National Initiative IX Addressing the Social and Moral Determinants of Health - Call for Applications

The Alliance of Independent Academic Medical Centers (AIAMC) is now accepting applications for participation in our National Initiative (NI) IX:  Addressing the Social and Moral Determinants of Health. Completed applications are due no later than FRIDAY, JUNE 2, 2023, and must be emailed in Word format.  All applicants will be notified of selection in late June, followed by pre-work this summer and our first meeting in October.

To learn more about participation in National initiative IX, plan to attend one of two informational webinars to be held on Friday April 28th at 11:00 am EDT and Tuesday, May 9th at 3:00 pm EDT.  The webinars are free, but pre-registration is required.  To register for one of the webinars, visit National Initiative IX Informational Webinars | AIAMC

NI IX Addressing the Social and Moral Determinants of Health will be an eighteen-month initiative that features monthly Zoom cohorts or webinars and four in-person meetings*.  Monthly cohort groups will be structured by themes based on focus areas identified in the applications, with best practices from all cohort groups shared at the meetings. Learning session topics will include discussions on the social and moral determinants of health; strategies to counteract these determinants; and the importance of creating and fostering environments that serve all our patients regardless of their circumstances.  (*Please note that Meeting Three will be virtual.)

The AIAMC’s sixteen years of experience with eight successful National Initiatives provide a rich and unique resource to the CLE community.  We have engaged numerous key leaders, including the Accreditation Council for Graduate Medical Education (ACGME), American Hospital Association (AHA), American Medical Association (AMA) and the American Association of Colleges of Osteopathic Medicine (AACOM) and look forward to their continued input and support.  The AIAMC is also an inaugural member of the National Collaborative for Improving the Clinical Learning Environment (NCICLE), facilitated by the ACGME and represented by more than 40 major health care organizations working to improve the educational experience and patient care outcomes within clinical learning environments.

WHY Social and Moral Determinants of Health?

The Social Determinants of Health

Social Determinants of Health are the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks1.  They are well documented2, yet too often ignored by those providing care3.  The Accreditation Council for Graduate Medical Education (ACGME) updated the Common Program Requirements effective July 1, 2023 to reflect the urgency for a systematic recruitment and retention of a diverse workforce of trainees, faculty, and education/academic staff, that professionalism requires residents to demonstrate competence in respect and responding to diverse patient populations, and that residents must demonstrate an awareness of a responsiveness to the larger context and system of health care including structural and social determinants of health and equity (systems-based practice)4

1 The Center for Disease Control and Prevention https://www.cdc.gov/places/social-determinants-of-health-and-places-data/index.html

2 US Department of Health and Human Services https://health.gov/healthypeople/priority-areas/social-determinants-health

3 Health Affairs https://www.healthaffairs.org/do/10.1377/forefront.20210415.305480/full/

The Moral Determinants of Health are about investing in actual human well-being, not just in the “repairs shops” such as medical centers and emergency services5, as noted by Donald Berwick, MD, MPP, President Emeritus, Institute for Healthcare. As Dr. Berwick shared with us at the close of our March Nashville meetings, “While most leaders in the US healthcare system acknowledge the importance of social and moral determinants of health, few organizations to date have moved beyond recognition into serious action at scale.  I am delighted that the Alliance of Academic Medical Centers (AIAMC) has chosen to address these critical issues, for the benefit of the people we all serve.  I will be here to wholeheartedly support your work along the way, and I look forward to celebrating your accomplishments at a two-year milestone ahead.  We know that this is the beginning of a long-term effort...indeed, it will take decades.  But we need pioneers to lead us, with courage, boldness, and passion.  Thank you, AIAMC, for being such a pace-setter!"

NI-IX focuses on doing the “right thing” within your scope of influence to address human well-being.  Is that climate change? The Criminal Justice system? Immigration?  Hunger and homelessness? Voting?  Action in any of these areas invests in human well-being and through our collective efforts in NI-IX, momentum and impact.  Please join us by making a difference by creating an expanded identity for physicians to include system citizenship as part of professionalism!6

BACKGROUND OF THE AIAMC AND OUR NATIONAL INITIATIVES

Role of the AIAMC

Founded in 1989, the AIAMC is the only national organization addressing the unique needs of independent academic medical centers. Our members share a common commitment to delivering exceptional patient care through education and innovation. For 34 years, the AIAMC has supported members in achieving exceptional health and well-being outcomes for the communities they serve by fostering an environment of learning, networking, and collaboration. More than 70 hospitals and health systems across the United States are members, representing nearly 600 senior academic leaders.

National Initiatives I thru VIII

The AIAMC National Initiative (NI) is the only national and multi-institutional collaborative of its kind in which residents help lead multidisciplinary teams in quality improvement projects aligned to their institution’s strategic goals.  NI V’s focus was on health disparities, and our eighth NI tackled JEDI: Justice Equity, Diversity, Inclusion.  Addressing the social and moral determinants of health is the next logical progression for us, and we know our members are uniquely poised to take on this critically important topic.

