Mekka Livingston

Fun Fact: Mekka has been in several commercials for Seattle KOMO Channel 4 News.

Lines of Service: 

• Legal
• Legal Ops and Contract Administration
• Chief Risk Officer
• Enterprise Risk Management
• Insurance
• General Counsel
• Senior Attorney Employee & Benefits
• Senior Attorney
• Compliance
• Talent Management
• CCPN PN Administration

Mekka is the Director of Employee Relations. A native of Seattle, Wash, she attended Morris Brown College, but received her Bachelor of Science in Human Relations from Amberton University. She joined the Cook Children’s family in March 2021, with over 25 years of experience in the healthcare industry.

In her role, Mekka oversees the employee relations team. It is also her responsibility to create and foster a productive, respectful, and legally compliant workplace environment.

Outside of the office, she enjoys spending time with her family and friends.

Denita Fowlkes

Fun Fact: Music is a huge part of Denita's life. She sang the National Anthem and the Black National Anthem at the NBA Milwaukee Bucks games with a group and has opened for major gospel artist Kirk Franklin.

Lines of Service:

• Campus Fac, Supp Services, Admin
• Facilities Maintenance
• Clinical Engineering
• Retail Services
• Starbucks, Food and Nutrition
• Environmental Services, Facilities Campus Appearance

Denita is an Employee Relations Representative. She is from Milwaukee, Wisc. She attended Milwaukee Area Technical College, where she received her associate’s degree in business administration, and Lakeland University, where she received her Bachelor of Business Administration Management with an emphasis in human resources. She has worked in the hospital industry for over 10 years.

In her role as an Employee Relations Representative, Denita provides human resources support and resources to employees and leaders across Cook Children’s. She is responsible for implementing HR programs and processes, ensuring employee compliance with policies and laws, and serving as a resource for employee to ask questions.

Denita believes that what makes Cook Children’s special is the way exceptional care and genuine compassion are combined. She feels blessed to work with an amazing employee relations team that truly embodies care and collaboration. One of her favorite memories has been the Employee Relations HR Pop Ups. She enjoys the opportunity to connect with employees across the organization and put faces to the names we work with every day.

Outside of the office, Denita enjoys spending time with her family and friends. Her family means everything to her, and she is very close with her five siblings. She also enjoys traveling, going to church, and expressing herself through music, whether that is singing or spending time in the studio. Each year, when fall rolls around, you will often find her cheering for the Green Bay Packers.

Heather Jones 

Fun Fact: Heather met her husband, Robbie, on Yahoo Chat. This October they celebrated their 24^th anniversary.

Lines of Service:

• Administration
• Health Foundation
• Foundation
• Major Gifts
• Communications
• Operations
• Philanthropy
• Advancement Services
• National and Regional Fundraising
• Planned Giving
• Education
• Sim Prog and Nurse
• CPE, Media Svc and ELearning
• Academic and Med Education
• Clinical Ed
• Library Services
• Marketing/Digital Marketing
• Team Experience
• Corp Coaching
• PR/Communication/Social Media
• Pastoral Care

Heather is the Manager of Employee Relations. She is from Coffeeville, Kansas. She attended Washburn University in Topeka, Kansas, where she received her bachelor’s degree in communication/public relations. She joined the Cook Children’s family in 2014.

In her role as Manager of Employee Relations, Heather oversees a team of five, which acts as a resource for employees and leaders across Cook Children’s. She is responsible for managing HR programs and processes, making sure policies and laws are enforced, and fostering a positive work environment.

Heather loves how everyone at Cook Children’s has a part in the pinky promise. Over the last few years, she realized that even though she does not work with patients directly, she supports the people who work directly with patients, and that is how she makes sure every child is taken care of. When Jones first started at Cook Children’s, she remembers being near Camelot Court when she ran into Santa Claus. Getting to run into Santa Claus in July made her realize how special Cook Children’s is.

Outside of the office, Heather loves to spend time with her family and her dogs. She has two senior beagles. She has also fostered 20 beagles. 

Jordan Baker

Fun Fact: Jordan’s wedding was featured in a magazine.

Lines of Service:

• Business Development
• Reg Strat Partner/Business Development
• Business Development, Home Health
• CCPN Finance
• Physician Compensation (CCPN)
• Primary/Specialty Services
• Neurology
• Multi-Specialty Clinics
• UCC- Plano, Allen, Frisco, Prosper, Aubrey, Celina, Little Elm, McKinney, Denton, Carrolton, Lewisville, Prosper, Lake Forest, Flower Mound, Highland Village, Collin County
• Practice Operations Administration
• Neighborhood Clinics
• Primary/Specialty Services Admin
• Orthopedics Practice Operations
• Operations RN
• Physician and Provider Recruitment
• Practice Operations Lubbock Gastro
• Urgent Care Clinics
• Primary Care Clinics

Jordan is a People Resource Manager and is originally from Chagrin Falls, Ohio. She attended Westminster College in Pennsylvania where she received her Bachelors in Business Administration. Jordan holds a Professional in Human Resources Certification, and has many years of experience, specifically, in healthcare Human Resources/Employee Relations.

In her role as People Resource Manager, Jordan acts as an advisor for employees and leaders who have HR related questions. She helps to administer HR processes and programs, and helps to ensure all HR policies and laws are followed.

Jordan believes that what makes Cook Children’s special, is the culture, and our people, working with joyful hearts to support the mission each day knowing that every child’s life is sacred. Her favorite memory thus far has been getting to know her team better and assisting her clients.

Outside of the office, Jordan enjoys spending time with her husband, CJ, and their son, Axe. She describes herself as a thrill seeker (think swimming with sharks and no cage!). She also enjoys shopping, interior decorating, traveling and reading her bible.

Tonyel Amie

Fun Fact: Tonyel had a 10-minute, completely random conversation with the one and only Kobe Bryant at an All-Star basketball game. It was a true once-in-a-lifetime moment.

Lines of Service:

• Construction/Real Estate
• Plan/Design/Construction
• Facilities Mgmt
• Real Estate
• System Effectiveness/PI
• Process Improvement
• Materials Management, Supply Chain
• Supply Chain- Logistics/Ops
• Supply Chain- Purchase/Vat
• Chief Nursing CNO
• Neurosciences
• Trauma Program
• Magnet Program
• Psychology
• Psychiatric Svcs
• Nsg Rsrch, EB Practice
• Operations, Administration
• Child Study Center
• Security Services
• Clinical Nutrition
• Emergency Management
• Manager- Call Center
• Global Health Services

Tonyel is a Senior Employee Relations Representative. Tonyel is a Fort Worth native. She attended Prairie View A&M University, where she studied sociology and social work. She later attended Western Governors University, where she received her MBA. Tonyel joined the Cook Children’s family in March 2025, after more than 10 years in the human resources field.

In her role as Senior Employee Relations Representative, Tonyel acts as a resource to those within the organization who have HR related questions. She implements HR programs and processes, enforcing policies and laws related to compliance, and works with leadership to create a positive work environment.

When she came to Cook Children’s she noticed a lot of people have great longevity here. She feels that that is what makes Cook Children’s such a special place, knowing that people are deeply invested in keeping the pinky promise and a heart for improving the health of every child. One of her favorite memories thus far has been the team outing to the Fort Worth Botanic Garden. She loved the comradery she was able to form in such a small amount of time.

Outside of the office, Tonyel enjoys spending quality time with her family and friends. She views her role at Cook Children’s as a great opportunity that she wants to continue to grow with personally and professionally.

Patience Ballard

Fun Fact: Patience recently found her love of hiking on a trip to Las Vegas.

Lines of Service:

• Administration
• Budget and Financial Planning
• Financial Reporting, Reim, Contracts, 340B
• Finance Govt Programs
• Reimbursements
• Finance CCMC
• Finance CCMCP
• System Finance, A/P, Payroll
• Payroll Services
• Accounts Payable
• Operations, Administration
• Rehab Svcs
• Clinical Performing Arts
• Admin Laboratory
• Radiology Svcs
• Pharmacy Administration
• Pharmacy
• CBO
• Revenue Cycle (PFS)
• Revenue Cycle (PFS-SBO)
• Revenue Cycle (PFS-Int)
• Patient Access Services
• CBO/PT Financial Services Revenue Cycle

Patience is a Senior Employee Relations Representative. She is from Odessa, Texas. Patience attended Strayer University, where she received both her bachelor’s and master’s in human resources. She joined the Cook Children’s family in September 2021.

In her role as Senior Employee Relations Representative, Patience provides human resources support to employees and leaders across the organization. It is job to apply HR programs and processes throughout Cook Children’s. She is also responsible for making sure all compliance policies are followed, providing answers to employees with HR related questions, and fostering a positive work environment.

Patience has seen Cook Children’s from the view of a patient parent and from the view of an employee.  Her son was born at 26 weeks and weighed a pound and a half. He was taken to Cook Children’s for surgery. Her daughter was also a patient at Cook Children’s when she needed an emergency appendectomy. Both times, her family had great experiences as patients, she says. She believes that what makes Cook Children’s special is all the behind the scenes never bleeds over into patient care, the child is the sole focus.

Outside of the office, Patience enjoys spending time with her family and friends. She has also found a love of hiking and being out in nature.

Christine Taylor

Fun Fact: Christine studied abroad in Germany.

Lines of Service:

• Nursing and Patient Service, Admin
• Emergency Services
• NICU
• Transport Ems/Communications
• Respiratory Care
• Nursing Administration
• PICU, TCU/RCU, 4P/EMU
• H/O Center
• Cardiology
• Anesthesia Services
• Surgery, SPD, Dodson, SPA
• Med-Surg-3P/N/S, 4N/S
• HH
• Dir Reimbursement HH
• Dir Finance HH
• CCHH
• HH Nurs/Edu/Compliance
• HH Med Del/Supply Svc.
• HH Business Operations
• HH Pharmacy and Clinical Ops.

Christine is a Senior Employee Relations Representative. A native of Sherman, Texas, she earned her bachelor’s degree in business management from Midwestern State University. She joined the Cook Children’s family in June 2016. 

In her role as Senior Employee Relations Representative, Christine acts as a resource to employees who may have questions relating to employee relations. Her responsibilities include, implementing HR programs and processes, making sure compliance policies and laws are followed, and fostering a positive work environment.

Christine believes what makes Cook Children’s special is the mission and knowing that even though she is not directly working with patients, she can impact their situation in some capacity. Knowing that is what keeps her going. Her favorite memory was getting to see a Christmas tree being installed at the Ronald McDonald house. She was able the view the progress through her office window. She also enjoys seeing the holiday spirit visible on campus.

