonatal nutrition is trying to understand the needs of premature babies now versus 10, 20 or 30 years ago. What approach works best to maximize their growth?”
Dr. Blanco says the only way to answer that question and continue to move forward is to look beyond what they know and systematically, patiently do the research.
The international accreditation, presented to the hospital in December 2021, signifies that University Health successfully implements the World Health Organization (WHO)/UNICEF Baby-Friendly Initiative's standards for the best possible breastfeeding support for mother and infant in the maternity setting and supports strong mother/baby bonding, among other measurements.
It's not only what happens in the delivery room that sets University Health apart. Baby-friendly education begins at the first prenatal doctor visits and continues until discharge.
"We can't fully educate someone within 24 hours of delivery, so we give small steps of education based on weeks of gestation," said Irene Sandate, University Health vice president and associate chief nursing officer for women and children. "We support women in their choice to breastfeed, which has long-term health benefits for both mother and baby."
Clinicians minimize separation of mother and baby in the hospital, and they ensure mom has the opportunity to hold her baby to the breast during the first hour after delivery so she an attempt to successfully breastfeed. Lactation consultants are available to meet with women who are having difficulty breastfeeding.
University Health had to accomplish major milestones in order to qualify for Baby-Friendly status. All staff members must complete several hours of additional training on baby-friendly practices, and surveyors conducted onsite visits to ask women about the prenatal education they received. Rates of breastfeeding initiation and at discharge were also considered. If a newborn is taken to the neonatal intensive care unit (NICU), women must also have access to a breast pump.
"Human milk is the best choice for those fragile and extremely ill infants as we establish nutrition," Sandate said. "There are lifelong health benefits if a woman can breastfeed and establish milk flow."
Departments across the hospital, as well as University Health's ambulatory partners, are involved in achieving the Baby-Friendly designation. Obstetrics, women's health, neonatal ICU care, neonatology, pediatrics, family medicine, nursing and other team members—along with relationships with referring providers from private offices—all come together to educate and support women in their decision to breastfeed.
"We help women make informed decision to breastfeed or not," Sandate said. "We support you in whatever you decide to do, but let's make sure it's an informed decision."
To the laboratory staff at University Health, a patient is a person, not just a result, even if they never see their face. Thanks to that compassion, Kaila's care team helped solve a critical mystery about her ailing health.
University Health doctors were trying to determine the underlying cause of a massive stroke that Kaila had suffered. The lab realized there was a problem - not with the integrity of the patient's blood sample, but with the blood itself.
They had uncovered a mysterious clotting issue that was interfering with her diagnosis. They shared the information with the clinicians, and with this knowledge, surgeons were able to provide the complex treatment she needed.
"With this patient, multiple blood samples were sent down to us in the lab," said Carrie Bartosh, laboratory manager in the Microbiology Department at University Hospital. "This patient had three different blood draws, each with three or more different tests, over several days, and every single time we kept getting an error with the internal control. Occasionally, this could be caused by a handling problem with a single sample, but when we see it interfering with multiple blood draws, it's highly unlikely that it's just a sample integrity error."
As anyone who has taken an at-home COVID-19 or home pregnancy test knows, there are two lines on the test - one indicating the quality-control factors and the other indicating the test result. As long as a line shows on the control side, it means the test result is valid - it can be trusted. If there's no line on the control side, the test is invalid because the results might be inaccurate.
The same concept holds true in laboratory tests at a hospital. In some blood tests, certain blood factors establish quality control to ensure trusted test results. Among those factors is Factor 13A, which is present in all human blood and is used to establish the integrity of the blood sample.
Scott Bowman, a microbiology scientist in the University Hospital lab, brought Kaila's multiple erroneous blood tests to Bartosh's attention, as did another lab scientist. The lab team contacted to Claudia Courtright, technical supervisor in Microbiology Services. Courtright reviewed the patient's medical history chart and discovered the likely underlying problem with the patient's clotting factors that needed to be investigated.
"We reached out to the team who was overseeing her care," said Bartosh. She told the physicians, "We think Factor 13 might be decreased, so if a clotting problem fits the clinical picture, that's something to look into. That's probably the interfering cause of her invalid results."
Bartosh explains that University Health lab scientists have college degrees and national board certifications, spending years studying pathophysiology, disease processes, effects on the body, and different ways to test for these effects. "It takes strong analytical and critical-thinking skills to understand the science that's happening with these tests," Bartosh said. "And it takes confidence to reach out to the physician to say, 'I have expertise here, and I know something is wrong.'"
Stephanie Whitehead, executive director of pathology services at University Health, emphasizes the lab's focus on patient care.
"We in the pathology department pride ourselves on delivering top-notch laboratory services that align with our patient-centered care approach," Whitehead said. "As a team, we understand the importance of supporting health care providers in delivering personalized care, which is why we offer a comprehensive test menu, and we prioritize quality, efficiency and process improvement in our operations."
Lab scientists may never see patients face-to-face, but that doesn't diminish their dedication to patient-centered care.
"You really feel for someone when they've had multiple draws and we aren't getting valid test results," Whitehead said. "We want to make sure she's getting accurate results for these tests in a timely manner so she can get the treatment she needs."
Bowman agrees: "It's not just a sample; it's a patient. That's somebody's aunt or uncle or brother. Our purpose here is for patient care, and as a result of doing our job, we found this abnormality that gave the clinicians something else to look at in this patient."
"When Scott started to see a pattern, he wanted to investigate further," Whitehead said. "He was a champion for Kaila."
There are special instances when the lab experts do, in fact, get to meet the people they help care for. On this occasion, the patient's parents wanted to meet the people who were behind the scenes of their daughter's care.
Shameka Upshaw, Kaila's mother, was grateful for the opportunity to meet the team that she says "went above and beyond" to give her daughter the best care she could get. "Scott and Carrie didn't just see the bloodwork sample; they saw her name," Upshaw said. "They understand that the samples they test every day are connected to a person who has real things going on, and the doctors need that information to figure out what was happening. Their care and attention to detail helped us in a very dark time. We appreciate the work they do every day for families like ours."
Bartosh said, "In a lab, we only see a patient's name, but we know there's a person attached to it." "To get to meet the patients and the family was probably the highlight of my entire career. I don't think there was a dry eye in the room."
"In this lab, we really care about the patients," Bartosh said. "Even though you don't see us, we are here and working hard to make sure all our patients have the best, most accurate lab results possible."
Jesus Moreno, 67, has overcome many years of drug addiction and opened a church in El Paso for other drug-dependent people who wanted to become sober. He and his wife, Lydia Moreno, committed themselves to helping others who wanted to abandon drugs and lead healthier lives.
His many years of substance abuse had, however, badly damaged Moreno's body. He needed both a kidney and a liver transplant to survive.
At the Transplant Institute, Moreno joined the Donor Champion program, which helps patients tell their relatives, coworkers and network of friends about their need for new organs. For Dr. Elizabeth Thomas and the transplant team, Moreno's previous drug addiction was not a factor in considering him for receiving two new organs.
"In our work, that is all in the past" said Thomas, the surgical director for the Living Kidney Donor Program. "We want to know, who are you today? Will you take care of these organs? That's what is important to us. We believe in second chances," she said.
The Donor Champion program teaches patients like Moreno how to use social media and personal connections to share their stories without making others and themselves uncomfortable. Each patient identifies a champion who leads their outreach effort, which is often successful in identifying living donors who are willing to come forward and donate a portion of their liver or a kidney to others who need them to survive.
Waiting for new organs from deceased donors can take many painful years, and some patients do not survive. Organs from compatible living donors can often be transplanted within weeks, are typically healthier and the donors recover quickly and continue to lead full live.
Moreno did not have to wait long for his living donors to step forward.
Like Moreno, Susana Cordes and Michael Jimenez had battled drug addiction. They joined Moreno's church, embraced its spiritual message and credited their pastor with helping them overcome their drug use. Cordes immediately stepped forward to donate part of her liver, understanding her remaining liver would regenerate and again be a full-functioning organ. The portion she donated would also grow into a new liver for Moreno.
Cordes was a good biological match for her pastor. Michael Jimenez, who stepped forward to donate one of his kidneys, was not. He agreed, however, to donate to another patient in return for that patient's living donor providing a kidney to Moreno. With compatible donors approved for both the liver and kidney transplants, Moreno medical team scheduled two surgeries, several days apart.
The more complex liver transplant came first because there was a potential for excessive bleeding and complications.
"We don't want to transplant a kidney into a less than stable patient," Thomas explained.
That surgery on September 27th went smoothly. Two days later, Jimenez donated his kidney to a recipient he didn't know. and the transplant team gave Moreno a new, functioning kidney from a separate donor.
The second transplant and Moreno's recovery also went beautifully.
"I never lost my strength because I always had hope that gift of life was going to come," said Moreno, who believes his faith in God led to his two "miracle" donors.
Every living organ donation that saves a life is precious, but the transplant team was especially moved by the love and devotion that prompted these donors to step forward.
"It is a beautiful cycle of life," Thomas said. "Mr. Moreno had beaten his drug addiction. He helped save them from their addictions, then they saved him from organ failure."
"It shows we are all deserving of a second chance," she said.
In developing new, high-tech ways to help children manage their diabetes and teaching high-risk adults how to prevent it altogether, researchers at University Health's Texas Diabetes Institute are fighting diabetes on every level and in every possible way.
Diabetes is common and increasing in Bexar County, and worldwide. Complications from the condition are also on the rise.
The condition occurs when blood glucose levels in the body are too high.
Type 2 diabetes is the most common and is closely tied to lifestyle, although it can have a genetic component. A poor diet high in saturated fats and carbohydrates, excess weight and lack of physical exercise can lead to Type 2 diabetes. While it typically occurs in adults, more children are being diagnosed with it.
Type 1 diabetes occurs when the pancreas stops making insulin. Without insulin, glucose cannot get into a person's cells, and this causes blood glucose levels to rise to an abnormal range. Patients must meticulously measure the carbohydrates in their food and monitor their glucose level to determine what does of insulin to take every day to keep their blood glucose in a safe range. It is an autoimmune condition, usually diagnosed in children and young adults, but it can appear at any age.
Compared to other available artificial pancreas technologies, the bionic pancreas requires minimal user input and provides more automation because the device's algorithms continually adjust insulin doses automatically based on the users' needs. Users initialize the bionic pancreas by entering only their body weight into the device's dosing software at the time of first use.
"The bionic pancreas offers a turnkey solution to diabetes management," said Rabab Jafri, MD, pediatric endocrinologist at the Texas Diabetes Institute and in the UT Health San Antonio Division of Pediatric Endocrinology and Diabetes.
