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Quarterly Action Alert:
Prepare for one or more current or former family participants to
become members of each Level 1 CQI team by October 1, 2018.
Quality Outlook F O U R T H Q U A R T E R 2 0 1 7 / 2 0 1 8 C Y C L E
“Without continual growth and progress, such words as improvement, achievement, and success have no meaning.”- Benjamin Franklin
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July 2018
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August 2018
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September 2018
Level 1 CQI
All Level 1 Teams
July 16-27, 2018
NFP Level 2 CQI
2:30 pm—4:00 pm
August 6, 2018
866-630-9345
Level 3 CQI
1:30 pm—3:30 pm
September 10, 2018
Pine A
866-630-9353
HFMoHV Level 2 CQI
10:00 am—11:00 am
August 13, 2018
866-630-9356
EHS-HBO & PAT Level 2 CQI
9:30 am—11:00 am
August 6, 2018
866-630-9348
Family Engagement in Continuous Quality Improvement
In recognizing that it would be impossible to improve a system without involving those that the
system affects, the DHSS Home Visiting Program came to appreciate that family engagement in
the three-tiered continuous quality improvement (CQI) process needs to happen at the level
where changes to processes and procedures that most directly affect families occurs. That level
is the local implementing agency (LIA), Level 1, the foundation of the process. It’s the level at
which those most closely associated with the program and services determine the best way to
develop plans for improvement. Family engagement will benefit the LIA level process in the
following ways:
incorporating families’ experiences/recommendations in PDSA cycles; building trust and increasing ownership of programming with families; and collaboratively setting goals that provide direct value to home visiting participants.
In February 2018, LIA staff were surveyed to assess their views on family engagement. The
results indicated individual perceptions were overall positive, but also indicated a need for
training and support to assist LIAs in identifying, engaging, and supporting family participants
to become members of the CQI process at Level 1. In April, the goal of incorporating one or
more current or former family participants into each agency’s Level 1 CQI quarterly meeting by
October 2018 was shared through a webinar. The future stages of the process to achieve the
goal were outlined with individual follow-up occurring with each LIA in May 2018.
As LIAs move toward family engagement at Level 1, each is at a different stage of agency
preparation; addressing logistics, identifying potential family partners, learning training and
coaching methods to shape competent and effective family partners, or recruiting family
participants. The DHSS Home Visiting Program is providing resources in the “Weekly
Gateway Update” posting to the Missouri Home Visiting Gateway Website, accessible to all
LIA staff. The variety of resources in this section include strategies such as: creating a parent
engagement roadmap, evaluating parent engagement, charting a path toward deeper partnerships
with families, and establishing a support network. Additional resources posted include a
checklist/self assessment tool and a sample confidentiality agreement. In the coming weeks,
more resources and supports to facilitate achievement of the goal to fully engage one or more
family participants as part of the Level 1 teams will be provided to elevate the effectiveness of
the Level 1 CQI process by involving those the process most affects.
Missouri Pregnancy Associated Mortality Review (PAMR) Program
Approximately 700 women die each year in the United States as a result of pregnancy or delivery
complications. The Missouri PAMR Program reviews maternal deaths that have occurred during
pregnancy or within one year of pregnancy to improve surveillance and analysis of pregnancy-
related deaths in Missouri. A pregnancy-associated death is defined as the death of a woman
while pregnant or within one year of the termination of pregnancy, regardless of the cause. A
pregnancy-related death is the death of a woman while pregnant or within one year of
termination of pregnancy, regardless of the duration and site of the pregnancy, from any cause
related to or aggravated by her pregnancy or its management, but not from accidental or
incidental causes. A team of experts reviews each case to develop recommendations for action
and to prioritize interventions to improve maternal health. The PAMR Program seeks to identify
systemic service delivery issues and gaps in care to facilitate improvements in the overall
systems of care. For more information, please visit http://health.mo.gov/data/pamr/index.php or
contact Ashlie Otto at [email protected] or 573-522-4107.
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CQI ACTIVITY LOGS
EHS-HBO & PAT Level 1 Teams, please submit your detailed activity log to
Chelsea Cross at: [email protected],
and Melinda Kirsch at: [email protected] by July 31, 2018.
HFMoHV Level 1 Teams, please submit your detailed activity log to
Betsy White at: [email protected],
and Tracy Marshall at: [email protected] by July 31, 2018.
NFP Level 1 Teams, please submit your detailed activity log to
Lauren Stone at: [email protected],
and Beth Stieferman at: [email protected] by July 31, 2018.
For the Level Two Teams, please submit your detailed activity logs to
Tracy Marshall at: [email protected] by August 23, 2018.
Please note the CQI-specific email address for submitting PDSA storyboards and
CQI activity logs. You may also send any of your CQI related inquiries to this
address for the quickest response, as multiple DHSS home visiting staff will access
this account. The CQI-specific email address is: [email protected].
Level 3 CQI Recap
FY18 - 3rd Quarter Level 3 CQI Recap - June 11, 2018:
CQI Parent Engagement was discussed by Melinda Kirsch.
Discussion on agencies submitting issues to discuss ahead of time at the Level 3 meeting.
Level 2 meeting minutes were reviewed by each Level 2 representative.
No unresolved issues were brought to Level 3 by Level 2 Teams.
The 4th Quarter Level 3 CQI meeting will be held on:
September 10, 2018
1:30 p.m. – 3:30 p.m.
