Field Experience Tennessee Department of Health Mission To protect promote and improve the health and prosperity of people in Tennessee 1998 Tobacco Master Settlement Agreement 206 b illion paid to states over the first twentyfive years of the agreement ID: 685282
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Jacy WeemsHSMP-4850 Field ExperienceTennessee Department of Health
Mission: To protect, promote, and improve the health and prosperity of people in TennesseeSlide2
1998 Tobacco Master Settlement Agreement
$206 billion paid to states over the first twenty-five years of the agreement Costs of treating smoking-related illnessFunding educational programs to reduce underage smoking
2013 – Tennessee General Assembly and Gov. Bill Haslam appropriated $15 million to the Tennessee Department of Health to mitigate tobacco use and related costs.
2014-2016 – $5
million is dispersed annually to all 95 health departments to fund tobacco prevention programs.Slide3
Tobacco Settlement Training
Year 1 Plan
Year 1 Report
Year 2 Plan
My Task
Tennessee Tobacco Settlement Program Planning Presentations
PDCA
Training – Director of the Office of Performance Management
December 2013 – Year 1 Program Plan due via
SurveyGizmoProblem StatementsBest PracticesJanuary 2014 – Year One Program Progress Report and PDCA form due via SurveyGizmoFebruary 8, 2015 - Program Plans for Year Two due via SurveyGizmoProblem StatementsBest PracticesCompose a report for legislators regarding Program progress Perform a qualitative study on PDCA cycle to measure appropriate utilization of PDCA
Tennessee Tobacco Settlement Program ProcessSlide4
Statewide Report of Year 1 Progress
Financial InvestmentMap of Participating CountiesGoals for ChangeStandard Measures of SuccessExperiences “From the Field”Common Improvements Identified by the Plan-Do-Check-Act Cycles of Learning
Project Progress GaugeSlide5
Use of the Plan-Do-Check-Act Cycle for Project Improvement: 2014-2015 Tennessee Tobacco SettlementSlide6
Quantitative Scoring
– PDCA Cycle of Learning[Step 1]: Compare Top Five/ Bottom Five[Step 2]: Created an index score[Step 3]: Identify
inclusion and exclusion
criteria
[Step 4]: Convenience & Random Sample
Overall Score Range: 0-12
Slide7
Results
Tennessee Tobacco Settlement Utilization of the Plan-Do-Check-Act Cycle
TDH
Geographic Region
Plan (0-2)
Do (0-2)
Check (0-2)
Act (0-2)
Understanding of the PDCA Cycle
(0-2)PDCA Implementation Score (0-2) PDCA Total ScoreRegion A1.871.601.220.911.41
1.19
8.19
Region B
1.33
1.50
1.00
1.17
1.00
1.33
7.17
Region C
1.67
1.92
1.42
2.00
1.83
1.5810.42Region D1.691.561.311.141.420.837.94Region E1.381.691.081.241.430.927.75Region F1.191.440.881.751.560.887.69Region G1.381.580.791.431.040.907.13Region H1.422.001.251.501.671.339.17Slide8
Strong Example of PDCA Implementation
Implementing Changes from Year 1 PDCA into Year 2 Plan – “What Would You Do Differently?”
Plan
Do
Check
Act
Year 2 Changes
From the beginning, create different PowerPoints with different additional focuses. For instance, one could have detailed 5As, plus detailed e-cigarette usage, while another could have detailed 5As, plus detailed general tobacco use to have in place based on audience need.
Understand beforehand the difficulty in collecting offices/addresses for all obstetricians in
[X] County to be able to get out the packets quicker. Bring together a focus group of healthcare providers for a brief time to discuss best approaches to provide training in the offices since many times, healthcare providers are on a busy/tight schedule, so it makes it hard to provide a one hour training and request feedback and surveys from all attendees. Better anticipated the number of questions received at many of the locations. Since they are already on a tight timeframe, time did not permit to go into detail on all the answers to their questions, especially their interest in e-cigarettes and how it relates to the intervention.
Based on feedback and separate training information, questions were updated for the 3-month and 6-month surveys to include more information such as implementing 5As components into electronic records. The training presentation was modified to include more time for questions and more information on e-cigarettes. In year two, the 5As Training will be expanded to include pediatrician offices in addition to the current OB/GYN offices. Training in the pediatrician offices will allow for program expansion to address secondhand smoke exposure.Slide9
"Use of PDCA Cycle in Year 2 Plan"
TDH Geographic Area
Pregnancy Smoking
Secondhand Smoke Exposure
Helping Children Not to Begin Tobacco Use
Region
A
0.75
1.64
1.17Region B
1.67
Region
C
0.75
Region
D
1.33
0.5
0.67
Region
E
0.75
1
1
Region
F
1.25Region G0.830.88Region H0.67Overall Average0.881.100.99 No projects were selected Less than two projects were selected
Results
Left: PDCA Index Scores by Project
Right: Use of the PDCA Cycle in Developing the Year 2 PlanSlide10
Highest Scoring Section: “Do”Lowest Scoring Section: “Act”
Low variation by region with exception of one outlierHighest Scoring Project: Teens Against Tobacco Use (TATU)Lowest Scoring Project: Supportive Media and MessagingBest PDCA Examples By ProjectPeer-Reviewed ReportResults and Analysis
What can we gain from these findings?
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2
3
4
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