On the Road at Cook Children’s Health Care System

On the Road at Cook Children’s Health Care System – October 2023

by Rikki Chadwick

We have reinvigorated our “On the Road” series with a visit to Cook Children’s Health Care System based in Fort Worth, Texas. Knowing every child’s life is sacred, Cook Children’s Promise is to improve the well-being of every child in their care and communities. Consistent with making things better for children, it has developed a rallying cry, or a “Pinky Promise,” that encompasses their Promise in one breath: Everything for the Child. With a motto like that, our excitement for the day was palpable.

The lead-up to our welcome was simple to navigate as we made our way past multiple parking garages, speckled with red and green lights, to alert us if the parking space was open. There are families and medical professionals making their way around the campus, naturally leading up to the drop-off area. We pass by Peaks the Dragon, Cook Children’s official mascot, as we pull right up to the main campus doors. We are waved into a parking bay by a smiling face who offered to assist with valeting our car, a great offering to avoid having to walk a great distance in the beaming Texas sun.

We were greeted by Missy Staben, Director of Experience Elevation, and Tori Valek, Experience Elevation Specialist. We arrived at a colorfully decorated conference room, and surrounding the table were additional members of the team. These included: Megan Chavez, Vice President of Cook Children’s Experience, Jill Koss, Director of Family Support Services, Martin Reidy, Director of Urology and chair of one of their Patient Experience Champion Committees, Vicki Kelley, Director of Family Engagement and Kim Arnold, Manager of space utilization and transition. They were eager to share their stories with us.

Experience at Cook Children’s

“We have been fortunate in that child and family experiences have been a priority for us for well over 15 years starting with a robust Child Life department focused on the emotional experience of receiving pediatric healthcare,” said Missy Staben, our guide for the day. Missy found herself at Cook Children’s 17 years ago and most recently has been part of structuring, implementing and growing its experience efforts. Although experience has always been a priority, it has evolved over time and has fully integrated itself by way of its culture platform, which it uses as a standard for the decisions made throughout the organization.

Experience is being championed from the top, with Megan Chavez leading the team. Megan has over 20 years of experience in healthcare, and she credits the commitment that staff makes daily to keeping experience at the forefront of all they do. When she joined the team in March 2020, experience was already embedded in the culture, she told us. It was her focus to ensure those positive effects permeated throughout their organization.

Patient Experience Champions Leading the Way

The experience infrastructure at Cook Children’s is robust, encompassing patient surveying, the Experience Elevation team, Child Life services, Parents as Partners, volunteers, guest relations, patient relations, and creative therapies (art, facility dogs, recording studio) and more. To create a positive, streamlined experience supportive of staff, patients and families, the medical center created its first Patient Experience Champion (PEC) committee almost ten years ago. This committee emphasizes the value of involving frontline staff in experience improvement efforts. The PEC members serve as role models for the patient and family experience. They participate in monthly meetings where they share best practices, stories, and ideas, and work through improvement projects. From there, the PEC members return and cascade the information throughout their department. Ultimately, they have found committee involvement helps employees reconnect to their ‘why.’

With the success of the initial PEC committee, they saw the need to develop the program further in the ambulatory setting. Three new PEC committees were formed: one for Primary Care and Neighborhood Clinics, one for Specialty Care Clinics, and one for Urgent Care Centers and Multi-Specialty locations. These PEC groups are made up of clinic director chairs, practice manager co-chairs, and frontline staff across the organization. The members have volunteered their time to support the strategic experience efforts in place, a true example of collaboration.

Infrastructure

By looking at experience as a collaborative and joint effort through one lens, the strategy they call “One Experience” allows experience leaders to understand the inter-relationships between what staff are seeing and feeling along with patients and families to support the best in quality and safety on all fronts.

The experience strategy is based on a hierarchy of needs. Awareness is the foundational piece to the triangle, followed by organizational alignment, responsiveness, empowerment, and lastly, the pinnacle, self-actualization. “By having this approach, we’re able to continuously build up and invest in a strong foundation, empower staff and leaders, and give them the tools to feel personally responsible for the experiences we create,” said Megan.

