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Sunday, January 17, 2021

Cook Children’s: 100 years old and still growing

As it was in the beginning – 100 years ago – Cook Children’s Medical Center is focused on a promise to improve the health and well-being of every child within its reach.

The promise began to take shape when a baby was abandoned on a Fort Worth doctor’s doorstep one cold November day in the early 1900s.

Ida Turner, a Fort Worth artist and postmistress, saw the baby, learned that no area hospital was prepared to provide charity care for an abandoned child and became determined to build a hospital that would provide medical care for every child, regardless of a family’s ability to pay.

Contributions poured in from hundreds of community leaders, and Fort Worth’s first children’s hospital was designed and built on donated land by donated labor at 2400 Winton Terrace West, in the Park Hill neighborhood east of Texas Christian University.

Named for its provision of care for infants and toddlers, Fort Worth Free Baby Hospital opened with 30 beds on March 21, 1918. The hospital had its own cows to provide milk, chickens to supply eggs and poultry, fruit trees and a vegetable garden, according to the Fort Worth Book of Neighborhoods.

Hospital names and locations changed several times over the next 100 years with expansions and mergers, and for many years two separate children’s hospitals operated in Fort Worth.

The most important milestones since the first children’s hospital was dedicated a century ago include:

• Opening of the W.I. Cook Memorial Hospital in its grand Italian renaissance revival style building at 1212 W. Lancaster Ave. in 1929. It was converted from a general hospital to a children’s hospital and renamed W.I. Cook Memorial Hospital Center for Children in 1952.

• Opening of the Fort Worth Children’s Hospital next to Harris Methodist, now THR Fort Worth, at the corner of Sixth Avenue and Cooper Street in 1961.

• Merger of the two children’s hospitals and the grand opening of the $22 million Cook Fort Worth Children’s Hospital in May 1989 at 801 Seventh Ave. The new hospital more than doubled in space five years later with a $53 million addition and it has continued to grow, fully opening its new $350 million South Tower last year.

But Cook Children’s promise has remained the same.

“Our promise is clear, concise and compelling,” says Rick Merrill, president and CEO of Cook Children’s Health Care System. “It is to improve the health and well-being of every child in our region through the prevention and treatment of illness, disease and injury.”

That promise has become part of Cook’s DNA, Merrill says.

“Promise is a powerful word that resonates with 60-year-old grandparents and 4-year-old children as well,” he says. “Everyone knows what a promise is.”

Merrill gives credit for keeping the promise to doctors, nurses, therapists, administrators, staff, trustees, donors and community volunteers – “an incredible group of caregivers who are committed to the promise” and take it personally.

“All of us know that we can make a difference,” he told the Fort Worth Business Press. “People will tell you Cook is very different – in a very good way. … It’s all driven by our promise and very thoughtful and deliberate strategy.”

Part of that strategy has been finding medical homes for more than 1,000 children living in homeless shelters in Tarrant County.

In an effort to care for children who might otherwise be overlooked, including those in shelters, Cook Children’s Neighborhood Clinics provide primary and preventive care for children with limited access to basic health services.

The homeless initiative, organized in 2008, serves children from birth to 16 years old and includes transportation to and from clinics in one of Cook’s vans, donated by the Cook Children’s Woman’s Board.

The idea was to help these children get regular medical care, Merrill said.

The program offers case management services to minimize the negative health effects of being homeless and follows up to make sure the children continue to get medical services after their families find homes.

Vision, dental and mental health care are included.

When he announced the homeless outreach initiative, Merrill said, “We will treat the homeless children as if they were our own because they are.”

In the last 12 years, under Merrill’s watch, Cook Children’s has built or remodeled seven community health clinics and greatly expanded the services they provide.

Cook pediatricians provide medical care at more than 60 primary and specialty care offices throughout North Texas and especially in the six counties closest to home.

The first community-wide Children’s Health Assessment & Planning Survey (CCHAPS) was conducted in 2008 to help identify specific issues affecting children in the six counties – Denton, Hood, Johnson, Parker, Tarrant and Wise – issues such as asthma, dental health, mental health, obesity, safety and child abuse.

Two more household surveys have now been completed, and Cook is working with 240 partner organizations throughout the six counties to improve and resolve the issues.

