Innovation in Motion
The practice’s administrator, Angelique Kissas, explains the mission of Skagit Pediatrics has always been to “serve our community.” In the past few years, as the founding and more senior partners have retired, the remaining partners have strived to maintain their legacy of offering compassionate expert pediatric care in their own community.
Despite the proximity to Seattle (about an hour’s drive away), Skagit County is considered a rural one, and as such the pediatricians are keenly aware of the socio-economic factors related to their community’s healthcare needs. The practice serves a population that is substantially dependent on Medicaid and social support. The county had 17,163 children enrolled in Apple Health, Washington state’s Medicaid program in early 20191. The county’s Latino population has also grown, and nearly 20% of the county speak a language other than English at home.2
Kissas explains, “As we have identified the needs of families in our county, there has always been a willingness to take a risk and try something new to address those needs.”
Dr. Levine relates, “Our community has grown and, like many rural communities, this growth has come with challenges. We have seen more families struggle to make ends meet. And, as families are more stressed, we have seen more need for social support and access to behavioral health.” As a group they have sought creative ways to improve care and help families navigate the healthcare system.
Among their efforts to meet these needs, they have established a Communications Nurse position. Along with the Triage Nurse, the Communications Nurse helps the practice manage patients with ADHD and behavioral difficulties, ensures appropriate follow up after ER visits, and manages registries of patients to ensure timely follow up for well care visits.
The practice has also established a program of integrated behavioral health. They began by developing better two-way communication with community mental health clinic partners, and this led to incorporating a licensed social worker as a member of the practice team. “We are now able to provide collaborative care services within our clinic and help families access services both within our practice and to better link them to local community services,” explains Dr. Andrea Lowe, a managing partner.
Already a Patient Centered Medical Home practice, Skagit Peds has begun the process of providing more robust screening and support for social determinants of health as a “Healthy Steps” Clinic with the financial support of a Healthy Tomorrows grant.
Kissas also detailed how the practice has participated in several studies via the University of Washington and Seattle Children’s. Doing so has given them the opportunity to be a part of academic research. Dr. Chalmers elaborates: “From early on, we participated in learning collaboratives in Seattle, either Children’s or University of Washington or some other group, where we were exposed to new ways of practicing medicine and they introduced us to the importance of population health.”
“I think that kept us engaged in staying at the front of the curve in terms of health-care processes. At the same time, we have become a reliable practice for many academic clinicians to work with.” These study protocols have included research into mental health issues such as ADHD and adolescent depression, as well as asthma management, and studies on vaccines and vaccine hesitancy.”