13
W hat a busy spring! By all accounts, the Grand Division meetings surpassed our greatest expectations for attendance, timeliness of topics and program quality. Thanks to Marianne Sharp, VP East TN; Crystal Manners, VP Middle TN; and Judy Martin, VP West TN along with a host of committee members for their hard work to make these opportunities available to us. Not to be outdone, Co-Chairs Megan Quinn and Christian Willams and the Program Committee have been hard at work to create an equally exceptional array of continuing education offerings for this year’s Fall Conference. With a theme like Managing Change: Opportunities for Public Health Impact, there is sure to be something for everyone. And speaking of themes, Joseph Goss and the Fun and Fitness Committee are lining up some magical fun with a Game of Thrones theme. I hear that dragons are involved! And the TPHA Board has been busy too. In our spring and summer meetings, we talked at length about Board responsibilities and organizational sustainability and growth strategies. We reviewed changing membership trends and celebrated our ever increasing student membership numbers. We brainstormed about succession planning, secured the services of Leslie Humphreys and Rick Long to review current TPHA structure, constitution and by-laws and to make recommendations for sustained growth. And finally, our 501c3 application is moving forward thanks to TPHA Executive Director, Kim Harrell. Amidst all this work, we paused to celebrate Public Health Week with a flurry of health promotion activities and were reminded that it’s time to honor the public health champions among us. Jennifer Valentine and the Awards Committee are looking for your nominations. Download details and the nomination forms for TPHA’s annual awards here. I hope you are already making plans to join us at Fall Conference. Opportunities to network with both old and new colleagues and to get the most up-to-date information about best practices promise to be exceptional this year – and maybe there will be dragons. But in the meantime, our work goes on, and I hope your summer is filled with extra time for relaxing fun with family and friends. Warmest regards, Cathy President’s Message from Cathy Taylor V OLUME OLUME 22, N 22, N O 2 S UMMER UMMER E DITION DITION Quarterly Quarterly Quarterly Kim Harrell Executive Director 615-426-1667 [email protected] Savannah Morrow Editor-in-Chief Public Relations Committee Chair [email protected] Maternal Mortality Key Findings 3 South Central Baby Showers 4 Knox partners with local hospital 5 Reducing Prenatal Smoking 6 CSS goes above and beyond 7 Northeast uses data mapping tool 8 Summer Institute at University of Memphis 11 INSIDE THIS ISSUE:

Quarterly · [email protected]. QUARTERLY PAGE3 the AR MO TN Nurses on Boards Training Intensive that was held October 1-2 in Branson, MO with attendees from each state. The

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Page 1: Quarterly · Bethany.Scalise@tn.gov. QUARTERLY PAGE3 the AR MO TN Nurses on Boards Training Intensive that was held October 1-2 in Branson, MO with attendees from each state. The

W hat a busy spring! By all accounts, the Grand Division meetings

surpassed our greatest expectations for attendance, timeliness of topics and program quality. Thanks to Marianne Sharp, VP East TN; Crystal Manners, VP Middle TN; and Judy Martin, VP West TN along with a host of committee members for their hard work to make these opportunities available to us.

Not to be outdone, Co-Chairs Megan Quinn and Christian Willams and the Program Committee have been hard at work to create an equally exceptional array of continuing education offerings for this year’s Fall Conference. With a theme like Managing Change: Opportunities for Public Health Impact, there is sure to be something for everyone. And speaking of themes, Joseph Goss and the Fun and Fitness Committee are lining up some magical fun with a Game of Thrones theme. I hear that dragons are involved!

And the TPHA Board has been busy too. In our spring and summer meetings, we talked at length about Board responsibilities and organizational sustainability and growth strategies. We reviewed changing membership trends and celebrated our ever increasing student membership numbers. We brainstormed about succession planning, secured the services of Leslie Humphreys and Rick Long to review current TPHA structure, constitution and by-laws and to make recommendations for sustained growth. And finally,

our 501c3 application is moving forward thanks to TPHA Executive Director, Kim Harrell.

Amidst all this work, we paused to celebrate Public Health Week with a flurry of health promotion activities and were reminded that it’s time to honor the public health champions among us. Jennifer Valentine and the Awards Committee are looking for your nominations. Download details and the nomination forms for TPHA’s annual awards here.

I hope you are already making plans to join us at Fall Conference. Opportunities to network with both old and new colleagues and to get the most up-to-date information about best practices promise to be exceptional this year – and maybe there will be dragons. But in the meantime, our work goes on, and I hope your summer is filled with extra time for relaxing fun with family and friends.

