Indiana Public Health System Indiana Public Health System Quality Improvement ProgramQuality Improvement Program

(PHSQIP)(PHSQIP)

Indiana Public Health System Quality Indiana Public Health System Quality Improvement ProgramImprovement Program

(PHSQIP)(PHSQIP)Multi-State Learning Collaborative – 3Multi-State Learning Collaborative – 3

Minneapolis - August 2008Minneapolis - August 2008

Kathy Weaver, RN, MPA, JDKathy Weaver, RN, MPA, JDManager, QI and AccreditationManager, QI and AccreditationIndiana State Dept of HealthIndiana State Dept of Health

&&Deb Koester, RN, MSN, DNP (c)Deb Koester, RN, MSN, DNP (c)

Public Health Projects Manager Public Health Projects Manager Purdue University, HealthcareTAPPurdue University, HealthcareTAP

The Road to Accreditation and The Road to Accreditation and Quality ImprovementQuality Improvement

The Road to Accreditation and QIThe Road to Accreditation and QI

Communicating for ChangeCommunicating for Change

Accomplishments to Date:Accomplishments to Date: Local NPHPS assessment V 2.0 in 20 pilot counties Local NPHPS assessment V 2.0 in 20 pilot counties

– started May 2007– started May 2007 RCA training ; project charters RCA training ; project charters State NPHPSP assessment August 2007State NPHPSP assessment August 2007 10 state-level teams 10 state-level teams ASTHO grant ASTHO grant QI Advisory team – included external partnersQI Advisory team – included external partners Pilot counties met – May 2008Pilot counties met – May 2008 Essential Services Lunch and Learns – began 2008Essential Services Lunch and Learns – began 2008 ES Advisory CommitteeES Advisory Committee

Preparing local health departments for Preparing local health departments for national voluntary accreditationnational voluntary accreditation

IN-PHQI Participating CountiesIN-PHQI Participating Counties Pilot Counties

Planning to Complete

Local : First steps to accreditation and QILocal : First steps to accreditation and QI

Local public health system partners have dedicated nearly Local public health system partners have dedicated nearly 60 days to completion of the assessments. 60 days to completion of the assessments.

Nearly 500 healthcare organizations have participated in Nearly 500 healthcare organizations have participated in the assessment process.the assessment process.

Over 300 hours of training have been delivered across the Over 300 hours of training have been delivered across the state. state.

Sixteen counties are now implementing performance Sixteen counties are now implementing performance improvement projects across Indiana. improvement projects across Indiana.

Average Local Composite Score Average Local Composite Score by Essential Serviceby Essential Service

Pilot Counties and ISDH TeamsPilot Counties and ISDH TeamsCounty Health Issue

Access to Care Childhood Obesity Community Health Assessment Coordination of Local Public Health

System Services Public Health Workforce Education School Absenteeism / Hand washing School-Based Healthcare Teen Pregnancy/STDs Undetermined Workforce Wellness

ISDH Teams

Team A - ObesityTeam B - EnvironmentTeam C - TobaccoTeam D - RegulatoryTeam E - Leadership DevelopmentTeam F - ImmunizationTeam G - Oral HealthTeam H - PreparednessTeam I - HRTeam J - Public Health Workforce Education

Allen County Healthcare Access ProjectAllen County Healthcare Access Project

Carroll County Health Choices CoalitionCarroll County Health Choices Coalition

Delaware County Health Living Take Action CoalitionDelaware County Health Living Take Action Coalition

Dubois County Public Health PartnershipDubois County Public Health Partnership

Howard County School Health CoalitionHoward County School Health Coalition

LaGrange County ♀Smart Teen Decisions♂ ProgramLaGrange County ♀Smart Teen Decisions♂ Program

Monroe County Health Assessment InitiativeMonroe County Health Assessment Initiative

Montgomery County Health Services PartnershipMontgomery County Health Services Partnership

Vanderburgh County Public Health is Our Health Too!Vanderburgh County Public Health is Our Health Too!

Preparing the State health department Preparing the State health department for national voluntary accreditation for national voluntary accreditation

State Assessment Composite State Assessment Composite Performance Scores for Each Essential Performance Scores for Each Essential

Service and OverallService and Overall

Local HealthDepartment

Fire Department

Pharmacy

County Schools

Healthy Communities

Drug Treatment Centers

Henry County Council

Henry County Commissioners

ICAP/WIC/ACH/Headstart

YMCA

4-H Coop

Landlord Association (Henry County)

Realtors

Red Cross

BanksImproving Kids Enviroment

Manufacturers

Churches

City of New Castle

Parish Nurses

IDEMCourts

Delaware County Health Dept

Madison CountyHealth Dept

CDCHCMH

USDAFDA

Mental Health

Knightstown Clinic

First Steps

Open Door

Safe Kids

Childcare Resource & Referral

Funeral Homes

Tribal Health

Shelters

EPA

Senior Citizen Outreach

Jail/Prison

Food Banks

Healthy Family Connections

Healthy Families

Mother Child Center

Licensed Daycares

OSHA & IDSHA

ISDH United Fund

Ind. Dept of Environmental

Mgmt.