Outside of the office, Christine enjoys spending time with her family. She has also recently gotten back into crochet and sewing.  

Nicole Roberson

Fun Fact: Nicole has conducted a TED Talk titled, “Leaders: Your Chain is Only as Strong as Its Weakest Links.”

Lines of Service:

• Cook Children’s Experience, Admin
• Patient Relations
• Family Sup Svcs/Child Life
• Experience Elevation
• Family Engagement
• Research
• Neurosciences
• Information Systems
• Chief Info Security Officer
• Chief Technology Officer
• Identity, Access/Risk Management
• Chief Clin Into Officer
• Ambulatory Clinical Apps
• Clinical Informatics
• Inpatient Clinical Apps
• Departmental Applications
• Chief Data and Analytics Officer
• Platform Services
• Analytics Institute
• Revenue Cycle and Ent Apps
• HP Applications
• Business Applications
• Revenue Cycle Applications
• Digital Experience
• Digital Technology, IS Administration
• Information Systems/CTO
• IT Operations
• IT Service Management
• Program Management Office
• IT Technology Service
• Case Management, Quality
• Dir. Physician Health Equity Integration
• Quality and Patient Safety
• Accreditation Compliance
• Clinical Collaboration
• Infection Prevention/Control
• Case Management
• Language Services
• Social Work Case Management
• RN Case Management
• Accreditation/HIM/Inf Ctrl/Credentialing
• HIM
• HIM Coding
• Ambulatory Quality
• Quality Performance Improvement
• System Credentialing
• Clinical Risk Management

Nicole is a People Resource Manager and she is from Dallas, Texas. She attended Keller Graduate School, where she received her master’s in human resource management and the American Graduate School of International Management (Thunderbird) where she received her MBA. She also attended Regent University, where she received her doctorate in organizational leadership. Nicole has worked in the industry for over 15 years.

In her role as People Resource Manager, Nicole acts as a support system for employees and leaders across the organization. She is responsible for administering HR programs and processes, making sure compliance policies and laws are followed, and promote a positive work environment.

Nicole believes that what makes Cook Children’s special is its dedication to helping and serving children. On her first day, she found a welcome package on her desk, and having lunch with the HR Department made her feel so welcomed and cared for.

Outside of the office, Nicole enjoys spending time with her family, watching movies, and eating at great restaurants. You can often find her in the backyard tending to her garden.

HR Business Partners

Marian Frymire

Service line: 
All Clinical Departments

Fun Fact: Marian is an avid volunteer. She is board member at Lighthouse for the Blind, a former board member at Clayton Youth Enrichment, member of Leadership Fort Worth, and Member of the Board of Examiners for Quality Texas Foundation for Performance Excellence. She is also in her 28^th year of volunteering for the Van Cliburn International Piano Competition, and currently serves as co-chair of the Logistics Committee.

Marian is a Human Resource Business Partner, with over 20 years of human resource experience. Marian is a Fort Worth native. She attended the University of North Texas, where she received her Bachelor of Arts degree in Radio/TV/Film and her master’s in instruction, technology, and cognitive psychology. She joined Cook Children’s in 2016 as a contractor and then in 2017 as a full-time employee.

In her role as a Human Resource Business Partner, Marian bridges the HR department and the business side of Cook Children’s. She is a member of the business units and her responsibilities include partnering with leadership to discuss talent planning, succession, structure of the organization. She also analyzes workforce data to identify trends and find solutions for any problems the data presents. In addition to that, Marian is also coaches’ leadership on performance management and employee development.

Marian believes that what makes Cook Children’s special is the employee’s dedication to serving the children in all of our communities. This dedication is never wavering and makes an impact on the communities Cook Children’s serves. Her favorite memories at Cook Children’s are from the engagement events like Hoopla, Jingle Mingle, Employee Cook Out and other department celebrations. She loves seeing the employees laughing, connecting and enjoying themselves.

Outside of the office, Marian loves to travel and has visited five countries in Europe in the last year and a half. She also enjoys spending time with her three grown children and five grandchildren.

Dana Hardgraves

Fun Fact: Dana lived in Japan for three and a half years.

Lines of Service: All Non-clinical/Corporate Departments

Dana is a Human Resource Business Partner and is a Fort Worth native. She attended Grand Canyon University, where she received her bachelor’s degree in healthcare administration, and later attended Western Governors University, where she received a master’s degree in management and leadership. She joined the Cook Children’s family in July 2024 and has over 10 years in the HR industry.

In her role as a Human Resource Business Partner, she connects the HR and business operations. Dana is in direct contact with the business side of Cook Children’s, helping to promote organization within the business units and align HR strategies with the goals of the business units. Some of her responsibilities include, partnering with leadership, designing organizational structures, analyzing workforce data, coaching managers, and leading important planning discussions.  

Dana believes what makes Cook Children’s special is how involved the hospital is within the community. When her son was a week old, he became very sick. He was admitted to Cook Children’s for two weeks. Seeing how all of the doctors and nurses cared for her tiny baby showed her the compassion from everyone at Cook Children’s, and she says those doctors and nurses saved her son’s life.

Outside of the office, Dana is a devoted sports mom. You can often find her at the baseball field or track watching her son. She also enjoys traveling, planting, crafting and cooking. One of her favorite things to do with her son is trying new dessert spots she found on TikTok.

The goal of Well-being Month was to promote the importance of self-care and connect you to the programs, benefits, and resources to help you thrive at work and home. 

Didn’t get a chance to participate in August? Here’s everything you need to know!  

Well-being Month Highlights

Supporting you to thrive at work and home:  

• Well-being Month 2024 Kick-off: Video messages from Rick W. Merrill, President & CEO, and Kristin Burrow, Chaplain of Well-being, on the importance of taking care of ourselves plus links to self-care resources
• Well-being Month 2024 Update: Video message from Melodie Davis & Lisa Farmer, Nursing Clinical Directors, on the Power of Connection and how teamwork and peer connection can boost your well-being plus tips on how to build connection with colleagues and friends
• Well-Bingo – Click here for winners 
• Beat the Heat Treat - Click here to see photos from event
• Visit Healthy Me learn about all the programs Cook Children’s offers to support your well-being.
• Sign up for the Virgin Pulse app to take part in fun fitness challenges, earn points for rewards and keep track of important health and wellness goals.
• Visit ULearn to sign up for upcoming self-care classes: Vitamin B (mindfulness), Vitamin Z (sleep) and Health & Stress Management
• Well-being Insights for Leaders – Click here to see the month’s posts on our Leadership Coaching CookNet page.
• Ways to connect at Cook Children’s: Did you know that connections with colleagues can support a positive work environment and boost your well-being?

Here are a number of ways to connect with your colleagues. Click the links to learn more.

Cook Children’s Cycling Crew: Join the Cycling Crew for weekly rides with cyclists of all experience levels. Their page has more information on future rides, charity rides and how to get the “official” Cook Children’s cycling jersey.

Employee Cares Champion: Partner with the Foundation and your colleagues to support giving initiatives that fund special programs and innovative projects benefiting our patients and families.

Employee Resource Groups (ERG’s): Make connections and build community through an employee resource group. Cook Children’s has four ERG groups – visit this page to learn more about each.

Blue Castle Collaborators – Toastmasters Group: Gain communication and leadership skills in a nurturing environment with your coworkers at bi-monthly virtual meetings.

Employee Volunteers: Learn about ways to connect with patients, families and colleagues through meaningful volunteer opportunities at Cook Children’s.

Patient Experience Champions (PECS): PECS work together as a group and with their teams to elevate the patient experience at Cook Children’s.

Zero Harm Coaches: Join coworkers who are passionate about continuous learning and educating their peers on safety and quality best practices.

Walking Groups: Meet up at the Wellness Zone on the Fort Worth campus to connect with coworkers while getting some exercise and fresh air. Options: Tuesday and Friday at 7 a.m.; daily at 10:30 a.m. and 12:35 p.m. The walks are approximately 30 minutes long. Not on the Fort Worth campus? Start a walking group at your location!

Virtual Energy Breaks: Join your colleagues for a virtual break to add 10 minutes of movement to your day! Email wellnesszone@cookchildrens.org to get the Zoom invitation to add to your calendar. Virtual energy breaks are scheduled Monday through Friday with morning and afternoon options.

eCards: Send an eCard to a colleague to recognize their work or to let them know you’re thinking about them. There are ten different categories and more than 40 cards to choose from including “happy birthday”, “congrats”, “thank you” and “welcome”.

That’s a wrap for this year’s Well-being Month! Have an idea for an activity or topic to cover in next year’s Well-being Month August 2025? Email teamexperience@cookchildrens.org.

It is this experience that has led us to what will hopefully be many Friday Facts contributions on the Cook Children’s Experience. In most health care systems, you may know our group as “Patient Experience.” However, here we are careful to call it the “Cook Children’s Experience” intentionally. Why is that? If we are focused on collaboration, then saying “patient” experience only focuses on one part. Collaboration means multiple parties working together toward a common goal. And that is exactly how our team views the care experience here.

Nationally, next week is a time designated as “Patient Experience Week.” Keeping our definition of this in mind, I hope all of you as my colleagues will take a minute to recognize yourselves, as well as each other, about the amazing care we provide each minute of every day. The work is not not always easy, it is often challenging, but the reward of safer and healthier children, families and coworkers is priceless.

I hope that in this special space of the weekly Friday Facts, we can share our collective best practices, successes and opportunities for improving the care experience of everyone in the health care system: patients, families and staff. I look forward to our continued collaboration and partnership together!

Amit Singh, M.D., on behalf of the entire Cook Children’s Experience Team!

As care providers, we have to be adept at creating connections quickly with human beings from all walks of life during some of the most stressful times of their lives. No matter how intelligent you may be at diagnosing diseases, or how technically proficient you are in the operating room, if you cannot communicate in a way that builds trust to form a therapeutic alliance with a patient or family, then all is lost.

Creating meaningful connections doesn't have to do with certain personality types or being an extrovert; it is a communication skill that can be learned, practiced and honed like any other skill we are taught in our training. One of the most impactful and simple actions to creating connection is to simply just sit down. Finding a way to level the playing field and be at eye-level with a patient and/or family member can not only ease tension and create a calmer environment, but it also minimizes the physical dynamic that standing over someone can create. Moreover, studies have shown that the perception of time spent at the bedside is increased when providers are sitting versus standing^1-3.

