When Partnerships Bring Care Closer to Kids

Summary

Podcast Summary: Advancing Health – "When Partnerships Bring Care Closer to Kids"
American Hospital Association | May 6, 2026

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Episode Overview

In this episode of Advancing Health, host Julia Resnik speaks with Dr. Alejandro Quiroga, President and CEO of Children’s Mercy Kansas City, and Mary Esselman, President and CEO of Operation Breakthrough. Together, they explore how their long-standing partnership brings pediatric health care directly into the heart of Kansas City’s most underserved neighborhoods. Through this collaboration, they eliminate barriers families face when accessing healthcare, weaving a model that connects education, social services, and health into a proactive, trust-based community ecosystem.

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Key Discussion Points and Insights

1. Challenges Facing Kansas City’s Underserved Kids

• Historical Divides and Access Barriers
  • Mary paints a vivid picture of their neighborhood, describing its long history as both an economic and racial dividing line in Kansas City. She highlights the scarcity of jobs, food, and transportation options:

    “We’re located at the corner of 31st Centrus, which has always been known as the dividing line in Kansas City, not only in terms of prosperity but also in terms of race.” (03:31)

  • Only 18% of jobs are accessible within 90 minutes, foreshadowing how daily logistics overshadow healthcare needs.
  • Julia notes that these challenges are universal across many US communities, not unique to Kansas City.

2. The Birth and Growth of Operation Breakthrough

• Started 55 years ago by two nuns in a living room, Operation Breakthrough now serves over 780 children and families.
• Unique for its comprehensive approach—melding education, care, social services, and health—all built on a foundation of relationships.
• Mary details the exponential growth and underlying relational model:

  “It’s not just about education or care, it’s about social services and health ... everything we do is based on relationships.” (03:31)

• Dr. Quiroga describes Operation Breakthrough as a “jewel in the middle of Kansas City” and calls the experience of touring the facility “the most purposeful place that you can see to help this community.” (04:13)

3. Integration of Health Services into Community

• The partnership began over 30 years ago with a nurse in a makeshift clinic; by 2008, they expanded to a full clinic.

• In 2013, they created the Partnership for Resilient Families, bringing leaders and practitioners together quarterly to address pressing needs collaboratively.

• The in-house clinic serves not only students but also their families and the wider community, lowering barriers to care and accommodating parents’ logistical challenges.

• Use of telehealth ensures parents don’t risk their jobs for appointments; the school nurse makes over 5,000 classroom visits a year, establishing trust.

  “Just making a health appointment, you know, can put their job at risk. And so we were seeing a lot of missed appointments and now Children’s Mercy contacts the supervisor, lets them know, we’re going to need mom for a few minutes ... we’re seeing a lot more of our preventative care happening.” (06:48)

4. Culture and Mission Alignment

• Both organizations share histories rooted in relationships and missions of service, delivered with persistence and adaptability.

• Dr. Quiroga highlights their parallel origins and the unbreakable bond this forms:

  “Nothing would have stopped these two organizations coming together ... our missions are so similar, we see the world so alike, that of course, we came about.” (08:58)

• The organizations see beyond traditional ROI, measuring impact by community benefit rather than financial returns.

  “This will not be a typical P and L ... you have to see the return on investment beyond just a very plain ROI. You have to see moms being able to work.” (11:25)

5. Impact Stories and Sustaining the Partnership

• Mary recounts a powerful story of a child who entered the program with severe medical needs—failure to thrive and a feeding tube—and who, after years of wraparound care, was finally able to have the feeding tube removed and thrive in kindergarten.

  “To be able to have a nurse to come and help ... and then be able to share jointly when that feeding tube comes out five years later. I mean, those are the kinds of stories I think that really showcase ... relationships that create trust amongst children, families, healthcare workers.” (12:24)

• Ongoing success demands patience, adaptability (“find the third way”) and persistent commitment despite regulatory, licensing, and financial hurdles.

6. Advice for Replication Nationwide

• Dr. Quiroga emphasizes that success depends on trust, alignment, and creative thinking:

  “If you want to get these things you have to first build trust, build a relationship, get alignment ... Relationships have an ROI. Aligning missions across what’s important and then using those relationships to deliver better care will have an ROI for the community.” (15:05)

• Mary encourages bold action, starting small but starting immediately:

  “Don’t wait because you can plan for years and life will have changed three times since then. So I think you just have to ... step in and start. And then I think you have to be willing to engage up and down through the hospital ... it has to be something that’s shared across the organizations.” (15:57)

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Notable Quotes & Memorable Moments

• On Building a Culture of Health:

  “Instead of creating a proactive culture of health, it’s reactive. You’re only going when it’s absolutely necessary and then it tends to be to the emergency room, not a trusted physician or healthcare partner.”
  – Mary Esselman (02:19)

• On Resiliency and Adaptation:

  “I have a little grid on my wall that says find the third way. And I always laugh because sometimes we’re on the 30th way, but I feel like we always stick it out and find a way to make it work.”
  – Mary Esselman (13:50)

• On the True ROI:

  “You have to see the return investment beyond just a very plain ROI. You have to see moms being able to work. How does this have community benefit in a way that is not traditional?”
  – Dr. Alejandro Quiroga (11:25)

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Timestamps for Important Segments

• Challenges Facing Kids in Kansas City: 01:12–03:11
• History and Model of Operation Breakthrough: 03:31–05:11
• Embedding Healthcare in Community Settings: 05:41–08:49
• Mission Alignment and Funding Realities: 10:24–12:10
• Impact Stories: 12:24–14:54
• Advice for Other Communities: 15:05–16:36

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Closing

This episode offers a compelling, granular look at what it takes to break cycles of hardship by rooting pediatric healthcare directly in neighborhoods, guided by trust, relationships, and authentic collaboration. The Kansas City partnership serves as an adaptable blueprint for other communities nationwide. As Mary concludes:

“When you have your missions aligned and you’re both committed to the relationship and working through the challenges, you are just a fabulous example of what you can build.” (16:36)

Transcript

[A]

Welcome to Advancing Health. For families living in poverty, healthcare can take a back seat in the list of daily priorities. Today we hear about a remarkable partnership in Kansas City that is turning that paradigm around by bringing care to kids.

[B]

When families are navigating poverty, accessing health care can become just one more challenge in an already complex system. That's why reducing those barriers and bringing care closer to where families are matters so much. In today's episode of Advancing Health, I'm joined by leaders from two organizations working together to do just that for children in Kansas City. I'm Julia Resnik, senior director of health outcomes and care transformation at the American Hospital Association. I'm talking with Dr. Alejandro Quiroga, President and CEO of Children's Mercy Kansas City, and Mary Esselman, President and CEO of Operation Breakthrough. Together, their partnership embeds pediatric care within a trusted community setting, bringing services closer to the children and families that need them most. Ale, Mary, thank you so much for joining me today to talk about this remarkable partnership.

[C]

Excited to be here.

[D]

Thank you for having us, Julia. Very excited to be here.

[B]

So for listeners who are unfamiliar with Kansas City, what does it look like to grow up as a kid in the community you serve, particularly related to factors that influence those kids health?

[C]

Well, I'd love to jump in on this one because I think if you can just picture where we're located, it really gives you an idea. We're located at the corner of 31st Centrus, which has always been known as the dividing line in Kansas City, not only in terms of prosperity but also in terms of race. You're looking at a community that has had a long period of time in which they've been underserved. That gives you a visual.

[B]

Ale, anything you want to add?

[D]

I mean, I think where our community has come through is like many communities in the U.S. i think we're talking about Kansas City. But like everything that we're going to say, it's something that can be translated to any community in the US and therefore the responsibility of local leaders, local partnerships to make sure that we serve them in the same way.

[B]

So what are some of those barriers that families face when it comes to health and education and economic opportunity?

[C]

Well, I think one thing you can look at is like in Kansas City, only 18% of jobs can be reached in about 90 minutes. So you can already think about childcare access, transportation. I know over the last 20 years, I mean, food access and food scarcity goes up and down. We do a bus tour called the city you never see. And one of the things we ask people to look at is like, as you're driving around the east side, like where would you get groceries, you know, how would you access services if you didn't have transportation? And I think when you have those kinds of fundamental needs that are missing, healthcare can oftentimes take a backseat. So instead of creating a proactive culture of health, it's reactive. You're only going when it's absolutely necessary and then it tends to be to the emergency room, not a trusted physician or healthcare partner.

[B]

Yeah. And I think all of that just impacts the long term health of kids and families in your community. Which brings us to the topic of our conversation, which is really Operation Breakthrough. So I've had the privilege of visiting, but I know that many of our listeners have not. So Mary, can you tell us what it is and how it was designed to meet the needs of kids and families in Kansas City?

[C]

Well, this year is actually our 55th year. Hard to believe, but it actually started in a living room. Two nuns were teaching on the east side and they had school age kids, but parents were like if we just had someone to watch our younger children, we could work. And so they thought we can do this. And so four in the living room turned to 40 to 400. And today it's over 780 children and families that are served. But what makes it unique is the fact that it's not just about education or care, it's about social services and health. And that's what I think where you see that uniqueness going from cradle to career in this tight knit community. And everything we do is based on relationships.

