Cook Children's annual report and community benefits

A Tradition of Champions
Cook Children’s annual report and community benefits

As much as we take pride in the rewards and recognition we receive for our work, we measure our success by the improved health of children in
our region. That is why our Cook Children’s team continues to work collaboratively with our community partners to address identified pediatric
health needs in our area.
We’ve established The Center for Children’s Health to provide the infrastructure to help us sustain our Community-wide Children’s Health
Assessment & Planning Survey (CCHAPS) and the resulting initiatives born from the data. Through CCHAPS, we’ve identified seven child
health issues: abuse, access to care, asthma, dental health, mental health, obesity and safety. In response, we are teaming up with others
within our six-county service area to develop targeted plans of action to tackle these issues.
In our ongoing effort to address access to care, we continue to expand and grow both our main campus and the services we provide in the
community. In April 2011, we opened Cook Children’s Urgent Care and Pediatric Specialties in Southlake; offering multiple services in one
convenient location for Southlake and surrounding communities. In response to increased patient volume at our neighborhood clinics, we
moved our Northside Fort Worth clinic to expand our capacity to care for the broad spectrum of needs of all children in our community.
Through the historic expansion of our medical center, we’ve nearly doubled the size of our campus. Bringing together our
inpatient and outpatient services, we’ve integrated the point of care while paying particular attention to enhancing
the patient and family experience. By expanding our programs, services and amenities, we’ve augmented our
capacity to meet the growing need for our services and transformed how we will care for generations of
children.
Our team is committed to making our community the best place in the country to raise a child. It is
an investment, and a promise, that we take seriously.
Sincerely,
Rick W. Merrill
President and CEO
Cook Children’s Health Care System

Our Promise:
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.

cook children’s medical center Expansion
Neonatal intensive care unit
Mansfield and southlake
Teddy Bear transport
Heart Center
Neurosciences
Hyperinsulinism center
cook children’s Home Health
camelot court room service
cook children’s Health Plan
Quality initiatives
community health outreach
the center for children’s health
Homeless initiative
project adam texas
awards/accomplishments
System Summary
Boards of Trustees
Map of locations
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The landscape of Texas sports changes constantly. New teams, new leagues, new stadiums ~ all to keep up with our state’s amazing
growth. Likewise, Cook Children’s also is improving and expanding its landscape to keep up with the growing area and number of
families it serves.
As part of the largest expansion in our history, Cook Children’s Medical Center improved on its already stellar reputation of care,
while making the stay for patients and their families more convenient and comfortable. In 2011, Cook Children’s completed phase
1 of the medical center expansion, with the addition of more than 600,000 square feet.
Levels two and three are home to Cook Children’s Neonatal Intensive Care Unit (NICU) with 99 all-private rooms, making it the
largest such NICU in the country. The second floor of the NICU is named in memory of Dave T. and Bernie Marie Miller in recognition
of their philanthropic support.
Level four is the Jane and John Justin Neurosciences Center and houses a 26-bed inpatient unit for transitional and rehabilitative
care. It includes Jeremy’s Gym, which helps patients with physical and neurological rehabilitation in the Rehabilitation Care
Unit (RCU) and Transitional Care Unit (TCU). The RCU features an overhead “track” system for moving mobility impaired
patients, such as those with spinal cord injuries or neuromuscular diseases.
Level five features a 28-bed unit dedicated to the treatment of children and teenagers with cancer and blood-related
disorders. This area is part of the Cook Children’s Hematology and Oncology Center in the new Dodson Specialty Clinics
building, opened in 2012.
Isabella, age 6
Grand Prairie Baseball
Association
Team: Tigers
Grand Prairie, Texas
01 | Cook Children’s 2011 Annual Report

Our medical center’s new north tower is home for many of Cook Children’s
inpatients, and consists of five floors, plus a lower level.
Some of our new family amenities include:
• A hair and nail salon for patients and their families.
• A food court/cafeteria, known as Camelot Court. Families can choose from Chick-fil-A ® , a brick oven pizzeria, a deli, an international station
offering dishes from around the world, a salad bar, a traditional home-style station and an after-hours station.
• An indoor playground called Pirate Cove that was funded by Cook Children’s employees.
• A Fort Worth Independent School District classroom for students.
• A Build-A-Bear Workshop ® gives patients an opportunity to make a furry friend to bring them peace during their stay in the medical center.
• The Dodson Specialty Clinics building (combines all specialties under one roof).
• The Dodson Surgery Center.
• A Child Life Zone (teen room, recording studio, patient library and family business center).
Our expansion plans for next season include:
• A frozen yogurt shop.
• A hair and nail salon for patients and their families.
“I have no doubt that the additions we are making to our medical center campus will only further allow
us to become a wonderful part of so many more stories of hope, healing and unparalleled care for
those who walk through our doors. Our donors’ generosity will touch the lives of the children we serve
for generations to come,” said Cook Children’s Health Foundation Vice President Grant Harris.
02

