The National Center for Medical Home Implementation (NCMHI or National Center) launched the Innovative and Promising Practices in Medical Home Implementation Initiative (Promising Practices) in 2015. This initiative provides opportunities for pediatric medical home projects, programs, and practices from across the United States to share implementation strategies. These strategies enhance the delivery of primary care services for children and youth, particularly those with special health care needs and those living in medically underserved communities. The Promising Practices profiles on the National Center Web site provide practical, replicable implementation strategies and tools for other interested in advancing the medical home model. This e-Newsletter provides tools, resources, and strategies to support innovative and promising practices in pediatric medical home implementation.
Implementation Resources from the National Center for Medical Home Implementation
      • Featured Innovative and Promising Practices in Pediatric Medical Home Implementation
        Archived on the National Center for Medical Home Implementation Web site, these featured innovative and promising practices provide examples of pediatric medical home implementation strategies at state-based organizations, pediatric clinics, local/community organizations, and family organizations. Profiles include background information, implementation strategies, and solutions to common challenges. The profiles may assist state agency staff, pediatric clinicians, family/caregivers, and other pediatric stakeholders interested in replicating similar projects and advancing pediatric medical home.
      • Tools to Support Maternal and Child Health Title V / Children and Youth with Special Health Care Needs Programs: Results from an Assessment and Evaluation Project
        Developed by the National Center for Medical Home Implementation (NCMHI), this
        poster highlights results from a mixed methods assessment and evaluation project conducted in fall 2017 by the NCMHI with Maternal and Child Health Title V / Children and Youth with Special Health Care Needs (MCH Title V / CYSHCN) programs. The purpose of the project was to gain insights on how the NCMHI can best support MCH Title V / CYSHCN programs implementing medical home and patient/family-centered care in their states. For more information on the project background, results, and next steps, contact NCMHI staff at medical_home@aap.org.
      • Recently Updated: Care Coordination Measurement Tool © and Accompanying Adaptation and Implementation Guide
        Created by the National Center for Care Coordination Technical Assistance, a partnership between Boston Children's Hospital and the NCMHI, the 2017 Care Coordination Measurement Tool© helps practices, pediatric clinicians, and other organizations quantify care coordination activities. The tool collects data that may be used to demonstrate the association between care coordination activities and outcomes for patients and families. An accompanying Adaptation and Implementation Guide provides step-by-step instructions on how to use the tool in diverse clinical and nonclinical settings.
      • Building Your Medical Home Web-based Resource Guide
        This free, Web-based
        resource guide developed by the National Center for Medical Home Implementation provides pediatric clinicians, families/caregivers, and other stakeholders with the tools, resources, and guidance needed for practice transformation. Included within the guide are resources, tools, and strategies for establishing a pediatric medical home. The guide includes information on starting the transformation process, integration of medical home functions, and sustainability.

Additional Implementation Resources

  • Healthy Tomorrows Program Infographic
    Developed by the Healthy Tomorrows Partnership for Children Program (HTPCP), this
    infographic presents investments in the program since 1989. Data suggest that former HTPCP grantees reported strong institutional commitment (69%) as a factor leading to sustainability. 96% of HTPCP grantees continue to exist in some form (including original form, expanded, absorbed, or partial) at one-year follow-up and 93% continue to exist in some form at five-year follow-up. The infographic provides strategies for pediatricians, state agencies, or families/caregivers interested in improving sustainability for their pediatric medical home programs.
  • Building Systems that Work for Children with Complex Health Care Needs: The Next Steps
    Developed by the American Academy of Pediatrics, this Pediatrics
    supplement features articles written by pediatricians, family leaders, advocates, and other pediatric stakeholders on evidence and strategies to implement medical home practices at the systems level. Topics discussed include care coordination, pediatric complex care, and care integration. This supplement provides supporting evidence, strategies, and resources for Maternal and Child Health Title V / Children and Youth with Special Health Care Needs programs, pediatricians, and family/caregivers interested in improving systems of care for children and youth with special health care needs. 
  • Pediatricians and Public Health: Optimizing the Health and Wellbeing of the Nation's Children
    A
    new policy statement authored by the American Academy of Pediatrics  Council on Community Pediatrics and Section on Epidemiology and Evidence discusses the importance of collaboration and partnership between pediatricians and public health professionals to promote optimal health and wellbeing for children and families. The statement provides examples of successful collaborations between pediatricians and public health and can be used to implement pediatric medical home at the systems level.

