March 10, 2022

Be on the lookout, Texas Children’s team members – an executive could be visiting your area soon to hear directly from you about how to build on our culture of quality, safety and experience.

In February, an initial Culture Rounds pilot took place at the Medical Center Campus on 9 West Tower (WT). This pilot proved successful and generated a wealth of feedback that led to the expansion of Culture Rounds, now including additional units and departments across the organization. The second pilot will begin on March 16.

Culture rounding is an evidence-based best practice enabling leaders to more closely engage with our employees, patients and their families while cultivating relationships and driving the prioritization of quality, safety and experience. Executives want to gather your thoughts to identify and address opportunities for improvement.

Assistant Vice Presidents Tarra Kerr and Paige Schulz are leading the effort, which aligns with the goal to listen to and learn from our team members’ voices as we build Texas Children’s tomorrow, together. In an additional show of commitment, Texas Children’s is also designating 2-3 p.m. every Wednesday as protected time for culture rounding.

“Hearing what’s on the minds of our employees and our patients can only make Texas Children’s better, and that’s our main objective in making the Executive Culture Rounds,” said Kerr. “We’ve already been able to act on feedback received in our first pilot and we look forward to hearing more every week about what we can do to make Texas Children’s an even better place to work and receive care.”

For the pilot program at 9WT, four teams rounded on the unit weekly for a total of four weeks. Each team consisted of two executives and one scribe who partnered with our team members and patient families to make a positive impact on safety, quality and experience.

For the second pilot that starts this month, 16 teams will make rounds for a total of 12 weeks, ultimately covering 32 different areas. Each team will be assigned to visit 1-2 care locations for the duration of the pilot period, which will allow for relationships to form and provide an opportunity to actively track the resolution of any identified issues.

For more information on executive culture rounds and quality, safety and patient experience, contact Quality Specialist Kandice Bledsaw via e-mail.

October 29, 2019

This fiscal year The West Campus Quality, Innovation, and Research Strategic Imperative team implemented two unique and informative events to engage and educate staff and providers on the importance of quality improvement work and its impact on improving patient care and outcomes.

“It stemmed from the four strategic imperatives for the organization, one of them being research quality and innovation,” Texas Children’s Hospital West Campus Assistant Vice-President Matt Timmons said. “It’s really about awareness, and a celebration of the improvements that were made over the last year.”

On August 29, dozens of employees from all disciplines attended West Campus’ Quality Boot camp which was geared toward enhancing their Quality Improvement (QI) knowledge and skills through an interactive education session applying the Institute of Healthcare Improvement’s quality tools listed below:

  • A Cause and Effect Diagram that helps you analyze the root causes contributing to an outcome.
  • Failure Modes and Effects Analysis, which is a systematic, proactive method for identifying potential risks and their impact.
  • Run Charts and Control Charts that help monitor performance and visualize variation.
  • The Plan-Do-Study-Act (PDSA) worksheet that helps teams assess whether a change leads to improvement using a methodical learning process.

“I appreciate going through the steps as a group and then getting to apply the knowledge for our own project,” a participant commented in a follow up survey.

In addition to the boot camp, on October 10, West Campus hosted a Quality Showcase. This event gathered West Campus staff and providers to listen and discuss visual presentations that highlighted innovative solutions through quality projects that have had a positive impact on patient care, outcomes, and access

In alignment with the organization’s strategic requirements, the West Campus leadership developed these efforts to inform, motivate, and execute quality effectively.

“You have to practice quality,” Texas Children’s West Campus Assistant Director of Respiratory Care Clinic, Gboly Harris said. “With this initiative we want to ensure that everyone is aware of quality practices to ultimately improve outcomes for patients.”