There’s nothing quite like opening day and September 2011
was opening day for Cook Children’s new all-private room
Neonatal Intensive Care Unit (NICU). Cook Children’s
became the first medical center in the region to provide a
state-of-the-art, all-private room NICU. The new unit gives
newborns and their families accommodations that help make
Cook Children’s excellent newborn care even better.
“Private rooms are the most current trend in building new
units,” said Nurse Manager Tammy Hoff, MS, RN, NE-BC.
“Anytime you have a private room, the benefit is going to
be that the family can be there. The family can have more
privacy and focus on their baby.”
The all-private room NICU was designed to allow parents to
stay with their baby at all times, giving them the opportunity
to bond with their baby and to be more active participants in
their baby’s care. The expanded NICU consists of 99 rooms
and 106 beds, separated into five areas. Rooms have been
included to specifically accommodate twins, triplets and
quadruplets. All of the rooms have a bed, chair and storage
closet to allow both parents to comfortably stay with their
baby overnight. Each floor also has a family lounge, laundry
room and showers.
“We are hoping to engage families sooner and encourage
them to participate in their babies’ care so they will be ready
to go home when the time comes,” said Tammy Hoff, MS,
RN, NE-BC, nurse manager. “Ultimately, we should see that
babies stay in our NICU for a shorter period of time.”
The staff has already seen some of the benefits of the
private rooms. Respiratory therapists have noted that they
do not have to manage babies’ oxygen saturation levels as
much, which can decrease when babies are irritable or cry.
In addition, it appears that moms have been pumping more
milk because of the opportunity to be close with their baby.
All of the milk is stored in our state-of-the-art milk bank. The
benefit of a milk bank is that fewer people handle the milk,
creating less room for error.
The new NICU has innovative features, including sound
insulation, lighting control and cardiac monitors, allowing
nurses to observe three patients at once. Nurses also use
a device called Vocera ® . This integrated monitoring system
lets nurses communicate with other staff members handsfree
and has patient alarm notification technology.
The NICU team consists of highly trained pediatric specialists,
physical and occupational therapists trained in newborn care
and an award-winning team of nurses that have additional
training in the specific areas of the NICU.
The entire NICU team is dedicated to including parents in
the care of their baby, while providing the best possible care
for patients. Caring for the family begins when they tour the
facility before the baby’s birth, through their stay and beyond.
Full-time lactation consultants, Child Life specialists, social
workers, case managers, physical and occupational therapists
and chaplains are available as support for the families and
complete the multidisciplinary team. The unit also has several
support groups to help guide the patient families while they are
staying at the medical center, as well as when they go home.
The second floor of the NICU is named in memory of Dave T. and
Bernie Marie Miller in recognition of their philanthropic support.
To learn more or schedule a tour, visit
www.cookchildrens.org/nicu or call 855-OUR-NICU.
03 | Cook Children’s 2011 Annual Report

Cook Children’s latest additions in Mansfield and Southlake
quickly established themselves as MVPs.
Mansfield
In November 2011, the newest Cook Children’s Rehabilitation Services clinic celebrated its first year in the rapidly growing community of
Mansfield. With so many new families moving into the area, our Mansfield location is serving an important role in meeting the community’s
needs. The office provides patient families access to an experienced team of physical therapists, occupational therapists, speech-language
pathologists and audiologists, all of which provide the best possible care. Services include comprehensive treatment for infants, children
and adolescents with sports injuries, traumatic injuries and congenital and developmental problems of the extremities and spine. This
new location, along with our plans to expand specialty care services in Mansfield, will keep many kids in the game for years to come.
Southlake
Cook Children’s opened the doors of Southlake’s first pediatric urgent care and specialties center in April 2011.
To celebrate, Cook Children’s hosted a series of family-geared events at the center, including:
Mikael, age 7
ASI Gymnastics
Keller, Texas
Brooke, age 4
Empire Gymnastics
Euless, Texas
• A We Do It All For Kids-fest, where families enjoyed activities and games, including a rock climbing wall, Wii gaming, bounce houses,
carnival-style games, arts, crafts and music.
• A Safe Kids Tarrant County Buckle Up safety event where 46 families’ car seats were checked for proper installation.
• A Kids’ Health and Safety Fair to give parents and kids valuable information about water, car, poison and bike safety, as well as athletic
and sports precautions.
Cook Children’s Urgent Care and Pediatric Specialties in Southlake has been a big hit in the community because it provides multiple
services in one convenient location. In fact, in its first year, the center treated 18,853 patients and continues to see a steady increase in visitors
on a monthly basis. The center accepts urgent care walk-ins from 11 a.m. to 10 p.m., daily, which provides accessible care for a child who is
sick or injured and saves many parents a trip to the emergency room. Additionally, online express registration helps save parents’ time.
Specialties offered at the center include Neurology, Cardiology, Gastroenterology, Pulmonology, Endocrinology, Orthopedics, Pediatric
Surgery, Nephrology, Sleep, Psychiatry and Psychology.
04

In October 2011, the Cook Children’s Teddy Bear Transport team was
acknowledged for being exactly that – a team. For the first time ever, the Children’s
Miracle Achievement Award for outstanding work and services provided to children in
the community went to a group. Previously, the Children’s Miracle Network Hospitals’
national conference honored an individual for the reward.
In the summer of 2011, a new transport nurse educator role was created. This nurse
educator has experience in transport, nursing and education, and goes to referring
facilities to teach others the S.T.A.B.L.E. program (Sugar, Temperature, Airway, Blood
pressure, Lab work, Emotional support). “We want to give hospitals the tools to help
stabilize patients until our team arrives to help,” Boudreaux said.
The team played a key role in the design for Teddy Bear Transport’s new hangar located
at Meacham International Airport in Fort Worth. Included in this design was a classroom
area for continued education among staff, community groups, physicians and other
members of the medical community. “We wanted a place where our team could meet
regularly with physicians and learn new skills to stay current with the standard of care
given in the medical center,” said Debbie Boudreaux, BSN, RN, CCRN, C-NPT, nurse
manager for Teddy Bear Transport.
Prior to the new hangar, the nurses, respiratory therapists, paramedics, dispatch
and helicopter and fixed-wing pilots were all in separate locations, stealing valuable
minutes from the team’s departure.
“We always knew our team was excellent and now the entire
transport community knows it as well,” said Debbie Boudreaux, BSN,
RN, CCRN, LP, C-NPT, nurse manager for Teddy Bear Transport, after
the team won the Children’s Miracle Achievement Award.
“By building this new facility the team is always together, which improves overall
response times, so we can get to our patients quicker,” said Boudreaux.
The team is also committed to clinical exposure by spending time at the medical center
weekly. In addition, team members experience situations they encounter on the job
in the medical center’s simulation lab, where they are able to work with human-like
mannequins that react similarly to people. This time helps transport staff stay on top of
their skills, improve their knowledge and build stronger relationships with other staff.
Transport members are also involved outside of the medical center. Jack Sosebee,
director of Cook Children’s Teddy Bear Transport, serves as chair of the standards
committee for the Association of Air Medical Services and as president of the Texas
Association of Air Medical Services, which shows how Cook Children’s is helping set
standards for the medical community. “We are committed to being the best we can
be for our patients and we intend to keep soaring to new heights,” Boudreaux said.
05 | Cook Children’s 2011 Annual Report

