Children and families require a child health care system that serves their unique needs and supports opportunity for life-long health and well-being. The current system, however, fails too many children, especially Black, Indigenous, Latino, and other children of color. To address these disparities, when looking at ways to improve children’s health care beyond medical care, the field is increasingly broadening its focus to include more preventive measures and to encompass the connections between children, families, communities, and the systems they interact with regularly. These activities, however, are 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 strategies:
- Adopting anti-racist practices and policies to advance health equity;
- Co-creating equitable partnerships between patients, families, and providers; and
- Identifying family strengths and addressing health-related social needs to promote resilience.
Widespread adoption of these strategies not only requires capacity building and workflow changes within practice settings, but also payment and accountability levers 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.
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 strategies;
- Identifying accountability and financing levers that support widespread adoption; and
- Developing, testing, and disseminating a pediatric transformation resource center that addresses the practice-level changes and the payment and accountability levers that support them.
The ACHT learning community, which began in June 2021, provides a platform for peer-to-peer exchange for competitively selected pediatric practices that are excelling in one or more of the strategies important for child health transformation and are committed to refining their efforts. The sites below are also taking part in a year-long pilot program to identify and test a policy or practice change:
- Child Health Clinic, Children’s Hospital Colorado, UC 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)
- 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
- Hala Durrah, MTA, Patient Family Engagement Consultant and Advocate
- Gretchen Hammer, MPH, Founder, Public Leadership Group
- Carey Howard, MPH, Program Director, Center for the Urban Child and Healthy Family at Boston Medical Center
A pediatric transformation resource center, 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.