So next time you find yourself at the start of a busy clinic or hospital day of patient encounters, try sitting down and seeing how it goes. We'd love to hear if it changes things for you and helps to create meaningful connections with your patients and families.

Amit Singh, M.D., on behalf of the Cook Children's Experience Team

References:

1. Swayden KJ, Anderson KK, Connelly LM,Moran JS, McMahon JK, Arnold PM. Effect of sitting vs. standing on perception of provider time at bedside: a pilot study. Patient Educ Couns. 2012;86(2):166–171
2. Johnson RL, Sadosty AT, Weaver AL, Goyal DG. To sit or not to sit? Ann Emerg Med. 2008;51(2):188–193, 193.e1–193.e2
3. Osborn R, Grossman M, Berkwitt A. The Effect of Sitting Versus Standing on Family Perceptions of Family-Centered Rounds. Hosp Pediatr. 2021 Nov;11(11).

When I meet with families during such a stressful time of hospitalization, I acknowledge and say that “Life doesn’t stop outside of the hospital”. Parents are often under an immense amount of daily life stress regardless of the health of their children. There are demands on their time from their jobs, from their friends and from their communities. Once their child is hospitalized, none of those things stop. It can be hard to juggle being present in the hospital or making clinic appointments or trying to get labs and studies done when necessary.

It is important that we think about this when we sit down to do our documentation when perhaps a patient or family hasn’t been able to follow our prescribed treatment plan. While we have been trained to use language such as “non-compliant”, what else is that language saying? Do we read it as a negative or simply just an objective statement? Does it imply the patient was refusing to follow or blatantly ignoring the plan? That could be true, but it is imperative that we explore the reasons for “non-compliance”. Is it that their pharmacy didn’t stock the formulation or their insurance couldn’t authorize the medication we prescribed? Perhaps they had no transportation to the clinic visit or to the radiology center for imaging?

We should strive to document exactly the reason rather than use a term that implies possible intentional lack of responsibility. There was an interesting study done comparing two different HPI’s for a patient presenting to an emergency department with a sickle-cell anemia related pain episode, one with more stigmatizing language compared to one with more neutral language¹. A total of 413 physicians-in-training were then asked to read these HPIs and complete a survey on their attitudes and thoughts on the hypothetical patient. Not surprisingly, exposure to the stigmatizing language note was associated with more negative attitudes towards the patient.

Thinking about the language we use in the medical record can be a form of reducing bias towards our patients and recognizing how their lives may impact the care we are recommending. For example, changing “non-compliant with medications” to “unable to obtain medications due to pharmacy availability” really can change the context and lessen bias. If we can understand more of our patients’ and families’ personal life and challenges, we can work towards a relationship-centered care model where we can partner with them on care plans that meet them where they are.

1. P Goddu A, O'Conor KJ, Lanzkron S, Saheed MO, Saha S, Peek ME, Haywood C Jr, Beach MC. Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record. J Gen Intern Med. 2018 May;33(5):685-691. doi: 10.1007/s11606-017-4289-2.

Amit Singh, M.D., on behalf of the Cook Children's Experience Team

Parents, guardians and caregivers are some of the most important people we meet when caring for a sick child. We rely on them to provide histories, clinical contexts and continuity for our patients. We have to trust that they are able to care for their children with the care plans we outline. They can be the most trusted person in the room for a child. Moreover, studies in family-centered care have shown that formal involvement of parents and caregivers in a child’s care can lead to improved safety, overall quality of experience and reduced disparities.^1-3

At Cook Children’s we are blessed to have a strong and wonderful group dedicated to parent and caregiver support in our Experience team which we want to highlight this week. Our Family Engagement Department encompasses a wide variety of services starting with our guest relations specialists (primary role is information desk and assistance with parent programming), and our parents on staff who help make up the Family-Centered Care and Parents as Partners programs. We also have many Patient and Family Advisory Councils which are groups of volunteer parents who have children cared for in the Cook Children’s system that play an integral role in advising on everything from simple parent education materials to larger quality improvement, patient safety and research initiatives.

Being in the hospital can be an exhausting experience for most caregivers and as such, our team is dedicated to providing spaces in the hospital for parents to take some personal time away from the bedside for self-care. Some fun programs to share with your families and colleagues include:

Parent Coffee Hour: Wednesdays 10:00-11:00 am in the Family Support Meeting Center and Thursdays from 7:30-8:30 am in the Child Life Zone

• A chance for caregivers to meet, share experiences, receive support and enjoy complimentary coffee and breakfast

Parent Care Cart: volunteer led at intermittent times

• Comfort and care items for parents and caregivers, including journals, coping cards, coloring pages, sleep masks etc., offered by a rounding volunteer Parent Mentor

It is imperative we think of parents and caregivers not only as witnesses to their child’s care, but as actual members of the child’s care team. We encourage you to explore the links above. And we hope the next time you or your group is considering a new initiative or improvement that impacts your patients and families, you will collaborate with the Family Engagement Department to be one of your team members.

References:

1. Gaiser MD, Santos J, Lord T, Venner S, Boguslaw J, Nsiah-Jefferson L. Patient and Family Advisory

Councils: Advancing Culturally Effective Patient-Centered Care. The Institute on Assets and Social Policy. Published 2016. https://heller.brandeis.edu/iere/pdfs/jobs/PFAC.pdf

2. Kuhn KJ, Mickelsen LJ, Morimoto LN, Larson DB. The use of patient and family advisory councils to improve patient experience in radiology. Health Care Policy and Quality, 2016;207: 965-970.

3. Sharma AE, Knox M, Mleczko VL, Olayiwola, JN. The impact of patient advisors on healthcare outcomes: A systematic review. BMC Health Services Research. 2017;17:693.

Helpful Resources:

1. American Academy of Pediatric website on Patient and Family Centered Care: https://www.aap.org/en/practice-management/providing-patient--and-family-centered-care/

2. Institute for Patient and Family-Centered Care. Ipfcc.org. https://www.ipfcc.org/

Having disagreements with patients and caregivers, while it is never fun, is an almost guaranteed occurrence in our line of work. How to handle these situations is not often taught to us overtly in our training but rather learned through a series of our own experiences, some successful and others less so. However, managing that immediate stress reaction of “fight or flight” when faced with this scenario can really make or break our chance for a therapeutic alliance.

The first and probably most important exercise is in acknowledging the difficulty in being a parent. There is much power in simple legitimization. Trying to comprehend the immense number of input streams these days from social media, 24/7 news cycles and plenty of misinformation can be overwhelming as a parent. Saying things like, “I know that being a parent can be hard, and making decisions when you aren’t sure what to do really can be scary…” can go a long way when encountering a family whose ideas differ from ours. This can be a way to open up a conversation when a patient isn’t necessarily on board with what we are saying or know to be true.

Another important aspect of relationship-centered care is asking questions to understand. Our gut instinct may be to start downloading facts/science as to why their decision may not be the “right” one. Instead, asking open ended questions with true curiosity may help elucidate the root cause of their decision making, and open an avenue for changing their mind. Asking questions such as, “In my experience, this treatment plan is usually very successful, so I want to understand some more about what is concerning you. Can you tell me a little more about why you feel that way?” In this way, we can try to put ourselves in our patient’s mind without judgment.

Lastly, focusing on building partnership is key. We don’t have to always agree but the spirit of shared decision-making means that we as health care clinicians do our best to provide the necessary information and options for treatment to allow a patient/family member to make the decision that is right for them. It is important that we create a safe space for them to feel comfortable and vulnerable enough to speak up when they don’t agree or need clarification. Reminding patients and families that their child’s safety is our number one priority, and we know it is theirs too, is important to call out. Statements such as, “I want to work together with you on a plan that you feel comfortable with, and I want to also ensure we are working with your child’s best interest in mind” can show that this is not a “me vs you” discussion but rather a “we” discussion focused on the child’s health. It may not end with the family member choosing what we think is best but, if we have provided the information and the space for appropriate decision-making, ultimately that may be the more attainable final goal.

To be a physician, we spent countless hours studying, learning and honing our craft. We choose to sacrifice portions of our youth (or middle adulthood) all in the name of the pursuit of our ultimate career as healers. So, when we make recommendations and treatment plans with the best of intentions and all of our knowledge behind us, and patients disagree with them or choose to follow an alternative path, this can be a source of frustration. Rather than feeling defeated or angry, if we lean in to where our patients are coming from, take time to understand how they are coming to their decision, and be deliberate in forming a trusting partnership, it may help make it more clear how we can perhaps allay fears or clear misconceptions and ultimately find a care plan that is both safe, effective and trustworthy. 

Amit Singh, M.D., on behalf of the Cook Children’s Experience Team

Helpful resources:

1. Approaches to the Difficult Patient/Parent Encounter – from Pediatrics
2. This Is How To Change Someone’s Mind: 6 Secrets From Research
3. Nursing Service Organization article - When the patient disagrees
4. Texas Medical Association - How to Handle Patient Confrontations

When closing an encounter with a family, we often have multiple things to achieve:  explaining our diagnosis and why we think it is what it is, prescribing a treatment plan, establishing when to follow up or escalate if things aren’t progressing as expected and then of course, answering questions about all of that! Being that it is the end of the encounter, it is also the one that can feel the most rushed. However, this is where lots of miscommunication and confusion can take place for a patient or family. That’s why it behooves us to take special care in how we deliver our information to ensure that the message is truly received and truly understood by the patients and families we serve.

In traditional medicine, this portion of the visit is usually where most of us will do the common “data dump”. For example, a routine visit with a new (but easily treatable problem) like say cellulitis might go something like this:

“I think your child has a cellulitis of their right arm. Cellulitis is a small infection of the skin and soft tissues that can cause the symptoms he is experiencing. We can treat cellulitis pretty easily so I am going to prescribe you some Keflex and he should take it three times a day for the next week. If it doesn’t get better then I want to see him again. Remember to make sure he takes the medicine for the full course otherwise the infection could get worse and he may need to get hospitalized and I wouldn’t want that to happen to him if we can avoid it. Any questions?”

