The Alabama Child Health Improvement Alliance (ACHIA), established by the AAP Alabama Chapter a decade ago, has developed and conducted a dozen nine-month quality improvement (QI) collaboratives on topics such as asthma, trauma-informed care, teen vaccinations, and obesity prevention and treatment.
“ACHIA is an essential component of how I practice medicine,” said Elizabeth Dawson, M.D., FAAP, chapter quality improvement chair and collaborative participant. “It has streamlined a highly efficient and effective way to do QI, and the children and pediatricians of Alabama have benefited from it.”
ACHIA got its start after chapter members participated in the AAP Asthma Continuous Quality Network to improve asthma care for their patients. That led the chapter to enlist support from statewide groups in 2013 to establish a standing QI partnership.
With technical assistance from the National Improvement Partnership Network (NIPN) and buy-in from payers, children’s hospitals and academic pediatric departments, the chapter established ACHIA in 2014 to improve child health outcomes at the community practice level. ACHIA is housed in the Department of Pediatrics at the University of Alabama at Birmingham and has part-time faculty support.
ACHIA recently addressed teen mental wellness by partnering with the state’s Pediatric Mental Health Care Access Program administered at Children’s of Alabama. The program provided the educational curricula and mentored physicians with challenging patients, while ACHIA’s QI collaborative helped practices improve universal depression screening, document the screen interpretation and plan, and follow up on positive screens.
Similar collaborations with Help Me Grow Alabama, the state’s Prevent Child Abuse agency, and the Alabama Medicaid Agency’s care coordination entity have strengthened relationships with other organizations seeking optimal health outcomes for children and youth in the state.
Benefits to Alabama pediatricians
Since 2014, 250 pediatricians and other pediatric health care providers have engaged in ACHIA collaboratives, with half of them participating more than once. Participants have earned a total value of 14,625 Maintenance of Certification Part 4 points.
The peer-to-peer learning model allows participating practices to share ideas and address barriers. Peer learning had an unanticipated value during the COVID-19 pandemic, when the 2020 collaborative served as a sounding board on sourcing face masks, setting up outside clinics and continuing to provide quality care with dwindling staff.
Additional benefits to participating practices include the development of QI skills in other areas and burnout prevention.
“It is wonderful to connect with other pediatricians around the state and share ideas to make the work accessible,” Dr. Dawson said. “QI can be daunting, but ACHIA takes the uncertainty away by the processes it provides to make this work tangible and rewarding.”
Partner support
ACHIA has been able to work on a breadth of child health issues thanks to funding and in-kind support from payers, hospitals and government agencies. The AAP also helped fund QI training for the ACHIA director and provided the data platform and guidance on developing measures. NIPN provided initial onsite support on how to start an improvement partnership as well as a decade of guidance on running a collaborative.
The ACHIA team is planning its first antibiotic stewardship collaborative, which kicks off in December and is beginning the selection process for topics to address in 2026 and beyond.
Meanwhile, the team continues to explore ways to make data collection easier and more robust so ACHIA can continue to help pediatricians provide quality care in the years ahead.
Dr. Benton is the director of the Alabama Child Health Improvement Alliance.
Resource
