Greater than the sum of its parts Challenges and growth of by dfhdhdhdhjr


									Introduction to the Community
      Health Assessment

  Gianfranco Pezzino, M.D., M.P.H.
       Kansas Health Institute
   MLC-3 First Learning Session
          March 25, 2010
    In this Session we Will…
 Learn about the MLC-3 project and its
  role in preparation for national
 Learn what a collaborative project is
 Learn about rapid change cycles
 Describe how this collaborative will
  work (goals and process)
What is the MLC-3
2008: 16 MLC-3 States
            MLC-3 Goals
 To improve public health services and
  the health of the communities by
  implementing quality improvement
 Strong emphasis on:
   Quality Improvement (QI)
   Preparedness for accreditation
 Based on collaborative projects
National Accreditation Process
 Under development by major public
    health organizations
   Voluntary
   Expected to be operational in 2011
   Standards and tools published
   “Beta-test” in progress
                             Timeline (in 2007)
    2007             2008             2009            2010             2011
1   2   3    4   1   2   3    4   1   2   3   4   1   2   3   4    1   2   3     4


                                              Beta test
            Standards and
Internal operations
Public Health Accreditation Board

             The KS MLC-3: the Broader
             Public Health System
                  KS Dept. of
                   Health and
KS Association                  KS Health
  of LHDs                        Institute

     What is a “Collaborative
 Institute of Healthcare Improvement, 1995:
  “Breakthrough Series”
 Goal: accelerate widespread
  implementation of best practices
 Based on teams participation
 Steps:
1. Test and measure practice innovations on
   small scale
2. Share experiences
3. Modify innovations, apply on larger scale
Plan                Plan changes aimed at
                    improvement, matched to root
                                                         Act               Plan
Do                  Carry out changes; try first on
                    small scale

Study/Check See if you get the desired
                                                       Check                Do
Act                Make changes based on what
                   you learned; spread success

                                                      Also called Plan-Do-Study/Check-Act
                                                        (PDSA), PDCA, PDCA Cycle, or
                                                                 Shewhart Cycle
      Courtesy: Public Health Foundation
                                     Expanded in 7 Steps

                     Select the problem or improvement
Plan                 Describe the current process
                     Describe all of the possible causes of the
                      problem, and agree on the root cause(s)
                      to address
                     Develop a workable solution and action
                      plan, including targets or measures to
                      know if the change is an improvement

Courtesy: Public Health Foundation
    Do                 Implement the solution or
                             process change

Check/Study            Review and evaluate the result
                             of the change

    Act                Reflect and act on learnings

  Courtesy: Public Health Foundation
                  Continuous Improvement

                                            The continuous improvement
         Act                         Plan
                                            phase of a process is how you
                                            make a change in direction.
                                            The change usually is because
                                            the process output is
                                            deteriorating or customer needs
       Check                         Do     have changed

Courtesy: Public Health Foundation
              MLC-3 Target Areas
 Health Status             Capacity

MCH- Infant Mortality

Tobacco Related Illness

Chronic Disease

Alcohol Related Injuries
Kansas Multi-State Learning 1st
 NE Corner

Lower 8 of SE

 KDHE Team
  Kansas Multi-State Learning
      2nd Collaborative
Region 1   Region 7
 Team       Team

