Quality Improvement at DHD#10. Presented by Jan Wiltse, PhD Health Planner/QI Coordinator

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1 Quality Improvement at DHD#10 Presented by Jan Wiltse, PhD Health Planner/QI Coordinator

2 2 Background information on District Health Department #10 10 County Health Department Office in every county Northwest lower peninsula of Michigan Rural 170 employees Largest geographic service area in state

3 District Health Department #10 Established October 1997 Population: 261,184 US Census Bureau, 2012 est. Kalkaska 17,099 Crawford 14,009 Manistee 24,672 Wexford 32,608 Missaukee 15,031 Mason 28,680 Lake 11,498 Oceana 26,310 Newaygo 47,959 Mecosta 43,318 DHD #10 Rhode Island Delaware Connecticut 5,796 square miles 1,214 square miles 2,057 square miles 5,009 square miles

4 4 History of QI QI policy board approved Limited involvement and projects Training for staff in 2009; limited follow-up Communication Story board Progress report to BOH

5 5 Challenges Unanticipated events during first QI project No one accountable Documentation lacking Low priority Very few QI projects conducted Limited staff training and involvement Not coordinated with other efforts at the HD

6 6 QI efforts were increased Prepared for National Accreditation And. Revised policy Increased number of QI projects Staff attended training

7 7 We made a strong commitment to QI! Health Officer Board of Health Division Directors Strategic Plan

8 8 Commitment to QI: Revised Policy Policy includes Formation and responsibilities of QI committee Role of the QI coordinator Development of a QI culture Staff training opportunities Measuring, monitoring, and reporting progress Agency support

9 9 Commitment to QI: Designated roles and responsibilities QI Coordinator Facilitate QI Committee Work with divisions to implement and track QI projects Document QI activities Work on developing a QI culture QI Committee Oversee QI activities and projects for HD Conduct agency-wide QI projects Includes broad representation from divisions Division Directors Identify QI project within each division as part of annual goal Provide QI updates at each staff meeting

10 10 Commitment to QI: Staff training Training at all-staff meeting QI training on-line for directors QI training and information at all division level staff meetings QI information included in new staff orientation Open Forum attendance November 2012 July 2013 November 2013

11 11 Commitment to QI: External training Presentation scheduled for Nurse Administrator s Forum meeting on May 5, 2014 Presentation on QI project at state conference Posted a QI project on PHQIX

12 12 Commitment to QI: Coordination Included in the Strategic Plan Guided by DHD#10 Mission Statement Vision Community Health Improvement Plan PHAB Standards and Measures

13 13 Commitment to QI: Accountability Responsibility of QI coordinator and QI committee Documentation and tracking Reporting Visibility

14 PLAN DO STUDY ACT 14 QI project area: Start date: Team members: AIM statement: Project reporting form Flow chart (current): Flow chart (proposed): Fishbone: Baseline data collection/review: Potential solutions: Theory for improvement: Test the theory: Study the results: Standardize or test new theory: Future plans:

15 15 Commitment to QI: Communication Scheduled reporting to Board of Health and administrators QI plan, resources, project summaries, and meeting minutes posted on DHD#10 intranet Update at annual all staff meeting Updates and presentations at division staff meetings Regular updates to staff by and posters

16 16 Current QI Projects Improving no-show rates in immunization clinics Improving breast feeding duration rates for WIC clients Revising the employee wellness program Increasing follow-up among Children s Special Health Care Services clients Improving use of the phone system through staff training and standardizing voice mail messages

17 17 Accreditation Michigan Local Public Health Accreditation Quality Improvement Section In last two review cycles (2010 and 2013) Met all indicators Received special recognition National Public Health Accreditation In process of submitting documentation

18 18 QI Culture Inform about QI Posters Storyboard Get staff involved Think about using the QI process

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23 23 Summary of lessons learned Make a commitment to QI Align QI efforts with Strategic Plan, Community Health Improvement Plan, mission, vision, PHAB standards and measures Assign tasks and maintain accountability Document and continually update efforts Encourage staff ownership of projects Develop a QI culture Communicate progress and continually reinforce message

24 Thank you! 24