“ jacy weems hsmp-4850 field experience tennessee department of health mission: to protect,...
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Jacy Weems
HSMP-4850 Field Experience
Tennessee Department of
Health
Mission: To protect, promote, and improve the health and prosperity of people in Tennessee
1998 Tobacco Master Settlement Agreement
$206 billion paid to states over the first twenty-five years of the agreement
Costs of treating smoking-related illness Funding educational programs to reduce underage
smoking2013 – Tennessee General Assembly and Gov. Bill Haslam appropriated $15 million to the Tennessee Department of Health to mitigate tobacco use and related costs.
2014-2016 – $5 million is dispersed annually to all 95 health departments to fund tobacco prevention programs.
Tobacco Settleme
nt Training
Year 1 Plan
Year 1 Report
Year 2 Plan
My Task
Tennessee Tobacco Settlement Program Planning Presentations
PDCA Training – Director of the Office of Performance Management
December 2013 – Year 1 Program Plan due via SurveyGizmo Problem
Statements
Best Practices
January 2014 – Year One Program Progress Report and PDCA form due via SurveyGizmo
February 8, 2015 - Program Plans for Year Two due via SurveyGizmo Problem
Statements
Best Practices
Compose a report for legislators regarding Program progress
Perform a qualitative study on PDCA cycle to measure appropriate utilization of PDCA
Tennessee Tobacco Settlement Program Process
Statewide Report of Year 1 Progress
Financial InvestmentMap of Participating CountiesGoals for ChangeStandard Measures of Success
Experiences “From the Field”Common Improvements Identified by the Plan-Do-Check-Act Cycles of Learning
Project Progress Gauge
Use of the Plan-Do-Check-Act Cycle for Project Improvement: 2014-2015 Tennessee
Tobacco Settlement
Quantitative Scoring – PDCA Cycle of Learning
[Step 1]: Compare Top Five/ Bottom Five
[Step 2]: Created an index score
[Step 3]: Identify inclusion and exclusion
criteria[Step 4]: Convenience &
Random SampleOverall Score Range: 0-
12
ResultsTennessee Tobacco Settlement Utilization of the Plan-Do-Check-Act Cycle
TDH Geograp
hic Region
Plan (0-2)
Do (0-2)
Check (0-2)
Act (0-2)
Understanding of the PDCA Cycle
(0-2)
PDCA Implementation Score
(0-2)
PDCA Total Scor
e
Region A 1.87 1.60 1.22 0.91 1.41 1.19 8.19
Region B 1.33 1.50 1.00 1.17 1.00 1.33 7.17
Region C 1.67 1.92 1.42 2.00 1.83 1.58 10.42
Region D 1.69 1.56 1.31 1.14 1.42 0.83 7.94
Region E 1.38 1.69 1.08 1.24 1.43 0.92 7.75
Region F 1.19 1.44 0.88 1.75 1.56 0.88 7.69
Region G 1.38 1.58 0.79 1.43 1.04 0.90 7.13
Region H 1.42 2.00 1.25 1.50 1.67 1.33 9.17
Strong Example of PDCA Implementation
Implementing Changes from Year 1 PDCA into Year 2 Plan – “What Would You Do Differently?”
Plan Do Check Act Year 2 Changes
From the beginning, create different PowerPoints with different additional focuses. For instance, one could have detailed 5As, plus detailed e-cigarette usage, while another could have detailed 5As, plus detailed general tobacco use to have in place based on audience need.
Understand beforehand the difficulty in collecting offices/addresses for all obstetricians in [X] County to be able to get out the packets quicker.
Bring together a focus group of healthcare providers for a brief time to discuss best approaches to provide training in the offices since many times, healthcare providers are on a busy/tight schedule, so it makes it hard to provide a one hour training and request feedback and surveys from all attendees.
Better anticipated the number of questions received at many of the locations. Since they are already on a tight timeframe, time did not permit to go into detail on all the answers to their questions, especially their interest in e-cigarettes and how it relates to the intervention.
Based on feedback and separate training information, questions were updated for the 3-month and 6-month surveys to include more information such as implementing 5As components into electronic records. The training presentation was modified to include more time for questions and more information on e-cigarettes. In year two, the 5As Training will be expanded to include pediatrician offices in addition to the current OB/GYN offices. Training in the pediatrician offices will allow for program expansion to address secondhand smoke exposure.
"Use of PDCA Cycle in Year 2 Plan"
TDH Geographic
Area
Pregnancy Smoking
Secondhand Smoke
Exposure
Helping Children Not to Begin
Tobacco Use
Region A 0.75 1.64 1.17
Region B 1.67
Region C 0.75
Region D 1.33 0.5 0.67
Region E 0.75 1 1
Region F 1.25
Region G 0.83 0.88
Region H 0.67
Overall Average 0.88 1.10 0.99
No projects were selected
Less than two projects were selectedResults
Left: PDCA Index Scores by ProjectRight: Use of the PDCA Cycle in Developing the Year 2 Plan
• Highest Scoring Section: “Do”• Lowest Scoring Section: “Act”• Low variation by region with
exception of one outlier• Highest Scoring Project: Teens
Against Tobacco Use (TATU)• Lowest Scoring Project:
Supportive Media and Messaging
• Best PDCA Examples By Project• Peer-Reviewed Report
Results and Analysis
What can we gain from these
findings?
Plan
DoCheck
Act
1 2 3 4 5