KANSAS
Wichita
Tulsa
Santa Fe
Albuquerque
Amarillo
Oklahoma City
OKLAHOMA
A RKANSAS
NEW
MEXICO
Lubbock
Wichita
Falls
Little Rock
Texarkana
El Paso
Odessa
Fort Worth
Abilene
Brownwood
Waco
San Angelo
TEXAS
Dallas
Nacogdoches
Shreveport
Jackson
L OUISIANA
Baton Rouge
Austin
Houston
Lafayette
New Orleans
Bryce, age 6
Burleson Champions
League
Burleson, Texas
Teddy Bear Transport:
2,000+ families served from
around the region every year
300+ years of combined experience
among the team
06

Just like in martial arts, Cook Children’s staff members have the most skilled hands. Patients at Cook Children’s
Heart Center are in excellent hands, thanks to a dedicated team of cardiologists, interventionists, surgeons and
electrophysiologists. That staff, combined with our state-of-the-art technology and family-centered care, ensures
patients with acquired or congenital heart defects receive the best possible care.
Cook Children’s Heart Center offers a variety of services, some of which include medical and surgical therapy, interventional cardiology
and cardiac arrhythmia management.
In 2011, Cook Children’s expanded its cardiology services by adding a cardiac magnetic resonance (CMR) program led by Steve
Muyskens, M.D. The cardiac MRI is noninvasive and takes pictures of the patient’s heart and surrounding structures using a large
magnet, radio waves and a computer. This test is performed to evaluate the structure and function of the heart and blood vessels and
typically provides information that cannot be obtained by other tests.
Did you know?
Since opening in 1996, Cook Children’s Heart Center has seen nearly 120,000 patients.
Cook Children’s Heart Center also began offering fetal echocardiography services in Southlake, Mansfield and Denton in 2011. With
this technology, our cardiologists use a sonogram to make an in-utero diagnosis of heart defects. Rebecca Davis, RDCS, is the
supervisor of the Cook Children’s Echo Lab and is one of only 13 American Registry for Diagnostic Medical Sonography fetal
registered sonographers in Texas.
To meet the growing needs of our patients, Cook Children’s welcomed James Kuo, M.D., cardiac interventionalist and Richard M.
Chemelli, M.D., medical director, Cardiovascular Intensive Care Unit to our team in 2011.
To learn more about Cook Children’s Heart Center, visit www.cookchildrens.org/heartcenter.
Promise, age 10 - Lauren, age 8
Roberto Kaelin Brazilian Jiu Jitsu
Keller, Texas
07 | Cook Children’s 2011 Annual Report

Cook Children’s Neurosciences excels because of its state-of-the-art technology, expert physicians and treatments. In 2011, the group began
using 3-D multimodal imaging to help localize seizures. The process combines a number of images from scans, including a positron emission
tomography (PET) scan, magnetic resonance imaging (MRI) and X-ray tomography (CT). By using this technology, the source of seizures is
more accurately identified, even in cases where prior imaging was reported as normal.
To help meet patient needs, the Cook Children’s Neurosciences team expanded in 2011 with two neurologists, Adrian Lacy,
M.D., and Brian Aalbers, D.O. With these additions, the Neurosciences team can treat even more patients.
Parents choose Cook Children’s Neurosciences program because of its exceptional outcomes and staff. The group
received the Cook Children’s Family Choice award for 2011 given by our organization’s Family Advisory Council. Made up
of patient families and staff, this council empowers families to be partners in the care of their children, which ultimately helps
Cook Children’s achieve the highest level of family-centered care.
Our Neurosciences department continues to grow and gain national recognition. Children
from 24 states have traveled to Fort Worth to receive treatment through this highly trained
group. In fact, our Neurosciences team helped more than 20,000 children in 2011.
Additionally, more Cook Children’s specialists are working together to provide comprehensive care to children with neurological
conditions. These experts include those from Pain Management, Endocrinology, Craniofacial Surgery, Cardiology, Hematology, Oncology,
Cook Children’s Home Health and more. As a unified team, our goal is to provide the best on-site Neurosciences program for our patients
and their families.
To learn more, visit www.cookchildrens.org/neuro.
08

The best teams have the best talent. That’s why Cook Children’s
physician Paul Thornton, M.D., is part of our team. Dr. Thornton,
medical director of Cook Children’s Endocrine and Diabetes
program, is nationally respected for his extensive clinical and
research experience in congenital hyperinsulinism (CHI).
Cook Children’s Hyperinsulinism Center is the only
one of its kind in the Southern United States and the
second in the country.
CHI is a rare and serious disorder with symptoms
usually appearing within
24 hours of birth or during early infancy. Because CHI conditions are difficult to diagnose
and manage, care by specialized clinicians can shorten hospital stays and improve the
patient’s outcome. Without early and aggressive treatment, the child may experience brain
damage, seizures and mental retardation.
Our CHI team
Dr. Thornton leads a team of experienced physicians and supporting specialists to treat hyperinsulinism
with the best care available. The entire CHI team is devoted to providing quality, family-centered
care to those we serve. The group consists of doctors specializing in endocrinology, pediatric surgery,
neonatology, neurology, gastroenterology, pathology and radiology.
Cook Children’s Hyperinsulinism Center is the
only one of its kind in the Southern United
States and the second in the country.
Kyle, age 6
Grapevine-Southlake Soccer Association
Grapevine, Texas
In addition to offering the very latest in treatment approaches, Cook Children’s is involved in leadingedge
research on CHI. Some of the current studies under approval by our Institutional Review Board
include long-term neurological outcome and genotype phenotype correlation.
For more information, visit www.cookchildrens.org/endocrinology.
09 | Cook Children’s 2011 Annual Report

