LAURA KETTEL KHAN: Rear Admiral Sarah Linde,
Chief Public Health Officer at the Health Resources and Services Administration of the
US Department of Health and Human Services. Thank you.
SARAH LINDE: Thank you, Laura. And thank you for having me. It’s an absolute pleasure to
be here. If I could go on to the next slide. The mission of HRSA is to improve health and
achieve health equity through access to quality services, a skilled health workforce and innovative
programs. So, we work to improve access to health care services for millions of people
who are uninsured, isolated, or medically vulnerable. The Healthy Weight Collaborative
is one such innovative program, but first, I want to tell you a word or two more on HRSA.
Next slide, please. How does HRSA achieve its mission? We have
a budget of more than $9 billion dollars, which funds 80 different grant programs. We
support the health center program which includes community health, migrant health, homeless
health, and public housing centers. And that includes nearly 9000 sites, and serves 21
million patients. We also fund maternal and child health through partnerships with state
and local governments, and 34 million woman and children throughout the country benefit
from those programs. The largest program, is the Maternal and Child Health Services
Block Grant to States, and this program focuses on reducing infant mortality and childhood
illness and controlling costs associated with poor pre- and neo-natal care.
Our Ryan White HIV/AIDs Program, provides care and services for half a million people
living with HIV and AIDs. And, the National Health Service Corps, and its over 9,000 primary
health care professionals work in medically underserved communities in exchange for loan
repayment or scholarships. Next slide, please. We also give financial support to colleges
and universities, and in so doing we develop, distribute, and retain a diverse, culturally
competent health workforce in the areas of medicine, dentistry, nursing, and public health.
We are the lead federal agency that bolsters rural hospitals and coordinates coalitions
of rural health providers to make health care more accessible for the 60 million residents
of rural America. We oversee all organ, tissue and blood cell
donations; we are the federal agency primarily responsible for poison control, and we administer
a drug discount program, known as the 340B program that allows the neediest patients
to receive discounted drugs through eligible providers participating in the program. Next
slide, please. So, now that you have a general overview of
what HRSA does, I’d like next to talk about using quality improvement to prevent and treat
obesity in communities and specifically about HRSA’s Healthy Weight Collaborative. HRSA
has a long history of supporting evidence-based quality improvement activities for clinical
care, for example in the areas of HIV and AIDs care, organ transplantation, and maternal
and child health. In September of 2010, $5 million dollars was
awarded to the National Initiative for Children’s Healthcare Quality through a cooperative agreement
and funded by the Prevention and Public Health Fund, described in the Affordable Care Act,
to establish the Prevention Center for Healthy Weight, or also known as the Collaborate for
Healthy Weight Initiative. There are two main activities of this initiative.
One, to plan, manage, and implement the Healthy Weight Collaborative. And second, to serve
as a resource center for widespread dissemination and communication of evidence-based interventions
that focus on the link between primary care, public health, and community related, and
sorry and the community related to obesity prevention and treatment. So, this slide shows
the timeline of other significant dates to include authorization of the ACA in March
of 2010. Next slide, please. So, what exactly is the Healthy Weight Collaborative?
It’s a national quality improvement initiative using the Breakthrough Series Approach in
which multi-sector teams comprised of primary care, public health, and community as well
as consumer representatives are applying evidence-based interventions to prevent and treat obesity
in children and families. The Breakthrough Series was developed by the
Institute for Healthcare Improvement in 1995 to help health care institutions design and
execute rapid-cycle quality improvement initiatives using evidence-based interventions that were
capable of achieving widespread change in a relatively short time frame and closing
the gap between what we know and what we do. Next slide, please.
This is the scariest slide of the set. But this just shows you what the process of improvement
is. The Healthy Weight teams engage stakeholders representing primary care, public health,
and community and this collaborative effort emphasizes common goals, rapid-cycle change
methodology, and integration, and it serves as the voice of the community. We believe
that all three sectors have to collaborate, using evidence-based approaches, to reverse
the obesity epidemic and improve the health of our communities.
Using the Breakthrough Series, a collaborative is a short-term learning system that brings
together a large number of teams, usually from clinical areas to seek improvement in
a focused topic area. For the Healthy Weight Collaborative, as I mentioned, the teams are
not only clinical, but also include primary care and the community, and the focused topic
area is a public health issue: obesity. So, this slide shows the process of the learning
collaborative….which includes team formation, faculty recruitment, a series of learning
sessions interspersed with action periods during which action is planned, carried out,
assessed, and revised. Next slide, please. For this Collaborative, the aims were to establish
sustainable partnerships and implement and test interventions to achieve healthy weight.
In order to meet those aims, the Collaborative supported approximately 50 teams from all
over the country. In phase one, 10 teams with previous experience in cross-sector collaboration
participated in both in-person and virtual Learning Sessions. And then in phase two,
we added about 40 additional teams participated in an entirely virtual Collaborative. The
two-phased approach was intentional so that we could harvest the emerging lessons and
refined experience of the Phase 1 work to inform and assist Phase 2 work. Next slide,
please. So, what interventions were tested? What have
the teams learned? Have any of their changes been successful? How are teams evaluating
their work? And how do they plan to sustain those changes? Those are all great questions
and I’m excited to introduce you to two of our Healthy Weight Collaborative teams. The
San Diego Healthy Weight Collaborative is being represented by Dr. Shaila Serpas, and
the Florida Healthy Weight Collaborative is being represented by Kari Elingstad. These
are two of the standout teams who will describe in more detail opportunities and challenges
the Healthy Weight Collaborative presented and also how they are evaluating their work.