The 13-week trial, conducted at University Health, UT Health San Antonio and 15 other clinical sites across the United States, enrolled 326 participants ages 6 to 79 years who had type 1 diabetes and had been using insulin for at least one year. Participants were randomly assigned to either a treatment group using the bionic pancreas device or a standard-of-care control group using their personal pre-study insulin delivery method. All participants in the control group were provided with a continuous glucose monitor, and nearly one-third of the control group were using commercially available artificial pancreas technology during the study.
An A1C test measures a patient's average blood sugar level over the last three months. A normal A1C is below 5.7% and 5.7% to 6.4% is considered prediabetes. A patient receives a diabetes diagnosis when their A1C reaches 6.5% and above.
In participants using the bionic pancreas, their A1C improved from 7.9% to 7.3%, yet remained unchanged among the standard-of-care control group. The bionic pancreas group participants spent 11% more time, approximately 2.5 hours per day, within the targeted blood glucose range compared to the control group. These results were similar in youth and adult participants, and improvements in blood glucose control were greatest among participants who had higher blood glucose levels at the beginning of the study.
"Every dose of insulin is determined by the bionic pancreas during its wear. The dosing cycle is 288 times a day (every five minutes)," Jafri said. "The improved glycemic control achieved with less effort are great steps forward and should help many children for whom this mode of therapy will be suitable. Improved blood sugar control results in a decrease in the long-term complications of Type 1 diabetes, which is especially important for children who may develop these complications at a relatively young age if their diabetes is not well controlled."
"Prediabetes is a condition in which the blood sugar numbers are not withing normal range. The numbers have not crossed into diabetes range," said Dr. Albert Chavez-Velazquez, endocrinologist and diabetes researcher at University Health Texas Diabetes Institute. "If left untreated, prediabetes can progress to a Type 2 diabetes diagnosis."
We know 1 in 3 adults worldwide may have prediabetes. The statistic may be higher in Bexar County. Of those with prediabetes, 80% are unaware that they have it. "Prediabetes is a warning. Patients should take aggressive action to lower their blood glucose levels. Once a patient's A1C reaches 6.5%, then they cross into diabetes range. A clinical diabetes diagnosis never goes away," said Chavez-Velazquez.
The prediabetes study underway at the Texas Diabetes Institute is trying to identify the best ways to help patients avoid a Type 2 diabetes diagnosis.
Study participants are seeing results. After two years, study participant Martha Hutchinson has lost 30 pounds and her A1C is no longer in the prediabetes range. Lifestyle changes, like regularly sleeping at least 8 hours a night, regular exercise and eating a healthy diet have helped improve her blood glucose level.
"The earlier the treatment begins, the higher the chances to send the prediabetes into remission and prevent complications," said Chavez-Velazquez.
In November, University Health’s Neonatal Nutrition & Bone Institute released the surprising findings of a five-year study comparing the body compositions of 48 low-birthweight, premature babies fed breast milk from their mothers to those fed human breast milk from a donor.
Previous studies had shown babies fed human milk from donors didn’t grow as quickly or develop as well as those with a diet of their mother’s milk. However, this study, printed in Pediatric Research, was believed to be the first to document differences in infants fed exclusive diets of human milk, as opposed to some percentage of formula derived from cow’s milk. The results demonstrated important differences from previous research and prompted a reexamination of the most effective diet for premature babies. It offered an especially hopeful option for mothers who could not produce enough of their own milk for their premature babies.
“We were surprised but pleased that we saw no differences in body composition for babies that received maternal milk and donor milk. That really goes to show that a human milk diet for these babies – particularly with our protocol – mimics the same body composition,” said Rachel Jacob, a dietician and manager of clinical nutrition who helped author the study.
The all-important “protocol,” essential to making donor milk just as nutritious as mother’s milk, was the addition of macronutrients which can be lost when donor milk is pasteurized. Those carbohydrates, proteins and fats are essential for helping a preterm baby add weight, avoid sickness and develop neurologically. When the neonatal team added the right combination of nutrients to the donor milk, preterm infants experienced the same vital growth and development as babies fed their mother’s milk.
A healing diet fueled by science and passion
“We will calculate exactly how many calories, how much protein, how much of everything is in that donor human milk,” explained Dr. Cynthia Blanco, a nationally recognized neonatologist who leads University Health’s infant nutrition program. She’s one of just six members of the American Academy of Pediatrics nutrition committee and the only neonatologist in the group.
Her research into improving infant nutrition, especially for babies born early, began more than 20 years ago, when she began working at University Health.
“I just felt that nobody was looking, in particular, at the nutrition for preterm babies. And since one of the most important things for a preterm baby in the last trimester is to grow – and they grow really, really rapidly in the last trimester – I felt somebody should focus on how to get the nutrients from the womb to babies to maximize their potential and long-term health.”
Groundbreaking discoveries
Since then, Blanco and a team from University Health and UT Health San Antonio have helped advance the field of infant nutrition with numerous studies, including one in 2018 that led the U.S. Food and Drug Administration in 2018 to approve a treatment for premature babies with a life-threatening liver condition.
The researchers documented an astounding reduction in infant deaths for the critically ill babies fed Omegaven, a fish oil-based solution. According to Blanco, the survival rate of the infants went from 10% to more than 90%.
Years of research add up
Each year the team builds upon what it’s previously learned and looks for even better methods to adapt nutrition and strengthen babies born with weaknesses.
The published study of an exclusive human milk diet for preterm babies was one of just several research projects conducted by the team this year. Another research project published in the Journal of Pediatrics, measured the effects of a human milk diet fed to 107 newborns with one instead of two pumping heart chambers, or ventricles. The single-ventricle condition would likely require multiple surgeries for the infants, so they needed to be as strong as possible to survive the procedures.
“If they don't grow well between their surgeries, they have a higher chance of dying. So it is extremely important for us to get them to grow for the next surgery. And we were able to get them to grow better with all human milk that had higher caloric concentration they were able to tolerate. So, likely they will have better survival because of that,” said Blanco.
The team is also looking at how to boost the health of newborns with a variety of congenital heart conditions. Once again it appears these babies often suffer from poor growth and difficulty in metabolizing food. They need a special feeding strategy that identifies the best way to deliver nutrition, the amount of food each baby can tolerate and a plan to customize and supplement their feeding.
A future based on research
Dr. Blanco sees the future of University Health’s infant nutrition program framed by this long history of progress through research. Some studies result in baby steps, others in giant strides. Collectively they have led to a sea change in our understanding of how nutrition can transform the health of sick and premature infants.
During the past 40 years, medical advances have resulted in preemies surviving with increasingly less time in the womb. That has resulted in evolving medical needs.
“What we're doing in the field of neonatal nutrition is trying to understand the needs of premature babies now versus 10, 20 or 30 years ago. What approach works best to maximize their growth?”
Dr. Blanco says the only way to answer that question and continue to move forward is to look beyond what they know and systematically, patiently do the research.
The international accreditation, presented to the hospital in December 2021, signifies that University Health successfully implements the World Health Organization (WHO)/UNICEF Baby-Friendly Initiative's standards for the best possible breastfeeding support for mother and infant in the maternity setting and supports strong mother/baby bonding, among other measurements.
It's not only what happens in the delivery room that sets University Health apart. Baby-friendly education begins at the first prenatal doctor visits and continues until discharge.
"We can't fully educate someone within 24 hours of delivery, so we give small steps of education based on weeks of gestation," said Irene Sandate, University Health vice president and associate chief nursing officer for women and children. "We support women in their choice to breastfeed, which has long-term health benefits for both mother and baby."
Clinicians minimize separation of mother and baby in the hospital, and they ensure mom has the opportunity to hold her baby to the breast during the first hour after delivery so she an attempt to successfully breastfeed. Lactation consultants are available to meet with women who are having difficulty breastfeeding.
University Health had to accomplish major milestones in order to qualify for Baby-Friendly status. All staff members must complete several hours of additional training on baby-friendly practices, and surveyors conducted onsite visits to ask women about the prenatal education they received. Rates of breastfeeding initiation and at discharge were also considered. If a newborn is taken to the neonatal intensive care unit (NICU), women must also have access to a breast pump.
"Human milk is the best choice for those fragile and extremely ill infants as we establish nutrition," Sandate said. "There are lifelong health benefits if a woman can breastfeed and establish milk flow."
Departments across the hospital, as well as University Health's ambulatory partners, are involved in achieving the Baby-Friendly designation. Obstetrics, women's health, neonatal ICU care, neonatology, pediatrics, family medicine, nursing and other team members—along with relationships with referring providers from private offices—all come together to educate and support women in their decision to breastfeed.
"We help women make informed decision to breastfeed or not," Sandate said. "We support you in whatever you decide to do, but let's make sure it's an informed decision."
To the laboratory staff at University Health, a patient is a person, not just a result, even if they never see their face. Thanks to that compassion, Kaila's care team helped solve a critical mystery about her ailing health.
University Health doctors were trying to determine the underlying cause of a massive stroke that Kaila had suffered. The lab realized there was a problem - not with the integrity of the patient's blood sample, but with the blood itself.
They had uncovered a mysterious clotting issue that was interfering with her diagnosis. They shared the information with the clinicians, and with this knowledge, surgeons were able to provide the complex treatment she needed.
"With this patient, multiple blood samples were sent down to us in the lab," said Carrie Bartosh, laboratory manager in the Microbiology Department at University Hospital. "This patient had three different blood draws, each with three or more different tests, over several days, and every single time we kept getting an error with the internal control. Occasionally, this could be caused by a handling problem with a single sample, but when we see it interfering with multiple blood draws, it's highly unlikely that it's just a sample integrity error."
As anyone who has taken an at-home COVID-19 or home pregnancy test knows, there are two lines on the test - one indicating the quality-control factors and the other indicating the test result. As long as a line shows on the control side, it means the test result is valid - it can be trusted. If there's no line on the control side, the test is invalid because the results might be inaccurate.
The same concept holds true in laboratory tests at a hospital. In some blood tests, certain blood factors establish quality control to ensure trusted test results. Among those factors is Factor 13A, which is present in all human blood and is used to establish the integrity of the blood sample.
Scott Bowman, a microbiology scientist in the University Hospital lab, brought Kaila's multiple erroneous blood tests to Bartosh's attention, as did another lab scientist. The lab team contacted to Claudia Courtright, technical supervisor in Microbiology Services. Courtright reviewed the patient's medical history chart and discovered the likely underlying problem with the patient's clotting factors that needed to be investigated.
"We reached out to the team who was overseeing her care," said Bartosh. She told the physicians, "We think Factor 13 might be decreased, so if a clotting problem fits the clinical picture, that's something to look into. That's probably the interfering cause of her invalid results."