For years, Cook Children’s made sure to cover its bases by
providing family-centered pediatric care in patients’ homes
around the Fort Worth region. But in 2011, that home field
expanded. Cook Children’s Home Health added an office
in Dallas to better serve the patients who sometimes have a
difficult transition from a medical center setting to their own
homes.
“We branched out to the Dallas area to help a group of patient
families who otherwise would not receive the special care we
provide,” said Brady Gendke, vice president of operations at
Cook Children’s Home Health. “For our outpatient orthotic and
prosthetic services, the care is also provided in the comfort
of the new Dallas office. Custom products are done locally in
our own lab, and modifications are done in our on-site lab to
increase quality and decrease wait times.”
Cook Children’s Home Health gives kids long-term care and
helps them heal in a familiar setting. It is led by a clinical team
with vast experience in pediatrics, including visiting nurses that
are Pediatric Advanced Life Support (PALS) certified.
Cook Children’s Home Health now serves patients in the
following counties:
• Bosque • Collin • Cooke • Dallas
• Denton • Ellis • Erath • Grayson
• Hill • Hood • Jack • Johnson
• Kaufman • Montague • Navarro • Palo Pinto
• Parker • Rockwall • Tarrant • Wise
Services include:
Marco, age 6
Fort Worth, Texas
• Medical equipment – home respiratory care is provided by registered or certified pediatric respiratory therapists.
Patients receive timely delivery of all supplies and equipment. Families are assisted by patient service representatives
and respiratory therapists with maintenance and storage of home medical equipment and supplies.
• Nursing – Pediatric Advanced Life Support (PALS) certified and specialized in hematology/oncology,
gastroenterology, pulmonary, neonatal intensive care unit (NICU), infusion therapy and IV management.
• Rehabilitation – expertise in caring for pediatric specific disease conditions, providing age-appropriate therapy and
collaborating with families to develop the child’s rehabilitation treatment plan. The rehab team is able to meet a
child’s needs for physical, occupational and speech therapy in the home environment.
• Biopharmaceutical – pharmacists are trained and experienced in the use and management of biotech
pharmaceuticals. They also provide patient educational tools to enhance quality of service.
• Infusion – including intravenous medications, infusion devices and other medications requiring precise dosage and
management. An infusion suite is available for patients who may not qualify for home visits or where a more controlled
setting is required.
• Orthotics and prosthetics – whether in our offices or in numerous clinical settings, our team provides top pediatric
orthotic and prosthetic care.
10

Sports nutrition has become a science, with as much focus on how a team eats as the amount
of time spent in the weight room. Cook Children’s places a similar focus on making sure
patients and families receive healthy food that’s also tasty.
The Camelot Court Room Service program was launched in August 2011. This
patient-friendly program meets the nutritional needs of kids and lets them enjoy their
meals at the times they choose. Patients get a menu from a nutrition associate when
they are admitted. Their menu offers delicious meals based on their specific diet
requirements.
The program is extremely popular with kids in the medical center. They have more control
of meal times and they get to choose meals based on how they are feeling. Overall, this
helps them eat more because they order what they can tolerate and are hungry to eat. The
meals are prepared individually for each order and if the patient needs any help with eating,
someone will come and assist them.
To place an order, the patient or a family member simply dials the room service telephone number
and a nutrition associate personally delivers the meal within 45 minutes. The room service
feature is another way Cook Children’s is able to get our team’s kids back in action!
Kalil, age 8
Northwest PeeWee Football Association
Team: Texans; Haslet, Texas
11 | Cook Children’s 2011 Annual Report

Great teams don’t rest on their laurels. They always look for ways to improve and don’t accept anything but being
the best. That’s certainly the case for Cook Children’s Health Plan.
In a year’s time, Cook Children’s Health Plan grew by more than 10 percent, from just over 91,000 members in December
2010 to more than 101,000 in December 2011.
Cook Children’s Health Plan provides essential coverage to low-income families who qualify for government-sponsored programs
such as Medicaid and the Children’s Health Insurance Program (CHIP). Children enrolled in the Cook Children’s Health Plan are
assured timely access to necessary medical care, including preventive services like well-child visits and immunizations.
While posting impressive numbers over the course of the year, the system brought in a new coach to guide the continued
success of our health plan. Bob Watkins, a pioneer in establishing successful health plans, including in Texas, joined the
team as president and chief operating officer of Cook Children’s Health Plan in September 2011. Since his arrival, Watkins
has placed an emphasis on making sure that physician resources are deployed like never before so that Cook Children’s
Health Plan members (CHIP and Medicaid members) are seen in the most timely manner. At the same time, the health
plan sees to it that members of Cook Children’s Physician Network are paid promptly and accurately so they can
maintain their practices.
“We’re providing health care to a
special population who may not
otherwise be able to access or
afford care. The health plan’s role
is to be able to finance, manage
and ultimately, in conjunction
with the entire Cook Children’s
system, deliver care to these
members of our community.”
Brooklyn, age 7
Lake Worth Youth Association
Team: Bullfrogs
Lake Worth, Texas
Cook Children’s Health Plan
President and Chief Operating
Officer Bob Watkins
12

In sports, people look at how you performed against quality opponents.
Cook Children’s quality initiatives meet or beat many of the national standards
and even some of our own high aspirations.
Bar coding medication and patient
arm bands assures that the right
prescription is administered to the
right patient, in the right dose, by
the right route, at the right time.
Cook Children’s has
exceeded our goal with
more than 97 percent of all
medications administered
using bar coding technology.
(Source: National Safety Patient Group Benchmark, 2011.)
13 | Cook Children’s 2011 Annual Report

Computer provider order entry
(CPOE) provides important
safety information about
medications at the time
of medication ordering.
CPOE also eliminates
the risk of transcription
errors because the order
goes directly from
the physician to the
In 2011, we had 85 percent
of eligible medications
ordered using CPOE. This
is 10 percent higher than
the national average.
(Source: Leap Frog Group, 2011.)
pharmacy.
Shaylee, age 9
Granbury Soccer Association
Team: Firecrackers
Granbury, Texas
14