[B]

Fantastic. Ale, anything you want to add there?

[D]

I'll tell you. When I first got to Kansas City, I got the call from Mary and of course my team told me that you have to go visit. And it's the most, I mean it's a jewel in the middle of Kansas City of something that is so hard to describe. But when I did the tour, my first tour, we walked through it and you see a classroom, then you're all of a sudden across a hallway and you're in the middle of a clinic. Then you cross a bridge and you're in workshop where there's welding of cars, that people are learning trades and everybody is all around this pantry, these volunteers. It is the most purposeful place that you can see to help this community and as you will hear from Mary, is actually doing that job, but through relationships in an extremely meaningful way. So it's, it's a very unique model that More communities should have.

[B]

Yeah. And when I visited, I was also blown away by, you know, the hydroponic gardens and kids learning how to run restaurants alongside early childhood education. Just like, how incredible that you've created that space for kids to learn and feel safe and grow. So I want to talk a little bit about the partnership between Children's Mercy and Operation Breakthrough. Can you talk about how that started and how you realized that bringing health care directly into the community could really make an impact?

[C]

Well, our founders, you know, Sister Berta was like a little firecracker. You know, if she thought we needed something, she just started it. And she might start it with a volunteer, and then she'd find a way to get everyone hooked in. And so it actually started 30 years ago where she said, we have got to have a nurse. And so, you know, what is now an office used to be the place where the nurse was, and we could start to really be more proactive. And then in 2008, we got to do an expansion, and then we got the full clinic, and that's been amazing. And then when you kind of track forward a little bit, which I think was one of the most important things we did, is in 2013, we formed a partnership for resilient families. And it's something that happens quarterly between Children's Mercy and ourselves and everybody from the top of the organization to those directly practicing with families, getting together to really talk about how do we help families and what are the current pressing issues that we need to address together to encourage that culture of health for our families.

[B]

So talk to me a little bit about what the clinic looks like and how does it work? Like, walk me through it.

[C]

Well, so when you come in, it's like, right front and center. And when. The beauty of it is it's not just for kids here, although we have plenty of them, it's also for the community. So imagine if you're here for early care and education, and. And then you go off to school, and you may not stay in the program for before and after school. A lot of those families still come here because of those relationships. So you can come in, and the clinics there, they've got core exam rooms. I mean, there's someone that goes and walks kids from class. An amazing telehealth model that keeps parents working. One of our biggest challenges for our parents is oftentimes their jobs don't have benefits or accrued time off. And so just making a health appointment, you know, can put their job at risk. And so we were seeing a lot of Missed appointments and now Children's Mercy contacts. The supervisor, lets them know, we're going to need mom for a few minutes to step aside. And we're seeing a lot more of our preventative care happening. But it's a great space. It's front and center, but it doesn't stop in the doors of the clinic. One of the things I love the most is the fact that there's a school nurse. She makes over 5,000 classroom visits a year. We're actually talking about a second nurse because we just opened a school and, you know, realizing that we have an upmoney. But imagine when every day you're seeing a nurse, suddenly that there's sometimes there's a lack of trust, especially for underserved in underserved communities. But when you're building those relationships as a child and a parent, and you have the freedom to ask questions, not just when you're sick, I think it changes everything. So there's just a lot of little pieces. Children, staff from across the hospital pop in on Monday, word on the street, so they can help do other things. And I will say, during COVID we wouldn't have been able to stay open the whole time if we hadn't had Children's Emergency, because the minute that we thought there might be a symptom, we were able to do that testing and keep everyone safe. And even beforehand, just the idea of washing hands and all of the things that we need people to know. Children's was there hand in hand.

[B]

And, you know, I think it's pretty unique to have a hospital that's so deeply embedded in community. Ali, can you. Can you share your perspective on that?

[D]

We've been here for 129 years, and for the first 50 years, we operated in the same way that Operation Breakthrough came about. Very organic. It's just one of our founders was a surgeon. The other founder was a dentist. And imagine two very strong women with a conviction that pediatric care has to be different before they have the right to vote. They founded a hospital before they have the right to practice. In the same way that the males did, they founded a hospital. And for the first 50 years, not a single bill came out of our institution. So when you're asking, like, how these two organizations came together, that's not the question. Nothing would have stopped these two organizations coming together and being embedded. Because our missions are so similar, we see the world so alike that of course, we came about. Pediatric health care is quite comprehensive. You can go from this type of partnerships to. Then you're talking about cardiac transplants. And they're all different, and they take different muscles and different understandings. And you have to have the right focus to know where to put your resources and what is being covered by other partners in the community or other organizations. And I think that's what we're doing here.