Warmest regards,

Cathy

President’s Message from Cathy Taylor

VV OLUMEOLUME 22, N22, N OO 22

SS UMMERUMMER EE DITIONDITION QuarterlyQuarterlyQuarterly

Kim Harrell Executive Director

615-426-1667 [email protected]

Savannah Morrow Editor-in-Chief

Public Relations Committee Chair [email protected]

Maternal Mortality Key

Findings 3

South Central Baby

Showers 4

Knox partners with local

hospital 5

Reducing Prenatal

Smoking 6

CSS goes above and

beyond 7

Northeast uses data

mapping tool 8

Summer Institute at

University of Memphis 11

INSIDE THIS ISSUE:

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Future of Nursing, Campaign for Action: Tennessee Action Coalition

A t more than three million strong, nurses are the largest part of the health care workforce and have a

powerful capacity to help people become and stay healthy.

In 2008, the Robert Wood Johnson Foundation (RWJF) worked in partnership with the Institute of Medicine (IOM), now the National Academy of Medicine, to convene an independent study of nursing’s role in transforming health care. Two years later, the IOM produced The Future of Nursing: Leading Change, Advancing Health, and a follow up report in 2015. These reports identify the nursing profession as central to efforts to improve the health care system, health care access, and population health. The reports offered recommendations to strengthen nursing to improve Americans’ health and health care. Shortly after the report was published, AARP and RWJF joined forces to ensure the IOM report recommendations would be carried out. They created the Future of Nursing: Campaign for Action to support state and national work. The Campaign includes Action Coalitions in every state and Washington, DC working on seven major, interrelated issues that together contribute to a healthier America through nursing. These include:

Improving access to care

Fostering interprofessional collaboration

Promoting nursing leadership

Transforming nursing education

Increasing diversity in nursing

Collecting workforce data

Building healthier communities

Each state Action Coalition is different. For example, some are part of state nursing workforce centers and some are independent non-profits. Some work on all seven Campaign key issues, and others focus on one or two. State Action Coalitions are at various stages of development and productivity. Some are robust with large, diverse memberships of nurses, business leaders, policymakers, and other groups and people interested in improving health and well-being in their communities, and others have had slower starts or periods of inactivity.

The TN Action Coalition (TAC) was inactive for a couple of years following several years of grant support and successful initiatives, including a webinar series and a 40

-Under40 Nurse Leaders event. TAC has recently been “re-booted” by previous and new members, both nurses and other health champions, who recognize nurses as familiar and trusted stewards of good health in Tennessee. The current activities build on previous work, focus on building a Culture of Health in Tennessee and are related to the 7 major Campaign issues. These include: Leadership development and integration of population health concepts into nursing education.

To that end, one of TAC’s key areas of work is our Tri-State Nurses on Boards (NOB) initiative with Arkansas and Missouri Action Coalitions. This builds on earlier NOB work in Arkansas and Missouri and one of the key recommendations in the Future of Nursing reports, which is to increase the number of nurse leaders in pivotal decision-making roles on boards and other bodies that work to improve the health of everyone in America.

The Nurses on Boards Coalition operationally defines boards as those that have strategic influence to improve the health of communities and the nation. They include any corporate, governmental, non-profit, advisory or governance boards or appointments that have fiduciary and/or strategic responsibilities. The Tri-State initiative is leading the way in the nation in training and encouraging nurses to seek out and serve on boards that focus on upstream approaches and help to build a Culture of Health. These can be as diverse as school wellness teams, housing and transportation authorities, economic and rural development committees and breastfeeding coalitions. Nurses are encouraged to find their passion and trained to go through a step-wise process in seeking and serving on a board that will make a difference in their communities. Nurse leaders and educators from each state developed

Submitted by Patti Scott

V OLUME 22 , NO 2 P AGE 2

Continued on Page 3, see Coalition

Tennessee attendees at the October 2019 Tri-State Nurses on Boards Training Intensive

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T he Tennessee Department of Health issued the first Maternal Mortality Review (MMR) report, Tennessee Maternal Mortality Review of 2017

Maternal Deaths. This report describes the state of maternal mortality in Tennessee based on a comprehensive review of deaths, by a multi-disciplinary committee, of women who died while pregnant or within one year of pregnancy. The goal of the Tennessee (MMR) Committee is to identify opportunities for preventing maternal deaths and promoting women’s health.

The committee reviewed 78 deaths of women who were either pregnant within one year of death or pregnant at time of death. Of these 78 deaths, 22 of them were related to pregnancy, 49 of the deaths were pregnancy associated, but not related and seven could not be determined whether they were pregnancy-related. The MMR committee determined 85 percent of all maternal deaths reviewed to be preventable.