Central lines (IVs inserted into large veins) are critical for treating many of our patients.
Cook Children’s Home Health continues to reduce central-line associated blood stream infections
per 1,000 central line days dropping from 1.44 in 2008 to .53 in
March 2012. The national average is .85.
(Source: Child Health Corporation of America, Home Healthcare Group Average, 2012.)
Cook Children’s Medical Center central-line associated blood stream infections per 1,000 central
line days has decreased from 5.90 in 2009 to .73 in March 2012.
(Source: Cook Children’s Medical Center, March 2012.)
Immunizations are an important factor in preventing many childhood illnesses. Cook Children’s leads
the way with immunization rates in our primary care offices at
nearly 100 percent. The state average is 80 percent.
(Source: Centers for Disease Control and Prevention, Immunization Rates Report, Morbidity and Mortality Weekly Report, September 7, 2012.)
15
| Cook Children’s 2011 Annual Report

In 2011, Cook Children’s Health
Plan members gave us a 92
percent satisfaction rating.
(Source: Cook Children’s Health Plan Dashboard, March 2012.)
Abby, age 9
Mansfield Volleyball
Team: Diamond Diva
Mansfield, Texas
Cook Children’s families gave
our system a score of 97.1 percent
for patient satisfaction in 2011.
This score shows that we continue to meet and exceed
our patients’ expectations.
(Source: National Research Corporation Picker/Child Health Corporation of America, March 2012.)
16

Knowing that every child’s life is sacred, it is the
promise of Cook Children’s to improve the life of
every child in our region through the prevention and
treatment of illness, disease and injury.
At Cook Children’s, more than 5,000 teammates come
to work every day determined to make good on our
promise. Our overall goal? To help kids stay strong
and healthy… and to help kids WIN.
Our not-for-profit status allows us to reinvest in our
communities we serve and is a key contributor to
helping us keep our promise. It gives us the freedom
to focus on providing exceptional care and innovative
prevention strategies, instead of improving a bottom
line.
The following pages will give you an overview of our
community benefits and will further demonstrate how
our organization makes a difference for the children
and families throughout our region.
Payton, age 9
The Y
Team: Cougars
Arlington, Texas
Awards
Cook Children’s Homeless Initiative was one of only 10 programs nationwide to be
named a 2011 Program of Excellence in the Hospital Charitable Service Awards.
Save a Smile received the Golden Apple Award from the American Dental Association
for Excellence in Access to Dental Care Programs.
17
| Cook Children’s 2011 Annual Report

Safe Kids Tarrant County
“I needed car seats [for children] that were placed with me in an
emergency. They came with nothing and no car seats. It would be very
difficult for me to go out and purchase all three seats at one time. I
appreciate the service. Thank you for providing this service.”
-Karen G.
Children’s Oral Health Coalition
“The health literacy workshop really opened my eyes to the urgent need for health care
providers, as well as patients, to understand the implications of low health literacy. This
information is so critical to me, that I am presenting a workshop on health literacy to my
classmates in the Texas Women’s University dental hygiene program. I feel that we all will
be better clinicians and that our patients will benefit considerably from our understanding
of how to better communicate health information.”
-Hollie A.
“I didn’t have the money for a car seat, but was worried about my child
and her safety and the way other people drive. I called 211 in search of
someone to help me secure myself and my child. They set me up with an
appointment. When I got there, there were people there to help me. They fit
my child in a car seat, showed me the correct way to hook and buckle her
up and it was great. It makes me feel better driving with her in a car seat.
Thank you so much for all your help. You have been great and even though I
had no money, they helped me out. Have a blessed day.”
-Jamie D.
Save a Smile
“They don’t fail you. They don’t give up on you.”
-10-year-old boy at a shelter regarding Cook Children’s Neighborhood Clinic
“We are appreciative of the donations of school supplies and clothes.”
-Parent feedback
“My son Armando needed a lot of treatment that honestly we couldn’t afford. Thanks
to the Save a Smile program all of his treatment was completed. I really appreciate the
program for all the help you gave us. God bless you.”
- Maria Q.
“We don’t have a dental plan, and we haven’t taken Marcos to the dentist in years
because we couldn’t afford it. He started saying that his teeth were hurting, when his
teeth were checked at school by your program. And now because of this program, we
can save his smile. Thank you.”
- Crystal C.
18

Served more than 35,400 children, families and community partners
through 149 community health outreach team-directed events and education, including dental
screenings, car seat checks/fitting stations, drowning prevention education, oral health
education and action planning on targeted health issues.
Checked 1,040 car seats for correct installation and distributed 552
car seats at car seat checks/fitting stations, through our Safe Kids Tarrant County program.
Distributed nearly 18,000 oral hygiene kits that included toothbrushes, tubes of
toothpaste and resource brochures to underserved children.
19 | Cook Children’s 2011 Annual Report

Provided dental screenings to 37,376 children in 202 Tarrant
County schools through Children’s Oral Health Coalition member organizations.
Served 16 schools and screened 6,129 children through the Save a Smile program.
In all, 110 dentists donated dental services totaling $625,557. Since 2003, the Save a Smile
program has orchestrated nearly $5 million in donated dental services.
Provided community resources and medical homes for homeless children at Cook Children’s
Neighborhood Clinics. Since April 2008, medical homes have been provided to 634 children,
including 193 children who maintained that status after leaving shelters.
20

League roster:
Larry Tubb
Senior Vice President, System Planning
Ginny Hickman
Assistant Vice President, Community Health Outreach
Marilyn Nappier
Director, Regional Service and Community Measures
Jose Gonzalez, M.D.,
Medical Director
Sports franchises are defined by the decade. The Dallas Cowboys of the 1990s. The Los Angeles
Lakers and Boston Celtics of the 1980s. The New York Yankees in just about every decade. But
what about the decade ahead? It belongs to the child. “The Decade of the Child: Healthy Children
2020 campaign” continued in 2011 and The Center for Children’s Health was formed. The center was
created to provide infrastructure and help sustain the Community-wide Children’s Health Assessment
& Planning Survey (CCHAPS) and the initiatives that were created using its data. The Center for
Children’s Health staff will continue to analyze CCHAPS data and find ways to connect the information
to the medical community, our community partners and ultimately, the general public.
Through CCHAPS, Cook Children’s executives and board members identified and committed to
beating seven opponents who stand in the way of the “Healthy Children 2020” campaign. With this
focus and the partnerships with new and existing coalitions formed in Denton, Hood, Johnson, Parker,
Tarrant and Wise counties, Cook Children’s can tackle these issues and The Center for Children’s
Health provides the framework to win these important battles.
Teams:
• Healthy Children Coalition for Parker County
• Hood County for Healthy Children
• Johnson County Alliance for Healthy Kids
• Wellness Alliance for Total Children’s Health
of Denton County
• Wise Coalition for Healthy Children
Opponents:
• Abuse • Asthma • Access to care
• Dental health • Mental health
• Obesity • Safety
21 | Cook Children’s 2011 Annual Report