​Training, Events, and Conferences

  • Rolling Up Our Sleeves: How to Plan and Implement Quality Improvement Activities Focused on Family Engagement
    Presented by the National Center for Medical Home Implementation (NCMHI) and the Association of Maternal and Child Health Programs, this
    recorded webinar provides Maternal and Child Health Title V / Children and Youth with Special Health Care Needs programs, family leaders, pediatric clinicians, and others with tools and resources to plan a quality improvement project to engage families and enhance family-centeredness in pediatric health care. Faculty discuss a family engagement quality improvement project conducted by the NCMHI, discuss challenges and successes of this type of project, and provide practical implementation tools and strategies for organizations interested in replicating these efforts.
  • A Conversation on the Emergence of Pediatric Complex Care
    Thursday, April 10, 2018 at 12-1pm Central
    Register Here
    Presented by the Lucile Packard Foundation for Children's Health, this webinar will discuss meaningful systems changes to support children and youth with complex medical conditions. The webinar will include a live discussion from the authors of the article Status Complexicus? The Emergence of Pediatric Complex Care. The lead author and experts in the field will review the article's key content and share insights on the implications of its recommendations. This webinar is intended for pediatric clinicians, Maternal and Child Health Title V / Children and Youth with Special Health Care Needs programs, families/caregivers and other stakeholders interested in enhancing systems of care.

​Partners and National Initiatives

      • Addressing Health Care Inequities Among Children and Youth with Special Health Care Needs (CYSHCN)
        Developed by the Catalyst Center and presented at the 2018 Association of Maternal and Child Health Programs Annual Conference, this
        presentation includes information on innovative strategies to reduce inequities in language access and culturally effective care in the CYSHCN population at the state and clinical level. The presentation discusses results from a study conducted with parents of CYSHCN who are from the Somali community in Boston. This presentation is for pediatric clinicians, Maternal and Child Health Title V / CYSHCN program staff, family/caregivers, and others interested in enhancing language access and culturally effective care in the pediatric medical home.
      • Association of Maternal and Child Health Programs (AMCHP) Innovation Station
        The Association of Maternal and Child Health Programs,
        Innovation Station, supports state efforts to build successful programs for maternal and child health populations, including children and youth with special health care needs. Applications are reviewed and cutting edge, emerging, promising, replicable and best practices from public health programs are disseminated. States are also able to apply for funding opportunities to replicate an existing Innovative Station best practice. The Web site houses information, tools, and resources for project implementation and is available to support state maternal and child health agencies.

Interview with a Healthy Tomorrows Partnership for Children Program Grantee

The Empowering Mothers Initiative (Empowering Mothers) is a former Healthy Tomorrows Partnership for Children Program grantee in Oakland, California. The program is based out of the Asian Health Services, a Federally Qualified Health Center, and focuses on providing pediatric care that is culturally appropriate and family-centered.

Empowering Mothers Initiative serves Asian immigrant and refugee communities. Many individuals in these communities are undocumented and may experience social isolation due to their immigration status. In addition, individuals in these communities are oftentimes uninsured, resulting in difficulties navigating a complex system of care and health inequities. The Empowering Mothers Initiative reduced these inequities by increasing language access, increasing social supports, and providing preventive health care during infancy. These strategies were accomplished by hiring community health workers who spoke the language of the refugee and immigrant communities.

Community health workers increased language access by translating parent education materials into the preferred languages spoken by the immigrant and refugee populations. They also provided leadership, recruitment, and facilitation to group well-child visits. The Empowering Mother Initiative group well-child visits include a two-hour meeting of age-based cohorts of eight mother-baby pairs of a respective ethnic group. During the visit, mothers are educated as a group, engage in discussion and peer learning/support, and are given one-on-one time with the pediatrician.

Healthy Tomorrows funding for the Empowering Mothers Initiative ended in March 2016 but the program continues to grow and effective clinical practices have even spread across the clinic. The Empowering Mother Initiative ensures sustainability and growth through the following strategies:

      • Group well-child visits allow the clinic to bill for both individual and group well-child visits. Conducting 60-70 group well-child visits with at least eight mother-baby pairs annually generates enough financial resources to hire a part-time program coordinator to sustain and manage the program.
      • Buy-in, championing, and financial support from the leadership team of Asian Health Services was gained after sharing qualitative data from participating mothers and ensuring financial viability and productivity. Below are strategies and implications of these efforts.
          • Mothers participated in focus groups and submitted open-ended surveys to discuss what they had learned and changes they made as a result of the initiative.
          • Financial viability and productivity data was also collected that compared productivity between group and individual well-child visits. Results indicated that group well-child visits were as cost-effective as individual well-child visits.
          • The pediatric clinic at Asian Health Services is being renovated, and because of the success of the Empowering Mothers Initiative, a new space for group visits was included in the renovation plans.

More information on the Empowering Mothers Initiative can be found here.