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ADVERSITY, QI, AND ACCREDITATION: 18 MONTHS AFTER A PUBLIC HEALTH “TOTAL MAKE-OVER” Paul Khuenert, MS, RN, Public Health Team Director, Robert Wood Johnson.

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Presentation on theme: "ADVERSITY, QI, AND ACCREDITATION: 18 MONTHS AFTER A PUBLIC HEALTH “TOTAL MAKE-OVER” Paul Khuenert, MS, RN, Public Health Team Director, Robert Wood Johnson."— Presentation transcript:

1 ADVERSITY, QI, AND ACCREDITATION: 18 MONTHS AFTER A PUBLIC HEALTH “TOTAL MAKE-OVER” Paul Khuenert, MS, RN, Public Health Team Director, Robert Wood Johnson Foundation

2 Adversity, QI and Accreditation: 18 months after a Public Health ‘Total Make-Over' Paul Kuehnert MS, RN (Former) County Health Officer & Executive Director Kane County, Illinois Public Health Team Director Robert Wood Johnson Foundation

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4 “Sweet are the uses of adversity, Which, like the toad, ugly and venomous, Wears yet a precious jewel in his head.” -Wm Shakespeare

5 Today’s Presentation Background and Context Recession of 2008 Impact on Kane County Health Department Strategic Response: 2010 ‘Total Makeover’ Transfer MCH personal health services 50% RIF, Re-organization Results to date Fiscal MCH Services Population health QI & Accreditation

6 Kane County, Illinois 515,000 residents 2 nd & 5 th largest IL cities 70% urban/suburban, 30% rural 1/3 of residents are Hispanic Second youngest county in Illinois Fastest growing segment: year olds

7 Kane County Health Department Established by resolution in 1985 Governance: County Board of 24 & County Chairman Annual Budget: $6 Million 62 FTEs

8 The Problem The current recession has reduced tax revenue while increasing service demands for governmental public health

9 KCHD at Crossroads: June 2010 Illinois has both cut grants and set a policy of late payment to vendors, including local government KCHD has lost $1m in state grant revenue & experienced payment delays up to 200 days

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11 The Opportunity The recession and the state fiscal crisis demand a strategic organizational response from the Kane County Health Department

12 The Strategy Transform the Kane County Health Department to completely focus on population health: Transfer direct client services to 3 FQHCs Reduction in workforce by 50% Re-organization using PHAB standards as framework

13 2010 Agency Reorganization THEN: 120 FTEs 50% grant-funded Budget: $10 million Focus: Mixed, individual-level programs and services & population focused NOW: 60 FTEs 20% grant-funded Budget: $6 million Focus: Population-focused health, 10 essential services All job descriptions include: QI, population focus, essential services, preparedness & response

14 New Capacity New Job Descriptions & Capacity

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16 Re-org Results So Far… 1.Financial sustainability 2.Impact on MCH services 3.Population focused practice 4.QI & Accreditation

17 1. Financial Sustainability

18 Financial Sustainability KCHD CFY 2010 Revenue: $8,882,749 Expend.: $9,536,488 ($653,739) (~50% from Grants) 31 total grants 26 state grants 122 FTES KCHD CFY 2011: Revenue: $6,683,413 Expend.: $6,272,263 $411,150 (~20% from Grants) 21 total grants 17 state grants 60 FTEs

19 Financial Sustainability Our FY12 budget: Slight increase to revenues Added 2.0 FTES Projected 2% positive margin

20 2. Impact on MCH Services

21 Quarterly Reports: www. Kanehealth.com

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24 3. Population Focused Practice New capacity led to new community assessment and planning process in Kane in : 1.Formal partnership with 5 hospitals, mental health board, 2 United Ways~~~additional $$ resources 2.Integrated planning and policy development with County Development and Transportation Departments 3.Alignment: policy, systems & environmental change

25 2011 Community Health Assessment & Improvement Planning Why? Efficient resource use: 9 Kane County agency partnership KCHD reorganization>>>capacity Alignment around health needs & priorities What? Comprehensive two-part report Assessment Improvement Plan 9 customized reports Health integrated in Kane 2040 Plan Web-based data and source reports Why? Efficient resource use: 9 Kane County agency partnership KCHD reorganization>>>capacity Alignment around health needs & priorities What? Comprehensive two-part report Assessment Improvement Plan 9 customized reports Health integrated in Kane 2040 Plan Web-based data and source reports

26 Population Focused Practice

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30 4. QI & Accreditation

31 QI Training Needs

32 Use of QI Tools

33 Staff Interest/Engagement

34 QI Projects Division/TeamProject OCHR, CHR SectionImprove response rates of employee call-down drills. DP, PHN SectionImprove rates of initial high risk infant follow-up visits within compliance levels. OCHR, Admin SectionImprove structured spending of grant funds. HP, Environmental Health Section Decrease critical food inspection violations (to decrease instances of FBI). HP, Community Health Section Improve pre & post meeting communication in Community Health DP, Communicable Disease Section Improve collection & reporting of immunization data DP, Immunization SectionImprove rate of immunization competence for PHNs KCHD Leadership TeamImprove KCHD financial management

35 Project Results (So Far!) Employee call-down drill rates increased from 36% to 88%. Vaccine accountability increased from 92% to 100%, decreased from 3 data systems to 1. PHNs “competent” (Benner) in delivering immunizations increased from 25% to 100%. Awareness of CH meetings and of partnership increased from ~60% to ~90%.

36 Accreditation Committee & Workgroups COMMITTEE 16 Leadership Team Members 8 CHS-III staff CHS-I & CHS-II staff as support, as needed WORKGROUPS 1 per domain Lead: Leadership staff expert (in that area) Support: CHS-III staff, Leadership team –CHS-III: No more than 2-3 domains PHAB Application Accepted: May, 2012

37 “Sweet are the uses of adversity, Which, like the toad, ugly and venomous, Wears yet a precious jewel in his head.” -Wm Shakespeare

38 Robert Wood Johnson Foundation Route 1 and College Road East, P.O. Box 2316, Princeton, NJ Phone: Paul Kuehnert Senior Program Officer & Team Director, Public Health Team

39 Stay Connected


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