Children’s Health’s Mission to Save Dallas’ Children
The hawking shell of what used to be RedBird Mall in southern Dallas is a place in transition. A new, free-standing Starbucks on the outskirts of the sprawling parking lot contrasts with a closed and vacant Golden Corral buffet. Across Camp Wisdom Road, there are multiple to-go daiquiri locations interspersed between fast-food restaurants and payday lenders.
Surrounding the mall, construction fences make traversing the retail space difficult, but they signal that change is on the way. Retail space is transforming into healthcare. The area is one of hope juxtaposed with neglect—healthcare with unhealthy options.
This corner of Dallas will soon be an outpost of Children’s Health, joining affiliated organizations Parkland and UT Southwestern in the former mall. But it will be more than just a place to see a pediatrician or specialist. It will be a symbol of a greater mission, a manifestation of the desire to serve the underserved and be an educational home for providers in the region. The southern Dallas development may be unconventional for a healthcare facility, but Children’s Health is no stranger to unconventional beginnings. In 1913, a group of nurses organized the Dallas Baby Camp, an outdoor clinic on the lawn of the old Parkland Hospital. It was part of the growing recognition that children were not just small adults in mind or body and needed their own hospital to serve their unique needs.
More than 100 years later, the health system is the only hospital in the region ranked in 10 out of 10 specialties by U.S. News & World Report and is the eighth-largest pediatric healthcare provider in the nation. In the 1990s, Children’s Health took over the safety net care for children of Dallas County from Parkland Hospital. But what makes the system stand out this year is how it is reaching out to the community to expand access to patients and serve as an educational outlet for area providers. For those reasons and more, Children’s Health has been named the Health System of the Year in D CEO’s 2021 Excellence in Healthcare Awards.
Minding the Gap
Dallas is one of the most segregated cities in the United States. An Urban Institute study recently ranked Dallas 272 out of 274 cities in the country for opportunity for all residents, especially underserved populations, to benefit from and contribute to economic prosperity. By any number of measures, Dallas is split between the haves and have-nots, and that lack of economic integration plays out in racial division, too. In a UT Southwestern measure of life expectancy in different Dallas ZIP codes, crossing a highway from a low-income neighborhood to a higher-income neighborhood can mean an increase of more than 20 years.
In Dallas, Interstate 30 is often the line of demarcation. Opportunity, resources, and, yes, healthcare are concentrated on the north side of town. While hospitals, clinics, and provider offices are ubiquitous in North Dallas, southern Dallas experiences a dearth of healthcare options. That distance can be a hurdle for the residents of the city’s southside, meaning they may not be able to get the care they need for themselves and their children.
Students in Dallas Independent School District, which is 94 percent students of color, experience asthma at more than a percentage point higher than the national average. Half of children in Dallas County are either obese or in danger of becoming obese as adults. These health gaps mean more missed class, growing the educational gaps that already exist between low-income students of color and their wealthier, White counterparts.
It is into this segregated environment that Children’s Health is planting, but their patients were already coming from communities like this. Seven of 10 Children’s Health patients have Medicaid or CHIP, half are Latino, and one-fifth are Black.
Partnering with UT Southwestern via a joint pediatric enterprise, the new development will anchor the Reimagine RedBird development and include around 68,000 square feet of space dedicated to pediatric service lines. The services will be anchored in primary care and include specialists such as cardiologists, pulmonologists, urology, and others. Co-locating primary care with these specialties will add convenience for patients who may not be able to make several appointments at different places.
“We as a system want to be able to go out to the community irrespective of their payer mix,” says Dr. Dai Chung, the chief medical officer of Children’s Health System and UT Southwestern’s Joint Pediatric Enterprise. “We truly believe in our mission, and we want to provide the best care for the kids in southern Dallas. That’s the foundation and why we have a strong presence there.”
The facility will be a pediatric resource closer to home for underserved in southern Dallas. The system is also making a push to have a clinic in RedBird that will focus on training pediatricians in the area to diagnose and treat mental health issues. It will have child psychiatrists who can help improve the area’s pediatric network to be able to identify and treat the lower-level behavioral healthcare matters in their practices. Initiatives such as this have a multiplying effect on the community, as pediatricians are better equipped and educated.
