Creating an Impact Evaluation for an Academic/Community Practice Partnership Adrianne J. Lane EdD, RN, CNE Cindy Foster, MS, RN, APRN Chief Nurse Administrator, Chair, Associate Professor and Professor of Nursing Northern Kentucky University Northern Kentucky University

NKU College of Health Professions NURSING 800 students 43 FT faculty Programs BSN Accelerated BSN RN-BSN: online MSN/NP: online Post Master’s Certification—NP: online DNP: online

Purpose and Objectives Describe a project undertaken to design an impact evaluation to measure outcomes of an academic/practice partnership. Objectives: Design a comprehensive evaluation plan based on a logic model Collect and analyze data for identified strategies within the plan Determine next steps in care delivery and sustainability based on impact evaluation.

Background Regional university has as a strong mission of community engagement. Nurse Advocacy Center for the Underserved in 2006. This center provides services to the underserved in a variety of locations including, but not limited to, an emergency shelter, a transitional living unit, and a local church. Center has been providing and evaluating services over the past 10 years, no formal mechanism existed to relate these services. Overall health needs of the region are outlined by the regional health department. No formal impact evaluation existed to measure the impact of the center on the overall regional health needs. 

Process for Development Partner support and funding Design a logic model Develop a focused plan for collecting data Meet with key stakeholders Design data collection tools patient survey, focus group, service-results check sheet Collect data at pre-determined center sites Conduct focus groups Analyze results of data collection and focus groups for check sheet development Comprehensive analyses informed by the logic model & Triple Aim: Health, Healthcare, and Costs. Community meetings for data collection alignment Futures planning A B C

Logic Model Problem: Some adults in Northern Kentucky lack access to healthcare Intervention: Create a Nursing Advocacy Center for the Underserved Goal: To provide culturally appropriate healthcare services to the underserved in their Northern Kentucky community by creating a Nursing Advocacy Center for the Underserved (NACU) Objectives: Develop the necessary infrastructure for the NACU Provide ongoing healthcare services by partnering & collaborating with the community Secure funding to sustain ongoing services provided through NACU

Logic Model Outcomes: Increase collaboration with community partners to identify health needs and resources of the underserved in Northern Kentucky Increase access to healthcare for the underserved in Northern Kentucky Increase numbers of NKU faculty, NKU students, volunteers, and partners in providing healthcare services via NACU Increase NACU involvement in advocacy activities for culturally appropriate healthcare for the underserved Increase satisfaction among patients, NKU faculty, NKU students, volunteers, partners of NACU, and key NKYHD stakeholders Stabilize NACU through ongoing funding Track demographics and service-related results Disseminate knowledge gained

Process for Development Develop a focused plan for collecting data (pt. data form, focus group, tbd check sheet) Collect pt. data forms at center sites Conduct focus groups with stakeholders Analyze results for check sheet development Collect data using check sheet Comprehensive analyses informed by the logic model & Triple Aim: Health, Healthcare, and Costs Stakeholder meetings for results sharing and goals alignment Annual impact evaluation provided to partner and future planning

Key Data -- Annual Impact Evaluation Demographics Allergies Insurance Tobacco Use Alcohol Use Recreational Drug Use Homeless Living Arrangements Employment Barriers to healthcare Perceptions of Personal Health

Outcomes Achieved Strengthening of academic-practice partnerships Creation of a sustainable impact evaluation plan Ongoing comparisons/adjustments to programming Future planning for this academic practice partnership Dissemination of the process for designing the impact evaluation

Rural Health Implications This process serves as model in developing an impact evaluation for programs/ projects r/t the health of a region or another entity. Creation of a logic model and an impact evaluation is key in measuring specific outcomes against global outcomes. Process serves as an collaborative pathway for creating effective evaluation between agencies. Evaluation is useful for linking rural needs, rural efforts, and rural outcomes with regional and/or state goals and objectives.

Recommended Best Practices Partner with county health departments and community stakeholders. Seek funding using impact evaluation. Submit annual impact evaluation to regional health department. Build and sustain trust with underserved populations through strengthening links with health care providers. Respect the underserved—go to where they go and provide the services they need based on comprehensive data.

Summary In summary---- Design a comprehensive evaluation plan based on a logic model Collect and analyze data for identified strategies within the plan Determine next steps in care delivery and sustainability based on impact evaluation.

Funding provided by AACN/CDC Academic/Public Health Impact Evaluation Projects -- Small Grants

Contact Adrianne J. Lane lanea6@nku.edu

References America's Health Rankings by United Health Foundation. 2012 Kentucky Health Statistics. Retrieved from http:/fiwww.americashealLhrankinqs.orq/KY/CHD Choudhry, L. , Douglass, M., Lewis, J., Olson, C.H., Osterman, R, & Shah, P. (2007). The impact of community health centers & community—affiliated health plans on emergency department use. Cooper, B. (2013, November 24). If businesses lead the charge to improve health of our workforce, NKY will flourish. The Cincinnati Enquirer. Healthy People 2020. Retrieved from https://www.healthvpeople.qov/ Health, United States, 2012. Retrieved from http://www.cdc.qov/nchs/data/hus/hus12.pdf Institute of Medicine (2011). The future of nursing: leading change, Advancing health. Retrieved from http://www.nap.edu/openbook.php?record Northern Kentucky Independent District Health Department. (2014). Retrieved from http://www.nkyhealth.orq/ Northern Kentucky University Mission. (2014). Retrieved from http://fue!theflame.nku.edu/mission.html

References, continued Rodak, S. (2013). Study: 71% of ED visits unnecessary, avoidable. Becker's Hospital Review. Retrieved from http://www.beckershospitaireview.com/capacity-manegement/study-71-of- ed-visits-unnecessarv- avoidable-html Sharma, M. & Petosa, R. (2014). Measurement and evaluation for health educators. Burlington, MA: Jones & Bartlett Learning. Timmreck, T- (2003). Planning, program development, and evaluation, 2nd ed. Sudbury, MA: Jones and Bartlett Publishers. United States Department of Health and Human Services National Prevention Council (2010.). Elimination of health disparities. Retrieved from http://www.sucgeongeneral.gov/initiatives/prevention/strateqv/elimination-of-health- disparities, html