Pine A Conference Room
Meet Me Call #s: local - 573-526-6012; toll free - 866-630-9353
Webinar Link: http://stateofmo.adobeconnect.com/level3cqi/
CQI Process Role
At this time, the roles of Scribe, Facilitator, and Leader should rotate or be
newly elected to fulfill the leadership roles for all team levels for the
2018-2019 year. The duties of members in these roles will be effective beginning
October 1, 2018. Please reference the Missouri Home Visiting CQI Handbook for
definitions and duties of the Scribe, Facilitator, and Leader roles.
The handbook can be accessed through the Missouri Home Visiting Gateway at:
http://health.mo.gov/living/families/hvcqigateway/.
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July
National Cleft and Craniofacial Awareness and Prevention Month
July is National Cleft and Craniofacial Awareness month. The Centers for Disease Control (CDC) estimates that about
7,000 babies will be born with a cleft in the U.S. this year. Additional cleft and craniofacial information found at:
http://www.cleftline.org/who-we-are/what-we-do/cleft-craniofacial-awareness-and-prevention-month/. National Cord Blood Awareness Month
The birth of a baby holds with it a miracle most parents aren’t aware of: the ability to save a life. A newborn’s cord
blood stem cells have the potential to provide lifesaving treatment for others. Cord blood is obtained from the umbilical
cord only after the birth of a healthy baby. Cord blood is rich in blood-forming cells that can be used in transplants for
patients with leukemia, lymphoma, and many other life-threatening diseases. It can be especially useful for transplant
patients from ethnically diverse backgrounds who often have difficulty finding a transplant match. Since cord blood is
stored frozen, it is available for use as soon as a match is identified. A baby’s donated cord blood stem cells may
increase the likelihood of someone benefiting from a cord blood stem cell transplant. Additional information regarding
cord blood banking is available through the Parents Guide to Cord Blood Foundation found at:
http://health.mo.gov/living/families/genetics/cordblood/index.php.
September Infant Mortality Awareness Month
Infant mortality, sadly is the death of a baby before his or her first birthday. The infant mortality rate is the number of
deaths that occur for every 1,000 live births. Pregnancy outcomes are influenced by a woman’s health before she
becomes pregnant. Preconception health focuses on actions women can take before and between pregnancies to
increase their chances of having a healthy baby. The important steps women can take to improve their preconception
health can be found at: http://health.mo.gov/living/families/infantmortality/index.php.
Newborn Screening Awareness Month
Newborn screening refers to screenings performed on newborns shortly after birth to protect them from the serious
effects of disorders that otherwise may not be detected for several days, months, or even years. Missouri law requires all
babies born in the state to be screened for over 70 different disorders. While most of these disorders are screened by
collecting a small amount of blood from the newborn's heel, there are also two point of care screenings included in
Missouri's Newborn Screening Program. These include newborn hearing screening and critical congenital heart disease
screening. The goal of the Newborn Screening Program is to prevent serious health problems through early screening.
To learn more about newborn screening visit:
https://health.mo.gov/living/families/genetics/newbornscreening/index.php.
August
National Breastfeeding Month; World Breastfeeding Week (August 1-7, 2018) In a world filled with inequality, crises and poverty, breastfeeding is the
foundation of lifelong good health for babies and mothers. World Alliance for
Breastfeeding (WABA) is a global network of individuals and organizations
concerned with the protection, promotion and support of breastfeeding worldwide.
Stay connected for more updates on: http://worldbreastfeedingweek.org.
Upcoming Health Awareness
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number X10MC2948501—Maternal, Infant and Early
Childhood Home Visiting Grant Program in the amount of $3,988,612 with 0% financed with nongovernmental sources. This information or content and conclusions are those of the author and should not be construed as
the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
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Successes and Celebrations!
The Missouri Home Visiting Weekly Updates can be found on the Missouri Home Visiting Gateway at
http://health.mo.gov/living/families/hvcqigateway/.
Reminder
Parents as Teachers National
Parents as Teachers National Center has partnered with the American Heart
Association to distribute 150 Infant CPR kits to families in the city of St. Louis. The goal
is to increase CPR response rates through onsite sessions with families, and providing
take home CPR kits.
Gardening Success with Delta Area Economic Opportunity Corporation
Delta Area Economic Opportunity Corporation (DAEOC) home visitors began working with
families in ways to introduce gardening. DAEOC bought seeds and home visitors worked with
families to plant the seeds in mason jars and watched them sprout for families with limited space.
One family (The Jacksons) are growing squash, tomatoes, onions, watermelon and peppers in the
garden in their back yard.
Randolph County Pilot Program Lets Parents Bring Babies to Work
When you check in at the Randolph County Health Department in Moberly, you'll
be greeted by two-month-old Anna Goddard snuggling with her mom, Laura, in a
baby wrap. That's because employees at the health department can bring their
babies to work until the infant is four months old through a new pilot program.
The department's WIC coordinator and lactation consultant, Leona Greer, had learned about programs in other
states where employees could bring their babies to work. The program in Arizona was so well received, the
governor started rolling it out to other state agencies. Greer thought her office would be the perfect place to give it
a try and see how it could benefit Laura and other parents.
Parents have to keep up with their job responsibilities, bring their own baby supplies, and properly throw out
diapers. They can't bring the baby to work sick and if the infant cries longer than 30 minutes, it's time to go home.
Also, while a goal of the program is to promote breastfeeding, formula fed babies can participate, too.
The health department's board will vote in July whether to make the pilot program permanent. So far, Laura is the
only parent participating in the program. For the complete story, please click here:
http://www.komu.com/news/randolph-county-pilot-program-lets-parents-bring-babies-to-work
