1. The King County Asthma Forum (KCAF) Kimberly Wicklund, MPH Coalition Coordinator/AAA Project Manager Phone: (206) 296-4570 kimberly.wicklund@metrokc.gov

2. King County Asthma Forum zMission- To bring together individuals and organizations to establish an ongoing asthma network to communicate about, collaborate on, and coordinate projects that improve and support asthma prevention, diagnosis, and management in King County.” zConvened in May 1998 zTarget population- anyone in KC concerned with asthma zMembership- 60 active members/150 in network who represent clinics and hospitals, public health, research, community-based organizations, caregivers of children with asthma, schools, health plans, and others.

3. KCAF Coalition Structure

4. KCAF Projects Endorsed- coordinate and affiliate with the KCAF, but are autonomous Sponsored- projects of the KCAF that receive its oversight yAllies Against Asthma ( RWJ) yBetter Homes for Asthma ( HUD) yHealthy Homes II- (NIEHS) yACT- Asthma Care Training ( CDC)

5. Service Integration The KCAF is attempting to develop a seamless system of care for children with asthma by integrating systems and services in the community. An integrated system will provide: yA coordinated, comprehensive “menu of options” that ensures that children with asthma and their families are linked with the services that best fit their needs. yExpanded reach of services by building on other programs’ work. yConsistent and accurate messages to patients and providers about asthma and services available in the community. yCoordinated communication so that programs can accurately promote each other’s work, and avoid turf issues, “tripping over each other”, and duplicating efforts.

6. Service Integration Strengths of the coalition approach zMultidisciplinary group provides broad expertise for developing strategic, creative approaches to integrate services zCollective knowledge contributes to decisions and intervention designs that are well informed zEstablishes a common vision and culture of collaboration to work together to achieve a common goal zBrings people out of silos and one dimensional thinking, and enhances their ability to create linkages between programs zProvides a transparent forum to work out turf issues zInvolvement of community partners opens doors and lends credibility to the work

7. Service Integration Challenges of coalition approach zHigh level of cooperation needed in communication, coordination and planning zRequires time, patience and commitment zConsistent participation can be difficult because people have other primary responsibilities. zExternal constraints (IRB, funding) can complicate service integration zPartners must make sacrifices, and balance compromise and cooperation with their own agendas and timelines zModification of procedures and tools may be needed for integration with other services zRequires expertise in programs in addition to your own

8. Service Integration Strategies implemented by KCAF zCross Project Coordination Group Ad-hoc committee that meets regularly to work out issues of integration and coordination, such as recruitment, referrals, and project details. zStanding Committees Serve as feedback loops to inform the KCAF of gaps in services as they relate to their particular areas of expertise. zBuilding trusting relationships with diverse partners opens doors to organizations and brings credibility

9. Service Integration Strategies implemented by KCAF zMake an effort to fit programs together: (AAA) zEnsure staff are trained in service integration and know other programs well zScreening tools and project protocols incorporate referrals to other services and programs zCommunity Health Workers serve as the hub of the service integration wheel

10. Standardization A priority of the KCAF has been the standardization of educational messages, care guidelines, and asthma management tools. This work toward standardization has been in an effort to: ypromote accurate, consistent educational messages about asthma, ymaximize impact of services, yuse existing resources to avoid reinventing the wheel, and ypromote best practices

11. Standardization of messages, tools & guidelines Strengths of the coalition approach zMultidisciplinary input makes them higher quality and more appropriate for broader audiences zInvolving multiple stakeholders creates buy-in and contributes to adoption and dissemination zCoalition endorsement gives credibility zProvides greater reach when promoting their use zStrengthens the development of a common vision

12. Standardization Challenges of coalition approach zPeople or others in their organization have a vested interest in their own way of doing things- resistance to change zCredit must be shared by all who contributed to their development zOrganizations/agencies may want ownership zSacrifices must be made to adopt the standardized approaches zTime needed to adopt them and achieve consensus (process oriented)

13. Standardization Strategies implemented by KCAF zDevelopment of key asthma messages used in: yCHW educational protocols for HHII and AAA yPuget Sound ESD’s peer educator program ySeattle Public School’s Health Services yChild immunization and developmental education registry zDevelopment of common asthma action plan for use by families, schools, clinics, childcare providers, etc. zClinic Learning Collaboratives to standardize care zStandardized instruments, protocols and educational materials are utilized by projects when appropriate

14. Conclusion yCoalitions provide an indispensable framework for integrating services and standardizing approaches. yCan service integration and standardization be accomplished without a coalition? yCoalitions provide accountability for adhering to an integrated model.