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Texas Health Presbyterian Hospital Dallas

Top percentile in Press Ganey, increased HCAHPS scores, magnet designation and more

Healthcare reform. The economic downturn. Discerning and empowered consumers. When times get tough and you’re faced with the biggest changes in your industry’s history do you sit and wait it out? Or, do you decide to become the best-of-the-best. The best hospital with the most engaged employees. A place where patients would leave and say, “I’ll never go anywhere else” because of the care they received.

For Texas Health Presbyterian Hospital Dallas, these challenging times have created a clear sense of purpose to be the best. A focus that’s recently produced impressive results. Named the number one hospital for employee engagement in the Texas Health Presbyterian system, it was re-designated in October 2011 with a Magnet recognition certification for nursing.

“It’s the highest honour a nursing service can receive in the world,” explains Cole Edmonson, Chief Nursing Officer, Texas Health Presbyterian Hospital Dallas. “Out of nearly 6,000 hospitals in the nation, only about 389 have designation. It sets to the public the expectation that they’re going to get excellent nursing care. For nurses, there’s such a sense of excitement and empowerment to work in an environment that is Magnet-designated. Magnet nurses raise themselves up to the highest expectations and use their professional voice to advocate for the patient.”

The same week the Magnet designation came through, hospital leadership received additional great news. In 2011, the hospital’s employee satisfaction and engagement scores increased from its 2008 scores of 69% to 79.8%. This took the hospital from scoring in the 51st percentile to the 93rd percentile in Press Ganey’s national database. With 77% of patients definitely recommending the hospital to others as a place to stay, the latest Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results put Texas Health Presbyterian Hospital Dallas higher than both the average for Texas hospitals and the average for all U.S. hospitals nationwide.

What’s behind these dramatic gains? Staff at all levels credit new leadership that solidified their purpose with encouragement and recognition. Leadership that built up team cohesiveness, created a sense of accountability and had a whole lot of fun.

“The dilemma we have in healthcare, it’s a hard job. It’s exhausting and it’s challenging,” says Britt Berrett, President, Texas Health Presbyterian Hospital Dallas. “But by gathering ourselves together as a team, a team that engages, has fun, and recognises its purpose, nothing is more rewarding.”

“It’s this sense of ‘I will reward you’,” explains Jessica Broussard, Director, Inpatient Rehabilitation Services. “I will recognise you. I appreciate all your hard work, but I’m also holding you to this and I really expect a lot from you because there’s a lot expected from me.”


“How do we refresh and renew the spirit of our nurses so that they can be fully engaged to the bedside?” says Edmonson. “We talk a lot about the power of kudos and the power of recognition, telling the story of what we do every day to make a difference in the lives of patients. How that individual nurse, department leader, respiratory therapist came together to create the kind of experience that changed the person’s life, whether that’s life coming into the world or that’s life going out.”

In fact, every team meeting starts with a kudos”“a shout out of appreciation to someone who’s made a difference. How to use the recognition system is introduced during orientation and again highlighted in quarterly employee forums.  Once a month, every department awards the ‘travelling trophy’ to another department. Giving thanks for another team for their contributions.

“We are all in the same place and all trying to deliver on the same goals,” says Edmonson. “We go out with the sense of appreciative purpose and find the great things going on in our organisation. One of the ways you do that is through awareness of exactly what people are contributing. We use the Applause System to capture those stories and recognise and award people for their efforts.”

Recognising and rewarding great work. Finding different ways to call out and celebrate team success and victories has delivered powerful results.

“When we introduced the Applause System and said, ‘Try it’, I believe employee engagement improved significantly,” says Berrett, “I believe the patient’s experience improved significantly. Teams that celebrate one another and celebrate those around them can help bless lives of patients they serve. It absolutely directly correlates.”

Critical Care Therapist Chrissy Minnett explains the impact of an aligned focus. “When you’re supposed to exemplify every day the values of respect, integrity, compassion and excellence, it shows up in your work. It makes you more invested.”


After hearing a keynote on The Orange Revolution, Lucy Bird, Nurse Manager, Orthopedics, thought, “If we’re going to find ‘Wow’ moments for patients, don’t we need to find ‘Wow’ moments for our staff?” This led to the creation of ‘Wow’ rounds. Once a quarter, Bird and her team take over the night shift, giving staff a break and a chance to enjoy dinner. The practice proved so successful, it’s now being carried out by other nursing units.

“We also have what we call the ‘Sacred 60’. One hour each day where leaders have to be rounding on their staff and on patients,” says Broussard. “We’re not supposed to be on email or phone and use the time to ask, ‘How’s everything going? Is there something that I can do for you? Are there any barriers that are making your job harder?’ It’s the little things that go a long way.” It’s the combination of the little and big things that have made a difference.

“People are making eye contact, they’re saying ‘good morning’, they’re smiling,” says Bird. “It’s just amazing when you have the leadership team that’s out there rounding, having fun at work. It’s built a culture of trust.”

“We set out to be a great place for people to work,” says Connie Wright, Director, Human Resources, Texas Health Presbyterian Hospital Dallas. “The best way for us to ensure this is to ask our employees, ‘How do you feel about working here? What can we do to make things better?’”

“And every day it does get better,” reports Pharmacy Technician Moses Chomba. “They do all these surveys. Then they come back and institute new things to make sure there’s better communication and we’re all being supported so we can ultimately provide better patient care.”

“This is not just a one-time event. This is a series of activities that emphasise who we are. Today, we’re celebrating pretty significant successes,” concludes Berrett. “Imagine where we’ll be in three to five years, hopefully we’ll inspire and bless others. Our hope is that this commitment and engagement unleashes unbelievable potential.”

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