Upon providing background information each presenter was asked to set sustainable goals in their areas, document the outcomes and preventative steps, and effectively expound on their model of care. Below are the 10 quality project focuses presented at the showcase:

  • Expanding West capacity through innovative solutions and transformational leaders
  • Preventing unplanned extubations together
  • Depression screening of inflammatory bowel disease patients
  • Alarm Fatigue
  • Standardizing ear, nose, and throat (ENT) education, post-op care of otolaryngology patients in acute care
  • MyChart activations
  • Swarm into sepsis: A collaborative approach in a pediatric community emergency center decreasing appointment no-show rates
  • Gastrostomy outcomes and improvement project and registered nurse training
  • Direct Admit Patient Project
  • Decreasing Appointment No Show Rates

“This showcase was encouraging to see people in their element, creating projects that they feel would be beneficial to other departments to have better quality of care for our patients,” Clinical Lead in Pediatric Surgical Services Caitlin Justus said. “Being able to have the opportunity to collaborate with others to gain tips on how we can succeed in our respective areas was very helpful.”

Following the showcase, Chief Quality Officer Dr. Eric Williams provided a few words to recap the information that was presented along with motivating employees to continue overcoming risk, meeting national guidelines and adopt other strategies they may have learned during those two hours.

“Patient safety is a large part of patient experience,” Williams said. “You cannot manage quality from one central space. It starts with your areas successfully providing tools to the rest of the campus that can ultimately enhance quality throughout the organization.”

Click here to learn more about each quality project.

July 1, 2019

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.

May 3, 2017

As a health care system, Texas Children’s believes that a critical component to offering outstanding clinical care is measuring the results of the care we deliver and doing our best to provide our patients and families with the safest environment possible.

“By tracking what we do, we learn about what happens to our patients, and we also learn about our performance as a health care delivery organization,” said Chief Safety Officer Dr. Joan Shook. “We know we can always do better and must continue to strive toward excellence in health care delivery.”

With that in mind, Texas Children’s has created a dedicated safety and outcomes website that parents can access directly from the Texas Children’s main landing page. The information on this page is organized into the following nationally recognized categories of quality measures:

  • Safe: Avoiding harm to patients from the care that is intended to help them.
  • Effective: Providing services based on scientific knowledge. This category also measures the outcomes of the care we provide.
  • Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs and values and ensuring that patient values guide all clinical decisions.
  • Timely: Reducing wait times and harmful delays for both those who receive and those who give care.
  • Efficient: Avoiding waste, including waste of equipment, supplies, ideas and energy.

When possible, the website shows how Texas Children’s compares to other children’s hospitals in the United States in these categories. Where no good comparisons are available, the website illustrates how Texas Children’s compares to our own performance in the past, and how we measure up to our own goals.

Some of the topics and data reported include: hand-hygiene compliance, catheter associated blood stream infections, surgical site infections, death and complications within 30 days of surgery, patient experience, third next available appointment, patients leaving emergency care and transfer denials. Additional measures will be added over time.

For each measure, information is provided that lays out what parents can do to help Texas Children’s deliver the highest quality pediatric care. The website also includes links to our health system’s evidence-based guidelines. A distinctive feature of the website is an email address for readers who want to provide input on what additional information they would like to know and ways we can improve our website.

“We invite you to check out how we are doing and to share our outcomes with patients and their families,” Shook said. “We believe our patients and families deserve the most complete and accurate information possible about how we are doing as a health care system.”

Texas Children’s Pavilion for Women also has launched a safety and outcomes website. Click here for more information.

February 28, 2017

Dr. Laura Monson, co-director of the Craniofacial/Craniosynostosis Clinic, was recently appointed Chief Surgical Quality and Safety Officer for Texas Children’s Hospital.

Monson was selected for the position after a thorough nationwide search and will succeed neurosurgeon Dr. Tom Luerssen, who has been the voice of surgery within Quality Operations Management at Texas Children’s driving surgical quality efforts at the hospital and throughout the system.

