Banishing burnout and building resiliency in pediatric providers 🌧🌤☀️

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Care Transformation Collaborative of RI

News & Updates | October 2022

Identifying Burnout and Building Resiliency in Pediatric Providers

The Rhode Island Chapter of the American Academy of Pediatrics (AAP-RI), in partnership with CTC-RI through American Rescue Plan Act (ARPA) funding, recently held a 3-part virtual series for pediatricians that addressed how burnout can be identified and resilience can be grown among medical providers who work with children and adolescents. Dr. Nelly Burdette, CTC-RI IBH Sr. Director / PCHC IBH Assoc. VP, was engaged to bring this vision to reality.

Each virtual module included approximately 30 minutes of content and 30 minutes of discussion, bridging evidence-based data and unique psychological perspectives to apply either individually, organizationally or communally from a burnout and resilience perspective. Read more.

Spotlight: Allison Brindle, MD, FAAP

President, Rhode Island Chapter American Academy of Pediatrics

CTC-RI, in partnership with the RI Chapter of the American Academy of Pediatrics (AAP-RI), recently held a 3-part virtual series on recognizing and reducing burnout among pediatric providers. We asked Allison Brindle, MD, FAAP President, AAP-RI, to reflect on why identifying and addressing burnout and building resiliency among pediatric providers is a priority for AAP-RI.

Why is pediatrician burnout and resiliency an important focus area for AAP-RI?

The children and families of Rhode Island have been under extreme stress. Child and adolescent mental health, health inequity, access to care for our most vulnerable patients - all of these issues have been present in Rhode Island. Pediatricians are at the frontlines of promoting health and helping families navigate these challenges. This was happening before the pandemic, and the needs have intensified over the last few years. The RI AAP wants to provide pediatricians with resources to promote resiliency at a time when so many are stressed and feeling burnout.

How have recent changes in the healthcare landscape and the continued impact of COVID-19 uniquely affected RI pediatricians this year?

COVID-19, while bringing its own unique healthcare challenges, also highlighted the cracks in the foundation of our healthcare system, mental health system and community supports. Further challenges such as the infant formula shortage and threats to reproductive healthcare have layered onto those challenges. While there has been some positive change in terms of continued access to telehealth for patients and families, increased Medicaid payment for primary care doctors in the budget, and increased support for services such as Early Intervention, there is still a lot of work to be done to support pediatricians and others who support children and families.

In what ways can pediatricians and care teams be better supported to avoid burnout and sustain a stronger workforce?

There is a growing body of literature to support institutional and community changes that can support pediatricians and workers across many different industries. The RI AAP will continue to advocate for policies in our state to support children, families, the pediatric workforce, and the workforce of others in the community who share our mission to support healthy children and families.

Qualitative Evaluation of IBH Learning Collaborative Finds IBH Is a Critical Primary Care Service

CTC-RI recently contracted with outside consultants to conduct a qualitative evaluation of its 3-year

pediatric integrated behavioral health (IBH) learning collaborative that ended in April. The goal of the IBH learning collaborative, funded by the RI Foundation, Tufts Health Plan, and UnitedHealthcare, was to help 8 practices establish an IBH program to better identify, assess, and treat behavioral health (BH) concerns in their pediatric population.

Overall, the qualitative evaluation found that pediatric IBH is a critical primary care service that can prevent more serious BH problems in children and adolescents and help patients and families better cope with BH symptoms and concerns as they emerge. Read more about key findings and recommendations from the final report.

Medicaid Pediatric Healthcare Recovery Program Enters Year 2

The State Fiscal Year 2023 budget included additional funding for the Medicaid Pediatric Healthcare Recovery Program. Medicaid, in partnership with CTC-RI, is offering a 12-month incentive program to improve immunization and lead screening results and improve capacity to assist children and families with behavioral health needs. There are 56 practices that have successfully applied for the next round of the Medicaid Pediatric Healthcare Recovery Program.

Payments are contingent on practices meeting immunization and lead screening targets or demonstrating prescribed improvement. In addition, practices will be paid to participate in a 6-series ECHO® (Extension for Community Healthcare Outcomes) behavioral health learning initiative. Read more.

