BY: ERIN CORNELL AND PAUL H. DWORKIN
Child Health Provider Outreach is a Core Component of the Help Me Grow (HMG) Model, however we understand that engaging the health care community can be difficult for HMG affiliates for a number of reasons.
We often hear from our National Affiliate Network how challenging it can be to explain the benefits of the Model to child health providers, as well as how tough it is to encourage them to embrace the Model as a care coordination extension service to their practices. However, many of our affiliates have had successful outcomes from their outreach to child health providers. We recently highlighted the work of several of them in a Child Health Provider Outreach breakout session at our 11th annual Help Me Grow Forum, held virtually for the first time.
We were honored to have Jill Sells, MD, FAAP, moderate the panel discussion. Dr. Sells is a pediatrician and early childhood systems consultant, with prior experience leading efforts such as Reach Out and Read in Washington State. We were also excited to have Emily Sherer, MD, the physician champion for Help Me Grow Indiana, Melissa Passarelli, of Help Me Grow Long Island, Loren Farrar of Help Me Grow Alameda County, Taylor Carrigan of Help Me Grow Pierce County and Abby Alter, of the Child Health and Development Institute of Connecticut share best practices from their work.
Affiliate panelists offered a wealth of information related to their experiences with child health provider outreach. Dr. Sells and Dr. Sherer provided an important perspective on best practices for engaging physicians in the work of HMG based on their roles as pediatric providers. They offered a number of suggestions for affiliates looking to build bridges with local pediatric providers. The following nine suggestions really resonated with us:
- Lay the groundwork: Learn about the medical community, build relationships with key people in a provider’s office, and understand the specific type of provider you want to reach, whether it’s someone with expertise in general pediatrics or a sub-specialist, such as a developmental-behavioral pediatrician.
- Make your request easy to understand: Be clear with what you are asking a provider to do, explain your request in simple terms without using jargon, provide context and key background information for your request, and explain your strategy related to their involvement.
- Set providers up for success: Make sure they understand the time commitment involved with your request and ask the provider what is feasible for them to help with or if they have ideas other than what you suggested. Also, be sure to offer ongoing support and thank them for their time, consideration and potential involvement.
- Identify providers interested in similar work: Talk to local community partners to identify child health providers who are interested in early childhood development. Such an approach fosters networking and partnerships, and minimizes the need for cold calling.
- Identify a physician champion: A physician champion is well suited to advocate for the use of HMG among other providers. Relying on a child health provider to communicate the benefits of using HMG will enhance buy-in from this group. At the same time, recognize that there are some roles in which a physician champion may be less appropriate to enhance outreach efforts.
- Key messages for providers: Communicate that HMG is not a direct service provider but rather links children to existing community resources. In addition, it is important to distinguish HMG from early intervention efforts and stress that one does not replace the other. The HMG Framing Toolkit that the National Center developed with the Frameworks Institute has been helpful for Dr. Sherer and HMG Indiana in successfully communicating to providers.
- Identify existing work that overlaps with HMG: This can open the door to important partnerships. For example, HMG Indiana was able to collaborate with a local organization that was already engaged in developmental screening to share data on screening rates. As an added benefit, HMG Indiana was able to tap into the organization’s relationships that were already established with many practices to enhance outreach.
- Involve providers in the planning process: Taking the goals of child health providers into account can be instrumental in getting them to engage with HMG. For example, providers can offer crucial input regarding the referral process, often preferring to make them through an electronic health record as opposed to a paper format. In addition, highlighting that HMG provides post-referral feedback can increase buy-in as providers know that children they referred actually went on to benefit from services.
- Form a child health provider workgroup: This can be an effective strategy to raise awareness about HMG. It has worked well in Indiana, where the workgroup meets virtually due to distance and meetings are limited to 30 minutes to accommodate providers’ busy schedules.
Additional tips that most resonated with us were examples shared of affiliates embedding data-driven approaches, which provide feedback to practices about performance on key metrics as well as monitor the progress, efficacy, and impact of outreach efforts. Here are two examples presented during the panel discussion:
- Data collected as part of continuous quality improvement (CQI)/Maintenance of Certification (MOC) provides practices with insights into how well they are reaching set targets on metrics such as rates of developmental screening, connecting families to helpful services, and communicating with families about results and next steps. Practices can leverage MOC or Continuing Medical Education credits from the training and outreach activities of HMG, providing an incentive for continued monitoring of performance.
- HMG communities can also track their own progress in outreach, by assessing the overall volume of referrals they receive and from which practices, the types of services to which families are ultimately referred, and satisfaction/engagement of practices with their outreach efforts. These data can in turn lead to changes in how HMG affiliates conduct outreach to foster greater reach and strengthen the relationships between HMG and pediatric practices.
Lastly, and perhaps most importantly: creating effective and sustained bidirectional relationships with practices creates a vehicle to expand beyond addressing developmental monitoring. For example, leveraging their close connections with pediatric practices, many affiliates have expanded their outreach to address related topics such as social determinants of health, trauma, adverse childhood experiences (ACEs), and even most recently, identified ways HMG could specifically support practices during the COVID-19 pandemic. These adaptations in child health provider outreach ensure that HMG can serve as a responsive and relevant support to pediatric practices on many different topics that impact children’s health and development.
We are inspired by the work of both our newer and long-standing affiliates in the area of child health provider outreach. By highlighting the exemplary work underway in advancing this core component, we hope to spark ideas among other affiliates about what is possible to encourage continued partnership building for the benefit of children and their families.