A death is considered preventable if there was at least some chance of the death being averted by one or more reasonable changes to patient, community, provider, facility and/or systems factors. The MMR Committee made recommendations for prevention for

those deaths considered to be preventable. Recommendations include multi-disciplinary teams and coordination of care for women; increased knowledge and awareness of best practice protocols and standards of care; ongoing education on topics such as domestic violence, hemorrhage and clotting disorders; expanding resources for substance use and mental health disorders; and increasing public awareness and understanding of risk factors for patients and providers.

TDH developed a maternity collaborative to assist with implementing these recommendations. The maternity collaborative has three main goals; 1) develop action steps to make progress on the recommendations made by the MMR committee; 2) share information on existing resources and best practice programs available for maternal health and 3) promote the recommendations within the community.

Additional information about the review committee and the MMR report can be accessed at: https://www.tn.gov/health/health-program-areas/fhw/maternal-mortality-review.html. If you are interested in participating in maternal mortality prevention efforts, or want to learn how to apply for the MMR committee please email [email protected].

QUARTERLY P AGE 3

the AR MO TN Nurses on Boards Training Intensive that was held October 1-2 in Branson, MO with attendees from each state. The aim of the training was to strengthen leadership skills in addressing social determinants of health and building a Culture of Health through board service. Topics with interactive activities included: Culture of Health, board service nuts and bolts, leadership assessment and skill building, and mentorship. Nurse leaders from each state served as faculty, including TAC co-leaders Drs. Alisa Haushalter and Patti Scott.

We are currently carrying out a 6 month individual follow up with each participant to learn about their board service and application of knowledge gained. A few examples of responses to date:

“I wanted to establish presence on a board I currently serve on. Before the training, I would bite my tongue. Now I have more confidence to speak up. I took away from the training the importance of nurses’ voice.”

“I found a mentor in a colleague who serves on the same board. She’s a lawyer and I admired her for being savvy. We work together on the board to have a united and stronger voice.”

“StrengthsFinder helped me to understand strengths of my colleagues. It’s so interesting to learn their skill sets and how the combination of skills helps us to get things done!”

“The StrengthsFinder assessment and group work enlightened me about myself and others. Now I want to do the assessments cross the board at work so I can place people where they can shine and thrive.”

We continue to work to improve the NOB training and make it accessible for more TN nurses. We are planning an updated Tri-State training intensive for mid-late fall, 2019 in Memphis. Learn more about Nurses on Boards, and TN nurses please register your board service and help meet the national goal of 10,000 nurses on boards by 2020!

The Tennessee Action Coalition welcomes nurses and champions for health, both individuals and organizations, to join us.

Get in touch for more information!

Continued from Page 2; Coalition

Maternal Mortality in Tennessee: Key Findings and Prevention Efforts Submitted by Bethany Scalise, BSN,RN; Maternal Mortality Nurse Coordinator

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V OLUME 22 , NO 2 P AGE 4

S everal counties in the South Central Region have hosted Community Baby Showers during the months of April-May focusing on expecting

mothers and families with children up to age 2. Participants were able to register to win door prizes, hear educational sessions as well as receive information and resources from various community agencies/business.

Lewis County Health Department partnered with the Health Council as well as other local agencies (i.e., Imagination Library, Centerstone Early Childhood Services, Davis House, HeadStart, etc.) to host their annual community baby shower for pregnant moms and families with young children. Thirty community members were in attendance. Participants were entered to win baby-friendly prizes as well as receive information on the Baby and Me Tobacco Free Program and other community resources.

Lincoln County Health Department partnered with the Chamber of Commerce and Child Care Resource and Referral to host their annual community baby shower. There were 36 pregnant women who participated in the event.

Perry County Health Department partnered with sixteen other local and surrounding county vendors to host their 2nd annual community baby shower. Brunch and door prizes were provided by the Health Department. Participants received information on various resources as well as learning more about the Baby and Me Tobacco Free program. It was a huge success with over 120 in attendance.

There are at least three more upcoming baby showers that will be held in our other South Central Counties during the spring/summer months.

South Central Busy with Community Baby Showers

Perry County Community Baby Shower

Submitted by Lindsey Wayland, Region Public Health Program Director

Lincoln County Nutrition Educator Haley Richardson and

Community Partner Shawnte Fulton

Lewis County Nutrition Educator Jessica Hollingsworth

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QUARTERLY P AGE 5

P artnerships between healthcare institutions and a health department present a viable

solution to improve continuity of care and quality breastfeeding support. The Centers for Disease Control and Prevention reports one in three mothers stop breastfeeding earlier than expected due to lack of hospital support. The hospital plays a crucial role in initiation and duration of breastfeeding, making it a fundamental setting for improving breastfeeding care. With less than a quarter of Tennessee women meeting the American Academy of Pediatrics recommendation to give infants breastmilk exclusively for the first six months of life, interventions to improve breastfeeding rates are warranted.