Bartosh explains that University Health lab scientists have college degrees and national board certifications, spending years studying pathophysiology, disease processes, effects on the body, and different ways to test for these effects. "It takes strong analytical and critical-thinking skills to understand the science that's happening with these tests," Bartosh said. "And it takes confidence to reach out to the physician to say, 'I have expertise here, and I know something is wrong.'"
Stephanie Whitehead, executive director of pathology services at University Health, emphasizes the lab's focus on patient care.
"We in the pathology department pride ourselves on delivering top-notch laboratory services that align with our patient-centered care approach," Whitehead said. "As a team, we understand the importance of supporting health care providers in delivering personalized care, which is why we offer a comprehensive test menu, and we prioritize quality, efficiency and process improvement in our operations."
Lab scientists may never see patients face-to-face, but that doesn't diminish their dedication to patient-centered care.
"You really feel for someone when they've had multiple draws and we aren't getting valid test results," Whitehead said. "We want to make sure she's getting accurate results for these tests in a timely manner so she can get the treatment she needs."
Bowman agrees: "It's not just a sample; it's a patient. That's somebody's aunt or uncle or brother. Our purpose here is for patient care, and as a result of doing our job, we found this abnormality that gave the clinicians something else to look at in this patient."
"When Scott started to see a pattern, he wanted to investigate further," Whitehead said. "He was a champion for Kaila."
There are special instances when the lab experts do, in fact, get to meet the people they help care for. On this occasion, the patient's parents wanted to meet the people who were behind the scenes of their daughter's care.
Shameka Upshaw, Kaila's mother, was grateful for the opportunity to meet the team that she says "went above and beyond" to give her daughter the best care she could get. "Scott and Carrie didn't just see the bloodwork sample; they saw her name," Upshaw said. "They understand that the samples they test every day are connected to a person who has real things going on, and the doctors need that information to figure out what was happening. Their care and attention to detail helped us in a very dark time. We appreciate the work they do every day for families like ours."
Bartosh said, "In a lab, we only see a patient's name, but we know there's a person attached to it." "To get to meet the patients and the family was probably the highlight of my entire career. I don't think there was a dry eye in the room."
"In this lab, we really care about the patients," Bartosh said. "Even though you don't see us, we are here and working hard to make sure all our patients have the best, most accurate lab results possible."
University Health has participated in the Battle of Flowers and the Fiesta Flambeau parades for more than a decade, with the continual goal of raising awareness of health and safety. The 2022 events, held April 8 and 9, were no different.
The “Saluting Our Superheroes” Battle of Flowers float celebrated health care providers for their dedication to fighting disease and protecting the lives of the San Antonio community. Everyone on the float donned superhero costumes—capes included. The Battle of Flowers Foundation recognized the float with third place in the Civic Float Division.
“It’s so amazing to walk through the streets and hear people yell, ‘University saved my life!’” said Anita Martin, director of community relations at University Health. “We’re proud of the good work we do, and we want people to know we’re part of this community.”
University Health’s marching unit lit up the night at the Fiesta Flambeau parade, receiving third place. Dozens of staff members joined the event, dancing and shaking hands with the crowd.
University Health joined the “Pride Bigger than Texas” festival and parade on June 25, 2022, to celebrate San Antonio’s diverse community.
The University Health LGBTQIA+ subcommittee has worked hard to foster a system-wide inclusive culture for patients and employees, including their participation in the event.
“Pride signifies that University Health is a place for everyone, where inclusion is celebrated and every employee can bring their authentic self to work,” said Missam “Sam” Merchant, the 2022-23 chair of the LGBTQIA+ subcommittee and a hospital supervisor at University Health. “It also means that our patients who identify as LGBTQIA+ understand that University Health is committed to their well-being and to eliminating health disparities that this community faces every day.”
Team members from several service lines, including Stop the Bleed, Gun Safety for Bexar, vaccine hesitancy and the Institute for Trauma-Informed Care, set up educational games and activities at the festival. To fight the extreme heat, participants gave out Pride-branded fans to the crowd.
University Health sponsored the Athlete’s Village & Expo, which promoted health, wellness and safety. Several service lines shared valuable information about many health topics, including Stop the Bleed, the Teddy Bear Clinic, vaccine hesitancy, bike helmet awareness and heart health awareness.
The Injury Prevention team’s Drive Now, Text Later station brought awareness to the dangers of distracted driving and helped promote pedestrian and cyclist safety. During the activity, participants texted on their cell phones while navigating a figure-8 course driving a pedal cart. Hitting a cone on the course represented hitting something—or someone—on the road. Then the participants got to see how far off course they drove while they were distracted. The goal was to encourage people to put their cell phones away and remain aware of their surroundings while driving a vehicle.
“People who didn’t hit any cones think they did a really good job, but they didn’t realize how slow they were driving,” said Fara Smith, program manager for Safe Kids San Antonio led by University Health. “In a real-world scenario, they would have slowed the flow of traffic and still become a hazard. Other people hit multiple cones, confirming how multitasking while operating a vehicle is dangerous both for those in the vehicle and all those around them. We also cautioned against other distractions, like eating while driving, putting on makeup, changing the radio and sometimes even your passengers.”
Some of the other stations included the Ready to Roll Station, the Play It Safe Station, the Teddy Bear Clinic and the Inflatable Heart. At the Stop the Bleed Station, visitors learned how to stop severe bleeding in case of a traumatic accident, knowledge that could save a life.
University Health is committed to providing patients with the highest quality of care, respect and compassion. One way we put this commitment into action is by engaging in continuous improvement, which includes seeking feedback from former patients and their families. These individuals are perfectly poised to offer feedback based on their personal experiences. They receive patient and family-centered care training and commit to serve on University Health's Patient and Family Advisory Council for one to two years as Patient Family Advisors. The feedback shared by the advisors helps foster meaningful collaboration to support patient and family-centered care practices and improve clinical and operational outcomes.
One of the council's recent accomplishments has helped improve the patient and family experience in University Hospital's emergency department. As the population increases, local emergency departments, including University Hospital, see an increase, local emergency departments, including University Hospital, see an increase in extended wait times. Waiting can cause distress, especially when the patient is feeling unwell. Extended waiting contributes to uncomfortable and undesirable experiences for patients and their families. The Patient Family Advisors noted that patients often experience hunger or thirst when waiting, feel cold in the waiting area and experience frustration when communicating their needs to busy staff.
The feedback from the Patient Family Advisors coupled with comments from patients' surveys, helped spark change. Reassessment timers built into the electronic medical records system helped better identify a patient's needs and concerns. Hourly rounding started in the department. Staff education promoted awareness of the new processes and emphasized why change was necessary. Hospitality items, such as snacks, coffee and blankets would provide comfort to patients while they waited.
The successful project resulted in a 2022 abstract presentation at the Institute for Healthcare Improvement (IHI) conference.
"The Patient Family Advisors provide a voice for those who receive care at University Health. The unique perspective from these highly engaged volunteers helps promote change. Their feedback encourages more thoughtful innovation in how we care for and support our patients and their families - both those who trust us with their health care today and those patients that will receive care at University Health in the future," said Erika Bowen, executive director, patient and family resource center at University Health.
When you want to reach people about what you can do for them, you have to understand what they want. That’s how University Health crafted its 2022 award-winning brand campaign on the theme of change.
“This brand campaign was about helping people in our community transition out of the pandemic and prioritize their health, positioning us as their partner for healthy change,” remarks Leni Kirkman, executive vice president and chief marketing communications & corporate affairs officer at University Health.
University Health is driven by its mission to improve the health of the community through high-quality, compassionate patient care, innovation, education, and research. Crafting this campaign began with thorough research that revealed that people associated University Health with change, and saw change as good.
BPD (formerly Revive) and the marketing team created a campaign theme to serve as a focal point for the campaign: “What will you change today?”
The brand manifesto appealed to an audience that might long for change but be intimidated by what they perceive as too much work. It gives people a simple vision that empowers them:
You don’t start changing the world by changing the world.
You start small. Change one thing. Then another.
Then another, and another.
Until soon, the world is a different place.
The same goes for yourself.
One small change leads to another.
At least for those who accept it.
Who embrace it.
Who believe in it.
Change pushes you to become who you really are.
Stronger. Funnier. More accepting. More loving.
Healthier.
And it starts today. Or any day you’re ready.
With one. Simple. Act.
So, what will you change today?
“Asking people what they’re willing to change becomes a catalyst for action,” said Laura Gilbert, marketing director for University Health. “It’s the question that shakes people out of their status quo and gets them thinking about the things in their lives that need to change.”
The campaign includes traditional and digital media to reach the broadest audience in the greater San Antonio market area in English and Spanish. Print, radio, digital, social, billboards, kiosks, website landing page, and critical internal communications were all part of the integrated campaign.
“We launched the campaign through internal channels, including the employee newsletters and intranet,” said Helena Steubing, creative services director at University Health. “Team members who volunteer for community events such as walks, health fairs, and immunization drives receive a t-shirt that says, ‘Change Maker.’” Internal hall signage and screen-savers help remind associates that they are essential agents of change.
University Health’s brand campaign generated impressive results during the first year:
“We are incredibly proud of this campaign,” Kirkman said. “We were just emerging from the pandemic, and it was time to look at health — beyond a virus — with a fresh, proactive, and empowering lens. It’s not easy to know where to start, so we provided lots of easy-to-consume resources and hoped people would begin to see us as a partner for healthy change instead of a place to go when you get sick.”
“We had learned a lot about the impact of non-medical drivers of health, or social determinants of health, during the pandemic,” she said. “This campaign tied in perfectly with the work happening across the organization, including establishing the new University Health Institute for Public Health.”
University Health has participated in the Battle of Flowers and the Fiesta Flambeau parades for more than a decade, with the continual goal of raising awareness of health and safety. The 2022 events, held April 8 and 9, were no different.
The “Saluting Our Superheroes” Battle of Flowers float celebrated health care providers for their dedication to fighting disease and protecting the lives of the San Antonio community. Everyone on the float donned superhero costumes—capes included. The Battle of Flowers Foundation recognized the float with third place in the Civic Float Division.
“It’s so amazing to walk through the streets and hear people yell, ‘University saved my life!’” said Anita Martin, director of community relations at University Health. “We’re proud of the good work we do, and we want people to know we’re part of this community.”
University Health’s marching unit lit up the night at the Fiesta Flambeau parade, receiving third place. Dozens of staff members joined the event, dancing and shaking hands with the crowd.
University Health joined the “Pride Bigger than Texas” festival and parade on June 25, 2022, to celebrate San Antonio’s diverse community.
