As much as children’s hospitals and health systems work to improve population health outcomes in their communities, significant factors determining children’s health occur outside their control. Addressing these concerns sits at the heart of Nemours Children’s Health’s Integrator Learning Lab.
The project established collaboratives in nine communities around the country to promote children’s health equity and enhance population health outcomes by aligning health care systems, community-based organizations and government agencies.
The collaboratives, known as “population health integrators,” received resources, coaching and technical assistance from national experts to test best practices to promote wellness and equity. However, success was driven from within the communities themselves.
“A really cool part was that all of the members of the community teams came in as both leaders and learners—there were some things they did really well and could teach others, and then there were areas where they may have been stuck and could learn from others,” says Allison Gertel-Rosenberg, MS, vice president, national prevention and practice at Nemours Children’s Health in Jacksonville, Florida. “It created a great balance within the group because they could work with each other to get past the barriers impacting their work.”
5 keys to attaining health equity
Gertel-Rosenberg adds that achieving the lofty goals shared by all parties around children's health and children's health equity means learning to work more effectively with both traditional and non-traditional partners.
The findings of the population health integrators uncovered five essential methods to promoting health equity:
- Establishing a common definition and understanding of equity and why it matters in population health.
- Heeding the voices of real-world experts through governance and decision-making structures that solicit the perspectives of the community members whom the network seeks to serve and compensate.
- Instituting data-sharing and data-driven resource allocation to identify groups experiencing inequities and carrying out community-led, informed mitigation strategies.
- Conducting “equity impact reviews” to assess the results and potential unintended consequences of current and proposed practices, policies and strategies, and revising as needed.
- Embedding equity-promoting workflows into daily operations.
Spreading the work through toolkits
A key result of the two-year Integrator Learning Lab project is the creation of toolkits, which community organizations can leverage to advance health equity. The toolkits are intended to support networks in strengthening strategic use of integrative activities—including tools for assessment, alignment, action planning, and implementation. The resources focus on helping communities prioritize integrative activities as well as providing a roadmap on how to put those activities into practice. Gertel-Rosenberg says a key component of their effectiveness is their adaptability.
“We recognize not every community was going to move through this process in lock step, so we wanted to create actionable tools that you could use differently in your community than I use in my community—but still arrive at shared understandings, agreements and learnings that move the work forward,” Gertel-Rosenberg says.
“We wanted to share tools and resources communities could use with the idea that the more communities take this on and use these tools, the better opportunity we have to see real changes for kids.”