Transcript Slide 1

Multi-State Learning Collaborative:
Lead States in Public Health Quality
Improvement
Open Forum
September 16, 2009
Chicago, Illinois
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This is
where
it all
started….
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Selected
Target Areas:
1. Workforce Development
Quality Improvement
2. Community Health
Assessments
3. Accreditation
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Quality Improvement Trainings
conducted by the Missouri Institute
for Community Health
1.
2.
3.
4.
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Carter
Douglas
Howell
Mercer
5.
6.
7.
8.
Oregon
Ozark
Putman
Reynolds
9. Shannon
10. Sullivan
11. Texas
12. Wright
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Sample Storyboard
from one of our
12 Local Health Departments
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Balanced Scorecard
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Improvements,
Changes, and Key
Accomplishments
Resulting from
MLC-3
QI Projects
Readiness for Quality
Improvement Evaluation
Interviews
12 of 12 LHD’s have been interviewed.
The purpose of the evaluation was to:
(a) understand how the Local Health Departments (LHD) in the
MLC-3 are progressing.
(b) collect information on quality improvement (QI) and how that
diffuses across the LHD through time.
(c) test the Community Readiness Model tool as a method for
understanding QI institutionalization.
Readiness for Quality Improvement
Evaluation Interviews
Many commented that storyboards were a very
productive exercise in that “it allowed focus
on one problem or issue in the department at
a time and now we can apply it to other
problems”.
The storyboard project was given a rating of 4.5
(1 = not successful to 5 = most successful).
Dimensions of Readiness
Dimensions of Readiness
A. Department Efforts
B. Department Knowledge
of the Efforts
C. Leadership (Governance &
Administration)
D. Department Climate
E. Department Knowledge
about the Issue
F. Resources
Levels of Readiness Scale
1. No Awareness
2. Denial / Resistance
3. Vague Awareness
4. Preplanning
5. Preparation
6. Initiation
7. Stabilization
8. Confirmation/ Expansion
9. High Level of Department
Ownership
7.00
6.00
5.00
4.00
3.00
2.00
1.00
0.00
Historical
Before MLC
R
es
o
ur
ce
s
Is
su
e
at
e
C
lim
p
er
sh
i
Le
ad
er
na
n
G
ov
Kn
ow
le
dg
e
ce
After MLC
Ef
fo
rt
Level of Readiness (1 to 9)
Readiness for QI at Historical,
Pre- and Post MLC-3 Time Points
Dimensions of Readiness
An increase in average was found across all dimensions.
Key Accomplishments
•
The group meetings are the most effective because we learn from each other.
•
This process has solidified our regional collaboration.
•
MLC-3 has caused our staff to all feel included and we are all looking at the same
questions.
•
To get ALL the staff included in a process…that pays the largest dividend.
We used to think…”why go looking for problems?” That was the mindset many years
ago…now, we know it must be a part of the job and we encourage employees to make
public the things that aren’t working. We even have it on the agenda.
•
“We’re already doing that” --doesn’t work anymore. Now we document and are able to
use what we do to see if it’s effective.
•
Governing Boards are a little slower in embracing QI (e.g., age, public health experience,
education level). They are supportive of anything we do just as long as the finances are
healthy. What is the responsibility of the GB in the support and participation in QI?
Key Accomplishments
•
Our efforts are now more systematic, instead of programmatic.
•
QI isn’t viewed as a “managerial” tool or merely a contractual obligation
anymore. It belongs to everyone.
•
Before, QI activities always made staff feel “put upon”…now they are engaged
and see its benefits.
QA used to be the priority and now that’s shifted to QI, which is more productive.
•
The best part is that all staff feel engaged instead of just administration. Our staff
meetings are so organized and productive now.
•
The mind set many years ago was that I had a job to do and if I had time will do
QI. You just didn’t go searching for problems…now, we know it must be a part of
the job and we encourage employees to make public things that aren’t working.
We even have it on the agenda.
Sustaining
Improvement
&
Next Steps
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Challenges:
• Time, Distance & Scheduling
• Starting from where they were
vs where we wanted to be
• Keeping the tools simple
• Agencies had experienced QI as a
contract deliverable vs as a way of doing
business
• Putting ourselves in their shoes and
being considerate of their work load
• Connecting their goals and projects with
our goals
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Key Lessons Learned:
•Listen for barriers
•Stay agile
•Align efforts
Maintaining Enthusiasm:
•Help others achieve their goals
•Adopt a helpful learning motto
•Provide opportunities for
recognition
•Celebrate often
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Tools & Resources We Can
Share:
Workshop agendas
Process Worksheet & Handouts
QI Tools –Simplified
QI Plan Template
Balanced Score Card Template
Strategy Map Template
Evaluation Tools
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Questions?
Contact:
Quality Improvement Consultant
Marty Galutia
[email protected]
Evaluator
Dr. Beverly Tremain
[email protected]
Co-Director
Janet Canavese
[email protected]
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