Improving Children s Health Together

Improving Children s Health Together

Improvement is our business. Committed professionals and organizations across the U.S. are working hard every day to make it easier for children and families to live healthier lives. Making meaningful and sustainable improvement is hard work. It requires a disciplined approach to leverage existing knowledge, explore new ideas and engage a broad community of learners. That s where NICHQ excels. For nearly two decades, has been mobilizing the best people and ideas into successful strategies, valued resources and practical solutions to improve children s health. We have led dozens of improvement projects, worked with thousands of practitioners, professionals and community leaders, and improved the lives of countless children and their families. Are you ready to improve?

NICHQ s Impact on the World >200,000 individuals exposed to a healthy weight message in their community 95% children with confirmed hearing loss referred for early intervention 20,000 more children receiving comprehensive wellness assessments each year in Massachusetts 135% improvement in sickle cell patients getting more coordinated care for their disease increase in average medical home index score for teams participating in NICHQ s collaborative 11,520 more mothers each year getting the support they need at hospital discharge to continue breastfeeding at home Our approaches yield results.

healthy weight >200,000 individuals exposed to a healthy weight message in their community The 49 communities participating in NICHQ s Collaborate for Healthy Weight initiative were asked to create a healthy weight message that was tailored to their target audience and then use that message to link activities across sectors in their community. All but one team developed and disseminated a healthy weight message and 29 teams reached their goal of having their message reach at least 50% of their target population. This means upwards of 200,000 individuals received a message customized to their community about how to maintain a healthy weight. Percentage Target Population Reached by Healthy Weight Messaging Results for All Collaborate for Healthy Weight Phase 1 Teams 100% 90% We have made more progress working with NICHQ through your learning process and collaboration than with any other group. 80% 70% Median 60% 50% Goal 30% 20% 10% 0% Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 Region 10 Ed Dzedzy, Administrator, Lincoln County Health Department, washington state, participant in Collaborate for Healthy Weight project

hearing screening The Improved Hearing Screening and Intervention Services (IHSIS) collaborative improvement project increased the rate of documented follow-up and intervention services for infants with hearing loss. What I ve learned is [NICHQ has] a better way to do things a faster, better and effective way. When you work through the process we ve been learning at NICHQ, everything is very efficient. Marbely Barahona, Parent Partner, participant in Improving Hearing Screening and Intervention Systems (IHSIS) project Aggregate data from 17 teams showed an increase from 87% to 95% in children with confirmed hearing loss being referred for early intervention services. This means in one year, hundreds of infants received appropriate follow-up care after their initial hearing loss diagnosis. Percentage of Children with Confirmed Hearing Loss Referred for Early Intervention Aggregate Average from 17 Teams in Improved Hearing Screening and Intervention Services (IHSIS) Project 100% 90% 80% 70% 60% 50% 30% 20% 10% 0% Aug 12 Goal Median Sep 12 Oct 12 Nov 12 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 95% children with confirmed hearing loss referred for early intervention

comprehensive well care The CHIPRA Massachusetts Medical Home Initiative helped 13 pediatric practices in Massachusetts implement a medical home model of care, which includes providing comprehensive well care. 20,000 more children receiving comprehensive wellness assessments each year in Massachusetts Aggregate results for the 13 practices show an increased implementation of a robust wellness assessment from 62% to 80% for ages 2-4; 63% to 94% for ages 5-12; and 80% to 94% for ages 13-18. This means approximately 20,000 more children are receiving comprehensive wellness assessments and appropriate immunizations each year in these practices as a result of their transformation into a medical home. Complete Wellness Assessments for Three Age Groups Aggregated Total of All CHIPRA Massachusetts Medical Home Initiative Teams January 2012-August 2013 100% 90% 80% 70% 60% 50% 30% 20% 10% 0% Dec 11 Goal Preschool Children (2-4 y/o) School Children (5-12 y/o) Adolescents (13-18 y/o) Jan 12 Feb12 Mar12 Apr 12 May 12 Jun 12 Jul 12 Aug 12 Sep 12 Oct 12 Nov 12 Dec 12 Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Both collaboratives helped us to communicate the message of prevention, to empower patients to take control of what they do have control over, and to discuss self-management goals more effectively. We have become better providers, a better health center and a healthier community. Rina Ramirez, MD, FACP, Medical Officer, Zufall Health Center, Dover, NJ, participant in two NICHQ-led collaboratives

