July 1, 2019

When Dr. Mark W. Kline accepted the position of Texas Children’s Physician-in-Chief in 2009, it was an extraordinary moment for the hospital. The bar set by his predecessors, Dr. Russell Blattner and Dr. Ralph D. Feigin, was high to say the least.

In the decade since, Kline has worked tirelessly to fulfill Texas Children’s mission of providing the very best care to the children and families who need us most. One need only look at Texas Children’s Hospital today to see the transformational difference his leadership has made.

“Dr. Kline has been a spectacular leader during his entire tenure at Texas Children’s, but his years as Physician-in-Chief have been nothing short of extraordinary,” said President and CEO Mark Wallace. “I know the entire Texas Children’s family joins me in congratulating him on this milestone, in thanking him for his vision, leadership and steadfast commitment to Texas Children’s, and in wishing him much success in the years to come.”

In honor of 10 incredible years as Physician-in-Chief, we sat down with Kline for 10 questions about what it has meant to serve in the role, the lessons learned and his hopes for the future.

After being named Physician-in-Chief, you said you had big shoes to fill. What has assuming that mantle meant to you?

Kline: I never take lightly the position I have here. It’s an honor and privilege every day to come to work because I follow in the footsteps of people like Dr. Blattner and Dr. Feigin. Also because Texas Children’s Hospital has such a pristine reputation for excellence that has been built over the past 65 years. Frankly, that’s why every day I sweat every detail – because I know I’m responsible for the legacy of Texas Children’s and would never want to do anything to dishonor the work of the many people who’ve gone before me to lay the foundation for what we have here today.

How do you manage your numerous responsibilities without being overwhelmed?

Kline: No one could do it alone, that’s for sure. I depend on the good people around me.

I concentrated the first year I was in the job on building a leadership team. I was able to do that successfully, and I’ve had good continuity among those team members. You have to surround yourself with people who are capable, who you trust and who you know will represent you well. They know what I’d be thinking at any particular juncture, and I know how they work, what they think and what their strengths are. We make it work.

With more than 1,400 faculty members, another 200-plus Texas Children’s Pediatrics providers, and with facilities in Austin, West Houston and The Woodlands, it’s imperative to have to have that kind of support.

When you first took the position, what was your personal vision for Texas Children’s, and how have the past 10 years compared to that expectation?

Kline: These 10 years have exceeded anything I ever imagined. The rate of growth that we’ve experienced has been truly remarkable. When I started, one of the perceptions I had was that the hospital was a little siloed in the Texas Medical Center. I imagined a Texas Children’s Hospital that was more far-flung across the community. Today, we certainly have a better representation across the greater Houston area. But even I didn’t anticipate the expansion into Austin. And of course through Texas Children’s Health Plan, we’re up into East Texas and all the way to the Red River in the north.

All of that really gets at the root of our mission. We were never Houston Children’s Hospital. We are Texas Children’s Hospital. And I think we’re right on the cusp of fully realizing the initial vision the founders had for the hospital when they named it.

What have been the most remarkable differences or changes you’ve seen at Texas Children’s?

Kline: If you look at patient visits, inpatient admissions, the size of our medical staff, research funding, number of applications to our educational programs – everything is two-and-a-half times bigger than it was a decade ago. But we’re not just bigger, we’re better than we have ever been. The fact that we have been able to substantially reduce serious safety events in the hospital despite the incredible growth – that’s truly remarkable.

We also have added some really differentiating programs – the kind of things where if you talked to someone at another institution about it, they’d say, “Wow, you’re doing that at Texas Children’s Hospital! Who else is doing that?” And the answer is no one. These are programs such as our Global Health services; Dr. Peter Hotez’s work on vaccines for some of the most prevalent infectious diseases in the world; and our Heart Center. There are a number of things that we do today that weren’t in existence 10 years ago that distinguish us from any other children’s hospital, and I’m really proud of those.

What are some accomplishments of which you’re particularly proud?