In June 2016, the Knox County Health Department (KCHD) was awarded the Project Diabetes Grant from the Tennessee Department of Health. One of the grant objectives was to partner with a local hospital to consistently perform at least seven of the Ten Steps to Successful Breastfeeding, the gold standard guideline for breastfeeding care from the Baby Friendly Hospital Initiative. KCHD collaborated with the University of Tennessee Medical Center (UTMC) to promote quality care that supports breastfeeding. A framework was developed to communicate the hospital breastfeeding policy, train staff on breastfeeding skills, encourage consistent messaging between providers and refer mothers to essential breastfeeding community resources.

KCHD and UTMC collaborated to plan the Supporting Successful Breastfeeding Series, providing evidence-based information to a variety of healthcare providers. The five-part series featured well-known physicians, lactation consultants, speech pathologists, nurse practitioners and other experts from the Knoxville area. Strategies were shared for supporting breastfeeding from pregnancy to after discharge. The series aimed to train staff on basic breastfeeding concepts and demonstrate best breastfeeding practices. The educational series proved to be well-attended, with over 400 total attendees.

Furthermore, KCHD and UTMC staff coordinated a multi-level intervention plan to educate specific staff

members. Staff from labor and delivery, mother/baby and the Neonatal Intensive Care Unit participated in “breastfeeding boot camps” to improve breastfeeding initiation and duration on their designated floor. The boot camp trainings were led by International Board Certified Lactation Consultants and focused on steps from the Ten Steps to Successful Breastfeeding that correlate with their duties. Likewise, a breastfeeding-specific grand rounds for physicians was developed to improve provider confidence in assisting breastfeeding mother-baby dyads and applying the breastfeeding policy in daily practice. KCHD’s 4th edition Community Breastfeeding Resource Guide was used as a training tool and resource.

KCHD staff modified the Baby-Friendly Guidelines and Evaluation Criteria to create a survey tool for UTMC staff to measure consistent breastfeeding practices. Medical staff completed the survey at baseline in 2016 and again in 2019 after receiving training. The initial survey was used to tailor education and environment change specific to areas in need of improvement. The final survey confirms UTMC is consistently performing eight of the Ten Steps to Successful Breastfeeding, exceeding expectations. KCHD and UTMC staff anticipate continued collaboration and to serve as an example of a successful partnership between a healthcare institution and local health department.

Knox County Health Department partners with local hospital to

advance breastfeeding support

From left to right: Cheryl Hill, Program Manager, Knox County Health Department;

Paige Huggler, Director, Regional Perinatal Program; Chelsea Johnson, Nutritionist,

Knox County Health Department; and Peggy Iachetta, Coordinator, Regional

Perinatal Program during the Supporting Successful Breastfeeding Seminar Series on

May 20, 2019, at the University of Tennessee Medical Center, Knoxville.

Submitted by Chelsea Johnson, MS, RDN, LDN, CLS; Nutritionist, Knox County Health Department

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V OLUME 22 , NO 2 P AGE 6

D id you know that smoking during pregnancy is still a common occurrence in Tennessee? In Tennessee, an average 14.3% (2014-2016

aggregate, TN Birth Statistical System) of women smoke during pregnancy, and that number ranges as high as 37.6% of women in some rural counties compared to 7.8% nationally. Smoking during pregnancy can cause preterm birth and low birth weight, and babies whose mothers smoke are about three times more likely to die from sudden infant death syndrome (SIDS).

To combat the harmful effects of prenatal smoking and other tobacco use, the Tennessee Department of Health administers the Baby & Me Tobacco Free Program™ (BMTFP), an evidence-based tobacco cessation program created to help women quit using tobacco and stay quit, resulting in improved birth outcomes and long-term positive outcomes for women and their families.

The program works by having medical providers and other community programs refer eligible pregnant women to their local health department. The local health department facilitates four prenatal and 12 monthly postnatal sessions incorporating education, support, carbon monoxide monitoring, and incentives to encourage cessation. In exchange for testing tobacco free, the mother receives monthly vouchers worth $25 that may be redeemed at Walmart for diapers or baby wipes. To improve outcomes further, a tobacco user who lives with the pregnant woman can also enroll, and, if they successfully quit, they earn additional monthly diaper vouchers for the mother. The Baby & Me Tobacco Free Program™ is currently operating through health departments in all 95 counties.

In May, 2019, Lentz Metro Health Department in Nashville celebrated Demetria B. who fully completed the Baby & Me Tobacco Free Program™ and had been smoke free for 69 weeks! Her quit date was in January 2018, and her baby’s first birthday was in May 2019. The diaper vouchers were a great incentive, and Demetria stayed strong by using the Tennessee Tobacco QuitLine early on and making sure her environments were smoke free.

