December 22, 2017

I love this time of year – not simply because of the wonderful holiday spirit that surrounds us (although I do enjoy that too!). But I always appreciate the time to reflect on the year we’ve had. And this has been a year that tested our leadership, showcased our culture, and most of all, demonstrated our determination.

If you felt especially busy this year, it was not just a feeling, it is a fact. We had an incredible year that set records across the system, including:

  • 33,659 surgeries
  • 227,985 patient days
  • 126,112 Emergency Center visits
  • 87,242 Urgent Care encounters
  • 438,501 Health Plan members
  • 3.7 million patient encounters

I know this is a really busy time, and we may not even realize the tremendous work we have done as an organization over the past several months. So I want to share a few of the hallmarks of a pretty awesome year.

  • Texas Children’s Hospital The Woodlands – Last Decemb122217OTMEOYsurgery225er, we opened the Outpatient
    Building at Texas Children’s Hospital The Woodlands, and we followed in April with the opening of inpatient services. There was an immediate response from the community. Within the five months remaining in fiscal year 2017, we had 991 admissions, 2,078 surgeries, 5,204 patient days and more than 12,000 EC visits. The families in North Houston were ready and waiting for Texas Children’s Hospital.
  • Texas Children’s Hospital West Campus – Now in our seventh year, we continued to see strong growth and expansion at Texas Children’s Hospital West Campus. In FY2017, we had 3,707 admissions, 6,934 surgeries, 15,004 patient days and more than 43,000 EC visits. And can you believe we now have over 1,000 employees and more than 200 faculty at the West Campus? It’s just amazing.
  • CareFirst – Our CareFirst initiative continues to unfold with our progress on Legacy Tower at our medical center campus. We celebrated our topping out of the tower in February, and we officially named it Legacy Tower in May. We’ve completed the exterior of the tower and the interiors of floors 8-10. Excitement is definitely building as we get closer to the May 2018 phase I opening. Also, as part of our CareFirst initiative, we opened Texas Children’s Mission Control in July. Located on the third floor of Texas Children’s Pavilion for Women, this suite is equipped with state-of-the-art technology and sharp employees from Room Management, Transport Services, Critical Care, Security and Facilities. The opening of Mission Control immediately improved the transfer process of our critically ill patients to and from Texas Children’s. Just months after the opening, we had reduced the time from dispatch to pick-up by 20 critical minutes.
  • Texas Children’s Pavilion for Women – On March 26 we celebrated five years of delivering 122217OTMEOYhappyfive230high quality and comprehensive care to women and newborns. In fiscal year 2017, we had 5,719 births and a 21% transfer rate to our NICU. The results at the Pavilion remind us what a sound strategy it was to move into the obstetrics space, giving us the ability to help secure our NICU volumes and, more importantly, to ensure the best possible outcomes for expectant mothers and their babies.
  • Austin expansion – In May we announced our plans to expand our pediatric and OB/GYN services into Austin, beginning with the opening of a welcome center in January 2018, followed by a Texas Children’s Urgent Care clinic in March 2018 and a Texas Children’s Specialty Care practice in October 2018. Over the next five years, we plan to expand our network in Austin to include four pediatric urgent care clinics, 18 pediatric primary care practices, three pediatric specialty care locations and two maternal-fetal medicine practices.
  • U.S. News rankings – The 2017 U.S. News and World Report Best Children’s Hospital 122217OTMEOYheartcenter225rankings were announced in July, and Texas Children’s shined again. Eight of our pediatric subspecialties ranked in the top 10, and the other two are very close and steadily climbing. Perhaps most exciting this year was that we had another specialty to rise to the very top spot – Texas Children’s was ranked No. 1 in the nation in cardiology and heart surgery.
  • The Promise Campaign – We reached a significant milestone in Promise: The Campaign for Texas Children’s. By the end of September, donors had contributed $408.9 million, pushing the organization ever closer to its $475 million fundraising goal. The amount raised during fiscal year 2017 alone – $124.7 million – is a new annual high for the hospital’s fundraising team.

As much as I have shared above, there are still many more stories of triumph and resilience across Texas Children’s. Take a look at Texas Children’s Health Plan. We had a tough year, but we’re on the right path, and we’re responding to the tremendous needs of the children who depend on access to exceptional heath care. What we’re already seeing as a result of the challenges we faced this year with STAR Kids and in caring for a huge population for medically dependent children is that we’re learning quickly, right sizing appropriately, and we are thinking like a system. That bodes well for the Health Plan, and it makes for a healthier future for all of Texas Children’s.

Last, I would be completely remiss if I didn’t mention Hurricane Harvey. Together, we weathered this historical storm that devastated the Houston area, and together, we came out on the other side of it stronger. The resolve, determination and courage of our staff and employees were inspiring. I was simply in awe of you, and the way you supported each other, our patients and their families. It was a shining moment for us that showcased incredible strength and kindness.

And that was Texas Children’s in 12 months. Wow! It is quite a lot to reflect on and appreciate. With each passing year, we continue to get better and better. We take challenges, and we create opportunities. We encounter problems, and we recalibrate swiftly. And we prove time and again that we are one amazing team.

I’ll see you back here in 2018 for the next chapter of this remarkable story. Until then, happy holidays!

