By Jean Yaeger

Strategies for process improvement are changing the approach Cook Children’s takes to the U.S. News & World Report rankings of the nation’s best children’s hospitals.

As we anticipate the announcement of the 2024-2025 rankings on Oct. 8, we wanted to share recent steps we’ve taken at Cook Children’s to improve collaboration and communication across departments.

What’s the goal? To provide a framework for completing the annual U.S. News applications, promoting our top specialties when the rankings are announced, and enhancing the care we provide to patients and their families.

Cook Children’s earned five gold badges on the 2023-2024 U.S. News Best Children’s Hospitals list:

·        Pediatric Cancer -- #30 in the nation

·        Pediatric Diabetes and Endocrinology -- #31 in the nation

·        Pediatric Neurology and Neurosurgery -- #36 in the nation

·        Pediatric Orthopedics -- #40 in the nation

·        Pediatric Pulmonology and Lung Surgery-- #48 in the nation

These are the 10 specialties that U.S. News scores: Cancer; Cardiology and Heart Surgery; Diabetes and Endocrinology; Gastroenterology and Gastrointestinal Surgery; Neonatology; Nephrology; Neurology and Neurosurgery; Orthopedics; Pulmonology and Lung Surgery; and Urology.

New this year, the Top 50 Behavioral Health programs will also be recognized. In another change this year, the Best Children’s Hospitals Honor Roll will not be ranked 1-10, but instead will promote all 10 as equal in achieving the highest quality of care. The Honor Roll is calculated by adding the points each hospital receives from its separate rankings on specialties.

U.S. News gathers data from almost 200 medical centers to create the pediatric rankings. Each specialty’s score comes in part from its safety record, infection prevention, nurse staffing, surgical outcomes, advanced technologies and other specialty specific measures. Filling out the survey is a significant undertaking by a wide variety of Cook Children’s employees; they are the experts who answer thousands of questions to be considered in the rankings.

Two specialists from Cook Children’s Quality Performance Improvement – Kim Kimberling since 2021, and Noelia Echols since 2023 – see the big picture. They’re the hub for making the process more cohesive, streamlined, accurate and data-driven.

The data required to submit the U.S. News survey is no small task, led by Melina Shulyak, Director of the Analytics Institute, and Linda Mercado, Senior Business Intelligence Developer.  In fact, Business Intelligence developers within the Cook Children’s Information Systems (IS) created 331 reports for the most recent round of U.S. News applications. Endocrinology was the specialty with the most reports at 83, followed by Neuroscience with 42 reports and Orthopedics with 35.

Noelia and Kim meet regularly with IS to help validate those reports as they are being generated. They also provide support to the staff members who answer survey questions using info from the IS reports.

“We have regular meetings, so I think that structure helps to keep us as well as them on track for submitting and meeting the deadlines,” Noelia said. 

Kim and Noelia describe their role as twofold. First, they want to assist in collecting, verifying and reporting the answers in the surveys. Secondly, they want to apply their training in process improvement to find ways to increase compliance with survey measures. In other words … to move up in the rankings.

“Just as customers do when buying a car, we hope the public looks at these badges when they’re shopping for the care that their child is going to receive,” Kim said. “If my child is diagnosed with cancer, where would I go?

“We feel that these badges pull quite a bit of weight for families in making decisions on care and where they’re going to have a procedure done or get treatment,” she said. “We want to be ranked in all of the areas that U.S. News scores in.”

In the next Connect newsletter, we’ll take a deeper dive into what goes into the preparation and teamwork behind the rankings at Cook Children’s.

If you have questions or want to learn more, contact the Cook Children's U.S. News & World Report team at USNews@cookchildrens.org or go to our CookNet site.

A special thank you to Javier Gelvez, M.D., PICU physician, and the Sepsis Committee team members who are leading the way. 

All Cook Children's employees can learn more about sepsis and earn the chance to win prizes by completing a special crossword puzzle and wordsearch. You can download both files on the upper right-hand side of this page.

To be eligible for a prize basket, be sure to email your completed puzzles to zeroharm@cookchildrens.org by Monday, Sept. 19.

Prize basket #1: Family Theme

• Zoo tickets
• Movie tickets
• Top Golf gift card
• S’mores supplies

Prize basket #2: Out on the Town Theme

• Pin Stripe Bowling gift card
• Top Golf gift card
• Movie tickets
• Gift cards to local restaurants

Red allergy band details: 

• Red bands pre-printed with “ALLERGY” should be placed only on patients with allergies 
• No NKDA bands 
  • If the patient does not have an allergy, they will NOT receive a band 
• Allergy bands will NOT list allergies 
  • No handwriting allergies on the band 
• Why red for allergies? 
  • Red signifies stop, reminding staff to verify allergies 

Yellow fall risk band details:

• Yellow “FALL RISK ” bands will replace the orange Humpty Dumpty bands 
  • This applies only to patients who score High Risk in the Humpty Dumpty Scale 
• Why yellow for fall risk? 
  • Yellow alerts everyone to take caution and slow down 

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. 

Patient safety is a top priority for our Cook Children's staff. Click here to read how our NICU and PICU teams came together to improve the care of our patients. 

“The tremendous improvement is a testament to the quality care we provide our patients,” said Sheralyn Hartline, NICU director. "I couldn’t be more proud of the team!. 

Click here to read this important story. You must be on the Cook Children's Network to read.

On Nov.  8, 2021, 3 Pavilion celebrated an important safety anniversary.   This would be an amazing feat for any medical unit, but especially remarkable for them. As a COVID-19 unit, staff members are unable to go in and out of rooms as frequently as they once did.

So how did 3P do it?  What is their magic power?

 Ashley Kovacev, unit manager, attributes their success to Family Engagement. As the COVID unit, staff rely on families to help monitor the PIV site, and that partnership has paid off in a big way! 

Click here to read the entire story. You must be on a Cook Children's Network.