Dietician and Patient
Community Responsibility & Sustainability Report

Our Patients

Patient Experience

As a faith-based nonprofit, Texas Health is in the business of caring for people in need; we put patients at the center of everything we do. Delivering an exceptional patient experience characterized by compassion, clear communication and helpful navigation through each step of the care process not only earns our patients’ trust, it also improves health and outcomes and lowers readmissions and costs—all things that are essential to our Mission, Vision and Values.

Each year, we deliver award-winning service to our patients and families and have a systemwide goal of achieving top decile performance. To measure this, we use a comprehensive patient satisfaction survey administered by Press Ganey Associates Inc., which benchmarks patient satisfaction scores against national, customized and local databases. More than 90 percent of Texas Health’s patients rated their overall care and likelihood to recommend our hospitals to others as good or very good.

Texas Health provides leaders and staff with coaching and other resources needed to reliably provide exceptional patient experiences throughout the system’s facilities and medical practices. In 2017, Texas Health will continue its focus on patient experience in three areas: caring behaviors, clinical excellence and operational efficiency.

Safe & Quality Care

Texas Health’s ability to fulfill its Mission to improve the health of the people in the communities it serves and preserve its reputation is based on providing safe and high-quality care that is evidence-based and scientifically sound. After all, it is our clinical expertise and innovation of care that earns patient trust and loyalty.

Considering the following statistics, it is incumbent on not only Texas Health, but the entire health care industry, to keep patients from being harmed while under our care. According to the National Patient Safety Foundation1:

  • Medication errors harm an estimated 1.5 million Americans each year, resulting in more than $3.5 billion in additional medical costs.
  • About 1 in 25 U.S. patients suffers at least one hospital-acquired infection during their hospital stay.
  • About 1 in 10 U.S. patients experiences an adverse condition, such as a pressure ulcer or a fall, during hospitalization.

As part of our journey to become a high-reliability organization, Texas Health is working to consistently provide a safe, quality experience to our patients each time they visit any of our hospitals, wellness centers or physician offices. This work is intentional and strategic, requires extensive research and literature reviews to identify evidence-based best practices, and involves the expertise of our leaders, clinical leaders, employees, as well as safety and quality improvement teams across all of Texas Health facilities.

1National Patient Safety Foundation

  • Care Design

    To reliably deliver safe and quality care, Texas Health is making significant investments to provide its teams with the tools, processes and training to succeed. A care design and deployment initiative—called Reliable Care Blueprinting—is facilitating this effort. This initiative has been led by our caregivers working in design teams, involving more than 220 people from various disciplines. They share and review evidence-based practices and develop processes that would enable our system to achieve the outcomes we desire.

    These groups are tackling our most significant safety and quality issues in hospitals and will continue over the next few years to create reliable processes for our entire care continuum. In 2016, we launched more than 16 modules, ranging from falls to obstructive sleep apnea, at all Texas Health wholly owned hospitals. These modules provide an evidence-based plan related to specific conditions or processes.

    Delivering care safely and coordinating treatment are key ways to improve health outcomes and reduce the likelihood of a hospital readmission. Readmissions typically occur when patients do not understand how to manage their condition, do not adhere to discharge instructions, or fail to receive timely physician follow-up. Texas Health’s care delivery mechanisms include:

    • Patient engagement: Using clinical analytic tools and the patient intake process, we deliberately identify the types of individuals at risk for poor self-management and readmission based on their health history. This allows us to more closely monitor and aggressively communicate with medium- and high-risk patients in real-time.

    • Care management: Clinical nurse managers and bedside nurses effectively manage patient care by confirming the medical services and care being provided are appropriate, and coordinating care to help verify patients see the right health professional at the right time.

      As a result, there has been a decline in the length of patient stays and number of readmissions, which has improved overall patient satisfaction.

