Texas Scottish Rite Hospital for Crippled Children dba Texas Scottish Rite Hospital for Children (TSRHC)

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2 Texas Scottish Rite Hospital for Children 2222 Welborn Street Dallas, TX Name: Date of Report: Date Report Adopted By Board of Trustees: To review report on- line: TSRHC EIN: Prior year Reports: Texas Scottish Rite Hospital for Crippled Children dba Texas Scottish Rite Hospital for Children (TSRHC) September 30, 2013 For the period October 1, 2012 September 30, 2013 September 12, (Available effective September 30, 2013) This is the first TSRHC Community Health Needs Implementation Strategy Report A copy of this written report is available for public inspection without charge at Texas Scottish Rite Hospital for Children. Contact: Manny Mendoza Senior Communications Officer, Public Relations manny.mendoza@tsrh.org Reproduction of this report in whole or in part should include the following recommended citation: Cooper- Walton, C., Devroy, N., Dalton, L., Bateman, M. (2013). Texas Scottish Rite Hospital for Children: Community Health Needs Implementation Strategy. Dallas, TX: Texas Scottish Rite Hospital for Children. 2

3 Community Health Needs Implementation Strategy As part of its Community Health Needs Assessment (CHNA), Texas Scottish Rite Hospital for Children (TSRHC) and The Dallas Fort Worth Hospital Council Foundation (DFWHCF) reached a consensus about significant community health needs based on the frequency and importance of survey responses received. TSRHC leadership identified and prioritized three significant needs within the scope of the hospital s practice that reach beyond the specific pediatric orthopedic needs normally identified by our patients. It is the intention of TSRHC to address all three of the significant community health needs identified. TSRHC will continue to fulfill its primary mission by providing premiere pediatric orthopedic services, conducting pioneering research related to the conditions we treat and providing education in our specialty areas as a leading teaching hospital. Continuing the hospital s policy to treat patients regardless of the family's ability to pay addresses a significant barrier to care identified in community- based research. The following three needs were prioritized in the hospital s CHNA according to the magnitude of the need (see CHNA Needs Assessment, Section V, Pages 14 17), its alignment with TSRHC s strengths and expertise and the opportunity to identify and refer or partner with other organizations that can more effectively meet the need: 1. Improve Access to Health Care Services 2. Improve Child Health Status 3. Improve Coordination of Care TSRHC is developing a strategy to address these prioritized needs that align with the hospital s mission and scope of practice. Action Steps I. Strategy For Improving Access a. TSRHC will further enhance its outreach program to ensure patient and patient families are aware of hospital services and overcoming barriers to access to care. 3

4 b. TSRHC has adopted a financial assistance program and those families that meet the eligibility criteria may qualify for free or discounted care. The hospital will continue to be rigorous in its efforts to communicate that policy and ensure that financial burdens are never a barrier to patient care. c. The hospital has begun investigating the possibility of opening new access points where patients may be seen and treated. d. TSRHC research data and informant interviews identified the current and growing shortage of pediatric orthopaedic specialists as a barrier to care. Adding to the anticipated high demand for physicians and surgeons is the expectation that a large number of physicians are expected to retire between 2008 and To address this need, TSRHC will: Provide medical education: o TSRHC will function as a premier teaching institution, providing comprehensive education and training to orthopaedic residents and post- graduate orthopaedic fellows and contributing to the education of allied health professionals by providing clinical experience and didactic education for students as well as continuing education for health care professionals. Currently, TSRHC is affiliated with 56 institutions including colleges, universities and technical training programs. o TSRHC provides four clinical fellowships each year. The Dorothy and Bryant Edwards Fellowship in Pediatric Orthopaedics and Scoliosis began in 1990, which provides training in all aspects of reconstructive pediatric orthopaedics, trauma and infections. o In addition, TSRHC offers a six- month international pediatric orthopaedic and scoliosis fellowship training program. As of September 2013, the TSRHC orthopaedic medical staff has trained a total of 140 orthopaedic fellows, 30 international orthopaedic fellows and 411 orthopaedic residents. o In addition, fellows from some of the major hand centers in North America as well as from countries throughout the world train here in the subspecialty of pediatric hand surgery for varying lengths of time. Provide clinical training and/or didactic education for allied health professionals in every discipline represented at the hospital. o The hospital maintains affiliation agreements with more than 50 colleges, universities and technical training programs. A significant portion of the clinical education provided is to future nurses. 4