Kline: You could start by going down the U.S. News & World Report rankings. We’re now the No. 3 children’s hospital in the country. The Heart Center is the No.1 center in the country for children, perhaps in the world. We have the No. 1-ranked Pulmonary Medicine service in the United States. We have four other subspecialties ranked among the top 3 in the nation in their respective categories. We’re better and deeper than we’ve ever been before.

The diversification of our research programs is also something to be proud of. Ten years ago, we had a total research portfolio of about $60 million across five areas. Today, we have more than $117 million in annual research funding across 16 discreet areas. There’s hardly an area of pediatric medicine where Texas Children’s is not making a meaningful contribution. That’s tremendously exciting.

And there’s not another children’s hospital in the world that can match Texas Children’s for contributions to global child health. We provide care and treatment for more HIV-infected children that any other organization or institution in the world. That’s something to really be proud of.

What’s one of the most important lessons you’ve learned?

Kline: I try to remind myself every day that there’s a lot of value in humility. As big as we are and as good as we are, it would be easy to feel a little bit smug. We can’t. We’ve got to pay attention and be better at every little thing we do. We owe it to the patients and the families that we serve.

Was there ever a special piece of advice anyone offered you that’s been particularly helpful in your role at Texas Children’s?

Kline: Sweat the small stuff.

What advice would you offer young caregivers – physicians, surgeons, nurses and others – who are early in their medical career?

Kline: Be open-minded about where the career will take you. It’s fine to have a plan, but be open to the possibility that the plan might change. I never planned to do what I’m doing now, but I’m happy I was open-minded to it because I really love it. It’s been a great ride.

How about those with an eye on assuming a leadership role in medicine?

Kline: This kind of role is not for everybody. You have to really be invested in it. But one of the attributes I have is that I’m not afraid to ask for help. And that’s a key for being a good leader – being able to call on others when you don’t know something, because nobody has all the answers. Doing that enables you to flesh out your own skill set and work collaboratively with others and their skills.

What do you hope the next 10 years look like at Texas Children’s?

Kline: Hopefully, we will continue to grow and extend our reach. I think we’ll be in more places than we are today, training more young professionals, building more capacity for the care of seriously ill children and doing what Texas Children’s Hospital does best.

I think we’re on a great trajectory. If we can continue that, and at the same pace, it’ll be a great 10 years ahead.

About Dr. Mark Kline

Dr. Mark Kline’s medical career began at the age of 15, when he started working at an emergency center in his hometown of San Antonio. At 16, he was a licensed EMT and on a trajectory for a career as a trauma surgeon, or so he thought.

Kline graduated summa cum laude from Trinity University (San Antonio) with a bachelor’s degree in biology. He came to Houston as a medical student at Baylor College of Medicine, where during clinical rotations he discovered a passion for Pediatrics. He graduated with honors from Baylor in 1981 and completed pediatric residency training, chief residency and a postdoctoral fellowship in pediatric infectious diseases at Baylor and Texas Children’s Hospital in 1987.

In 1996, Kline witnessed firsthand the devastation of pediatric HIV/AIDS during a trip to hospitals, clinics and orphanages in Romania. This experience gave birth to the Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children’s Hospital. The program builds health care infrastructure, trains health professionals and provides medical care and treatment to children and families across sub-Saharan Africa and in Romania. BIPAI currently provides HIV/AIDS care and treatment to more than 350,000 of the world’s poorest and least fortunate children and families, more than any other organization worldwide.

Those efforts have also given rise to Texas Children’s Global Health programs. Leveraging resources, infrastructure and medical programs initially created through BIPAI, Global Health now partners with more than 18 governments, UNICEF, USAID, CDC, WHO and many others, to share expertise and best practices around the world in underserved nations such as Argentina, Colombia, Haiti, Malawi, Mexico, Pakistan, Tanzania and Uganda.

An internationally respected leader in pediatric HIV/AIDS and global child health, Dr. Kline has been the recipient and principal investigator for more than $150 million in research grants from the U.S. National Institutes of Health and Centers for Disease Control and Prevention. He has authored more than 250 scientific articles and textbook chapters and has presented over 350 national and international lectures. Dr. Kline is editor-in-chief of Rudolph’s Pediatrics, one of the world’s most widely recognized and read medical textbooks.

