Children's Health becomes 1st US pediatric system to achieve level I, II surgery designations

Two Texas pediatric hospitals  — Children's Medical Center Dallas and Children's Medical Center Plano — have been granted level I and level II surgery center designations from the American College of Surgeons.

The system is the first pediatric health system in the U.S. to achieve both designations at multiple facilities, according to a May 23 news release.

"I think the fact that not many pediatric systems have multiple hospital campuses is kind of what sets us apart," Dai Chung, MD, chief medical executive at Dallas-based Children's Health, the system that owns and runs both Children's Medical Center campuses. 

While the medical center in Dallas had previously been designated as a level I facility for children's surgery in 2021, the facility was up for recertification and Dr. Chung and his team saw that timing as a good opportunity to also pursue a similar designation for the Plano location.

"We felt that with the recent growth happening at the Plano hospital, it was important for us to implement a quality improvement, performance improvement, patient safety program at Plano hospital as well," Dr. Chung told Becker's. "It's a natural evolution for the hospital, which has, over the past few years, significantly increased the scope and scale of what we deliver with regard to surgical care." 

Leveling up

The difference between its level I and level II designations at the Dallas vs. Plano hospitals mainly lies in what the Plano hospital can offer. Right now, Children's Health has built out several surgical capabilities at that site, but the Dallas location can handle the highest and most severe acuity patients, features a neonatal ICU, and around-the-clock coverage of various surgical programs, Dr. Chung explained. 

"I suspect over time, the Plano location may evolve into perhaps getting a higher level distinction as the campus is about to have an expansion and grand opening at the end of this year, which will also affect the scope and scale of what is offered," he said. 

Every year, Children's Health performs more than 23,000 surgical procedures on average, according to Dr. Chung, so even organizing teams to get at the same table regarding the ACS surgery center designations, took time. But, having all key players at the same table to identify opportunities for improvement, quality assurance, quality improvement, and more, really was key to streamlining the approach, Dr. Chung said.

For chief medical officers looking to implement similar initiatives for ACS designations, Dr. Chung recommends the following: 

  • Consider working with IT experts to use data from electronic medical records in a way that protects patient information and privacy. This can expedite some of the review process.

  • Have a quality improvement process that ensures reflection, evaluation and performance metrics to measure and track progress.

  • Standardize processes as much as possible.

Into the next ERA(S) 

Looking ahead, Dr. Chung said he and his staff are focused on making even more improvements for pediatric patients, specifically related to an enhanced recovery after surgery (ERAS) program the health system has implemented. 

"We meet regularly, and we not only review particular unique cases, but we're always looking to launch projects to improve our processes," Dr. Chung told Becker's. "So one of the things that we've done widely across several disciplines is that we rolled out what's called the ERAS pathway… What that is, in short, is that various common operations that we built-out standard steps or processes, which allows us to keep providing routine, protocolized care…to make sure that we minimize variants so that we can actually be safer in what we do."

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