“This is a very impressive group of community leaders who all
• Analyzed CCHAPS data specific to children in each county
for child abuse, asthma, dental health, mental health, obesity
and safety. Each county chose a health issue to set its focus:
Denton County – Mental health
Hood County – Child abuse prevention
Johnson County – Childhood obesity prevention
Parker County – Childhood obesity prevention
Wise County – Child abuse prevention
• Formation of coalitions for five counties.
• Continued to play an important role in new and existing
Tarrant County coalitions that address priority issues,
including Safe Kids Tarrant County, the Children’s Oral
Health Coalition, Mental Health Connection, Immunization
Coalition of Tarrant County and the Keller
Independent School District Asthma Coalition.
seem motivated and invested in this cause.”
-Community action planning participant
“Statistics! I haven’t been able to get health data
by county – now I have it!
-Community action planning participant
“The stats on the children of Parker County
and the collaboration of how to fight
these things were very useful.”
-Parker County Child Health Summit attendee
“Thanks to Cook Children’s for collecting the CCHAPS
data and helping us prioritize issues for action.
Denton County is grateful for this important support!”
-Bing Burton, Ph.D., Denton County Health Department Director
• Made 70 presentations of CCHAPS findings to local,
regional and national audiences through The Center for
Children’s Health team, reaching 1,798 professional and
community members.
22

In 2011, Cook Children’s continued to celebrate success with its Homeless Initiative and the impact it’s making on the community. In fact, it was one of only 10 programs nationwide to be named a 2011 Program
of Excellence in the Hospital Charitable Service Awards.
Cook Children’s launched the Homeless Initiative in 2008 to help combat the problem of homeless children in Tarrant County who were not receiving the most basic medical or dental care. Since then,
Cook Children’s and its community partners in the program are continually making progress at helping kids that are often forgotten.
Following are just a few examples of the Homeless Initiative’s successes for the program’s first four years:
• Provided primary care through three Cook Children’s Neighborhood Clinics to 639 children through 1,454 patient encounters, including 465 well-child visits
and 859 sick-child visits.
• Completed additional medical services for the children, including 209 for dental services, 136 for vision services, 75 for behavioral health and 286 for other services.
• Helped 193 children maintain a medical home at one of Cook Children’s Neighborhood Clinics after leaving the shelter.
• Coordinated with the Tarrant County Health Department to provide tuberculosis testing to 401 children. Cook Children’s nurses also brought flu and H1N1 vaccines
on-site to children and adults at the shelters.
• Provided preventive health education to 1,534 caregivers on behavioral health topics, nutrition, colds and flu, stress management, primary care, immunizations,
emergencies, sudden infant death syndrome/co-sleeping, prevention of child abuse, asthma, communication and parenting topics.
• Organized donation drives for Cook Children’s employees to contribute supplies, new shoes, coats, bedding, towels, washcloths, socks and underwear.
• From March 2008 through September 2011, Cook Children’s has funded $727,554 to cover Homeless Initiative expenses.
23
| Cook Children’s 2011 Annual Report

Teams are usually formed because there is a need to beat an
opponent. In the case of Project ADAM, the opponent is sudden
cardiac arrest. Project ADAM Texas at Cook Children’s is the
only affiliate in the entire state and one of only nine affiliates
around the country. Project ADAM helps schools implement
public access defibrillation (PAD) programs through support and
education. The mission of the program is to serve children and
adolescents through education and deployment of life-saving
programs that help prevent sudden cardiac arrest.
to protect the young lives of other children who may have
a cardiac arrest in a public setting. She began fighting for
AED education throughout the state of Texas and across
the nation.
Now, more than eight years after the passing of Sarah,
Friend is still fighting. And it was her passion and
determination that led her to bring the Project ADAM
program to Cook Children’s.
The events leading up to Cook Children’s involvement in Project
ADAM began on July 14, 2004, when Laura Friend dropped her
daughter, Sarah, off at a water park for her junior lifeguard class.
But Sarah never came home. Just three weeks shy from turning
13 years old, Sarah collapsed climbing the stairs of a water
coaster and was not resuscitated. She died of cardiac arrest due
to a heart disease, unknown to the family, called hypertrophic
cardiomyopathy – a thickening of the heart muscles or enlarged
heart.
When Friend learned that neither of the two AEDs housed in
the water park were used on Sarah because the park had no
emergency plan in place, her grief turned to anguish. Instead of
focusing on her own loss, Friend made it her new life mission
As its first year, 2011 was busy and productive for Project
ADAM Texas.
Season highlights include:
• Gave 150 school presentations on sudden cardiac death, amounting to more than 25,000 people reached.
• Presented Birdville Independent School District the Project ADAM Heart Safe designation for the successful implementation of a
quality sudden cardiac arrest program.
• Helped break attendance records at Cook Children’s Grand Rounds when Matt Dzurik, M.D., a Cook Children’s cardiologist,
presented on behalf of Project ADAM.
• Received recognition for providing AED education that saved the life of an Azle, Texas football player who went into sudden cardiac
arrest and was saved by a school nurse. The nurse had attended a Project ADAM training session just a few months earlier.
• Participated in a Capitol Hill Summit in Washington D.C., about sudden death in youth sports.
For more information, visit www.cookchildrens.org/heartcenter.
24

