Advancing Public Health Quality Improvement in Montana's County and Tribal Lands

1. Montana MLC-3 Quality improvement in alignment with the national accreditation program

2. County and Tribal Lands in Montana

3. Big Sky Country

4. …from the mountains • River valleys • Canyons • Forests • Grassy plains • Badlands • Caverns

5. to the prairies… • Fourth largest state • Population: 944,632 • 56 counties • 22 counties have less than 5,000 people • 7 Indian reservations • 2 cities over 100,000

6. Key Partners • MT Department of Public Health & Human Services • Association of Montana Public Health Officials • NW Center for PH Practice • MT Association of Counties • MT Public Health Association • MT Environmental Health Association • University of MT—MPH Program

7. Public Health System Improvement Task Force • Association of MT Public Health Officials • Indian Health Services • Local Health Departments • MT Association of Counties • MT Department of Environmental Quality • MT Department of PH & Human Services • MT Environmental Health Association • MT Primary Care Association • MT Public Health Association • Montana University System • Tribal Health Departments

8. Q I Accomplishments 1995: System Improvement Task Force initiated 1997: Participant in national Turning Point Initiative, including Performance Management Collaborative 2000: Strategic Plan for System Improvement 2001: State and local/tribal capacity assessments 2002, 2004, & 2006: Local/tribal preparedness assessments and quality improvement 2003: State system NPHPSP assessment and QI 2003—2008: Local system / governance NPHPSP assessments and quality improvement 2005: ASTHO award for emergency preparedness assessments and quality improvement 2007: Updated public health laws—includes the 10 ES 2008: Train local Boards of Health on new laws; introduce voluntary accreditation

9. MLC-3 Key Activities • Continue Montana’s PH system assessment and QI efforts. • Use Montana’s updated PH laws as a foundation for accreditation. • Implement 2 mini-collaboratives to focus on childhood immunization and customer service. • Contribute to the national accreditation discussion, research and process. • Regularly monitor, evaluate and report on MLC-3 efforts and progress

10. Preparing for Voluntary Accreditation • Local/tribal capacity reassessment & QI activities (repeat of 2001) • State NPHPSP re-assessment & mock accreditation review • Regional training on quality improvement • Inform the Montana public health community • Inform the PHAB • Prepare manuscripts for publication

11. Mini-collaborative Targets • Reduce the incidence of vaccine preventable disease • Customer Service

12. Mini-collaborative Process • Request for proposal • Training in LEAN Healthcare, applying principles of the Toyota Production Model • Quarterly face-to-face meetings • Monthly webinars

13. Evaluation Plan • Track timeliness of activities • Determine achievement of grant activities • Measure satisfaction levels of key partners • Measure fidelity of assessments and QI processes • Measure contribution to the PH science base • Measure changes in system capacity and performance • Measure alignment with National Voluntary Accreditation Program

14. Communication • Quarterly reports • Quarterly articles for MACO newsletter • Annual presentations at MPHA and MEHA conferences • Publications in national journals