This type of conversation is really a monologue. Moreover, this is where we can be particularly guilty of using medical jargon which further can confuse patients and families. But when we think of relationship-centered care we want to shift this more towards a dialogue where both people are having a conversation. I don’t know about you, but in settings where I am not as educated as the person talking to me, remembering everything they said (say car mechanic listing off all the things they just did on my car and when I need to come back and what to pay attention to for example) can be particularly difficult. Studies have shown that in the typical example given above, patients often don’t retain much of what we tell them (40-80%). In fact, some of the information that is retained is often incorrect.^1,2

So, how can we ameliorate this? How do we turn the monologue into a dialogue? One trick is to employ the use of Ask-Respond-Tell or ART loops.³ This framework and tool helps change our usual data dump into more of a conversation. So for the example above, using ART Loops it could go something more like this:

Provider: “So we’re at the end of our time together, thank you for bringing in your son to get checked out. After talking with you and examining him, I think he has a case of what we call cellulitis (pause then…)ASK#1: Have you ever heard of the term cellulitis before?

Patient: “No I don’t think so?”

RESPOND: “No worries! Not many people would know unless they’ve experienced it so I wouldn’t expect you to know! TELL: I can explain. Cellulitis simply means a mild infection of the skin and some of the tissue below the skin. It’s easily treatable with antibiotics so I am going to write you a prescription for a medication called Keflex today.

Patient: “Ok”

ASK#2: Has your son ever had to take antibiotics before?

Patient: “Not for something like this but for an ear infection once”

RESPOND: “Ah ok got it, yes that is pretty common”. TELL: This antibiotic will need to be taken three times a day for 7 days. ASK #3: Do you foresee any trouble getting him the medication three times a day for the next week?” (and so on and so forth)

With the reframing into ART loops, we’ve now changed the monologue into a dialogue and we are simply having a conversation with our patient about the care plan. Studies have shown that doing this style of communication can improve retention of the information we are providing. Moreover, this style of conversation may uncover impediments to our treatment or follow up plans that we have not have uncovered until later leading to delays in care or unnecessary inbasket messages, patient phone calls, or repeat visits to clinic.

While it may feel like it takes more time to do this, I encourage you try on this style on for size at the end your visits with patients. As a hospitalist, I have shifted to doing this more and I have found that patients and parents have responded well with increased understanding of the plans each day and seem to be more engaged. And this also has led to less pages to return to clarify something simple that was misunderstood if I had employed the usual monologue/download. I would be interested to hear your experiences and thoughts or other tips and tricks for effective communication skills. Please feel free to email me at amit.singh@cookchildrens.org.

Amit Singh, M.D.

On behalf of the Cook Children’s Experience Team

 References

1. Kessels RP. Patients' memory for medical information. J R Soc Med. 2003 May;96(5):219-22. doi: 10.1177/014107680309600504. PMID: 12724430; PMCID: PMC539473.
2. Ley, P. (1989). Improving patients’ understanding, recall, satisfaction and compliance. In: Broome, A.K. (eds) Health Psychology. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-3228-0_5

Chou, C. M. (2017). Skill set three: Delivering diagnoses and treatment plans. In C. M. Chou & L. Cooley (Eds.), Communication Rx: Transforming healthcare through relationship-centered communication (pp. 50–52). McGraw-Hill Education.

Once we become an attending, there is an unspoken rule that we are now magically fit to practice independently in all regards. In medicine however, we’ve committed ourselves to a career that includes life-long learning and improvement; our learning doesn’t stop once training is over. Moreover, we are periodically tested on our clinical knowledge and technical skills in order to maintain board certifications and competencies, but we are often never provided real-time feedback on our “softer” skills like leadership or communication (both patient facing and interprofessional). Should coaching then be a natural part of our career?

It turns out that the data shows, it most definitely should.  Many physicians have experienced positive results from coaching and not only in situations where perhaps coaching was used as remediation or for poor performance (which shouldn’t be the motivation; it should be proactive). Multiple studies have shown that coaching can help with burnout and positively impact physician well-being^1,2. Coaching has even become part of medical training showing positive impacts not only on the students, but on the coaches as well^3,4.

In an excellent and powerful TED talk on this very subject which I encourage you to watch, renown physician and surgeon Dr. Atul Gawande notes, “I think it's not just how good you are now, I think it's how good you're going to be that really matters.” He recounts when he decided to get a coach and how odd and uncomfortable it felt to invite a peer into the operating room with him to provide feedback. At the end of his case, he says that the notes he was given were simple, but powerful. He realized that his peer was able to see things from a perspective he never would have. And that is what excellent coaches do; they can help us understand how we can be a better version of ourselves with simple observation and feedback.

Coaching can be an important addition to our professional development as healthcare providers. Most all professionals performing at the very top of their practice have utilized coaching to continuously improve. If we can create a culture where this is normalized and a standard practice, we can all collectively help each other grow to be even more effective and compassionate at the bedside, and with each other. It is my hope that we can build a provider coaching program here at Cook Children’s similar to many other healthcare enterprises. If you think coaching is something you would like to see or be a part of, we’d love to hear from you.

 Amit Singh, M.D., on behalf of the Cook Children’s Experience Team

References/resources

1.       Dyrbye LN, Shanafelt TD, Gill PR, Satele DV, West CP. Effect of a Professional Coaching Intervention on the Well-being and Distress of Physicians: A Pilot Randomized Clinical Trial. JAMA Intern Med. 2019 Oct 1;179(10):1406-1414. doi: 10.1001/jamainternmed.2019.2425. PMID: 31380892; PMCID: PMC6686971.

2.       Kiser SB, Sterns JD, Lai PY, Horick NK, Palamara K. Physician Coaching by Professionally Trained Peers for Burnout and Well-Being: A Randomized Clinical Trial. JAMA Netw Open. 2024 Apr 1;7(4):e245645. doi: 10.1001/jamanetworkopen.2024.5645. PMID: 38607628; PMCID: PMC11015346.

3.       Hoang K, Grow HM, Rooholamini SN, McPhillips H, Selling SK, Rassbach CE, Blankenburg R. Impact of Longitudinal Coaching on Pediatric Residents' Professional Identity Formation: A Multi-Institution Qualitative Study. Acad Pediatr. 2024 Jul;24(5):866-874. doi: 10.1016/j.acap.2024.04.012. Epub 2024 May 8. PMID: 38729301.

4.       Selling SK, Rooholamini SN, Grow HM, McPhillips H, Hoang K, Blankenburg R, Rassbach C. The Effects of Coaching Pediatric Residents on Faculty Coaches' Relationships, Learning, and Professional Identity Formation. Acad Med. 2023 Mar 1;98(3):376-383. doi: 10.1097/ACM.0000000000005011. Epub 2022 Oct 4. PMID: 36205486.

5.       https://www.ted.com/talks/atul_gawande_want_to_get_great_at_something_get_a_coach?subtitle=en

Depending on your specialty, most of us will have the opportunity to form lifelong relationships with our patients and families. However, there are many times when we meet them for the very first time during perhaps one of the most stressful times of their lives. It is our job to focus and lean into their illness. We are trained to charge forward to diagnose, manage, treat and educate. Often, taking the time to get to know our patients can get lost or seem irrelevant during those times. However, once the initial work is started, taking a moment to ask a question like, “I know we are seeing your child when they are ill and not feeling well but tell me, I’d love to know what they’re like when they don’t have to be sick. What brings your child joy? What makes them smile and laugh?” can really be a powerful tool for connection and treatment.

As a hospitalist, I am uniquely seeing patients when they are very sick and requiring hospitalization. In the midst of treating infections, working up unknown diagnoses, or trying to wean a patient off oxygen, I have found asking this question can really help create a little bit of calm in a sea of stress for families. Parents often really light up hearing their child talk about their favorite cartoon or favorite activity. It has given me an opportunity not only to learn more about the child I am taking care of, but also goes a long way to forming a therapeutic alliance with the family. With a question that takes maybe 10 seconds to ask and another 20 seconds to listen to the answer to, families are shown that we value their child as a human being. As a result of trying to asking this question more regularly, I have been fortunate to meet so many young authors, artists, competitive athletes and musicians. Their abilities often have me in awe of (and a little jealous of) their talents!

In some health systems, patient biographies are integrated directly into their care processes and health records for all to see. The My Life My Story project is an amazing example of how this can be formalized^1,2. As part of this program, Veterans are interviewed about their life story and this interview is written up into a first person narrative. The Veteran then reviews it and, with their permission, it is entered into the healthcare record as a resource for the care team to know more about them a person, in their own words. What a wonderful opportunity to leverage our EMR to foster connection with our patients! Getting to know your patients in a structured and formal way isn’t just good bedside manner either. Studies have shown that not only does it go a long way to fostering compassionate care, but staff surveyed say that reviewing these narratives helped them provide better treatment or care, and helped them make more personalized decisions about the plan of treatment for their patients.

Pediatricians are particularly adept at longitudinal relationships given the length of time we are privileged to see our patients and families. If we can try to be intentional about asking our patients and families directly about what brings them joy, it can really go a long way in fostering relationship-centered care that demonstrates compassion and personalization.

 Resources and References

1.  My Life, My Story | VA Boston Health Care | Veterans Affairs
2. Lam JA, Feingold-Link M, Noguchi J, Quinn A, Chofay D, Cahill K, Rougas S. My Life, My Story: Integrating a Life Story Narrative Component Into Medical Student Curricula. MedEdPORTAL. 2022 Jan 26;18:11211.
3. Nathan S, Woolley AB, Finlay L, Moye J. Teaching Pharmacy Students and Residents Patient-Centered Care Through Interviewing Veterans. Am J Pharm Educ. 2021 Sep;85(8):8384.
4. Roberts TJ, Ringler T, Krahn D, Ahearn E. The My Life, My Story Program: Sustained Impact of Veterans' Personal Narratives on Healthcare Providers 5 Years After Implementation. Health Commun. 2021 Jun;36(7):829-836. 

We sat down with Megan Chavez, Vice President of Cook Children’s Experience, to discuss how the patient family experience department works with teams across the Cook Children’s System to cultivate healthy experiences for patient families and our teams.

Q: Let’s start with the basics; what does “experience” mean in the context of health care?

A: Experience for our patient families is their perception of their health care experience; their emotional journey, the trauma of receiving care, the fear of the unknown, their relationship with the people that are caring for them. The basis of all of that is a trusting human-to-human relationship, and that’s really where we started to understand that the field of experience is fundamental to the practice of health care.

Q: What are some examples of things that contribute to experience?

A: The thing that matters most is their interactions with all of us.  In addition, it’s every touch point, every conversation, every process, technology and the physical environment. 

Even the building itself; it’s really hard for me to feel relaxed in a sterile and very cold environment that’s full of loud noises. If you look in our buildings, you’ll see that there is designed thoughtfulness at every level. There’s small, hidden things on the floor because kids, when they’re nervous, look down. When you look up, there are wonderful paintings above your head. Parents are going to look straight ahead, so we think about what to put at their eye line. We’re trying to do everything we can to tell them “We got you; we’re in this with you.”

