Quality Care

  • Medicaid Strategies to Promote Increased Access to Long-Acting Reversible Contraception (LARC)

    Posted May 24, 2016 by Tamara Kramer; Karen VanLandeghem, MPH

    Unplanned pregnancies can present a tremendous challenge for many women, healthcare payers and the community, and are associated with a number of negative health outcomes, such as delayed prenatal care and premature births. Efforts like the Centers for Medicare and Medicaid Services’ (CMS) recent guidance and the Collaborative Improvement & Innovation Network to Reduce Infant Mortality (IM CoIIN) have improved maternal and infant health outcomes, while also highlighting the $10 billion cost burden Medicaid expends on unplanned births.

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  • Putting the Cross-Sector Gears in Motion: How 3 Best Babies Zones Are Moving Towards Cross-Sector Action to Reduce Disparities in Infant Mortality

    Posted May 17, 2016 by Monica Barr

    The Best Babies Zone (BBZ) Initiative has been working on the social determinants of health for four years. In 2012, BBZ was launched to address the social, economic and environmental factors that contribute to poor birth outcomes. With funding from the W.K. Kellogg Foundation, three small pilot “zones” were launched in Cincinnati, OH, New Orleans, LA, and Oakland, CA. In these cities, a lead organization connects and convenes partners from across sectors, creating possibilities for innovative projects that address the root causes of infant mortality in that community.

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  • Boxing Out Unsafe Sleep Practices for Babies

    Posted May 10, 2016 by Josh Grant

    In the 1930s, Finland’s infant mortality rate reached 65 deaths per 1,000 live births, leading to the 1938 introduction of baby boxes—kits that include a mattress, bedding, diapers, a box that serves as a crib and other necessities. By 2015, that rate had dwindled to an estimated 2.52 deaths per 1,000 live births. In 2014, there were 3,500 sudden unexpected infant deaths in the United States, 25 percent of which were caused by accidental suffocation or strangulation in bed. Learning from Finland’s success, organizations in the U.S. are beginning to offer their own baby boxes to new families.

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  • Rhode Island Targets Social Factors to Achieve Health Equity

    Posted May 05, 2016 by Rachel Kremen

    While a higher percentage of Rhode Islanders have health insurance compared to the U.S. average, achieving health equity has been a challenge for the state—especially for its infant mortality rate. Now, the Rhode Island Department of Health is targeting key social factors that impact infant mortality in minority groups, including education, income and stress. The Rhode Island Commission for Health Advocacy and Equity was created in 2011 to address the inequity, by bringing together state agencies to focus on the social determinants of health—typically defined as the wider set of forces and systems shaping the conditions of daily life. Aligning the efforts of those inside and outside the state is also key.

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  • Medicaid Strategies to Promote Full-Term Births

    Posted May 03, 2016 by Tamara Kramer

    Reducing the rate of pre-term birth is a major priority for state health agencies and a growing concern for state Medicaid programs. Medicaid agencies provide coverage for over half of the nation’s births each year and pay for a higher rate of premature or low-birth weight babies than the private insurance market (10.4 percent versus 9.1 percent). Pre-term birth, a birth that occurs prior to 37 weeks of gestation, is the leading cause of infant mortality in the United States. Early delivery is associated with a host of long-term health issues for the infant, including sight and hearing loss, cerebral palsy and developmental and intellectual disabilities.

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  • Rooming-in: An Essential Evolution in American Maternity Care

    Posted April 28, 2016 by Jennifer Ustianov, MS, BSN, RN, IBCLC

    Over the past few years, many U.S. hospitals have moved away from the traditional use of nurseries for healthy newborn infants, choosing to move toward rooming-in and couplet care. Rooming-in is an evidence-based practice that promotes keeping healthy newborn babies and their mothers together in post-labor recovery rooms. This recent change in practice and policy for many hospitals is partially based on recommendations in the World Health Organization’s (WHO) Ten Steps to Successful Breastfeeding and the increased movement toward earning Baby-Friendly designation in the U.S.

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  • A New Primer for PCPs on Starting a Healthy Weight Clinic

    Posted April 21, 2016 by Josh Grant

    Developed as part of the Mass in Motion Kids Learning Collaborative, NICHQ’s new Healthy Weight Clinic Guide teaches providers how they can develop, implement and maintain community-based pediatric healthy weight clinics. The Healthy Weight Clinic Guide is an opportunity for healthcare providers, families and children to address obesity together and promote healthy living.

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  • Using Telementoring to Improve Care for Patients With Sickle Cell Disease

    Posted April 19, 2016 by Sonya Spillmann, RN

    In the United States, nearly 100,000 people have the inherited red blood cell disorder sickle cell disease (SCD), yet access to knowledgeable providers throughout their lifespan is one of the biggest challenges for these patients. With a desire to narrow this disparity, groups of SCD experts are teaching healthcare providers how to capably manage patients with SCD by harnessing the power of technology, including telementoring.

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  • Recommendations for Promoting Young Children’s Socioemotional Development in Primary Care

    Posted April 14, 2016 by Cindy Hutter

    Early childhood is a critical window of opportunity for promoting early socioemotional health. When children's socioemotional health (defined as a child’s capacity to form secure relationships, experience and regulate emotions and explore and learn) is compromised, it can have significant implications on long-term wellness including failure in school, inability to make or sustain friendships, and poor self-image. Through a project called Promoting Optimal Child Development, NICHQ, along with Ariadne Labs and the Einhorn Family Charitable Trust (EFCT), worked together to develop recommendations for using pediatric primary care practices to reinforce positive socioemotional behaviors in primary caregivers of children ages 0 to 3.

