On his blog this week, Mark Wallace shares his excitement about Texas Children’s once again being named among the top children’s hospitals in the nation according to the most recent U.S. News & World Report rankings. He also announces a new Connect series that will feature each of the 10 subspecialty areas ranked in the U.S. News survey and highlight the programs, improvements and advancements that helped earn this year’s outstanding rankings. Read more
Early on the morning of June 18, Texas Children’s Heart Center staff filed into Taussig auditorium on the 16th floor of Lester and Sue Smith Legacy Tower. Details about the meeting’s purpose had been scarce. Little did everyone know that they’d been called in for a big reveal.
Texas Children’s Heart Center had once again been named the best place in the country for pediatric cardiology and heart surgery in the U.S. News and World Report 2019-2020 Best Children’s Hospitals rankings – the center’s third straight year at No. 1.
“It’s thrilling for our team to be recognized for the care we provide to our patients every day,” said Chief of Pediatric Cardiology Dr. Daniel Penny. “Even though we received the top honor, we know there is always room for improvement. We are continuing to evolve as a true multidisciplinary team that is dedicated to setting a new standard for the treatment of children and adults with congenital heart disease.”
The U.S. News rankings use a well-accepted framework for evaluating quality of health care, which factors in patient outcomes, such as mortality and infection rates; available clinical resources, such as specialized clinics and programs and external accreditations; and compliance with best practices. Improved rankings demonstrate a health care organization’s commitment to not only providing high-quality care, but also to identifying gaps where improvements are needed.
But where do you go when you’re No. 1?
“Our goal is to be so far ahead that no one can catch us,” said Dr. Christopher Caldarone, Texas Children’s chief of Congenital Heart Surgery. “Being No. 1 is a state of mind, where commitment to excellence is inherent in everything a program does. Our team has a No. 1 mindset. We work hard, we constantly measure our performance, and we drive ourselves to improve in every aspect of providing care.”
Big wins for patients and families
This past year, the Heart Center built on the successes of previously existing programs and also implemented new initiatives to increase transparency, reduce risk of infection and improve the quality of care.
Participated in STS National Database public reporting
The Society of Thoracic Surgeons (STS) is a national leader in health care transparency and accountability. Participation in STS public reporting demonstrates a commitment to quality improvement in health care delivery and helps provide patients and families with access to information that can help them make more informed health care decisions.
Texas Children’s holds a three-star rating in the STS Congenital Heart Surgery Database (CHSD), which is calculated based on overall risk-adjusted operative mortality for all patients undergoing pediatric and/or congenital heart surgery. The rating is the highest category of quality and places Texas Children’s among the elite congenital heart surgery programs in the U.S. and Canada. Additionally, STS recognized Texas Children’s for having operative and adjusted operative mortality rates that were consistently below expected rates over a 4-year period.
Implemented a program to routinely track and submit IMPACT data
In partnership with clinical and physician leadership, the Heart Center’s Cardiac Catheterization Labs implemented processes to submit metrics on all catheterization procedures included in the American College of Cardiology’s IMPACT Registry®. This national register collects quality-focused data on the management and outcomes of pediatric and adult congenital heart disease (ACHD) patients who undergo diagnostic and interventional cardiac catheterization procedures. The registry also allows Heart Center leadership to compare performance against a national aggregate for quality improvement initiatives.
Increased the number of cardiac intensive care unit (CICU) RNs with greater than 2 years’ experience
CICU care requires a multidisciplinary team effort. Success is due, in part, to the team’s being able to rely on experience. In the months leading up to the Heart Center’s move into Lester and Sue Smith Legacy Tower, CICU leadership worked tirelessly to not only recruit the very best nurses, but also to retain them. This enables the nurses to gain valuable experience and mature as caregivers, and also helps improve the overall quality of the CICU team. The response has been extremely positive, with low turnover.
Implemented a universal methicillin-resistant Staphylococcus aureus (MRSA) decolonization treatment protocol
To reduce the risk of infection faced by all surgical patients during the perioperative period, the Congenital Heart Surgery team partnered with experts from Infectious Disease to implement a universal decolonization protocol for MRSA, which causes infections that are more difficult to treat than methicillin-susceptible staph. The protocol, which involves five days of antibiotic ointment in the nose and five days of special wipes, has the added benefit of decreasing MRSA wound infections, and incidence of methicillin-susceptible staph ventilated-associated pneumonia and central line infections.
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.
June 10, 2019
Texas Children’s Pavilion for Women has been designated a level IV maternal care facility, the highest level of care available. The designation was finalized late last week and followed a rigorous site visit conducted by the EMS/Trauma Systems Office of the Texas Department of State Health Services. A level IV maternal care facility provides comprehensive care for pregnant and postpartum patients, from those with low-risk conditions up to and including the most complex medical, surgical and/or obstetrical conditions that present a high-risk of maternal morbidity or mortality.
