using data to drive daily practice and program success gabrielle bargerstock, mph business...
TRANSCRIPT
Using Data to Drive Daily Practice and Program Success
Gabrielle Bargerstock, MPHBusiness Development Manager
Nurse-Family Partnership National Service Office
Florida Association of Infant Mental Health/MIECHV Conference
Many Paths to Enhancing Parent Child Relationships
April 25, 2014
Presentation OverviewBrief discussion of data as a
conceptData types and usageContext: MIECHV Program &
BenchmarksData Analysis Tools and Strategies ActivitiesResources
What is Data?Facts or information used usually
to calculate, analyze, or plan something
Factual information (as measurements or statistics) used as a basis for reasoning, discussion, or calculation
Information output …that includes both useful and irrelevant or redundant information and must be processed to be meaningful.
What is Data?According to Russell Ackoff: the content of the human mind can be classified into five categories:1. Data: symbols2. Information: data that are processed to be
useful; provides answers to "who", "what", "where", and "when" questions
3. Knowledge: application of data and information; answers "how" questions
4. Understanding: appreciation of "why“5. Wisdom: evaluated understanding.
Challenges in Prevention
The work requires: Substantial knowledge and skill Entails many steps (ex: assessing
need, setting priorities, planning/delivering programs, monitoring, and evaluation.)
Implementation in varied settings and communities◦ Requiring tailoring
Adherence to model fidelity
Other Complicating FactorsGetting enough data vs. being a
burden
Credible numbers vs. “we know things are better”
Determining the right focus at the right time◦process vs. outcomes◦quantitative vs. qualitative
Types of DataProcess
Process evaluation looks at a program’s implementation and establishes whether quantifiable targets have been achieve and strategies implemented as planned.
Can be useful determining whether a program should be refined continued, expanded, or eliminated.
Process data includes information such as the total program participants, demographics, how many homevisits have been completed per client, etc.
Outcome Outcome evaluation
measures the change that has occurred as a result of a program.
An outcome evaluation would tell you how many program participants demonstrated changed behaviors as a result of programmatic activities i.e. initiated breastfeeding, quit using drugs or alcohol, improved test scores, returned to school or work, etc.
Types of Data:Quantitative
Data that can be accurately represented numerically.
Data that can be measured.
Mathematic measurements, frequency of events, or categorical surveys (Yes/No, or rate a response on a 1-5 scale, etc).
Length, height, area, volume, weight, speed, time, temperature, humidity, sound levels, cost, members, ages, etc
Qualitative:
Descriptions
Data can be observed but not measured.
Colors, textures, smells, tastes, appearance, beauty, etc.
Includes things like verbal interviews or surveys that ask questions that are open ended
VS
Maternal, Infant, & Early Childhood Home Visiting (MIECHV) ProgramFacilitates collaboration and partnership to
improve health and development outcomes for at-risk children through evidence-based home visiting programs.
Program Purposes:1)Strengthen and improve the programs and activities
carried out under Title V of the Social Security Act;
2)Improve coordination of services for at-risk communities; and
3)Identify and provide comprehensive services to improve outcomes for families who reside in at-risk communities.
MIECHV includes grants to states and six jurisdictions; as well as grants to tribes and tribal organizations.
Maternal, Infant, & Early Childhood Home Visiting (MIECHV) ProgramMIECHV is an evidence-based policy initiative.
◦ Requires that the majority of grant funds (75% or more) to be spent on programs to implement evidence-based home visiting models.
◦ Up to 25 percent may be spent on promising approaches that must be rigorously evaluated
Currently, 14 home visiting models meet the HHS criteria for evidence-based home visiting.
Florida Association of Healthy Start Coalitions oversees in Florida. Ten sites funded.
Florida’s Benchmark PlanLegislation authorizing MIECHV funding requires
that all programs collect data to evaluate program performance and outcomes across six benchmark areas for all enrolled families: ◦ Maternal and child health; ◦ Childhood injuries and abuse and neglect; ◦ School readiness; ◦ Domestic violence; ◦ Family economic self-sufficiency; and ◦ Coordination of services.
Florida’s online data collection system – Florida Home Visiting Information System (FLOHVIS)
For more information contact Virginia Holland, Data Manager ([email protected]).
Data In Daily PracticeUsing data on a day to day basis
doesn’t have to be complicated or difficult to understand◦You do it already, many times a day
Goal: Move from informal usage of data, to conscious focus on analysis
In other words: Ongoing Quality Improvement or CQI
Types of AnalysesRoot Cause Analysis (RCA) is the
formal search for an individual or group of true causes of a problem and not just the symptoms. ◦ more than just one root cause to a problem
often exists and they can interact with each other.
RCA can capture both the big-picture perspective and the details. It can also be pointed at any problem, both simple and complex.
Simplest technique: Ask ‘Why’ five times…
Types of AnalysesThe Plan-Do-Study-Act (PDSA) cycle is a simple yet powerful tool for accelerating quality improvement. The PDSA cycle is shorthand for testing a change—by planning it, trying it, observing the results, and acting on what is learned. This is the scientific method, used for action-oriented learning.
The steps in the PDSA cycle are: Step 1: Plan--Plan the test or observation, including a data
collection plan Step 2: Do -- Try out the test on a small scale Step 3: Study--Set aside time to analyze data and study
the results Step 4: Act--Refine the change, based on what was
learned from the test
Real Life Example:Home visiting staff weren’t entering
data into the program and state’s reporting systems in a timely fashion, resulting in negative actions by the state oversight agency and payment penalties.◦Core Reason Why:
Staff didn’t adequately understand or have comfort with operating the computers and subsequently the database system.
◦Response: Training AND modification of hiring practices
Quality Improvement Process
ProblemIdentification
Determine Interventions
ImplementMeasure, Analyze & Evaluate
Activities to Consider Have a two hour meeting to
review current work (no more, no less)
◦Identify all key areas ◦Reflect on data, resources, and results ◦Chose 1 or 2 initiatives to stop and/or
start ◦Set ‘by when’◦Identify three points in time where
you can report out on your efforts Ex: Team Meeting, Staff event, Board
Presentation, Community Meetings
Activities to ConsiderMake daily operations more
efficient, easier, rewarding…. ◦Survey employees, clients, etc. for
processes/activities that are duplicative, time-consuming, nonsensical.
◦Identify one activity (or more) you could eliminate immediately and then stop doing it.
◦For activities that are necessary are there areas for potential streamlining?
Activities to ConsiderElevator speeches and key
statistics statements◦If you don’t have them, create them
as a team or ask individual team members to each develop one then discuss
Set a ‘What by when’ goal or create a 100 day challenge