1. Sharing your CQI Story: Creating a CQI Story Board Tribal MIECHV Annual Grantee Meeting Washington, DC
May 6, 2015

2. Welcome & Introductions

3. Today’s Session CQI Story Board Introduction
Why use a CQI Story Board?
CQI Story Board Template
CQI Story Board Examples
CQI Story Board Hints and Tips
Sharing your CQI Story Board
CQI Story Board Discussion
Additional Questions

4. Why Use a CQI Story Board?
To tell the story of your CQI project from start to finish!
An important part of the PDSA Cycle (Step 9)
Helps your CQI team celebrate all your hard work and accomplishments!
Great tool for sharing your improvement work with others including tribal and organizational leadership, families, partnering agencies, and community advisory groups
Has the potential to help other home visiting programs experiencing similar challenges

5. In a Nutshell, CQI Story Boards…
Are organized around the steps in the PDSA Cycle
Should use graphics (charts and pictures) and simple, concise language (bullets and numbers) to communicate the project’s story
Are designed to be printed poster-size
Should be written so that someone outside of your CQI team will understand your project from start to finish
Can be created over the life of your project and started as soon as your Plan stage begins

6. CQI Story Boards: The Template
Available in both MS Word and Publisher formats
Set up to be printed as a 2 ft. x 3 ft. poster
Can be printed in an 8 ½ x 11 size
Most effective view for editing is about 33% (in MS Publisher)
Images are inserted as pictures (preferably .tiff files)

7. CQI Story Boards: Section by Section

8. General Project Information
Provides basic information about your tribal home visiting program
Program’s name
Where your program provides home visiting services
Who your program serves
Helps the reader see who was engaged in the work of the project and the project’s focus

9. Plan Stage: Steps 1 and 2 How was an area for improvement identified?
How were resources estimated and committed?
Was approval obtained, if needed?
Pulled directly from your Team Charter
How were team members identified/selected?
What team member roles and responsibilities were assigned and how?
What was the initial timeline for the improvement?
Final Aim Statement, pulled directly from your Team Charter

10. For Example… PLAN Stage Getting Started
Through Michigan’s MIECHV funding, Kent County Healthy Start (KCHS) is engaged in CQI work on an ongoing basis.
In July 2013, the team identified a need to improve well baby visits among participating families.
The team developed the following problem statement: Well Baby visits for participants enrolled in KCHS are not taking place (or are not being documented) at the intervals recommended by the program and the American Academy of Pediatrics.

11. For Example… PLAN Stage Assemble the Team
A subgroup of the Healthy Start Continuous Quality Improvement Committee was asked to participate on the CQI team.
The team consisted of a team leader, a facilitator, a scribe, a data analyst, and site supervisor and Family Support Worker representatives.
The team met once per month.
The team’s work was guided by the following aim statement: By January 31, 2014, Kent County Healthy Start will increase the rate of completed well baby visits by 25%.

12. Plan Stage: Step 3 What is the process being improved?
What baseline data have been reviewed and how were they analyzed?
How was input from customers/stakeholder obtained?
Insert a map of the current (prior to improvement) process to be improved with a brief explanation.
How was root cause determined?
Insert a Fishbone Diagram or other CQI tool used to examine root cause with a brief explanation.

13. Average percent of well child visits completed/documented: 30%
For Example…
PLAN Stage
Examine the Current Approach
Baseline Data:
Average percent of well child visits completed/documented: 30%

14. For Example… PLAN Stage
Examine the Current Approach – Map of Current Process

16. For Example… PLAN Stage
Examine the Current Approach – Fishbone diagram to examine root cause

18. Plan Stage: Step 4
How did the team identify all potential solutions to the problem based on the root cause?
What solution did the team pick and why?
Insert an Affinity Diagram or other CQI tool used to identify potential solutions, with a brief explanation.

19. For Example… PLAN Stage
Identify Potential Solutions – Affinity Diagram

21. Plan Stage: Step 5
Insert your Improvement Theory/Theories (If/Then Statements) from your Team Charter.

22. For Example… PLAN Stage Improvement Theories
The team developed the following predictions to guide their test:
If we improve our data entry procedures, then our rate of well baby visits will improve.
If we provide education to parents about the importance of well child visits, then our rate of well baby visits will improve.

23. Do Stage: Step 6
How was the test carried out? This is a great place to use bullets!
Did the team carry the test out on a small scale (with a home visitor or two, a certain subset of families, etc.)?
Did the team create anything to execute the test (i.e. survey, tracking document, guidance document, etc.)? This is a great place to include images of these materials!

24. For Example… DO Stage Test the Theory
Clear data entry procedures were implemented with all program staff in October 2013.
Data was reviewed at monthly CQI team meetings to catch issues with the new procedure as they arose.
Supervisors monitored data closely and followed up with home visitors on a regular basis.
Home visitors discussed the importance of well child visits with families on an ongoing basis.

