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Quarterly Action Alert:

During 3rd Quarter Level 1 meetings review the progress of your team’s individual PDSA project(s) currently submitted

in the Gateway CQI Project Tracker

Quality Outlook

T H I R D Q U A R T E R 2 0 1 8 / 2 0 1 9 C Y C L E

“CHANGE is the law of LIFE and those who look only to the past or present are certain to miss the future.”- John F. Kennedy

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June 2019

Level 1 CQI All Level 1 Teams April 8-19, 2019

NFP Level 2 CQI 2:30 pm—4:00 pm

May 6, 2019 650-479-3207

Access Code: 806 756 131 #

Level 3 CQI 1:30 pm—3:30 pm

June 10, 2019 Pine A

650-479-3207 Access Code: 808 742 805 #

HFMoHV Level 2 CQI 10:00 am—11:00 am

May 13, 2019 650-479-3207

Access Code: 802 555 581 #

EHS-HBO & PAT Level 2 CQI 9:00 am—10:00 am

May 9, 2018 650-479-3207

Access Code: 803 163 263 #

Coming Soon: State Priority Focus #3

The Missouri Department of Health and Senior Services (DHSS) Home Visiting Program previously implemented two state continuous quality improvement (CQI) priority focus projects in fiscal years 2017 and 2018. These were: State Priority Focus #1: Increase Client Retention; and State Priority Focus #2: Complete Post-Enrollment and Age Forms within Valid Time Frames. Thanks to the efforts of all contracted DHSS home visiting local implementing agencies (LIAs) both projects exceeded targeted outcomes.

In October 2018, annual performance measure reporting for FY 2018 identified a number of areas that could indicate lost opportunities for support, education, and services. Of the concerns that were identified, the number of recommended well-child visits that were either not completed by families or not recorded was significant. Analysis indicated a number of factors could contribute to improvement in not only capturing the information about a child’s recommended well-child visit, but also in supporting home visitors to help families overcome possible barriers to completing their child’s next well-child visit opportunity. At the DHSS programmatic level, more opportunities to record well-child information and provide technical assistance to LIAs were initiated in November 2018.

During the third quarter of FY 2019, the first two quarters of well-child completion data derived from submitted age forms will be analyzed. These findings will provide the basis for State Priority Focus #3: Increase the Percentage of Completed Well-Child Visits.

The goal of this new state priority focus is to increase the percentage of completed well-child visits that, in turn, supports families in obtaining and sustaining a medical home, improving the physician/patient relationship, and providing for early detection and intervention of medical and developmental concerns.

During fourth quarter of FY 2019, individual specific, measurable, attainable, relevant, timely (SMART) aims that include baseline and target percentages for improvement in completed well-child visits will be provided to each LIA to guide the development of multiple, short plan, do, study, act (PDSA) cycles.

The DHSS Home Visiting Program looks forward to the contributions of all LIAs in reaching the goal of this new state priority!

Coming in June 2019

DHSS Home Visiting Leadership Academy

DHSS contracted home visiting LIA supervisors will join together on June 5th and 6th, for two days of leadership academy trainings on resiliency, self-care, and team building. On June 6th, all home visitors will have the option to join their leaders in team building activities at the University of Missouri’s Venture Out Program. Look for more information to be shared through the Gateway Weekly Updates.

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CQI ACTIVITY LOGS

EHS-HBO & PAT Level 1 Teams, please submit your detailed activity log to Kristen Mandrell at: Kristen.Mandrell@parentsasteachers.org, and Melinda Kirsch at: HVCQI@health.mo.gov by May 1, 2019.

HFMoHV Level 1 Teams, please submit your detailed activity log to

Linda Kozlowski at: linda.kozlowski@phelpscounty.org, and Tracy Marshall at: HVCQI@health.mo.gov by May 1, 2019.

NFP Level 1 Teams, please submit your detailed activity log to

Lauren Stone at: LStone@stlouisco.com, and Beth Stieferman at: HVCQI@health.mo.gov by May 1, 2019.

For the Level Two Teams, please submit your detailed activity logs to

Melinda Kirsch at: HVCQI@health.mo.gov by May 24, 2019.

Please note the CQI-specific email address for submitting PDSA storyboards and

CQI activity logs. You may also send any of your CQI related inquiries to this

address for the quickest response, as multiple DHSS home visiting staff will access

this account. The CQI-specific email address is: HVCQI@health.mo.gov.

Prior Quarter Level 3 CQI Meeting

FY18 - 1st Quarter Level 3 CQI Recap - December 10, 2018.

Meeting minutes are posted in the secure section of the DHSS Home Visiting website accessible to DHSS

contracted LIA staff using the secure user-id and password at:

https://health.mo.gov/homevisiting/cqi/.