CTC-RI Kicks Off Pediatric Weight Management ECHO® and Quality Improvement Initiative

CTC-RI has kicked off its first ECHO® training series on the topic of pediatric weight management. Staff from 7 selected pediatric practices participated. The meeting included an overview of the ECHO® program, as well as a didactic presentation from Vania Kasper, MD on the Epidemiology of Obesity (AAP guidelines). Anchor Pediatrics presented a client case study. Read more and view the presentation.

September Meeting of CTC-RI Clinical Strategy Committee Focuses on Primary Care Capitation

The September meeting of the CTC-RI Clinical Strategy Committee included an engaging presentation and discussion of primary care capitation. Pano Yeracaris, MD, MPH reviewed CTC-RI's past capitation work. Peter Hollman, MD, Brown Medicine, Geriatrics and Palliative Medicine/CTC-RI Board President, then moderated a panel discussion that included:

Cory King, MPP, Chief of Staff, RI Office of the Health Insurance Commissioner
Ana Tuya-Fulton, MD, MBA, FACP, AGSF, Chief Population Health Officer & Executive Chief of Geriatrics & Palliative Care, Care New England/Chief Medical Officer, Integra Community Care
Marty Kerzer, DO, Prospect Medical
Hugo Yamada, MD, CharterCare Medical Associates, Lincoln
Andrea Galgay, MBA, Chief Operating Officer, RIPCPC
Matt Collins, MD, MBA, Executive Vice President and Chief Medical Officer, BCBSRI

Discussion focused on the challenges of, and strategies for, adopting primary care capitation across a larger portion of patients. Attendees also learned how systems of care have positioned themselves for primary care capitation in global risk contracts. Read more.

CTC-RI and PCMH Kids Hold Quarterly Meeting on Improving Child Health in RI

CTC-RI and PCMH Kids held the quarterly Improving Child Health in RI meeting (formerly known as the PCMH Kids Stakeholder Meeting). Drs. Beth Lange and Pat Flanagan presented information on the Medicaid Pediatric Relief Fund program and led a discussion on statewide priority areas related to child health. Also discussed were current activities of PCMH Kids, gaps that have been identified, and opportunities for greater impact. Read more.

Join IBH practice facilitators for monthly lunchtime 'Meet and Eat'

CTC-RI offers a monthly opportunity to have a casual Zoom conversation with our Integrated Behavioral Health (IBH) practice facilitators, Dr. Liz Cantor and Dr. Kristin David. This is an opportunity for IBH clinicians (Psychologists, Therapists, Social Workers, and Nurses) to connect with other IBH professionals, discuss best practices, challenges, successes, and more!

The Zoom event occurs every 3rd Friday of the month at noon. The next discussion is tomorrow, Oct. 21. Register here.

CTC-RI December Breakfast of Champions to Continue Conversation on Unconscious Bias

CTC-RI’s Dec. 9 Breakfast of Champions will continue the conversation on unconscious bias. The event will focus on what can be done to improve team functioning and positively impact patient care and health equity. Read more and register to attend.

CCE Program Holds September Best Practice Sharing Meeting

CTC-RI and RIDOH’s Diabetes, Heart Disease and Stroke Program (DHDS) have kicked off the final year of the Care + Community + Equity (CCE) program. During the program’s recent Best Practice Sharing meeting, enrolled practices reviewed their quality improvement programs for the coming year.

Rhode Island was awarded the National Association of Chronic Disease Directors (NACDD) 2022 Chronic Disease Innovator Award, an award given to a state, tribal, or territorial chronic disease unit that demonstrates an innovative approach to reducing the burden of chronic disease prevention and control. Participating practices were also recognized by the American Heart Association for their demonstrated performance in Blood Pressure, Type 2 Diabetes and Cholesterol. Read more.

New Study Compares Per-Person State Healthcare Spending Adjusted for Standardized Factors

A new study from the Institute for Health Metrics and Evaluation (IHME) highlights state-specific factors, allowing for an “apples to apples” comparison of per-person state healthcare spending, writes Christopher Koller, president of the Milbank Memorial Fund and former Health Insurance Commissioner for the State of Rhode Island. According to the study’s analysis of state-level health spending per person in 2019, Rhode Island spent $10,930 per person, with a standardized per-person spend of $10,840. The study notes that standardized per-person health spending was adjusted for several factors including age, sex, economywide prices, mean income, population density, smoking rates, and physical activity rates. Read more.