135% improvement in sickle cell patients getting more coordinated care for their disease sickle cell care Grantee sites participating in the Working to Improve Sickle Cell Healthcare (WISCH) initiative sought to improve screening and follow-up for people with sickle cell disease and trait, and improve care across the lifespan for individuals with sickle cell disease. Aggregate results from four of the grantee sites show an impressive improvement in the percentage of patients with an evaluation by a hematologist within the past 12 months. The median in January 2012 was and climbed to 94% in May 2013. This means hundreds more patients with sickle cell disease are experiencing care from a specialist. Patients with Hematologist Evaluation within Last 12 Months Average for Four Grantee Sites in WISCH Project January 2012 to May 2014 100% 2nd Median 90% NICHQ, in my mind, has the experience and staff expertise to bring 80% 70% to sickle cell disease the sort of rigor in methods development and analysis of outcomes to move the bar of caring for people with sickle cell disease several notches up. Kwaku Ohene-Frempong, MD, President, Sickle Cell Foundation of Ghana, participant in WISCH project 60% 50% 30% 20% 10% 0% 1st Median Jan 12 Mar 12 May 12 Jul 12 Sep 12 Nov 12 Jan 13 Mar 13 May 13 Jul 13 Sep 13 Nov 13 Jan 14 Mar 14 May 14

medical home The Implementing a Learning Collaborative on the Medical Home for Children with Special Healthcare Needs project addressed the need to improve the quality of care for children with special healthcare needs and their families by implementing the medical home model in primary care practices. Participating in the NICHQ first medical home learning collaborative for children with special healthcare needs was a catalyst to major quality improvement initiatives in my practice. Jennifer Lail, MD, Assistant Vice President of Chronic Care Systems at Cincinnati Children s Hospital Medical Center, participant in NICHQ s medical home initiatives Aggregate results from the eleven Title V teams and 30 primary care practices involved in the learning collaborative show a overall increase in the average total medical home index. The index is a widely used measure of a practice s progress toward the goal of becoming a medical home. This means the thousands of children served by these practices are receiving more patient-centered, comprehensive, team-based, coordinated care as a result of the practices transformation into a medical home. increase in average medical home index score for teams participating in NICHQ s collaborative Average Medical Home Index Scores For All Sites in the Medical Home Learning Collaborative 6 Pre-Collaborative (2003) Post-Collaborative (2004) 5 4 3 2 1 0 Organizational Capacity Chronic Condition Mgmt Care Coordination Community Outreach Data Mgmt Quality Improvement Total

11,520 more mothers each year getting the support they need at hospital discharge to continue breastfeeding at home breastfeeding The Texas Ten Step Star Achiever Breastfeeding Learning Collaborative is a quality improvement initiative to help Texas hospitals create environments in which women s choices concerning breastfeeding can best be supported, with the goal of increasing exclusive breastfeeding. Data from a cohort of 20 teams show a steady increase from 49% to 73% of hospitals providing discharge support to mothers. This means 11,520 more mothers each year are getting the support they need to continue breastfeeding when they leave the hospital. Discharge Support Average for All Hospitals in Texas Ten Step Star Achiever Breastfeeding Learning Collaborative (Cohort A) 100% 90% 80% [NICHQ] has really embraced what we re doing in Texas and they have never missed a beat. It s a pretty well-oiled machine and it s been exciting to work with them. Veronica Hendrix, Texas Ten Step Program Coordinator, Texas Department of State Health Services, Participant in the Texas Ten step star achiever breastfeeding learning collaborative 70% 60% 50% 30% 20% 10% 0% Baseline Median Jan 13 Feb 13 Mar 13 Apr 13 May 13 Jun 13 Jul 13 Aug 13 Sep 13 1st Adjusted Median 2nd Adjusted Median Oct 13 Nov 13 Dec 13 Jan 14 Feb 14 Mar 14 Apr 14 May 14 Jun 14 Jul 14

We look forward to helping your organization make improvements in areas that matter most for the health of children and families. The NICHQ team can help you: Continuously improve system performance Execute rapid-cycle tests of change Convene disparate stakeholders Engage patients and families Collect data and measure progress Spread and sustain changes We re ready when you are! Learn more at www.nichq.org or contact us at communications@nichq.org. Scale up localized improvements Gain and maintain leadership buy-in for change Infuse collective impact theory into system change Train professionals to be advocates for effective policy change Foster innovation to support improvement efforts Develop condition-specific QI initiatives to achieve benchmarks

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