Rachel Lettieri, Pediatrics Northwest

Nominated by Mary Ann Woodruff, MD, FAAP

How does this individual go above and beyond to impact and improve the lives of children and families in our community?

“This nomination is for Rachel Lettieri, and the Pediatrics Northwest team of Community Health Workers (CHWs). Fitting that Rachel be honored along with the team of CHWs she incomparably leads.

From the moment (Dec 2021) Rachel was hired to be Pediatric Northwest's first Director of Care Coordination, her impact on the lives of children and families right here in Pierce County began. She dove in to develop a plan for creating a team of CHWs at the practice, effectively working to retrofit a cumbersome medical system with a team of additional carers. She grasped the truth that only about 30% of what is addressed at the pediatric primary care medical home is medical, the rest being related to social health needs and the social determinants of health and began doing something about it. In planning the work of CHWs, she became the first person at the practice to function as one, in order to understand what she would be asking of her team, to carefully hone the workflows and also recognizing how great the needs were for the families in our community. She is that rare person who can care for the individual and simultaneously employ a systems level view, at the practice, and beyond..

Two CHWs started in July 2022 and the other 6 the following spring, the latter hired as part of the WA HCA CHW grant. Rachel had seized the opportunity to apply for CHW grant and ultimately was chosen as part of the team that guided CHW training across the state, serving as faculty for the WCAAP's CHW Learning Collaborative.

She continues to oversee the CHW team, providing weekly reflective supervision for each of them, creating improved work flows, analyzing what is working, communicating to all other teams at the practice about the work of CHW. She has co-led lunch and learns at all 4 offices, centrally about listening to each office's staff.

Her capabilities, work ethic and leadership qualities have been recognized. Her title is now Director of Care Transformation which more aptly describes the breadth of her work. She co-leads the Care Transformation Committee at the practice and is on the Governance Committee of the Pediatrics Supporting Parents Grant, a national grant, wherein Pediatrics Northwest partners with the WCAAP from 2022-2026 in order to improve wellness care for young children at the practice by co-creating with families, creating effective teams of care, and supporting families in early relational health. Her leadership in PSP is recognized by the funders, the backbone agency, ZTT and leadership in the 4 other communities participating in the grant.

Rachel is pivotal to the work of creating an actual Family Partnership in our community, a powerful ally for families. This is having a direct effect in our community as the learnings from these sessions are being elevated. Folks across the country are taking note of this. Imagine what could happen if the experiences of black and brown families are heard and then acted upon.

Rachel is a valued member of the Health Provider Outreach Committee and its Leadership Committee. She serves on the Perinatal Mental Health Task Force, the Head Start/ECEAP Mental Health Policy Group, the Nurture Connection (national movement for ERH), the WCAAP Early Childhood Committee and other ad hoc WCAAP work groups.

And then she has also been the Family Leader for the battalion that her husband, Steven, commanded: supporting families, hosting events

Our CHWs are a tremendous force for good. Each day they listen to families we serve and assist them in ways that families want. They find activities and camps for children, help to seek mental health care, they support families from the beginning, introducing themselves at the first well child visits, and now will be participating in Project Nature, introducing families of the youngest to outdoor resources, discussing barriers, and having the families choose an outdoor related toy/activity. Common requests involve housing instability, food insecurity, lack of diapers etc. Individually the CHW represent communities often not considered and together they are a force for good. A beehive of energy and synergy, now becoming advocates in our community and state.”

What special qualities does this individual bring into their work?

“Rachel embodies servant leadership. Central to this leadership is being able to listen to others. 'Being heard is so close to being loved that for the average person, they are almost indistinguishable (D. Augsburger).’

Relational: Rachel's successes are related to her ability to quickly relate, make connections and do the more difficult work of maintaining relationships

Team builder: Wherever she is, she is seeking to build consensus, improve the status quo, forge effective teams.

Action orientation: Rachel is incredibly productive and efficient, and also takes the time to understand systems first.

Reflective: She models this for her team of CHWs

Plays well with others: Rachel is a joy to work with, just to be with.

Rachel has modeled these attributes for her team of CHWs.

They are all great listeners. Families are sharing with our CHWs challenges that they were not able to share with their pediatrician. The CHWs are an effective mix of listening, reflecting and acting... They are team oriented, reaching out to one another for counsel and to us as the pediatricians. They have become valued team members in a short period of time.”

Describe a specific instance or project where the individual exemplified their special qualities, contribution, or innovative solution?

“Rachel's innovation: pivoting from developing a the family partnership to creating a family partnership in the community that can be shared amongst primary care practices.

She is pivotal to the Pediatrics Supporting Parents Governance Committee- her voice is listened to. She has been central to the planning of our upcoming PSP gathering- developing creative ways for the 5 communities to connect.

Rachel routinely steps in to help her team of CHWs if they need help- ie someone is out ill. She is responsible for creating very effective and unique work flows for our CHWS

Every day our CHW team comes up with innovative solutions to some of the most vexing issues that families request help with.”

What else should we know about this nominated individual?

“Rachel and her team of CHWs are trailblazing what can be when there is a dedicated focus on accompanying families as the families want, not as we hope for or based on needs or judgements.

I am so in awe in what has been created in such a short amount of time..

Families are grateful and feel heard.

This is only a small snapshot of Rachel and her CHW teams work amongst us.”