1. Mini-Grant Application: Quality Improvement in the Area of Immunizations Catherine Shoults, M.P.H., Kansas Health Institute Kansas Public Health Conference September 20 th, 2011

2. Presentation Outline: Part One: Overview of Immunize Kansas Kids Part Two: Why a quality improvement grant and overview of QI grant Part Three: Details of IKK QI grant Slide 1

3. Part One: Overview of Immunize Kansas Kids

4. What is IKK: Partnership between: Kansas Department of Health and the Environment Kansas Health Foundation Kansas Health Institute Coalition supports innovative, collaborative, and sustainable methods to increase age-appropriate immunization rates for Kansas children Slide 3

5. Part Two: Why a quality improvement grant and overview of QI grant

6. Why QI Grant: Supports the mission of IKK –Innovative Forum for agencies to test their ideas –Collaborative Grantees can be individual agency or coalition –Sustainable Grantees can determine best practices Slide 5

7. Goal for Grantees: Your goal is not to immediately fix a problem but to identify the problem and determine the best intervention to address the issue Slide 6

8. IKKs Goal for QI Grants: Short-term goals –Identify most effective intervention through the use of the QI process and tools Intermediate goals –Create a community within the grantees that uses QI in their public health activities Long-term goals –Improve vaccination rates in Kansas –Change the approach to vaccination problems Slide 7

9. Why participate in QI grant: Health care has show that QI can: –Effectively manage resources Save time Save money This grant will help you: –Find the root cause of your immunization problem –Determine and optimize a solution –Teach you how to integrate QI into your work Slide 8

10. Plan-Do-Study-Act Cycle: Institute for Healthcare Improvement Utilizes a cycle that answers: –What are we trying to accomplish? –What changes can we make that will result in improvement? –How will we know that change is an improvement? Slide 9

11. Cycle of Improvement: ID problem and generate idea Small tests of change Analyzing what works Adjust and do it again Slide 10

12. 1.Select problem or improvement opportunity 2.Describe the current process 3.Describe all possible causes of problem – Agree on the root cause(s) to address 4.Develop workable solutions and action plan –Targets or measures to know if the change is an improvement Plan Seven Stages of the Cycle Plan-Do-Study-Act Cycle: Slide 11

13. 5.Implement the solutions or process changes 6.Review and evaluate the result of the change 7.Reflect and act on learnings Do Study Act Seven Stages of the Cycle Plan-Do-Study-Act Cycle: Slide 12

14. Part Three: Details of IKK QI Grant

15. Project Goal: Identify and address an issue that creates a barrier to the effective delivery of immunization services Slide 14

16. Project details: Grants range from $5,000-10,000 –Regional or multicenter applicants can apply for larger amounts Project must be completed in 12 months –Expected time range is 6-8 months Up to 10 projects awarded Slide 15

17. Your organization should apply if: You deliver immunization services You coordinate or support vaccination activities Grants can also be submitted jointly as a partnership between providers or as an effort by a public health preparedness region Slide 16

18. Your project must: Utilize the Institute for Healthcare Improvements system for accelerating improvementInstitute for Healthcare Improvements system Plan: Explore the problem and identify possible solutionsPlan Do: Implement on a small scaleDo Study: Analyze resultsStudy Act: Modify and Implement again on a larger scaleAct Slide 17

19. Example PDSA: The county health department sponsors a vaccine drive every year and they have found that parents and children often leave because the line is too long –Plan: The health department wants to try a standing vaccine drive –Do: The health department offers both a standing line at one vaccination drive and an optimized sitting line at their next drive –Study: During the drive, the health department recorded how many people went through each line and if any people left before getting their vaccination –Act: The standing + sitting model was found to have more people go through and less people leave prior to vaccination so all health department drives follow that model Slide 18

20. Your project must: Incorporate promising and evidence-based practices or policies for the delivery of immunization services Evidence-based practice: the use of information whose effectiveness has been established through research Slide 19

21. Evidence-based practice: Home visits to increase vaccination rates Vax programs in schools/ child care areas Vax programs in WIC settings Client or family incentive rewards Client reminder and recall system Providers assessment and feedback Provider reminders Slide 20 Source: CDCs Community Guide

22. Your project must: Include measurable objectives Measurable Objectives: These items should show what you want to do, how you will quantify it, and the timeframe of completion Slide 21

23. Measurable objectives should be: SMART –Specific –Measurable –Actionable –Realistic –Timed For example: The September 2011 vaccine drive will have a wait time for vaccination no longer than twenty minutes per child Slide 22

24. Your project must: Include methods for evaluating changes that occur as a result of the project Example of methods for evaluation: Comparing the line throughput time before and after the intervention Slide 23

25. Overview of Requirements: 1.Center your project around the PDSA Cycle 2.Consider using promising or evidence- based practices 3.Create measurable objectives 4.Include evaluation in your proposal

26. What the funds can be used for: Direct and personnel costs –Personnel (salaries and benefits) –Travel –Printing/Supplies –Telephone –Other direct costs Slide 24

27. What the funds cannot be used for: Infrastructure Improvements –Software –Hardware –Furniture –Construction Subsidizing purchase of vaccines Lobbying Slide 25

28. Dates and deadlines: Rolling submission December 31, 2011: last day to submit proposal for this cycle Within thirty days we will suggests improvements, accept, or reject the proposal –If your proposal is rejected, you can submit a new proposal –Only one proposal per entity will be funded Slide 26

29. Contact information: Email immunize@khi.org for a grant proposal templateimmunize@khi.org Electronically submit proposal to immunize@khi.org immunize@khi.org –In the subject line please put 2011-12 IKK QI Proposal Slide 27

30. Technical assistance: KHI is available to help guide you through this process Feel free to contact immunize@khi.org if you have any questionsimmunize@khi.org Slide 28