The University Health LGBTQIA+ subcommittee has worked hard to foster a system-wide inclusive culture for patients and employees, including their participation in the event.
“Pride signifies that University Health is a place for everyone, where inclusion is celebrated and every employee can bring their authentic self to work,” said Missam “Sam” Merchant, the 2022-23 chair of the LGBTQIA+ subcommittee and a hospital supervisor at University Health. “It also means that our patients who identify as LGBTQIA+ understand that University Health is committed to their well-being and to eliminating health disparities that this community faces every day.”
Team members from several service lines, including Stop the Bleed, Gun Safety for Bexar, vaccine hesitancy and the Institute for Trauma-Informed Care, set up educational games and activities at the festival. To fight the extreme heat, participants gave out Pride-branded fans to the crowd.
University Health sponsored the Athlete’s Village & Expo, which promoted health, wellness and safety. Several service lines shared valuable information about many health topics, including Stop the Bleed, the Teddy Bear Clinic, vaccine hesitancy, bike helmet awareness and heart health awareness.
The Injury Prevention team’s Drive Now, Text Later station brought awareness to the dangers of distracted driving and helped promote pedestrian and cyclist safety. During the activity, participants texted on their cell phones while navigating a figure-8 course driving a pedal cart. Hitting a cone on the course represented hitting something—or someone—on the road. Then the participants got to see how far off course they drove while they were distracted. The goal was to encourage people to put their cell phones away and remain aware of their surroundings while driving a vehicle.
“People who didn’t hit any cones think they did a really good job, but they didn’t realize how slow they were driving,” said Fara Smith, program manager for Safe Kids San Antonio led by University Health. “In a real-world scenario, they would have slowed the flow of traffic and still become a hazard. Other people hit multiple cones, confirming how multitasking while operating a vehicle is dangerous both for those in the vehicle and all those around them. We also cautioned against other distractions, like eating while driving, putting on makeup, changing the radio and sometimes even your passengers.”
Some of the other stations included the Ready to Roll Station, the Play It Safe Station, the Teddy Bear Clinic and the Inflatable Heart. At the Stop the Bleed Station, visitors learned how to stop severe bleeding in case of a traumatic accident, knowledge that could save a life.
University Health is committed to providing patients with the highest quality of care, respect and compassion. One way we put this commitment into action is by engaging in continuous improvement, which includes seeking feedback from former patients and their families. These individuals are perfectly poised to offer feedback based on their personal experiences. They receive patient and family-centered care training and commit to serve on University Health's Patient and Family Advisory Council for one to two years as Patient Family Advisors. The feedback shared by the advisors helps foster meaningful collaboration to support patient and family-centered care practices and improve clinical and operational outcomes.
One of the council's recent accomplishments has helped improve the patient and family experience in University Hospital's emergency department. As the population increases, local emergency departments, including University Hospital, see an increase, local emergency departments, including University Hospital, see an increase in extended wait times. Waiting can cause distress, especially when the patient is feeling unwell. Extended waiting contributes to uncomfortable and undesirable experiences for patients and their families. The Patient Family Advisors noted that patients often experience hunger or thirst when waiting, feel cold in the waiting area and experience frustration when communicating their needs to busy staff.
The feedback from the Patient Family Advisors coupled with comments from patients' surveys, helped spark change. Reassessment timers built into the electronic medical records system helped better identify a patient's needs and concerns. Hourly rounding started in the department. Staff education promoted awareness of the new processes and emphasized why change was necessary. Hospitality items, such as snacks, coffee and blankets would provide comfort to patients while they waited.
The successful project resulted in a 2022 abstract presentation at the Institute for Healthcare Improvement (IHI) conference.
"The Patient Family Advisors provide a voice for those who receive care at University Health. The unique perspective from these highly engaged volunteers helps promote change. Their feedback encourages more thoughtful innovation in how we care for and support our patients and their families - both those who trust us with their health care today and those patients that will receive care at University Health in the future," said Erika Bowen, executive director, patient and family resource center at University Health.
When you want to reach people about what you can do for them, you have to understand what they want. That’s how University Health crafted its 2022 award-winning brand campaign on the theme of change.
“This brand campaign was about helping people in our community transition out of the pandemic and prioritize their health, positioning us as their partner for healthy change,” remarks Leni Kirkman, executive vice president and chief marketing communications & corporate affairs officer at University Health.
University Health is driven by its mission to improve the health of the community through high-quality, compassionate patient care, innovation, education, and research. Crafting this campaign began with thorough research that revealed that people associated University Health with change, and saw change as good.
BPD (formerly Revive) and the marketing team created a campaign theme to serve as a focal point for the campaign: “What will you change today?”
The brand manifesto appealed to an audience that might long for change but be intimidated by what they perceive as too much work. It gives people a simple vision that empowers them:
You don’t start changing the world by changing the world.
You start small. Change one thing. Then another.
Then another, and another.
Until soon, the world is a different place.
The same goes for yourself.
One small change leads to another.
At least for those who accept it.
Who embrace it.
Who believe in it.
Change pushes you to become who you really are.
Stronger. Funnier. More accepting. More loving.
Healthier.
And it starts today. Or any day you’re ready.
With one. Simple. Act.
So, what will you change today?
“Asking people what they’re willing to change becomes a catalyst for action,” said Laura Gilbert, marketing director for University Health. “It’s the question that shakes people out of their status quo and gets them thinking about the things in their lives that need to change.”
The campaign includes traditional and digital media to reach the broadest audience in the greater San Antonio market area in English and Spanish. Print, radio, digital, social, billboards, kiosks, website landing page, and critical internal communications were all part of the integrated campaign.
“We launched the campaign through internal channels, including the employee newsletters and intranet,” said Helena Steubing, creative services director at University Health. “Team members who volunteer for community events such as walks, health fairs, and immunization drives receive a t-shirt that says, ‘Change Maker.’” Internal hall signage and screen-savers help remind associates that they are essential agents of change.
University Health’s brand campaign generated impressive results during the first year:
“We are incredibly proud of this campaign,” Kirkman said. “We were just emerging from the pandemic, and it was time to look at health — beyond a virus — with a fresh, proactive, and empowering lens. It’s not easy to know where to start, so we provided lots of easy-to-consume resources and hoped people would begin to see us as a partner for healthy change instead of a place to go when you get sick.”
“We had learned a lot about the impact of non-medical drivers of health, or social determinants of health, during the pandemic,” she said. “This campaign tied in perfectly with the work happening across the organization, including establishing the new University Health Institute for Public Health.”
University Hospital was once again honored as a Level IV Maternity Center, the highest possible designation given by the Texas Department of State Health Services division of Health and Human Services (HHS). The designation is valid for three years.
The 2022 recognition reconfirms that University Health providers and facilities offer women and babies the highest level of maternal and perinatal care during some of the most vulnerable moments of their lives. This comprehensive care includes working with moms during pregnancy all the way through the postpartum period.
As part of the designation process, reviewers from the American College of Obstetricians and Gynecologists conduct a site visit of University Health facilities as well as evaluate all available services and at what level those services are provided. Very few delivery hospitals in the state achieve the Level IV designation.
"These state designations are steeped in quality data to address common factors for maternal fatality and morbidity," said Irene Sandate, University Health vice president and associate chief nursing officer for women and children. "If we call ourselves a Level IV Maternity Center, we're compelled to raise maternity care in our region to the highest level of care. We spend a lot of time discussing quality."
The review process is based on objective measures of quality related to scheduled early deliveries, caesarean deliveries, newborn complications, breastfeeding rates, practices to improve maternal outcomes, transparency on racial and ethnic disparities, episiotomy rates and vaginal birth rates.
Sandate noted that along with the Level IV maternity care designation, University Health also holds a Level IV neonatal intensive care unit (NICU) designation by the Texas Department of State Health Services. This is the highest level of care of premature and very sick babies. Sandate called the two designations a "powerhouse combination-we can take care of anything in this facility. If you need it, it's here."
Obstetrics is only one of the many departments that must come together to help University Health achieve the maternity care designation. Other adult specialties also may have to become involved—such as cardiac intensive care, neurological intensive care and emergency medicine—to ensure good outcomes for women and babies.
"All these teams have to rise to the occasion, sometimes on short notice," Sandate said. "If the emergency department gets a woman who is actively bleeding and she can't make it to our unit, we have to go there and take over. We have drilled together to converge on one location to make all this happen."
In addition to the state designation as a Level IV Maternity Center, University Health also received recognition from several other groups for its exceptional level of maternity care.
U.S. News & World Report named the facility a 2022-2023 High Performing Hospital for Maternity Care. Newsweek and data firm Statista recognized University Health as one of America’s Best Maternity Hospitals in 2022. And Money and the Leapfrog Group named University Health to its 2022 list of Best Maternity Care Hospitals in America. In addition to objective measures of quality, the Leapfrog Group also takes into account a survey of patients’ experience at the hospital.
"The Lown Institute Hospitals Index is a unique, nationally recognized measurement of how well hospitals and health systems to promote health equity, improve clinical outcomes, reject low-value care, incentivize healing over profits and value the clinician-patient relationship," University Health Executive Vice President and Chief Medical Officer Dr. Bryan Alsip said.
Measures include: community benefit, clinical outcomes, patient safety, inclusivity, pay equity, avoiding overuse, cost efficiency and patient satisfaction. University Health is the only San Antonio health system listed in the Texas Top 20 for 2022.
Resembling old-fashioned house calls augmented with technology, Hospital at Home provides high-quality virtual and in-person acute care for patients with certain conditions that previously required hospitalization. The program has lowered readmission rates and reduced hospital-acquired infections, helping patients smoothly transition to ambulatory care. When COVID-19 surges overwhelmed the country, the Centers for Medicare & Medicaid Services created Hospital at Home as a way to create flexibility in federal hospital regulations and increase capacity in U.S. hospitals. Hospital at Home provided non-emergency care to patients who might otherwise have delayed treatment in order to avoid going to a hospital. University Health was the first hospital in the country to admit postpartum patients to this program.
Since it was created in 2021, Hospital at Home has freed up thousands of beds at University Hospital, making room for sicker patients. The multidisciplinary care team includes doctors, nurse practitioners, registered nurses, social workers, physical therapists and other specialists who care for patients of all ages and economic status, including uninsured patients. Patients have reported high satisfaction after Hospital at Home treatment, saying they felt better and more engaged in their care.
In 2022, University Health received two elite distinctions for its use of technology to benefit both patients and clinicians. As new technologies become available, University Health remains at the forefront of these advances as part of its unceasing dedication to improving patient care.
The Healthcare Information and Management Systems Society's Electronic Medical Record Adoption Model (EMRAM) recognized University Health as a Stage 7 institution—the highest achievement. This score acknowledges University Health’s commitment to organizational performance and patient outcomes through its use of electronic medical records (EMR).