Q: The patient and care team relationships are a huge part of the Experience Department’s focus. Why is that?

A: We’ve learned that a patient’s experience impacts their recovery and overall outcome. In the last handful of years, we have started to look at experience as an ecosystem of creating really strong human-to-human relationships in order to create this safe, trusting environment to provide and receive healthcare.

And pediatrics is even more complicated because you’re dealing with a whole family. These moments are often life-defining not just for the patient, but for the entire family. We have to understand what creates strong human connections and what gets in the way of it.

Q: How do you go about analyzing if those connections are happening, both for patients and clinicians?

A: The way we stay really close to the experience and make it part of decision making is through a very comprehensive, continuous listening strategy. We are always getting information and looking for behavior signals from patients and families as well as staff about what they are thinking and feeling—do they feel respected, heard, valued and cared for?

We ask patient families in a survey, “how likely are you to recommend us to a friend or family member?” And this year our goal is 85.7% recommend us highly; that tells us people felt really cared for if they are willing to send their loved ones to us for care. Because everyone plays a part whether you are patient-facing or behind the scenes making those moments possible, we have our CareShare bonus based on this.  We are exceeding that goal fiscal year-to-date at 86.4%, which is phenomenal.  Another way we listen is through our17 family advisory councils and our parents can tell us what is working and what’s not.

We also know that in order to bring our best self to our patients and families, we as individuals have to  be ok and our teams have to be working well together.  Staff working well together is our biggest key driver in creating patient family trust in their care team.  We are getting better and better at connecting the dots between team experience and patient family experiences. We can tell what is working and what’s not from those insights. For example, employees typically stay at Cook Children’s for a long time. People say they feel they have a place here and they are surrounded by like-minded people and we are focused on doing the right thing for patients and families. That’s the magic sauce; people saying, “It's different here, I have a professional home here and I feel like what’s right for the patient guides our decision making.”

Q: Cook Children’s has historically made patient experience a priority. How does this department further that mission?

A: Cook Children has been doing lots of things that are patient family experience-based, we just have now pulled it all together into one department. Cook Children’s has grown so much. We’re so big and our patients are sicker and more complex because we can support them. We have care teams that may be working with another care team that has never met. So, we want to make sure that they still have that same cohesion even though they’re working across lots of geographies and locations.  

Q: What makes your role rewarding for you?

A: Every day you see the best of people. Even when families are coming in and facing this horrible thing and that might not bring out the best in people. But we don’t back off. We can’t stop car accidents from happening, but what I can guarantee you is that we are going to circle that family with love and support and make sure that they have the best next steps that they can have. That’s pretty incredible to be a part of.

By Heather Duge

If the Patient and Family Experience Team could be described in two words, it would be embracing togetherness. Megan Chavez, Vice President of Cook Children’s Experience, oversees strategy and integration points and said the patient experience is part of a larger ecosystem.

“As we grow, we strive to create one experience so no matter where you go it feels like Cook Children’s,” Megan said. “Teamwork is fundamental to who we are and taps into the expertise of all of us.”

“When we say “patient experience,” it’s about the relationship with the patients and families – do they trust us to provide care for them? It is critical to good outcomes,” Megan said.

Vicki Kelley, Director of Family Engagement, takes a different approach to the front desk – it’s the first touch in the relationship with families. 

“Our staff realize that this first connection can help families begin to recognize this is a place they can trust,” Vicki said. 

The staff who work at the information desks take their job seriously to provide a safe, warm and welcoming environment. In addition, her department oversees 16 Family Advisory Councils. The councils partner with the team and share their perspectives with staff in multiple ways to help make patients’ and families’ experiences better. Vicki and her team also plan parent programming such as movie and date nights for the families. The Parents as Partners Program offers opportunities for families who are newly admitted, feeling overwhelmed or with a new diagnosis to be mentored by those who have walked in their shoes.

“Families know that we embrace who they are; they also want to be part of the team to help their child heal,” Vicki said. “They tell us that when someone shows empathy, they stand out. These are important magical moments that stay in the memories of patients and families. Our department is all about positive connections to engage families in their Cook Children’s experience.”

Empathy, connection and communication is the focus for Amit Singh, M.D., Pediatric Hospitalist and Physician Director of Experience on the Patient and Family Experience Team.

“It should be all-encompassing – from the moment our patients walk in the doors to the moment they leave,” Dr. Singh said. 

Dr. Singh helps lend a physician’s voice from the clinical perspective. His diligence in listening to colleagues has led him to meet individually with each of the medical directors to ask questions related to patient care. He hopes to help create a culture change with everyone being mindful of how each interaction impacts patients and families in significant ways.

“I’ve been amazed by how dedicated everyone is at Cook Children’s,” Dr. Singh said. 

Michele Mitchell, Director of Patient Relations, meets with families to address any issues and learn from them. She works with clinical care teams to break down the best way to support families. 

“Our goal is to always keep family-centered protocols in an emotionally safe environment,” Megan said. “We know people can’t pour from an empty cup, so we constantly look to provide staff with what they need to fulfill that. We work in lockstep and protect what makes Cook Children’s so amazing.”

Jill Koss, Director of Family Support Services, has a team that provides programming to support the psychosocial needs and emotional safety of patients and families. Child life specialists and activity coordinators are a big part of her team as well as staff supporting adult and teen volunteers. Jill also oversees summer camps such as Camp Sanguinity for patients with cancer or blood disorder diagnoses. These camps serve as a haven for patients who otherwise would not be able to participate in traditional camps. 

“We know that patients who are old enough want to be included in the decisions being made about their care, and one of the ways we do that is through the Comfort Menu,” Jill said. “The menu gives kids choices and control during a time when they may feel like a lot is out of their control. They can choose a comfort position, to listen to music, to look at a book, how they want to take their medications and more.”

Fear impacts health in significant ways, so patients are also offered a facility dog visit, creative art and music therapy, clown visits and activities in the child life zone. These are just some of the programs provided that support the emotional safety of the patients. 

Missy Staben, Director of Experience Elevation, brainstorms ways to improve through training, processes and technology. Her team manages more than 170 Patient Experience Champions (PECs)– five groups of frontline staff who meet monthly to work on patient experience projects. The team also supports patient survey management and the system Care Share goal.

Stefanie PerryCharles, Site Administrator at Walsh Ranch and co-chair on the UCC Patient Experience Champions, said the parent involvement is what makes Cook Children’s special. 

“We have a parent advocate in every meeting who brings her child to the hospital often and sees many specialties,” Stefanie said. “She advocates and helps us with issues on the outside that we don’t always see and encourages us as we set the standard for improving.”

Transparency is key in all the team does.

Tracie Lawson, a Practice Administrator who has been at Cook Children’s for more than 20 years and a co-chair for the PCP Patient Experience Champions, has a passion for helping the patients’ parents.

“When I get the parents on the phone or talk to them face-to-face, I just want to fix it,” Tracie said. “They can be frazzled, tired and worried and I want to be that person who says we’re here for you.”

Tracie does this by breaking down barriers. She looks at any problem through the eyes of the patient and family and asks how it could be affecting them. 

Tracie and her team are a resource for primary care offices and give staff members a voice to talk through issues.

Sheena Brewer, Practice Manager at the Willow Park clinic, serves as co-chair for the Primary Care Patient Experience Champions group. Sheena and her Patient Experience Champions committee team developed the ambulatory care patient experience bundle which CCPN follows. 

“We are connected as one, and the families feel that,” Sheena said. “The focus on our team is togetherness and taking care of each other at the clinics to give exceptional care to patients and families. We do this by sharing ideas throughout the system and being open and honest in issues we need to fix.”

Sheena said primary care is so important as oftentimes the patients and families come to them first before going to the medical center or refer to a specialty. 

“Building trust with the families is huge so they know we are putting their child first,” Sheena said. “We talk a lot about looking for moments of magic to help patients feel more comfortable. The expectation from as soon as we hire someone is that we treat everyone like family, and we collaborate with the parents, so they feel confident in their care.”

Jill agrees that everyone should be treated like family, and she said it all comes down to kindness. “Kindness to everyone is so important – no matter where a staff member is working or engaging with patients and families.”

Meet the Patient Experience Team

Each day challenge yourself to complete the activity below to elevate the experience. 

Patient Experience Week is April 29- May 3. People caring for people.

Patient Experience Challenges 

April 29                1. Begin your day with a positive affirmation.

April 30                 2. Smile! Smile at others when moving about your day.

May 1                    3. Keep your cell phone in your pocket when walking around or in meetings.

May 2                    4. Send a thank you note or ecard to someone

May 3                    5. Connect with coworkers and patients with a kind greeting and ask what is something they enjoy doing.  

Email patientexperience@cookchildrens.org with examples of the challenge each day. We'll randomly pick a winner for a $25 gift card!

By incorporating these values into daily experience challenges, you can inspire your team to create a more compassionate, collaborative, and respectful healthcare environment. This, in turn, will lead to improved patient satisfaction, better health outcomes, and a more rewarding work experience for everyone involved.

Remember, the small things often make the biggest difference. 

Let's celebrate with our Child Life team as they mark their 45-year anniversary at Cook Children’s. Our dynamic Child Life team can be seen throughout our medical centers in Fort Worth and Prosper, outpatient areas, Emergency Department, and Urgent Care Centers.

“As a Child Life Specialist, I never take for granted the privilege it is to be able to come alongside and support patients and families in some of their most difficult and vulnerable moments," saysTori Thompson, CCLS.  "Through the power of play, preparation, emotional support and more, we work to empower our patients and families to help them feel well equipped to handle the difficulties hospitalization may bring their way.”

The Association of Child Life Professionals says that Certified Child Life Specialists play a critical role in helping children and their families cope with stressful experiences to minimize the effects of stress, anxiety and trauma. Specialists provide preparation, education, distraction, play, and coping tools to promote and protect emotional safety in times of duress.

What Does Child Life Do at Cook Children's?

At Cook Children’s, the Child Life department has 84 employees. Here are some of the services Child Life offers to our patient families:

• Activities and toys for patients and families to engage in while they are in the medical setting.
• Developmentally appropriate teaching about diagnosis, treatments and life changes.
• Opportunities to desensitize and explore real medical equipment through play.
• Preparation for medical exams, procedures and surgeries.
• Assistance with coping strategies, distraction and/or support during stressful events.
• Support to siblings and other family members visiting a patient.
• Celebration of birthdays, milestones, holidays, and essential life experiences.
• A visit to a child's school after a life-altering injury or chronic illness to help classmates understand and make it easier for the patient when returning to classes.
• Developmental assessments and referrals to community resources.
• End-of-life support to patients and families as well as bereavement support for family members.

