In Search of PHAB Open Forum Friday June 13 th ,2014

1. In Search of PHABOpen ForumFriday June 13th,2014 The Story of East Central District Health Department PHAB

2. PHAB History & Progress • ECDHD is on Step Threeof seven • Completed the PHAB Online Orientation. • Submitted a Statement of Intent (SOI) • Completed the Application • Selected and uploaded all of our documentation • Currently awaiting review of documentation and Site Visit The most important step is knowing what PHAB is asking for and then reviewing the standards, measures, and required documentation.

3. ECDHD is not “there” yet! • On the Journey for 13 years • Don’t Have all the Answers • Our Quality is not Perfect • “There” is always moving • It is Continuous Quality Improvement for a reason

4. ECDHD Foundation For PHAB • Have had a Quality Plan since 2003 – • Requested every department to have performance measures • Mandated in 2011 for every department to have performance measures – • Always planned to apply for PHAB Board-Leadership-Staff

5. Challenges we encountered • 20 Staff Total in Health Department - 6 WIC staff, 4 Administration, 3 EDN, 1 PHER coordinator, 1 Environmental Health, 2 Alcohol and Tobacco prevention, 2 Minority Health and 1 Disease Surveillance • Lost all of our documentation in 2013 after collecting it for a full year when mind manager crashed. • Lost our PHAB coordinator right before the PHAB training.

6. Successes Lessons Learned • We persevered through our adversity . • We adapted our plan as we needed to do so. • We were able to MAKE the time. • Use two computer monitors! • Use Adobe Acrobat XI Pro • Call for help if you need it! • Have someone else read the measure and see if they understand what you submitted. • Do not write the narrative as a team as you finish the measure – too rushed. • We needed more time than one hour a week to complete PHAB. • To put our logo and creation date on all your documents.

7. To be successful in PHAB • Assign a Project LEAD • ASSESS where you are • Define an Overall PLAN • Assemble a TEAM • List TASKS to be done • EVALUATEand celebrate progress • Use PHAB RESOURCES including your accreditation specialist

8. Break down the tasks “Inch by Inch life's a cinch, Yard by Yard it is mighty hard”

9. Performance Measures We all start somewhere • We are not experts! • Picked a few Items here and there and started measuring • Made it goal that every year we would improve our quality • Mandatory for everyone • We now track 152 performance measures

10. Performance Measures

11. Employee Surveys • Based on Gallup • 33 Questions • Started in 2005

13. Understanding PHAB Requirements – As Simple as basic math

14. After Reaching the Summit: Sustaining the Momentum Gretchen Sampson MPH RN COPPHI Open Forum Meeting Kansas City, Mo June 13, 2014

15. Polk county • County Population = 45,000 • Rural yet 50 miles from MSP • 26 FTEs; $2.3 M budget • Level 3 Local Health Dept • Diverse Programming

16. The Thrill of Victory! Accredited May, 2013

17. The Agony of Reality (Accredited does not = perfect!) PCHD’s First 3 Months After Accreditation • June – Birth to 3 Program State Review, grant applications due, CHIP community workgroups forming • July – Department Budgets Due, WIC program site visit by State Health Department, summer students in agency, more CHIP work, PHAB celebration • August – Gearing up for Marketplace roll-out, more budget work, county board votes to phase out home care program, school nursing services starting

18. It Ain’t Over Despite the Warning Below! • PHAB requires an annual report - in e-PHAB • Two parts to complete • Section I and Section II: submitted separately • 30 days to complete Section II once Section I approved • Section II is primarily narrative responses with 500 word limits

19. Section 2 Takes Some Thought! • Quality Improvement efforts need to be described in detail – PCHD’s nemesis! • CHA/CHIP implementation and revisions need to be discussed • Agency strategic plan implementation must be addressed • Yes, Really! The Big 3 Plus QI Are Your Buddies FOR LIFE

20. Time to Shine Again! • PHAB also wants to know if you supported other health departments since being accredited • Examples: PHQIX, Journal Articles, Examples to NACCHO’s Toolbox, Presentations, Assistance to other health departments

21. Emerging PH Issues & Innovations You Are All Smarter Than the Average Dog When it Comes to This Stuff!! • Final portion of Section 2: Has the HD conducted work in any of the following areas? Informatics Health Equity Communication Science Costing Services/Chart of Accounts Emergency Preparedness Workforce Public Health/Healthcare integration • These areas are included in PHAB Standards and Measures Version 1.5

22. CHALLENGES • PHAB annual reporting process is new • Two key staff took new positions elsewhere • Two new staff needed major training • Major agency program phase-out in 2013 • New community coalition being formed and facilitated by PCHD • CHIP work in full gear requiring major effort

23. Reflections • Easy to let everyday life lull you into complacency – recognize it but stay awake; the first year flies!!! • Keep accreditation team active and meeting regularly • Now that annual report is a known entity, learn the report categories & work towards meeting required elements • CHA/CHIP work is ongoing core public health work – shouldn’t’ be a struggle to report on it • Strategic plan should be guiding your work • Quality Improvement never ends – maintain your commitment to QI and Performance Management

24. Teamwork is the underpinning of all achievement!

25. Need more encouragement? Gretchen Sampson RN MPH Director/Health Officer Polk County Health Department Balsam Lake, WI 54810 715-485-8506 gretchens@co.polk.wi.us