1、H1N1: Applying Quality Improvement to Current Public Health Issues September 18, 2009 10:30 11:30 AM,Agenda,Introduction of Panelists Discussion of H1N1 Flu and how QI could help with this Fall flu season Short statement by panelists Overview of a recent use of the QI tools on H1N1 Q&A,Panelist,Ron
2、Bialek, MPP, President of the Public Health Foundation (PHF), Lillian Shirley, Director, Multnomah County (OR) Health Department Kim McCoy, MPH, Principal Planning Specialist, Minnesota Department of Health William Riley, Ph.D., Associate Dean, University of Minnesota School of Public HealthModerato
3、r: Jack Moran, Ph.D., Senior Quality Advisory, PHF,It Is Official June 11, 2009,The World Health Organization (WHO) has formally declared a pandemic in the growing outbreak of H1N1 influenza. WHO told its member nations June 11 that it is raising its pandemic warning level from phase 5 to 6. This is
4、 the highest alert level. The declaration means that a new flu virus is spreading quickly around the world.,It Is Official June 11, 2009,Calling H1N1 a pandemic does not mean that WHO thinks it is severe. Most cases have been mild. As of June 10, WHO said the disease was in at least 74 countries. Th
5、ey had reported 27,737 cases of swine flu. These included 141 deaths.,60 million to 120 million people in the U.S. will be sickened by the virus and hospital emergency rooms overwhelmed. The report estimates that as many as 1.8 million in the U.S. will be hospitalized, and up to 300,000 victims will
6、 land in intensive care units. “Importantly, these very ill patients could occupy 50% to 100% of all ICU beds in affected regions of the country at the peak of the epidemic They warned such an antidote will not be available until mid-October when the pandemic is expected to be in full swing. In a no
7、rmal flu season, about 36,000 Americans die annually and 200,000 require hospitalization.,Swine flu could kill 90,000 Americans, White House panel warns:,Purpose,Exploring opportunities to use the quality improvement process to enhance preparedness and improve response to the H1N1 flu.,H1N1 Flu Back
8、ground,The H1N1 flu that is spreading worldwide and will reemerge later in the year as we enter Fall flu season. There will be a vaccine, which will require LOTS of people to be vaccinated. In addition, there will be many who refuse to be vaccinated (or just can not get to it) who develop flu and ma
9、y require antiviral meds. Most States and communities will have to follow their current pandemic flu plans.,H1N1 Flu QI Question,Given that we could have a pandemic on our hands later this year, how could we utilize QI methods, tools, and techniques to review and refresh State and Local pandemic flu
10、 plans and improve the outcomes?What specific suggestion would you recommend?,Public health is full of highly dedicated and hard working individuals We cant do more with less, but can we do better with what we have? H1N1 Its not only what we have learned, but what havent we learned? What went as exp
11、ected? Did it really? Have we mapped the processes followed against those in our plans? If it went well, dont believe it.,Ron Bialek Comments:,Leadership commitment and support Articulate value to using a specific Model/Methodology It creates a common language, tools, skills for analysis across H1N1
12、 response Emergency Management, Immunization programs, Epi, Surveillance, Hospital and Health Care partners, Public Information It can be used to support ongoing work/goals in Public Health programs and departments i.e. Accreditation 9.31 B Can be adapted and used to real time stats as work unfolds,
13、Lillian Shirley, Comments: Application of Q.I. Essential for Success,Kim McCoy Comments:,Emergency preparedness is built on a quality improvement framework Plan develop emergency preparedness plans Do exercise/test your plans Study conduct debrief/hotwash/after action report Act revise or implement
14、plans Effective response to an emerging issue demands that we adapt rapidly Like our preparedness plans, our improvement skills will improve with practice,Bill Riley Comments:,Public Health departments are well-versed in QI principles QI is top down and bottom up Best training for QI is to conduct a
15、n improvement project Projects and Collaboratives can be organized locally and guided from a distance,Recent Usage In Applying Quality Improvement to Current Public Health Issues,H1N1 Planning with Quality Improvement Tools Public Health Foundation Consultative QI Workshop August 2009 Topeka, Kansas
16、 Conducted For The Kansas Department of Health and Environment,General Approach On How To Use The Basic Tools Of Quality Improvement,Issue To Consider,Flow Chart Existing Process,Brainstorm & Consolidate Data,Cause & Effect Diagram Greatest Concern,Use 5 Whys To Drill Down To Root Causes,Gather Data
17、 On Pain Points,Translate Data Into Information,Pie ChartsPareto ChartsHistogramsScatter Plots, etc.,Flow Chart New Process,Monitor New Process & Hold The Gains,Run ChartsControl Charts,Data Management Strategy,“As Is” State to “Should Be” State,“As Is” State,Brainstorming,Analyze Information and De
18、velop Solutions,Solution and Effect Diagram,Source: The Public Health Quality Improvement Handbook, R. Bialek, G. Duffy, J. Moran, Editors, Quality Press, 2009, p.160,Prepare,Surveillance & Testing,Community Mitigation,Communication Planning,Response,Follow-up,Force Field Analysis,SIPOC+ CM,Flow Chart,Cause And Effect,Flow Chart Summary,Solution And Effect,Implementation Planning,H1N1 Planning with Quality Improvement Tools Process Overview,Measurement,Summary,Final comments from panelists,Q&A,Thanks to our Panelists,
