Across the nation, the child health care field is embracing a shift from the traditional child-focused model of well and sick visits to a more preventive focus on children, their families, and the systems and communities they interact with regularly. Progress has been gradual, with early successes identifying opportunities to enhance the health and well-being of our nation’s children and youth, including the origins of the patient centered medical home movement and innovative models that promote screening and referral for social needs.  This activity, however, is largely disconnected from other health care transformation efforts, with far less investment in child health system reform than is occurring in adult health care settings. There is strong agreement across the child health care field about the fundamental elements necessary to transform pediatric practice. The significant challenges of the past year — the COVID-19 pandemic coupled with a national reckoning regarding racial inequities — amplify the imperative for the child health care field to push transformation to a comprehensive approach that focuses on child and family well-being.

Accelerating Child Health Transformation (ACHT), an initiative led by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, is seeking to accelerate the adoption of key elements necessary to advance family-centered pediatric practice. Identified through a comprehensive scan of best practices in the field, the project is focused on three key elements:

  1. Adopting anti-racist practices to advance health equity;
  2. Co-creating equitable partnerships between families and providers; and
  3. Identifying family strengths and health-related social needs to promote resilience.

Widespread adoption of these elements not only requires capacity building and workflow changes within practice settings, but also new payment and accountability structures to support and sustain these enhanced approaches to care. Accordingly, ACHT will also look to inform the development and implementation of alternative payment methods and approaches to quality measurement that encourage broader adoption of identified best practices.

Project Activities

Over three years, ACHT will convene leading experts, pediatric providers, and family-led organizations across the nation to accelerate the adoption of anti-racist practices to advance health equity and promote care approaches that are family-driven and address social risks and needs by:

  • Developing a national learning community to inform and support the adoption of the key elements;
  • Identifying payment mechanisms and quality measurement strategies that support widespread adoption; and
  • Developing, testing, and disseminating a pediatric transformation toolkit that addresses the practice-level changes and the payment and accountability levers that support them.

Project Participants

The ACHT learning community, which kicks off in June 2021, will provide a platform for peer-to-peer exchange for 12 competitively selected pediatric practices that are excelling in one or more of the elements needed for child health transformation and are committed to refining their efforts. Sites include:

• Child Health Clinic, Children’s Hospital Colorado, University of Colorado Anschutz Medical Campus, Aurora, CO
• Westside Pediatric and Adolescent Clinic, Denver Health, Denver, CO
• University of New Mexico ADOBE Program, Albuquerque, NM
• Pediatrics Northwest, Tacoma, WA
• Primary Health Care, Des Moines, IA
• Philadelphia FIGHT Pediatrics, Philadelphia, PA
• The Center for Collaborative Primary Care, St. Christopher’s Pediatrics, Philadelphia, PA
• Hasbro Children’s Hospital Pediatric Primary Care, Providence, RI
• AtlantiCare Health Services, FQHC, Atlantic City, NJ
• Nemours Children’s Primary Care, Orlando, FL
• The Children’s Health Center, San Francisco General Hospital, San Francisco, CA
• Cincinnati’s Children’s Hospital Medical Center Academic Pediatric Primary Care, Cincinnati, OH

A team of six family representatives will represent the family voice and engage directly with the sites during the learning community. These representatives are:

• Nikki (Charisse) Montgomery, Executive Director, Madvocator Educational and Healthcare Advocacy Training
• Louis Mendoza, Manager, Washington State Fathers Network
• Morris Carr, Men's Health Coordinator, Access Community Health Network
• Tamela Milan, Community Engagement Specialist,
Access Community Health Network
• Emily Cervantes, Program Manager, Public Policy Research and Analysis, Colorado Latino Leadership, Advocacy, and Research Organization
• Siddhant Srivastava, medical student, Heritage College of Osteopathic Medicine, Ohio University

ACHT is guided by an advisory group of national experts in the pediatric field, including:

• Megan Bair-Merrit, MD MSCE, Professor of Pediatrics, Boston University School of Medicine; Executive Director, Center for the Urban Child and Healthy Family, Boston Medical Center
• Renée D. Boynton-Jarrett, MD, ScD, Associate Professor of Pediatrics, Boston University
School of Medicine and Founding Director, Vital Village
• Charles Bruner, PhD, Network Resource Manager, InCK Marks
• Benjamin Danielson, MD, Clinical Professor, Department of Pediatrics, University of Washington School of Medicine; Pediatrician, University of Washington Medicine
• Stephanie Doyle, MPH, Senior Associate, Center for the Study of Social Policy
• Hala Durrah, MTA, Patient Family Engagement Consultant and Advocate
• Kay Johnson, MPH, MEd, President, Johnson Group Consulting
• Gretchen Hammer, MPH, Founder, Public Leadership Group
• Carey Howard, MPH, Program Director, Center for the Urban Child and Healthy Family at Boston Medical Center

Spreading Lessons

A pediatric transformation toolkit, slated for publication in 2022, will be informed by the learning community and developed in collaboration with subject matter experts and partners in the field. Look for future resources and stories coming out of this work to help spread opportunities to facilitate child health transformation in pediatric practices across the nation.