Department of Natural Resources

PU Extension

Child and Adult Protective Services

Newspapers

City of Middletown

City of Knightstown

New Castle Community

Schools

School Nurses

New Castle Animal Shelter/

Humane SocietyIVCA

EMS

EMA

Assisted Living

SWCD

Citizens Nursing Homes

WICLabs

NEHA AFDOLibrary Physicans

IPHA IEHA

Civic Orginizations

Rural Health Clinics

IOWPA

DNR

CPSBSU

IU School of Law

PoliceCounty

Government

SHRWD-South Henry

Reg Waste Dist.

Mini-CollaborativesMini-Collaboratives

2 State-level collaboratives – overall 2 State-level collaboratives – overall theme being theme being Communicating for Communicating for ChangeChange

At least 2 local-level collaborativesAt least 2 local-level collaboratives

Local mini-collaborativesLocal mini-collaboratives

Planning on at least 2Planning on at least 2 3-4 LHDs per collaborative3-4 LHDs per collaborative They will select target based on their They will select target based on their

assessment resultsassessment results Length of time – not determined; Length of time – not determined;

based on QI achievementbased on QI achievement Each will receive funding to support Each will receive funding to support

effortsefforts

ISDH Priority Initiatives for 2008ISDH Priority Initiatives for 2008

Priority DomainsPriority Domains Tobacco Use – as a back-upTobacco Use – as a back-up Obesity PreventionObesity Prevention Immunizations Immunizations Safety NetSafety Net Health Literacy/Health Literacy/EducationEducation PreparednessPreparedness E-healthE-health Systems Systems

State Assessment Composite State Assessment Composite Performance Scores for Each Essential Performance Scores for Each Essential

Service and OverallService and Overall

Indiana is at 46 PH workers per Indiana is at 46 PH workers per 100,000 population100,000 population

Indiana Target Area: Public Health Indiana Target Area: Public Health Workforce DevelopmentWorkforce Development

Essential Service # 8 assessmentEssential Service # 8 assessment

0

2

4

6

8

10

12

14

16

18

20

22

Yes No

Do you have a written workforce education plan for Do you have a written workforce education plan for all the staff in the department?all the staff in the department?

Essential Service # 8 questionEssential Service # 8 question

0

2

4

6

8

10

12

14

16

18

20

22

Yes No

Does your department assist LHDs or local Does your department assist LHDs or local public/community health services to develop performance public/community health services to develop performance improvement strategies of their workforce?improvement strategies of their workforce?

Essential Service # 8Essential Service # 8

ISDH Essential Service #8Overall

46%

54% Compliant

Not Met

This pie chart indicates the compliance of the This pie chart indicates the compliance of the responding departments to all 4 model standards. responding departments to all 4 model standards.

Communicating for ChangeCommunicating for Change

Communicating for Change on Communicating for Change on Workforce DevelopmentWorkforce Development

Objective: Develop a PH Workforce Objective: Develop a PH Workforce Education State PlanEducation State Plan

Communicating for ChangeCommunicating for Change

Adult ImmunizationAdult Immunization Most cost-effective prevention measureMost cost-effective prevention measure Adult vaccinationsAdult vaccinations Flu vaccine issues 2007-2008Flu vaccine issues 2007-2008 Zostervax for adultsZostervax for adults

State Fair

Communicating for ChangeCommunicating for Change

Tobacco useTobacco use Progress in awarenessProgress in awareness Limiting second-hand smoke exposureLimiting second-hand smoke exposure Tobacco tax increasesTobacco tax increases Medical advancesMedical advances Immigrant smoking habitsImmigrant smoking habits Tobacco use still too highTobacco use still too high

Tobacco Free School Map Tobacco Free School Map 2001 20082001 2008

% Hoosiers Protected by % Hoosiers Protected by EffectiveEffective Local Smokefree Local Smokefree

Workplace LawsWorkplace Laws2003

1.1%

2008

29.8%

House Enrolled Act (HEA) 1678House Enrolled Act (HEA) 1678

Effective July 2007Effective July 2007 Increased cigarette taxIncreased cigarette tax All of the revenue went to healthAll of the revenue went to health

HEA 1678HEA 1678

Created a tax credit for companies Created a tax credit for companies that had not been offering a health that had not been offering a health care benefit if the company started care benefit if the company started offering a qualifying benefit and offering a qualifying benefit and maintained it for at least two years. maintained it for at least two years. The tax credit is the lesser of $2,500 The tax credit is the lesser of $2,500 or $50 per employee.or $50 per employee.

HEA 1678HEA 1678

Appropriates an additional Appropriates an additional $1,200,000 for tobacco control$1,200,000 for tobacco control

Appropriates $11,000,000 to the Appropriates $11,000,000 to the ISDH for childhood immunizations.ISDH for childhood immunizations.

Working toward AccreditationWorking toward Accreditation

Execution Trumps StrategyExecution Trumps Strategy

““We are all faced with a series of great We are all faced with a series of great opportunities brilliantly disguised as opportunities brilliantly disguised as impossible situations.”impossible situations.”

Charles R. SwindollCharles R. Swindoll

Working toward AccreditationWorking toward Accreditation

Learn from the mistakes of others. You Learn from the mistakes of others. You can’tcan’t

live long enough to make them all live long enough to make them all yourself.yourself.

Eleanor RooseveltEleanor Roosevelt