This approach has paid off in allowing Cook Children’s to reach its goals consistently, even through the pandemic. “We never took our foot off of the pedal in prioritizing the human experience no matter how challenging the moment became,” said Megan. “We did not lose ground in our improvements that took years to build and cultivate. This was important to all of us in fueling our ability to keep going and find purpose in our daily efforts, even in the darkest times.”

Each staff member echoed the sentiments of those before them. “The most successful component has been engaging our front-line staff, as well as leaders, as experience champions,” said Missy. Representation from all parts of the care continuum working together on a regular basis ultimately improves experiences for all at this organization.

As a vast health system that includes not only hospitals but home health, medical practices and urgent cares over a wide geography, Cook Children’s has made working together a priority. A leader in Texas pediatric care, the health system has seen great success and impact in its ambulatory practices in defining and implementing a common Cook Children’s experience. They share how their Patient Experience Champions defined this idea together and then created a movement within their individual locations to embody it. “The common experiences place a heavy emphasis on the relationships we have with each other, as people first, outside of our roles in healthcare,” said Tara Allen, Executive Champion for the ambulatory patient experience, with whom we had the opportunity to chat with on the phone after my visit.  It’s a great example of looking at every experience as one human experience.

We were handed some informational pieces that are given to staff to help them understand the importance of the ripple effect of experience and how simply it can be achieved. A card entitled “Ambulatory Experience Bundle” provides four simple steps that not only tell staff why it’s important to elevate experience but also how to achieve it. Having access to this support creates organizational alignment and common core experience standards.

Involving Patients & Families

Though Cook Children’s staff are responsible for carrying out their Promise, they are not remiss of the value of patient involvement and parent feedback. To have an accurate sense of the patient’s experience, they accurately capture first-hand accounts of people’s experiences by way of surveying, advisory councils and other tools. This then allows leadership to share feedback with staff, including physicians, to best inform their decisions and understand how this is impacting the care and well-being of patients.

Jill Koss, the recipient of the 2023 Distinguished Service Award from the Association of Child Life Professionals, knows how important it is to involve the patient in decision-making, both in regard to their care and beyond it. She tells us about the opening of their updated Dodson Specialty Clinics and how integral patient and family engagement was to its success.

The Dodson Specialty Clinic offers more than 35 specialties, with six new services, including a retail pharmacy, Peaks Tech Zone, Maternal Fetal Medicine, a sibling support center, a Cook Children’s retail shop, a café and a new parking garage with more features and benefits to make one’s visit more comfortable and accessible. Throughout Dodson’s expansion, patients and families were involved nearly every step of the way. Patients and families got to walk the building on countless occasions to provide their feedback and suggestions to create the ultimate care experience for all. “The engagement of our families in our 15+ advisory councils and all our Experience Champions, coupled with strong, consistent support from our senior leaders starting with our CEO, has been critical [to our success],” said Megan.

We switch gears now to touring the facility, and we have the opportunity to meet with more staff, including Brienne, one of Cook’s therapy dogs! We pass hallways on the first floor decorated with pieces of art, curated by Jill. Our favorite piece of art was a gigantic Lego hospital display. Missy tells us that Lego built the display to accurately represent every garage, building, playground, and walkway that made up the Cook Children’s Health Care System Main Campus. Built by Lego engineers and flown in from Denmark, no detail was missed, especially not the helicopter pad decorated with miniature helicopters.

Ups & Downs

Though Cook Children’s continues to evolve and sees success in their quest for patient and family-centered care, the road hasn’t always been easy. The realities of the current state of healthcare have created challenges along the way. Since Patient Experience Champions meet regularly to discuss their peaks and valleys, this round table of leaders is truly keyed into the most difficult aspects they face. The most challenging, they say, has been finding balance in an ever-changing landscape of unpredictable patient volumes coupled with a tired workforce. Additionally, the distractions of the pandemic and staffing challenges have created roadblocks that they continue to work through and around.

Throughout our visit, the distinct sense of ownership from the team, from the Vice President of Experience cascading all the way down to the Patient Experience Champions, deeply reflects the organization’s Promise to improve the health of every child. And, of course, to ensure they are doing everything they can to provide safe, healthy communities where families can raise happy, healthy kids.