Systems Design

  • Missouri is Bringing Risk Appropriate Care to its Moms and Babies

    Posted September 20, 2016 by Josh Grant

    Missouri aims to move the state’s hospitals away from self-designation for levels of risk appropriate care to better support perinatal regionalization—the idea that a system exists to designate where babies are born or transferred according to the level of care they need at birth—and improve health outcomes for moms and babies.

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  • Hearing a Chance to Improve: QI’s Impact on State Audiology Services

    Posted August 18, 2016 by Josh Grant

    Successful hearing intervention requires early screenings and follow-ups to confirm diagnoses and determine the right treatment for each patient. To prevent loss to follow-up and ensure that more children could receive adequate hearing services, Louisiana's Early Hearing Detection and Intervention program learned quality improvement principles to adjust their processes and procedures.

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  • How Sharing Data Can Help Cities and States Reduce Infant Mortality

    Posted June 23, 2016 by Josh Grant

    Data sharing is one of the most significant barriers between city and state health departments when it comes to reducing infant mortality. States and cities accumulate a great deal of data at various levels on birth outcomes and maternal care, but they don’t always make it readily available to each other.

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  • Clinicians and Patients Work Together to Improve Preconception Health in the U.S.

    Posted June 14, 2016 by Sarah Verbiest, DrPH, MSW, MPH

    Fostering the creation of healthy families by choice, not chance, is not a new idea. Organizations and agencies are working to improve pregnancy planning, spacing and preventing unintended pregnancies. Given the high rates of unintended pregnancy in the U.S., action is needed from all stakeholders–consumers, health providers, policy makers–in proactively supporting this critical conversation.

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  • NYS Breastfeeding Collaborative Welcomes New Hospitals

    Posted May 26, 2016 by Josh Grant

    More mothers in New York will soon experience better improvements in hospital maternity care, as 21 more hospitals join the state’s Breastfeeding Quality Improvement in Hospitals Collaborative (BQIH). Cohort A saw 12 New York hospitals work together and use quality improvement (QI) methods to change their systems and practices to better support a mothers choice to breastfeedings. Cohort B will see 20 new hospitals participate in the collaborative, building off the momentum and learnings from their predecessors.

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  • 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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  • 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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  • Why I Participate: By Parent Partner Mercédez Cahue

    Posted March 31, 2016 by Mercédez Cahue

    Mercédez Cahue shares her breastfeeding experience and why she joined the Texas Ten Step Star Achiever Breastfeeding Learning Collaborative as a parent partner.

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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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  • Far From a Gold Medal Performance

    Posted February 28, 2014 by Jonathan Small, MBA

    We have a long way to go before we get a gold medal in child health outcomes. I suggest we begin in a humble place – with the recognition that, while we may have much to teach other countries, we also have a lot to learn.

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  • The Secret Ingredient to Fixing Systems Problems

    Posted February 12, 2014 by Cindy Hutter, MBA

    The mantra in quality improvement is “every system is perfectly designed to get the results it gets.” Regardless of your system of choice—your workplace, your home, your community—you’ll need knowledge to improve the system and get the results you want. It’s impossible to be a change agent without being a knowledge seeker first.

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