Public Health by C3PEDF9

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									   GOOD MORNING!
We will be starting shortly.
• Please orient yourself to Live Meeting
  including use of Q and A
• Please mute your microphones and/or
  telephone
• Please email Tegan Ruland at
  tegan.ruland@wisconsin.gov if you are
  having any difficulties
Performance Improvement
      in Public Health
    Learning Session #1:

 Wisconsin Public Health
Improvement Initiative 101
   Welcome and Introductions
• Brief description of Learning Sessions

• Brief introduction of those participating

• Overview of Live Meeting process
  including muting, accessing handouts, and
  asking questions
  Learning Sessions Planned:
• Today:
  Wisconsin PH Improvement Initiative 101
• 5/9/2011:
  PH Performance Management 101
• 5/16/2011:
  PH Quality Improvement 101
• 5/23/2011:
  PH Accreditation 101
   By the end of this session you
         should be able to:

• Describe current efforts in Wisconsin
  related to public health performance
  improvement and accreditation.

• Access additional information and
  resources for learning.
The significant problems we face cannot
   be solved at the same level of thinking
   we were at when we created them.
--- Albert Einstein
Where is Public Health at now?

  • Nationally

  • Wisconsin
 Essential Services of Public Health
• Monitor health status        • Enforce laws and
                                 regulations
• Diagnose and investigate
                               • Link people to needed
• Inform, educate, and           services / assure care
  empower
                               • Assure a competent
• Mobilize community             workforce
  partnerships
                               • Evaluate health services
• Develop policies and plans
                               • Research
    Public Health Framework:
• What is done by governmental public
  health – standards we operate by

• What communities collaborate on

• What all of us should expect
Why Public Health Essential
       Services?


Wisconsin Statute says we have to!
Public health infrastructure includes the
  systems, competencies, frameworks,
    relationships, and resources that
    enable public health agencies to
    perform their core functions and
    essential services. Infrastructure
     categories encompass human,
   organizational, informational, legal,
       policy, and fiscal resources.
Where are we at in Wisconsin?
                        WIQI



     WI
                                             Prevention
Statute/Rule
                                             Block Grant
  Change             Public Health
                     Accreditation
                      and Quality
                     Improvement




       HW2020:                            CDC
      Capacity and                   Infrastructure
        Quality                           Grant
            Goal:

Everyone Living Better, Longer
                        WIQI



     WI
                                             Prevention
Statute/Rule
                                             Block Grant
  Change             Public Health
                     Accreditation
                      and Quality
                     Improvement




       HW2020:                            CDC
      Capacity and                   Infrastructure
        Quality                           Grant
                    WIQI
  Wisconsin's Public Health Quality
         Initiative (WIQI)
Began in 2008 and was funded by the Robert
Wood Johnson Foundation (RWJF). This
national effort is aimed at improving the nation's
public health system by setting benchmarks to
measure health department quality.

Partners included the Institute for Wisconsin’s
Health, Inc. (IWHI), Wisconsin Division of Public
Health (WDPH) and the Wisconsin Association
of Local Health Departments and Boards
(WALHDAB).
                     WIQI
Goals:
  1.Contribute to the development of an effective
  national voluntary accreditation program.

  2.Engage Wisconsin communities in improving
  their health departments through adoption of
  assessment and quality improvement methods

  3.Prepare Wisconsin's local and state health
  departments for national voluntary accreditation
                        WIQI



     WI
                                             Prevention
Statute/Rule
                                             Block Grant
  Change             Public Health
                     Accreditation
                      and Quality
                     Improvement




       HW2020:                            CDC
      Capacity and                   Infrastructure
        Quality                           Grant
Prevention Block Grant 2011
Federal block grant dollars allocated to
      support accreditation, quality
  improvement and Community Health
     Improvement Planning though
  competitive application and grants to
 Local Health Departments and Tribal
          Health Departments
  Prevention Block Grant 2011
Competitive Grant – Focus on improving resources
  available to local health departments and tribes
         related to Accreditation - $30,000.

• Polk County Health Department was recipient

• Grant focusing on doing rapid assessment of
  local health departments related to accreditation,
  developing website as repository of local
  accreditation document examples, and providing
  basic support of accreditation.
   Prevention Block Grant 2011
 Local and Tribal Health Department Template Objectives

• Accreditation: By December 31, 2011, Health
  Department will implement continuous quality
  improvement, strategic planning, and/or self assessment
  to prepare for accreditation. (18)

• CHIPP: By December 31, 2011 will be complete a
  community health assessment and community health
  improvement plan with measurable objectives. (18)
                        WIQI



     WI
                                             Prevention
Statute/Rule
                                             Block Grant
  Change             Public Health
                     Accreditation
                      and Quality
                     Improvement




       HW2020:                            CDC
      Capacity and                   Infrastructure
        Quality                           Grant
  Healthiest Wisconsin 2020:
 Everyone Living Better, Longer
    HW2020 Capacity and Quality

State health plan infrastructure focus area
  that identifies two objectives for all health
  departments (state, tribal, local).
        HW2020 Objectives
• By 2020, all Wisconsin health departments
  will implement established quality
  improvement processes in daily practice.

• By 2020, all Wisconsin health departments
  will be accredited using an established
  standard.
      HW2020 Objectives
Next Step….tentative proposal to look at
  development of a state-wide leadership
   group to provide leadership and move
 forward with action related to these state
           health plan objectives.