“Care is always a better idea closer to home,” says Chris Durovich, CEO of Children’s Health. “This is a holistic endeavor to keep the child physically and mentally well. Our efforts are a natural extension of who we are and what we do. We are working with community providers to be a resource of primary care, specialty care, and mental health for the growing community in southern Dallas.”
The Other Pandemic
While the COVID-19 pandemic disrupted every aspect of society, the isolation and cancelation of life threw gasoline on the flames of an already burning pediatric mental health crisis. A study of more than 80,0000 children from the Journal of the American Medical Association found that 12.9 percent of children experienced depression, and 11.6 percent felt anxiety before the pandemic. The August 2021 study found that depression was present in 25.2 percent of children, while 20.5 percent had anxiety. The conditions of the pandemic caused prior levels to double.
At times during the pandemic in North Texas, there weren’t enough inpatient psychiatric beds; Children’s Health would house patients in other areas or the emergency department while staff made contact with other facilities across the region to find a bed in another facility. But help was on the way.
Given an influx of children with mental health conditions into the health system’s emergency departments, Children’s Health created an innovative partnership with Perimeter Health, a relatively recent arrival to the North Texas region. Its Perimeter Behavioral Hospital of Dallas began accepting patients in the early days of the pandemic, and has quickly grown. The Georgia-based health system provides behavioral health services for children and adults; its quality and ability to expand caught the eye of Children’s Health. The systems began sharing best practices and quality data, and soon a small partnership grew in a big way.
Perimeter has two pediatric behavioral health hospitals in North Texas; the partnership allows patients who come into Children’s Medical Center needing psychiatric hospitalization to be transferred to Perimeter, where it had reserved and staffed 40 beds explicitly for use by patients arriving from Children’s Health. Perimeter remodeled its space to add the capacity, and now provides 10 intensive care unit beds for children with more intense behavioral health needs.
“It’s a unique relationship, says Philip
Willcoxon, regional CEO at Perimeter. “It will be interesting to see how it works. So far, it has worked very well. But it’s a case study to say, ‘Does this work here? Can it work in other markets?’ At the end of the day, it goes back to the patient getting the appropriate level of care. These relationships are important, not just for our needs or Children’s Health’s needs, but the needs of the patient and their family.”
The partnership gets children out of a hectic emergency room quicker, helping them receive the treatment they need in a timely manner. The timing couldn’t have been better. “I can’t even imagine what it would be like if they had not opened up at that time,” says Sue Schell, Children’s Health vice president and clinical director of behavioral health. “Prior to that, there were very few patients that could be hospitalized. That’s frightening when you think about it and look at the impact on the pandemic.”
A Community Effort
The United States has some of the best hospitals in the world, and if patients need top-notch pediatric care, they can’t do much better than Children’s Health. But if barriers prevent those patients from receiving the excellent care offered by the system, it might as well not exist. Both the partnership with Perimeter Health and the RedBird expansion are part of a larger trend in healthcare of improving access for patients. And in a year where a lingering pandemic has made regular medical care and a connection to an integrated system even more critical, Children’s Health is satisfying a growing need for kids and their families in North Texas and around the country.
Part of Children’s Health’s mission is to provide the right care, at the right place, at the right time. With the tide of mental health needs threatening to overwhelm providers and more than one in five children in Dallas County living in poverty, that mission needs to be fulfilled now more than ever.
“As we are able to reach into communities and provide primary care with our partners, it helps us steward our resources and enables us to continue in our mission,” Durovich says. “Kids from Highland Park and South Dallas are all coming through here, and we are going to continue to provide care where they live and go to school. It’s a community effort.”
Mental Health Hub
Children’s Health is the regional base of a state program called the Child Psychiatric Access Network, which allows pediatricians to register and have access to pediatric mental health experts. Many primary care physicians do not feel adequately trained to address mental health issues, even though as many as one-third of all cases involve mental health concerns. The Texas Legislature funded the program to give pediatricians across the state free access to child psychiatrists at Children’s Health. The primary care providers can discuss patients and situations with experts to allow them to grow in their own practice and treat low-level mental health conditions without referring the patient to a psychiatrist. Because of a shortage of pediatric mental health providers, scheduling a visit can often take weeks or months to schedule. Children are more likely to get in to see their pediatrician than a mental health specialist, and consulting via CPAN can help providers manage symptoms before they become an emergency.