“This designation certifies that we offer the highest level of care for the most complex obstetric patients,” said Dr. Christina Davidson, a maternal-fetal medicine specialist and chief quality officer at Texas Children’s Pavilion for Women. “It speaks to the expertise of our clinical teams and the processes we have in place to ensure high-quality care and the positive outcomes we strive for.”
With the overall goal of reducing infant and maternal morbidity and mortality in the United States, the designation comes as the result of legislation passed in 2013 requiring Texas to establish and implement neonatal and maternal level of care designations by March 1, 2018. The intent of the legislation is to ensure both neonatal intensive care units (NICUs) and maternal care facilities have the resources and expertise to provide high-quality, specialized patient care that leads to the best outcomes for mothers and babies.
Texas is one of the first states requiring maternal care facilities undergo a site visit to verify the level of care provided to patients meets the Maternal Levels of Care classifications as defined in the Texas Administrative Code. Completing the designation process is a requirement to receive Medicaid reimbursement for obstetrical care by August 31, 2020.
“This designation is the fruit of the work we perform daily. It is recognition by the Department of State Health Services of Texas Children’s commitment and investment to maternal health,” said Dr. Nan Ybarra, director of nursing for inpatient services at Texas Children’s Pavilion for Women. “With over 6,200 deliveries annually, we are committed to serving women in our community and partnering with community hospitals to strengthen their maternal care processes and programs – our singular goal is to improve outcomes for pregnant women across Texas and beyond.”
Texas Children’s announced in January it opened one of the nation’s few intensive care units dedicated solely to obstetrical critical care. It is the only four-bed maternal ICU in the country staffed 24/7 by both pulmonary critical care and maternal-fetal care teams embedded in a hospital’s labor and delivery unit. This maternal ICU offers a specialized, private space for high-risk expectant and postpartum mothers with conditions such as sepsis, peripartum bleeding, placenta accreta, maternal heart disease and other serious conditions.
The hospital also has a nationally known placenta accreta spectrum program, where a team of experts provide comprehensive, multidisciplinary care for women with this potentially life-threatening pregnancy complication that occurs in approximately 1 in 1,000 to 2,000 pregnancies.
Additionally, in 2017, Texas Children’s obstetrics service partnered with the hospital’s Kangaroo Crew to create the Maternal Transport Service, further bolstering its reputation as a primary referral site for patients with high-risk pregnancies. The team, consisting of a Kangaroo Crew nurse, labor and delivery nurse, respiratory therapist, and EMT, can provide specialty care to mothers while enroute to the Pavilion for Women, helping the hospital’s community partners transport their sickest patients for the most optimal outcomes for mothers and babies.
“It’s crucial for women, especially those experiencing a high-risk pregnancy, to be educated about the level of obstetrical care available in the facility in which they plan to deliver,” said Dr. Michael Belfort, obstetrician/gynecologist-in-chief at Texas Children’s Pavilion for Women.
May 14, 2019
Texas Children’s Hospital has been recognized by Forbes as one of America’s best employers. Forbes recently released its annual America’s Best Large Employers list and ranked Texas Children’s No. 276 among the best 500 large companies in the nation. Texas Children’s was one of 25 health care organizations on the list, and one of only three in Texas and Houston.
Forbes partnered with market research company Statista to measure the leading employers around the country and the world by asking those in the best position: the workers. Statista surveyed 50,000 Americans working for businesses with at least 1,000 employees. All the surveys were anonymous, allowing participants to share their opinions openly. The respondents were asked to rate, on a scale of zero to 10, how likely they’d be to recommend their employer to others. Statista then asked respondents to nominate organizations in industries outside their own. The final list ranks the 500 large employers that received the most recommendations.
As you’ll recall, Forbes worked with Statista just last year on its first-ever ranking of America’s best employers for women. Texas Children’s was ranked No. 11 among the best 300 companies in the nation – and the best in Houston.
“Creating a culture not only of excellence but of collaboration and camaraderie has been a mission of ours, and I am so proud of what we have accomplished as One Amazing Team and of what we have built together at Texas Children’s Hospital,” said President and CEO Mark Wallace.
December 3, 2018
A delegation of Texas Children’s physician leadership, executives and experts were recently invited to attend the 6th annual U.S. News & World Report Healthcare of Tomorrow summit in Washington, D.C. There, they met with top hospital leaders, policymakers, insurers, consumer advocates and other industry professionals from across the country to discuss some of the most important topics in health care today.
Texas Children’s had a major presence throughout the event. Not only did we sponsor key discussion sessions, but every attendee had their event credentials on a Texas Children’s-branded lanyard, Additionally, a raffle of four sets of Rudolph’s Pediatrics, the landmark pediatric health care reference, of which Physician-in-Chief Dr. Mark W. Kline is editor-in-chief, was extremely well received at our conference booth.
