Cook Children

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Customer-centered care is a goal for all medical service providers. “The customer comes first.”  “The customer’s always right.”  No matter which phrase you use, they all apply in the health care market.

When the customers are children, the message doesn’t change; it’s just altered for the audience.  That’s how Cook Children’s Health Care System addresses its patients and their families, with a one-statement promise that is understood

“Knowing that every child’s life is sacred, it is the promise of Cook Children’s to improve the health of every child in our region through the prevention and treatment of illness, disease and injury,” said CEO Rick Merrill.  “Since we’re a children’s hospital, we wanted to do something that meant something to everyone we serve.”

Cook Children’s Health Care System, with about $1 billion in assets, is the coordinating arm for a number of companies, including a 300-bed acute care children’s facility that handles more than 1 million patient encounters annually.  Two physician joint ventures exist within the system – a surgery center in Plano, Texas and a hospital in Hurst, Texas.  The system also operates a health plan, a home healthcare entity, and a physician network that employs more than 350 physicians, nurse practitioners and physicians’ assistants.  In all, the system carries a total of 500 staff physicians.

While the system’s primary service area is Tarrant County, in which Fort Worth is located, it also serves the five contiguous counties

2020 Program

In keeping with the system’s promise to improve children’s health in the region, Cook Children’s launched an initiative called “Every Child 2020.”  The goal of this initiative, Merrill said, is to improve the health of children in the system’s six-county service area so that by the year 2020 Fort Worth and its surrounding area would be known as one of the healthiest places in the nation to raise children.  Priorities for this initiative are being developed by gathering 9,000 comprehensive children’s health surveys. It’s a unique approach to identifying children’s health needs and implementing solutions.

“What we wanted to find was what are the top health issues, where do those issues exist, why do they exist and what can we do to help those children,” he said.  “Those areas that we identify and prioritize will be the areas that we will work on in the Every Child 2020 initiative.”

Merrill expects that Cook Children’s will join forces with a number of community organizations as they move toward the 2020 goal. A key component of this initiative is the system’s neighborhood clinics, which focuses on caring for children that might otherwise be overlooked. Cook Children’s opened the clinics for children with limited access to primary care. The neighborhood clinics provide full-time walk-in access to high-quality providers, additional services include health education, nutritional education, dental health and behavioral health.

Financial Stability and Capital Expenses

The presence of a large natural gas reserve called the Barnett Shale brings Fort Worth some economic stability during the current economic downturn.  With a healthy economic environment and prudent spending, Cook Children’s has significant reserves. Considering a potential market turn around in the next 12-18 months and some interim financing from local banks, this is an optimum time for the system to proceed with the launching of a $250 million, three-year expansion project at its main campus.

“If we are true to our promise and true to fulfilling Every Child 2020 then we need to make sure that we have room to accommodate the growing demand facing our organization.”

Phase one of the expansion project includes a patient care tower at the main campus that will add about 150 beds and an adjacent parking garage. The new patient care tower includes neo-natal intensive care beds, pediatric intensive care beds and medical-surgical beds.  Phase II includes construction of a new medical office building will triple the size of the existing space. Included in Phase II is the renovation of existing space, such as the operating rooms and the laboratory.

Staff Strategy

Merrill believes his job is to set the strategy and direction for Cook Children’s, then hire competent people who can do their jobs without upper management interference.

“I really think this approach drives better performance and people take a lot more pride in their efforts,” he said.

Cook Children’s is unique in that 40 percent of its board members are physicians.  This places physicians in the position of helping to make decisions about strategy and operations within the organization.  While this arrangement may be intimidating to some, Merrill said this is a dynamic that works well because of the type of physicians who have come to Cook Children’s.

“These are some of the brightest, most gracious physicians I’ve ever worked with,” he said.  “They understand what we’re trying to do with our promise and Every Child 2020.  We all move together in lockstep to accomplish great things.”

Focus on Quality

Cook Children’s has a board-level focus on quality and safety that stems from the system’s collegial atmosphere.  The first move in that direction is the creation of dashboards specific to quality, then to look at how the system compares with its peers, and then ultimately to become one of the best in every one of these categories.

“My dream is to one day have one of the safest hospitals in the entire country – that would be a wonderful legacy to leave,” Merrill said.

Management Philosophy

The unique aspects of a children’s hospital maintain this CEO’s passion for his job.  Upon his arrival at Cook Children’s 18 months ago, Merrill went through the organization asking physicians and other employees “What are we doing really well?” and “If I can fix one thing for you what would that be?”

“From a leadership perspective, we continue to support those things that we do very well,” Merrill said.   “You learn a lot when you spend time out in the organization and those questions.”

Goals for the Future

With the Every Child 2020 initiative and expansion plans under way, Merrill believes that Cook Children’s is positioned to achieve some remarkable things in the years ahead.  The greatest deterrent to achieving that success will be to rest on our laurels, he said.

“We’re only going to settle for what’s best and what can truly allow us to achieve greatness as an organization,” he said.  “There is really nothing that can keep us from achieving the great things that we’re setting our sights on for the next 10 years.”

by Kathy Knaub-Hardy

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