Among the many quality projects Luerssen was instrumental in establishing during his tenure are the OR-specific Surgical Checklist and the Surgical Quality Committee. Luerssen also was essential to the success of the hospital’s American College of Surgeons Level 1 Children’s Surgery Center Verification.

Surgeon-in-Chief Dr. Charles D. Fraser and Senior Vice President/Chief Quality Officer Dr. Angelo Giardino said Monson distinguished herself in the selection process as having just the right vision and passion to lead the Texas Children’s surgical quality program into the future.

“Dr. Monson has demonstrated a remarkable commitment to improving the quality of care and quality of life for her patients as evidenced by her many cleft lip and palate and craniofacial research programs,” Fraser and Giardino said. “She is continually educating herself on quality improvement and has been an internal champion for it within the Department of Surgery.”

Monson will begin her new role on Wednesday, March 1. Click here for more information about Monson and her clinic experience and interests.

October 4, 2016

10516qualityday640On September 16, more than 50 projects were featured at the 2016 Texas Children’s Quality Day event, “Leading Tirelessly, Always Improving: Celebrating Quality, Safety, and Process Improvement Innovations at Texas Children’s and Advanced Quality Improvement (AQI) 14 Graduation.”

Held at Texas Children’s Pavilion for Women Conference Center, this special day was organized by the Quality Education Team and other Texas Children’s quality leaders. The event included presentations on exciting improvement initiatives implemented by the graduates of the AQI 14 class and showcased the many improvement projects/programs developed by staff and leaders across the organization.

“I am truly amazed and inspired to work with such a talented organization,” said Dana Danaher, director of Quality Education, Collaboratives and Advocacy at Texas Children’s. “I am privileged to facilitate building ongoing improvement capability for long-term sustainability.”

Chief Quality Officer Angelo Giardino kicked off the event with an inspirational keynote to the audience of more than 80 attendees. In recognition of the Daily Operational Briefing (DOB), a culture-changing safety practice adopted by Texas Children’s in November 2015, he presented a special quality award to Dr. Lane Donnelly, Dr. Joan Shook and recently retired Texas Children’s COO Randy Wright for their leadership in supporting the implementation of the DOB.

Following this motivational opening, the recent graduates of the AQI program presented their projects. Examples of some of the improvements discussed included:

  • MyChart activation
  • Discharge readiness
  • Improving isolation compliance
  • Postpartum depression screening
  • Reduction of medication re-dispenses

With more than 400 AQI graduates trained over the seven years that Texas Children’s has offered this valuable education, Giardino says Texas Children’s has great capacity to continue leading tirelessly to improve quality.

“The privilege of getting this training comes with a responsibility to use this new knowledge and the skills to do quality improvements to make things better for the women and children that we seek to serve,” Giardino said.

August 9, 2016

81016qualityposter640Have you implemented a quality improvement project in the last 18 to 24 months that aims to significantly improve patient outcomes and safety, operational processes, patient experiences, and/or organizational systems at Texas Children’s? If your project has implemented at least one round/PDSA cycle of improvement, please consider sharing your work at this year’s Quality Day.

Below are important dates to keep in mind for employees interested in submitting a poster:

  • Deadline for intent to submit poster: Monday, August 15.
  • Participant notification of acceptance: Tuesday, August 23
  • Deadline for poster submission for printing: Thursday, September 1.

The selected posters will be presented during poster sessions at the 2016 Texas Children’s Hospital Quality Day on Friday, September 16 at the Pavilion for Women Conference Center. The theme this year is “Leading Tirelessly: Always Improving.”

Organized by Texas Children’s Quality Education Team, Quality Day will showcase the exciting improvement initiatives implemented by the graduates of the Advanced Quality Improvement 14 class as well as spotlight other projects developed by staff and leaders across the organization that are aimed at improving outcomes and processes.

For questions regarding the Quality Day Call for Posters, contact Dana Danaher at Ext.4-2160. Be sure to click on the flyer to get more details on poster requirements.