Minnesota TIGER Summit: Together We Can Do IT…

1. Minnesota TIGER Summit:Together We Can Do IT… Meaningful Use of the Omaha System for Program Evaluation in Public Health Nursing June 16, 2010Northland Inn – Brooklyn Park, MN 1:00 pm - 5:00 pm

2. CHS Administrators envisioned using electronic health records to gather data for program evaluation, starting in the 1990’s 3 software programs adopted in CHS agencies CareFacts CHAMP PH DOC Common denominator: the Omaha System Vision: Evidence-based Program Evaluation

4. By 2000, 87% of counties in Minnesota had a public or private agency using one of the 3 software systems Users began to recognize the potential to work together Minnesota Omaha System Users Group started in 2001, led by state and county public health nurses omahasystemmn.org Minnesota Omaha System Users Group

5. Over 200 participants state and local public health private home care & hospice Universities (faculty & students) Software industry Metro, central MN, southeastern MN Wisconsin Washington State Diverse Stakeholders

6. Using the Omaha System to support programs Family home visiting Disease prevention and control Waiver programs Home care Hospice Healthy Communities Diverse Programs

7. Grass roots collaboration Internationally recognized leaders Documentation and practice quality Dissemination of tools Two scientific publications A national American Public Health Association award International visitors Results

8. Overview Karen Monsen, PhD, RN, University of Minnesota School of Nursing, mons0122@umn.edu Implementation Katie Halder, MS, RN, PHN, Douglas County Public Health katie.halder@mail.co.douglas.mn.us Quality Jill Timm, JD, RN, PHN, Program Manager, Maternal Child Health, Washington County Department of Public Health & Environment, jill.timm@co.washington.mn.us Using Data Diane Thorson, MS, RN, PHN, Director/CHS Administrator, Otter Tail County Public Health, dthorson@co.ottertail.mn.us Panelists/Topics

9. Learning curve for implementation Computer literacy Unique attributes of each program Always adapting and changing Gets easier with time and software improvements Software

10. Learning curve for the Omaha System The Omaha System is the standardized language within the software Provides structure Client assessments Client outcomes Practitioner interventions The Omaha System

11. Learning curve for both software and terminology What is a software mystery? Have a great relationship with vendors to solve these Examples: Entering dailies and Omaha Interventions What is an Omaha System terminology mystery? Use Omaha System resources to solve these Book Web sites Meetings Mysteries

12. Documentation efficiency Keeps improving Initial charting time Efficiencies

13. For all 3 software programs, it is the Omaha System that allows us to work together, describe our practice, and show our outcomes Software implementation needs to include Omaha System training and support Outcomes

14. Vision to use data to demonstrate outcomes relies on having quality data Omaha System users share this vision and have developed tools Manuals Pathways KBS rating guides Quality

15. Supporting documentation efficiency and quality Provided by vendors Adapted & edited by local agencies Updated periodically to reflect changes Utilized during orientation and early use of an electronic documentation system Manuals

16. Started in 2001 to describe practice Helped with documentation efficiency and convenience MOSUG pathways web page Now developing evidence-based, peer reviewed pathways Pathways

17. Started in 2002 in Ramsey County Based on the information in the Omaha System book Expanded definitions for improved accuracy Revised every 1-2 years This summer’s revision will include Washington State Omaha System users Inter-rater Reliability

18. See the results transforming practice Knowing standards of care Incorporating evidence into practice Valuing reliability and avoiding bias Confidence in the quality of our programs as well as our data Commitment

19. Nurse-Family Partnership evaluation Otter Tail County uses the PHDOC software program Omaha System data Can analyze Problems, Signs and Symptoms, Targets, and Knowledge, Behavior, and Status outcomes Otter Tail County Program Evaluation

20. LTBI Breastfeeding Obesity Early Childhood Screening MSHO The Future of Omaha System Program Evaluation

21. Assessment forms required with other programs do not match with the Omaha System Working with other agencies and state officials to resolve issues in data collection Starting to see the benefits of using standards (meaningful use of data)‏ Challenges

22. Serves high risk pregnant women and children ages 0-2 Program has been carefully tested Omaha System pathways will support our nurses Omaha System outcomes will allow us to evaluate our local program and results Nurse-Family Partnership

23. Surveillance/Assess: Signs/Symptoms Physical: pregnancy discomforts, danger signs… Teaching: Anatomy/Physiology: prenatal classes, childbirth preparation Case Management: other community resources such as Quit Line, WIC Developing Standards of Care

24. Most Frequent Problems were Pregnancy and role Change Most Frequent Signs/Symptoms were low income, loss of previous role, and difficulty with prenatal exercise/rest/diet/behaviors Most Frequent Category is Teaching Most Frequent Targets are signs/symptoms and feeding procedures Looking at the NFP data

25. KBS rating data KBS Ratings Knowledge Behavior Status Omaha System Problem Av Chg Clients Av Chg Clients Av Chg Clients Pregnancy 1.1 10 -0.11 10 0.3 10 Role Change 0.38 8 0.13 8 0.13 8 Outcomes Evaluation

26. Thank you! Questions?