The Kraft Practitioner Program
The Kraft Practitioner Program is a two-year program aimed at better enabling community health centers to recruit and retain talented physicians and masters-prepared nurses by providing leadership development, mentorship and structured learning opportunities for top-performing community health center clinicians.
A highlight of the Kraft Practitioner experience is the independent project that each clinician pursues over the program’s two years. Support from the Kraft Center enables Kraft Practitioners to step away from their clinical responsibilities for one day each week to dig into projects that both interest the Kraft Practitioner and address the health needs of the community.
As a continuation of our “Profiles in Compassion” series, here’s a window into one community health center and the Kraft Practitioner who has been serving there.
Meet Aisling Lydeard and The Dimock Center
Aisling Lydeard always knew that she wanted to care for patients who faced greater obstacles than the norm. But it wasn’t until she interviewed at The Dimock Center in Roxbury that Lydeard, a nurse practitioner with specialty certification in women’s health, found a place where her professional expertise and her personal sense of mission could really come together.
“They have been taking care of generations of families here,” she explained, adding emphatically: “And in ways that are so much more than just health care.”
Indeed, The Dimock Center, which was founded in 1862 as the New England Hospital for Women and Children, is notable as the first hospital in New England opened and operated by women for women, and only the second in the country with this distinction. Dimock today functions as a community health center, providing health care and a host of related services for more than 15,000 patients.
“Centering” at Dimock
Lydeard’s work in Dimock’s ob/gyn department hews close to the center’s original mission. And now, her participation in the Kraft Practitioner Program is making it possible for her to implement a new model of prenatal care called “centering” that will help the health center do even more to bring about good pregnancy outcomes for women and their babies.
“Centering was something we really wanted to do here at Dimock even before I started the Kraft program,” noted Lydeard. “But we just never had the time or the resources to figure out the logistics.”
A lot of research had shown that centering models of care in pregnancy, which replace routine individual visits with a series of group visits, contribute to reductions in pre-term deliveries and low birth weights, she continued. This finding was even more significant given that approximately 90 percent of Dimock’s patients are black or Latino – the two demographics at highest risk in Boston for pregnancy complications. So Lydeard didn’t have to think twice about the health center challenge she wanted to tackle as part of her Kraft Center involvement.
Just as she suspected, the endeavor proved to be no small undertaking.
Lydeard’s first step was to complete a formal training course in centering standards and approaches. She immediately put that new knowledge to work, launching her first centering group at Dimock just a few months later.
Despite some initial hesitation, her patients soon embraced the new model, which brought them together with seven other women with similar due dates for a series of ten two-hour group visits over the course of their pregnancies. Lydeard admitted that she was actually somewhat startled (but pleased) that the women showed up for visits so consistently, given the gaps in child care, lengthy transportation routes and other obstacles they frequently had to navigate just to get there.
Short-Term Programs with Long-Term Impact
Now, some eighteen months after beginning the Kraft Practitioner Program, Lydeard has five centering groups up and running. A new one starts every other month. Dimock is on track to become certified as an official centering site. And the members of Lydeard’s very first centering group all successfully delivered their babies, who are now around five months old.
Lydeard is already looking ahead to the second piece of her project, which will examine data related to the pregnancy outcomes associated with centering at Dimock.
The long-term cost benefits of centering models of prenatal care are obvious in terms of the larger health care system, she explained – fewer pre-term deliveries mean fewer expensive NICU (neonatal intensive care unit) stays and less need for long-term health care services for babies born pre-maturely. However, even with support from the Kraft Center, Dimock has still had to invest some of its own limited resources in getting centering implemented. Lydeard is hopeful that outcomes data specific to the health center can be useful in obtaining grants to offset program costs going forward.
For her part, Dimock’s President and CEO, Myechia Minter-Jordan, MD, MBA, well-recognizes the enormous benefits that centering has already brought to the health center’s patients.
“The impact on patients has been incredible,” she emphasized. She added that the social support that centering provides is especially critical for mothers-to-be who, like most of Dimock’s patients, also cope with poverty-related stressors, ranging from food insecurity to substandard housing and homelessness, on any given day.
As Dimock’s leader, Minter-Jordan has been pleased by the growth she has observed in Lydeard, too. Lydeard was recently promoted to clinic manager, she noted. And she said that she would love to see Lydeard go on to represent the ob-gyn department as a member of Dimock’s larger leadership circle as well.
Lydeard herself has similar goals.
“I never want to stop taking care of patients,” she said. “But after this experience, I do want to sit at the table and have input into the impact we can have on our patients overall.”