When Rick W. Merrill talks about the coordination needed to maintain quality healthcare services in an institution such as Cook Children’s Health Care System, he likens it to the inherent trust necessary between a pilot and co-pilot in a cockpit. While prepping for takeoff, in the air or preparing for landing, the co-pilot is not only expected to alert the pilot if something seems amiss, he or she is required to do so.

“Our approach to healthcare applies the same principles. We are most proud of the collaborative atmosphere that is a hallmark of Cook Children’s,” says Merrill, who took over as president and CEO of Cook Children’s in August 2007 when Russell K. Tolman retired after 25 years. “Our physicians, nurses, and caregivers work together as a team, in the truest sense of the word, to provide the best care possible for our patients. That’s when and why amazing outcomes occur.”

In fact, Merrill says he has not seen anything like it over the course of his 27-year career in healthcare.

“This spirit of collaboration and teamwork was here prior to my arrival,” he admits. “It’s my job to promote and nurture that culture and provide them with the tools they need to ensure that it thrives.”

Founded almost a century ago as the Fort Worth Free Baby Hospital, Cook Children’s has grown into a national award-winning, nonprofit integrated healthcare system comprised of eight companies. Along with the Health System umbrella company, based in Fort Worth, Texas, the system is comprised of:

  • Cook Children’s Health Plan – A provider of HMO coverage for more than 110,000 people who qualify for government-sponsored programs.
  • Cook Children’s Home Health – Offers clinical services such as initial discharge, patient assessment, home care instruction and ongoing treatments or evaluation for patients continuing their recovery or rehabilitation at home.
  • Cook Children’s Health Foundation – As a nonprofit organization, Cook Children’s relies on philanthropic contributions to support its continual promise to the children and families it serves.
  • Cook Children’s Physician Network – As one of the largest private pediatric multi-specialty physician groups in the nation, it has increased access to care in many communities through north and West Texas.
  • Cook Children’s Medical Center – The medical center brings together top clinical staff, advanced technology and equipment, leading surgical techniques, rehabilitation facilities and ancillary services designed to meet the needs of its patients.
  • Cook Children’s Northeast Hospital – A joint-venture facility in Northeast Tarrant County that offers urgent care, diagnostic imaging and day surgery, as well as a growing list of surgical services to serve both inpatient and outpatient needs.
  • Cook Children’s Health Services – A for-profit company that provides services to independent physician practices. It is designed to help doctors deliver a high-quality of healthcare at an affordable price.
  • Cook Children’s Pediatric Surgery Center – This freestanding, joint-venture ambulatory surgery center is located in Plano, Texas. It specializes in the quality care of children.
Delivering on a ‘Promise’

Because collaboration and a shared commitment to quality care for its young patients was already well in place when Merrill took the reins at Cook Children’s, he saw the opportunity to enhance the organization’s integration of services and care and harness employees’ commitment to the children they serve. As one of his first acts as president and CEO, Merrill set out to deliver what he called a “new era of promise.”

He streamlined the mission and vision of the organization into a powerful promise that captured the shared commitment of its employees and resonated with employees, patient families and the community, as well. Cook Children’s promise is: "Knowing that every child's life is sacred, it is the promise of Cook Children's to improve the health of every child in our region through the prevention and treatment of illness, disease and injury."

To fulfill that promise, however, Merrill had to know what health issues commonly afflicted those in the north Texas community. To find these answers, Cook Children’s completed its first community-wide children’s health assessment and planning survey (CCHAPS) in 2009. After surveying 22,000 households and 6,000 business and community leaders, Merrill says Cook Children’s had the most comprehensive health assessment ever conducted on a population of people 14 years old and younger in the United States. The survey results produced rich demographic data identifying health issues in the six counties served by Cook Children’s.

“We’re now developing our plans to tackle the top-line health issues we have identified,” Merrill says. “There’s no way Cook Children’s can do this alone, though. We’ve made a significant commitment to work with other caregivers, agencies, community partners and government offices to identify public health issues so we could begin tackling these issues – together.”

He compares this collaborative effort to the way the healthcare industry joined forces with government and law enforcement agencies to address child abuse years ago.

“In the past, there were 20 agencies working to fight child abuse,” Merrill says. “Eventually, they said, ‘What if we worked together and leveraged our resources rather than working independently?’ That is exactly what we are trying to do right now with CCHAPS.”

Another issue unearthed by the survey is dental care, or the lack thereof within certain demographics. Cook Children’s has been working for several years to address this gap in dental services for children through its Save a Smile program and the Children’s Oral Health Coalition, which it leads.

“The amount of dental disease in the surrounding area is significant,” Merrill says. “We’re putting forth our best effort in a collaborative fashion with other agencies and organizations to crack the code on this and other issues that exist among children. We’ll continue to augment these grassroots efforts and expand our partnerships with schools and volunteer community dentists to address dental care.”

Expansion and Beyond

Cook Children’s recently completed a $300 million expansion of its main medical center campus. The expansion included the addition of 106 private neonatal rooms, which allows parents to stay with their little loved ones throughout the duration of their stay at the hospital. The expansion also included the opening of the new Dodson Specialty Clinics, adding many amenities, programs, services and new technology all with a single purpose in mind – to better serve patients and families.

Initiatives like the CCHAPS survey and the expansion are part of Cook Children’s promise to improve the health of children. Merrill wants to leave the organization in better shape than when he arrived, which means providing quality care for the lowest cost possible for children throughout north Texas.

“My vision would be to leave this organization and walk out the door knowing that we have fulfilled the promise that we made,” Merrill says. “That we have one of the safest, best outcome and lowest-cost children’s hospitals in the entire country. And, that we’ve made our community the best place in the country to raise a child. If that can be accomplished in the next 15 years, we’ll have accomplished something very special.”

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