In just the two years since its statewide rollout, the Baby & Me Tobacco Free Program™ has enrolled nearly 9,000 pregnant women who smoke. In 2017 alone, 96 low birth

weight deliveries were prevented among women enrolled in the program, resulting in an estimated $3.2M in healthcare cost savings to Tennessee. Increasing referral sources into the Baby & Me Tobacco Free Program™ will be a primary focus over the next year.

For more information about the Baby & Me Tobacco Free Program™, visit www.babyandmetobaccofree.org. For healthcare providers who want to learn more about making referrals to the program, contact Audrey Tooley [email protected] or your local health department.

Reducing Prenatal Smoking: The Baby and Me Tobacco Free Program

In May, Metro Nashville Health Department celebrated Demetria

B. who fully completed the Baby & Me Tobacco Free Program™

and had been smoke free for 69 weeks!

Submitted by Corrie Groesbeck, MPH, CHES; Tobacco Cessation Program Director

L ast month, the city of Huntland in Franklin County was awarded nearly $1 million dollars by the Blue Cross Blue Shield Foundation. Regional Healthy

Development Coordinator for the Southeast Region, Beth Blevins, wrote the grant application to improve outdoor space in Huntland. Most of the funding will go

towards construction of a new basketball court, outdoor exercise equipment, and other fun features. Also, a portion of the money will be set aside for on-going maintenance for the new features so that the citizens of Huntland can enjoy this wonderful outdoor space for years to come!

Submitted by Amanda Goodhard, A&P Coordinator, Southeast

City of Huntland Awarded Blue Cross Blue Shield Foundation Grant

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QUARTERLY P AGE 7

O ur Upper Cumberland CSS staff has a history of going above and beyond to help their families. CSS Social

Counselor Candace Vaden has recently taken monumental efforts to assist the family of a four-year old child. The child has an extensive medical history and requires a wheelchair for mobility. His family was unprepared for the space he would need for his medical equipment.

Vaden began discussing potential resource opportunities to assist with funding an additional room and bathroom with a roll-in shower. She helped the family apply to various foundations for assistance and they were awarded a total of $8,500.

Ultimately, through collaboration with multiple agencies and community volunteers, Vaden insured the child and family could stay in their home. Businesses came together to donate building supplies including cinder blocks for foundation, a heating and air conditioning unit and other items. All work was completed by licensed individuals in either plumbing, electrical, and painting.

Final touches to the room will be completed in June 2019 by the “Make a Wish” foundation. They are providing multiple therapeutic toys for him to enjoy. The room will be decorated in a superhero theme quite fitting for one super boy!

CSS Social Counselor

Goes Above and Beyond

for Fentress County

Family

Submitted by Amanda Randolph, MPS,

A&P Coordinator, Upper Cumberland

Please send comments, corrections, submissions, and

queries to [email protected]

Approximately 321 fifth graders participated in the “Wipe Out Tobacco 2019” Health Fair held at Jacksboro Middle School on May

9. The event was sponsored by the Campbell County Health Council and made possible by TN Tobacco Settlement funds.

Campbell County Kids Wipe Out Tobacco

R ecent opportunities have enabled Roane County to renew its emphasis on developing a healthy built environment and leveraging the numerous natural assets for improved health

and economic development. The county and its municipal governments have received numerous grant awards for parks, trails, and greenspace development, and interdepartmental cooperation has been a key component to these recent successes. In addition to active development of the funded projects, the county is working collaboratively with the municipal Parks and Recreation departments and the Health Department to develop a Master Plan for its parks systems. The Access to Health through Healthy Active Built Environment grants available through the Tennessee Department of Health have funded efforts as well.

Additionally, Roane County’s magnificent natural resources provided it a unique advantage when given the opportunity to participate as a pilot community for the Tennessee RiverLine 652 project. The county has 56,000 acres of recreation that include 16,000 acres of public parks and wildlife areas surrounded by 39,000 acres of water set against the backdrop of the Great Smoky Mountains National Park, according to The Roane Alliance, an economic development organization. Watts Bar Lake has more than 700 miles of shoreline. The RiverLine 652 project’s vision is for a continuous system of hiking, biking, and on-water experiences along the 652-mile reach of the Tennessee River from Knoxville, TN to Paducah, KY and will involve multi-modal trail use. Approximately 40 miles of the Tennessee River runs through Roane County. Roane County is one of 5 communities selected for this pilot project (along with Benton County, TN, 2 in Alabama, and 1 in Kentucky). A series of community workshops and community engagement events are taking place this summer to gather feedback, assess community needs and priorities, and identify ideas and opportunities to enhance recreation opportunities and river access.