5 o More than 200 nursing students from 5 different nursing schools participate in clinical practice rotations at TSRHC in the course of a typical year. More than 300 nursing students from 5 other nursing programs are provided short courses and lectures by TSRHC nursing staff. o Other disciplines which provide clinical, technical and/or administrative education to students in their area of expertise include: Administrators, Child Life Specialists, Dieticians, Dentists, Dental Assistants, Dental Hygienists, Physician Assistants, Orthotists and Prosthetists; Physical and Occupational Therapists; Psychologists, Radiographers, Social Workers, Sonographers and Therapeutic Recreation Specialists. e. TSRHC will introduce, expand, or enhance telemedicine/telehealth initiatives to increase patient access to health care. Telemedicine encompasses different types of programs and services provided for each patient, including: Specialist referral services Patient Consultations Remote patient access Medical education Consumer medical and health information f. TSRHC is committed to providing a culturally appropriate environment for its pediatric patients and their families. A diverse cohort of employees and volunteers ensures reflectivity of its current and future patient mix. TSRHC employs the skills, expertise, and care of more than 850 employees and further, has the benefit of more than 800 volunteers. We also provide extensive language translation services to patients and their families through hospital staff and contracted outside services. In addition, employees are required to complete online training and education courses that include cultural sensitivity and patient communication segments. II. Strategy For Improving Care Coordination a. TSRHC will encourage more coordination between general practitioners and TSRHC specialists either through the use of an Electronic Health Record (EHR) or similar mechanisms. b. Improved IT Systems TSRHC is making a significant investment in its information systems infrastructure and human resources to expand and enhance our ability to collaborate and communicate with other health care providers who also play a role in the total spectrum of patient care for the patients we share. 5

6 Each month TSRHC receives referrals from physicians. It is very important to us that each one of these patients is well taken care of and that our assessments and treatments are communicated back to these physicians. c. TSRHC is also committed to helping each family find the medical expertise and resources that they need if the services that they require are not within our scope of practice. Our Christi Carter Urschel Family Resource Center utilizes full time social workers to help parents and siblings of children with physical and developmental limitations and served more than 4000 families last year with resources to help them through a variety of needs. We also helped to coordinate more than 1800 appointments outside the walls of our facility for patients last year. That program will be evaluated and opportunities for improving care considered. d. Care options change for patients after age 18 or 21, depending on the type of services received. Social workers and financial counselors help families understand options and help them navigate processes to acquire funding as adults. TSRHC will continue to work with government- supported income (SSI/SSDI) and/or medical coverage (Medicaid, Medicare, etc.) to facilitate continuing care. For patients who need guardianship after the age of 18, TSRHC social workers will help connect families to attorneys that help with the process. III. Strategy For improving Child Health a. TSRHC continuously assesses the quality of care provided not only with an ongoing patient care evaluation process, but also in collaboration with The Sarah M. and Charles E. Seay Center for Musculoskeletal Research that is comprised of five centers for excellence. TSRHC will continue to bring clinicians, researchers and other healthcare professionals and supporting staff together to perform innovative and clinically relevant research on challenging pediatric disorders. b. TSRHC continues to develop a broad network including providers of general pediatric services. We will continue to support conferences, symposia and other learning opportunities dedicated to improving child health. c. TSRHC will remain committed to a robust research program that will help us to increase our knowledge, treatment options, and overall care of the patient. We currently have research programs in all of our centers for excellence and through these projects we are able to enhance our patient care. d. Many of our patients have obesity issues, as well as other nutritional needs. Although TSRHC does not have a formal obesity clinic, we are committed to meeting the needs of the whole child. TSRHC has clinical dieticians on staff that are available to all patients. TSRHC takes an interdisciplinary approach to weight 6

7 management which includes the clinical dietician, social services and psychology. Depending on the needs of the child and the family, weight management needs can be accomplished through separate appointments with the clinical dietician, and the interdisciplinary team here at the hospital or through a referral to a dietitian or weight management program in their community. TSRHC participates and/or supports various community weight management programs including: o The Dallas Area Coalition to Prevent Childhood Obesity TSRHC is an active partner in The Dallas Area Coalition to Prevent Childhood Obesity. o Shapedown TSRHC has coordinated this program for patients as well as a multi disciplinary healthy eating class for patients with orthopedic problems. o Children's Medical Center (CMC) in the COACH Clinic TSRHC supports this program, which was established for children who are diabetic or pre- diabetic, and the LEAN Program for weight management. As TSRHC continues to identify children who would benefit from these programs, the appropriate referrals are made to CMC. o Medicaid and Children With Special Health Care Needs (CSHCN) programs These programs also provide support to the TSRHC patients and families and will pay for several visits related to certain weight management issues with a clinical dietitian. As children who would benefit from these services are identified, referrals are made. In Conclusion: TSRHC is dedicated to the health and happiness of children. We will fulfill our primary mission by providing premiere pediatric orthopedic services, conducting pioneering research related to the conditions we treat and providing education in our specialty areas as a leading teaching hospital. We will be guided by what is best for the child. We are committed to continuous improvement to meet the health care needs of the community within the scope of our practice and we will strive to expand and share knowledge regarding the care of our patients through research, education and outreach programs. ##### 7