Dell Children’s Medical Center of Central Texas is the 11th children’s hospital in the country to be verified by the American College of Surgeons as a Level I Children’s Surgery Center. It earned the certification by meeting the highest criteria in the college’s new Children’s Surgery Verification Quality Improvement Program.
The program will help the hospital to continue to improve the quality of surgical care and ensure it is following the highest standards of care.
“I’m a mom,” said Dell Children’s chief surgeon Dr. Nilda Garcia. “One of the things I fear most is anything happening to my child. For me, being a mom, it means this hospital has gone above and beyond in their care of my child.”
Texas Children’s Hospital in Houston is the only other hospital in Texas to receive this verification.
Dell Children’s had to meet strict criteria and send a lot of data to the verification team over the course of about a year. Three doctors representing the college came to Austin in late April to verify Dell Children’s had met the criteria.
To meet this certification level, Dell Children’s had to make some changes. It joined the National Surgical Quality Improvement Program, which requires sending a lot of data about procedures, outcomes and complications to the college. The college gives feedback about how Dell Children’s compares to other hospitals in the country.
The hospital also created an office specifically to look at surgical quality, what kinds of criteria it should establish, why certain cases fell out of that criteria and how the hospital can improve.
Dave Golder, who is the director of the surgical quality program at Dell Children’s, says the hospital has reduced the number of CT scans it uses to diagnose things such as an appendicitis, instead relying on a physical exam by a doctor and an ultrasound by someone trained in detecting an appendicitis to diagnose one. This reduces radiation exposure to kids. Staff have reduced the number of Foley catheters used in surgeries, which reduces the risk of infections, and have reduced the amount of blood transfusions given.
Golder says he’s most proud of how the hospital outperformed other hospitals in preventable harm events such as sepsis, surgical infections and urinary tract infections following surgeries.
“Standardized care is a cultural thing and it has taken off (at Dell Children’s) in the last five or six years,” Garcia says. “The interest in adhering to (criteria) has been remarkable really.”
Going forward, the hospital is working on how it controls patients’ pain to reduce the amount of opioids given, as well as reducing the amount of unnecessary antibiotics given. It’s also working on how to implement Enhanced Recovery After Surgery programs that will do things such as give carbohydrates to patients before surgery, get patients moving quicker after surgery and shorten the length of stay after surgery.
Dell Children’s will continue to submit data every year to the college and will be reverified for the Level I certification every three years.
“We are maturing,” says Garcia, “and this is a step toward that.”