The Big Story from Small Health Departments

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The Story of East Central District Health Department
PHAB
PHAB History & Progress
 ECDHD is on Step Three of
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



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.
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
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
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.
Successes
 We persevered
through our
adversity .
 We adapted our plan
as we needed to do
so.
 We were able to
MAKE the time.
Lessons Learned
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
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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.
To be successful in PHAB


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Assign a Project LEAD
ASSESS where you are
Define an Overall PLAN
Assemble a TEAM
List TASKS to be done
EVALUATE and celebrate
progress
 Use PHAB RESOURCES
including your
accreditation specialist
Break down the tasks
“Inch by Inch
life's a cinch,
Yard by Yard it
is mighty
hard”
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
Performance Measures
Employee Surveys
 Based on
Gallup
 33 Questions
 Started in
2005
Understanding PHAB Requirements –
As Simple as basic math
A FTER
R EACHING THE
S UMMIT:
S USTAINING THE
M OMENTUM
Gretchen Sampson MPH RN
COPPHI Open Forum Meeting
Kansas City, Mo
June 13, 2014
P OLK

County Population =
45,000

Rural yet 50 miles from
MSP

26 FTEs; $2.3 M budget

Level 3 Local Health Dept

Diverse Programming
COUNTY
T HE T HRILL
Accredited
May, 2013
OF
V ICTORY !
T HE A GONY OF R EALITY
( A CCREDITED
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 rollout, more budget work, county board
votes to phase out home care program,
school nursing services starting
I T A IN ’ T O VER D ESPITE THE
WARNING B ELOW !

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
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Section II is primarily narrative responses
with 500 word limits
S ECTION 2 TAKES S OME
T HOUGHT !
The Big 3
Plus QI
Are Your
Buddies
FOR LIFE

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!
T IME
TO
S HINE A GAIN !

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
E MERGING PH I SSUES &
I NNOVATIONS
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
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
R EFLECTIONS

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
T EAMWORK
IS THE UNDERPINNING
OF ALL ACHIEVEMENT !
N EED 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
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