Last year, Texas Children’s Palliative Care Program celebrated being awarded The Joint Commission’s Gold Seal of Approval for Palliative Care Certification. Texas Children’s Palliative Care Program is one out of ninety programs across the country to receive this distinction. Learn more by visiting our 2018 virtual Annual Report.

Since implementing Texas Children’s Patient Access Initiative, Texas Children’s continues to make great strides to ensure our patients and their families get in the door easier to access our high quality services.

One of the many impactful changes benefitting patient families has been their ability to easily and quickly schedule their appointments online as a result of new features the organization has implemented. To date, more than 10,000 appointments have been scheduled online via MyChart and DocASAP.

In May 2018, Texas Children’s launched direct scheduling that allows current patients to schedule return appointments online through MyChart. Since its implementation, over 7,909 visits have been scheduled online and many patients and their families describe the scheduling process as “easy and convenient.”

“I was surprised that Texas Children’s now offers this option,” wrote a Texas Children’s family. “It was very convenient and the process for scheduling appointments was very simple and streamlined.”

In addition to direct scheduling via MyChart, over 2,814 appointments have been made via DocASAP, Texas Children’s online scheduling partner, since November 2018. Offered in both English and Spanish, this online scheduling tool is available to new patients, current patients, and referred patients at Texas Children’s three hospital campuses including our specialty care locations in Houston and Austin, and Texas Children’s Pavilion for Women.

“I am excited about the progress we’ve made to better serve our patients and their families,” said Sarah Ringold, assistant director of Perioperative Business Operations at Texas Children’s and project manager for the online scheduling team for Patient Access. “It is amazing to be able to offer families the flexibility of scheduling online, and to continue to improve the online scheduling tool to make it more and more effective for our patients.”

Other patient access milestones

Texas Children’s implemented other enhancements to improve patient access across the system. Below is an update on where we are today:

  • MyChart activations: Texas Children’s continues to see an increase in the number of patients signing up for MyChart. In October 2017, the organization had approximately 61 percent of distinct patients sign up for MyChart. As a result of system wide efforts to raise patient awareness and engagement, we have now exceeded over 74 percent activation rate for MyChart throughout the system as of June 2019.
  • Electronic Waitlist: Since implementing this MyChart feature that automatically sends texts and email notifications when appointments become available sooner, 3,794 patients have accepted an appointment on average 39 days earlier than their prior appointment. The total patient volume includes Texas Children’s Pediatrics (TCP), all subspecialties, sleep studies and therapies. Due to its success, TCPs in Austin and College Station will go live with this convenient electronic tool by the end of the summer.
  • Referrals: The referrals team continues to work through enhancements to the referral process in an effort to improve patient access. In April and May 2019, Texas Children’s received over 6,000 referrals from external providers that were processed through the central transcription team – the highest number of referrals from external providers to date. In addition, TCP surgical referrals and medicine referrals referred to Texas Children’s specialties also reached their highest levels at 91 percent and 87 percent, respectively. Current initiatives are in process to increase scheduling conversion and appointment capture rates for various specialties.
About Texas Children’s Patient Access Initiative

Launched in August 2017, Texas Children’s Patient Access Initiative is an on-going, collaborative effort to improve patient access across the organization. Since then, Texas Children’s has made significant progress to ensure patients easily and conveniently get in the door so we can provide the care they need, when they need it.

Click here for a list of other tools and features we’ve implemented across the system to improve access, care coordination and patient experience at Texas Children’s.

Texas Children’s Health Plan is launching a campaign to educate consumers about the importance of having health insurance.

The Get Insured campaign urges families to “Have a better plan for your kids” and will run from now until September 1.

“Texas has the highest percentage of people without health insurance in the United States and a large percent of these are children,” said Cristina Garcia-Gamboa, Texas Children’s Health Plan Marketing Director. “Applying for CHIP and Medicaid is a lengthy and daunting process and we want consumers to know we are here to help.”