Sixty-nine hospitals and health systems and more than 1,400 individuals have participated in the AIAMC National Initiatives since 2007 driving change that has resulted in meaningful and sustainable outcomes improving the quality and safety of patient care.  Projects of participating institutions must align with that institution’s strategic goals, and engagement of the C-Suite and a multidisciplinary team is required.  For more information on each National Initiative’s area of focus and academic publications, visit https://aiamc.org/national-initiative. 

OBJECTIVES AND OUTCOMES OF NATIONAL INITIATIVE IX

At the end of NI IX, each participant will have engaged their clinical learning environment in addressing social and moral determinants of health.  Specific goals and outcomes for NI IX include: 

·       Read and be able to articulate local Community Health Needs Assessment (CHNA)

·       Assess social and moral determinants of health (SMDH)                                                                  

4ACGME Common Program Requirements (Residency) Effective July 1, 2023. Accessed April 6, 2023  https://www.acgme.org/globalassets/pfassets/programrequirements/cprresidency_2023v3.pdf 

5Berwick DM. The moral determinants of health. JAMA. 2020 Jul 21;324(3):225-6.

6Gonzalo JD, DeWaters AL, Thompson B, Mazotti L, Riegels N, Cooney R, Reilly JB, Wolpaw T, Wolpaw DR. System Citizenship: Re-Envisioning the Physician Role as Part of the Sixth Wave of Professionalism. The American Journal of Medicine. 2023 Mar 6. https://doi.org/10.1016/j.amjmed.2023.03.001

·       Establish and measure programs for learners and others related to SMDH

·       Engage the C-Suite in a review of Medicare requirements and how SMDH affect the clinical learning environment

·       Significantly and measurably advance the clinical learning environment’s efforts in SMDH, disseminating results within your organization’s Micro, Meso, and Macro environments

·       Participate in a collaborative national effort to identify and share best practices

·       Author one or more peer reviewed scholarly products at the conclusion of the Initiative

SELECTION AND EXPECTATIONS OF NI IX PARTICIPANTS

Application:  A completed application is required for consideration, and a member of the selection committee may follow up with a phone consultation, if needed.  Completed application forms are due to Mindi Apicella, AIAMC Administrative Coordinator, in Word format via email mindi@aiamc.org no later than June 2, 2023.

Team: Each selected participant must have a team identified prior to the start of NI IX, composed of:

A.      Identified Team Leader who will be responsible for:

 (1) The project from conception to completion including establishing and maintaining a collaborative, interprofessional team charged with aligning team aims with measures and methods to improve care

 (2) Submitting all reports, documents, and NI IX required evaluations on time

 (3) Ensuring that the team is represented at all NI IX meetings, local on-site meetings, and monthly conference calls or webinars

B.      Composition of each team must include:

(1)  Resident(s)/Fellows(s):  Ideally, these team member(s) should be available to participate throughout the entire project, i.e., graduate on or after June 2025, to ensure continuity of team membership throughout the entire project period (Summer 2023 thru Spring 2025)

(2) Leadership from your hospital or health system’s Community Health Office as well as external community organization representatives

(3) Representation from your hospital or health system’s Office of Patient Experience

 (4) Faculty, Program Director(s) and/or DIO seeking opportunities to align with the ACGME’s Common Program Requirements effective July 1, 2023 

Meetings:   Attendance of the team leader or his/her designee at all meetings is required.  Other team members may attend as schedules and budgets allow.  The four learning sessions will be held as follows:

Note that meetings two and four will be held in conjunction with the AIAMC Annual Meeting.

Meeting four commitments include a staffed poster display and attendance at the annual awards dinner.

Zoom Meetings and Webinars:  In addition to attending the four meetings, NI participants will be required to participate in monthly activities including Zoom meetings and webinars.  During these activities, timely and educational topics will be presented, progress reports will be shared, and participants will network and brainstorm with one another regarding how to implement sustainable and positive change more successfully.

Financials: 

AIAMC Members:  The participation fee for AIAMC member institutions selected is $4,000.  Payment options are available.  In addition to the $4,000 participation fee, member institutions will be responsible for covering any costs incurred for travel to on-site meetings.  The participation fee will cover one registration for each of the four meetings.  If additional team members wish to attend the meetings, they may do so at a rate of $250 per person per meeting. 

Non-Members:  The participation fee for non-AIAMC member institutions selected is $6,000.  Payment options are available.  In addition to the $6,000 participation fee, institutions will be responsible for covering any costs incurred for travel to meetings.  The participation fee will cover one registration for each of the four meetings.  If additional team members wish to attend the meetings, they may do so at a rate of $250 per person per meeting. 

Alternatively, institutions eligible for membership may join the AIAMC at the regular annual dues rate of $6,625 and participate in National Initiative IX for just $2,000.  A membership application form https://aiamc.org/become-member must be submitted by June 2nd to be eligible for the 50% new-member discount.

For More Information:

James (“JP”) Orlando, EdD, Chief GME Officer and DIO, St. Luke’s University Health Network,

at james.orlando@sluhn.org

Kimberly Pierce Burke, AIAMC Executive Director, at kimberly@aiamc.org