EMR technology has been shown to help health care organizations build a high-performing workforce and support an exceptional patient experience. Keeping track of patients’ medical information digitally improves safety by reducing errors in care, length of stay and order duplications. In 2022, University Health earned Stage 7 status for both inpatient (EMRAM) and outpatient (O-EMRAM) measurements.
In addition to the EMRAM recognition, University Health also earned 2022 Digital Health Most Wired status in the acute care category from the College of Healthcare Information Management Executives (CHIME). Only 18 organizations earned level 10 certification—the highest possible—in this category.
Health organizations named among the nation’s Most Wired have successfully adopted digital health technology and are recognized as pioneers leading the way in digital excellence. CHIME noted that Most Wired organizations like University Health are driving change in the health care industry as a whole, inspiring other institutions to use digital innovation to improve patient care and engagement, clinical quality and safety, security, and data analytics.
The interdisciplinary Supportive Care Services team provides complex and compassionate care for patients facing serious or life-threatening illness, and in 2022, one University Health physician and two nurses received national awards for their exceptional palliative care.
The Hastings Center and the Cunniff-Dixon Foundation join together every year to present awards to health care providers who exemplify this outstanding care. Among many criteria, the awards consider the providers' empathy, family engagement, communication skills and compassionate alleviation of suffering.
Dr. Rachel Vandermeer received the Early-Career Physician Award. Two awards for Nurses Providing Optimal Palliative Care in the Hospital Setting went to Erin Perez, DNP, APRN, ANP-C, AGNP-C, ACHPN, a palliative care nurse practitioner, and to Juanita Georges, LVN, a Supportive Care Services ambulatory nurse. Only six physicians and two nurses per year are awarded this honor, with 2022 being the first year for nurse nominations.
"It is an honor and privilege to work with this dynamic and extraordinary team," said Marla Khalikov, RN, MSN, CPHRM, director of Supportive Care Services and Inpatient Geriatrics at University Health. "Having three members recognized for their exceptional care provision is a testament to our collaborative efforts to ensure patients receive comprehensive and compassionate care."
Dr. Vandermeer was pivotal in the development of the University Health Perinatal Supportive Care Program, which provides palliative care to families expecting a baby with serious illness.
Perez is the first nurse practitioner to chair the Texas Palliative Care Interdisciplinary Advisory Council and is dedicated to the advancement of palliative care for vulnerable Texans.
Georges displays excellence in both clinical and managerial roles, supporting patients and members of the interdisciplinary Supportive Care Services Team.
University Hospital was once again honored as a Level IV Maternity Center, the highest possible designation given by the Texas Department of State Health Services division of Health and Human Services (HHS). The designation is valid for three years.
The 2022 recognition reconfirms that University Health providers and facilities offer women and babies the highest level of maternal and perinatal care during some of the most vulnerable moments of their lives. This comprehensive care includes working with moms during pregnancy all the way through the postpartum period.
As part of the designation process, reviewers from the American College of Obstetricians and Gynecologists conduct a site visit of University Health facilities as well as evaluate all available services and at what level those services are provided. Very few delivery hospitals in the state achieve the Level IV designation.
"These state designations are steeped in quality data to address common factors for maternal fatality and morbidity," said Irene Sandate, University Health vice president and associate chief nursing officer for women and children. "If we call ourselves a Level IV Maternity Center, we're compelled to raise maternity care in our region to the highest level of care. We spend a lot of time discussing quality."
The review process is based on objective measures of quality related to scheduled early deliveries, caesarean deliveries, newborn complications, breastfeeding rates, practices to improve maternal outcomes, transparency on racial and ethnic disparities, episiotomy rates and vaginal birth rates.
Sandate noted that along with the Level IV maternity care designation, University Health also holds a Level IV neonatal intensive care unit (NICU) designation by the Texas Department of State Health Services. This is the highest level of care of premature and very sick babies. Sandate called the two designations a "powerhouse combination-we can take care of anything in this facility. If you need it, it's here."
Obstetrics is only one of the many departments that must come together to help University Health achieve the maternity care designation. Other adult specialties also may have to become involved—such as cardiac intensive care, neurological intensive care and emergency medicine—to ensure good outcomes for women and babies.
"All these teams have to rise to the occasion, sometimes on short notice," Sandate said. "If the emergency department gets a woman who is actively bleeding and she can't make it to our unit, we have to go there and take over. We have drilled together to converge on one location to make all this happen."
In addition to the state designation as a Level IV Maternity Center, University Health also received recognition from several other groups for its exceptional level of maternity care.
U.S. News & World Report named the facility a 2022-2023 High Performing Hospital for Maternity Care. Newsweek and data firm Statista recognized University Health as one of America’s Best Maternity Hospitals in 2022. And Money and the Leapfrog Group named University Health to its 2022 list of Best Maternity Care Hospitals in America. In addition to objective measures of quality, the Leapfrog Group also takes into account a survey of patients’ experience at the hospital.
"The Lown Institute Hospitals Index is a unique, nationally recognized measurement of how well hospitals and health systems to promote health equity, improve clinical outcomes, reject low-value care, incentivize healing over profits and value the clinician-patient relationship," University Health Executive Vice President and Chief Medical Officer Dr. Bryan Alsip said.
Measures include: community benefit, clinical outcomes, patient safety, inclusivity, pay equity, avoiding overuse, cost efficiency and patient satisfaction. University Health is the only San Antonio health system listed in the Texas Top 20 for 2022.
Resembling old-fashioned house calls augmented with technology, Hospital at Home provides high-quality virtual and in-person acute care for patients with certain conditions that previously required hospitalization. The program has lowered readmission rates and reduced hospital-acquired infections, helping patients smoothly transition to ambulatory care. When COVID-19 surges overwhelmed the country, the Centers for Medicare & Medicaid Services created Hospital at Home as a way to create flexibility in federal hospital regulations and increase capacity in U.S. hospitals. Hospital at Home provided non-emergency care to patients who might otherwise have delayed treatment in order to avoid going to a hospital. University Health was the first hospital in the country to admit postpartum patients to this program.
Since it was created in 2021, Hospital at Home has freed up thousands of beds at University Hospital, making room for sicker patients. The multidisciplinary care team includes doctors, nurse practitioners, registered nurses, social workers, physical therapists and other specialists who care for patients of all ages and economic status, including uninsured patients. Patients have reported high satisfaction after Hospital at Home treatment, saying they felt better and more engaged in their care.
In 2022, University Health received two elite distinctions for its use of technology to benefit both patients and clinicians. As new technologies become available, University Health remains at the forefront of these advances as part of its unceasing dedication to improving patient care.
The Healthcare Information and Management Systems Society's Electronic Medical Record Adoption Model (EMRAM) recognized University Health as a Stage 7 institution—the highest achievement. This score acknowledges University Health’s commitment to organizational performance and patient outcomes through its use of electronic medical records (EMR).
EMR technology has been shown to help health care organizations build a high-performing workforce and support an exceptional patient experience. Keeping track of patients’ medical information digitally improves safety by reducing errors in care, length of stay and order duplications. In 2022, University Health earned Stage 7 status for both inpatient (EMRAM) and outpatient (O-EMRAM) measurements.
In addition to the EMRAM recognition, University Health also earned 2022 Digital Health Most Wired status in the acute care category from the College of Healthcare Information Management Executives (CHIME). Only 18 organizations earned level 10 certification—the highest possible—in this category.
Health organizations named among the nation’s Most Wired have successfully adopted digital health technology and are recognized as pioneers leading the way in digital excellence. CHIME noted that Most Wired organizations like University Health are driving change in the health care industry as a whole, inspiring other institutions to use digital innovation to improve patient care and engagement, clinical quality and safety, security, and data analytics.
The interdisciplinary Supportive Care Services team provides complex and compassionate care for patients facing serious or life-threatening illness, and in 2022, one University Health physician and two nurses received national awards for their exceptional palliative care.
The Hastings Center and the Cunniff-Dixon Foundation join together every year to present awards to health care providers who exemplify this outstanding care. Among many criteria, the awards consider the providers' empathy, family engagement, communication skills and compassionate alleviation of suffering.
Dr. Rachel Vandermeer received the Early-Career Physician Award. Two awards for Nurses Providing Optimal Palliative Care in the Hospital Setting went to Erin Perez, DNP, APRN, ANP-C, AGNP-C, ACHPN, a palliative care nurse practitioner, and to Juanita Georges, LVN, a Supportive Care Services ambulatory nurse. Only six physicians and two nurses per year are awarded this honor, with 2022 being the first year for nurse nominations.
"It is an honor and privilege to work with this dynamic and extraordinary team," said Marla Khalikov, RN, MSN, CPHRM, director of Supportive Care Services and Inpatient Geriatrics at University Health. "Having three members recognized for their exceptional care provision is a testament to our collaborative efforts to ensure patients receive comprehensive and compassionate care."
Dr. Vandermeer was pivotal in the development of the University Health Perinatal Supportive Care Program, which provides palliative care to families expecting a baby with serious illness.
Perez is the first nurse practitioner to chair the Texas Palliative Care Interdisciplinary Advisory Council and is dedicated to the advancement of palliative care for vulnerable Texans.
Georges displays excellence in both clinical and managerial roles, supporting patients and members of the interdisciplinary Supportive Care Services Team.
When University Health was notified of an ongoing active shooter event at Robb Elementary in Uvalde on May 24, 2022, the medical team immediately began preparing to receive the most critically wounded survivors. By the end of the day, University Hospital's Level I trauma center had received four patients with critical gunshot injuries.
A heartbroken public wanted to help.
Within hours, the University Health Foundation began fielding inquiries from people across the country generously offering in-kind donations and monetary assistance for the patients and the Uvalde community. The next morning, the Foundation created the Uvalde Victims Relief Fund.
"We did not have a process in place to collect or distribute donations during a crisis, but we knew that people felt an unwavering need to contribute to the healing of the patients, families and community impacted by the shooting," said Sara Alger, president of the University Health Foundation. "We immediately set up the fund, along with critical processes, and collaborated with the University Health Corporate Communications team to share information about the Foundation and the Uvalde Victims Relief fund when speaking to the local and national media."
Ultimately, the Foundation received more than $550,000 from 1,850 donors to support the patients and their loved ones who were treated at University Hospital. The donations were used to cover unpaid medical expenses and other needs identified by the hospital's social workers. Unspent funds were earmarked for future donation to Uvalde nonprofit organizations to assist the community in ongoing relief and healing efforts.
The Foundation also collected other critical donations, including food and hotel rooms, so families could stay close to their loved ones and provide much needed comfort in a time of uncertainty and unrest.
