New Year, Renewed Focus
A Message from Charlie Homer, MD, MPH
NICHQ's President and CEO
At the end of 2013, NICHQ’s Board of Directors expanded our organization’s mission beyond its healthcare improvement roots to a broader focus on children’s health. Our new mission statement, “Improve Children’s Health,” merely formalizes what we have been focused on for some time—making improvements in the many arenas both inside and outside the clinical setting that influence the health of children. In the years ahead, we will continue to help organizations in all sectors who share our mission make breakthrough improvements so children and families can live healthier lives.
Many positive things occurred in 2013 to give me great optimism for the advancement of this mission in 2014 and beyond.
In 2013, population health, one of the pillars of our nation’s quality strategy (“Better Care, Healthy People/Healthy Communities, Affordable Care”) began to garner the attention it deserves. The Institute of Medicine and National Quality Forum convened working groups that are drafting papers and reports that point to how to bridge health and healthcare. More importantly, they, along with major national foundations (Robert Wood Johnson Foundation and W.K. Kellogg Foundation) and the mass media have begun to recognize the critical importance of reducing the level of “toxic stress” that environments of poverty and violence impose on young children, as well as the need to build resilience in families and communities to help buffer children from such forces.
Adding to this momentum, leaders in child health in the US brought new energy and vision to the children’s agenda. Michael Lu, associate administrator of HRSA’s Maternal and Child Health Bureau, has articulated a fresh vision that brings innovation, improvement and accountability to the fore, dramatically increasing the visibility of this national resource. Jim Perrin, new president of the American Academy of Pediatrics (AAP), has positioned his voice and that of the Academy’s 60,000 members behind a campaign to eliminate childhood poverty, the root cause of so many health problems affecting children and society.
We made progress on the ground as well. In 2013, our nation witnessed early signs not simply of the leveling of the epidemic of childhood obesity, but its reversal in places that need it most—large urban centers such as NYC and Philadelphia and places of deep poverty, such as Mississippi. These bellwethers give us indications that concerted, multi-level interventions from the smallest community to the largest policy, taken together, can have an impact on child health and our future.
NICHQ has worked in many of these areas during the past year, and in others as well. I’d like to share with you some of the highlights of our accomplishments this past year and hint at where we will go in 2014.
- Our work to promote healthy living continued with our ongoing role in Mass In Motion Kids, in which we are assuring that primary care sites in two low-income communities of Massachusetts are aligned with broader community change. As part of this work we developed an organizational self-assessment tool to help clinical care sites assess the extent to which their own work environments enable health living. Look for this tool on our website in 2014.
- We completed our Collaborate for Healthy Weight project. This multiyear effort catalyzed multi-sector coalitions to improve healthy living conditions in 49 communities across the US. Early this year, we will be launching our new “Collaborative Action Now to Defeat Obesity (CAN DO) Playbook,” an online training program to guide other communities in finding common ground to defeat obesity at a local level.
- Together with Let’s Go Maine and the AAP, we finalized the “Next Steps: A Practitioner's Guide For Themed Follow-up Visits For Their Patients” to help primary care clinicians move beyond prevention in their practices in addressing childhood obesity.
- With the Partnership for Healthy America, we secured the commitment of three electronic health record vendors to incorporate “healthy weight plans” for children into their systems. We seek to expand the number of vendors, assist with implementation and evaluate the impact of these plans going forward.
- Together with the Massachusetts chapter of Family Voices, we created a practical guide for primary care practices to create Patient and Family Advisory Councils.
- The teams participating in the Working to Improve Sickle Cell Healthcare (WISCH) program have made breakthrough strides in reducing delays in patients receiving appropriate pain medication in emergency departments.
- Teams participating in the Collaborative to Improve Care for Children with Autism Spectrum Disorder reduced waiting times for appointments by more than 50%.
- Our improvement methods also enabled several states to reduce the number of children who are lost to recorded follow-up services after failing their newborn hearing screen who are lost to follow up through our Improving Hearing Screening and Intervention Services (IHSIS) project.
- Our work to improve maternity care to better support breastfeeding gained further momentum. One hospital in the Best Fed Beginnings project (the Medical University of South Carolina) achieved Baby Friendly designation, and more than 30 are in the final stage.
- Similarly in Texas, we have nearly completed the first of three groups of hospitals and are now recruiting hospitals in the Austin and Houston areas. Tools and trainings from these lessons will be forthcoming and made available to other hospitals, so stay tuned.
- NICHQ received a new cooperative agreement from the federal Maternal and Child Health Bureau to extend its Collaborative Improvement and Innovation Network on infant mortality to the rest of the US. This program offers new energy, ideas and assistance to help address one of our most persistent health challenges and source of disparities.
- For the first time in many years, NICHQ offered a publicly available course on QI fundamentals (“The ABC’s of QI”) to reach many professionals who weren’t involved in one of our projects. Look for more publicly available offerings in 2014.
The past year was productive and vibrant for NICHQ and for child health efforts across the country, and I am quite optimistic that the current year will be even more so. I expect to see more focused efforts to improve children’s health through integration of social, medical and environmental realms. From NICHQ, you can expect open-enrollment courses and webinars, web-based tools and online communities where committed professionals can exchange knowledge, ideas and lessons learned.
You can anticipate not only the improvement knowledge you have come to expect from NICHQ, but innovations as well. Soon we will unveil a new look and a new website reflecting our expanded focus. And NICHQ has a few other surprises in store for this year. What would a new year be without a few surprises?