Presentation on theme: "Tuba City Regional Health Care Corporation"— Presentation transcript:
1Tuba City Regional Health Care Corporation Michelle Archuleta, MSHPDP Director, Project Director DM GrantsSDPI Diabetes Grantee MeetingNovember 14, 2008Washington, DC
2Discovery into what makes a Successful Collaboration Past, Present, FutureLeadership InfluencesWhat is our role in creating change as a programEmergenceAdaptive Systems, Complexity TheoryLessons learned
3Impact of SDPI Community Directed Grant Navajo Nation – Special Diabetes Programs, community services, wellness centers, Urban Program (NACA) FlagstaffNavajo Area IHSService Unit Level – Clinics, Hospitals (locally directed diabetes & treatment efforts)Clinic Area Initiatives – Dental, GestationalCommunity Initiative - HPDP (Navajo Philosophy of Life - Four Direction Framework)Wellness, Prevention, Total Population HealthCoordinated School Health, Community Fitness, Health Communications, Wellness on Wheels, Community Development
4Tuba City Regional Health Care Corporation Discovering what happens when networks of relationships form among people who discover they share a common cause and vision of what’s possible.
5Healthy People and Communities from Four Directions Immunization Rates consistently over 90%Culturally appropriate parenting skillsEarly Childhood DevelopmentEldersCommunityCapacityBuildingspecific health data systemsWellnessplanningCoordinated School HealthNutritionExpanding community fitness opportunitiesPromoting Healthy RelationshipsDomestic Violence Prevention WorkshopsAdult Preventative Health Screenings
6Success of Navajo Area HPDP Understanding where you come from helps you move forwardFour Directions of Navajo Philosophy of LifeEmbracing cultural wisdomSet the vision, framework, adapted to meet the needsTime of creating and employing tools, went after knowledgeTime of dreaming and making discoveriesCommunity focused approach delivered in collaboration and partnership within the Navajo Area IHS medical system and HPDP CoordinatorsProgram RefinementPrimary, Secondary, & Tertiary Prevention EffortsCapacity Building & Community Development
7TCRHCC Coordination of SDPI Diabetes Grants Community Directed (non-competitive)33% Community Based Diabetes Prevention EffortsHealth Promotion DepartmentHPDP Director – Michelle Archuleta, MSHPDP Funded Program Staff: 1-HP Coordinator, 1-School Health Coordinator, 1- Administrative Assistant (hospital funded)HPDP Grant Funded Program Staff: 1-HP Specialist, 1-School Health Assistant, Grant Writer (vacant)SDPI Grants are administeredHPDP Director - DM Grants Project Director(Budgets, fiscal expenditures, continuation applications, personnel, ensure and support program staff to continue their success in obtaining the goals of our DM Grants)
8Primary/Secondary Prevention The overall objective is to decrease the incidence of diabetes among Navajo and San Juan Southern Paiute people through a focused, coordinated series of innovative projects promoting wellness.To expand the coordinated school health program in every school (headstart through high school) in Tuba City and surrounding communities;To develop and implement a fitness/nutrition promotion program based on a mobile “wellness on wheels” unit;To provide a culturally-appropriate media campaign promoting physical activity, nutrition and diabetes awareness;Increase opportunities for participation in physical activity through a coordinated community-based program of events, clubs, local wellness center, community mini-grants, and fitness programs;To develop and implement process and impact evaluation for the Tuba City Area;To increase rates of reported physical activity;To decrease consumption of “high fat” or “high sugar” foods;To increase rates of consumption of fruits and vegetables; andTo continue support and implement the lessons of the DPP in personal coaching and support.
9Diabetes Clinical Services under Division of Medical Services Community Directed (non-competitive)67% Diabetes TreatmentDCS Director – Kristin Graziano, DO, MPHGrant Funded Program Staff: 1-DM Coordinator, 1-PH Nutritionist/Educator, 2-DM Health Techs & 1-DM Educator, CDE (hospital funded)
10Tertiary Prevention/Care & Treatment The long-term objectives are:To decrease the incidence of diabetic complications among Navajo and San Juan Southern Paiute people (e.g. neuropathy, retinopathy, nephropathy, vascular and heart disease), by improving the coordination and availability of care for diabetic patients and their families in Tuba City and surrounding communities;To improve compliance with diabetes standards of care for patients receiving care from the Tuba City Regional Health Care Corporation;To increase screening rates for diabetes;To improve control of blood glucose, blood cholesterol, and blood pressure;To improve access to diabetic care services including educational and nutritional counseling, eye, foot and oral health screening, and case management;To receive IHS recognition status for the Diabetes Clinical Education Program.