Who Is Part of Our Child Life Team?

Child Life specialists and activity coordinators are assigned to specific units and collaborate with other members of the child life team. Let us introduce you to them:

• Activity Coordinators provide and facilitate play opportunities for patients.
•  Sit…Stay…Play is our Facility Dog program and we currently have six dogs. Our dogs provide many services including distraction, unconditional love, motivation, social interaction, and emotional support.
• The Child Life Zone is a treatment-free area where we offer games, events, a library, a recording studio, a broadcasting studio, and so much more. 
• Our Creative Arts Program is made up of music therapists, a resident artist, and a drama therapist who provide opportunities for supporting a patient’s autonomy and allowing emotional expression[JB1]  through a variety of artistic media.
• Laughter League is the team of therapeutic medical clowns that provide humor and laughter to help our patients in their healing.
• Our school program includes Fort Worth school district teachers who partner with Cook Children’s to provide school services to hospitalized patients.

How Can I Celebrate and Learn More?

As we celebrate Child Life Week at Cook Children’s, here are some opportunities for staff across the Medical Center-Fort Worth to meet the Child Life team and learn about what they do every day for our patient families:

Visit the Child Life Zone: come experience the Child Life Zone for yourself at a Play & Learn event. This is your chance to play air hockey, explore the library, and learn more about the Child Life department. 11 a.m. to 1 p.m. on Monday, March 18

Facility Dog Visit: come meet and greet one of the Sit…Stay…Play! Facility Dogs and a Child Life Specialist Handler at the time clock in the basement by the South Tower staff elevators. 6:30 a.m. on Tuesday, March 19

Facility Dog Visit: Meet and greet one of the Sit…Stay…Play! Facility Dogs and a Child Life Specialist Handler at the time clock in the basement by the South Tower staff elevators. 6:30 a.m. on Thursday, March 21

Learn more about the Child Life Zone on the Cook Children’s website here: Child Life Zone (cookchildrens.org)

We appreciate our Child Life team and look forward to learning and celebrating with them throughout the week of March 18-22.

Get your costumes, group skits and décor ready and mark your calendars for Oct. 31. The 2023 hybrid Halloween Hoopla events will include a live event at 2:30 p.m. at the Medical Center-Fort Worth. There will also be a virtual costume contest across the system that day. 

Our goal is for all Cook Children’s employees to share magical moments happening from wherever you work. From costumes to skits, Halloween Hoopla truly showcases the creativity in all of us and we invite you to participate and connect with one another. Registration forms for on-campus and virtual costume and skit contests will be available soon.

For more details and guidelines on the contests, please read the Halloween Hoopla 2023 Participant Guide which is located on the upper right side of this page under DOWNLOADS. Find the registration forms there as well. 

All employees are invited to wear costumes Oct. 28 to 31.

We would love to hear about how you plan to celebrate Hoopla at your location. Please email Amy.Smith@cookchildrens.org for support or questions. 

 Dates to know:

10/16 Deadline to record original music with Raymond Turner

10/18 Deadline to submit skit registration forms – Both on site in-person and virtual skits

10/23 Deadline to submit skit music to Raymond Turner

10/31 On-site in-person event – Register for Costume Contest by 1 p.m.

10/31 Deadline to Submit Virtual Skit Video (11:59 p.m.)

10/31 Deadline to submit Individual and Group Costume for Virtual Costume contest (11:59 p.m.)

11/3   Start of employee voting on CookNet

For Halloween Hoopla support or questions, contact Amy.Smith@cookchildrens.org
 

We know. Nobody enjoys getting shots. But we know that the “poke to protect” is imperative to keep ourselves, our families and our patients safer from illnesses such as COVID and flu. That’s why Cook Children’s has a Comfort Menu that caregivers use for pain management with our patients. It includes tools such as cold spray, Buzzy (a device that uses cold and vibration to block pain) and the ShotBlocker distraction device. 

So this flu season, we’re inviting employees to experience the Comfort Menu for themselves when they get their flu shot. That way they will be able to share with patients and families how helpful these items can be in reducing pain and fear around vaccines. 

Comfort Menu items will be available for you to try at several of the onsite employee flu vaccine fairs and leaders can pick up a can of cold spray to use for department-specific events. Find a flier on this initiative at the upper right of this article under Downloads.

Click here for the schedule of more Beat the Heat Sweet Treat events at various Cook Children's locations. 

And don't forget to send us your photos! Email us at InternalCommunications@CookChildrens.org.

Stay cool and have a great rest of the summer!

Join us for fun, connection and a sweet treat to beat the heat in August! Employees at the following locations can enjoy a scoop of their favorite flavor of ice cream on the dates below. Ice cream will be served outside from various vendors.

Off-site Locations/Clinics and 100% Remote Teams

 We’re providing leaders with an Inter-Department Transfer (IDT) amount of $8 per person to create their own summer treat event.  Leaders, find an ice cream or snow cone truck in your area, bring in ice cream, have cookies or other treats catered or sent to your team. You can also come up with a theme, contest, game or activity for your event to add to the fun.

Department leaders will find a date and time that works best for their teams in the month of August. See the attached instructions and IDT form for how to order your treat and submit for reimbursement to your cost center - located under downloads at the top right of this page.

*Please share photos from your event to share with the system to InternalCommunications@cookchildrens.org

Special Offer from Melt Ice Creams

Melt Ice Creams has offered a 10% off discount to all Cook Children’s employees. Throughout the month of August, employees can show their Cook Children’s employee badge at checkout at any Melt location to receive 10% off their purchase. 
Locations: Magnolia, Bishop Arts, Sundance Square, Mule Alley – Stockyards

Create Your Own Cone Raffle

Staff can create their own ice cream cone using our new brand colors by printing out the template located under downloads (top right corner of this page). Take a picture of your creation and send to Amy.Smith@cookchildrens.org by the end of day on Monday, August 31 in order to be entered in the raffle to win a $5 Starbucks gift card. Five winners will be announced in a September edition of the Connect Newsletter.

Dress Up Raffle - Join Us for “Sprinkle Day”

Wear polka dots on the day of your sweet treat event and take a photo of yourself in your “sprinkles” to enter a raffle for your chance to win a $5 Starbucks gift card. Polka dot scrubs, shirts, pants, socks, headbands and other accessories all count as long as they are work appropriate.

Please submit your raffle entry by emailing your photo to Amy.Smith@cookchildrens.org by the end of day on Monday, August 31.  Five winners will be announced in a September edition of the Connect Newsletter.

Consequences of the COVID-19 pandemic, including isolation, long hours and staffing shortages, made smiles seem like they were another victim of supply chain issues at the Richland Hills Neighborhood Clinic (NHC).

In late 2021, the team’s patience for patients and each other became limited at times.

“Their scores on the survey questions about ‘likelihood to recommend’ and ‘clerk/receptionist courtesy’ were not looking strong. I knew we wanted to and could do better,” said Shelly Rosenberry, practice manager at Richland Hills NHC.

To jumpstart a new year in 2022, Rosenberry reached out to Missy Staben, director of Experience Elevation for Cook Children’s Health Care System, to find a fix.

“Shelly came to me and said, ‘I want this group to shine as individuals and as a team,’” Missy said. “She envisioned a project that would lift up each other, in addition to the patients and families.

“Brainstorming for a project that would work for the Richland Hills NHC team started with parameters around the experience for the team and patient, behaviors to increase human connections, positive team recognition, and objective measurement. Additionally, creating a project with frontline staff involvement was crucial to its success.”

When the clinic’s practice administrator, Maricela Ramos, got involved, Missy said it was the first patient experience project involving both the manager and an administrator.

“Our staff was challenged to meet the needs of our patient families and each other, even at our most vulnerable position,” Ramos said. “It was a true testing of the ability to provide excellent customer service amid staff shortages and at times we were not completely successful.”

Designing the Project

Rosenberry wanted the team’s input on her theme idea, which she called ‘Be the reason someone smiles today.’

“[The staff] gave her the input she sought and agreed on activities for improvement and measurements of success,” said Rosenberry. “I displayed a poster with our theme headline in a location where it was visible to the team as they went about their work. They could see how everyone was doing as comments were posted.”

Rosenberry’s team challenged each other to notice when a teammate did or said something that made a teammate or patient/family member smile. The process was to write a note on the poster to the teammate who generated the smiles, then take a flower cutout from the designated jar and place it on the poster for others to notice the new comment.

At the end of the quarter, if the team’s ‘likelihood to recommend’ scores improved by 2-3%, they would celebrate with a pizza party. At the party, managers would reveal the name of the person who received the most comments on the poster. That person’s reward would be a gift basket from the doctors (their idea!) and the privilege of using the Employee of the Month parking spot.  

As a daily reminder of their goals, Rosenberry supplied each person with a sticker of a smiley face and the project’s theme statement, to place near their computer. Another team-building exercise Rosenberry added to her routine is the ‘10-second Start.’ On the mornings that began with a huddle, she included sharing a brief positive comment – a patient family compliment, a motivational quote, or even a team member’s words of gratitude.

Rosenberry admits that in the beginning she had to push the project activities a bit. One day she brought in s’mores for the staff with a note, “Give out s’more smiles today.” Instead of focusing on problems, the team learned to notice what others did to support them and their patients. Building trust and a positive culture takes many little steps that pay off in big ways for patient families and each other.  

What Was The Result?

The team at the Richland Hills NHC smiled their way into improved patient satisfaction. The scores for ‘likelihood to recommend’ increased 3% and those for ‘clerk/receptionist courtesy’ increased 16%. The results have them believing in the power of a positive attitude and intentional encouragement toward others. The Q2 theme has been “Kindness is uplifting. Lift someone up today.” The staff ‘filled up’ balloons with their comments to each other and placed them on the poster. 

Who Won The Prize? 

Oh, do you want to know who received the most comments during the Q1 project? It was Nancy Bruno, medical assistant at Richland Hills NHC; and when Rosenberry announced Nancy’s name, the team ‘exploded.’ It is not surprising, given that Nancy was an early adopter of the program, posting acknowledgments about others on kick-off day.

“I couldn’t believe it. I was happy and excited,” Nancy Bruno said. “Our workplace feels different since we started the project. We work better together as a team and we acknowledge each individual’s hard work.”