    • Care transition: Care transition managers evaluate patients and plan an appropriate post-acute transition based on clinical criteria, funding sources, social support and patient choice. They also share patients’ health history, care plans and treatment needs with all post-acute providers to improve quality of care and reduce the likelihood of readmission.

      Our top priority is to effectively manage the care transition from the hospital to home, so that we can improve health outcomes and reduce patient length of stay and readmissions. Appropriate care transition planning and coordination helps us direct patients to the right level of care or services they need—when they need it the most.

  • Clinical Leadership

    Strengthening nursing leadership at the point at which care is delivered reduces readmissions, improves patient satisfaction and safety, drives compliance with core measures and saves money2. Texas Health’s team of clinical nurse leaders manages the clinical care given to groups of 12 to 16 patients at a time.

    Some of the ways clinical nurse leaders enhance communication between the care team and influence quality patient outcomes is by providing continuity of care, leading interdisciplinary care briefings, and reviewing clinical data to provide optimum acute care coordination. Additionally, they mentor, share evidence-based practices at the bedside, assist patients with health decision planning and collaborate with the care transition team to provide patient support upon discharge.

    2American Association of Colleges of Nursing

  • Performance Improvement

    To drive ongoing clinical improvements, Texas Health continuously reviews industry benchmarks, identifies internal and external best practices, shares lessons learned and sets performance goals. We also monitor how well we deliver reliable care that is safe, outcome-focused and provided in a kind and compassionate way. Comparing our progress against publicly reported clinical, safety and efficiency measures enables us to assess our progress against other organizations of our size and scope as well.

  • Patient Safety

    Texas Health is committed to the health and safety of our patients. We work tirelessly to refine our practices, reduce risks, strengthen our safety culture, and promote a safe and healing environment while aligning our patient safety goals with the goals of The Joint Commission. Our goal is zero harm.

    Texas Health is actively working to consistently provide safe patient experiences as part of our journey to become a high reliability organization. We are accomplishing this goal by strengthening our processes to reduce system failures and respond effectively when they occur. While we have deployed evidenced-based tools and strategies to protect patient safety and enhance care quality since the organization’s inception, we routinely assess these approaches to make necessary refinements and to introduce new methods that are proven to be more effective.

    In 2016, we deployed and trained caregivers on a new reliability learning tool to help us more accurately capture safety events and incidents—such as falls, sepsis or hospital-acquired infections—so that we can accelerate improvements where needed. Having robust data helps us identify the root cause of these events so that we can act to prevent their reoccurrence. It also helps us design learning programs to drive high reliability in a standard manner across the organization.

    Additionally, we trained physicians, clinicians and staff on error prevention strategies that remind them to consider safety in all they do and speak up when they see unsafe behaviors. In 2017, high reliability coaches will observe clinical teams to encourage adoption of these strategies and assess their effectiveness.

    By using and sharing best practices, increasing how often patients receive evidence-based care and reducing variation across the organization, Texas Health has made progress in recent years in advancing clinical quality. Additional data can be found in our Quality and Safety Report, which is updated monthly.

    Readmission Rate

Improving Population Health

To fulfill Texas Health’s Mission, we must not only care for people when they are ill, but also work to keep them healthy and out of the hospital. Through our Population Health, Education & Innovation Center, teams are identifying, developing and implementing innovative population health strategies, tools and programs to help North Texans achieve greater overall health and well-being. Some of these include:

  • Developing Blue Zones® Communities

    Since 2013, Texas Health has been collaborating with the City of Fort Worth, the Fort Worth Chamber of Commerce and many community partners and sponsors to transform the city of Fort Worth into a certified Blue Zones Community® by 2018. It was originally estimated that residents’ poor health could potentially cost the city $5 billion in lost productivity and health care costs over the next 10 years, which would undermine its economic viability and quality of life.

    Individual Engagement

    Blue Zones Project Fort Worth makes healthy choices easier for residents by optimizing the city’s physical surroundings, policies and social connections. The project is engaging with those who live, work, play and pray in all ZIP codes throughout the city. Since the initiative began, Texas Health has provided strategic direction and counsel, funding and support.

