No Boundaries

Cherry blossoms, frizzy hair, and a truly accessible Metro. Where am I? In Washington, DC, of course (you knew at the cherry blossoms!), attending the 5th annual NIH Science of Dissemination and Implementation Conference.

When Lucy was nearly 2, she and I traveled from London to visit my brother who was then working as a creative writing and English teacher at a private school in Georgetown. Ben was an unknown at that point, but I remember making one of many foreshadowing comments at that time–“if I was using a wheelchair, I’d want to live in DC”. Twelve years later, I still think that. It’s totally possible that Ben will end up here one day, if not for the accessibility but because there are so many awesome research and scientific opportunities.

Ben on the Mall, Washington DC, April 2009

As the mother of a child with medical complications, I’ve learned first-hand that not all evidence-based practices are implemented quickly or easily into our health care delivery system. For example, in the 1960s, the American Academy of Pediatrics started promoting the medical home model as a way of coordinating care for children with special health care needs. The idea was that each child and his/her family would be part of a pediatric practice that would really know the child and family, their needs, and would engage with them in shared-decision making about each step in the child’s care. But over 40 years later, not all children have access to such care.

We were one of the lucky ones, who moved to Massachusetts when Ben was one year old, and found the ideal pediatric practice who did promote such an idea–but Ben’s pediatrician has always been an early adopter. How can other health care providers adopt innovations in a timely manner and sustain them over time? That’s the point of implementation science. There is actually a science to sharing information on evidence-based practices with key stakeholders who need to be engaged to make changes in health care, and ways in which researchers, community-based organizations and patients can all work together to facilitate such change.

Simulation studies, ethnographic approaches, and more are the methodologies that will help me understand the role of social networks–from both the provider and the patient perspective–in implementing evidence-based practices during my two-year Implementation Research Institute Fellowship. I’m not specifically talking about Facebook, but it’s similar. Physicians, nurses, and other providers are part of both virtual and on-the-ground social networks. I’ve become part of a select social network called Mass Family Voices as the mother of Ben. We parents tell each other what services work for our child, which doctors to see, which organizations really go out of their way to help us. Health care providers do the same thing. They seek advice from others in their social network on what is the best way of treating a particular patient, the ways in which they should be engaging patients in their care. As the mother of Ben, I already know the power of the social network for disseminating information. As an implementation scientist, I hope to harness this power to motivate health care providers and organizations to improve mental health care for patients.

So, back to accessible DC. Is it too early to ask Ben to start thinking about a summer internship at the NIH?