Texas Children's Hospital
Houston, Texas
A core commitment to family-centered care
Texas Children's Hospital in Houston, Texas, recognizes the importance of family to the patient's health and well-being. At Texas Children's, families are respected and supported in their roles as caregivers and decision-makers.
Texas Children's upholds the following core principles of family-centered care:
- People are treated with dignity and respect;
- Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful;
- People build on their strengths by participating in experiences that enhance control and independence;
- Patients, families and providers collaborate in policy and program development, professional education, and the delivery of care.
Texas Children's has sent a multidisciplinary team to the "Hospitals Moving Forward with Family-Centered Care" seminar each year since 2000. Each team has included at least one parent and has returned to Houston with renewed enthusiasm and commitment to the core principles of family-centered care.
Family-centered care is incorporated into all services at Texas Children's Hospital, including the Texas Children's Emergency Center, which handles approximately 80,000 visits yearly.
Welcoming families with open arms
Families are welcomed to Texas Children's with artfully decorated halls, brightly colored walls, spacious waiting rooms filled with children's art, two-story geometric play forms, aquariums, bubble tubes and well-stocked play areas. At times waiting is inevitable, but it's made easier when parents are given pagers when they check in at centralized waiting desks. They can freely visit the special areas designed for children and families until the pager notifies them that the staff is ready to see them. A food court, featuring Chick-Fil-A Express, Subway, Villa Pizza and specialty coffee at the Beanstalk Café, offers families' appetizing alternatives to everyday fare.
The supportive attitude at Texas Children's reaches far beyond the pleasant atmosphere that greets patients, families and visitors. The philosophy of family-centered care at Texas Children's Hospital recognizes that parents and health care professionals, working as teams, provide the best possible care for children. In support of this, Texas Children's has implemented many changes based on informational sessions held with families of patients. For instance, families participated in planning discussions throughout the design process for Texas Children's history-making expansion.
These sessions gathered input from parents that helped enhance the family-centered care experience Texas Children's provides to its patients and their families. Two essential principles that surfaced during those meetings have laid the foundation for Texas Children's approach to care:
- Families are involved in patient-care decisions.
- Treatments are designed based on family input.
In 2000, the Family Advisory Board (FAB) was formed to provide a strong voice in developing the concept of family-centered care. The board's membership was originally derived from the families who were participating in the design of the new Texas Children's buildings and spaces. The synergy developed from that process has continued to energize the partnership. Using materials from the Institute for Family-Centered Care, an orientation was held for all original FAB members, including the staff participants. Expectations were set and goals defined.
The board now meets monthly to discuss issues including communication and the hospital environment. Texas Children's staff members work with the board, using the FAB's input to help plan policies, make decisions on new programs and review changes in operating procedures.
Members of the FAB have presented at Texas Children's Management Forum and Executive Council. They also have presented at Grand Rounds for Baylor College of Medicine, held at Texas Children's.
Following the first meeting of the Children's Advisory Board in September 2004, ongoing monthly meetings will allow staff to hear what the patients want and need directly from the experts, the kids themselves. Transportation vouchers will be provided to enable many children to participate.
Expanding on what families want
Early in the process of planning the hospital's expansion, which was completed in 2001, Texas Children's arranged for the architects to meet with parents and patients to discuss their needs and suggestions. FKP Architects, whose staff includes parents who have stayed more than 600 nights with their children at Texas Children's Hospital, listened to parents of chronically ill children who visit the hospital often.