What’s the first question you hear after a team wins the championship? “Can you repeat?” After all, it’s much
harder to stay on top once you’ve reached the highest level. But not for the Cook Children’s Medical Center
nursing team. This extraordinary team achieved magnet designation for the second time!
Developed by the American Nurses Credentialing Center (ANCC), the Magnet Recognition Program ® is all
about celebrating organizations that demonstrate quality patient care, nursing excellence and innovations in
professional nursing practice. Cook Children’s is on a continual journey with Magnet to display that we value
a higher standard of care for our patients and a higher level of education among our nursing staff members.
Magnet’s guiding principles have been Cook Children’s game plan for helping recruit and retain
better nurses, improve patient satisfaction and achieve greater safety and quality outcomes.
By using evidence-based nursing practice, advanced nursing research and participating
in interdisciplinary collaboration, we were able to reach Magnet status for two
consecutive terms. This feat has only been achieved by 3 percent of all hospitals in
the nation. Each of these disciplines are important to us as an organization, as
well as the Magnet program.
At Cook Children’s, we continually raise the bar in
what we expect from ourselves. We are not content
to simply rest on past achievements. Continuous
improvement is the expectation.
Jade, age 8
Ballet Folklorico Azteca
Fort Worth, Texas
25
| Cook Children’s 2011 Annual Report

COOK CHILDREN’S REWARDS AND RECOGNITION - 2011
January 2011 – Cook Children’s Medical Center achieves Magnet ® re-designation. Fewer than 7 percent of hospitals nationally have achieved Magnet status and only 3
percent of hospitals have achieved Magnet re-designation.
February 2011 – Cook Children’s Health Care System is again named to the SDI’s Top 100 Integrated Healthcare Networks. This marks the third straight year we’ve
been in the top 100 and the third straight year that we are the only free-standing children’s system to make the list.
April 2011 – Cook Children’s Health Care System receives the Texas Award for Performance Excellence (TAPE) from Quality Texas Foundation. Only 38 companies/
organizations have received this award over the past 17 years. With only seven recipients from the health care field, we are the FIRST pediatric health care system to receive
this award, honoring us as a role model organization demonstrating exceptional performance and the highest level of quality.
April 2011 – U.S. Department of Health and Human Services, in collaboration with Critical Care Societies Collaborative awards an Outstanding Leadership Award to
Cook Children’s Medical Center for achievement in eliminating central line-associated bloodstream infections (CLABSIS). This national award recognizes our efforts to
eliminate health care-associated infections and our notable achievements that lead the way toward achieving this goal.
May 2011 – U.S.News and World Report releases its list of Best Children’s Hospitals 2011-2012. Cook Children’s is ranked in six out of the 10 specialties: Cancer #36,
Diabetes/Endocrine #29, Gastroenterology #50, Neonatology #47, Neurology/Neurosurgery #35 and Pulmonology #32.
August 2011 – Cook Children’s Urgent Care Center Lab in Southlake is awarded accreditation from the College of American Pathologists
for providing the highest standard of care for our patients.
September 2011 – The Fort Worth District Dental Society is the honored recipient of a Golden Apple Award in the category of Excellence
in Access to Dental Care Programs. This national award presented by the American Dental Association recognizes the group’s work
through the “Save a Smile” program led by Cook Children’s.
October 2011 – For the second year in a row, Cook Children’s Pediatric Surgery Center in Plano, Texas, is awarded the APEX Quality Award by
CTQ Solutions. Awardees are determined by excellence in patient satisfaction and delivery of care during the past twelve months.
October 2011 – Children’s Miracle Network Hospitals honors Cook Children’s Teddy Bear Transport Team with a 2011 Miracle Achievement
Award at its annual celebration in recognition of the team’s exceptional accomplishments and notable work.
November 2011 – For the third year in a row, Cook Children’s is named to The Dallas Morning News’ “Top 100 Places to
Work.” More than 1,100 companies were considered for this list. Out of the large companies ranked, we are the only non-profit
in the top 10, the highest ranked Fort Worth-based company.
December 2011 – For the second consecutive year, Cook Children’s Medical Center is one of 65 hospitals from around the country
named to The Leapfrog Group’s “Top Hospitals” list, recognizing hospitals that deliver the highest quality of care. We are one of 11
children’s hospitals and the only hospital in Texas on this prestigious list.
26

FY 2011
Inpatient Care
Licensed Beds 321
Admissions 11,874
Patient Transport
Ambulance 1,590
Airplane 221
Helicopter 229
Total Patient Transports 2,040
Outpatient Visits
Specialty Clinics 83,785
Neighborhood Clinic Visits 91,087
Outreach Clinics 10,658
Total Outpatient Visits 185,530
FY 2011
Emergency/Urgent Care Visits
Emergency Department 104,901
Urgent Care 3,931
Total Emergency/Urgent Care Visits 108,832
Intensive Care Admissions
Neonatal Intensive Care 801
Pediatric Intensive Care 1,166
Total Intensive Care Admissions 1,967
Surgical Procedures
Inpatient 4,492
Outpatient 12,032
Total Surgical Procedures 16,524
Primary Care Practice Visits 381,986
Specialty Patient Encounters 322,543
Home Care
Skilled Visits 8,754
Equipment/Supply Items 1,087,956
Pharmacy Doses 189,744
Medical Staff
Physicians 607
Volunteers 1,359
Volunteer Hours 96,596
Full-time Employees 4,364
FY 2011 Figures from Cook Children’s Health Care System’s “Detailed Statistics Reports”
dated 9/30/2010 and 9/30/2011.
27 | Cook Children’s 2011 Annual Report