25. Study Stage: Step 7 Was the test successful?
Did the results match the team’s theory?
Did the team experience any unintended side effects?
Was there an improvement?
Did the team need to test the improvement under other conditions?
What did the team learn?
Remember to SHARE the results! This is a great place to use data tools!
Facilitator note: How to use this section when your CQI project didn’t lead to improvement: report the data, how the results measured up against the Aim, and what the team learned from this process.

26. Average percent of well child visits completed/documented: 66%
For Example…
Study Stage
Study the Results
Average percent of well child visits completed/documented: 66%

27. Act Stage: Steps 8 and 9
If the improvement was a success on a small scale, did the team then test it on a wider scale?
Was the improvement standardized?
Did the team develop a new theory?
How did the team celebrate its successes?
How did the team communicate results with stakeholders?
What long term plans for additional improvements were made?

28. For Example…
ACT Stage
Standardize the Improvement or Develop a New Theory
Data entry procedures were standardized based on the project’s success
Establish Future Plans
Data will continue to be monitored on a monthly basis at QI meetings to ensure sustainable improvement
Project work will be shared with the Great Start Collaborative, Local Leadership Group, and other home visiting programs in the community
A new CQI project will be started based on examination of current data

29. Questions

30. Story Board Skills: Inserting Graphics
Go to the “Insert” menu  choose ”Picture”  select location of file
Handout: How to Save and Insert Images on the Story Board

31. Story Board Skills: Inserting Graphics
You can also copy and paste graphics into your story board.
For example, if you have a chart in an Excel sheet, you can select the chart, right click, select “Copy”, then right click on your story board and choose “Paste”.

32. A Word of Caution About Graphics
Most images created in Excel (e.g. graphics, charts) can be resized to a fairly large size.
However, other images, such as logos and photos, as well as most images from the Internet, can only be enlarged to a point before they start becoming pixilated and unsuitable for print.
This is due to the number of dots per inch (dpi) on the image. The more dots that are packed in per inch, the better.
Tiff (.tiff) files are the clearest graphic file you can use on your story board.
Handout: How to Save and Insert Images on the Story Board

33. CQI Story Board Hints and Tips
Include only essential information
Provide enough detail that the project progression is clear
Start with the information you have
Add to your story as your team completes activities
Use color!
Keep it simple!
Make it fun!

34. CQI Story Board Hints and Tips Cont.
Use your Team Charter as a primary resource
Information in your final Team Charter should be the same on your story board
Ask for a grammar and content review
Introduce your audience to graphics – why did you include it and what does it mean?
Keep narrative brief and focused on the most important things you want your reader to know
Don’t forget to spell check

35. Sharing your CQI Story Board
Story Boards can be used with different audiences in a variety of ways
Post your story board in your program office in an area where customers and stakeholders convene
Take your story board to a conference or interagency meeting and use it as talking points
Turn your story board into a printable Power Point presentation to share at a tribal board meeting or conference
Create a shorter narrative to highlight your CQI success story
Turn your story board into a brief article to share your CQI story in your tribal and/or program newsletter

36. CQI Story Board Resources
CQI Story Board templates with guidance
Information on page 41 of Embracing Quality in Public Health: A Practitioner’s Quality Improvement Guidebook
Handout: How to Save and Insert Images on your CQI Story Board

38. Additional Questions

39. CQI Story Board Discussion
As we walked through the story board template and example, what stood out to you and why?
In what ways do you see your CQI team using the story board and with whom?
How might your CQI team modify the story board template to share your work with different stakeholders?
What other formats might your CQI team use to share your CQI story?

40. Wrap-Up Additional Questions
Resources will be shared electronically with all
Thank you!
Contact Information:
Robin VanDerMoere

41. The Tribal Home Visiting Evaluation Institute (TEI) is funded by the Office of Planning, Research and Evaluation, Administration for Children and Families, Department of Health and Human Services under contract number HHSP WC.
TEI is funded to provide technical assistance to Tribal Home Visiting grantees on rigorous evaluation, performance measurement, continuous quality improvement, data systems, and ethical dissemination and translation of evaluation findings.
TEI1 was awarded to MDRC; James Bell Associates, Inc.; Johns Hopkins Bloomberg School of Public Health, Center for American Indian Health, and University of Colorado School of Public Health, Centers for American Indian and Alaska Native Health.
For more information on TEI contact:
Nicole Denmark Kate Lyon
Federal Project Officer Project Director
Office of Planning Research and Evaluation James Bell Associates, Inc.
The Tribal Evaluation Institute is funded by the Office of Planning, research and Evaluation within the Administration for Children and Families. TEI was awarded to James Bell Associates in partnership with the University of Colorado’s Centers for American Indian and Alaska Native Health and Michigan Public Health Institute. For more information, contact the individuals on this slide.