Cook Children’s Unveils Plan to Expand Critical Care to Meet Community Demand

Written by Ashley Antle

Iann Ledesma spent nearly half of his first year of life in the Neonatal Intensive Care Unit (NICU) at Cook Children’s Medical Center in Fort Worth. For 193 days, his mother, Giselle, rarely left her son’s side. Having had two previous miscarriages, she relished every moment with her newborn, not knowing if her baby would live to be held again.

“It was challenging since I had previous miscarriages,” Giselle said. “With my first baby, he was a 16-weeker, he just passed in my hands. So it was challenging for me to hold Iann when he was very tiny because he would give me flashbacks.”

Even so, Giselle says holding him was a dream come true.

Iann was born prematurely at just 22 weeks, which is considered the edge of fetal viability. As the only Level IV NICU in Tarrant County, Cook Children’s is equipped with the highest level of neonatal care available. Families with critically ill or premature babies come to Cook Children’s from all over the city, region, state and beyond when their infants need complex care.

However, the unit is bursting at the seams.

As recently as September, 102 of Cook Children’s 106 NICU beds were filled—an unprecedented level of demand that shows no signs of easing given Fort Worth’s population boom. Cowtown is now the 12th largest city in the United States, with 59 people moving to the city every day. As Fort Worth’s population grows, so does the demand for pediatric critical care.

Big Growth Fuels Big Plans

Cook Children’s Medical Center has been a fixture in Fort Worth and a trusted leader in pediatric health care for 106 years, consistently rising to meet the needs of the children and families in the communities it serves. To keep pace with current and projected growth in the area, the health system is preparing to meet the moment once again by embarking on a 10-year master plan to expand and enhance its Fort Worth medical center.

“Our place in this world is to be there when kids need us, and to provide that necessary support for that family and that child so that they’re able to have as productive of a life as they possibly can,” said Stan Davis, president of Cook Children’s Medical Center. “So the belief is we do that by having the facilities, having the physicians and caregivers, having the technology, but also having the heart and the commitment of our community and our team to be able to do that when it’s necessary. That’s why we’re here. We stand in the middle of being able to and not being able to provide that necessary critical care.”

The plan includes a new 700,000-square-foot medical tower, known for now as the West Tower, which will add another signature blue peak to Cook Children’s flagship campus and Fort Worth’s skyline. It will be a seamless extension of the existing medical center, connected both above and below ground, and make way for an expansion of the NICU with an additional 37 beds. It also allows for an expansion and redesign of the Pediatric Intensive Care Unit (PICU), and increases capacity for Hematology/Oncology services and research, as well as additional operating rooms and imaging services.

“We have capacity issues in these areas we’re expanding,” Davis said. “We, unfortunately, from time to time have had to divert kids to other places as far away as San Antonio, Oklahoma and Louisiana. We feel like we provide the best care possible for the kids in our community. In order to do that, we need to have the facilities and the accommodations to keep kids here and close to their home.”

Giselle and her husband, Franco, live in Arlington. She says having access to Cook Children’s expert level of care and technology close to home gave them hope for Iann’s future.

“At the beginning, we didn't know what to expect from Cook Children's, to be honest,” Giselle said. “But now I can tell you that if they didn't have a bed for Iann, I would feel hopeless, because I know from my experience that's where miracles happen.”

Connecting the Dots to Peaceful Healing

Much like the NICU, the PICU is experiencing ever-growing patient volumes. During busy sick seasons, it’s not uncommon to see 500 to 600 patients in a single day in the Emergency Department (ED), with many requiring admission to the PICU. Respiratory illness is the top driver of PICU admissions, followed by neurologic injury and disorders of the endocrine system.

“If we don’t have adequate beds in the PICU, kids end up waiting or being held in the ED, which is not the ideal environment for them. They need to be in that critical care environment,” Davis said.

But Cook Children’s isn’t just building to increase bed space. It’s evolving, innovating and advancing to connect the dots between health care delivery and an enhanced patient and family experience.

The medical center’s current 20-year-old ward-style PICU, where nothing more than a curtain separates patient beds, is no longer conducive to the type of experience Cook Children’s believes in giving patients and families. One that balances expert medical care with the creature comforts that support healing of the whole person. 

For example, children in neighboring PICU beds and their families often absorb the sights, sounds and intensity of another child’s situation, especially when there is an emergency. In an already high-stress and emotionally charged environment, this can be a source of increased anxiety and fear for patients and families.

The redesigned PICU will feature 56 private rooms where patients can heal peacefully. Plans call for ample natural light in each room to aid in sleep cycles and support the mental health of patients and their families.

“One thing that always gets asked of me is ‘Are we building for the future?’ Yes, we are,” said Spencer Seals, Cook Children’s vice president of Construction and Real Estate. “While this tower is over 700,000 square-feet, we have about 160,000 square-feet of shell space. What that means is, as we’re going through the programming of everything that has to go in this tower for this campus, we want to make sure that we have the ability to continue to expand services and continue to serve that growing population in Fort Worth.”

Big Steps for Iann and Cook Children’s

Just as Cook Children’s takes a big step forward in its growth, Iann is making significant strides towards his future, too. Now 19 months old, he’s crawling and pulling up to stand. He’ll be walking in no time, his proud mom says.

“It's just been amazing that he's getting things done, but it's on Iann's timing,” Giselle said with a chuckle. “We learned that from the beginning.”

As Iann continues to make progress at his own pace, Cook Children’s is advancing with a similar sense of purpose—one that ensures every child will have access to the care they need when they need it most.

“It’s an ambitious plan, but it’s exactly what we need to support the growing population and demand for services in our area,” said Rick W. Merrill, president and CEO of Cook Children’s Health Care System. “Kids and families rely on us, and have for more than a century, and we want to make sure we’re in a position to continue to be a beacon of hope, where every child receives the care they deserve now and for generations to come.”

About Cook Children's

Cook Children’s is more than a health care system: we strive to be an extension of your family, growing with your child from their first steps to adulthood. By collaborating to deliver on our Promise—to improve the well-being of every child in our care and our communities, we connect the dots for our patients. Between primary and specialty. Between home and medical home. Between short-term care and long-term health.

Based in Fort Worth, Texas, we’re 10,000+ dedicated team members strong, passionately caring for over 2 million patient encounters each year. Our integrated, not-for-profit organization spans two medical centers (including our state-of-the-art location in Prosper), two surgery centers, a physician network, home health services and a health plan. It also includes Child Study Center at Cook Children's, Cook Children's Health Services Inc., and Cook Children's Health Foundation. In 2024, Forbes named Cook Children’s the top health care employer in the U.S., and third on the list of ‘America’s Best Large Employers.’

And our impact extends beyond the borders of Texas. We proudly treat children from virtually every state in the nation and 32 countries. By seeing the world through the eyes of children and their families from all backgrounds, we’re able to shape health care suited to them: connected by kindness, imagination and respect—with an extra dose of magical wonder.

Discover more at cookchildrens.org.