1 Learn more about Rapid Test Cycles! During Level 1 CQI Team Meengs Play the Coin-Spinning Game For YouTube instrucons copy and paste the following in your browser hps://www.youtube.com/watch?v=3U9lLiPOhtM The Coin-Spinning Game worksheet is available at: hps://www.jbassoc.com/wp- content/uploads/2018/07/Module-5_Coin-Spinning-Game-Worksheet.pdf Quality Outlook FOURTH QUARTER 2018/2019 CYCLE “When we strive to become beer than we are, everything around us becomes beer, too.”- Paulo Coelho S M T W TH F SA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 July 2019 S M T W TH F SA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 August 2019 S M T W TH F SA 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 September 2019 Level 1 CQI All Level 1 Teams July 8-19, 2019 NFP Level 2 CQI 2:30 pm—4:00 pm August 12, 2019 650-479-3207 Access Code: 805 636 435# Level 3 CQI 1:30 pm—3:30 pm September 9, 2019 Pine A 650-479-3207 Access Code: 803 820 987# HFMoHV Level 2 CQI 10:00 am—11:00 am August 6, 2019 650-479-3207 Access Code: 804 648 780# EHS-HBO & PAT Level 2 CQI 9:00 am—11:00 am August 26, 2019 650-479-3207 Access Code: 802 291 852# Rapid Test Cycles The Missouri Department of Health and Senior Services (DHSS) Home Vising Program State Priority Focus #3: Increase the Percentage of Completed Well-Child Visits, is being iniated in this fourth quarter of Federal Fiscal Year (FFY) 2019. The State Priority Focus #3’s goal is to increase the percentage of completed well-child visits by individual local implemenng agencies (LIAs), that will in turn liſt the total percentage of DHSS Home Vising Program completed well-child visits. Achievement of this goal supports families in obtaining and sustaining a medical home, improves the physician/paent relaonship, and provides for early detecon and intervenon of medical and developmental concerns. Specific, Measurable, Aainable, Relevant, and Timely (SMART) aims developed during the third quarter of FFY 2019, from the first three quarters of submied well-child compleon data, are being distributed to each LIA. Each SMART aim will include baseline and target percentages for improvement. Each LIA will use the base and target percentage goals to develop connuous quality improvement (CQI) projects that ulize Plan, Do, Study, Act (PDSA) cycles. A new concept of PDSA rapid test cycles was introduced to all LIA supervisors during the DHSS Home Vising Leadership Academy on June 5, 2019, by Julie Leis, Technical Assistance Specialist for MIECHV Region VII, HV-PM/CQI, Senior Research Associate, James Bell Associates. This new State Focus Priority #3 provides a mely opportunity to try out PDSA rapid test cycles. As described by Julie Leis, rapid tesng cycles are connual, small, quick tests of change strategies to accelerate improvement. The benefits of rapid tesng are to reduce risk and cost, increase or decrease the belief that the change results in improvement, learn to adapt change to other condions, and gain buy-in for the change. Small change strategies can have a big impact when used together in a ramp cycle process. A ramp cycle is a connual set of PDSA rapid cycles that together can result in system improvement. Each cycle builds on what was learned in the previous cycle. PDSA rapid cycles within a ramp cycle typically go from very small tests to progressively larger tests. Determining early when to increase the scale of the test is important. If the first test of a change strategy yields promising results and changes are minor, it can be scaled up because there is evidence the change strategy works and big failures are unlikely. However, if results were not posive, scaling up the change strategy does not make sense without being adapted and tested again on another small scale. Each new test of a change strategy should be clearly related to the last test. The scale of the test should be increased by just one increment at a me. Depending on the test, one increment could be one client or one home visitor. Test of change strategies should be scaled up or down based on results. Addional informaon about rapid tesng and other CQI resources can be found in the following links: CQI Toolkit: hps://www.jbassoc.com/resource/connuous-quality-improvement-toolkit/ PDSA Ramps worksheet: hps://www.acf.hhs.gov/sites/default/files/opre/ module_5_pdsa_ramps_handout_508.pdf The PDSA Cycle—Step by Step checklist: hps://www.acf.hhs.gov/sites/default/files/opre/ module_5_the_pdsa_cycle_step_by_step_ handout_508.pdf PDSA Cycle Worksheet: hps://www.jbassoc.com/wp-content/uploads/2018/07/Module-5_PDSA-Cycle- Worksheet-Blank.pdf
Transcript
1
Learn more about Rapid Test Cycles! During Level 1 CQI Team Meetings Play the Coin-Spinning Game
For YouTube instructions copy and paste the following in your browser https://www.youtube.com/watch?v=3U9lLiPOhtM
The Coin-Spinning Game worksheet is available at: https://www.jbassoc.com/wp-content/uploads/2018/07/Module-5_Coin-Spinning-Game-Worksheet.pdf
Quality Outlook F O U R T H Q U A R T E R 2 0 1 8 / 2 0 1 9 C Y C L E
“When we strive to become better than we are, everything around us becomes better, too.”- Paulo Coelho
S M T W TH F SA
1 2 3 4 5 6
7 8 9 10 11 12 13
14 15 16 17 18 19 20
21 22 23 24 25 26 27
