Nemours Children’s Health is a nationally recognized pediatric health system serving families across 85+ locations in four states, with major operations in both the Delaware Valley and Florida. Founded by philanthropist Alfred I. duPont, Nemours was built on the belief that “everyone has a responsibility to reduce suffering in this world.” Today, that vision translates into a robust, multi-layered commitment to health equity, medical excellence, and what the system calls going “Well Beyond Medicine.”

Through its comprehensive care network spanning primary care, specialty services, urgent care, and two free-standing children’s hospitals, Nemours delivers care shaped by the understanding that up to 80% of a child’s health is determined outside of the clinical environment. Social, behavioral, economic, and environmental factors are all considered in the organization’s patient experience strategy.

“We’re not just treating a condition; we’re treating a child, within a family, within a community,” said Dr. Greco. “If we want to improve child health outcomes, we must also impact the environments where children live and grow.”

The system’s diverse patient base—especially the high percentage of Spanish-speaking families in Florida—prompted a deliberate effort to align clinical staff demographics and language competencies with the populations they serve. This groundwork set the stage for a successful, data-driven patient experience improvement initiative.

In March 2020, amid the COVID-19 pandemic, heightened awareness of systemic inequities, and increasing national focus on health equity, Nemours Children’s Health began its partnership with NRC Health. At the time, the organization was already deeply committed to advancing equity and whole-child health. But it lacked the tools to examine patient experience data through the lens of identity.

That changed quickly.

With the help of NRC Health’s custom reporting capabilities, Nemours began breaking out patient experience scores by race, ethnicity, and language—well before these features were widely available on most platforms. What they uncovered underscored the need for immediate action.

Although the systemwide score for the question “Did you know what to do if you had questions after your visit?” ranked in the 60th percentile compared to peers, more specific data told a different story:

• The top box score for this survey item was 15 points lower for Spanish-preferring families than for English-preferring families.
• There was significant variation in racial/ethnic groups on the top box score for this survey item, with 21 points between the highest top box score (patients identifying as white) and the lowest top box score (patients identifying as Korean).

Further, knowledge about how to have questions answered also impacts return to the ED. Patients are more likely to return to this care setting when they don’t know how to have their questions answered—and this difference is heightened within some racial/ethnic groups.

• Spanish-speaking families had a 9.2% emergency department return rate within 48 hours when they didn’t feel clear on next steps—compared to just 3% among those who said they did know what to do.
• Black-identifying patients showed an 8.6% return rate under similar circumstances.

The disparities in knowing what to do following a visit weren’t visible in the aggregate. But through NRC Health’s support and readiness to customize reporting, Nemours found a measurable and crucial equity gap tied directly to patient quality and safety of care and set out to address it.