[B]

Mary, anything you wanted to add?

[C]

I think it's pretty amazing when you have organizations that have been around this long and you still have those original missions intact. And I love when you talk about relationships, because in both organizations, everything we do coalesces around building relationships. And you can really see it. The other thing I think, for those listening, I think is important is it shows that you can take a large hospital system and you can take a smaller, nimble nonprofit, and you can find ways. I feel like it doesn't matter what the barriers we encounter, we find ways to work through them. And I think that's what it takes. When you look at the length of our partnership and how we continue to grow and thrive, I love that everything

[B]

is built on relationships and trust. But really, just like when it gets down to it, what are those elements that you need to get this kind of community clinic running and running smoothly for as long as you have?

[D]

The funding part is really difficult. Right? You have to think about how do you allocate funding to that? And that comes in a partnership. We raise funds together, we raise funds separately, we allocate different budgets. That is a tough conversation. And that's where most of these partnerships will stop. You have to be fueled by the mission, but you have to find the funding to be able to do this. And this will not be a typical P and L. And most healthcare systems would get stuck there. So what is the return on investment here? And you have to see the return investment beyond just a very plain roi. You have to see moms being able to work. How does this have community benefit in a way that is not traditional?

[B]

And I'm sure that you see the impact of this every day, whether it is in those health outcomes, whether it's mom being able to work. Do you have any stories about a child or a family that really reflects why this is so important?

[C]

One that comes to mind, just because we've been talking about it recently, is we get a lot of children that have really high health needs. I mean, when you think about sometimes it's environmental, sometimes it's multi generational, and so the ability to be able to serve children with high needs. We had a baby who's now in kindergarten. So you can imagine, I mean, this has been over a span, but failure to thrive. Feeding tube couldn't digest proteins. So a lot of medical needs, you can imagine a classroom teacher and, and the fear that goes with trying to make sure we're providing adequate care and to be able to have a nurse to come and help with that and be there day to day through that process and then be able to share jointly when that feeding tube comes out five years later. I mean, those are the kinds of stories I think that really showcase not only from a medical perspective, but just relationships that create trust amongst children, families, healthcare workers. What does it take to make this type of a partnership? I think it takes patience. You know, I'm never that patient. So like when I have an idea, I'm ready to like charge in and, and make it happen. And I think in both our cases, like the desire and the want is always there, but the mechanics of getting there can be difficult. And I have a little grid on my wall that says find the third way. And I always laugh because sometimes we're on the 30th way, but I feel like we always stick it out and find a way to make it work because I think it's it. We make it sound really easy, but there's. We both live in the, in the world of licensing and rules and so as much as we might want something, we still have to make it happen within those boundaries. And I love the fact that we all are back at the table at our meetings, as we're working on things and I love that, you know, I talked about the partnership for resilient families, but we also have a weekly call with direct providers. So we're really navigating what's trending in terms of health challenges. How do we communicate it where there isn't a lot of health illiteracy in families and to work together on those. And then I think it makes a robust environment for residents. They have made it a priority to have all of their pediatric residents spend two days here so they're really feeling firsthand how important health is and doing it directly with populations that aren't taking place kind of in a sterile clinic room.

[B]

You've both been doing this for a while. I'd love to hear your advice to other hospitals, to other community based organizations that are thinking about embarking on this sort of partnership.

[D]

I think when you live within a large healthcare system, people will see that as a soft call or something that is like a given. The literature will tell you that that is not the case. If you want to get these things you have to first build trust, build a relationship, get alignment. And, you know, there's a system of doing that. This has fallen into an organic way, but we have developed best systems that reinforce that relationship. Relationships have an roi. Aligning missions across what's important and then using those relationships to deliver better care will have an ROI for the community. You're going to have to be creative, you're going to have to think different, but you have to push yourself to do so.

[B]

Absolutely. Mary, take us home.

[C]

So for those of the thinking we could do this, and you can, it might start out small, but if you're really persistent and you really believe in it, I think I would always say don't wait because you can plan for years and life will have changed three times since then. So I think you just have to, you have to step in and start. And then I think you have to be willing to engage up and down through the hospital. It can't just be the clinic director, it can't just be the nurse. It has to be something that's shared across the organizations and it will change the ability to ensure that kids are meeting developmental milestones. When you see these kinds of partnerships

[B]

and I think that, you know, when you have your missions aligned and you're both committed to the relationship and working through the challenges, you are just a fabulous example of what you can build. So, Mary, Ale, thank you both for being here and sharing this work with us and for the work that you both do every day to help the kids of Kansas City.

[A]

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