28 29 30 31
July 2019
S M T W TH F SA
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30 31
August 2019
S M T W TH F SA
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30
September 2019
Level 1 CQI All Level 1 Teams
July 8-19, 2019
NFP Level 2 CQI 2:30 pm—4:00 pm
August 12, 2019 650-479-3207
Access Code: 805 636 435#
Level 3 CQI 1:30 pm—3:30 pm September 9, 2019
Pine A 650-479-3207
Access Code: 803 820 987#
HFMoHV Level 2 CQI 10:00 am—11:00 am
August 6, 2019 650-479-3207
Access Code: 804 648 780#
EHS-HBO & PAT Level 2 CQI 9:00 am—11:00 am
August 26, 2019 650-479-3207
Access Code: 802 291 852#
Rapid Test Cycles The Missouri Department of Health and Senior Services (DHSS) Home Visiting Program State Priority Focus #3: Increase the Percentage of Completed Well-Child Visits, is being initiated in this fourth quarter of Federal Fiscal Year (FFY) 2019. The State Priority Focus #3’s goal is to increase the percentage of completed well-child visits by individual local implementing agencies (LIAs), that will in turn lift the total percentage of DHSS Home Visiting Program completed well-child visits. Achievement of this goal supports families in obtaining and sustaining a medical home, improves the physician/patient relationship, and provides for early detection and intervention of medical and developmental concerns.
Specific, Measurable, Attainable, Relevant, and Timely (SMART) aims developed during the third quarter of FFY 2019, from the first three quarters of submitted well-child completion data, are being distributed to each LIA. Each SMART aim will include baseline and target percentages for improvement. Each LIA will use the base and target percentage goals to develop continuous quality improvement (CQI) projects that utilize Plan, Do, Study, Act (PDSA) cycles.
A new concept of PDSA rapid test cycles was introduced to all LIA supervisors during the DHSS Home Visiting Leadership Academy on June 5, 2019, by Julie Leis, Technical Assistance Specialist for MIECHV Region VII, HV-PM/CQI, Senior Research Associate, James Bell Associates. This new State Focus Priority #3 provides a timely opportunity to try out PDSA rapid test cycles. As described by Julie Leis, rapid testing cycles are continual, small, quick tests of change strategies to accelerate improvement. The benefits of rapid testing are to reduce risk and cost, increase or decrease the belief that the change results in improvement, learn to adapt change to other conditions, and gain buy-in for the change. Small change strategies can have a big impact when used together in a ramp cycle process. A ramp cycle is a continual set of PDSA rapid cycles that together can result in system improvement. Each cycle builds on what was learned in the previous cycle. PDSA rapid cycles within a ramp cycle typically go from very small tests to progressively larger tests. Determining early when to increase the scale of the test is important. If the first test of a change strategy yields promising results and changes are minor, it can be scaled up because there is evidence the change strategy works and big failures are unlikely. However, if results were not positive, scaling up the change strategy does not make sense without being adapted and tested again on another small scale. Each new test of a change strategy should be clearly related to the last test. The scale of the test should be increased by just one increment at a time. Depending on the test, one increment could be one client or one home visitor. Test of change strategies should be scaled up or down based on results. Additional information about rapid testing and other CQI resources can be found in the following links: CQI Toolkit: https://www.jbassoc.com/resource/continuous-quality-improvement-toolkit/
Please note the CQI-specific email address for submitting PDSA storyboards and CQI activity logs. You may also send any of your CQI related inquiries to this address for the quickest response, as multiple DHSS home visiting staff will access this account. The CQI-specific email address is [email protected].
Level 3 CQI Meeting Recap
2nd Quarter Level 3 CQI Recap - March 11, 2019.
Meeting minutes are posted in the secure section of the DHSS Home Visiting website accessible to DHSS contracted LIA staff using the secure user-id and password at: https://health.mo.gov/homevisiting/cqi/.
The 4th Quarter Level 3 CQI meeting will be held on:
EHS-HBO & PAT Level 1 Teams, please submit your detailed activity log to Kristen Mandrell at: [email protected], and Melinda Kirsch at: [email protected] by July 31, 2019.
HFMoHV Level 1 Teams, please submit your detailed activity log to Linda Kozlowski at: [email protected],
For the Level Two Teams, please submit your detailed activity logs to Melinda Kirsch at: [email protected] by August 30, 2019.
FFY 2019 Scribe and Leader roles expiring!
During this 4th quarter of FFY 2019, the CQI process leadership roles of Scribe and Leader should be re-selected at each team level meeting for the 2019-2020 year.
The responsibilities of members fulfilling these roles will be effective beginning October 1, 2019. Please reference the Missouri Home Visiting CQI Handbook
for definitions and duties of the Scribe and Leader roles.
