1. Creating a Culture of Quality: Using Performance Improvement to Tell the Story of Public Health in Yolo County JILL COOK, HEALTH AND HUMAN SERVICES AGENCY ASSISTANT DIRECTOR JAN BABB, COMMUNITY HEALTH BRANCH DIRECTOR EMILY VADEN, ACCREDITATION COORDINATOR

2. Objective After our presentation, we hope you will see Performance Improvement as:  Manageable  Valuable  Invigorating  Empowering for staff

3. Where is Yolo County?

4. Yolo Demographics Population: 207,000 Population by Race: 2007-2011 Race CaliforniaYolo County NumberPercentNumberPercent White22,860,34162%132,73467% Black/African American2,252,1296%5,0063% American Indian/Alaska Native287,7121%2,4851% Asian4,825,27113%25,62613% Native Hawaiian/Other Pacific Islander141,3820.4%1,1121% Some Other Race5,142,47814%20,51010% Two or More Races1,459,8874%11,4166%

5. Yolo Demographics Cont. ~50,000 residents (24%) of Yolo County residents are enrolled in MediCal

6. Organizational Overview Public Health Department Department of Health Services Health and Human Services Agency 2011 2013July 2015

7. Leadership Development &QI Operational Excellence Strategic Planning Employee Satisfaction Surveys CQI/PDCA Training Feedback & Updates

8. Leadership Development &QI Operational Excellence Strategic Planning Employee Satisfaction Surveys CQI/PDCA Training Feedback & Updates Vision Set by LeadershipSelection of CQI Teams Tools and Support Leveraging Current State

9. Leadership Development &QI Operational Excellence Strategic Planning Employee Satisfaction Surveys CQI/PDCA Training Feedback & Updates Vision Set by LeadershipSelection of CQI Teams Tools and Support Leveraging Current State Practical ApplicationRelationship Building Eye on the Big Picture

10. Getting Staff Buy-In DIFFUSION OF INNOVATIONKEY COMPONENTS Modeling CQI ◦Meeting evaluations ◦Incorporating and reviewing those regularly Communication ◦Regular and consistent ◦Accreditation/QI as standing item on all-staff meetings ◦“Documentation Hall of Fame” and “Roadmap to Accreditation” posters

11. NACCHO QI Road Map Tool First assessment: Oct 2014 Second assessment: June 2015 Scoring: 0 – nothing in place 1 – just getting started 2 – moving in the right direction 3 – adequate; have made good progress over the last year 4 – very good performance; plans in place to expand QI efforts throughout the organization 5 – QI is institutionalized Foundational Element Pre- training Average Score Post- training Average Score Leadership commitment2.332.71 QI Infrastructure1.501.79 Employee empowerment and commitment 0.581.54 Customer focus2.832.50 Teamwork and collaboration1.582.86 Continuous process improvement 0.831.71

12. Performance Measures A LCOHOL D RUG & M ENTAL H EALTH o Average time to enter data into Avatar C ALIFORNIA C HILDREN ’ S S ERVICES o Percent of clients 18 & older with a transition plan C OMMUNICABLE D ISEASE o Percent of completed CD reports N UTRITION E DUCATION AND O BESITY P REVENTION o Percent of county residents who recognize the branding for Harvest of the Month campaign I MMUNIZATIONS o Percent of NHV clients who have up to date records in CAIR W OMEN, I NFANTS AND C HILDREN o Number of WIC appointments lost to follow-up each month

13. Leadership Development &QI Operational Excellence Strategic Planning Employee Satisfaction Surveys CQI/PDCA Training Feedback & Updates Vision Set by Leadership Selection of CQI Teams Tools and Support Leveraging Current State Practical ApplicationRelationship Building Eye on the Big Picture Diffusing PI Throughout Agency Data Dashboard PI Added to Employee Orientation OpEx Support

14. Lessons Learned 1) Change management 2) “Keep it Real” 3) Separate accreditation from performance improvement

15. “We are what we repeatedly do. Excellence, then, is not an act, but a habit.” ~ Aristotle