             Interested???
                        WIQI



     WI
                                             Prevention
Statute/Rule
                                             Block Grant
  Change             Public Health
                     Accreditation
                      and Quality
                     Improvement




       HW2020:                            CDC
      Capacity and                   Infrastructure
        Quality                           Grant
       Wisconsin Statutes and
        Administrative Rules
• Draft 140 rule change includes definition
  and language that links to PHAB

• Legislative Study Committee proposal to
  change statute to include PHAB language
                        WIQI



     WI
                                             Prevention
Statute/Rule
                                             Block Grant
  Change             Public Health
                     Accreditation
                      and Quality
                     Improvement




       HW2020:                            CDC
      Capacity and                   Infrastructure
        Quality                           Grant
    CDC Infrastructure Grant
   Goal of this national funding is for State,
 local, tribal health departments to have the
      support to develop the culture and
infrastructure for performance management
     (PM), quality improvement (QI), and
                 accreditation.

Nationally, $42.5 million given to 76 state,
tribal, local, and territorial health department
      as part of the Affordable Care Act.
             National Public Health
             Improvement Initiative
Strengthening Public Health Infrastructure for Improved Health
   Outcomes
Impact:
• Fills gaps vital to improving health & controlling costs not covered by
   categorical funding streams
• Increased efficiency and effectiveness in preparing for, preventing,
   and responding to acute and chronic threats to the Nation’s health
• Provides economies of scale (e.g., through regionalization and
   shared resources)
Outcomes:
• Increase in dedicated staff’s time, systems’ capabilities, and routine
   performance tracking and reporting (Performance Management;
   100% Component I; 63% of Component II grantees)
• Increase in the number of evidence-based policies, laws, or
   regulations (Policy & Workforce Development; 42% of Component II
   grantees)
    CDC Infrastructure Grant

  Wisconsin wrote for the non-competitive
    application ($300,000) as well as the
competitive funding. We were awarded $1.96
 million per year for 5 years starting 9/2010.
        CDC Infrastructure Grant
                  Funding is focused on:

• Reaching goals and objectives in HW2020
• Achieving national accreditation standards for state,
  local, tribal health departments
• Strengthening population metrics
• Moving to a Quality Improvement culture in DPH,
  local, and tribal health departments
        What is being done with the
          funding? (examples):
•   State infrastructure development – in process
•   Local Mini-Grants - awarded
•   QI training for DPH and local/tribal health departments – in process
•   Assessment and planning for Performance management in DPH – in
    process
•   Rapid cycle improvement related to HW2020 focus areas and
    business processes– in process
•   Development of detailed community data sets for surveillance and
    QI – in process
•   Start at preparing for PHAB accreditation in DPH
•   Development of DPH workgroup to focus on disparities – in process
•   Measurement of HW2020 – in process
•   TA to tribal health departments – in process
•   More….
      Who are our partners?
• IWHI
• WALHDAB/Local Health Departments
• Tribal Health Directors/Tribal Health
  Departments
• PH Foundation
• UW – NIATx
• UW – Evaluators
• CDC
• Others
                   IWHI
• Support for accreditation preparation of
  local health departments
• QI training and consults to WIQI agencies
     - Team of three QI consultants
• Continued web presence - blog and
  resources
• Development of a Tribal accreditation work
  group
           PH Foundation
• Assessment of DPH for readiness to be an
  agency that is undertaking Performance
  Management.
• Support to build culture of Performance
  Management in agency.
• Support with Rapid Cycle Improvement
  related to Contracting process
                   UW
• Contract to support evaluation of CDC
  grant
• Contract to train all DPH managers in
  NIATx Change Leaders Academy –
  Quality Improvement
 CDC Infrastructure Grant –
supplemental funding in 2011

Additional funding ($34 million) is being
   released by CDC in May, 2011.
 Wisconsin is eligible for an additional
  $993,000 in infrastructure dollars.
       CDC Infrastructure Grant –
      supplemental funding in 2011
       Proposed focus for these dollars include:

•   Mini-grant funds
•   QI training and technical assistance
•   Increase DPH readiness for accreditation
•   Increase focus on health disparities
•   Electronic data exchange
•   Shared services support
•   More
            National Resources:
• CDC: http://www.cdc.gov/ostlts/NPHII/index.html

• NACCHO: http://www.naccho.org/topics/infrastructure/

• ASTHO: http://www.astho.org/Programs/Accreditation-and-
  Performance/

• PHAB: http://www.phaboard.org/

• PHF: http://www.phf.org/focusareas/pmqi/pages/default.aspx

• NALBOH: http://www.nalboh.org/Board_Governance.htm#

• NIHB: http://www.nihb.org/public_health/accreditation.php
 Primary Wisconsin Resources:
• CDC Infrastructure Grant: Mary Young, DPH Southern
  Regional Office
  mary.young@wisconsin.org
• Prevention Block Grant: Jackie Bremer, DPH Northern
  Regional Office
  Jacquelyn.Bremer@wisconsin.org

• HW 2020 Capacity and Quality Focus Area: Lieske
  Giese, DPH Western Regional Office
  elizabeth.giese@wisconsin.gov

• WIQI: Nancy Young, IWHI
  grayhorse@mac.com
                Websites:
• IWHI
  http://www.instituteforwihealth.org/project-
  portal/
• DPH
http://www.dhs.wisconsin.gov/localhealth/ind
  ex.htm
• Accreditation site (soon to be available)
  http://www.phawisconsin.com/
       Conclusion:

“Do what you can, with what
  you have, where you are.”

       Teddy Roosevelt
Tell us what you thought of today’s
              session:

http://4.selectsurvey.net/dhs/TakeSurvey.as
  px?SurveyID=n2M24m53

								
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