An Institutional Approach to Equity and Improvement in Child Health Outcomes

Area of Science:

• Health Services Research
• Pediatric Health Equity
• Learning Health Systems

Background:

• Pediatric health inequities are widespread, with healthcare institutions often screening for social needs without adequate linked responses.
• Existing efforts to advance health equity within institutions are frequently isolated, hindering cross-learning and innovation.
• Learning network methodologies offer a promising approach for addressing complex, multidimensional challenges in healthcare.

Purpose of the Study:

• To establish and evaluate an institutional Health Equity Network (HEN) designed to accelerate action and learning in addressing pediatric health inequities.
• To support clinical action teams in implementing targeted interventions that address both medical and social determinants of child and adolescent health.
• To reduce the equity gap in hospitalization rates between Black patients and all other patients.

Main Methods:

• Established an institutional Health Equity Network (HEN) comprising 10 action teams focused on eliminating pediatric health inequities.
• Teams deployed targeted interventions addressing medical and social factors affecting patient and family wellbeing.
• Promoted rapid learning and intervention scaling through monthly "action period calls" and "solutions labs".

Main Results:

• The HEN facilitates a structured approach to addressing pediatric health inequities through collaborative action teams.
• The network enables sharing of successes, challenges, and potential solutions for scaling interventions, such as medical-legal partnerships.
• Early outcomes focus on the primary measure of reducing the hospitalization rate gap between Black patients and other patient groups.

Conclusions:

• Equity-oriented learning networks, like the HEN, can accelerate progress in addressing complex factors contributing to inequitable pediatric health outcomes.
• The HEN model demonstrates a strategy for fostering innovation and cross-learning among healthcare institutions striving for health equity.
• This advocacy case study details the design, implementation, and initial outcomes of the HEN, providing a framework for similar initiatives.