Maternal and Child Health Training Program
Grant Title: Pediatric Pulmonary Center
Web Site: University of Washington Project
Gregory J Redding, MD
University of Washington
4800 Sand Point Way NE
Seattle, WA 98105
Chronic respiratory conditions, including asthma, are the most common disabling conditions in childhood. Many underserved children with these conditions do not have adequate medical homes. Trained clinical leaders are needed to address the systems and policies that impact these children.
Goal 1: Provide interdisciplinary clinical and leadership training to graduate trainees in the health care professions that assures understanding of care for special respiratory health care needs children. Objective 1: Co-manage the care of at least 10 child. with CSRHCN as a member of at least 2 interdisciplinary health care teams and lead the team(s) in the manage. of 2 children and ident. at least two disparities in care among these 10 patients that are spec. to culture, race, income, and/or place of residence. Objective 2: Identify gaps and barriers in care resulting from trans. of care across care systems and settings for at least 1child with chronic respir. dis. and ident. (and implement where possible) a strategy to reduce gap(s) or overcome barriers with faculty and other trainees. Objective 3: Identify 2 of 8 Public Health Core Competencies for Public Health Professionals and use them in conducting PPC Leadership practicum experiences. Goal 2: Maintain a model clinical and leadership training program, which exemplifies MCH values that serves children with special respiratory health care needs and their families. Objective 1: Recruit, orient and train at least 20 medium term (MT) (at least 130 hours of participation in the PPC program) and at least 5 long term (> 300 hours) trainees annually. Objective 2: Promote gender, ethnic, cultural and socio-econ. diver.within the program by recruiting at least 20% of fac., MT and LT trainees, family consult., and com. advisors from div. backgrounds and under-represented groups from MCH Region X that partic.as teachers, advisors to and collab.with the program. Objective 3: Convene a PPC Adv. Board and a Parent Adv. Board twice per year, emphasizing the recruit. of diverse participants to find new opportunities and review curricula, program activities, and training results. Goal 3: Increase the capacity of the MCHB infrastructure to assure health equity, improve health outcomes, and improve systems of care for CSRHCN. Objective 1: Serve local, regional, or national health audiences and Title V agencies by providing at least 20 CE and 20 TA events annually and use distance learning formats for 10% of the presentations. Objective 2: Annually review at least one Region X Title V State Block Grant and indicators of health outcomes that pertain to CSRHCN and partner with that state’s Department of Health to identify at least two strategies for PPC faculty/trainees to support improvements in these indicators. Objective 3: Collaborate with other MCHB programs at the UW and nationally to develop at least one new product, teaching strategy, or publication annually that advances the strategic training goals of the Maternal Child Health Bureau. Goal 4: Develop, evaluate, synthesize, and disseminate new knowledge through interdisciplinary research related to MCHB populations that promotes health and function and addresses emerging issues. Objective 1: Each faculty member annually creates new knowledge and disseminates in written, face to face and Web 2.0 formats the results of at least one project with a LT trainee as original research, guidelines, curricula, educational products, or policies pertaining to CSRHCN and their families. Objective 2: Each LT trainees will use a Web 2.0 format to disseminate their leadership capstone knowledge to future PPC trainees, peers and other MCHB training programs through a PPC Capstone Library. Objective 3: During this project period, all faculty jointly review and develop 1 or more new formats or uses for the National Information Reporting System (NIRS) and other databases used by MCH training programs to depict scope and impact of their programs regionally and nationally. Goal 5: Develop an interdisciplinary program for trainees and faculty to enhance skills and resources for MCHB leaders to respond rapidly and effectively to the changing landscape of healthcare. Objective 1: Annually identify, use, and share public data sources that can be used to develop and update 1 or more evidence-based clinical decision guidelines for CSRHCN. Objective 2: Jointly develop with the other UW MCH training programs and annually update a web-based Library of Resources that describes public health metrics specific to CSHCN to support this population as emerging issues arise in order to effectively support the current and future MCH infrastructure. Objective 3: Develop a four seminar series that meets quarterly each year in conjunction with other UW-MCH training programs entitled “Emerging Issues in Maternal Child Health,” that highlights emerging health, economic, policy and system issues related to CSHCN and their families.
Methods to achieve the program’s goal and objectives include orientation, serial self-assessments, reflective journaling, unidisciplinary courses for graduate degrees, interdisciplinary seminars about MCHB history, vision, and MCHB Training Strategic Plan, Healthy People 2010 objectives, Bright Futures clinical standards; a Core PPC lecture series, interdisciplinary clinical practicums in inpatient units, outpatient, telehealth and community-based clinics, identification of disparities in clinical care and strategies to improve them, participation in research, leadership field experiences to learn advocacy and coalition building, the UW MCHB Leadership Training Consortium workshops, and a Leadership Capstone Project addressing >6 leadership competencies. Program methods include maintaining faculty in all 5 disciplines, annual faculty self-assessments regarding cultural competency, family centered care, and leadership development; recruiting and retaining diverse trainees and faculty, clinical service to underserved children in four states, parent involvement with teaching and program evaluation, regional continuing education, distance learning, technical assistance and collaboration with Title V agencies in Region X states, interdisciplinary research on systems of care and pulmonary conditions, faculty development, and collaboration with the national network of PPCs.
Partners include 3 UW MCHB Leadership training programs for joint leadership training; public health school and community based clinics as clin. Training sites serving diverse underserved groups regionally; Title V agencies in WA, AK, and ID, telehealth services, and tech. assist.; joint research and advocacy opportunities with state agencies; nat. research networks, UW WWAMI sites for continuing education; and national professional organizations and national MCHB programs for joint initiatives.
Evaluations of training include tests, faculty oversight of clin. Prac., patient logs, journaling, attendance at workshops, oral present., and use of elec. Info.systems, serial self assess., and completion of a Leadership Capstone project. Program evaluation includes Advis. Committee and family input of curriculum and trainee activities, trainee diversity, # of children served; continuing education, tech.assist., advocacy activities; joint Title V agency and MCHB projects and res. Pubs.
Five long-term and 32 medium term trainees were trained. Continuing education included 22 training sessions to 2047 individuals. PPC staff provided clinical services to 170 infants ages <1 of which 54% received funding from Title XIX and services to 3,715 children between ages 1 and 22 of which 47% received funding from Title XIX. PPC faculty worked on 82 technical assistance projects and collaborated with 186 agencies in the following regional, national, and international categories: other divisions/departments in a university, title V (MCH Programs), state health department, health insurance/organization, education, medicaid, social service agencies, juvenile justice or other legal entity, developmental disability agency, early intervention, other government agencies, prof. organizations/associations, family and/or consumer group and foundations PPC faculty published 43 items that included: book chapters, journal articles and abstracts/posters. Other program accomplishments included: technical assistance in improving asthma education, improving the use of airway clearance techniques in patients with cystic fibrosis, advances in surgical treatment of spine and chest wall deformity in children, and participating in the Washington State Disaster Preparedness Pediatric Task Force.