The outpouring of care and encouragement from strangers and friends inspired additional opportunities for philanthropy to bring light to this tragedy. Prior to the shooting, 10-year-old Mayah Zamora, had planned to attend Texas country singer Kevin Fowler's concert in San Antonio with her family. When Mayah shared that she was a huge fan, the team at the Foundation contacted Fowler, who paid a special visit to her in at University Hospital to deliver swag and sing his hit songs with her. This was a high point in Mayah's healing journey.
The kindness and generosity of others made a lasting impression on Mayah. After she was released from University Hospital on July 29, 2022, she looked for ways to give back to the community who supported her. From selling lemonade to fund care packages for patients at the hospital to meeting with people who donated blood after the school shooting, she has been dedicated to finding ways to pay kindness, compassion and generosity forward and make a difference with her life.
Since 2006, the Medical Miracles Gala has brought the San Antonio community together, celebrated health and healing, and provided for the advancement of critical care for future patients and their families.
On May 6, 2022, University Health Foundation proudly hosted the 17th annual Medical Miracles Gala to benefit University Health's Level I pediatric trauma center and burn program, which is the only regional program providing comprehensive burn care for children suffering from traumatic burn injuries.
The evening celebrated and honored Chaciti McMorris, who was 6 years old in 2010 when a kitchen accident caused devastating burn injuries on 28% of her body. She was rushed to University Hospital's Level I trauma center. At the time, the pediatric burn center at University Hospital was just getting started. Two years earlier, when Hurricane Ike hit Galveston Island, South Texas lost access to critical pediatric burn care. University Hospital's Level I trauma team recognized the need to make comprehensive pediatric burn care accessible in San Antonio and across South Texas and started the program.
At the time of Chaciti's accident, University Hospital's pediatric burn center offered significant resources, including physicians, surgeons, physical and occupational therapists, reconstructive teams, and specialized nursing care.
Like many pediatric burn patients, as Chaciti recovered and grew, she required ongoing follow-up care from the pediatric burn center. Because the burn center was also growing and evolving, she served as a role model for the program. As her care team recognized and anticipated her needs, they built the program around her.
"Patients like Chaciti have really helped us grow our burn program to the level of national recognition, because we recognized her needs. We built a program maybe for her, but really for all the children ofSouth Texas who have come since her care and who have benefitted from the needs that she had," said Dr. Lillian Liao, Pediatric Trauma Medical Director.
During the gala, Chaciti shared her story, her love and appreciation for her health care team, and her goal to help other children suffering from burns. Her journey and passion for the program helped raise more than $833,000 during the gala to transform pediatric burn care and to ensure patients have the resources and support they need to survive and thrive post-hospitalization.
"I can honestly say that today, when a child comes in, their care is more comprehensive than when we first started. that's because of patients like Chaciti. Their journey is our journey," added Dr. Liao.
"I would never change being a burn survivor, because it had some great impacts on me," Chaciti said.
Chaciti graduated from high school in 2022 and is attending college, studying to become a Child Life Specialist.
When University Health was notified of an ongoing active shooter event at Robb Elementary in Uvalde on May 24, 2022, the medical team immediately began preparing to receive the most critically wounded survivors. By the end of the day, University Hospital's Level I trauma center had received four patients with critical gunshot injuries.
A heartbroken public wanted to help.
Within hours, the University Health Foundation began fielding inquiries from people across the country generously offering in-kind donations and monetary assistance for the patients and the Uvalde community. The next morning, the Foundation created the Uvalde Victims Relief Fund.
"We did not have a process in place to collect or distribute donations during a crisis, but we knew that people felt an unwavering need to contribute to the healing of the patients, families and community impacted by the shooting," said Sara Alger, president of the University Health Foundation. "We immediately set up the fund, along with critical processes, and collaborated with the University Health Corporate Communications team to share information about the Foundation and the Uvalde Victims Relief fund when speaking to the local and national media."
Ultimately, the Foundation received more than $550,000 from 1,850 donors to support the patients and their loved ones who were treated at University Hospital. The donations were used to cover unpaid medical expenses and other needs identified by the hospital's social workers. Unspent funds were earmarked for future donation to Uvalde nonprofit organizations to assist the community in ongoing relief and healing efforts.
The Foundation also collected other critical donations, including food and hotel rooms, so families could stay close to their loved ones and provide much needed comfort in a time of uncertainty and unrest.
The outpouring of care and encouragement from strangers and friends inspired additional opportunities for philanthropy to bring light to this tragedy. Prior to the shooting, 10-year-old Mayah Zamora, had planned to attend Texas country singer Kevin Fowler's concert in San Antonio with her family. When Mayah shared that she was a huge fan, the team at the Foundation contacted Fowler, who paid a special visit to her in at University Hospital to deliver swag and sing his hit songs with her. This was a high point in Mayah's healing journey.
The kindness and generosity of others made a lasting impression on Mayah. After she was released from University Hospital on July 29, 2022, she looked for ways to give back to the community who supported her. From selling lemonade to fund care packages for patients at the hospital to meeting with people who donated blood after the school shooting, she has been dedicated to finding ways to pay kindness, compassion and generosity forward and make a difference with her life.
Since 2006, the Medical Miracles Gala has brought the San Antonio community together, celebrated health and healing, and provided for the advancement of critical care for future patients and their families.
On May 6, 2022, University Health Foundation proudly hosted the 17th annual Medical Miracles Gala to benefit University Health's Level I pediatric trauma center and burn program, which is the only regional program providing comprehensive burn care for children suffering from traumatic burn injuries.
The evening celebrated and honored Chaciti McMorris, who was 6 years old in 2010 when a kitchen accident caused devastating burn injuries on 28% of her body. She was rushed to University Hospital's Level I trauma center. At the time, the pediatric burn center at University Hospital was just getting started. Two years earlier, when Hurricane Ike hit Galveston Island, South Texas lost access to critical pediatric burn care. University Hospital's Level I trauma team recognized the need to make comprehensive pediatric burn care accessible in San Antonio and across South Texas and started the program.
At the time of Chaciti's accident, University Hospital's pediatric burn center offered significant resources, including physicians, surgeons, physical and occupational therapists, reconstructive teams, and specialized nursing care.
Like many pediatric burn patients, as Chaciti recovered and grew, she required ongoing follow-up care from the pediatric burn center. Because the burn center was also growing and evolving, she served as a role model for the program. As her care team recognized and anticipated her needs, they built the program around her.
"Patients like Chaciti have really helped us grow our burn program to the level of national recognition, because we recognized her needs. We built a program maybe for her, but really for all the children ofSouth Texas who have come since her care and who have benefitted from the needs that she had," said Dr. Lillian Liao, Pediatric Trauma Medical Director.
During the gala, Chaciti shared her story, her love and appreciation for her health care team, and her goal to help other children suffering from burns. Her journey and passion for the program helped raise more than $833,000 during the gala to transform pediatric burn care and to ensure patients have the resources and support they need to survive and thrive post-hospitalization.
"I can honestly say that today, when a child comes in, their care is more comprehensive than when we first started. that's because of patients like Chaciti. Their journey is our journey," added Dr. Liao.
"I would never change being a burn survivor, because it had some great impacts on me," Chaciti said.
Chaciti graduated from high school in 2022 and is attending college, studying to become a Child Life Specialist.
| Clerical | Management | Professional Nursing | Provider Professional (Non-Nursing) | Service | Technical | Volunteer |
|---|---|---|---|---|---|---|
| Sonia Juarez | Matthew Camden | Nicholas Guerrero | Trisha Kealoha | Maria Alba | Leandro Villarreal | Michelle Almanza |
| Lisa Wienckowski | Roger Samson Jr. | Kathleen Kent | Julie Rowe | Claudia Luna | Susanne Picon | Huey Boulet |
| Sandra Arredondo | Loretta LaPoint | Cindy Pocasangre | Lisa Castellanos | Tareq A. Mohammed | Crysta Hernandez | Adelina Rodriguez |
| Margreet Smith | Marissa Henderson | Noe Tovar | Stephanie Knight | Maria Leija | Miguel Martinez | Ruth Vargas-Martinez |
CLERICAL - Sonia Juarez
MANAGEMENT - Matthew Camden
PROFESSIONAL NURSING - Noe Tovar
PROVIDER - Andres Pardo-Agila
PROFESSIONAL (Non-nursing) - Trisha Kealoha
SERVICE - Tareq A. Mohammed
TECHNICAL - Leandro Villarreal
VOLUNTEER - Huey Boulet
THE COMMITMENT TO SERVICE EXCELLENCE - Julie Rowe
Baby Friendly Designation OB Team
Acute Hospital Care, At-Home Team
Critical Care Team
OB Team
Baby Friendly Designation OB Team
For more than a century, University Health has been dedicated to improving the good health of the community through high-quality, compassionate patient care, innovation, education and discovery.
University Health:
In 2022, property taxes made up 19 percent of University Health’s revenues.
Visit our Public Notices & Reports webpage for more detailed information about University Health's 2022 Audited Financial Report.