56 Participate in First Asthma Essentials ECHO®

CTC-RI hosted its first Asthma Essentials ECHO®, bringing together partners from multiple learning and care communities to engage in the ECHO “all teach, all learn” model. Pat Flanagan, MD facilitated the first session, which included 56 participants. The event included both a didactic session and a case presentation. Join us for Session 2 on Nov. 9. Read more.

Best Practices in Team-Based Care Sessions Focus on Improving Care for People with Diabetes and Improving Hypertension Patient Care

The September Best Practices in Team-Based Care meeting included a presentation on improving care for people with diabetes through team-based care. Diana Mercurio from RIPCPC and Jessica Ryan from Thundermist, both organizations that participated in the CTC-RI pharmacy quality improvement project, presented their organizations’ efforts to decrease diabetes-related emergency department and inpatient utilization.

This month, CTC-RI offered Best Practices in Improving Hypertension Patient Care: a Team-Based Approach. On November 15, CTC-RI will offer Best Practices in Lead Screening. Read more.

CTC-RI's Linda Cabral, MM Presents Rhode to Equity Poster at Camden Coalition Conference

CTC-RI Senior Program Manager Linda Cabral, MM, recently shared the work of the Rhode to Equity (R2E) project at the Camden Coalition’s annual conference, a gathering of those working to improve care for people with complex health and social needs. She shared a poster highlighting the project’s background, teams, partnerships, and year 1 outcomes. Read more.

Rhode Island COVID-19 Updates

Rhode Island is now reporting new COVID-19 data every Thursday. As of October 13, 2022:

Cases per 100,000 previous week: 144
Hospitalized previous week: 139
Deaths previous week: 7
Total deaths to date: 3,681
Vaccinated with two shots: 85.7%
Vaccinated with booster: 56.5%

Practice Resources

Bradley Learning Exchange to Offer Suicide Prevention, Screening and Response Training on Oct. 25

This 3-hour class teaches participants to administer the evidence-based Columbia Suicide Severity Rating Scale screener and use the results to respond appropriately to the person being screened. Designed for those without a behavioral health background, this training teaches participants about suicide risk factors and warning signs. Learn more.

Save the Date! 2022 RI World Diabetes Day In-Person Event on November 14

A free morning full of helpful, eye-opening, and inspirational presentations, discussions, and Q&A sessions. Whether you're a clinician, caretaker, or person living with diabetes, there will be sessions for you! Light refreshments will be available. Register.

RIDOH Office of Special Needs Invites New Members to Youth Advisory Council

The RI Dept. of Health (RIDOH) invites young people of all abilities to join its Youth Advisory Council. This diverse group offers opportunities to gain leadership skills, make new friends, and have a say in public health projects for young people in RI. The group meets virtually each month. Read more.

ECHO® Series to Highlight Issues Impacting Quality of Life for Older Adults

A new ECHO® series on Issues Impacting the Quality of Life for Older Adults has launched. Topics include:

Oral health and older adults
Incontinence concerns and older adults
Hearing issues and older adults
Vision concerns among older adults

Sessions are held via Zoom. These learning sessions amplify the capacity of providers to deliver best practice care to their patients. Read more.

Upcoming CTC-RI Committee Meetings and Workgroups

October 21, 07:30-09:00AM – Clinical Strategy Committee
October 28, 07:30-08:45AM – Board of Directors
November 18, 07:30-09:00AM – Clinical Strategy Committee
November 15, 08:00-09:00AM – Best Practices in Team-Based Care (formerly NCM/CC Best Practice Sharing)

Upcoming Learning Collaboratives and Professional Development

October 21, 12:00-01:00PM – Integrated Behavioral Health Practice Facilitator Meet & Eat
October 27, 08:00-09:30AM – NCQA BH Distinction Learning Collaborative Midpoint Meeting
November 03, 07:30-08:00AM – Virtual Coffee Breaks with Drs. Flanagan & Lange
November 03, 08:00-09:30AM – CHT Expansion Best Practice Sharing
November 09, 07:30-08:30AM – Asthma ECHO®
November 16, 07:30-08:30AM – Health Care Transitions Learning Collaborative
November 18, 12:00-01:00PM – Integrated Behavioral Health Practice Facilitator Meet & Eat

Care Transformation Collaborative of RI | ctc-ri@ctc-ri.org | ctc-ri.org