11TCRHCC SDPI Demonstration Project DPP Competitive GrantRural Outreach – Lifestyle Intensive ProgramDiabetes Prevention Program under HPDPDPP Coordinator – Evelina MahoGrant Funded Program Staff: 1-Program Assistant (recruiter), 1-Community Activity Specialist, RPMS Specialist, 1-Administrative AssistantAfter-Core Program: program volunteersREZ Fitness Leaders
12Influences Robyn Maho, HP Coordinator Evelina Maho, DPP Coordinator Dedicated to the health and well-being of Families & CommunitiesRobyn Maho,HP CoordinatorHopi/NavajoGrew up in HPDPEvelina Maho,DPP CoordinatorHome Grown-Tuba CityStrong with Navajo CultureAnd TraditionsMichelle Archuleta,HPDP DirectorGrant Administration SkillsOrganizational DevelopmentKristin Graziano,Diabetes Physician AdvisorClinic ChampionPublic HealthCommitted People
13The Lifecycle of Emergence NetworksDiscovering Shared Meaning and PurposeNew Practices Become the NormCommunitiesofPracticeSystems ofInfluenceK’eDeveloping New Practices TogetherUsing Emergence to take Social Innovation to ScaleThe Berkana Institute Margaret Wheatley
14Project Teams – Shared Leadership Strength Based Approach EmergenceProject Teams – Shared LeadershipStrength Based ApproachManagement Training- Move out of roles into passionInvited others to participateFormed Networks, CoP’s,New systems of InfluencePhysicalActivitySchoolHealthDataSpecialProjectsHealthEducationClinicCommunityOutreachMediaMarketingFitness
15Emergence HPDP and DPP coming together Growing Pains Trusted we would be stronger together than separate
16diabetes prevention program Begins Prevention Tuba City Regional Health Care CorporationBeginsPreventionWithMe
17What is Organizational Development Change – Paradigm ShiftsFacilitation, Collaborative MethodsHuman BehaviorLarge and Small ScaleOrganization Effectiveness-systems & processesMulti, Cross Disciplinary ApproachesLeadership DevelopmentManagement TrainingGuiding, Coaching, Mentoring, Influencing
18CONVENTIONAL APPROACH Chalk LinesDefineProblemsTime DragsNo FunHard WorkMechanical» Vibrant «AnalyzeFailures» Alive «STATIC, INERT, DEADHOW DOES THIS HAPPEN ?!?EXAUSTED!Top Only – Few involved answers from expertsFocusing on what’s wrong Searching for “Root Cause” of Failure/Decay if you look for problems, you’ll find and create more problems “Fix” the past Obstacles treated as barriersOVERWHELMEDNO TIME TO MAKE IT HAPPENLow EnergyE F
19APPRECIATIVE APPROACH AMPLIFYWHATGIVESLIFESearchfor WhatWorksTime Flies» Vibrant «NEW PossibilitiesCREATIVITY» Alive «UnexpectedMORE ALIVE!ORGANIC, EMERGENTIn-SyncHOW DOES THIS HAPPEN ?!?Energy CAN’T be stoppedAll (or all levels) involved solutions fromwithin Focus on WHAT WORKSSearch for root causes of success “If you look for successes, you’ll find and create more successes” Create the Future Obstacles treated as Ramps into NEW TerritoryWhole Greater than Sum of PartsHIGH EnergyE F
20Leadership in a liberating way Being reflectiveWorking experientiallyThinking criticallyLeadership occurs at all levelsAnyone can be a leader
21A Critical Understanding of Leadership “Leadership is a relationship, in which leaders inspire or engage others to extend their capacity to imagine, think and act in positive new ways.”- Amanda Sinclair, Leadership for the Disillusioned
23Managing Change and Understanding Transition LeveLofManagementNew BeginningNeutral ZoneTransitionPeriod, PhaseLetting Go,Ending,LosingTime
24How did Tuba City do it? PL - 638, thrust us into change Relied on Partnerships – Navajo Area HPDPDM Program InvolvementDM registry, DM Audit, Educators, Screenings, clinic partnersLearned new language (Grants Policy Manual)DGO, PMS, Continuation Application process, NEPA, SF 269, 270, cost-reimbursement, A1-33, grants.gov, NOAPassion – Identify the champions and support themLeadership – Lifecycle of Emergence – Networks, CoP, Systems of InfluenceOrganizational Development – reflection, experiential, critical thinkingTiming and Good Luck
26The Essential’s People – participate, contribute, come together Vision – who, what, why, when, where, and howCommunity Based – culture, environment, family, schools, outreachPatient Care – individual, family, relationship basedLeadership – emerges, expands, invitesPassion – follow, nurture and encourageCoordination, Communication, CollaborationCHANGE
27Future Needs (2000) Stable funding More time to assess results More data re what works with our population;What motivates continued participation?Would support groups be effective?What are the best ways to teach nutrition?How do we get community/political buy-in?