In addition to patient-care rooms that are 50 percent larger, the expansion incorporated the following parent-suggested features:
- Sleeping accommodations for parents staying in children's rooms are equivalent to twin beds in size and comfort;
- Separate light controls allow parents to read without disturbing children;
- Ample storage, including a small safe for valuables, is provided for family items;
- Dry-erase markers are part of admissions packets so parents and patients can write on reusable boards in each room;
- Built-in TV/VCR/electronic game hook-ups are provided at each bedside;
- Laminated work surfaces are built into footwalls;
- Rollaway beds accommodate additional relatives;
- Ronald McDonald House of Houston provides hotel-style rooms within the hospital, available for overnight stays and nap time, and a comfortable living room and kitchen area for respite;
- Designated areas on bed floors enable family members to talk privately, out of hearing range of the patient;
- Family areas on each floor include ice machines, microwaves, coffee all day, and breakfast muffins every morning;
- Free laundry facilities on the family services floor are close to the patient care units;
- Rooming-in rooms (essentially hotel rooms within the hospital) give parents of newborns the opportunity to try their home routines before discharge; and
- A recreation area on the16th floor offers families an escape from the rigors of medical treatment.
Sweet 16: The floor where families find personal services
In keeping with its family-centered care concept, Texas Children's has consolidated useful resources on the family services floor, the 16th floor of the West Tower
- Radio Lollipop is Texas Children's award-winning, in-hospital radio station, which broadcasts through the hospital's television system on "Terrific Tuesdays," "Thrilling Thursdays and "Super Sundays." Broadcasts feature interactive games, art projects and contests in which patients can win prizes. Volunteer disk jockeys take musical requests and put children on air from their bedsides or in the studio, where patients can visit and watch presenters play Top 40 hits and children's favorites. Children also call in to request songs from their rooms. Radio Lollipop is coordinated by the Child Life and Volunteer Services departments and staffed by its own team of dedicated volunteers. Texas Children's is one of two Radio Lollipop hospitals in the nation.
- The preteen room, for patients ages 8 to 12, features a stage, video games, a pool table, an air hockey table, scheduled craft projects and Starbright computer stations. Starbright allows patients to play games, access the Internet and either chat online or videoconference with children at other hospitals.
- The teen room, for patients ages 13 and older, includes a theater screen and Starbright computer stations. Patients play video games, listen to music, enjoy various crafts and play pool.
- School classroom instruction is available to patients staying at Texas Children's more than five days.
- A hair salon, staffed by a professional stylist from Fantastic Sam's, offers free basic services for patients and parents.
- A snack area provides vending machines and microwave ovens for families 24/7.
- Pi Beta Phi Patient/Family Library offers thousands of books for all ages, medical and parenting resources, paperback fiction, magazines, foreign-language books and scheduled story times. Also available are video and audio tapes, tape players, a computer station, board games, puzzles and switch/adaptive toys for children with special needs. Phi Beta Phi book nooks are located in waiting rooms throughout the hospital's buildings. Volunteers take a book/video cart to patient rooms.
- Family resource room offers access to phones, fax, computers, printer, copier and the Internet with e-mail access. Patients and their families can create and update personal Web pages, called Care Pages, to communicate with friends and family and to update them on the child's condition. A voice mail system for parents will be implemented in the fall of 2004, so families can post a message for callers, updating the latest news. In addition, friends and family can leave messages of support for parents and patients.
Continuing commitment to training
Texas Children's Hospital has continued its commitment to family-centered care through ongoing education and training. The hospital is providing leadership support to bring the Institute for Family-Centered Care's annual seminar for hospitals providing pediatric, maternity, and newborn intensive care to Houston, in April 2005.
The hospital hires and educates staff to support its philosophy of family-centered care. Texas Children's has one of the largest child-life departments in the country, with more than 30 child-life specialists and child-life partners. These professionals have studied child development and the reactions of children to health care settings. They provide emotional and psychosocial interventions with hospitalized children and their families based on individual needs. Child-life specialists serve all areas of Texas Children's Hospital including the inpatient floors, outpatient clinics, neonatal units, renal dialysis and the emergency center.
As further expression of its commitment to involving families in care and considering all of the patient's needs when planning treatment, Texas Children's Hospital initiates and encourages patient and family support groups, community outreach, patient camps, school re-entry services, and other supportive services for the entire family.
At Texas Children's Hospital, family-centered care involves an ongoing process of growth, change and improvement. The hospital values the process of working together to explore new paths, take greater strides and reach higher goals. The journey is just beginning.