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Minnesota Public Health Collaborative for Quality Improvement
Health Improvement Planning:
Community Engagement
September, 2009
Minnesota public health system
75 local health departments11 tribal governments53 community health boardsState Community Health Services
Advisory CommitteeMinnesota Department of Health
Quality improvement in MN
Governor’s Lean initiative– 10 Kaizen events at MDH since 2007
MLC-2– QI collaborative with 8 teams– Each team selected their own topic
MLC-3– QI collaborative with 40 teams– Health Improvement Planning:
Community Engagement
Community Engagement Collaborative
Eligibility: all community health boards and tribal governments
Goal: build Community Leadership Teams for SHIPEvidence: Prevention InstituteQI Framework: Model for ImprovementMethodology: Breakthrough Series*Timeframe: November 2008-June 2009
*Institute for Healthcare Improvement
Community Engagement Collaborative
Prework conference callMonthly webinars
– New QI tool each month2 face-to-face learning sessions
– Prevention Institute– Spitfire Strategies
Monthly reports Follow-up conference callStoryboards
Community Leadership Team
0
1
2
3
4
5Membership
Expectations
Roles
Resources
Objectives
Measures
0=not started
5=complete
MN Public Health Collaborative for Quality Improvement Community Engagement
Monthly Report Form
CHB:
Aim:
Measures:
PL
AN
Month / Year: / Reported by:
Please summarize the action steps you have taken in the past month.
Describe the results of your action steps and what you learned from the process.
1.
2.
3.
4.
DO
5.
CH
EC
K
What advice or assistance do you need from MDH, its partners, or the other project teams?
What have you accomplished in the past month? What are you proud of?
Quality Improvement tools used: Activity Network Diagram Interrelationship Digraph Affinity Diagram Matrix Diagram Brainstorming Nominal Group Technique Fishbone Diagram Pareto Chart
Challenges/Lessons Learned
Few vs. many teams – the key is meaningful feedback
Difficult to apply QI to a “soft” topicTeams often know what is best – give
permission to be flexible Showcase relevant, realistic examplesQI is a tool, not a projectPerfect is not the goal
Problem StatementAnoka county health department identified a lack of community representation in the Planning Workgroup for the Statewide Health Improvement Program initiative. A fish-bone diagram helped them to pinpoint possible causes of under-representation. AimEstablish a representative* Planning Workgroup by June 30th, 2009 to identify and/or develop strategies to accomplish the Partnership for Better Health goals and objectives. Goals1. Draft an informational letter to be sent to all Partnership for Better Health members (prior to the next meeting) inquiring about their interest in the Planning Workgroup.2. Recruit at least two persons to represent each sector on the Planning Workgroup. 3. Ensure membership of the planning Workgroup is representative of the Anoka County commissioner districts.*Representative: At least two persons who represent each sector of the Partnership for Better Health, 1-2 professionals who are experts in related topic areas, and members are present from each Commissioner’s district.
Measures• Informational letters are sent to all Partnership for Better Health members.• Follow-up phone calls are placed to highly desired team members.• Interest from highly desired team members is tracked on master contact list.• Find a member to represent Commissioner District 4.• Worksite sector representative members increase by 2.• Community sector representative members increase by 2.• Topic expert members increase by 2.
Implement the plan• Identified characteristics of needed workgroup members. • Drafted a charter to define expectations of the workgroup. • Outlined a process for member recruitment (below.)• Communicated with potential members via mail and phone. Milestones Achieved• Applied principles of the Prevention Institute 8-step process for building effective coalitions.• Improved understanding of what motivates team members to participate.• Established common expectations of workgroup roles, responsibilities, and deliverables.• Expanded membership of the group from 7 to 13.
Establish a representative Community Leadership Team (CLT) of the Partnership for Better Health (Partnership) by June 30, 2009.
Educate potential CLT members on Partnership purpose
Inform potential CLT members of need and opportunity
Identify CLT members
Orientate new members to the CLT
Share PBH history
Share PBH purpose
Share PBH charter
Explain why we need their help
Explain SHIP grant opportunity
Create list of Partnership members interested in CLT
Place follow-up calls to gauge interest
Welcome and thank new CLT members
Inform new CLT members about orientation process
Bring new CLT members together for orientation meeting
Address history, prior activities, current activities, etc.
Identify factors that impact workgroup membership
Standardize the improvement1. Defined a standardized recruitment process.2. Developed an orientation process for new workgroup members.3. Approved a charter that defines the purpose and expectations of the workgroup.4. Increased the diversity and subject-matter expertise of workgroup membership to include all 4 SHIP sectors and each of the Commissioner’s districts. • The leadership team is a driving force so it was sometimes hard to balance the wants of the team with the needs or requirements of the health department.• It was often helpful to use the tools to evaluate past efforts and then apply what we learned to future work. • We identified some problems that we were not able to “fix;” that was frustrating.
Lack of charter (that identifies roles/responsibilities, decision making process, mission, etc.)
Potential members don’t have time.
Inadequate information regarding the direction of the Partnership for Better Health
and opportunities for participation.
Do not know all of the experts in the community
(Anoka County).
Lack of lead agency staff time to do
recruitment.
Potential members do not understand personal or organizational benefit
of participating.
Closed Planning Workgroup meetings.
Inertia related to use of technology that could bring off-siters “in” (e.g., videoconferencing).
I=0, O=5 Driver
I=2, O=1
I=2, O=0
I=3, O=0 Outcome
I=1, O=0
I=1, O=0
I=1, O=4 Driver
I=1, O=1
That’s it for today! Celebrate!
Thank you
