NACHRI 2010 Annual Leadership Conference Session

Right Sizing Pediatric Emergency Care Utilization Through Public-Private Partnership  

Jacqueline Bowens, MS, Executive Vice President and Chief Government and External Affairs Officer
Robin Scott, MHA, Manager, PMO Support Services
Joseph Wright, MD, MPH, Senior Vice President, Child Health Advocacy Institute
Children’s National Medical Center, Washington, DC

Learning Objectives:  After viewing this session, attendees should be able to:

  1. Important aspects of public-private partnership to address community need 
  2. Interventions to promote community education, reduce misuse of ED, and increase linkages to medical homes
  3. Financial sustainability and ROI of satellite ED beyond government-funded period

As policymakers and providers seek to address challenges in healthcare delivery, several approaches to address misutilization of emergency services have been piloted. This project demonstrates innovative leadership in leveraging public-private partnerships to enhance access to care, as well as educate patients/families on the appropriate use of emergency services.
Initiative Description: 
Recent studies demonstrate that trends in emergency department (ED) utilization by pediatric patients are associated with sociodemographic factors such as health literacy, family education levels, and the availability and ease of access to primary care services. In response to findings from a local community needs assessment, a collaborative agreement was initiated between two hospitals to open a satellite pediatric ED. Competitive funding from municipal government was provided to support construction and initial staffing levels. Goals of the collaboration are twofold: 1) increase access to pediatric emergency services within a defined service area, and 2) expand opportunities for child and parent health education in an effort to minimize misuse of these services. Anticipated factors that will lead to project success include incorporation of on-site community health education as an integral component of ED operations, and the development of synergistic partnerships to capitalize on health care resources at the neighborhood level.
Designing an accountable, coordinated, high quality care system for children in an underserved community by co-locating a pediatric ED on an adult hospital campus with a general, undifferentiated ED; integrating a community health educator as part of the ED staffing model; leveraging municipal relationships for start-up capital and operational funding.
Please refer to the Potential Results/Outcomes section.
Potential Results/Outcomes: 
To serve as a best practice model through demonstration of both the organization’s corporate citizenship and commitment to community benefit. Metrics of success include decompression of the main campus ED, one of the nation’s busiest, while expanding service to areas with marginal health outcomes and/or limited access to pediatric-specific emergency care. An increase in utilization of nearby primary care services by patients upon discharge from the satellite ED is also anticipated. These outcomes will contribute to declines in patients presenting to the main campus and satellite EDs for ambulatory care sensitive conditions, leading to more appropriate medical home utilization.
Lessons Learned: 
Developing a shared mission among key stakeholders is essential towards program success. In particular, the ability to demonstrate efficient stewardship of public resources has proven to be a critical confidence builder among external stakeholders. Strong internal support is also necessary relative to building in non-revenue generating functions, like the community health education function, in the interest of population-based, public health benefit. Initial findings indicate that intra-organizational collaboration between clinical and advocacy centers of excellence can facilitate a unified project mission of health promotion and disease prevention from both a clinical service delivery and child health advocacy perspective.
Future of Initiative/Next Steps: 
Go forward goals are to expand utilization of community health educators as requisite supplement to pediatric emergency care services, and to engage the primary care provider community to coordinate with ED care follow-up such that patients and families will enjoy more appropriate and timely access to longitudinal and preventive care.

Presenter Biographies:

Jacqueline Bowens, MS, Executive Vice President and Chief Government and External Affairs Officer
Children’s National Medical Center, Washington, DC

Ms. Bowens is responsible for the strategic direction of Legislative and External Affairs, Public Affairs, Advocacy and Community Affairs, Community Partnerships, and Volunteer and Consumer Support Services. She was recognized as the 2004 Alumnus of the Year by the University of Southern California Black Alumni Association. Ms. Bowens is a member of the Board of Directors of the District of Columbia Hospital Association. She also is a graduate of Leadership Greater Washington and is a former president of Women in Government Relations.

Robin Scott, MHA, Senior Project Manager
Children’s National Medical Center, Washington, DC

Ms. Scott holds a Master of Health Administration Degree from Virginia Commonwealth University.  She currently serves as Manager, PMO Support Services, and is responsible for the coordination of financial management activities, process redesign efforts, and end-user training programs for corporate initiatives managed by the Project Management Office.

Joseph Wright, MD, MPH, Senior Vice President, Child Health Advocacy Institute
Children’s National Medical Center, Washington, DC

Dr. Wright provides strategic leadership for the organization’s advocacy mission, public policy positions and community partnership initiatives. He has served as attending faculty in the Division of Emergency Medicine at Children’s since 1993, and recently served the institution as executive director of the Center for Hospital-Based Specialties. Dr. Wright has devoted much of his academic energy to addressing the concerns of the underserved. He has been recognized for his efforts as a winner of the Shining Star award from the Los Angeles-based Starlight Foundation, and is an elected member of Delta Omega, the national public health honor society.

Related Files
Right Sizing (Handout) (Adobe PDF File)
Right Sizing - presentation (Adobe PDF File)