b'SPECIALIZED CARE TEAMS.In close collaboration with UT Southwestern, we are actively involved in large, national studies to better understand and provide optimal care for babies on these specialized care teams:Extracorporeal membrane oxygenation (ECMO): Childrens Health has been a leader in ECMO for more than 25 years. We have been designated an ECMO Center of Excellence by the Extracorporeal Life Support Organization and are highly experienced in using this technique to help the tiniest babies. Congenital diaphragmatic hernia (CDH): This complex condition requires a dedicated, multidisciplinary team of highly trained experts that help families and their babies achieve a successful outcome. Our CDH team first meets families in the FETAL Center and offers comprehensive evaluation and imaging; a delivery plan that will enable prompt supportand care; and surgery by some of the nations top pediatric surgeons, using the latestsurgical techniques.Intestinal failure: Childrens Health offers comprehensive care for intestinal failure via a team NICU advanced practice manager Marcia Bishop, MS, APRN, NNP-BC, and nursethat includes neonatologists, surgical specialists and gastroenterologists, along with nutrition managers Whitney Lewis, BSN, RN, CPN, and Kymeyone Lanehart, BSN, RN, CPN, created a NICU Solution Board that is now implemented systemwide. support, to provide intestinal adaptation. We see more babies and children with intestinal NURSES TAKE THE LEAD. failure and related disorders than almost any center in North Texas, giving us the experience and expertise to match each patient with the treatment that delivers the best opportunity for The essence of quality improvement is not a system that assigns errors to individuals anda good outcome. seeks punitive reform, but one that fosters the engagement of invested, dedicated hard-working health care professionals and identifies how the system can better support staff toNeonatal resuscitation: Childrens Health and UT Southwestern have specialized resuscitation provide the highest-quality care to patients. teams at our partner delivery hospitals. Our practiced and collaborative team attends the birth at partner hospitals, and the team strives to better understand and optimize the resuscitative In addition to a monthly safety meeting strictly for nurses, Lisa leads a monthly meeting thatpractices of neonates within Level IV NICUs through the Childrens Hospitals Neonatal involves leaders from several teamsfrom social work to speech therapyto troubleshootConsortium.problems and find better ways to work together in the NICU. The multidisciplinary approach works for safety just like it does for providing care: We draw The Neonatal team has access to 52 subspecialties and state-of-the-art services on all perspectives to find the best solutions, says Lisa Mason, DNP, RN, NEA-BC, Seniorsuch as ECMO on transport for resuscitation and life-saving support.Director, Fetal Neonatal Program.Nurses also play a key role in identifying important questionsand in leading the search for answers. We kickstart this process by requiring all first-year nurses to identify a quality improvement project, research potential solutions and propose one to our team. This creates an atmosphere where nurses feel empowered to ask hard questions, which is the critical first step toward improving care, Whitney says. To solicit ideas more widely, the NICU installed a solution board in a hallway. This is a large display onto which anyonefrom nurses and providers to clinical techscan post a comment about something that would improve their work. We have found that even the smallest suggestion has the potential to vastly improve workflow, efficiency and satisfaction.The solution board does wonders for staff engagementwhich leads to higher performance and better care for our patients, Whitney says.The Texas Department of State Health Services cited our safety record and commitment to quality when we were recently re-designated with Level IV status. Dr. Dariya says the supportive and solution-oriented culture of the NICU extends from its ties to UT Southwestern.'