healthy start implementation process n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Healthy Start Implementation Process PowerPoint Presentation
Download Presentation
Healthy Start Implementation Process

Loading in 2 Seconds...

play fullscreen
1 / 19

Healthy Start Implementation Process - PowerPoint PPT Presentation


  • 95 Views
  • Uploaded on

Healthy Start Implementation Process. Eulalee Green Health Development Manager Registered Dietitian eulalee.green@nhs.net 07939 831 821. Overview. Background The Project Plan Future Plans. Background . 2005-2008: 35 children with rickets

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Healthy Start Implementation Process' - mickey


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
healthy start implementation process

Healthy StartImplementation Process

Eulalee Green

Health Development Manager

Registered Dietitian

eulalee.green@nhs.net

07939 831 821

overview
Overview
  • Background
  • The Project Plan
  • Future Plans

Healthy StartImplementation Process

background
Background
  • 2005-2008: 35 children with rickets
  • 2007-2009: 20/22 children with tuberculosis had vit D

deficiency

  • 2004-2007: 17 hypocalcaemic seizures at 1-2 months old
          • 2 required PICU,
          • 1 long term complications
  • 2008: 2 infant: cardiac failure due to vit D deficiency
  • 20% of paediatric fracture patients are vit D deficient

Source: Dr Michie, Consultant Senior Lecturer in Paediatrics, Ealing Hospital

Healthy StartImplementation Process

background1
Background
  • Rates over 5 years (2003 – 2008)
  • 23 electoral wards

Healthy StartImplementation Process

healthy start project
Healthy Start Project
  • Early 2009: DoH identified high seizure rates in

Ealing

  • June 2009: HS project started
  • Aim:
    • Reduce neonatal hypocalcaemic seizures (vitamin D)
    • Reduce congenital malformation rates (folic acid)

Healthy StartImplementation Process

milestones
Milestones
  • Baseline data
  • Stakeholder Interviews
  • Map current processes
  • System redesign
  • Implement and monitor
  • Health Staff training
  • Community Publicity
  • Monitoring
  • Outcome evaluation
  • Roll-out to non-PCT sites

Healthy StartImplementation Process

baseline data
Baseline Data
  • 8 sites over 3 neighbourhoods
  • 20,750 Children: 0-4 yrs
  • 11,000 women: pregnant or with a child <12mths old

Healthy StartImplementation Process

stakeholder interviews
Stakeholder Interviews
  • Public Health – Strategic Lead
  • Universal Children Services – client advice
  • Maternity Services – client advice
  • Family Nurse Partnership
  • GP Services & Paediatricians – client advice
  • Health Centres – supplement sales & budget
  • Children Centres – client advice
  • Supplies Department – distribution to centres
  • Accounts Department- reporting to DoH & reclaim funds

Healthy StartImplementation Process

the process july 2009
The Process (July 2009)
  • Account Department had unwritten process
  • Centres had different processes
  • Quarterly returns not submitted
  • Monies banked incorrectly
  • Wrong account and supply codes used
  • Staff confused about recommendations
  • GP & MW not involved

Healthy StartImplementation Process

system redesign aug 2009
System Redesign (Aug 2009)
  • Draft: Flow Chart, FAQ, Leaflet
  • Key stakeholders meeting
  • Prepare final documents
  • Pilot at one site
  • Roll-out to other PCT sites
  • Deliver training for Reception Staff
  • Implement system and monitoring

Healthy StartImplementation Process

health staff training sept 2009
Health Staff Training (Sept 2009)
  • Practice Managers – 25 managers
  • Pharmacists – 2 sessions, about 40 pharmacists
  • Health Visiting Team – 4 neighbourhood meetings – 40 staff
  • Midwives –Queen Charlottes & Ealing Hospital – about 30 staff
  • Ealing Hospital – 45 minute presentation hour from 9:00 am to 6:00 pm - up to 135 staff
  • Clinic administrators – 10 staff
  • Children Centre Staff (delivered by the Children Centre Dietitians)
  • Corum outreach team – 30 staff

Healthy StartImplementation Process

community publicity sept 2009
Community Publicity (Sept 2009)
  • Baby TV film
  • Poster
  • Two articles a year, in Ealing Matters, Team Talk Core Brief, and Nutrition Today
  • Weaning Groups 6x a week – CCD
  • Breastfeeding Peer Supports – CCD
  • Switch-Script on GP system

Healthy StartImplementation Process

monitoring 2009 2010
Monitoring(2009 – 2010)
  • PH collates HS uptake
  • Vouchers held by the centre for 12 months
  • Every month figures and copies of banking slip
  • Compile quarterly sheets
  • Quarterly figures sent to Accounts

Healthy StartImplementation Process

uptake data
Uptake Data

Healthy StartImplementation Process

outcome evaluation
Outcome Evaluation
  • Difficult to obtain and time consuming
  • Hospital coding errors, so need to hand search patient records
  • Hypocalcaemic seizures – only 2 between 1 Sept 2010 to 28 Feb 2011

Healthy StartImplementation Process

process in 2010
Process in 2010
  • Written Process (FAQ & Flow Charts)
  • Distribution sites submitting correct information
  • HV, CNN & MW understand vitamin recommendations
  • Accounts Department – some problems
  • GP – some problems
  • Not distributing from non-PCT sites

Healthy StartImplementation Process

problems
Problems
  • Process monitoring
  • Outcome monitoring
  • Accounts department not including HS as one of its priority
  • Distribution of refund
  • HS vouchers – infant vitamin voucher not from 1 mth

Healthy StartImplementation Process

future plans
Future Plans
  • Investigate how families are using vouchers
  • Access GP training programme
  • Re-look at non-PCT sites
  • Write in to the SOP for:
    • GP antenatal booking
    • 1st Antenatal appointment
    • New birth visit
  • Training staff at birth registration offices
  • Children Information Services website
  • Local library services

Healthy StartImplementation Process

plea to the doh
Plea to the DoH
  • Children vitamin vouchers from 1 mth
  • Constant messages on HS sites and leaflets to include drops from 1 month for African, Afro-Caribbean, Middle Eastern and Asian babies
  • Request hospitals to remove ‘paediatric’ as diagnostic code
  • Request GP, midwifery and health visitor IT systems, include auditable fields for vitamin D, folic acid, and breastfeeding

Healthy StartImplementation Process