| 2021 Operating Revenue | Dollars (in Thousands) | Percentage | 2022 Operating Revenue | Dollars (in Thousands) | Percentage |
|---|---|---|---|---|---|
| Net Patient Revenue | 1,239,782 | 50% | Net Patient Revenue | 1,396,759 | 49% |
| Premium Revenue | 614,741 | 25% | Premium Revenue | 823,460 | 29% |
| Other Revenue | 106,759 | 4% | Other Revenue | 109,754 | 4% |
| Net Non-Operating Revenue | 522,704 | 21% | Net Non-Operating Revenue | 516,340 | 18% |
| Total Revenue | 2,483,986 | 100% | Total Revenue | 2,846,313 | 100% |
| 2021 Expenses | Dollars (in Thousands) | Percentage | 2022 Expenses | Dollars (in Thousands) | Percentage |
|---|---|---|---|---|---|
| Depreciation | 87,787 | 4% | Depreciation | 92,273 | 4% |
| Purchased Services, Supplies, Other | 872,910 | 39% | Purchased Services, Supplies, Other | 975,253 | 37% |
| Salaries/Benefits | 736,998 | 33% | Salaries/Benefits | 853,336 | 33% |
| Medical Claims | 507,004 | 24% | Medical Claims | 697,307 | 27% |
| Total Expenses | 2,204,699 | 100% | Total Expenses | 2,618,169 | 100% |
| Name | Years of Service | Job Title |
|---|---|---|
| Margarita Gallegos | 45.0 | Transfer Center leader |
| Terri Shaw | 44.0 | Systems Analyst |
| Richard Medina | 43.0 | Information Systems Manager |
| Johnny Puente | 42.0 | Logistics Technician |
| JoAnn Mizell | 40.0 | Nurse Coordinator, Patient Education |
| Hiro Shinzato | 39.0 | Lab Technologist |
| Roger Rodriguez Jr | 39.0 | License Vocational Nurse |
| Gary Hill | 38.0 | Clinical Pharmacist |
| Rosealie McBeth | 38.0 | Pharmacy Technician |
| Albert Bustos | 37.0 | Maintenance Employee |
| James Dixon | 35.0 | Multimedia Coordinator |
| Conrado Gamboa | 35.0 | Clinical Pharmacist |
| Jacquelyn Fuller | 35.0 | Nurse |
| Rosalinda Hinojosa | 35.0 | Reimbursement Specialist |
| Leticia Vega | 35.0 | Registration Access Specialist |
| Betty Ledesma | 34.0 | Ultrasound Technologist |
| Christine Lopez | 33.0 | Coding Technologist |
| Jorge Caballero | 33.0 | Volunteer Coordinator |
| Susan Marshall | 33.0 | Respiratory Therapist |
| JoAnn Fisher | 33.0 | Financial Access Specialist |
| Belinda Montgomery | 32.0 | Health Information Specialist |
| Jesus Lopez | 32.0 | Plumber |
| Belinda Green | 32.0 | Pharmacy Manager |
| Robert Garcia | 31.0 | Clinical Pharmacist |
| Gregory Evins | 29.0 | Unit Clerk |
| Trinidad Capre | 27.0 | Clinical Nurse |
| Laura Martinez | 27.0 | Financial Access Specialist |
| Margaret Spriggs | 26.0 | Nurse |
| Virginia Camero | 26.0 | Clinical Nurse |
| Gary White | 26.0 | Police Officer |
| Ignacio Jauregui III | 26.0 | Clinical Pharmacist |
| Donald Statz | 26.0 | Police Sergeant |
| Tamyra Valero | 25.0 | Health Solutions Specialist |
| Linda Devora | 25.0 | Registration Access Specialist |
| Carlos Cortes | 25.0 | UMA Staff Physician |
| Melissa Snow | 25.0 | Chemical Dependency Counselor |
| Shari Taylor | 25.0 | Clinical Nurse |
| Kenneth Jackson | 25.0 | Information Systems Developer & Architect |
| Martin Soliz | 24.0 | Pharmacy Technician |
| Cheryl Brown | 24.0 | Lab Clerk |
| Guadalupe Guzman | 24.0 | Unit Clerk |
| Carolyn King | 24.0 | Epic Analyst |
| Sylvia Moncivais | 23.0 | Registration Access Specialist |
| Michael Works | 23.0 | Surgical Technician, Team Leader |
| Helen Brenning | 23.0 | Clinical Pharmacist |
| Debra Guevara | 23.0 | Data Coordinator |
| Virginia Saldana | 22.0 | Critical Care Technician |
| Rhonda Friedrichsen | 22.0 | Techology Engineer |
| Gail Alexander | 22.0 | Hemodialysis Technician |
| Lorri Savoie | 22.0 | Leader, Epic Team |
| Richard Salinas | 22.0 | Logistics Manager |
| Ernest Joseph | 22.0 | Technology Monitor |
| Deborah Wehrly | 22.0 | Clinical Nurse |
| Ramona Faramarzi | 22.0 | Radiologic Technician |
| William Bedwell | 21.0 | Reimbursement Treasury, Exec. Dir. |
| Gloria Bryan | 21.0 | Environmental Associate |
| Maria Reyes | 21.0 | Coding Technologist |
| Nancy Aguirre | 21.0 | Medical Assistant |
| Rusmir Alic | 20.0 | Environmental Associate |
| Peggy Velasquez | 20.0 | Medical-Surgical Technician |
| Sylvia Ortiz | 20.0 | Clinical Nurse |
| Surraiya Ali | 19.0 | Clinical Nurse |
| Rafael Oliveras | 19.0 | Lab |
| Carlos Valdez | 19.0 | Engineering Technician |
| Laverne Johnson | 19.0 | Pbx Operator |
| Rossiter Livingstone | 19.0 | Surgical Technician |
| Kim Ryan | 19.0 | Nurse |
| Susan Vaughn | 19.0 | Senior Executive Assistant |
| Lucy Berlanga | 19.0 | Clinical Pharmacist |
| Lourdes Tremitiere | 18.0 | Clinical Nurse |
| Maria Govea | 18.0 | Environmental Associate |
| Margarita Ollervides | 18.0 | Refund Coordinator |
| Raudel Rivera | 17.0 | Clinical Pharmacist |
| Jose Fernandez | 17.0 | Financial Support, Exec Dir |
| Carmen Sanchez | 16.0 | Director, Clinical Informatics |
| Jackie Bender | 16.0 | Clinical Nurse |
| Anastacia Hernandez | 16.0 | Environmental Associate |
| Peter Menard | 16.0 | Coding Specialist |
| Leticia Borrego | 16.0 | Financial Access Specialist |
| Linda Martinez | 16.0 | Medical-Surgical Technician |
| Marina Angeles | 16.0 | Nurse |
| Sandra Humphries | 16.0 | Surgical Technician |
| Rosie Rodriguez | 16.0 | Physician Credentialing Specialist |
| Francisco Garcia | 15.0 | Sourcing & Contracting Specialist |
| Deborah Irvin | 15.0 | MRI Technologist |
| Olga Gonzales | 15.0 | Clinical Nurse |
| Cielito Ascio | 15.0 | Clinical Nurse |
| Evangeline Pheasey | 15.0 | Technical Supervisor |
| Joan Autry | 14.0 | Financial Operations Manager |
| Maria Arzate | 14.0 | Senior Verification Specialist |
| Martha Vergara | 14.0 | Medical Lab Scientist |
| Linda Ramos | 14.0 | Finance Cashier |
| James Magers | 14.0 | Information Systems Manager |
| Regina Delgado | 13.0 | Behavioral Health Services Director |
| Donnette Saldana | 13.0 | Radiologic Technologist |
| Monica Cremona | 12.0 | Nursing Case Manager |
| Lydia Nava | 12.0 | Health Information Specialist |
| Rosalinda Garza | 11.0 | Financial Access Specialist |
| Leroy Delapena | 11.0 | Pbx Operator |
| Angelmira Diaz | 11.0 | Registration Access Specizlist |
| Leticia Velten | 11.0 | Clinical Nurse |
| Robert Hernandez | 11.0 | Clinical Facilities Coordinator |
| Sara Moreno | 10.0 | Nurse |
| Rosa Jimenez | 10.0 | Visitor Management Ambassador |
| Domingo Carrillo | 10.0 | Security Ambassador Supervisor |
| Kristine Torres | 8.0 | Nurse |
| Sylvia Liedecke | 8.0 | Sourcing and Contracting Specialist |
| James Wright | 8.0 | Systems Analyst |
| Araselia Casarez | 7.0 | Food Service Technician |
| Meredith Dickey | 7.0 | Nurse |
| Alfredo Gonzales | 7.0 | Pbx Operator |
| Rene Ramon | 7.0 | Environmental Services Supervisor |
| Suzanna Barbosa | 6.0 | Nurse Case Manager |
| Nina Nyman | 6.0 | RAC Coordinator |
| Michelle Fleischer | 5.0 | Food Service Technician |
| Mario Rodriguez | 5.0 | Mail Room Coordinator |
| Valerie Arreguin | 5.0 | Trauma Coding Technician |
Hospital & Community Health Unique Patients: 259,761
Total Community Clinic Visits: 722,303
Preventive Care: 62,418
Primary & Walk-In Care: 495,295
Specialty Care: 477,370
Mammography: 40,851
Births: 3,980
Inpatient Discharges: 31,692
Outpatient Hospital Visits: 116,470
ED Visits: 107,405
Prescriptions Filled: 1,164,480
Lab Tests: 4,467,410
Radiology Procedures: 444,818
Total University Health Employees: 8,242
UT Health Physicians: 1,120
UMA Physicians: 169
Resident Physicians: 865
The 2022 Report to the community was written and published by the University Health Corporate Communications & Marketing Department.
Executive Sponsor
Leni Kirman, Executive Vice President, Chief Marketing, Communications and Corporate Affairs Office
Project Director
Elizabeth Allen
Creative Director
Helena Steubing
Staff Contributors
Abril Villarreal-Medina
Alejandro Ibarra
Allison Hays Lane
Amanda Stevens
Amy Yoder
Andrea Wazir
Andrew Castillo
Andrew Smith
Anita Uribe Martin
Brittany Wagner
China Whitby
Grecia Lopez
Joe Campa
Kendall Sherman
Laura Gilbert
Leni Kirkman
Mae Darrin
Rebeca Saucedo
Salvador Guajardo
Selene Mejia
Shelley Kofler
Sherrie Matthews
Photography and Video
Mark Greenberg
Darren Abate, Koasis Media
| Clerical | Management | Professional Nursing | Provider Professional (Non-Nursing) | Service | Technical | Volunteer |
|---|---|---|---|---|---|---|
| Sonia Juarez | Matthew Camden | Nicholas Guerrero | Trisha Kealoha | Maria Alba | Leandro Villarreal | Michelle Almanza |
| Lisa Wienckowski | Roger Samson Jr. | Kathleen Kent | Julie Rowe | Claudia Luna | Susanne Picon | Huey Boulet |
| Sandra Arredondo | Loretta LaPoint | Cindy Pocasangre | Lisa Castellanos | Tareq A. Mohammed | Crysta Hernandez | Adelina Rodriguez |
| Margreet Smith | Marissa Henderson | Noe Tovar | Stephanie Knight | Maria Leija | Miguel Martinez | Ruth Vargas-Martinez |
CLERICAL - Sonia Juarez
MANAGEMENT - Matthew Camden
PROFESSIONAL NURSING - Noe Tovar
PROVIDER - Andres Pardo-Agila
PROFESSIONAL (Non-nursing) - Trisha Kealoha
SERVICE - Tareq A. Mohammed
TECHNICAL - Leandro Villarreal
VOLUNTEER - Huey Boulet
THE COMMITMENT TO SERVICE EXCELLENCE - Julie Rowe
Baby Friendly Designation OB Team
Acute Hospital Care, At-Home Team
Critical Care Team
OB Team
Baby Friendly Designation OB Team
For more than a century, University Health has been dedicated to improving the good health of the community through high-quality, compassionate patient care, innovation, education and discovery.
University Health:
In 2022, property taxes made up 19 percent of University Health’s revenues.
