Dallas is among cities, counties and other local governments that have recently adopted race equity plans. In the 2022-2023 goals and metrics report, city officials have said they want to track their goals, which include tracking air quality in certain areas and upgrading water and sewer lines in neighborhoods that haven’t seen investment for decades. There’s a line in there about improving the health of the city’s Black and Hispanic residents, who represent more than 60% of the population of the country’s ninth-largest city and are more likely than their white peers to have preventable chronic diseases.
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Dallas, Baltimore children’s hospitals embrace high-tech features in behavioral health areas to promote calmness
Children and teenagers presenting to emergency rooms with behavioral health crises sometimes wait hours to days for a bed in a psychiatric unit or facility. Children’s Medical Center in Dallas is trying to make that stay less stressful for patients and their families by incorporating technologies such as mood lighting, projected images of calming scenery and an interactive touchscreen allowing patients to draw, play music or games.
Also, this year, the University of Maryland Children’s Hospital in Baltimore opened a new inpatient psychiatry unit for patients ages 5-17 featuring nature themes, special lighting and patients’ choices of relaxing sounds. In both cases, clinicians aim to create more calming environments to help de-escalate behavioral and mental health crises.
The Dallas hospital opened three “Philips rooms” (named after Phillips, their health care technology partner) in their emergency department in June 2021. A fourth is scheduled to open in 2022.
The inspiration behind these rooms
Inspiration came partly from two memorable patient experiences, said Keri Kaiser, senior vice president and chief marketing and experience officer for Children’s Health, during a recent webinar hosted by Becker’s Healthcare. Kaiser was in the ED one day when she saw a young girl, who was extremely violent, being held in a bare room alone. She was in the custody of Child Protective Services and had no parents or guardians with her. Because of her aggression, staff limited their interaction while hoping to find a placement in a psychiatric facility. On another occasion, Kaiser’s friends told her that their daughter, who was being held in the ED, was physically safe but felt helpless being stuck in a bare room.
Shortly after, Kaiser and others with the health system were scheduled to visit Philips to see what technology advancements could be brought to the neonatal intensive care unit. The company has worked with hospitals to offer what it calls the “ambient experience” — a variety of room designs, dynamic lighting, image projection and calming sounds to make waiting areas, and procedure and recovery rooms more pleasant. As Kaiser viewed these options, she asked if they could also be used for behavioral and mental health patients in the ED.
Geneva Burnap, M.B.A., R.N., N.E.A.-B.C., a nurse, and senior director for emergency services at Children’s Health, said during the webinar that she initially got some pushback about creating these rooms, because behavioral health holds only made up 4.5% of their patients. But studying analytics, she and her colleagues found that some 20% of care hours were spent on these patients.
Investigation finds hospital’s leader spent public money on personal interests
Reese Dunklin and Sue Goetinck Ambrose of The Dallas Morning News document how Kern Wildenthal, the former UT Southwestern Medical Center president and its current chief fundraiser, spent hundreds of thousands in public dollars in recent years to build campus wine cellars, pay for his opera interests and travel to paradises around the world.
The investigation details a collapse in controls over taxpayer dollars and triggered a University of Texas System internal inquiry that found many of the same problems. Two auditors were jettisoned in response, Wildenthal will be forced to pay restitution and reforms are being considered. Continue reading
Dallas reporters use AHRQ data to measure patient safety
The Dallas Morning News continues its 19-month investigation into patient safety at UT Southwestern Medical Center and Parkland Memorial Hospital.
The project, “First, Do No Harm: An investigation of patient safety in Dallas hospitals,” is behind the website’s paywall but The Dallas Morning News has granted AHCJ members access. To find out how to access the stories, please click here and log in as an AHCJ member.
Among the latest reporting:
Dallas Morning News reporters Ryan McNeill and Daniel Lathrop took advantage of AHRQ’s Patient Safety Indicator (PSI) software, typically used internally by hospitals, to process 9 million publicly available patient records from Texas hospitals, all of which came from between
Parkland, the prominent local hospital that has earned scrutiny on numerous prior occasions, was just the most notable of a number of area hospitals that came up short (and generated headlines), but our interest lies more with the reporters’ investigative methodology as well as the path they’ve blazed for broader hospital quality reporting.
All their work was done in consultation with experts in the field, including academics, government officials and hospital administrators. An outside review indicated McNeill and Lathrop used the software properly, and their results were in line with a similar public analysis. But that’s not to say it was a simple process.
The newspaper spent six months analyzing nearly 9 million state hospital discharge records using Patient Safety Indicators, or PSI, software. This highly sophisticated system was designed for the federal government as a tool to measure potentially preventable complications among hospital patients.
The PSIs do not present a complete safety picture because they are based on administrative data — a summary of diagnoses, procedures and outcomes derived from patients’ medical charts, as opposed to a complete review of all medical records.
It’s not a perfect measure, but it’s one of the best available.
PSIs “reflect quality of care inside hospitals,” according to the Agency for Healthcare Research and Quality, a division of the U.S. Department of Health and Human Services. It released the PSI software in 2003 and periodically updates it, most recently in August. The News used that version for its final analysis.
The software analyzes the administrative data that nearly every hospital in Texas reports to the state. No patient-identifying information is included.
The results on 15 PSIs are statistically “risk-adjusted” because some hospitals treat a disproportionate share of unhealthy patients, who face a greater risk of potentially preventable complications. Rates from eight of the indicators are used to determine a hospital’s patient safety “composite score.”
The AHRQ has just started posting some PSI measures on Hospital Compare, and the Texas health department plans to follow suit in 2013, but reporters looking to get their hands on a broader swath of the data will still have to follow the Dallas duo’s do-it-yourself approach.
The reporters’ work drew criticism from the Texas Hospital Association, which said the methodology was “not intended for use in public reporting.” McNeill refutes its claims in a blog post. Daniel K. Podolsky, president of UT Southwestern Medical Center, also sent a letter criticizing the reporting. George Rodrigue, managing editor of The Dallas Morning News, published a point-by-point response to Podolsky’s letter.
Hospital sues to block release of records
Parkland Memorial Hospital in Dallas, the subject of recent reports that patients were at risk, has sued the Texas attorney general in an attempt to prevent the release of records requested by The Dallas Morning News.
Parkland filed the latest lawsuit — its fifth against the AG related to the newspaper — on Monday. This time the goal is to block release of Parkland police department records dealing with the psychiatric emergency room. The News is not seeking medical records.