September 25, 2015 | (3) Comments
MPR1378 US NEWS Ranking By the Numbers
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Here at Texas Children’s Hospital, we talk quite a bit about our U.S.News and World Report ranking and its importance. Each year, approximately 184 freestanding children’s hospitals in the country submit data on 10 pediatric subspecialties. For each of those subspecialties, teams of leaders, clinicians and employees are working together all year long to gather and validate our data, analyze our results as compared to our peers, look at best practices and determine what improvements we need to hard wire into our care processes. And as we begin a new fiscal year, we consider the impact this year’s results will have.

The U.S. News Best Children’s Hospitals rankings measure and cast a spotlight on the quality of our patient care and on our patients’ outcomes. In the 2015-2016 rankings, Texas Children’s Hospital maintained the no. 4 spot in the nation. Let me say that again: no. 4 in the nation. And we were once again listed on the Honor Roll, which recognizes hospitals that rank in the top 10 percent in at least three specialties. We had six services in the top 10 percent, and three achieved the no. 2 ranking in the country.

Now I’ll admit I like to be first as much as anyone, and here at Texas Children’s where we are an organization of high achieving, passionate team members who lead tirelessly day in and day out, it rankles us just a bit that we keep coming in fourth. But let’s explore what being no. 4 in the nation really means.

From a measurement perspective, our survey results demonstrate how hard we’re working as an organization to deliver high quality care to our patients. The more consistently we deliver high quality care and the safer we deliver that care to our patients, the better their outcomes are, and the better our overall numbers are. Our rankings in the 10 subspecialty areas included in the survey are the result of a methodology that weighs outcome and care-related measures, such as nursing care, advanced technology, credentialing, outcomes, best practices, infection prevention, and reputation, among other factors.

And when you consider what’s measured by the survey and our relatively short history as a children’s hospital, you can appreciate what an incredible reflection our no. 4 ranking really is – particularly in comparison with the esteemed institutions that sit at nos. 1, 2 and 3, including Boston Children’s Hospital, founded in 1869; Children’s Hospital of Philadelphia, founded in 1855; and Cincinnati Children’s, founded in 1883.

Think about it. We were founded many decades later in 1954. Yet, here we stand on par with the other preeminent teaching children’s hospitals in the U.S. We debuted on U.S. News’ first honor roll in 2009, alongside these three historic pediatric centers. Today, Texas Children’s is world renowned for our advancements in pediatric subspecialty care.

Our ranking is just one aspect of our incredible trajectory and just one reflection of the many amazing advancements of our clinical programs, our employees, and of the gifted physicians, scientists and clinical staff who serve our patients. In six decades, we’ve done just about as well as any children’s hospital in the United States, maybe even the world.

To some, the survey might still appear to simply be a contest of “popularity.” And for many years, the methodology did indeed focus primarily on hospitals’ reputational scores. But what used to be a contest of popularity, has become a national benchmark survey that heavily scores clinical outcomes, best practices and infection prevention.  These are quality and safety indicators that mean the difference for every patient in our care and drive each of us in our work every day.

So I believe we absolutely should take great pride in being no. 4, but I also believe “just about as well as” is not good enough when we consider the precious lives in our hands. The responsibility is ours – not to figure out how to be no. 1, but to raise our performance bar on quality patient care, on consistency and on overall excellence as an organization.

We must constantly question ourselves and our colleagues about how we can make the care processes better for our patients. Are there certain structures that we should pay attention to? Are there outcomes around which we should drive higher performance? What do our survey results suggest we can do better? And not just for the 10 subspecialties this survey focuses on – we are striving for the same high quality in all 40 of Texas Children’s pediatric subspecialties. Our rankings are a reflection of our actions and our focus. If we keep both on course, the numbers will follow.

Our national ranking is important – but it is not the end game. It is not why we care, why we drive ourselves to constantly do better. Our pursuits and our actions here at Texas Children’s are not for prizes or recognition, but rather for the fulfillment of our mission. We are driven by an intense desire to ensure the best possible outcomes for every child, woman and family who comes hopeful and expectant to our doorstep. And our “prize” is actually in the improved quality of life they’re afforded because we’ve given them our best.


September 14, 2015 | (6) Comments

I’ll admit I don’t cook much. I grill, of course, but I’m smart enough to leave most of the cooking to my wife Shannon, who is phenomenal in the kitchen, especially when she bakes. She’s always turning out something amazing. And she’s one of those cooks who is so good she can improvise with or without a recipe. She tosses in a dash of this, drops in a scoop of that, and it’s perfection every time.

One of my favorite things Shannon makes is chocolate chip cookies. Everyone lucky enough to taste one of the cookies wants to know what she puts in them and how she makes them taste so good. Like most good cooks, Shannon has some “secret” ingredients that make her cookies different and better than the norm. She figured out that using real butter, cream cheese and pure vanilla extract in her recipe makes a superb chocolate chip cookie – a cookie that others want to eat and emulate.

