Summit County Pathways HUB Project

Our SCALE Journey

Learning from SCALE & IHI

Leading Within... The Journey

When we joined the SCALE Project in Fall of 2016, we began a journey that we did not expect. Our team had experience with planning for and managing grants, community initiatives and projects. However, the Journey began quite unlike other projects we had been assigned to. We were familiar with program deliverables, partnerships and granting agencies, but the foundational principles, tools and structure needed to ground our work were new to us. Each of us had strong skills and training in quality improvement, but the approaches and tools coupled with the philosophical pillars created a new synergy in our work.

We quickly adopted the principles of 'leading within', 'leading together', 'leading for equity', and 'leading for outcomes'. The last three principles were very important to us. 

Leading Together

We could not move this model forward in the community without our community health workers and community champions. These individuals became critical partners in the planning and implementation of our strategies for recruitment, enrollment, new partners, training and capacity building.

Leading for Outcomes

While we were implementing the model, we spent a great deal of time discussing metrics. How do we know if we are successful? How does this initiative align with the others in the community? We knew that our data revealed a great disparity between black and white infant mortality rates and that race was a significant factor. We changed our conversations about the data from discussing rates to discussing stories and lives impacted; moreover, we emphasized the role that race played in this issue. We knew we could not talk about infant mortality without discussing race. Here is some of the data emphasizes these points:

Leading for Equity

Each year Ohio loses the equivalent of ~ 36 kindergarten classrooms to black infant mortality, with approximately three of them being from within Summit County specifically.

To highlight the role of leading for outcomes and equity, we had to explain social determinants of health and its connection to infant mortality. This image is commonly used by other Pathways HUB to depict the hidden factors that impact health.

It became apparent that these principles not only refined our quality improvement methods, but focused our work in addressing infant mortality. SCALE provided us with the laboratory to experiment with the tools through small tests of change and implement the changes quickly. 

Not only have we adopted the Plan, DO, Study, Act (PDSA) methodology in the Pathways Community HUB work, we have begun to spread it through our partners connected to the HUB. To date, the HUB enrollees have positive birth outcomes and while the sample is small at this time, it is moving in the direction of a positive change.

Learning from Other Communities

Bright Spot Visit: Michigan HUBs

In August, Summit County HUB coordinated and participated on multiple conference calls with HUBs in Ohio and Michigan. The HUB team asked questions about operations, implementation, successes, challenges and future plans for sustainability and programming. On August 18, 2016, Summit County spoke with 2 HUBs in Michigan that were funded by the Center for Medicaid and Medicare Innovation Center. These HUBs established as a result of this funding with a focus on chronic disease. We felt that engaging with them as they had been operational for several years, had great outcomes and were certified under the Rockville Institute Pathways HUB certification process, we could learn a tremendous amount from their experiences. Although we did not visit these locations in person, there was a great deal of learning that took place. The two HUBs in Michigan were Muskegon Michigan and Ingium Michigan.