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U Mass Team Improves Pediatric Well Care Visits for Black and Latino Patients by More Than12%


 By Ana Pujols McKee, MD, Executive Vice President, Chief Medical Officer, and Chief Diversity, Equity and Inclusion Officer

The term “steal shamelessly” is thrown around in jest professionally but the intent is pure.

After all, a winning practice for one organization can usually be adapted to benefit another organization. That was the goal of the inaugural Bernard J. Tyson National Award for Excellence in Pursuit of Healthcare Equity. We reached out to Kaiser Permanente earlier this year because its late CEO Dr. Bernard Tyson tirelessly championed efforts to reduce disparities and we anecdotally knew of MANY great initiatives that would honor his legacy. There are some amazing grassroots initiatives out there and we wanted to provide a national platform to highlight this work.

Choosing a winner wasn’t easy and it wasn’t my job alone. The 2021 Awards Panel members included distinguished medical professors and health care leaders from:

  • University of California, San Francisco
  • Rush University Medical Center
  • University of Chicago
  • Johns Hopkins University
  • National Institute of Health
  • Kaiser Permanente Bernard Tyson School of Medicine
  • Foundation for Opioid Response Efforts

Our work group was amazed by the brilliance of the initiatives submitted in addressing racial disparities in health care. The finalists tackled some of today’s toughest dilemmas, as well as those we’ve been working on for generations, including:

  • teen pregnancy prevention
  • minority transplant equity
  • COVID-19 response in Black and Brown communities
  • COVID-19 care equity

I hope you take the time to read about all the applications here.

Well Child Visit Adherence
Historically, it’s been problematic for Black and Latino families to adhere to a traditional well-child visit schedule. It’s not that parents set out to neglect routine medical care but there are sometimes obstacles like:

  • transportation
  • language 
  • scheduling and inflexible employment obligations

UMass Memorial Health saw an opportunity and spearheaded the initiative Prioritizing Child Health: Promoting Adherence to Well-Child Visits to address disparities in adherence to well-child visits in Worcester, Massachusetts. These efforts resulted in a 16% improvement in adherence to well-child visits among Black patients and a 12% improvement among Latino patients.

Overcoming Barriers
At the height of the COVID-19 pandemic, the UMass team piloted its initiative. Strategies implemented included:

  • conducting well-child visits during acute care appointments
  • scheduling the next visit at the time of the current visit
  • providing patients and their families with an information sheet highlighting the importance of preventive care visits
  • implementing an improved reminder system
  • making telehealth appointments available
  • arranging transportation
  • actively reaching out to patients who canceled or were “no-shows” for their visits to reschedule
  • creating a well-child tip sheet to help measure success

Results would be impressive in normal times and were astonishing in the middle of a pandemic. Black child visit adherence rose from 59% to 75% and Latino child visit adherence rose from 64% to 76%. UMass Memorial Health’s results also showed reduced disparities in adherence between patients identifying as white and those identifying as Latino or Black. The fact that this occurred while many parents were avoiding routine preventive care really reinforces the notion that simple changes can make a difference in improving racial disparities in health care.

Leveraging the Initiative’s Success
I hope you will consider joining me this Nov. 19 for a virtual awards ceremony at 11 a.m. CT. The UMass team certainly deserves this recognition for honoring Dr. Tyson’s legacy.

For me, one of the highlights of this awards presentation will be learning more about the continuation of the UMass project. The UMass team plans to expand its project by applying an antiracism lens to identify how structural racism and discrimination act as barriers in the health system’s social determinants of health (SDOH) screening and referral system. The team’s ultimate goal is to identify optimal strategies that ensure equitable implementation of SDOH interventions. 
This team is keeping Dr. Tyson’s legacy alive by making actionable improvements in pediatric well-visits and then working to reduce health disparities in more patient populations. The brilliance of this project lies in the fact that it really can be adapted to many organizations seeking to take those important first steps to make health care more equitable for all. Let’s steal that enthusiasm shamelessly!

Ana Pujols McKee, MD, is the Executive Vice President, Chief Medical Officer, and Chief Diversity, Equity and Inclusion Officer of The Joint Commission. In this role, Dr. McKee focuses on and develops policies and strategies for promoting patient safety and quality improvement in health care and leads The Joint Commission enterprise in meeting its goals of improving diversity and inclusion.