Continuous Quality Improvement Toolkit

The Office of Planning, Research & Evaluation - An Office of the Administration for Children & Families created a CQI Toolkit containing nine modules: Module 1: Introduction to CQI

Module 2: Using Data to Drive CQI and Identify Topics

Module 3: Creating the CQI Culture and Forming a Team

Module 4: Creating SMART Aims

Module 5: Understanding the PDSA Process and Measurement

Module 6: Process Maps

Module 7: Root Cause Analysis Tolls

Module 8: Key Driver Diagrams

Module 9: Reliability Concepts and Sustaining Gains

Each module contains a facilitation guide, PowerPoint slides with facilitation notes, and handouts and activities for participants. Under each module click the “+” by the topic heading “Related Documents”. The modules can be viewed at: https://www.acf.hhs.gov/opre/resource/cqi-toolkit-a-resource-for-miechv-awardees.

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April

National Child Abuse Month April is Child Abuse and Neglect Prevention Month. Go Blue Day is Friday, April 5, 2019. Raise awareness for child abuse and neglect by wearing blue on this day in support of the importance of child abuse and neglect prevention! Go Blue Wellness Walk is on Friday, April 19, 2019. For additional information on child abuse and neglect, please visit https://ctf4kids.org/public-awareness/child-abuse-prevention-month/. National Infant Immunization Week (April 27 - May 4, 2019) National Infant Immunization Week (NIIW) is an annual observance to promote the benefits of immunizations and to improve the health of children two years old or younger. For more information, please visit https://www.cdc.gov/vaccines/events/niiw/overview.html.

June

National Safety Month Most unintentional injury-related deaths occur off the job, often when least expected; during a vacation, while doing chores at home, or while driving across town.

The National Safety Council encourages everyone to be aware of hazards related to leisure and recreational activities, and take proper safety precautions. For more information about the top causes of unintentional injury and death in homes and communities, please visit https://www.nsc.org/home-safety.

World Sickle Cell Day (June 19, 2019) Sickle Cell Day is observed on June 19. Sickle Cell Disease (SCD) is a group of inherited red blood cell disorders. In SCD, the red blood cells become hard and sticky and look like a C-shaped farm tool called a "sickle". People with SCD can live full lives and enjoy most of the activities that other people do. For those who have SCD, it's important to learn how to stay as healthy as possible. For more information about SCD, please visit www.health.mo.gov/living/families/genetics/sicklecell/index.php.

May

National Children’s Mental Health Awareness Day (May 9, 2019) Thursday, May 9, 2019, is National Children’s Mental Health Awareness Day. National Children’s Mental Health Awareness Day seeks to raise awareness about the importance of children’s mental health and to show that positive mental health is essential to a child’s healthy development from birth. For more information, please visit https://www.samhsa.gov/children/awareness-day. Better Hearing & Speech Month The purpose of Missouri’s Newborn Hearing Screening Program is to identify infants with hearing loss and link them with early intervention services by six months of age. Early identification and treatment of hearing loss is essential so that speech, language, communication, and learning can develop as typically as possible. For more information on Newborn Hearing Screening, please visit http://health.mo.gov/living/families/genetics/newbornhearing/. The Hear to Learn is a website developed to house resources, bring people together, and foster a community of learning. For more resources, please visit http://www.heartolearn.org/about/index.html.

Upcoming Health Awareness

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number X10MC2948501—

Maternal, Infant and Early Childhood Home Visiting Grant Program in the amount of $3,988,612 with 0% financed with nongovernmental sources. This information or content and

conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

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Reminder The Missouri Home Visiting Weekly Updates for DHSS contracted LIA staff using the secure user-id and

password can be accessed at: http://health.mo.gov/living/families/hvcqigateway/.

The third annual DHSS Specific Session of the Home Visiting Summit

was held Wednesday, March 6, 2019, at Tan-Tar-A Resort in Osage Beach, Missouri. For the first time, the 2019 DHSS Specific Session was a full-day event! Evaluations confirmed it as an overall success!

The DHSS Specific Session, supported by the Maternal, Infant, and Early Childhood Home Visiting Program Grant and the Title V Maternal and Child Health Services Block Grant, brought together 71 participants that included home visitors, supervisors, and data entry personnel from the eleven DHSS contracted home visiting LIAs. Among the eleven LIAs, there were four evidence-based home visiting models represented: Early Head Start Home Based Option; Healthy Families America; Nurse Family Partnership; and Parents as Teachers.

The day’s featured speakers provided training, information, and resources on topics that support model goals and align with performance measures all DHSS contracted LIAs are currently working to enhance.

2019 Home Visiting Summit

DHSS Specific Session

Jessica Mostaffa, The Family Conservancy Presented:

Recognition, Screening, and Referral for Depression

Sommer Rose and Amy Sielaff

Children’s Mercy Hospital

Presented:

Safe Sleep Practices and

Home Safety Education

DHSS Office of Epidemiology Staff Presented:

FY 2018 DHSS Home Visiting Performance Measures