How does Nancy think the project has affected the team’s relationships with the clinic’s care providers – the doctors and nurse practitioners?

“It’s improved our being able to communicate better and have fun together. The doctors [also] notice more the work everyone has put in,” she said.

“The team is proud of their success and even more pleased with the amazing experience the process created for them. The story can be a template for the rest of us,” said Shelly Rosenberry.

If you are interested in a project like this one to improve the team and patient experience at your location, reach out to missy.staben@cookchildrens.org or victoria.valek@cookchildrens.org.

In the waiting area, they set up a trifold board where parents can leave a message and/or feedback. Their goal is to fill up the board as much as possible.

There is also a star display of staff and providers each holding up a word or phrase that they feel is important to the patient experience. 

The front office team is also excited to show off their Peaks connect the dot pictures! 

While elevating the experience of frustrated families is the responsibility of every employee of Cook Children’s, it is the entire focus of the Patient Representative team, who transform things gone wrong into opportunities to impress.

The Patient Representative team works with administrators, doctors, nurses, social workers, unit and department managers and medical directors to resolve problems or concerns. Their goal is to ensure patients and families have the most positive experience possible at Cook Children’s. They provide support, clarity and an important bridge that allows patients to focus on getting well. The team provides reassurance to families that the patients’ best interests are our goal.

Studies have shown negative experiences present hospitals with unique opportunities.  Families who believe they have been listened to empathetically after encountering challenges can become more loyal to a hospital than other families who experienced no problems throughout an entire visit.

The Patient Representative team (Reagan White, Lauren Simpson, and Hugo Busane) strive to make such outcomes a reality for families at Cook Children’s, and they want to share ways others can improve patient satisfaction as well.  Walking into a room to try turning frustration into loyalty may feel like a leap into the dark, but it is as easy as Listening, Empathizing, Acknowledging, and Problem Solving (LEAP).

Improving communication is the starting point for promoting patient satisfaction, and nothing works better than making parents feel heard.   Active listening is the key.

Active listening begins when you stop thinking about how you’re going to answer someone while they’re still talking. If you fall into that trap, your attention is on what you intend to say rather than what they are saying.  Clearing your thoughts and looking people in the eye will help them know you are interested in hearing them. As the team says, treat the person before you treat the problem. 

Connect by relating human to human. Once you have really heard what families have to say, you have already done a lot to create an emotional connection.  Connecting with people is the source of real empathy.  Try finding out more about what led up to that moment for this family.  Were they running late?  Having trouble finding where they needed to be?  Try imagining what it would feel like to be in their shoes, and you’re on the road to empathy.

If they believe there was a service failure on our part, acknowledgement and problem solving may be in order.  You do not need to accept blame for what happened, but you should acknowledge their experience, and be empathic.   You may not know what really happened yet, but you can still assure families it will be addressed. If they require further follow-up, connect them with a unit based leader or a Patient Representative.  Together we can effectively collaborate to turn a dissatisfied customer into a satisfied and loyal customer.

Beyond working directly with families having problems in reactive fashion, Patient Representatives are becoming increasingly proactive, rounding when time allows, and visiting families facing challenges before bigger problems emerge.  Alerting your leaders or a Patient Representative early on to a family that might benefit from a visit can help everyone involved.

Patient Representatives are also a resource for staff. They act as crisis intervention responders who develop a plan in conjunction with providers/manager/staff when dealing with upset family members. We also provide guidance to leaders and frontline staff about how to effectively communicate with families. We collaborate with clinical and non-clinical staff to gain that “trust” back from patients and families when a service recovery opportunity presents itself. We all work together with the best intentions for the patient and family to have a good experience. Together we can make sure patients get the best care possible.

Join the Patient Representative team as they work to assure we make the right thing happen for families and children seeking care at Cook Children’s. Let’s all work to elevate each person’s experience.

How did you Connect…Collaborate…Elevate… a patient, family or team experience? 

We have shared some examples below but please share your story by submitting itto patientexperience@cookchildrens.org by Friday, May 6, 2022.*

Three prizes (Target gift card) will be awarded.

Tell us a story of the connection you make with a family.

“I was talking with a mom of one of my patients and we discovered that we went to the same elementary school!  We shared some great memories of the school and our teachers!”

Tell us a story of how you collaborated to provide care.

“I just wanted to shout out Dr. D for being really kind, compassionate to both my wife and our daughter. He really took the time to not only make sure that my daughter was all healthy which she is. Thank goodness, but he really took the time to talk to my wife about just the lifestyle changes and you know, the stress and the postpartum depression that could happen. He really got her in a good head space after we had a rough 4 days in the hospital. So it's great when you see a physician not only take care of the child, but also make sure the family is well taken care of, as well. So just wanted to shout him out and the whole staff, but definitely thank you Dr. D. You have a patient forever.”

Tell us a story of how you elevated the patient, family or team experience.

“The patient was very apprehensive about the blood draw so I explained the Comfort Menu and asked how I could best support the patient and allowed mom to do a comfort position and distract with toys.  I explained what I was going to do and when, and took the time to talk to and be playful with the patient. After hearing about how poorly a lab draw in the doctor's office went last time I wanted to make a better experience this time.”

Cook Children’s Experience Standards

 Connect…Seeing the world through your eyes

• “How are you today?”
• “I love your shoes/socks/etc.”
•  “It is so good to see/talk to you.”

Collaborate…Embracing togetherness

• “What matters most to you?”
• “What do you think about…?”
• “You know your child best.”

Elevate…Finding moments of magic

• “Sounds like we should…”
• “I will walk you there.”
• “We’ve got this!”

Next week is all about the Cook Children’s Experience standards:

Connect-Collaborate-Elevate

If you ordered a PX Experience standards T-shirt, show it off by wearing it this week!!

April 25, Day One 

View the experience standards video to learn about all three standards.  Once you have viewed the video, email patientexperience@cookchildrens.org with “I watched the video” in the subject line.  One lucky staff member will be chosen at random to receive a Target gift card.

Experience Standards (vimeo.com)

April 26, Day Two - Connect

Complete the Peak Connection connect-the-dots puzzle.  Feel free to color Peaks, too!  

Scan and send your completed Peak connections worksheet to patientexperience@cookchildrens.org.  One lucky staff member will be chosen at random to receive a Target gift card.

April 27, Day Three – Collaborate

Collaborate with a friend to complete the work search puzzle.  When finished, scan and send the completed puzzle to patientexperience@cookchildrens.org.  One lucky staff member will be chosen at random to receive a Target gift card.

April 28, Day Four – Elevate 

Reminds us to “Reflect and take the next steps together” so let’s take this literally and join us for a walk.  You are invited to join us on the playground outside of the cafeteria and we'll walk together. Here are the times:

• 9 a.m.: a 15-minute walk
• 10 a.m.: a 1-mile walk
• 11 a.m.: a 30-minute walk
• 1 p.m.: a 1-mile walk
• 2 p.m.: a 15-minute walk
• 3 p.m.: a 30-minute walk

Employees who join us for these steps together will be able to add their names into a drawing for a Target gift card by sending an email to patientexperience@cookchildrens.org. The more walks you participate in, the more times your name goes into the drawing… and you’re taking a healthy break too!

Can’t join us for the walks but want a chance to win the Target gift card? Send a selfie to patientexperience@cookchildrens.org of you taking a walk. Be sure to include your name and contact information in case your name is drawn as a winner for the Target gift card. 

April 29, Day Five – Connect-Collaborate-Elevate story submission.  

Click here for details.

Cook Children’s has expanded our partnership with Press Ganey to now include Patient Experience.  Press Ganey helps health care organizations optimize every patient and family interaction to build connection, trust, and loyalty. 

As your experience improvement partner, Press Ganey remains committed to helping you enhance care delivery by providing reliable tools to capture meaningful feedback and delivering actionable performance insights.

Cook Children’s will launch targeted surveys beginning on April 1, 2022.  The surveys ask foundational questions to focus on what matters to patients and capture targeted data that allow for performance improvement and robust benchmarking. These surveys capture patient feedback on critical components that impact the care experience, including loyalty drivers and focused priority areas.

“Patient experience measurement plays an important role in supporting our organizational priorities and journey toward preeminence,” said Megan Chavez, vice president of Patient and Family Experiences at Cook Children's . “The Press Ganey team has created a thoughtful approach and process that will help you transition and they will work closely with you to ensure that the migration process is seamless.”

The benefits of this partnership include:

• An integrated approach.  Cook Children’s partners with Press Ganey through Workforce Engagement, NDNQI, Member Experience, Consumerism and Patient Experience
• Robust benchmarking capabilities
• True partnership with a dedicated Press Ganey success team
• Advanced reporting that leverages sophisticated analytics
•  Expert library of on-demand improvement resources

By Nancy Cychol,  Chief of Hospital Services

Cook Children’s is filled with wonderful people, like you, who dedicate their lives to helping our patients and families. Whether you schedule appointments, help families work through insurance or billing questions, provide important support services, serve our community or deliver direct patient care, each of you help to turn excellent care into everyday miracles.

We don't just show up for work. We aim to make the health of every child in our community better. That's the Cook Children's Promise. And that’s why I’m writing to you about Employees Care.

 When you give to Employees Care, you make a difference! You can be confident that your donations are directly impacting those you serve. No matter how big or small your donation may be, you create healing through generosity.

We’ve passed the half-way point of our 2022 Employees Care initiative. With a participation goal of 4,000 employees giving back to Employees Care, we’ve already reached 68% of that goal. And there’s still time to give.

I know, with your help, we will reach our goal and the best part is the impact we will each have on the lives of our patients and families.

For more information about the programs you can support or to make your donation to Employees Care, simply click here.

Thank you for joining me and so many of your colleagues in supporting this year’s campaign.

With gratitude,

Nancy

Patient Experience Week is April 25-29 and we have a FREE T-shirt for employees to wear to celebrate. 

Visit the site here to get your T-shirt! The deadline to get your T-shirt is Monday, March 7. 

For your login, type “cookgroup” and then for your password use “boblilly.”  

During Patient Experience Week, you'll also have the opportunity to practice our Experience Standards at Cook Children's. At the end of the week, you'll have the chance to submit your story for prizes about how you implemented Connect, Collaborate and Elevate.  Your story will be shared in internal communications. 

We enjoyed seeing all the pictures and memories from games that you shared with us:

Rachel Reyna, program specialist, Autism Services “Here is a picture of my nieces and I after a Cowboys game this season. GO COWBOYS!!”

