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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