Why Maternal & Child Health Reminds Me of Hockey

Michael Warren
President of the Board of Directors
Association of Maternal & Child Health Programs

Some of you might be surprised to learn that Nashville, Tenn., is a hockey town. As I write this, my Nashville Predators are, for the first time in franchise history, in the middle of the Stanley Cup Finals –  and the energy is palpable as our southern city embraces hockey and cheers on my home team.

During this time of hockey hoopla, and as we think about emerging issues in maternal and child health (MCH), I am reminded of the words attributed to hockey legend Wayne Gretzky: “I skate to where the puck is going to be, not where it has been.”

This hockey analogy is particularly relevant for MCH leaders. Our “game” is fast-paced. It can be rough. You win some; you lose some. It takes a team to achieve a victory. (And oh yeah, we, too, are big fans of helmets!) And just like hockey, sometimes in MCH there’s a surprising move.

Those surprises can be pleasant — a shot that seemingly comes out of nowhere and lands in the net — or not, like a slam into the boards from a fast-moving player from the other team. Off the ice, good leaders, perhaps channeling Gretzky, try to anticipate what those surprises might be and from where they might originate.

The story of maternal and child health in the United States has been one of emerging issues, none more salient than the current efforts to address the far-reaching effects of Zika virus. Just a few short years ago, most of us would not have thought about devastating birth defects being caused by the bite of a mosquito. Yet now, many of our states and territories are in an all-hands-on-deck stance as we work to prevent mosquito bites and prevent pregnancy among women who are at risk.

As we think about MCH’s emerging issues, how can we best anticipate and prepare for upcoming challenges? How can we skate to where the puck is going to be? Here are a few thoughts:

Think about building basic capacity in advance. Just like a hockey coach works to build a team, assuring the right offensive and defensive lines, an MCH leader needs to assure a competent workforce is in place to address the needs of the MCH population in his or her state. (This is best done when not in the middle of an MCH crisis.)  Hockey teams usually use the off-season to build critical skills among players and prepare for challenges they will face in the upcoming season.

MCH leaders can utilize tools like those found through the MCH Navigator to help assess staff competencies, shore up weaknesses, and build on strengths so MCH teams can handle whatever might come their way.  You can also strategically assess your workforce to identify critical gaps. For example, you might discover you don’t have an epidemiologist working on your MCH team and you really need one. So you might choose to convert an unfilled position to an epidemiologist or write an epidemiologist into a new grant application.

Be on the lookout for emerging issues. Often there are warning signs that a particular issue is going to surface. Perhaps stakeholders outside of your organization can give you a heads-up about concerns or issues that have not yet risen to your attention. Through Title V, we have a built-in opportunity to do this every five years with the comprehensive needs assessment.

However, we should also be conducting ongoing surveillance for new issues that might have arisen since the last needs assessment or for major changes in key MCH focus areas. Just as a goalie continually scans the ice to anticipate where the next puck might come from, MCH leaders must constantly look to see what might be coming next.

Plan for a surge. Hockey fans know that when a team is behind and heading into the last minutes of a game, it will often pull its goalie and substitute in an offensive player in the hopes of scoring a goal. The team is shifting resources to “surge up” to meet the demand of a pressing need. The flexibility afforded to states through the flexible Title V/MCH Block Grant funding also allows for states to rapidly shift funds and efforts to meet their unique needs, which may include response to an emerging issue.

One example of how MCH leaders might do this is by cross-training staff in critical functions, allowing staff to temporarily divert from their normal activities in times of crisis. Important in this process of surge planning is to learn from prior efforts: What were the lessons from prior emerging issues? How did you respond and how could that response have been improved? Is there anything you can do now to address those opportunities in preparation for the next emerging issue?

As your professional association, AMCHP stands at the ready to help you prepare for and respond to emerging issues in MCH. AMCHP staff are available to provide technical assistance on emerging topics, and can assist you in workforce development activities to help prepare you for topics that may come your way in the future. They also can provide guidance and support as you conduct your five-year and ongoing needs assessments and connect you with peers in other states who might have important learnings to share.

As you head out onto your “ice,” this pediatrician feels compelled to tell you to make sure you’re wearing your helmet and pads (safety first!) and that you’re well-nourished and ready for the game (be prepared!). And know that you’ve got a team of folks at AMCHP who want to support you throughout the game, along with colleagues who are cheering you on from across the country. They, like you, want to achieve that ultimate goal of improved health and prosperity for women, children and families all across our country.

Go Predators! (Or whomever you may be rooting for!)