Transformational Leadership

Across our system, nurses inspire their colleagues and motivate their teams to continue achieving exemplary outcomes. By modeling actions that are consistent with the mission and vision of Children’s Health, our nurse leaders guide and empower clinical decision-making across the organization by aligning all initiatives with the strategy and priorities of our organization.

Our nursing strategic plan, which contains goals and tactics that cascade from the overarching organizational strategy, is arranged into five sections:

Promoting and advancing the role of the nurse
Preparing the future nursing workforce
Transforming nursing practice
Advancing professional nursing excellence
Fostering a culture of clinical inquiry.

In 2021, we continued working to optimize our leadership roles to promote greater engagement, increased retention and ongoing professional development of our nurses. Focused on strengthening connections and communication, we sought feedback from all nurses and bolstered our communication strategy to better promote and advance the various roles our nurses hold.

Collaborating at every opportunity, our nurse leaders guided their teams through numerous extraordinary projects and initiatives in 2021. In addition to the exemplars noted throughout this report, this work included:

Extended care coordination between community pediatricians and Children’s Health for medically complex patients
Successful completion of the American College of Surgeons (ACS) Quality Verification Program™
Management and staffing of employee, patient and community COVID-19 vaccine clinics.

Expanding Connection and Communication

Launched in 2020, the CNO Advisory Cabinet continued to be a primary source of direct communication between nurse executives and clinical nurses regarding the professional nursing practice environment in 2021. This open channel has further cemented professional relationships across a variety of roles and levels within the organization. Cabinet members not only advise nurse executives but also evaluate the impact of the decisions made. Key decision points from cabinet members’ input shaped the continued guidance and evaluation of our ongoing COVID-19 management strategies, including staffing adequacy, caregiver visitation restrictions, Occupational Health screening processes and vaccine administration for employees and patients.

Nurses connect logo Rooted in the strong desire to expand the way we communicate with and connect to nurses, cabinet members recommended and helped design our first nursing podcast, “Nurses Connect.” The podcast was launched in November 2021 with content determined by a short survey completed by nurses across the system. Podcast episodes are succinct, timely and directly related to nurses’ professional work, with the first topics focused on the future of nursing at Children’s Health and nurse recognition.

In addition to the CNO Advisory Cabinet, nurse leaders at Children’s Health facilitate connection and communication with all nurses. While maintaining safety protocols and continuing virtual options, we also implemented a few small-group, in-person interactions in 2021 alongside our traditional communication methods, such as:

CNO Forums: The first of these, held virtually in August, drew more than 680 participants to learn more about the evolution and management of the COVID-19 pandemic, our nursing strategy for the coming year and key takeaways from nursing-led research and quality efforts.
Talks With Tammy: These informal small-group conversations with the chief nursing officer feature updates on top-of-mind matters and dialogue with clinical nurses.

Nursing Newsletter: This monthly publication includes a letter from the chief nursing officer and regular features on opportunities for further education and professional growth, exemplars of nursing practice, nurse honors/awards and more.

Town Halls: Executive and senior nurse leaders regularly present at these meetings, providing system-wide clinical and operational updates.
Weekly Rounding: Nurse leaders round in patient care areas to connect with team members. During their weekly rounds, our leaders bring the Recognizing Employee Dedication (RED) cart full of snacks, beverages and small gifts as an additional way to recognize team members for their hard work.

Supporting Our Clinical Teams

Mid-2021 brought the height of the COVID-19 pandemic in pediatrics nationwide, occurring simultaneously with a rise in cases of other more common respiratory viruses such as RSV. Further advancing our profession, our nurse leaders began developing innovative initiatives to address increased patient care needs and nurse burnout in a variety of areas. These unique strategies included:

Beyond the Bedside Nurse Redeployment: The increased number of kids presenting with respiratory viruses in the summer of 2021 led to the development of the System Surge Staffing and Planning workgroup. As participating nurse leaders brainstormed ways to meet increased staffing needs, nurses across the system began volunteering to help. Beyond the bedside nurses contribute to our mission in over 100 departments across the system in non-clinical and indirect patient care roles, and with support from our Clinical Education partners these nurses were trained to return to the bedside. The response was overwhelming, and beyond the bedside nurses were excited about the opportunity as they demonstrated selfless service and commitment to excellence by helping fellow nurses care for patients at the bedside again.
Psychiatry Resource Nurse Pilot: The nationwide mental health crisis among adolescents and teens can be clearly seen and felt at Children’s Health. Our patients are often admitted with complex, intertwined medical and behavioral concerns, leading to the development of the Psychiatry Resource Nurse pilot program, launched in late 2021. The program provides an expert psychiatry nurse seven days a week to support all clinical areas and entry points, compliance monitoring and the maintenance of a safe environment for patients, their caregivers and our team members.

The program is both proactive, identifying needs and ways to meet them before a crisis develops, and reactive, responding to situations requiring a behavioral emergency resource team and assisting with de-escalation, as well as auditing behavioral-restraint events in real time to improve compliance with documentation standards. Importantly for nurses’ resilience and patient safety, the psychiatry resource nurses facilitate a debriefing after incidents that require patient restraint.
Workflow Redesign: In Dallas, Clinical Managers in Acute Care Services worked to standardize and implement conditional discharge orders in Epic to support a more efficient patient flow process from the Emergency Department (ED), optimizing inpatient bed availability. Additionally, Dallas campus leaders led teams to redesign the flow of patients within the ED, developing a dedicated waiting space for lower-acuity patients so those with more urgent needs could be seen more quickly.
Patient Experience and Care Kits: Many patients and families had long wait times in the Emergency Department during COVID-19 surges. In Plano, nurse team leaders led a project to improve the experience of our patients and families when they encounter delays. Seeing the experience through the eyes of the patient and family led them to create new processes for communication from triage to discharge, and they developed a Care Kit. It included items that families needed if they were staying the night such as a blanket, socks, a phone charger and other essentials. This improvement project produced a significant increase in patient satisfaction, and it brought great joy to nurses to provide Care Kits to families during such a stressful time.