University of Alabama at Birmingham Pediatric Pulmonary Center

Abstract

Problem:

Approximately 18.1% of US children are considered Children with Special Health Care Needs (CSHCN), with Alabama and the southeast consistently ranking worse than the national average in prevalence of CSHCN, CSHCN who live in poverty, proportion of African American CSHCN, and infant mortality. Children with chronic respiratory conditions such as asthma, bronchopulmonary dysplasia (BPD), cystic fibrosis (CF), technology dependence, sleep-disordered breathing, and respiratory complications from neuromuscular disorders are a substantial portion of CSHCN. There is a significant provider shortage, with only 61.3% of pediatric pulmonary fellowship positions filling from 2015-19, and an aging workforce. Companion shortages of nurses, social workers, nutritionists, and respiratory therapists who specialize in pediatric pulmonary care have resulted in a critical need to train the next generation of professionals and family leaders in interprofessional, family-centered, culturally competent care for this vulnerable population. While telehealth has potential to improve access to care, only 12% of pediatric pulmonary practices nationally are using telehealth applications. Only 2 pediatric subspecialties in Alabama currently offer any telehealth services.

The UAB PPC has a 40-year history of interprofessional leadership training, having trained 219 fellows/trainees, who practice throughout the US. Fellows/trainees from the past 5 years alone practice in 6 states with 19% from underrepresented minority groups. The PPC at UAB seeks to train MCH leaders in pediatric pulmonology, advanced practice nursing, social work, respiratory therapy, nutrition, and family leaders.

Goals and objectives:

The critical need for training will be addressed by five project goals.

1. Planning, implementing, and evaluating an interprofessional leadership training program in an exemplary clinical setting, framed by the MCH Leadership Competencies V4.0;
2. Ensuring the provision of family engagement, family partnership, and family-centered care in training, Continuing Education/Subject Matter Expertise activities (CE), and Technical Assistance/Consultation (TA) activities;
3. Increasing access to health care for CSHCN, increasing access to interprofessional training, and increasing access to CE and TA by employing innovative methods and using technology;
4. Enhancing the knowledge and skills of professionals in MCH-related fields by disseminating knowledge related to pediatric pulmonary conditions, pediatric sleep disorders, public health, care of vulnerable MCH populations, and other topics which support MCH State and National Performance Measures by providing CE and TA; and
5. Increasing the diversity of MCH faculty/students/providers to be reflective of the community; increasing the cultural competence of MCH faculty/students/providers; and reducing health disparities/increasing health equity in CHSCN with chronic respiratory conditions.

By providing interprofessional training and clinical services, expanding access to training and clinical care through use of innovative technology, engaging family leaders, and increasing diversity/health equity, the UAB PPC will serve students and families who are future leaders, and will serve CSHCN, particularly children with chronic pulmonary conditions and sleep disorders. State Title V Block Grants, health care providers, and related agencies will also be served through the provision of CE and TA, which focus on vulnerable populations and integrating primary care, specialty care, and public health.