Tag Archives: public health

Communicate, Collaborate and Innovate to Reduce Infant Mortality

Peter Gloor, PhD
Peter A. Gloor, PhD

Compared to other Western countries, infant mortality in the US is shockingly high.
High infant mortality is a social problem that can only be solved through massive collaboration and out-of-the-box innovation.

To tackle this issue I propose to tap into the “creativity of the swarm,” using collaborative innovation to help parents and caregivers take the best possible care of their children even before they are born and increase the quality of care in the first years of an infant’s life.

A good starting place, I believe, is to connect parents and healthcare providers in what I call Collaborative Innovation Networks (COINs). These are dynamic teams in which diverse stakeholders with a shared vision collaborate to achieve a common goal. COINs form from the interaction of like-minded, self-motivated individuals who enable innovative ideas to be pushed forward. The participants join because they are committed to the common vision and want to be part of the innovation that “will change the world.”

How many people could be motivated by the goal of reducing infant mortality?

Through COINs, we can collectively address key topics such as breastfeeding, screening for developmental delays, and recognizing maternal depression. We can increase the quality of care for infants by creating peer learning and innovation groups of parents, where knowledgeable parents help others learn to take better care of their babies. Weaving a network of social support around parents in need helps them weather the storms of daily life. Just like in the beehive where bees take care of their young as a community, mothers and fathers in a collaborative innovation network can learn from and support each other.

One of the key factors for high-functioning COINs is communication. As we have found in our research, better communication leads to better collaboration, which in turn leads to more innovation. Ultimately, we want to increase the collective intelligence of these teams. In research at the Center for Collective Intelligence, my colleagues found that there are four key predictors that will increase collective intelligence of groups:

  1. The more team participants communicate with one another, the more collectively intelligent the team is.
  2. When participants communicate equally, instead of a few participants doing most of the talking, the collective intelligence of the team is higher.
  3. When everyone contributes equally to team success, a team is more collectively intelligent.
  4. The higher the emotional intelligence (measured through a test called “Reading the Mind in the Eyes”) of each team member is, the higher the collective intelligence of the team is.

It all starts with connecting parents and healthcare providers, encouraging them to better communicate such that they can innovate more. Talking more, talking more evenly, contributing ideas more evenly, and taking care of the emotional needs of each other will help to create better networks that will generate better ideas to reduce infant mortality.

Peter Gloor, PhD, is a research scientist at the Center for Collective Intelligence at MIT’s Sloan School of Management and is the pioneer of the Collaborative Innovation Networks (COINs) concept upon which NICHQ’s Infant Mortality Collaborative Improvement and Innovation Network (CoIIN) project is based. Mr. Gloor is serving as an expert advisor to NICHQ on this project.

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Overcoming the Epidemic of Compassion Fatigue

Lauren A. Smith, MD, MPH
Lauren A. Smith, MD, MPH

As I take on my new role at NICHQ as leader of a national initiative to reduce infant mortality, I find myself in a struggle very familiar to those of us in public health who focus on promoting the health and wellbeing of entire communities – that is, how to maintain the public’s engagement and interest in the health priorities we are championing. Given the many priorities and important issues that are competing for our collective attention, it is easy to understand how policy makers and the public become numbed to the recurrent “calls to action” and the exhortations to pay more attention to: domestic violence, bullying and teen suicides, opiate addiction, gun violence, breast cancer, diabetes, obesity, prematurity and infant mortality…and the list goes on. All of these issues are incredibly important and for those families and communities who are touched by them, each leaves a lasting legacy of sorrow and lost potential. If all of these causes (and more) are worthwhile, how do we make gains on any when the initial response might be to lament that we can’t do everything?

When faced with seemingly overwhelming challenges, humans can be very effective at partitioning the huge into the feasible. The first step is maintaining our faith that our efforts, when thoughtfully and creatively applied, can actually change outcomes. Once we have that confidence, then we need to gain the attention of our communities and key stakeholders whose insights and collaboration are required for our efforts to be successful. How do we break through the cacophony of dire statistics and grave warnings about so many “epidemics”?

I believe we need to adjust our language, not to substitute our appropriate reliance on data with sensationalized attention grabbing headlines, but rather to make the problem more concrete for those who don’t confront it every day.

Infant mortality is a good case in point. The US rate of 6 deaths per 1,000 live births doesn’t really have much tangible meaning to the general public. In fact, if anything, six seems like a pretty small number. But what about 24,586? That is the number of US infants who died before their first birthday in 2010. This is the equivalent of about 1,000 kindergarten classrooms of children that will never be filled. Recognizing that not all infant mortality is preventable, the question then becomes not what do we do with the number six, but how many of those kindergarten classrooms can we commit to filling with children who are healthy, happy and ready to learn. Suddenly the problem and the motivation to fix it become more real. For a state with an infant mortality rate of 9.7 per 1,000, a 20 percent decline to 7.7 would be incredibly impressive in the world of public health. But realistically, how many people will really be excited by a change from 9.7 to 7.7? For most, that hardly seems like a change at all. Yawn – turn the page, flip the channel and move on. But if we were to say that this equates to saving three entire classrooms of future kindergarteners, it might pique more interest. People can visualize a classroom of giggling kindergarteners, while describing a change from 9.7 to 7.7 has none of the same power to evoke our basic human desire to protect our offspring.

Thinking of our social “epidemics” in this way changes the discussion from statistics to people, from counting to compassion. It will help the public better understand the issue, commit to solutions, and recognize and applaud successes – and, most importantly, support more efforts to save the next classroom of children and the next.

9,000 Too Many

Karen Sautter ErrichettiEarlier this week, members of the public health community rejoiced at a major victory for healthier Americans. After years of lobbying and the activism of public health professionals everywhere, we realized the fruits of our labor and paved the way for our children to live longer lives. I would have done cartwheels if I were coordinated, athletic, and wore proper cartwheeling shoes.

No, I am not talking about CVS’ decision to stop selling tobacco (although that’s pretty ground-breaking too).

I’m talking about this story. “Fewer U.S. children dying in car crashes.” According to a CDC report released on Tuesday, deaths occurring to children under 12 due to car crashes decreased by 43% from 2002 to 2011. Since crash deaths are the leading cause of child death in the country, this is a big deal.

As a public health advocate, there is nothing more I like better than seeing this kind of headline. But it was accompanied by this statistic: one in three children who died in car crashes 2011 were not wearing a seat belt. That means 3,000 car accident deaths of the 9,000 that occurred over the last decade might have been prevented if seat belts had been worn.

Even more startling was this study finding: Almost half of all black (45%) and Hispanic (46%) children who died in crashes were not buckled up. That’s 1 in 2 children between 2009-2010.

So how can we make sure we continue this downward trend in child deaths due to car crashes in the next decade? The evidence is very clear on public health strategies to prevent child deaths in car accidents. Parents should use appropriate car seats, booster seats and seat belts on every car trip. Strategies to reduce disparities in car accident deaths should also be developed and tested.

At NICHQ, we have applied quality improvement to some of the most daunting public health problems facing children, including childhood obesity, asthma, and sickle cell disease. When we start a project, it begins with a bold aim statement: What are we trying to accomplish?

Healthy People 2020’s objective is a good place to start: Increase age-appropriate vehicle restraint system use in children aged 0 to 7 years by 10% by 2020. But how can we get this done faster? How about 20% or even 30%? Let’s expand this goal to children aged 12 and under. Because 9,000 children is too many.

Weigh in on your ideas to realize this goal in the comments section. Or join our Facebook page and share your opinion!