Roane County Revival Submitted by Laura Conner, Roane County Health Department

Director

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D uring the October 2018 Tennessee Department of Health’s Annual Leadership

Conference, Melissa Stratman, CEO of Coleman Associates, spent a full day outlining how government-run public health departments providing primary care services can become patient-centered medical homes. Ms. Stratman spoke of ideal patient visits, clinic redesign, patient offices, jockeying the schedule and daily huddles. The leadership team from the Northeast Public Health Region was inspired! We know we can carry out the TDH mission to protect, promote and improve the health and prosperity of people in Tennessee if we can create a patient-centered experience within our health departments.

In January 2019 the region welcomed a new team of Public Health interns. One intern acted as the lead for baseline data collection and trained five additional interns to assist with the two-step process of tracking patients throughout their health department visit and translating the tracking notes to a visual map of each patient’s visit.

Data collection teams, armed with Coleman Associates Patient Tracking Toolkit, visited each of the four primary care sites in the region throughout February and March. The objective was to identify “typical” primary care clinic days and spend the day tracking as many patients as

possible during the day. The recommendation from Coleman Associates is to secure data from 10 patients at each health department. Staff and patients knew they were being followed and graciously allowed students to document the time associated with each step of the visit as well as wait times and general details of patient staff interaction. Patient confidentiality was of primary importance and there is no identifying information associated with patient tracking or mapping.

Once Patient Tracking Toolkits are completed, the information gets translated to the Patient Mapping

The Coleman Project: Baseline Patient Experience Mapping

V OLUME 22 , NO 2 P AGE 8

Submitted by Jayne Harper, A&P Coordinator, Northeast

March 28, 2019 ETSU Public Health Intern Kofi Amoh-Mensah presents patient

experience maps to Greene County Health Department Primary Care Team

Continued on Page 9, see Coleman

Apply for the Bloomberg Fellowship Program

T he Bloomberg American Health Initiative seeks to improve the health of America by tackling critical 21st Century challenges to

public health. Their approach is to work and engage with Fellows and Collaborating Organizations in five focus areas: Addiction and Overdose, Environmental Challenges, Obesity and the Food System, Adolescent Health and Violence. Their Bloomberg Fellowship Program offers a fully-funded MPH degree to individuals who are on the front lines of change in their communities. They provide both a world-class education for Fellows while also engaging with their employers. Applicants must already be working with an organization and will continue working with the organization after graduation. Applications for the fellowship will be available in August, due December 1 and will be found online. Learn more online at americanhealth.jhu.edu/fellowship.

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Toolkit. This is a systematic way to visually represent a patient visit and clearly shows how long a patient spends under the health department roof (cycle time), how many times a patient physically moves from location to location, which staff members patients interact with and for how long (value added time) and the time patients spend waiting between staff interactions (non-value added time). A subset of the value added time is patient-provider time which documents the number of minutes a patient spends with the advanced practice nurse or physician during their visit. Total revenue value units (RVUs) for the visit and number of handoffs from staff member to staff member were calculated also. Pictured here is the lead Coleman Project intern explaining patient visit maps to the Greene County Health Department Primary Care Team.

When county directors reviewed initial patient maps, they wanted them completed for General Clinic patients also. General Clinic provides Women, Infant and Children (WIC) Program services, well child examinations, immunizations, brief birth control visits (such as Depo injections) and sexually transmitted disease (STD) tests. Tracking and mapping have been adapted to allow for slight differences in the visits that vary from primary care.

The team of students was able to capture baseline Primary Care and General Clinic data from four local health departments (LHDs) this spring. An intern based at the Regional Office this summer is collecting baseline General Clinic data from the other four health departments. Although regional leadership has access to data from all LHDs, comparisons should not be made

among health departments because there are different staffing patterns and physical layouts at each location.

A snapshot of the data from a minimum of 10 Primary Care patients within each LHD shows average cycle times vary from 52 to 89 minutes, average value added time ranges from 32 to 41 minutes, average non-value added time varies from 22 to 56 minutes, average patient provider times span 12 to 23 minutes and RVU averages vary from 3.3 to 4.0 per visit.

There were between 8-10 General Clinic patients tracked at each of the same LHDs. Average cycle times vary from 73 to 94 minutes, average value added time ranges from 38 to 56 minutes, average non-value added time varies from 18 to 34 minutes, average patient provider times span 23 to 33 minutes and RVU averages vary from 3.6 to 4.4 per visit.

Local health departments in the region have begun implementing some Coleman strategies to become more patient-centered. For example, teams have begun huddling in the afternoon to prepare for tomorrow’s patients, making visits more efficient. Some nurse assistants “jockey the schedule” to accommodate patients who arrive early or to fill holes created by no shows or patients who only give short notice of not being able to come, or to move patients around creatively so additional services can be provided to patients onsite. One site is beginning to use carts-on-wheels with laptops so patients can remain in one exam room while workers come to them, reducing the number of times the patient moves locations within the LHD. Future tracking and mapping data should reflect positive impacts of these strategies, as well as results from Patient Satisfaction Surveys.