“The goal of Get Insured is to educate families eligible for CHIP or Medicaid of their options to manage care through our health plan and encourage parents to have a plan for their children. We are also tying our message back to the importance health coverage has on a child’s future,” Garcia-Gamboa added.

Through this campaign, The Health Plan is also touting the newly created application assistance team, which is available to help parents apply for CHIP or Medicaid. The goal is to make sure that children get quality health care and are protected through life’s unexpected moments.

The effort will run locally in the greater Houston service area across TV, radio, outdoor, digital, social media and grass roots efforts. The campaign is member-centric and addresses both the emotional and rational benefits of having a plan, complete with an easy phone number for potential members to call. (1-888-559-PLAN)

The two 30-second TV spots in both English and Spanish depicts children and expecting parents dreaming of their own/child’s future and how Texas Children’s Health Plan can help them achieve those goals.

Want to help? Here’s how you can show your support for Get Insured.

Refer a friend or family member to plan now. If you know someone who is uninsured, tell them to apply for Medicaid or CHIP. Remind them to plan now for the health of their family.

As members of the Texas Children’s family, we strive to provide exceptional service each and every day. And, as part of the Disney Team of Heroes (DToH) initiative, we have partnered with the Disney Institute – Disney’s professional development and external training arm – to develop the DToH Children’s Hospital Service Training. This training is intended to enhance our already strong culture of care and service by turning ordinary interactions into moments of comfort, compassion and inspiration for patients, families and each other.

This week, Disney Institute has begun delivering an on-site version of the training to a representative group of employees and leaders from inpatient, outpatient and support services across our system to refine and inform this exciting new program.

In order to effectively roll out this impactful training across our system in the future, we need your help!

We are looking for 25 dynamic and engaging employees (including leaders) to train our workforce on how to deliver exceptional service through our Texas Children’s values and Disney’s service principles.

We are thrilled to introduce the DToH Train the Trainer Program! This new program will offer employees the distinguished opportunity to directly equip the workforce with concepts, skills, behaviors and tools to further our goal of providing innovative, patient-centered engagement.

In order to apply to be a DToH Service Trainer, you must be prepared to fulfill the following time commitments:

  • Deliver a minimum of 12 trainings per year and additional dedicated time each month for preparations and logistics
  • Be available to attend the DToH Train the Trainer Program on Oct. 14 – 18, 2019

Ideal applicants should exhibit a passion for the culture, strong communication and interpersonal skills, and a commitment to treat everyone like a valued customer, among other desired behaviors.

Additionally, you must meet eligibility requirements, which are outlined in the online application, and you must complete the following:

  • A 300 – 500 word personal statement on why you want to be a DToH Service Trainer
  • A 90-second video on how you see “Live Compassionately” demonstrated at Texas Children’s

Click here to fill out the online application and submit your video and personal statement, which are due by Friday, July 12.

In order to assist you with your application, we are offering Virtual Information Sessions that will provide a detailed overview of the eligibility requirements, time commitment and selection process. You are not required to attend a session in order to apply.

Dates/times available:

  • Friday, June 28, Noon to 12:30 p.m.
  • Tuesday, July 2, 8 a.m. to 8:30 a.m.
  • Tuesday, July 2, 9 a.m. to 9:30 p.m.

Click here to sign up for a Virtual Information Session. Once you enter HealthStream, select the “TCH DToH Children’s Hospital Service Virtual Information Session” to enroll.

If you are selected to move forward in the process following the review of the applications, you will be called back to participate in live auditions in August.

We look forward to seeing the magic you will create!

On May 29 and 30 The Woodlands campus hosted Texas Children’s inaugural quality and safety course, Resilience Engineering in Healthcare (REHC). A small cohort of 36 learners from across the system, combined with 20 faculty and safety specialists were handpicked to be a part of this innovative training. Eight additional Texas Children’s executives served as observers who engaged, watched, and became more informed, during the presentations.

System Chief Quality Officer Dr. Eric Williams, partnered with Quality and Safety leadership to develop the training and bring awareness to the ongoing complexity of our work environment, importantly highlighting its impact on patient safety. According to a study by Johns Hopkins University, more than 250,000 people in the United States die every year due to medical errors, making it the third leading cause of death following heart disease and cancer. This current and long-standing dilemma in healthcare is what sparked Williams and his team to develop an approach that allows us to harness adaptability to build and design a safer patient environment.