“CCHAPS was the brainchild of our strategic planning department,” Merrill said. “There was not a lot of data out there at any level – local, state or national – to give us a very clear picture of specific issues affecting children’s health. We decided to collect data to give us a very clear picture of our six-county area. We now have more data than any region in the nation, and we share it. We are stewards of the data.”

For example, the survey showed that asthma was one of the biggest health problem for children in this region, and CCHAPS’ community leaders began educating families about things that trigger asthma attacks such as smoke, dust, mold and dander. They educated families on how asthma attacks can be reduced and prevented and when to use which asthma medications.

Teams identified families that brought children to the emergency room three or more time a year for asthma and remunerated families for things such as replacing and removing carpeting, Merrill recalled.

In general, Cook’s outreach now extends to an area roughly the size of New Mexico, stretching from Wichita Falls south to Waco and west to Abilene, Big Spring, San Angelo, Midland and even El Paso.

In addition, Cook’s Teddy Bear Transport includes two planes – one a twin-engine jet – a helicopter and five ground ambulances to transfer young patients from as far away as Seattle, Washington, to Fort Worth for specialty care.

And the hospital has one of the largest all-private neonatal intensive care units in the country, with the capacity to care for 106 of its smallest and often most fragile patients.

Cook’s cardiovascular program has international reach. Children come to Fort Worth for surgery and complicated cardiac catherization interventions from as far away as the Middle East, Latin America, Italy, Germany, Britain, Thailand, Japan, China and parts of Russia, Merrill noted.

Among other noteworthy programs is one that uses deep brain stimulation to treat kids’ movement disorders and a cancer treatment that uses radioactive isotopes to kill cancer cells inside the body and requires a special lead-lined room to treat neuroblastoma.

“Very few hospitals do any deep brain stimulation [on children], and we have done more than 100 cases,” Merrill said. Many hospitals can perform the procedure on adults.

Cook helped pioneer bone marrow/stem cell transplants for children with certain cancers and blood disorders beginning in 1986 and now it gets referrals from all over the United States. Cook oncologists have completed more than 1,000 such transplants.

Cook Children’s Hyperinsulinism Center is one of only two in the nation – the other is at Philadelphia Children’s – that has a team of medical and surgical specialists who treat every aspect of congenital hyperinsulinism, which causes hypoglycemia (low blood sugar) in infants and children. A rare and often severe genetic disorder, hyperinsulinism can cause seizures and even permanent brain damage if it is not found and treated early.

In addition to Cook Children’s Medical Center in Fort Worth, Cook Children’s integrated child health system includes the Cook Children’s Health Care System, Cook Children’s Physician Network, Cook Children’s Home Health Care, Cook Children’s Pediatric Surgery Center, Cook Children’s Health Plan, Cook Health Services Inc. and the Cook Health Foundation.

“We have a long-term perspective. We are in this for the long haul, and we know it takes an integrated system. We have the most integrated child health system in the country,” Merrill said in a recent telephone interview.

It also takes a lot of community support.

Cook constantly strengthens its support with community engagement programs such as “Experience the Mission,” where Cook invites groups of eight to 12 people to participate in “a day in the life of Cook Children’s.”

On that day, movers and shakers in the community put on scrubs, wash their hands well and follow doctors and nurses inside various hospital departments, including emergency and intensive care, to spend time with the kids and caregivers.

“They absolutely get a first-hand look at who we are and what we do. It’s an incredibly emotional experience,” Merrill said. “In some cities you are defined by how much you make, but in Fort Worth you are defined by how much you give. People leave here wanting to partner with and support us.

“This community wants us to be pre-eminent in services and programs. It makes a big difference to be in a community that wants to help you keep the promise.”

The last 100 years have been remarkable, he said.

“As I think about the next 100 years, I think about fulfilling the promise and being the pre-eminent model for pediatric health care in this country – and about being the healthiest place to raise a child.

“In many ways, we already are, but it’s a moving target. Everyone is raising the bar,” Merrill said. “We want to stay ahead.”

In today’s competitive health care market, especially when medical treatments and equipment just keep getting better – less invasive, more likely to produce cures with fewer side effects – there is no place for complacency.

To stay ahead, Merrill said, it is necessary to keep moving forward on common health issues such as asthma, obesity, diabetes, accidents and injuries, as well as on rare and complex conditions that can be treated almost nowhere else.

“My job is to keep the culture powerful and positive,” he noted. “The greatest enemy of our ‘best’ is the ‘good’ we often settle for. … We at Cook will never say, ‘We have arrived.’”

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