Support the TPHA Scholarship Fund!

You can donate:

Gift items or

gift cards

Please let Tatum Johnson at [email protected] know by August 15 the items you wish to donate.

Gift

Card Gift

Card Gift

Card $

QUARTERLY P AGE 9

Continued from Page 8; Coleman

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V OLUME 22 , NO 2 P AGE 10

Meet the Winners of the TPHA Visionary Awards

This year’s Student Video Challenge Award went to

Samantha Walker, a public health student at the

University of Tennessee, Knoxville.

East TN Visionary Award Recipient Save the Children,

pictured L-R, Marianne Sharp (TPHA VP for East

Tennessee), Michelle Smith (Save the Children), Crystal

Chambers, (Save the Children), Mathew McConaughey

(Health Educator with Sevier County Health Department).

Middle TN

Visionary Award

Recipient Dr.

Michele Pardue,

pictured with Dr.

Lisa Piercey,

Commissioner

Tennessee

Department of

Health.

TPHA BALLOT 2019-2020

Members will be notified by email when online voting is open.

PRESIDENT-ELECT (Vote for One)

Alisa Haushalter | Catherine Sedergren

BOARD REPRESENTATIVES/EAST TENNESSEE

(Vote for Two)

Rebekah English | Ingrid Long |

Marianne Sharp | Carrie Thomas

VICE PRESIDENT/WEST TENNESSEE (Vote for One)

Matt McDaniel | Jonna Sims

VICE PRESIDENT/MIDDLE TENNESSEE (Vote for One)

Shannon Railling | Devin Toms

VICE PRESIDENT/EAST TENNESSEE (Vote for One)

Kristen Spencer | Mark Stoutenberg

West TN Visianary Award Recipient: Memphis Inner City Rugby.

From left to right are the following: Kim Harrell, ED; Anfernee

Little, Student Program Participant ; Shane Young, Partner -

Award Recipient; Tina McElravey, Nominator; Dr. Judy C.

Martin, West TN VP

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Public Health Summer Institute 2019

“Data Analytics and Population Health”

-Day: Infectious Disease Epidemiology

August 5 (Mon.) 9:00 am- 4:00 pm; Xinhua Yu, MD, PhD,

MS; Univ of Memphis Clement Hall (Room 219)

This advanced workshop focuses on disease agents that cause

disease, modes of transmission, and methods of tracing/

controlling the causes of communicable diseases within a

community. Fee: $100.

1-Day: Health Program Evaluation

August 6 (Tue.) 9:00 am- 4:00 pm; Debra Bartelli, DrPH;

Univ of Memphis Robison Hall (Room 117)

Participants will gain applied skills and practice in evaluating

community and public health programs. Fee: $100

½ Day: Effective Leadership

August 7 (Wed.) 9:00 am- noon; Mark Hendricks, MHA;

Univ of Memphis Robison Hall (Room 117)

This interactive workshop applies current theories of leadership,

strategic thinking, and organizational behavior to the process of

leading teams and building collaboration. Fee: $50

½ Day: Health Equity and Population Health

August 7 (Wed.) 1:00- 4:00 pm; Debra Bartelli, DrPH;

Univ of Memphis Robison Hall (Room 117)

This hands-on session provides hands-on experience to the

process of enhancing population health through addressing

community needs and promoting community empowerment.

Fee: $50

2-Day: “R” for Beginners

August 8-9 (Thur.-Fri.) 9:00 am- 4:00 pm; Meredith Ray,

PhD; Univ of Memphis Clement Hall (Room 219)

This introduction to R provides hands-on experience creating

coding for manipulating, analyzing, and presenting data using R.

Fee: $200

2-Day: SAS for Beginners

August 12-13 (Mon.-Tue.) 9:00 am-4:00 pm; Vikki Nolan,

DSc, MPH; Univ of Memphis Clement Hall (Room 219)

This interactive session will provide an introduction to SAS with

practice writing code, performing basic data manipulations, and

using basic SAS procedures to summarize a dataset. Fee: $200

1-Day: Intermediate/Advanced SAS

August 14 (Wed.) 9:00 am- 4:00 pm; George Relyea, MS;

Univ of Memphis Clement Hall (Room 219)

This workshop will provide experience in the use of SAS to

inform research. Fee: $100

1-Day: Data Mining

August 15 (Thur.) 9:00 am- 4:00 pm; George Relyea;

Univ of Memphis Clement Hall (Room 219)

This interactive session introduces data management, common

commands in glm, survival analysis, mixed models, graphs, and

essential programming techniques in Stata. Ideal for those who

use Stata for daily analysis. Fee: $100

1-Day: GIS for Population Health August 16 (Fri.) 9:00 am- 4:00 pm; Yong Yang, PhD; Univ of

Memphis Clement Hall (Room 219)

This interactive session will provide basic skills of spatial data

preparation, management, visualization, and analysis. It is best

suited for people working in the health field, but with no previous

experience in GIS. Fee: $100.