Williams hypothesized that, “Teams that are adaptable and resilient are more likely to be successful at managing the unexpected, mitigating risk, and increasing the speed that we deliver better and safer health care.”

An organization’s performance is resilient if it can function as required under expected and unexpected conditions alike. Resilience engineering is about better designing that ability to cope. The Team of Teams model from the McChrystal Group, a global advisory services and leadership development firm was also shared as a method of how to overcome the obstacles of operating in a complex work environment.

“We need to transform our approach to patient safety into one that is not solely focused on preventing human error in hindsight, simply because complex systems like healthcare can be highly unpredictable,” Director of Quality Education & Simulation Kelly Wallin said. “Routinely, individuals and teams are constantly adapting to manage expected and unexpected events before they ever lead to patient harm. The goal for our organization to learn how teams can best become more resilient and adaptive. That is the transformational skill set we need to share across the organization.”

This course is the first of its kind that includes immersive coursework topics. A total of four in-person sessions include information delivered via didactics, simulation-based training, and also theater-based improvisation.

By the end of the training, the expectation is that participants will be able to describe the presence of organizational resilience in health care. This includes the ability to increase both personal skills and their ability to teach others resiliency skills such as – anticipation, monitoring, response and learning. They also will be able to implement and evaluate safety, and resilience interventions in their own respective units.

“This innovative training was a breath of fresh air,” Director of Perioperative Services Amanda Ward said. “It was inspiring to learn approaches that enables a team to see through a new lens and was an extremely positive experience for me. I came back looking for opportunities to use what I had learned in my own department.”

With data collected during the training combined with participant feedback, the team expects to refine and revise the course and continue to offer it as advanced training.

“Every two weeks we’re distributing missions for each one of these learners to report back from within their workplace,” Wallin said. “We want to know how have they either utilized or identified something they’ve learned in this course; something that works well in the real world that we need to capture and build into our organizational training strategies.”

In September part two of this quality and safety course will take place at The Woodlands campus. Williams and Texas Children’s executives are looking forward to seeing this training progress and become an annual course.

“The training was extremely informative and hands on. I look forward to our organization focusing more on building our resilience potential,” Assistant Vice President of The Woodlands Campus Ketrese White said. “The goal is that we can adjust and adapt our safety management procedures to incorporate the tactics taught in this course. This will only catapult Texas Children’s success and allow us to continue to provide high quality, reliable care.”

This coursework could not have been possible without the generous support of the Tressler family, whose kind donation was specifically directed to improve quality and safety.

Congratulations to Clinical Staff Development Specialist, Lauren Ivanhoe, MSN, RN-BC, CEN, who is the recipient of the this year’s third quarter, Best of the West award.

Ivanhoe is a well-respected healthcare education professional throughout the campus, system, and nationally. She freely lends her educational expertise and leads initiatives anchored in staff development and patient safety.

The Best of the West award recognizes an employee each quarter who has exceled at demonstrating Texas Children’s values – leading tirelessly, living compassionately, amplifying unity and embracing freedom.

“Lauren has gone above and beyond to ensure we are aware and capable of best practices,” her co-workers expressed. “She is one of those people who is always willing to help and support the team.”

Ivanhoe recently worked closely with the West Campus Radiology Team to simulate patient care in the mobile CT scanner. She has spent countless hours coordinating and developing training content that translated into safe practice. Additionally, Ivanhoe has worked extremely hard to develop and train staff in preparation for the Epic Upgrade, Beaker go-live, and Interoperability transition.

She also coordinates Cy-Fair Independent School District student schedules for on-site training, contributing to a pipeline of future health care professionals.

“It goes without saying that Lauren is more than deserving of this award and we are better as a campus and system because of her passion and dedication,” the radiology team collectively mentioned. “We cherish the wealth of knowledge she shares and absolutely admire her uplifting and encouraging attitude.”