Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109911

Diane Abatemarco, PhD, MSW¹, Anna Sevilla, MPH², Steven Kairys, MD, MPH³, Karen L. Benjamin, MPH, CHES², Ruth S. Gubernick, MPH⁴, and Tammy Piazza-Hurley⁵. (1) Graduate School of Public Health, University of Pittsburgh, 130 Desoto Street, Room A 223, Pittsburgh, PA 15261, (412) 383-9629, dja17@pitt.edu, (2) Health Systems and Policy, UMDNJ-School of Public Health, 683 Hoes Lane West, #321, Piscataway, NJ 08854, (3) Department of Pediatrics, Jersey Shore Medical Center, Route 33, Neptune, NJ 07754, (4) Consultant-Maternal & Child Health Prog. Devel. Specialist, 5 Woodbury Drive, Cherry Hill, NJ 08003, (5) Division of Safety and Health Promotion, American Academy of Pediatrics, 141 Northwest Point Blvd., Elk Grove Village, IL 60007

Healthcare organizations and pediatric practices in particular, are generally considered to be rigid, bureaucratic, and incapable of change. Unlike specialty practices, pediatric practices must attend to a broad spectrum of acute and chronic concerns, which creates work environments overwhelmed with stress, high staff turnover rates, and multiple demands. Most practices have a very high patient volume and function on the margins of financial viability, leaving little time for self-reflection and organizational quality improvement.

Modeled after the Project ULTRA, an approach first utilized with family medicine, the UMDNJ-School of Public Health and the American Academy of Pediatrics (AAP), funded by the Doris Duke Charitable Foundation, developed a collaborative project to facilitate organizational change in pediatric practices. Six pediatric practices in New Jersey participated in the study. Using the framework of complexity theory and understanding that pediatric practices are complex adaptive systems, our objective was to impact preventive care in pediatric practices by catalyzing creative organizational change and tailoring the intervention to each practice's unique complexity and circumstances. Practices were asked to allocate time and space for learning and reflection. Practice teams included representatives from multiple levels of the practice and one parent of a practice patient. An outside facilitator trained in complexity science and tools of relationship management moderated the regularly scheduled team meetings.

Quantitative and qualitative methods of evaluation demonstrate areas of improvement including increased communication and leadership in the practice. As a result, a creative partnership within the practice has been developed that facilitates organizational quality improvement and may lead to enhanced patient care.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Discuss how detailed information is collected to create a quantitative and qualitative snapshot of the culture and organization of the pediatric practice.
• Articulate the procedure for establishing a creative partnership to facilitate organizational quality improvement and enhanced patient care.

Keywords: Quality Improvement, Pediatrics

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.