FY 2011
Cook Children’s Health Plan
Membership 95,105
Net Revenue
Cook Children’s Medical Center $620,357
Cook Children’s Physician Network $120,540
Cook Children’s Home Health $34,933
Cook Children’s Health Plan $196,138
Investment Income $30,613
Contributions $5,558
Other Revenue $38,604
Total Sources of Revenue $1,046,743
Operating Expense $726,083
Community Benefit $93,341
Interest Expense and Fees $12,056
Capital Expenditures $131,070
Funds Available for Reinvestment $84,193
in Pediatric Health Care
FY 2011
Charity Care at Cost
Cook Children’s Medical Center $2,414,460
Cook Children’s Physician Network $638,085
Cook Children’s Home Health $61,680
Total Charity Care $3,114,225
Total Uncompensated Care at Cost
(Charity + Medicaid Shortfall + Bad Debt)
Cook Children’s Medical Center $32,045,457
Cook Children’s Physician Network $3,175,463
Cook Children’s Home Health $11,148,474
Total Uncompensated Care $46,369,394
Numbers Above Based on Revised IRS Methodology.
Total Uses of Revenue $1,046,743
Dollar Amounts Above are in Thousands.
Abby, age 5
Dancin’ Etc.
Mineral Wells, Texas
28

COOK CHILDREN’S HEALTH FOUNDATION
board of trustees
COOK CHILDREN’S HEALTH CARE SYSTEM
board of trustees
COOK CHILDREN’S PHYSICIAN NETWORK
board of directors
COOK CHILDREN’S MEDICAL CENTER
board of trustees
James R. Dunaway Jr., Chairman
Nancy K. Howard, Vice Chairman
Richard F. Garvey, Secretary/Treasurer
R. Jeffrey Alexander
Keely Appleton
Robin W. Arena
Brian D. Barnard
G. Thomas Boswell
Julia Davidson
Clarabele (Pit) Dodson, Trustee Emeritus
Randy Eisenman
Linda Morris Elsey
Martin H. Englander
David G. Fischer
Russell L. Fleischer
Rafael G. Garza
Joy Ann Havran
Mason D. King
Nicholas M. Kypreos
George F. Lebus
G. Malcolm Louden
Dan E. Lowrance
Tracy P. McGehee
Skylar P. Merrifield
Brian Newby
Michael R. Pavell
Joseph C. Penshorn
John M. Richardson, M.D., Trustee Emeritus
Todd Ritterbusch
Edwin S. “Win” Ryan
Vickie V. Stevens
Gary G. Walsh
James E. Webb
George M. Young Jr.
James R. Dunaway Jr., Chairman
M. Suzanne Whitworth, M.D., Vice Chairman
Rafael G. Garza, Secretary/Treasurer
Kimberly D. Aaron, M.D.
R. Jeffrey Alexander
G. Thomas Boswell
Michael J. Deitchman, M.D.
Gretchen Eames, M.D., MPH, Ex Officio
Richard F. Garvey
Angel W. Hernandez-Mulero, M.D., Ex Officio
Marsha Hilcher
Nancy Kay Howard
Christopher M. Huckabee
Samuel Kleinman, M.D.
Frank McGehee, M.D.
James P. Miller, M.D.
Donald K. Murphey, M.D., Ex Officio
Michael R. Pavell
Joseph C. Penshorn
Peter L. Philpott
Deborah Schutte, M.D.
Jason V. Terk, M.D.
Gary G. Walsh
James E. Webb
Kevin D. Wylie, D.O.
M. Suzanne Whitworth, M.D., Chairman
Deborah Schutte, M.D., Vice Chair, Specialty Care
Michael J. Deitchman, M.D., Vice Chair, Primary Care
Kevin D. Wylie, D.O., Secretary
Frank McGehee, M.D., Treasurer
Sandra Arca, M.D.
Vanessa Charette, M.D.
Maria del Pilar C. Levy, M.D.
James P. Miller, M.D.
Jason V. Terk, M.D.
Linda Thompson, M.D.
James Wheeler, M.D.
Todd Wolf, M.D.
Peter L. Philpott, Chairman
Marsha Hilcher, Vice Chairman
Andrew S. Wayne, Secretary/Treasurer
Corliss Baldwin
John P. Boswell
James F. Herd Sr., M.D.
Christopher M. Huckabee
W.M. “Mack” Lawhon
Sharon Schieffer Mayes
Patti McConnell
Roger P. Nober
Bonnie Petsche
John M. Richardson, M.D., Trustee Emeritus
COOK CHILDREN’S HOME HEALTH
board of trustees
Joseph C. Penshorn, Chairman
Angel W. Hernandez-Mulero, M.D., Vice Chairman
Robin W. Arena
John P. Boswell
Matthew V. Dzurik, M.D.
Richard P. Howrey, M.D.
Bonnie Petsche
Vickie V. Stevens
29 | Cook Children’s 2011 Annual Report

COOK CHILDREN’S NORTHEAST HOSPITAL
board of trustees
Richard P. Goode, Chairman
David Gray, M.D., Vice Chairman
Nancy C. Cychol
Stanley E. Davis
Candace Grantham
Joe Minissale
Natalie Roberge, M.D.
Andrew S. Wayne
COOK CHILDREN’S PEDIATRIC SURGERY CENTER
board of trustees
Jay Roden, M.D., Chairman
Richard P. Goode, Vice Chairman
Nancy C. Cychol
Stanley E. Davis
David Ewalt, M.D.
Rick W. Merrill
Joe Minissale
COOK CHILDREN’S HEALTH PLAN
board of trustees
Michael R. Pavell, Chairman
Donald K. Murphey, M.D., Vice Chairman
Brian D. Barnard
Vanessa Charette, M.D.
Martin H. Englander
David G. Fischer
James F. Herd Sr., M.D.
George F. Lebus
G. Malcolm Louden
Brian Ryals, M.D.
Karen Schultz, M.D.
Linda Thompson, M.D.
Hudson, age 5
Colonial Country Club
Fort Worth, Texas
30

Wichita Falls
N
Denton
Rhome
114
Keller
377
Highland
Village
Grapevine
Lewisville
Plano
75
Abilene
North
Richland
Hills
Southlake
635
Midland
Willow Park
Lake
Worth
Cook Children’s
Medical Center
121
30
Arlington
360
Grand
Prairie
Dallas
San Angelo
Fort
Worth
20
20
Benbrook
Brownwood
Granbury
1187
Mansfield
Desoto
45
Burleson
Waco
Cook Children’s Medical Center Surgery Center Primary Care Specialty Clinic Neighborhood Clinic
Cook Children’s Northeast Hospital
31 | Cook Children’s 2011 Annual Report