REGISTER HERE For information please contact Dr.

Marian Levy [email protected]

Register for the Tennessee Interprofessional Practice and Education

Consortium Annual Meeting

R egistration is now open for the Tennessee Interprofessional Practice and Education Consortium’s (TIPEC) annual meeting on August 2 at Lipscomb University, Ezell Center. Register and pay online here> TIPEC Conference 2019 now through July 15, 2019. $50 for professionals/free for students. The meeting will

include networking, problem-solving, a keynote address, and working group break-out sessions. Dr Renee Bogschutz will present “Leveraging a Statewide Consortium to Collaboratively Advance Interprofessional Practice and Education the Texas Model”. For more information about TIPEC, the keynote speaker and meeting agenda, click here> TIPEC

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Students With Their Eyes on the Prize

C ongratulations to the Southern College of Optometry Chapter of the

Student Public Health Vision Care Association on winning the APHA Vision Care Section's first ever Eye Spy Challenge. In the month of March, clubs at different optometry schools were challenged to find the most eye/eye-care related images or objects around the community. SCO SPHViCA won the Eye Spy trophy and a $200 prize! Pictured are: Dr. Gregory Wolfe (Faculty Advisor and TPHA member), Samantha Lee '21, Corey Burr '20, Savannah Caro '21, and Katie McGee '20 (SPHViCA club officers).

T he Program Committee has worked diligently to bring attendees a wide range of speakers and workshops that align with this year’s theme,

“Managing Change: Opportunities for Public Health Impact.” On behalf of the Program Committee, we are excited to share a sneak peek at this year’s plenary speakers!

Robert Childs, MPH and Donnie Varnell will discuss harm reduction and law enforcement at the morning plenary session on Thursday. Childs is currently a Technical Expert Lead at JBS International, focusing on providing technical assistance on rural overdose prevention projects. Prior to working at JBS, he served as North Carolina Harm Reduction Coalition’s (NCHRC) Executive Director. At NCHRC, Childs helped develop the largest syringe exchange network, as well as community and law enforcement based naloxone distribution programs in the US South. Childs’ work has been featured in the New York Times, the Lancet, People, the Wall Street Journal, USA Today, the Daily Beast, Kaiser Health News, Fox News, NBC News, ABC News, Human Rights Watch, Governing, MMWR, NPR & the Huffington Post.

Robert will be joined by Donnie Varnell who served as the head of the State Bureau of Investigation’s Diversion and Environmental Crimes Unit before becoming NCHRC’s law enforcement liaison to advocate for naloxone access, connections to care and treatment, and the introduction of Law Enforcement-Assisted Diversion (LEAD) programs. He is now an investigator with the Dare County Sheriff’s Office and continues to

work to support the integration of harm reduction services within law enforcement agencies.

We are pleased to welcome the 14th Commissioner of the Tennessee Department of Health, Lisa Piercey, MD, MBA, FAAP, for her inaugural address at TPHA. Dr. Piercey spent a decade in health systems operations, most recently as Executive Vice President of West Tennessee Healthcare, a public, not-for-profit health system with over 7,000 employees serving 22 counties. Dr. Piercey is board certified by the American Board of Pediatrics in both General Pediatrics and in the specialty field of Child Abuse Pediatrics. She is a Fellow of the American College of Healthcare Executives, where she served as President of the Mid-South Healthcare Executives chapter, as well as the National Chairman of the Management Series Editorial Board.

The closing plenary, “Leading in an Environment of Uncertainty” features, Kathy Pearson, PhD. Dr. Pearson is a strategist, Systems Thinking expert, and authority in decision making. She is President and Founder of ELS, a firm focused on executive development and learning across industries. An award-winning educator, Dr. Pearson works extensively with mid- to senior level executives, where she teaches on a variety of topics including Executive Decision Making, Strategic Agility, Change Managing and Execution.

In addition to the noted speakers, we have a variety of workshops planned with topics ranging from ACEs to obesity and everything in between. It promises to be a full and impactful conference and we hope to see you there!

Submitted by Megan Quinn and Christian Williams, Program Committee Chairs

2019 TPHA Annual Education Conference | Managing Change:

Opportunities for Public Health Impact

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