Quality Improvement for a Healthy Minnesota Gail Gentling Office of Public Health Practice Minnesota Department of Health

Overview Minnesota’s Public Health System Multi-State Learning Collaborative Minnesota Public Health Collaborative for Quality Improvement (QI Collaborative) Performance Management Accreditation Statewide Health Improvement Plan (SHIP)

Public Health in Minnesota 53 Community Health Boards, 75 local health departments, 7 tribal governments 1 SCHSAC – State Community Health Services Advisory Committee Partnership, coordination and communication Longstanding (30-year) local assessment and planning process

Minnesota and MLC Joined in second phase (MLC-2) Partnership among the Minnesota Department of Health, Local Public Health Association, University of Minnesota School of Public Health Established MN Public Health Collaborative for Quality Improvement Strengthened public health performance management system

Minnesota Public Health Collaborative for Quality Improvement Based on the Model for Improvement Plan-Do-Study-Act (PDSA) cycle Structure similar to IHI Breakthrough Series* Project teams: Local public health staff MDH public health nurse consultant SPH faculty and graduate student Others impacted by the issue 8 quality improvement projects with 34 local health depts *Institute for Healthcare Improvement Breakthrough Series: http://www.ihi.org/IHI/Results/WhitePapers/TheBreakthroughSeriesIHIsCollaborativeModelforAchieving+BreakthroughImprovement.htm

Minnesota Public Health Collaborative for Quality Improvement Health Improvement Planning Up to 60 community health boards or tribal governments Focus on community engagement November ‘08 through October ‘09 Reducing Risk Factors…/Obesity Focus on policy and environmental change January ‘10 through December ‘10

Performance Management Essential local public health activities Performance measures Assessment and improvement planning Capacity Health Outcomes Accountability review process

Performance Management Goals: Identify gaps in current system with respect to national accreditation standards Update system components to be consistent with accreditation standards Facilitate dialogue about relationship between state and national systems

Accreditation Establish a SCHSAC local accreditation workgroup Facilitate dialogue at MDH about the value of state accreditation Assess state and local public health readiness for accreditation Develop state and local guidelines for accreditation preparedness Consider state incentives for local accreditation

Statewide Health Improvement Plan (SHIP) Legislation passed in 2008 session Focused on prevention and control of obesity and tobacco use Makes funding available to local public health for 2 years July 2009 - $20 million July 2010 - $27 million Use HIP collaborative to plan for it and Obesity collaborative to implement it

Lessons Learned from MLC-2 Allow yourself plenty of planning time Include quality improvement AND subject-matter experts Failure is as valuable as success – do not be afraid to talk about it Structure is your friend Be flexible Collaboration is the key to the collaborative