Using Data to Drive Daily Practice and Program Success

Gabrielle Bargerstock, MPHBusiness Development Manager

Nurse-Family Partnership National Service Office

Florida Association of Infant Mental Health/MIECHV Conference

Many Paths to Enhancing Parent Child Relationships

April 25, 2014

Presentation OverviewBrief discussion of data as a

conceptData types and usageContext: MIECHV Program &

BenchmarksData Analysis Tools and Strategies ActivitiesResources

What is Data?Facts or information used usually

to calculate, analyze, or plan something

Factual information (as measurements or statistics) used as a basis for reasoning, discussion, or calculation

Information output …that includes both useful and irrelevant or redundant information and must be processed to be meaningful.

‘Knowing where you are going is the first step in

getting there.’

What is Data?According to Russell Ackoff: the content of the human mind can be classified into five categories:1. Data: symbols2. Information: data that are processed to be

useful; provides answers to "who", "what", "where", and "when" questions

3. Knowledge: application of data and information; answers "how" questions

4. Understanding: appreciation of "why“5. Wisdom: evaluated understanding.

Challenges in Prevention

The work requires: Substantial knowledge and skill Entails many steps (ex: assessing

need, setting priorities, planning/delivering programs, monitoring, and evaluation.)

Implementation in varied settings and communities◦ Requiring tailoring

Adherence to model fidelity

Other Complicating FactorsGetting enough data vs. being a

burden

Credible numbers vs. “we know things are better”

Determining the right focus at the right time◦process vs. outcomes◦quantitative vs. qualitative

Types of DataProcess

Process evaluation looks at a program’s implementation and establishes whether quantifiable targets have been achieve and strategies implemented as planned.

Can be useful determining whether a program should be refined continued, expanded, or eliminated.

Process data includes information such as the total program participants, demographics, how many homevisits have been completed per client, etc.

Outcome Outcome evaluation

measures the change that has occurred as a result of a program.

An outcome evaluation would tell you how many program participants demonstrated changed behaviors as a result of programmatic activities i.e. initiated breastfeeding, quit using drugs or alcohol, improved test scores, returned to school or work, etc.

Types of Data:Quantitative

Data that can be accurately represented numerically.

Data that can be measured.

Mathematic measurements, frequency of events, or categorical surveys (Yes/No, or rate a response on a 1-5 scale, etc).

Length, height, area, volume, weight, speed, time, temperature, humidity, sound levels, cost, members, ages, etc

Qualitative:

Descriptions

Data can be observed but not measured.

Colors, textures, smells, tastes, appearance, beauty, etc.

Includes things like verbal interviews or surveys that ask questions that are open ended

VS

Maternal, Infant, & Early Childhood Home Visiting (MIECHV) ProgramFacilitates collaboration and partnership to

improve health and development outcomes for at-risk children through evidence-based home visiting programs.

Program Purposes:1)Strengthen and improve the programs and activities

carried out under Title V of the Social Security Act;

2)Improve coordination of services for at-risk communities; and

3)Identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities.

MIECHV includes grants to states and six jurisdictions; as well as grants to tribes and tribal organizations.

Maternal, Infant, & Early Childhood Home Visiting (MIECHV) ProgramMIECHV is an evidence-based policy initiative.

◦ Requires that the majority of grant funds (75% or more) to be spent on programs to implement evidence-based home visiting models. 

◦ Up to 25 percent may be spent on promising approaches that must be rigorously evaluated

Currently, 14 home visiting models meet the HHS criteria for evidence-based home visiting.

Florida Association of Healthy Start Coalitions oversees in Florida. Ten sites funded.

Florida’s Benchmark PlanLegislation authorizing MIECHV funding requires

that all programs collect data to evaluate program performance and outcomes across six benchmark areas for all enrolled families: ◦ Maternal and child health; ◦ Childhood injuries and abuse and neglect; ◦ School readiness; ◦ Domestic violence; ◦ Family economic self-sufficiency; and ◦ Coordination of services.

Florida’s online data collection system – Florida Home Visiting Information System (FLOHVIS)

For more information contact Virginia Holland, Data Manager (vholland@fahsc.org).

Data In Daily PracticeUsing data on a day to day basis

doesn’t have to be complicated or difficult to understand◦You do it already, many times a day

Goal: Move from informal usage of data, to conscious focus on analysis

In other words: Ongoing Quality Improvement or CQI

Types of AnalysesRoot Cause Analysis (RCA) is the

formal search for an individual or group of true causes of a problem and not just the symptoms. ◦ more than just one root cause to a problem

often exists and they can interact with each other.

RCA can capture both the big-picture perspective and the details. It can also be pointed at any problem, both simple and complex.

Simplest technique: Ask ‘Why’ five times…

Types of AnalysesThe Plan-Do-Study-Act (PDSA) cycle is a simple yet powerful tool for accelerating quality improvement. The PDSA cycle is shorthand for testing a change—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method, used for action-oriented learning.

The steps in the PDSA cycle are: Step 1: Plan--Plan the test or observation, including a data

collection plan Step 2: Do -- Try out the test on a small scale Step 3: Study--Set aside time to analyze data and study

the results Step 4: Act--Refine the change, based on what was

learned from the test

Exercise

Real Life Example:Home visiting staff weren’t entering

data into the program and state’s reporting systems in a timely fashion, resulting in negative actions by the state oversight agency and payment penalties.◦Core Reason Why:

Staff didn’t adequately understand or have comfort with operating the computers and subsequently the database system.

◦Response: Training AND modification of hiring practices

Organizational Example - NFP

Continuous Improvement

Quality Framework

Quality Improvement Process

ProblemIdentification

Determine Interventions

ImplementMeasure, Analyze & Evaluate

Activities to Consider Have a two hour meeting to

review current work (no more, no less)

◦Identify all key areas ◦Reflect on data, resources, and results ◦Chose 1 or 2 initiatives to stop and/or

start ◦Set ‘by when’◦Identify three points in time where

you can report out on your efforts Ex: Team Meeting, Staff event, Board

Presentation, Community Meetings

Activities to ConsiderMake daily operations more

efficient, easier, rewarding…. ◦Survey employees, clients, etc. for

processes/activities that are duplicative, time-consuming, nonsensical.

◦Identify one activity (or more) you could eliminate immediately and then stop doing it.

◦For activities that are necessary are there areas for potential streamlining?

Activities to ConsiderElevator speeches and key

statistics statements◦If you don’t have them, create them

as a team or ask individual team members to each develop one then discuss

Set a ‘What by when’ goal or create a 100 day challenge

Resources/Tools

Additional Questions?