Kline and Surgeon-in-Chief Dr. Larry Hollier also represented Texas Children’s as featured event speakers.
Taking compassionate care into the global community
In his keynote address, “Global Child Health at the Tipping Point: Lessons from the Field,” Kline stressed that though significant progress has been made to improve child health and mortality rates worldwide, challenges still remain, especially in resource-limited countries. He also said that through increased awareness, partnership and active engagement, those challenges can become opportunities for health care providers to improve the lives of the world’s poorest and least fortunate.
To illustrate this point, Kline highlighted the successes and lessons learned of the Baylor International Pediatric AIDS Initiative (BIPAI) at Texas Children’s Hospital in helping stem the tide of the AIDS pandemic, particularly in sub-Saharan Africa. The network, which Kline founded in 1996, has grown from a single pilot HIV clinic in Romania into a comprehensive global health network – the largest HIV/AIDS network in the world – that includes 16 centers and clinics in 14 countries, providing care for hundreds of thousands of children and families, education for nearly 90,000 health care professionals, and research into pediatric health.
Kline also explained how leveraging the BIPAI network’s infrastructure has enabled Texas Children’s to extend its global reach and to offer care for many other diseases and disorders, including pediatric cancer, sickle cell anemia, OB/GYN care, tuberculosis, malaria, malnutrition and other conditions.
“For too long, children have been on the outside looking in, and it’s particularly true for the poor children of the world, who’ve not had the same access to life-saving therapies as American and European children,” Kline said. “The HIV/AIDS pandemic certainly challenged the world’s commitment, and our compassion, for these children. But our success in the fight against HIV/AIDS has opened the door to treatments for a host of other serious diseases that have threatened the health and well-being of children and families for generations.”
Using partnership to drive patient experience
At a discussion session entitled “The New Patient Experience Era: Focusing on the Consumer of Tomorrow,” Hollier and other panel members addressed how enhancing the patient experience can lead to improvements in quality and safety and to increased consumer and caregiver satisfaction.
Hollier discussed the crucial role that partnerships have played in improving patient experience at Texas Children’s.
“We believe strongly that partnerships – with our providers and employees, with our families, and with experts inside and outside of health care – are a critical component of driving an exceptional experience,” Hollier said. “As families’ expectations evolve, we continue to explore more innovative solutions to help us meet them where they are in their care journey, and to ensure they feel supported at every step along the way.”
One such solution was an initiative to improve communication and interaction between providers and patients and families. Partnering with experts at Press Ganey and Academy of Communication, and drawing information from provider and patient/family surveys, we developed a communication training curriculum for caregivers that elevates the level of engagement for families. Providers now feel empowered to manage interactions between both patient and parent, and are better equipped to communicate important information in a way that families will understand.
Texas Children’s also relied on partnership with families during the development of Lester and Sue Smith Legacy Tower. A 20-member Family Advisory Board worked for three years, from initial planning to the go-live date, to ensure that families’ needs were kept at the center of important decisions. Their input was essential for room and facility layouts, in simulation exercises, and for the development of family support resources during the move into the new building.
For Texas Children’s Department of Surgery, partnerships have been integral in enhancing tech processes, which has led to several improvements across the Texas Children’s system, including streamlined and transparent data sharing, consolidation and standardization of our and our providers’ online presence, and more frequent updates and scheduling information for families during surgery through the EASE app.
Hollier also highlighted Texas Children’s recent partnership with Disney, a $100 million initiative that has the potential to transform the patient experience in children’s hospitals across the globe. Initial concepts for development include allowing children to customize their hospital visit with their favorite Disney stories and characters, reimagining spaces through augmented and virtual reality experiences, and creating themed treatment and patient rooms with interactive elements.
October 4, 2018
According to a recent Physicians’ Choice survey conducted by Medscape, Texas Children’s Hospital was recognized as one of the nation’s top three hospitals for the treatment of pediatric conditions.
Between May 17 and August 13, Medscape surveyed more than 11,000 U.S. physicians to get their opinions on which hospitals they would send family members to for specialty care. Texas Children’s ranked in the top three for pediatric care along with Boston Children’s Hospital and Children’s Hospital of Philadelphia.
Medscape identified 10 clinical conditions or procedures and asked, “Suppose you or someone in your family were diagnosed with a complex or difficult case of (condition). Assuming no barriers to treatment at the hospital you prefer, what hospital would you choose for treatment?”
Based on this survey, doctors felt the most important part of choosing a hospital was expertise followed by a hospital’s reputation among other physicians. Additional factors in choosing a hospital included: having leading technology available, low error and infection rates, and treatment and studies published in respected medical journals.
“We are honored that our hospital was recognized by physicians as one of the best pediatric hospitals in the nation,” said Texas Children’s President and CEO Mark Wallace. “This is a testament to the exceptional quality of work we do across our system every day, and indicative of our hospital’s reputation in pediatric care.”