Visit our Public Notices & Reports webpage for more detailed information about University Health's 2022 Audited Financial Report.
| 2021 Operating Revenue | Dollars (in Thousands) | Percentage | 2022 Operating Revenue | Dollars (in Thousands) | Percentage |
|---|---|---|---|---|---|
| Net Patient Revenue | 1,239,782 | 50% | Net Patient Revenue | 1,396,759 | 49% |
| Premium Revenue | 614,741 | 25% | Premium Revenue | 823,460 | 29% |
| Other Revenue | 106,759 | 4% | Other Revenue | 109,754 | 4% |
| Net Non-Operating Revenue | 522,704 | 21% | Net Non-Operating Revenue | 516,340 | 18% |
| Total Revenue | 2,483,986 | 100% | Total Revenue | 2,846,313 | 100% |
| 2021 Expenses | Dollars (in Thousands) | Percentage | 2022 Expenses | Dollars (in Thousands) | Percentage |
|---|---|---|---|---|---|
| Depreciation | 87,787 | 4% | Depreciation | 92,273 | 4% |
| Purchased Services, Supplies, Other | 872,910 | 39% | Purchased Services, Supplies, Other | 975,253 | 37% |
| Salaries/Benefits | 736,998 | 33% | Salaries/Benefits | 853,336 | 33% |
| Medical Claims | 507,004 | 24% | Medical Claims | 697,307 | 27% |
| Total Expenses | 2,204,699 | 100% | Total Expenses | 2,618,169 | 100% |
| Name | Years of Service | Job Title |
|---|---|---|
| Margarita Gallegos | 45.0 | Transfer Center leader |
| Terri Shaw | 44.0 | Systems Analyst |
| Richard Medina | 43.0 | Information Systems Manager |
| Johnny Puente | 42.0 | Logistics Technician |
| JoAnn Mizell | 40.0 | Nurse Coordinator, Patient Education |
| Hiro Shinzato | 39.0 | Lab Technologist |
| Roger Rodriguez Jr | 39.0 | License Vocational Nurse |
| Gary Hill | 38.0 | Clinical Pharmacist |
| Rosealie McBeth | 38.0 | Pharmacy Technician |
| Albert Bustos | 37.0 | Maintenance Employee |
| James Dixon | 35.0 | Multimedia Coordinator |
| Conrado Gamboa | 35.0 | Clinical Pharmacist |
| Jacquelyn Fuller | 35.0 | Nurse |
| Rosalinda Hinojosa | 35.0 | Reimbursement Specialist |
| Leticia Vega | 35.0 | Registration Access Specialist |
| Betty Ledesma | 34.0 | Ultrasound Technologist |
| Christine Lopez | 33.0 | Coding Technologist |
| Jorge Caballero | 33.0 | Volunteer Coordinator |
| Susan Marshall | 33.0 | Respiratory Therapist |
| JoAnn Fisher | 33.0 | Financial Access Specialist |
| Belinda Montgomery | 32.0 | Health Information Specialist |
| Jesus Lopez | 32.0 | Plumber |
| Belinda Green | 32.0 | Pharmacy Manager |
| Robert Garcia | 31.0 | Clinical Pharmacist |
| Gregory Evins | 29.0 | Unit Clerk |
| Trinidad Capre | 27.0 | Clinical Nurse |
| Laura Martinez | 27.0 | Financial Access Specialist |
| Margaret Spriggs | 26.0 | Nurse |
| Virginia Camero | 26.0 | Clinical Nurse |
| Gary White | 26.0 | Police Officer |
| Ignacio Jauregui III | 26.0 | Clinical Pharmacist |
| Donald Statz | 26.0 | Police Sergeant |
| Tamyra Valero | 25.0 | Health Solutions Specialist |
| Linda Devora | 25.0 | Registration Access Specialist |
| Carlos Cortes | 25.0 | UMA Staff Physician |
| Melissa Snow | 25.0 | Chemical Dependency Counselor |
| Shari Taylor | 25.0 | Clinical Nurse |
| Kenneth Jackson | 25.0 | Information Systems Developer & Architect |
| Martin Soliz | 24.0 | Pharmacy Technician |
| Cheryl Brown | 24.0 | Lab Clerk |
| Guadalupe Guzman | 24.0 | Unit Clerk |
| Carolyn King | 24.0 | Epic Analyst |
| Sylvia Moncivais | 23.0 | Registration Access Specialist |
| Michael Works | 23.0 | Surgical Technician, Team Leader |
| Helen Brenning | 23.0 | Clinical Pharmacist |
| Debra Guevara | 23.0 | Data Coordinator |
| Virginia Saldana | 22.0 | Critical Care Technician |
| Rhonda Friedrichsen | 22.0 | Techology Engineer |
| Gail Alexander | 22.0 | Hemodialysis Technician |
| Lorri Savoie | 22.0 | Leader, Epic Team |
| Richard Salinas | 22.0 | Logistics Manager |
| Ernest Joseph | 22.0 | Technology Monitor |
| Deborah Wehrly | 22.0 | Clinical Nurse |
| Ramona Faramarzi | 22.0 | Radiologic Technician |
| William Bedwell | 21.0 | Reimbursement Treasury, Exec. Dir. |
| Gloria Bryan | 21.0 | Environmental Associate |
| Maria Reyes | 21.0 | Coding Technologist |
| Nancy Aguirre | 21.0 | Medical Assistant |
| Rusmir Alic | 20.0 | Environmental Associate |
| Peggy Velasquez | 20.0 | Medical-Surgical Technician |
| Sylvia Ortiz | 20.0 | Clinical Nurse |
| Surraiya Ali | 19.0 | Clinical Nurse |
| Rafael Oliveras | 19.0 | Lab |
| Carlos Valdez | 19.0 | Engineering Technician |
| Laverne Johnson | 19.0 | Pbx Operator |
| Rossiter Livingstone | 19.0 | Surgical Technician |
| Kim Ryan | 19.0 | Nurse |
| Susan Vaughn | 19.0 | Senior Executive Assistant |
| Lucy Berlanga | 19.0 | Clinical Pharmacist |
| Lourdes Tremitiere | 18.0 | Clinical Nurse |
| Maria Govea | 18.0 | Environmental Associate |
| Margarita Ollervides | 18.0 | Refund Coordinator |
| Raudel Rivera | 17.0 | Clinical Pharmacist |
| Jose Fernandez | 17.0 | Financial Support, Exec Dir |
| Carmen Sanchez | 16.0 | Director, Clinical Informatics |
| Jackie Bender | 16.0 | Clinical Nurse |
| Anastacia Hernandez | 16.0 | Environmental Associate |
| Peter Menard | 16.0 | Coding Specialist |
| Leticia Borrego | 16.0 | Financial Access Specialist |
| Linda Martinez | 16.0 | Medical-Surgical Technician |
| Marina Angeles | 16.0 | Nurse |
| Sandra Humphries | 16.0 | Surgical Technician |
| Rosie Rodriguez | 16.0 | Physician Credentialing Specialist |
| Francisco Garcia | 15.0 | Sourcing & Contracting Specialist |
| Deborah Irvin | 15.0 | MRI Technologist |
| Olga Gonzales | 15.0 | Clinical Nurse |
| Cielito Ascio | 15.0 | Clinical Nurse |
| Evangeline Pheasey | 15.0 | Technical Supervisor |
| Joan Autry | 14.0 | Financial Operations Manager |
| Maria Arzate | 14.0 | Senior Verification Specialist |
| Martha Vergara | 14.0 | Medical Lab Scientist |
| Linda Ramos | 14.0 | Finance Cashier |
| James Magers | 14.0 | Information Systems Manager |
| Regina Delgado | 13.0 | Behavioral Health Services Director |
| Donnette Saldana | 13.0 | Radiologic Technologist |
| Monica Cremona | 12.0 | Nursing Case Manager |
| Lydia Nava | 12.0 | Health Information Specialist |
| Rosalinda Garza | 11.0 | Financial Access Specialist |
| Leroy Delapena | 11.0 | Pbx Operator |
| Angelmira Diaz | 11.0 | Registration Access Specizlist |
| Leticia Velten | 11.0 | Clinical Nurse |
| Robert Hernandez | 11.0 | Clinical Facilities Coordinator |
| Sara Moreno | 10.0 | Nurse |
| Rosa Jimenez | 10.0 | Visitor Management Ambassador |
| Domingo Carrillo | 10.0 | Security Ambassador Supervisor |
| Kristine Torres | 8.0 | Nurse |
| Sylvia Liedecke | 8.0 | Sourcing and Contracting Specialist |
| James Wright | 8.0 | Systems Analyst |
| Araselia Casarez | 7.0 | Food Service Technician |
| Meredith Dickey | 7.0 | Nurse |
| Alfredo Gonzales | 7.0 | Pbx Operator |
| Rene Ramon | 7.0 | Environmental Services Supervisor |
| Suzanna Barbosa | 6.0 | Nurse Case Manager |
| Nina Nyman | 6.0 | RAC Coordinator |
| Michelle Fleischer | 5.0 | Food Service Technician |
| Mario Rodriguez | 5.0 | Mail Room Coordinator |
| Valerie Arreguin | 5.0 | Trauma Coding Technician |
Hospital & Community Health Unique Patients: 259,761
Total Community Clinic Visits: 722,303
Preventive Care: 62,418
Primary & Walk-In Care: 495,295
Specialty Care: 477,370
Mammography: 40,851
Births: 3,980
Inpatient Discharges: 31,692
Outpatient Hospital Visits: 116,470
ED Visits: 107,405
Prescriptions Filled: 1,164,480
Lab Tests: 4,467,410
Radiology Procedures: 444,818
Total University Health Employees: 8,242
UT Health Physicians: 1,120
UMA Physicians: 169
Resident Physicians: 865
The 2022 Report to the community was written and published by the University Health Corporate Communications & Marketing Department.
Executive Sponsor
Leni Kirman, Executive Vice President, Chief Marketing, Communications and Corporate Affairs Office
Project Director
Elizabeth Allen
Creative Director
Helena Steubing
Staff Contributors
Abril Villarreal-Medina
Alejandro Ibarra
Allison Hays Lane
Amanda Stevens
Amy Yoder
Andrea Wazir
Andrew Castillo
Andrew Smith
Anita Uribe Martin
Brittany Wagner
China Whitby
Grecia Lopez
Joe Campa
Kendall Sherman
Laura Gilbert
Leni Kirkman
Mae Darrin
Rebeca Saucedo
Salvador Guajardo
Selene Mejia
Shelley Kofler
Sherrie Matthews
Photography and Video
Mark Greenberg
Darren Abate, Koasis Media
James Adams
Chair
Margaret Kelley, MD
Secretary
Jimmy Hasslocher
Board Member
Dianna M. Burns-Banks, MD
Board Member
