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

Mini-Grant Application: Quality Improvement in the Area of

ImmunizationsCatherine Shoults, M.P.H., Kansas Health Institute

Kansas Public Health Conference September 20th, 2011

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

Part One: Overview of Immunize

Kansas Kids

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

Part Two: Why a quality improvement grant

and overview of QI grant

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

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

IKK’s 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

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

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

Cycle of Improvement:

ID problem and generate idea

Small tests of change

Analyzing what works

Adjust and do it again

Slide 10

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

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

Part Three: Details of IKK QI Grant

Project Goal:

Identify and address an issue that creates a barrier to the effective

delivery of immunization services

Slide 14

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

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

Your project must:

Utilize the Institute for Healthcare Improvement’s system

for accelerating improvement

• Plan: Explore the problem and identify possible solutions

• Do: Implement on a small scale

• Study: Analyze results

• Act: Modify and Implement again on a larger scale

Slide 17

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

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

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: CDC’s Community Guide

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

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

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

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

What the fundscan be used for:

• Direct and personnel costs – Personnel (salaries and benefits)– Travel– Printing/Supplies– Telephone– Other direct costs

Slide 24

What the funds cannot be used for:

• Infrastructure Improvements– Software – Hardware– Furniture– Construction

• Subsidizing purchase of vaccines

• Lobbying

Slide 25

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

Contact information:

• Email [email protected] for a grant proposal template

• Electronically submit proposal to [email protected] – In the subject line please put

“2011-12 IKK QI Proposal”

Slide 27

Technical assistance:

• KHI is available to help guide you through this process

• Feel free to contact [email protected] if you have any questions

Slide 28