Laura Sonefeld (Chicago Bears), Rayne Delgado (Dallas Cowboys) and Steve, Child Life  “A house divided”

Leigh Garrett, principal trainer, EPIC “This is a picture of my husband, Sirrod, and son, Ethan, and myself at the Dec. 23, 2018 Cowboys game. This was the last year they made the playoffs before the 2021-22 season and we got to watch them do it!”

Home Health Support Services team members

Clara Villa, medical receptionist, Midland Specialty Clinic “Go Cowboys!! Reppin' my team today and tomorrow.”

Abigail Hodgson, corporate communications manager, Public Relations “I went 0-3 attending Bears games this season with my dad, mom, sisters and husband… Time for a new year and a new coach!"

Shirley Graham, director, Finance “This is at The Ohio State game a few years ago when they played in Arlington to defeat TCU. Buckeyes fans are the BEST!"

By Anu Partap, M.D.

If you are interested in Quality and Safety, then you love data!  And data is everywhere! Dashboards, publications, meetings, social media, email, even the news (sometimes accurate)!  

When working with data, we routinely look critically - “Is the denominator the right one”?  Or “Did the authors make an analytical mistake with their confidence interval?” 

Health disparity/equity work adds interesting dimensions to data interpretation.  Smaller subpopulations are often included in larger data sets.  Subgroup results can often differ in surprising ways when compared to the data as a whole. 

Health equity analyses asks us to uncover “What hidden pearls are buried in these data when they are stratified/divided into subgroups?” 

Cook Children’s teams are analyzing data for health disparities more and more, both internally and as a national partner with peer hospitals.  Sometimes the answers or “hidden pearls” of information are reassuring; sometimes the findings are concerning, leading us to ask “What do we do now?”

In either direction, looking at data with a health equity lens is gratifying, as it naturally aligns with our Promise to every child.  To help everyone get started on analyzing data for health disparities/equity, below are sample health equity questions you can ask of any (accurate) data from (most) any source to look at subgroups to find “hidden pearls”: 

1.  Are data stratified and provided by:

• Families with different economic resources or insurance plans?
• Patient races/ethnicities?
• Patient ages?
• Patient geographies? 
• Patient/caregiver spoken languages for health care?
• Patient sex, sexual orientation or gender identities?

2)      Do stratified/subgroup data show differences from the whole and against other subgroups?  If yes, why and what do we do next? 

Try one out!  Share what you find!  We’d love to hear from you. anu.partap@cookchildren.org. 

Hello Cook Children’s! And Happy New Year to you all!

I hope you had an enjoyable and peaceful holiday season and found an opportunity to spend time with your loved ones.

Unfortunately, we begin the New Year with a message that has become all too familiar to you: Our COVID numbers are on the rise.

Who would have thought back in the early spring of 2020 that we would still be talking about COVID-19 today? But here we are.

I want to take this opportunity to tell you all that I get it. I know this has been a long, exhausting almost 23 months.

As we approach nearly two years in our fight against this pandemic, you are probably feeling stressed, burned out or just plain tired of it all. I hear you and I understand.

But despite this, you continue to be there for the patients and families we serve. You walk into your place of work and give it your all. You continue to provide the very best care you will find anywhere in the country.  You also find time to be there for each other. Please continue to look out for your teammates and take care of yourselves.

I encourage you to find those moments in the day to connect with one another. To hear from one another. Learn what someone is going through or just take a few minutes out of an extremely busy day to catch up with a coworker and find out how their family is doing. All of these suggestions seem like small gestures but they can mount up to something that means the world to someone.

Speaking on behalf of the entire leadership team, I offer you our most sincere thanks and appreciation for all you have done.

Now to tell us a little bit about where things stand from a Command Center perspective, let’s hear from our Chief Operating Officer, Stan Davis.

Stan Davis, Chief Operating Officer

 Thank you Rick. 

We have been sharing a lot of ever-changing, fast-moving information as this latest variant travels across the globe and seems to have found a home right here in North Texas.

Our numbers have gone through the roof and as I’m speaking, I know many of you are fighting COVID yourself or watching a loved one take on the virus.

For part of three years, we have all been impacted by the COVID-19 virus. We have watched you work tirelessly with little time off. We have watched as you have worked to overcome your own illness and cried for loved ones lost. 

COVID went from something vague to something very real in only a few short months and it just won’t leave us alone.

I know many of you listening to me right now are so tired. You don’t want to hear one more word about COVID. But please know this, now is not the time to let our guard down.

The truth is the virus is still relatively new and as our scientists and doctors gather new information, we change, evolve and pivot with the times. We never take these changes lightly.

We consult with state and national organizations to learn the latest data and most importantly, we talk to the smartest people I know:  our very own Infectious Diseases and Infection Control teams. Dr. Whitworth and Dr. Mazade have been with us throughout the pandemic, providing us with the latest information to keep us all safe.

So I know we have sent you many emails but it is one of the key ways we keep you informed. Please read your emails and make sure your teammates see the latest information.

The only way we can truly beat this thing is by working together. I want to call out a few specific points you probably read in a recent communication:

• This variant is spreading very quickly and easily. We need everyone to go back to the basics. This means wearing a mask at all times, washing your hands often and keeping your distance from others
• Let’s also avoid in person meetings whenever possible. Continue to Zoom and Skype.
• If you have questions about what to do if you are exposed or have symptoms, please visit cookchildrensconnect.com or talk to your manager to learn what steps to take. 
• For now, let's pause any work gatherings like birthday parties, baby showers and other celebrations. Host a virtual gathering instead.

As our numbers and the information changes, we will share the latest with you.  

I just hope you know how much we appreciate you and how honored we are to work alongside you during this very challenging time.

 We know that we can make it through this because of you.

I join Rick in saying thank you to every single one of you.

 Now I will turn things back over to Rick.

Mr. Merrill:

As we have mentioned, we understand these our challenging times. Please check in on one another and remember the resources that are  available to you. Please see the link below if you need someone to talk to or need help.

We just wanted to check in with you all and say thank you for keeping Our Promise to our community and to each other.

Please know, we believe in you and we will continue to take care of you.

As we build on the Cook Children’s Experience and do our best to see the world through your eyes, we will tackle 2022 in the best way we know how... together  - with our eyes always on Our Promise.  

Thank you

Dear Friends and Colleagues,

Last year at this time we anticipated the world would be open and we would be about our usual business. That has not been the case, but we have all persevered! I am so thankful for you. And, I’m glad that we get to kick off another season of Holiday Benevolence. Thank you for joining me in making the holidays brighter for many of the children and families we serve.

Below you will find links to the following:

• The Child Life Wish List. With these gifts, our Child Life staff will help Santa visit every inpatient and sibling on Christmas morning. These gifts will also be of benefit throughout the year as birthday gifts, encouragement aids, party favors, and game prizes. 
• Articles to share with your family, friends, community, congregations, clubs, etc., wanting to help our patients during the holiday season: How to Help Cook Children’s Patient Families During the Holidays and cómo ayudar a las familias de los pacientes de Cook Children’s durante la Temporada de Fiestas.
• Ways to find holiday assistance for a needy child in your clinical practice. 

Please Note: If your department or clinic prefers to sponsor a family for the holidays, you need to let us know by Friday, Nov. 19. We will do our best to find a match for you quickly, so you can take advantage of those great after-Thanksgiving sales. Please tell us how large a family you want to sponsor and any other restrictions/preferences--a clinic in a particular city might prefer to sponsor an outpatient family in their community, etc.

To sponsor a family, please email pam.foster@cookchildrens.org and include the name of the point-person for your group. (No individual sponsors, please.)

COVID guidelines: The gifts must be delivered in a safe, socially distanced manner. Please choose a central location to meet the family, and wear your mask at all times. We will not be entering anyone’s home.

Each year your response to the needs of children and families makes my heart smile!

Thanks to the trust you build with your co-workers and the families we serve, we are able to provide excellent care across the system. And it's important that no matter where a family finds care within our system, they feel that Cook Children's experience. 

You helped define the actions that consistently bring our unique experience to colleagues, patients, families, donors and health plan members. The steps you take form and nurture relationships that allow us to deliver on our Promise. We call these actions our Experience standards. When these actions link together, we create a rhythm to every interaction and the strong bond needed to provide great care. 

Connect: Relate human-to-human by seeing each other as people first. Find common ground to provide more equitable care. Connect with families so they know they are part of the care team. Show people that you care and establish rapport.

Collaborate: Listen and partner to understand each other's perspectives. Value what our families and peers bring to the table and what is most important to them. Come to an agreement with them and create respect.

Elevate: Reflect on what you've talked about so far. Take action to take the next steps together and create moments that matter. Honor the story you've created together and support choices you make as a team. 

This patient went from the ER to the OR, to the CT scanner, and then to the PICU. 

This was a very high stakes, tenuous situation and I want to commend everyone  involved in helping to get this child taken care of:

• ER: The ER nurse was very helpful and got the patient ready for the OR in record time and the ER doctor readily recognized the seriousness of the situation without delay. 
• CT: The CT tech accommodated our stat request for a CT to be done immediately upon leaving the OR.
• PICU: The PICU team was ready and waiting for us upon our arrival and jumped right in to get this child settled in the PICU with her tenuous airway. 
• OR: The entire team, from the preop nurses to the anesthesia techs worked seamlessly. We had so much help in the OR and everyone was jumping in where they were needed to help out. They retrieved countless sets for me that I had not anticipated needing and therefore had not asked for. I think every person working last night was in our room helping out - nurses, CST, anesthesia techs. We had 2 fabulous CRNAs helping us. the CSTs were working like a bucket brigade retrieving equipment and helping me with the procedure. When went to the PICU, the OR staff continued to help by bringing down a scope and some equipment we needed to re-secure the ETT. They stayed until the patient was fully tucked in.

There is no way I can mention everyone by name because there were just too many people helping; and quite frankly, in some cases, people jumped in without even being asked, and in the case of the ER nurse, she was so quick in prepping this patient that I did not even have time to get her name. Drs. (Jose Olarte-Motta) and (Chandra Reynolds) were the PICU M.D and MDA involved and I am eternally grateful to them. 

This team is why I work here. This teamwork is why I think Cook Children's is the best hospital in the world. This teamwork is why this patient made it through this situation. This team epitomizes Cook Children's Culture. And I want every person involved in this child's care to know that they made a difference for me, and more importantly for the patient. 

She is alive because of them. 

Thank you,

Michelle Marcincuk