The handbook can be accessed through the Missouri Home Visiting Gateway at:
National Cleft and Craniofacial Awareness and Prevention Month
July is National Cleft and Craniofacial Awareness month. The Centers for Disease Control (CDC) estimates that about 7,000 babies will be born with a cleft in the U.S. this year. Additional cleft and craniofacial information can be found at: http://www.nccapm.org/.
National Cord Blood Awareness Month
The birth of a baby holds with it a miracle most parents aren’t aware of, the ability to save a life. A newborn’s cord blood stem cells have the potential to provide lifesaving treatment for others. Cord blood is obtained from the umbilical cord only after the birth of a healthy baby. Cord blood is rich in blood-forming cells that can be used in transplants for patients with leukemia, lymphoma, and many other life-threatening diseases. It can be especially useful for transplant patients from ethnically diverse backgrounds who often have difficulty finding a transplant match. Since cord blood is stored frozen, it is available for use as soon as a match is identified. A baby’s donated cord blood stem cells may increase the likelihood of someone benefiting from a cord blood stem cell transplant. Additional information regarding cord blood banking is available through the Parents Guide to Cord Blood Foundation found at: http://health.mo.gov/living/families/genetics/cordblood/index.php.
September
Infant Mortality Awareness Month
Infant mortality is the death of a baby before his or her first birthday. The infant mortality rate is the number of deaths that occur for every 1,000 live births. Pregnancy outcomes are influenced by a woman’s health before she becomes pregnant. Preconception health focuses on actions women can take before and between pregnancies to increase their chances of having a healthy baby. Watch this video https://vimeo.com/155442704, to see the impact infant mortality has on our Missouri communities. This video is by Pamela Xaverius, Ph.D., Associate Professor of Epidemiology, St. Louis University. The important steps women can take to improve their preconception health can be found at: http://health.mo.gov/living/families/infantmortality/index.php.
Newborn Screening Awareness Month
Newborn screening refers to screenings performed on newborns shortly after birth to protect them from the serious effects of disorders that otherwise may not be detected for several days, months, or even years. Missouri law requires all babies born in the state to be screened for over 70 different disorders. While most of these disorders are screened by collecting a small amount of blood from the newborn's heel, there are also two point of care screenings included in Missouri's Newborn Screening Program. These are newborn hearing screening and critical congenital heart disease screening. The goal of the Newborn Screening Program is to prevent serious health problems through early screening and early treatment. Learn more about newborn screening at: https://health.mo.gov/living/families/genetics/newbornscreening/index.php.
Upcoming Health Awareness
This newsletter is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), grant # X10MC32201, as part of an award totaling $3,906,090.00
with 0% percentage financed with nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.
August National Breastfeeding Month; World Breastfeeding Week (August 1-7, 2019)
In a world filled with inequality, crises, and poverty, breastfeeding is the foundation of lifelong good health for babies and mothers. World Alliance for Breastfeeding (WABA) is a global network of individuals and organizations concerned with the protection, promotion, and support of breastfeeding worldwide. Stay connected for more updates at: http://worldbreastfeedingweek.org and https://health.mo.gov/living/families/wic/breastfeeding/
The Missouri Home Visiting Weekly Updates can be found on the Missouri Home Visiting Gateway accessible to DHSS contracted LIA staff using the secure user-id and password at:
“How you are is as important as what you do.” - Jeree Pawl
On June 5 and 6, 2019, ten of the eleven Department of Health and Senior Services (DHSS) supported home visiting agency supervisors came together at the Holiday Inn Executive Center in Columbia, MO for the 2019 DHSS Home Visiting Program’s Leadership Academy. The eleventh supervisor was able to join key sessions via webinar. This was the first in what is hoped to become an annual activity to provide professional development opportunities to the program’s contracted supervisors to gain skills and insight in supporting home visitors as they work to improve family outcomes. The agenda for June 5, 2019, opened with a variety of interactive leadership activities lead by DHSS home visiting staff that illuminated the importance of leaders to be aware of the different ways individuals may perceive the same things, as well as getting everyone out of their chairs! A live webinar was then presented by the dynamic Dr. Nefertiti B. Poyner, Early Childhood Specialist, Devereux Center for Resilient Children National Trainer, on “Building Your Bounce Professional Development Learning Series - Train the Trainer Session.” The afternoon wrapped up with another live webinar presented by Julie Leis, Technical Assistance Specialist for MIECHV Region VII, HV-PM/CQI, Senior Research Associate, James Bell Associates, on “Continuous Quality Improvement (CQI) Rapid Tests of Change,” that engaged everyone in conducting rapid tests of change using a variety of change...namely pennies, nickels, dimes, and quarters.
The morning of June 6, 2019, supervisors attended a “Self-Care Workshop” presented by Jessica Mostaffa, LPC, IMH-E® III, Clinical Program Manager of The Family Conservancy. Supervisors then joined home visiting staff for a team challenge course conducted by the University of Missouri Venture Out Program and was held on campus at the University Recreation Center. The team challenge course consisted of a series of challenges that focused on trust, effective communication, conflict resolution, and FUN!