Healthcare innovators are always trying to lower the bars to access care, and Children’s Health has played a massive role in connecting children to providers through Dallas-Fort Worth. The health system’s school-based telehealth program allows children to see a provider and be diagnosed while at school or learning from home, avoiding the scheduling, extra trip to the pediatrician, and missed work that often follows a sick child. The appointment can also lead to a prescription that can be delivered to the home or picked up at a local pharmacy. Whether it is asthma, flu, pink eye, earaches, or other conditions, the program connects students and their parents at more than two dozen school districts and more than 200 schools via their school’s nurse with a Children’s Health physician or nurse practitioner.
2021 Excellence in Healthcare Winners and Finalists
Achievement in Community Outreach: National Association of Hispanic Nurses, Dallas Chapter
Finalists: Baylor Scott & White Health and Wellness Center; Taylor Counseling Group; Texas Health Resources
Achievement in Innovation: TimelyMD
Finalists: BlockitNow; Children’s Health; IntelliCentrics
Achievement in Medical Research: UT Southwestern Medical Center and Texas Health Resources
Finalists: Baylor Scott & White Health; Prism Health North Texas
Outstanding Wellness Program: Baylor Scott & White Health
Finalists: Choice Health at Home; Methodist Health System; Whitley Penn
Outstanding Health System: Children’s Health
Finalists: Baylor Scott & White Health; Dallas-Fort Worth Hospital Council; Medical City Healthcare; Methodist Health System; Texas Health Resources
Outstanding Healthcare Collaboration: Nexus Recovery Center and Parkland Health & Hospital System
Finalists: Baylor Scott & White Health, Texas A&M University, and Baylor College of Medicine; Children’s Health and Perimeter Health; Methodist Health System and Dallas County
Outstanding Medical Real Estate Project: Texas Health Resources
Finalists: Baylor Scott & White Health and American Cancer Society; Children’s Health; UT Southwestern Medical Center
Outstanding Merger or Acquisition: Steward Health Care
Finalists: AMN Healthcare; MB2 Dental; StratiFi Health
Lifetime Achievement in Healthcare: Dr. William C. Roberts, Baylor Scott & White Health
Outstanding Healthcare Advocate: Robert Ferguson, Texas Health Resources
Finalists: Karla Alvarado, Baylor Scott & White Health; Dr. John Carlo, Prism Health North Texas; Diana Driscoll, POTS Care
Outstanding Hospital Executive: James (Jim) Scoggin Jr., Methodist Health System
Finalists: Dr. Dai Chung, Children’s Health; Kirk King, Texas Health Resources; Zach Mueller, Medical City Healthcare; Janice Walker and Dr. Alejandro Cristobal Arroliga, Baylor Scott & White Health
Outstanding Healthcare Executive: Stuart Archer, Oceans Healthcare
Finalists: Dr. Christopher Crow, Catalyst Health Network; Awstin Gregg, Connections Wellness Group; Clayton Walberg, Aspen RxHealth; Dr. Andrew Ziskind, Southwestern Health Resources
Outstanding Healthcare Innovator: Vicki Nolen, Christus Health
Finalists: Nick Reddy, Baylor Scott & White Health; Kirsten Tulchin-Francis, Scottish Rite for Children; Danielle Wesley, Children’s Health
Outstanding Healthcare Practitioner: Dr. Jeffrey Zsohar, Baylor Scott & White Health
Finalists: Dr. Anthony F. Boyer, Methodist Richardson Medical Center; Dr. Dawn Denise Johnson, Children’s Health; Dr. Allison Liddell, Texas Health Dallas
Outstanding Healthcare Volunteer: Kristen Baidy, Children’s Health
Finalists: Tim Davis, Texas Health Presbyterian Hospital Denton; Marjorie Jackson, Methodist Health System; Raymond Ornelaz, Baylor Scott & White Health