The same thing happens in industry. When you make a departure from the norm, add something special and different, you often end up with a winning combination, a successful structure or business model that others want to emulate. Usually it’s because of a combination of ingredients that are not easily accessed or replicated. Organizations like this have what I call a “secret sauce.”

Here at Texas Children’s we’ve got a lot of secret sauces, and one of the most potent is our shared leadership model, thanks to six very special “ingredients.”


Andropoulos portrait
Dr. Dean B. Andropoulos, Anesthesiologist-in-Chief
Dr. Michael A. Belfort, OB/GYN-in-Chief
George Bisset portrait
Dr. George S. Bisset III, Radiologist-in-Chief
Dr. Charles D. Fraser, Jr., Surgeon-in-Chief
Dr. Mark W. Kline, Physician-in-Chief






2k9-0493-DSC_8453 Dr James Versalovic
Dr. James Versalovic, Pathologist-in-Chief












Before these six medical leadership roles existed, Dr. Ralph Feigin was our sole physician-in-chief, and he and I worked together to lead the organization. Our relationship laid the foundation for the shared leadership model we have today. After Dr. Feign passed away, Dr. Kline became physician-in-chief. And soon after, we established the surgeon-in-chief and ob/gyn-in-chief roles, assumed by Drs. Fraser and Belfort, respectively. Most recently, we rounded out the leadership team with Drs. Andropoulos, Bisset and Versalovic as in-chiefs over our three hospital-based services.

Having these six leaders in their formalized roles has created a distinctive and powerful dynamic at Texas Children’s. All are making enormous strides in developing their divisions to be of the highest quality and caliber and of a standard essential to our continued commitment to excellence. Each of them brings a unique and brilliant perspective to the table, and it is of tremendous value to me, to the executive team and to the organization that we have this clinical leadership team in place.

The strength of our leadership model really shined through a few years ago as we worked through the renewal of our three-year operating agreement with Baylor College of Medicine. Having the in-chiefs at the table was incredibly helpful, each one providing a different guidepost that we needed to make critical decisions related to our academic partnership. I was able to introduce and represent their best thinking and ideas, their divisions’ needs and must-haves and, ultimately, advocate for the things that would ensure the best outcome for the organization.

Our shared leadership model looks very different now than it did in those early days with Dr. Feigin and me. Today, that model cascades to leaders at all levels across Texas Children’s. We embrace and practice collaborative, shared leadership between our administrative and clinical leaders across the organization. Other health care organizations may look like that on paper, but ours demonstrates it daily. We work together at every level, and it’s a true partnership. We make decisions together, not just unilaterally. That’s our secret sauce, and it all starts with the remarkable relationship I’ve been afforded with our six in-chiefs.

You know that my Maxim no. 4 is about having a leadership definition, and you all know that my definition is “Vision + Structure + People, with people by far being the most important element.” The in-chiefs breathe life into that definition. Our shared leadership model demonstrates how we’ve taken a great vision and a really smart, appropriate structure and populated it with incredible people. Each in-chief “ingredient” in our secret sauce is unique, but they all share a common attribute – an intensely focused passion for our one mission at Texas Children’s.

When you’re cooking with this kind of clinical leadership team’s knowledge, experience, focus and investment in our mission, it makes for a pretty enviable secret sauce. And with their help, we are serving up something pretty amazing, every single day.

And about those chocolate chip cookies … Shannon said we could share her recipe with the organization. Now everyone can know the secret to delicious cookies.

Shannon’s Chocolate Chip Cookies


1 cup unsalted real butter (NOT margarine)*

1 T Philadelphia Cream Cheese*

¾ cup white sugar

¾ cup brown sugar

1 tsp high quality vanilla extract*

4 eggs

2¾ cup all-purpose flour (may need to add up to 3 cups)

1 tsp salt

1 tsp baking soda (make sure it is fresh*)

2 cups 100% milk chocolate chips (the large ones if you can find them), NOT semi-sweet; Ghirardelli is my favorite brand.*


  1. Preheat oven to 375 degrees.
  2. Mixing the ingredients by hand is best, but optionally, you can carefully use a Cuisinart with the dough attachment.
  3. Cream together butter, cream cheese, white and brown sugars and vanilla extract.
  4. Beat 4 eggs and add to cream mixture.
  5. In a separate bowl, mix all-purpose flour, salt and baking soda.
  6. Gradually add the dry mixture to the wet.
  7. Gently stir in the chocolate chips.
  8. Drop dough by the spoonful onto un-greased baking sheet.

Bake for 8-10 minutes at 375 degrees. Keep an eye on them due to variances in ovens. Cooking time will also vary depending on the size of spoon used.

For giant cookies, I use an ice cream scoop sprayed with PAM, and the recipe will make about 12 with a slightly longer cooking time.

Remember cookies continue to bake after they are taken from the oven so take them out just before they are the color you want them to be.

 A different twist:  Mark really likes these with chopped up peanut butter cups too!

*Denotes the specific touches that I have found contribute to a superior cookie.