Region 2

Region 3     Region 5
 Team         Team

KDHE Team               Region 8
     C.H.A. Collaborative in a
 Based on teams and regional projects
   10 regional teams
     • 62 LHDs, 64 counties
   1 “state” team
 About 10 months of activities
 3 face-to-face sessions, one final learning
   Much work takes place between sessions
 CE offered at all sessions
 Travel costs paid
 Incentive $$ to each team
    Why are We Doing This?
1. C.H.A. are key tools for development
   of health improvement plans
2. Will be pre-requisite for national
3. Experience in Kansas is limited
  C.H.A. Collaborative Charter
 This collaborative will provide tools
  and skills to the participants to assist
  them in performing a community or
  state health assessment and
  improvement plan
 Emphasis on selected critical steps
  C.H.A. Collaborative Focus
1. Data issues:
   a) Finding the right data
   b) Compiling the data
   c) Interpreting the data
2. Community engagement process and
3. Q.I. tools and techniques used throughout
 We will NOT complete a C.H.A. during the
   C.H.A. Collaborative Goals
1. To improve the level of readiness of
   public health agencies in Kansas for
2. To learn and practice basic concepts
   on C.H.A. and improvement plan
3. To increase knowledge and skills on
   Q.I. tools
 C.H.A. Collaborative Objectives
 By the end of the Collaborative project
 each participating team will be able to:
  1. Describe a C.H.A. and health improvement
  2. Discuss major components of a C.H.A. and
     health improvement plan
  3. Plan the execution of a C.H.A. and health
     improvement plan
  4. Use tools to stimulate community engagement
  5. Use tools for quality improvement
  Phases of the Collaborative
 Pre-session activities
 Learning sessions
    1, 2 and 3
 Action periods
   Between learning sessions
 Learning congress
    Final event
Outline of Activities
  (Handbook, page 19)
Pre-session Activities (Page 10)
 Read and review the RFP
 Read and review the Collaborative
 Form a team and select a team leader
 Participate in a pre-work call (March
 Register and arrange for travel to the
  first learning session.
 Team leaders: orientation session
         Learning Sessions
 3 full-day face to face meetings
 Coordinated by the University of Kansas’
  Area Health Education Centers (AHEC)
   CE offered
 Hands-on, collaborative work
 Faculty will provide input on C.H.A., QI
  tools, technical assistance on project
 Teams will work independently and jointly
 “Storyboards” present team work’s “story”
          Action Periods
 Time between learning sessions
 This is when most of the work takes
 Technical support available
 Monthly conference calls
       Learning Session 1 (today)
 Introduction to the C.H.A. Learning Collaborative
      Collaborative - Process, Goals, Teams
      Team work and dynamics
      Introduction to storyboards
      Expectations, milestones, deliverables
 Introduction to C.H.A. and improvement plans
      Steps to prepare for a community health assessment
      Process and techniques to engage the community
      Community health assessment core indicators for Kansas
      Collecting core indicators for your geographical area
      Indentifying comparison communities
 Application of Q.I. tools in the various steps of the
 Assignment of tasks for Action Period 1
              Action Period 1
 Each team will perform following
     Development of a team charter
     Data “assembly”
     Data interpretation and discussion.
     Comparison to “peer communities”.
     Community engagement:
       • test on a small scale at least one community
         engagement technique
   Update storyboard
           Learning Session 2
 Each team will:
   Report results of action period 1
     • Describe QI tools used
     • Discuss results of community engagement test
   Present brief profile of health in their
   Develop a few public health issue
   Select one issue statement to explore
            Action Period 2
 Each team will:
   Explore issue statement selected
     • Gather input (on a small scale) from the
     • Start identification of possible options to
       address the issue
   Update storyboard
          Learning Session 3
 Each team will:
   Report results of their work during Action
    Period 2
   Describe QI tools used
 Discuss a possible health improvement
  plan for their selected issue.
 Present the health improvement plan to
  other teams
 Describe quality improvement tools that
  may be used in the “do” portion of the
           Action Period 3
 Complete activities left unfinished at
  the end of Session 3
 Develop final storyboard
        Learning Congress
 Final event of project
 Celebrate success, discuss
 Open to larger audience
   Disseminate results and methods
        Expectations (Page 22)
 Project staff and faculty will:
      Provide information on subject of Collaborative
      Offer coaching to teams
      Perform one site visit to each project site
      Provide e-mail list and other communication venues for
       shared learning
      Assess team progress and provide feedback to teams
      Plan and implement learning sessions
      Create a summary storyboard to summarize the results
       of the Mini-Collaborative project
      Provide C.E. units for Learning Sessions
      Support travel of one team representative to at least one
       national MLC-3 meeting
 Teams are expected to:
   Perform pre-session activities
   Appoint a team leader
   Provide resources to support the team,
    including staff time to devote to this effort
   Develop a team charter
   Participate in each learning session
   Share information with other teams
   Submit brief monthly updates
   Create brief storyboards
     Developing a Team Charter
 Answer the following questions:
    1. What is the purpose of this team?
    2. What is the final product?
    3. How will the team measure the success?
 Consider also:
    Team composition
    Team process, roles, responsibilities
 Examples of goals:
    Establish a planning workgroup to conduct a CHA
    Develop strategies to engage residents
    Have (N) community partners sign a letter of commitment to
     participate in a CHA.
    Develop a timeline and high-level plan to conduct a CHA
 Travel costs paid directly by project
  management team
   Subject to limits on number of
    participants, vehicles
 Each team will receive a $2,000
       Calendar of Activities
 Pre-session work: March 1– March 24
 Team leaders orientation: March 10
 Pre-session conference call: March 17, 1:00 p.m.
 Learning Session 1 – March 25-26, Topeka
 Action Period 1 - March 27 to June 13
 Learning Session 2 - June 14, Wichita
 Action Period 2 - June 15 to September 26
 Learning Session 3 –September 27, TBA (Salina?)
 Action Period 3 –September 28 to November 14
 Outcomes Congress –November 15, Overland Park
 Collaborative project ends – December 31
Kansas Health Institute

Healthier Kansans through
    informed decisions

To top