Storyboard Instructions and Template At the coordinators meeting you will have the opportunity to share a storyboard that tells the story of some of your quality improvement work over the past year. The goal of this storyboard is to share with others your effort(s) in continuous measureable improvement. Your storyboard should be organized into four parts: 1) what you are trying to accomplish (aim), 2) how are you measuring if the strategies are making a difference (measures), 3) some changes you’ve tested through PDSA cycles to reach improvement (strategies), and 4) lessons learned & next steps Instructions • Your audience will be small groups of EHDI coordinators & teams • Please bring 50-75 copies of your storyboard, printed with multiple slides per sheet (be mindful of how pictures and background print) • You have 12 minutes to tell your story. Keep it simple and straightforward, yet be creative and have fun! • Your QI advisors are available to help you prepare your storyboard • If you have questions about the Wednesday meeting, please email Alyson Ward at [email protected]
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2016 Storyboard Template and Examples - Infant Hearing Storyboard... · Your storyboard should be organized into four parts: 1) what you are trying to accomplish ... Q3 2015 3 1 33.33%
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QI Team:• Lead: Nicole Brown, EHDI Coordinator (Long-term Follow up) - [email protected]• Kirsten Coverstone, EHDI Coordinator (Short-term follow up)• Melinda Marsolek, MDH Epidemiologist • Gina Oberg, PHN Hennepin County• Diane Graske, PHN Anoka County • Lona Daley, PHN Clay County• Mary Clausen, PHN Ramsey County• Rebecca Graham, PHN Wright County • Margaret Ratai, PHN St Louis County• Tony Ronco – NCHAM QI Advisor
AIM Statement• By December 31, 2015, we aim to decrease the number of children LTFU/D after not
passing their newborn hearing screening by improving the timeliness and resolution of “lost to follow-up” notifications sent to local public health (LPH).
• Specifically, we will:• Increase the percent of MDH Hearing Screening Notifications that are resolved from
34% to 50%.• Increase the number of MDH Hearing Screening Notifications that are resolved
within 1 month.
Why this aim? LPH are notified when MDH has exhausted all follow-up efforts. Only 34% of these cases sent to LPH are resolved.
How does it relate to overall LTFU goal/s?Reduce LTFU at diagnosis
• Numerator: # of MDH Hearing Screening Notifications that are resolved Denominator: # of MDH Hearing Screening Notifications sent
• Numerator: # of MDH Hearing Screening Notifications resolved within one month• Denominator: # of MDH Hearing Screening Notifications sent
• Reviewing data• Review percentages and plot data points on a run chart monthly• Run Charts Monthly
What Strategies Should We Test?We used a process map to help us figure out where to start, it lead to 2 improvement theoriesTheory 1: Improve parent education will reduce loss to follow-up
When talking with families:• Declined rescreening/diagnosis - 11% of the time. • Lack of education -32% of the time.
Theory 2: Improve contact information• Wrong number /disconnected phone number = 23% of the time. • Most successful in obtaining updated contact info from:
Improve Parent Education (based on Theory 1)• Strategy #1 - Standardization of educational materialsParent handout was developed and refined with input from LPH nurses and parents. Handout was printed and provided to LPH nurses doing follow-up.
Improve Contact Information (based on Theory 2)• Strategy #2 – Development of a checklist for LPHNurses tested a checklist developed based on successful approaches steps that the nurses found most successful. Testing included identifying the specific steps that are more successful in contacting families.
• Strategy #3 - Utilize Second Phone Number Collected at Discharge A second phone number is collected on the bloodspot card, however LPH EHDI Key Contacts have not had access to this second phone number.
Strategies
Strategy 3 in detail:Utilize Second Phone Number Collected at DischargeWhy was this strategy tested?Other states had success with this strategy.
What was the process for identifying the strategy?• LPH mapped current state, collected data on follow-up process, identified
cause using process map• Wrong number or disconnected phone number 23% of the time
What is the potential for the strategy to improve LTFU/D?Based on other state success, we considered we would have the same success. Also, when LPH staff was able to talk with families, they were most often successful in “closing case”.
PDSA #1• Plan- Contact families in Anoka and Hennepin Counties that we have
been unable to contact due to disconnected/wrong numbers and no response by using second phone numbers collected on the bloodspot card.
• Do- MDH provided 2nd phone number to LPH for cases with wrong/disconnected #. LPH attempted to contact families using these numbers.
• Study- 0 of 6 new phone numbers were helpful.
• Act- Abandon? Anoka county LPH nurse wanted to continue testing.
PDSA #2• Plan- Contact families in Anoka County with disconnected/wrong
numbers and no response by using second phone numbers collected on the bloodspot card.
• Do- MDH provided 2nd phone number to LPH for cases with wrong/disconnected #. LPH attempted to contact families using these numbers.
• Study- 0 of 3 additional new phone numbers were helpful.
• Act- Abandon.
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Lessons Learned/Moving Forward
Overall what have you learned from testing this strategy?• Why didn’t MN have the same results as other states with second contact? • Need to move beyond phone calls!
• 28% = voice message left & majority never returned call. • Utilization of other MCH Programs?
• 4 Midsize counties → 55% of cases resolved• 2 Largest counties → 22% of cases resolved
Moving Forward• Moving toward electronic reporting• Future tests once MN Screen (OZ) has been implemented• Need to contact families beyond phone calls – focus on metro counties