December 18, 2017

Our Radiologist-in-Chief Dr. George Bisset told me something recently that got me thinking. A few weeks ago, Dr. Bisset requested a product demonstration from a vendor. The vendor representative offered to provide the demo over Webex, but Dr. Bisset insisted on a face-to-face presentation. He felt the meeting and the product’s potential impact was important enough that it should be held in person so his team could get a real sense of the product’s use and value.

The representative agreed, and Dr. Bisset scheduled a meeting for the vendor to meet with 15 key stakeholders. Within minutes of starting the meeting, more than half of the attendees were on their phones. And they remained on their phones for most of the presentation. Aside from being an embarrassing display for the organization, the lack of attention to the presenter conveyed that his presence was neither warranted nor appreciated or that some were too busy to give the presenter the attention he deserved.

How many times have you been on the receiving end of this scenario? Or, let’s be honest, are you often the person holding the phone? This is not who we are as an organization, and this is not how we want to represent ourselves or be perceived by others. Our lack of attention shows a lack of consideration for the people we are around. As individuals, spouses, parents and friends, it is important for us, personally, to be engaged in the moments with the people who are important to us. This is important professionally as well, and it speaks to our culture at Texas Children’s.

As Dr. Bisset and I were discussing how the attention to mobile phones has become almost obsessive, he shared this video with me in which the presenter speaks to how this is impacting us – and worse, our children and grandchildren – and the dramatic differences he sees when mobile phones are removed from use in a meeting or other environments.

I shared the video with our leadership team, and received some very interesting feedback. One remark that really struck a chord with the team was when our CFO Weldon Gage quoted Ronald Heifetz, Director of the Center for Public Leadership at the John F. Kennedy School of Government, Harvard University, “Attention is the currency of leadership.” What a powerful thought. Great leaders optimize how they spend their attention. They are skilled at getting others to focus their attention on the right things at the right times.

So I’m challenging you, whether it is with your families or colleagues, to examine how you can make some meaningful changes. Watch the video, and let’s make a commitment to change our habits. Let’s make the effort to really be present in our conversations, activities and meetings. Although we at Texas Children’s are getting better every day, this is an opportunity for us to be a more respectful, fully engaged culture, and that’s worth putting the phone down.

Click here to watch the video mentioned above.

December 11, 2017

One of the most frequent calls I get is from a concerned parent asking for my assistance to get an appointment for their child. On August 1, I held a meeting to discuss patient access and scheduling at Texas Children’s. I heard from each member of my leadership team and was advised that they receive calls for assistance every day. Did you know that we have nearly 100 distinctive sites that schedule patients and approximately 600 FTEs dedicated to this extremely decentralized process? This issue is extremely widespread across our system and it isn’t just A problem at Texas Children’s – it is THE problem at Texas Children’s.

I appointed Dr. Larry Hollier, Associate Surgeon-In-Chief and Richelle Fleischer, Senior Vice President of Revenue Cycle to co-chair a task force to study and make recommendations on how we can significantly enhance the patient scheduling process throughout the Texas Children’s enterprise. That multi-disciplinary task force has been hard at work, and I want to thank them, our nursing and medical staff leadership, and our In-Chiefs for all of their support and hard work. In addition, I know you are all aware that I have made access and patient scheduling a goal for the organization this year.

I’d like to share the thoughts from the mother of one of our Texas Children’s patients. She has a chronically ill child and every time she wants to get an appointment for her child within the Texas Children’s system, she takes a deep breath, says a prayer for her own patience and for that of whomever might be at the other end of the phone at Texas Children’s. She mentally prepares “to go to war.”

This is exactly what many of our families face when they attempt to get their children here to receive the care they need. And those words – “go to war” – those really are the words we heard from a frustrated, yet determined mom simply seeking the best for her child. Sadly, she is not alone. In a recent patient access survey, “frustrated” was the word families most frequently used to describe our scheduling process. Should it be that hard? Should a family already stressed by a health issue be further challenged by our system? No, it should not be that hard.

We are so much better than this, and we can do better. We pride ourselves on being the best at what we do and providing exceptional care. But if our expertise is locked behind a maze of limited availability and complicated processes that vary from service to service, we end up denying care to those who need us most. We can work smarter and more efficiently to do the most basic thing our patients and their families expect of us – we can open the door to our system and make it easier to get inside.

Fortunately for us, we already have the tools and technology in place to more than meet our patient families’ needs. What’s actually more critical to effect the changes we need is a shift in the way we think and a willingness to move out of our comfort zones and to do what’s necessary to make getting here easier for our families. Truly caring for our patients means being attentive to every element of their experience with us. In this case, it means we must change the way we do some things.

A few weeks ago, I emailed you about our FY2018 goals. As an organization, we are focusing on four priorities: Access, Care Coordination, Quality and Finances. In a few weeks, we will be making some changes specifically targeting the access challenges. Although we have leaders working diligently on the issue of access daily, I want everyone at Texas Children’s thinking about this. What can you do to help families get into our door? No one knows our system as well as you do, so when an idea hits you, I want to know … leave me a note below.

Demand for our care and services is ever increasing. The wisest thing we can do to ensure the health and future of Texas Children’s is to maintain the respect and reputation we have earned. Our goal is to exceed our families’ expectations. And being the one amazing team we are, I know we can do this. We must.