    Blue Zones Approved

    The city of Fort Worth has been implementing changes in these key areas:

    • Policy: Advance community policy work to ensure surroundings and infrastructure support healthy lifestyles, such as making the city more walkable and bikeable, improving access to fresh fruits and vegetables and supporting the development of an active transportation plan. To date, the project team has completed 15 policies and initiated 10 more.
    • People: More than 18,250 individuals committed to improving their personal well-being by taking the Blue Zones® Personal Pledge in 2016 and more than 40,000 people have engaged in the project, either by attending an event or volunteering.
    • Places: In 2016, 58 Fort Worth employers of all sizes, including Texas Health, became Blue Zones Project Approved™ worksites, including four faith-based organizations. These organizations are taking steps to make their businesses healthier for employees and members. For example, across Texas Health, you will see designated parking spots painted blue that are purposely far away from the front door to encourage people to get more steps in their day.
    • Presence: The Blue Zones Project team partners with local media, civic and private organizations, and like-minded community initiatives to increase the visibility, awareness, effectiveness and impact across the city. Through a multi-faceted influencer campaign featuring some of the city’s most familiar faces, including Texas Health CEO Barclay Berdan and Mayor Betsy Price, familiarity with Blue Zones Project is now up 100 percent over the prior year; those with a favorable impression increased to 79 percent.

    The city of Fort Worth has seen improvements in its Gallup/Healthways Well-Being Index score since the program began. Scores increased from 58.8 percent in 2014 to 61.4 percent in 2016, which makes the city’s ranking now on par with the nation.

    Fort Worth Thriving

  • Expanding Access to Care

    Texas Health has been transforming its model of health services to one that designed to keep people healthy and out of hospitals except when they are acutely sick or injured. To support this transformation, we are building a clinical network of size, scale and capability to provide North Texans with the right care at the right time and in the right setting. From forming accountable care organizations to aligning with specialty providers, our goal is to make care seamless and convenient for our consumers.

    We created a joint venture with one of the nation’s leading operators of freestanding emergency rooms to increase access to high-quality, convenient emergency medical care in the Dallas-Fort Worth area. More than 30 freestanding ERs and a hospital in Carrollton became aligned with Texas Health.

    We also continued expanding behavioral health services by offering inpatient and outpatient mental, psychiatric and behavioral services throughout the North Texas region.

  • Making Care More Affordable

    Texas Health is taking several steps to make health care more affordable. These include:

    • Advocating for reasonable insurance plans for Texans as well as for compensation for providing care to the indigent, uninsured and underinsured.
    • Improving care coordination to reduce duplication, costs and readmissions.
    • Providing wellness and preventive services to avoid costly hospital visits.
    • Assessing how we can bundle payments to offer a set of services for a flat fee.
    • Helping consumers navigate the system so they get the services they need and avoid those they do not.

    In 2016, we partnered with Aetna to create a new health plan company that will provide employers and consumers in North Texas with more affordable, high-quality and better-coordinated care. This agreement is the first of its kind in North Texas to fully align the incentives and capabilities of a national insurer and major health system. Sharing ownership and accountability equally will help eliminate redundancies of care, reduce administrative burdens and may save employers 15 percent.

  • Preventing Issues Before They Escalate

    Texas Health is helping consumers make healthier choices and is providing services that help prevent health issues from occurring and/or escalating. For example, we:

    • Implement various community health programs—from wellness education to behavioral health management—that address the whole person in his or her own unique environment.
    • Sponsor Faith Community Nurses, who provide health education and resources to thousands of people in congregations and North Texas communities.
    • Affiliate with national nonprofit health organizations to make a greater impact on specific health issues, such as heart health or diabetes.
    • Offer preventive health services and behavior management to help people make healthier choices.