Texas Children's 2017 Annual Report

Texas Children’s becomes first in state to achieve Level IV NICU designation


On April 7, 2017, Texas Children’s Hospital became the first hospital in the state to achieve Level IV NICU designation by the Texas Department of State Health Services.


“As a Level IV NICU, our neonatal team has the resources and expertise to deliver the highest level of care available for premature and critically ill newborns,” said Texas Children’s Chief of Neonatology Dr. Gautham Suresh. “This designation ensures our neonates, who require highly specialized resources and 24/7 multidisciplinary care, are treated in the right level of NICU to achieve the most optimal outcomes.”


The designation process comes as a result of legislation passed in 2013 requiring Texas to establish and implement neonatal and maternal level of care designations by March 1, 2018. Texas is one of the first states requiring NICUs to undergo a site visit to verify they meet the Neonatal Levels of Care classifications as defined in the Texas Administrative Code. Completing the designation process is a requirement in order to receive Medicaid reimbursement for neonatal services by September 1, 2018.


The process required tremendous collaboration among NICU leadership, staff and employees, as well as various support services that help the neonatal team care for these critically ill babies, including Pharmacy, Respiratory, Physical Therapy, Lactation, Nutrition and Social Services.


Several key requirements for Level IV NICU designation included the development of a Quality Assessment and Performance Improvement (QAPI) committee and a program plan outlining the Newborn Center’s breadth and depth of services, policies, procedures and structure for prioritizing quality improvement initiatives. While the Newborn Center already had an active quality and safety program, it was incorporated into the QAPI program.


Texas Children’s also participated in a rigorous survey site visit conducted by the American Academy of Pediatrics NICU Verification Program in November 2016 which included interviews with NICU nursing and physician leadership, as well as reviews of the hospital’s policies, medical records and credentialing process. Surveyors toured all of the NICUs and other areas that support neonatal services.


“A lot of hard work went into achieving our Level IV NICU designation, and I am so proud that our teams pulled together,” said Newborn Center Vice President Judy Swanson. “This collaborative milestone solidifies our reputation in providing the highest level of neonatal care to our tiniest, most fragile patients and their families.”