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  • Trends in Sickle Cell Disease Focus on Therapeutic Treatments, Care Transitions and Global Health

    Posted April 07, 2016 by Cindy Hutter

    Since NICHQ was named the National Coordinating Center for the Sickle Cell Disease Treatment Demonstration Program (SCDTDP) in 2010 there have been increases in the number of providers prescribing disease modifying therapies, such as hydroxyurea to treat patients with sickle cell disease (SCD), better care in emergency departments, along with increases in the number of patients receiving regular care with providers knowledgeable about treating SCD. As the project enters into a new phase, we recently sat down with Suzette Oyeku, MD, MPH, medical director for NICHQ’s sickle cell work to learn more about the project’s evolution and learnings.

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  • Focusing on Population-Level, Collaborative, Perinatal Outcomes Improvement

    Posted March 24, 2016 by Ed Donovan

    It is becoming increasingly clear that efforts to improve risk-appropriate site of delivery may benefit from close collaboration among perinatal care providers, payers and public health organizations. State health departments and state hospital associations often manage repositories of population-level perinatal data while perinatal quality collaboratives can engage front-line providers. Collaborative partnerships among these entities can facilitate improved outcomes at the population level.

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  • NICHQ's Internal PTF Model Proves a ‘Promising Practice’ in Medical Home Transformation

    Posted February 25, 2016 by Cindy Hutter

    The National Center for Medical Home Implementation has named NICHQ’s CHIPRA Massachusetts Medical Home Initiative an “innovative and promising practice” in pediatric medical home implementation. The initiative focused on helping 13 pediatric practices in Massachusetts successfully implement a medical home model of care. Unique to the project was the use of an internal practice transformation facilitator (PTF)—a motivated individual currently employed within the practice—to manage the day-to-day implementation needs of the pediatric medical home transformation.

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  • Moms Deserve Better Care In The Fourth Trimester

    Posted January 20, 2016 by Alison Stuebe

    In the weeks following childbirth, mothers must adapt to plunging hormones, recover from birth and learn how to feed and care for a new infant. Amid these challenges, moms receive minimal support from the healthcare system. Postpartum visits are typically scheduled four to six weeks after birth, leaving moms to cope on their own for more than a month. Moms need more support in the weeks following birth.

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  • Knowing What to Do for Sickle Cell Patients Is Not Enough

    Posted November 30, 2015 by Elissa Faro, PhD

    Sometimes, even when we have guidelines and evidence-based practices to improve care and outcomes for individuals with sickle cell disease, it isn’t always enough.

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  • Inspiring Change through Motivational Interviewing

    Posted September 08, 2015 by Rachel Kremen

    Helping people make a long-term, healthy lifestyle choice doesn’t have to be daunting. The key lies in motivating—not indoctrinating—the client. Motivational interviewing is a style of communication for helping someone explore and resolve their ambivalence to change.

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  • Resources and Must Reads for Infant Mortality Awareness and Sickle Cell Awareness Month

    Posted September 01, 2015 by NICHQ

    NICHQ is joining with organizations around the country and world to celebrate Infant Mortality Awareness Month and National Sickle Cell Awareness Month in September. NICHQ has a long history of working to improve outcomes on these health topics. We invite you to explore and share our resources, stories, videos and other materials related to reducing infant mortality rates and improving care for individuals with sickle cell disease.

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  • Advice from One MD to Another on Supporting Breastfeeding

    Posted May 01, 2015 by Todd Wolynn, MD, IBCLC, MMM

    I’m often asked how I, a man, got involved in breastfeeding medicine. The truth is: I just happened to be in the right place at the right time. And that experience made me the right person.

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  • Managing the Universe of Special Healthcare Needs

    Posted November 17, 2014 by Katrina McCarty, MPA

    A vast universe of symptoms, medications, complications, specialists and tests constantly surround my friend Julie. She is 38 and has Type 1 diabetes (T1D), which she was diagnosed with at age 10. Her quest for a long and prosperous future of good health is both harrowing and inspiring.

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  • Viewing Health as a System

    Posted March 07, 2014 by Charlie Homer, MD, MPH

    Improvement science teaches us to view outcomes—such as health—as the inevitable product of a system, with the implication that achieving improved outcomes requires changing the system itself. A deep understanding of the system and how it functions can enable smarter decisions about selecting high leverage changes in order to improve system performance.

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  • Improvement - A Philosophy to Live By

    Posted January 11, 2014 by Meghan Johnson, MSc

    For as long as I can remember, I have been working to make things more organized, effective and efficient. I have spent countless hours organizing and reorganizing things in my life – everything from my son’s toys and games to the storage of our digital photos. It shouldn’t be surprising, then, that I have spent over a decade in project management and just over a year ago, found my way to NICHQ and discovered quality improvement science.

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  • Removing the Burden of Care Coordination

    Posted January 06, 2014 by Cindy Hutter, MBA

    I had never heard of the concept of a medical home before coming to NICHQ, but I’ve now seen what is possible in a patient-focused system where primary care physicians and specialists coordinate to deliver high-quality healthcare. In situations like mine, where there are no established protocols to follow, the need for a medical home is most critical—and paradoxically, most lacking.

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