Children’s hospitals must address a number of community health needs — but how do they select which area to prioritize?
Nonprofit hospitals are tasked with identifying and addressing key health needs in their communities by conducting a Community Health Needs Assessment (CHNA), but how they define their community can occur in unique ways. While many pediatric health care organizations define their community geographically by zip code or county line, Kennedy Krieger Institute views their community through the lens of a special population — children, youth, and adults with, or at risk for, disorders of the developing nervous system across the state of Maryland.
“We have a host of partners across the state that support and contribute to the overall health and wellness of the population we serve,” said Jacqueline Stone, PhD, MPA, PT, chief clinical officer at Kennedy Krieger. “We define our community as the state of Maryland because of the specialized services and programs offered to support our patients and their families.”
An anchor institution for care
Located in the Baltimore-Washington D.C. region, Kennedy Krieger includes a pediatric rehabilitation and specialty hospital offering inpatient care, outpatient clinics, five school campuses educating publicly funded students, clinical training, community programs, and a comprehensive research institute.
In the U.S., 17.3% of children experience developmental delays or disabilities, and in Maryland, 23.21% of children from 0 to 17 years old have a special health care need. As a comprehensive specialty system, Kennedy Krieger focuses on the community needs of those with or at risk of developmental disabilities, so they can achieve equitable health care within their community.
Data shared by community partners
Kennedy Krieger’s CHNA relies largely on publicly available data. The institute collects and analyzes information with multiple community partners. Since 2013, the hospital has included federal surveys, state partners, and advocacy organizations in their CHNA process.
These sources and entities serve the same population as Kennedy Krieger, allowing them to incorporate and leverage their data to help identify community needs.
“The CHNA is not specifically about your organization, it’s about that community you serve,” Stone said. “Everyone must do a needs assessment. We work together and smarter, so we are not duplicating efforts.”
Several organizations that share data include:
- The Maryland Center for Developmental Disabilities (MCDD). Located at Kennedy Krieger, MCDD serves people with disabilities through pre-service training, community service, information sharing, and research.
- The Developmental Disabilities Council. The council advocates for policies and practices that promote inclusion of people with developmental disabilities.
- Disability Rights Maryland. This advocacy organization is dedicated to advancing the legal rights of people with disabilities.
Kennedy Krieger also utilizes and analyzes information from the National Survey of Children’s Health and Annie E. Casey Foundation’s KIDS COUNT® and participates in public meetings to help prioritize community needs.
Assessment to action
A plan is not etched in stone. As Kennedy Krieger looks at the priorities from the last three years, those may need to shift as there are changes in the community.
“There are times we have our priorities and implementation plan, but we’ve had to transform and reimagine what it really is,” Stone said. “We identify community needs, but over the years they escalate.”
For example, Stone and the community health team anticipated pediatric behavioral health to be a community priority. As they analyzed the data, they realized the need was amplified by the lack of access to providers with expertise in neurodevelopmental disabilities.
In response, Mary Leppert, MD, a neurodevelopmental physician, and her team launched Project ECHO® cohorts to build capacity of knowledge and service in Maryland communities. Through tele-education, the initiative allows expert teams to share knowledge and best practices, improve workforce capacity, and enhance access to specialized and multidisciplinary care.
“When we talked about a shortage of providers, we discussed what we can do with existing providers to be able to increase their knowledge and give them confidence as they care for kids,” Stone said.
Keeping the conversation going
Kennedy Krieger’s next CHNA report will be published June 2025. However, conversations with community partners won’t stop just because data collection is complete. The community health team plans to form a group made up of different internal and external stakeholders to discuss the CHNA and implementation action plans.
“A collective group with people who see things through different lenses will be essential,” Stone said. “It will also add accountability so we can more readily share community outcomes not only internally, but to the community as well.”
