1. Indiana Public Health System Quality Improvement Program (PHSQIP)

2. Multi-State Learning Collaborative – 3 Minneapolis - August 2008 Kathy Weaver, RN, MPA, JD Manager, QI and Accreditation Indiana State Dept of Health & Deb Koester, RN, MSN, DNP (c) Public Health Projects Manager Purdue University, HealthcareTAP

3. The Road to Accreditation and Quality Improvement

4. The Road to Accreditation and QI

6. Communicating for Change

7. Accomplishments to Date: Local NPHPS assessment V 2.0 in 20 pilot counties – started May 2007 Local NPHPS assessment V 2.0 in 20 pilot counties – started May 2007 RCA training ; project charters RCA training ; project charters State NPHPSP assessment August 2007 State NPHPSP assessment August 2007 10 state-level teams 10 state-level teams ASTHO grant ASTHO grant QI Advisory team – included external partners QI Advisory team – included external partners Pilot counties met – May 2008 Pilot counties met – May 2008 Essential Services Lunch and Learns – began 2008 Essential Services Lunch and Learns – began 2008 ES Advisory Committee ES Advisory Committee

8. Preparing local health departments for national voluntary accreditation

9. IN-PHQI Participating Counties  Pilot Counties  Planning to Complete

10. Local : First steps to accreditation and QI Local public health system partners have dedicated nearly 60 days to completion of the assessments. Local public health system partners have dedicated nearly 60 days to completion of the assessments. Nearly 500 healthcare organizations have participated in the assessment process. Nearly 500 healthcare organizations have participated in the assessment process. Over 300 hours of training have been delivered across the state. Over 300 hours of training have been delivered across the state. Sixteen counties are now implementing performance improvement projects across Indiana. Sixteen counties are now implementing performance improvement projects across Indiana.

11. Average Local Composite Score by Essential Service

12. Pilot Counties and ISDH Teams County Health Issue  Access to Care  Childhood Obesity  Community Health Assessment  Coordination of Local Public Health System Services  Public Health Workforce Education  School Absenteeism / Hand washing  School-Based Healthcare  Teen Pregnancy/STDs  Undetermined  Workforce Wellness ISDH Teams Team A - Obesity Team B - Environment Team C - Tobacco Team D - Regulatory Team E - Leadership Development Team F - Immunization Team G - Oral Health Team H - Preparedness Team I - HR Team J - Public Health Workforce Education

13. Allen County Healthcare Access Project Allen County Healthcare Access Project Carroll County Health Choices Coalition Carroll County Health Choices Coalition Delaware County Health Living Take Action Coalition Delaware County Health Living Take Action Coalition Dubois County Public Health Partnership Dubois County Public Health Partnership Howard County School Health Coalition Howard County School Health Coalition LaGrange County ♀ Smart Teen Decisions ♂ Program LaGrange County ♀ Smart Teen Decisions ♂ Program Monroe County Health Assessment Initiative Monroe County Health Assessment Initiative Montgomery County Health Services Partnership Montgomery County Health Services Partnership Vanderburgh County Public Health is Our Health Too! Vanderburgh County Public Health is Our Health Too!

14. Preparing the State health department for national voluntary accreditation

15. State Assessment Composite Performance Scores for Each Essential Service and Overall

20. Mini-Collaboratives 2 State-level collaboratives – overall theme being Communicating for Change 2 State-level collaboratives – overall theme being Communicating for Change At least 2 local-level collaboratives At least 2 local-level collaboratives

21. Local mini-collaboratives Planning on at least 2 Planning on at least 2 3-4 LHDs per collaborative 3-4 LHDs per collaborative They will select target based on their assessment results They will select target based on their assessment results Length of time – not determined; based on QI achievement Length of time – not determined; based on QI achievement Each will receive funding to support efforts Each will receive funding to support efforts

22. ISDH Priority Initiatives for 2008 Priority Domains Tobacco Use – as a back-up Tobacco Use – as a back-up Obesity Prevention Obesity Prevention Immunizations Immunizations Safety Net Safety Net Health Literacy/Education Health Literacy/Education Preparedness Preparedness E-health E-health Systems Systems

23. State Assessment Composite Performance Scores for Each Essential Service and Overall

24. Indiana is at 46 PH workers per 100,000 population

25. Indiana Target Area: Public Health Workforce Development

26. Essential Service # 8 assessment Do you have a written workforce education plan for all the staff in the department?

27. Essential Service # 8 question Does your department assist LHDs or local public/community health services to develop performance improvement strategies of their workforce?

28. Essential Service # 8 This pie chart indicates the compliance of the responding departments to all 4 model standards.

29. Communicating for Change

30. Communicating for Change on Workforce Development Objective: Develop a PH Workforce Education State Plan

31. Communicating for Change Adult Immunization Most cost-effective prevention measure Most cost-effective prevention measure Adult vaccinations Adult vaccinations Flu vaccine issues 2007-2008 Flu vaccine issues 2007-2008 Zostervax for adults Zostervax for adults

32. State Fair

33. Communicating for Change Tobacco use Progress in awareness Progress in awareness Limiting second-hand smoke exposure Limiting second-hand smoke exposure Tobacco tax increases Tobacco tax increases Medical advances Medical advances Immigrant smoking habits Immigrant smoking habits Tobacco use still too high Tobacco use still too high

34. Tobacco Free School Map 2001 2008

35. % Hoosiers Protected by Effective Local Smokefree Workplace Laws

36. House Enrolled Act (HEA) 1678 Effective July 2007 Effective July 2007 Increased cigarette tax Increased cigarette tax All of the revenue went to health All of the revenue went to health

37. HEA 1678 Created a tax credit for companies that had not been offering a health care benefit if the company started offering a qualifying benefit and maintained it for at least two years. The tax credit is the lesser of $2,500 or $50 per employee.

38. HEA 1678 Appropriates an additional $1,200,000 for tobacco control Appropriates $11,000,000 to the ISDH for childhood immunizations.

40. Working toward Accreditation Execution Trumps Strategy

41. “We are all faced with a series of great opportunities brilliantly disguised as impossible situations.” Charles R. Swindoll

42. Working toward Accreditation Learn from the mistakes of others. You can’t live long enough to make them all yourself. Eleanor Roosevelt