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Thrive at Five

Monday, March 12, 2018 - 14:30

When a young child comes into the primary care center at Cincinnati Children’s Hospital, the medical team reviews vaccination records, checks weight, and screens for dental, vision, and hearing health. As part of the hospital’s Thrive at Five project, the team also checks the child’s speech, literacy, and mental, emotional, and behavioral health. If a child is lagging in any of these areas, the medical team helps the parent or guardian find appropriate resources to prepare the child to succeed in kindergarten.

Thrive at Five is part of Cincinnati Children’s All Children Thrive (ACT) learning network. The network brings together families, community and civic leaders, educators, social service providers, faith leaders, health care providers, researchers, and others to collaborate, discover, and implement findings to create environments where children thrive.

“We started around 2010 trying to solve problems closely associated with poverty — unintended injury, infant mortality, obesity, and uncontrolled asthma,” says Robert Kahn, MD, MPH, Physician Lead, Community and Population Health, James M. Anderson Center for Health System Excellence at the University of Cincinnati. “We had enough success in these four areas that the hospital has made leading community health efforts a pillar of our hospital’s strategic plan.”

As a result, the learning network has expanded to include many more community members with resources to address root causes of problems that prevent children from thriving — including food insecurity, inadequate housing, social isolation, and low literacy, in addition to physical health.

Pediatricians who participate in the program by collecting baseline data, implementing interventions to improve health, and then measuring outcomes, can and do claim Maintenance of Certification (MOC) credit for Quality Improvement (Part 4).

“The quality improvement requirements of MOC are intended to encourage and reward innovations in practice,” says Virginia Moyer, MD, MPH, ABP Vice President of MOC and Quality. “As programs like ACT spread across the country, we all can discover new ‘best practices’ from each other’s work.”

Thrive at Five is one example of a concerted effort to set achievable markers for children, says Courtney Brown, MD, MSc, a pediatrician at Cincinnati Children’s and Assistant Professor of Pediatrics at the University of Cincinnati. Specific markers of physical health, cognitive development, and social competence are measured from birth. The goal is to have the children at acceptable levels in all categories by age 5½.

“It’s exciting,” Dr. Brown says. “We try to solve the problems of one child at a time, and from that, we figure out ways to make the whole system better for everybody.”

As one part of Thrive at Five, the medical team encourages parents and children to read together. Cincinnati Children’s serves as the leader of the Greater Cincinnati Reach Out and Read Coalition and supports nearly 20 primary care medical centers across Cincinnati that participate in Reach Out and Read, serving nearly 30,000 children and families.

Samerra Lewis reads to Dr. Jessica Walters in the waiting room at Cincinnati Children’s Hospital. The hospital reports that children served by Reach Out and Read score three to six months ahead of their non-Reach Out and Read peers on vocabulary tests. Since the program started in Boston nearly 30 years ago, it has spread to all 50 states. Pediatricians who work to enhance their Reach Out and Read programs may be able to claim MOC Part 4 credit.

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