City and County of San Francisco DEPARTMENT OF PUBLIC HEALTH San Francisco Department of Public Health Black/African American Health Initiative (BAAHI) Attachments
Collective Impact Working Groups Increase Breast Cancer Screening for Black/African American Women Increase Chlamydia Screening in Black/African American young women Increase Cage Assessment in African American Men in mental health clinics Increase hypertension control and Black/African Americans City and County of San Francisco DEPARTMENT OF PUBLIC HEALTH
BAAHI: Breast Cancer Screening General Project Plan Overview Proposed Work plan 2014 2016 Workgroup Membership Problem Analysis Performance Measure and Dashboard Development Creation of Workgroup, partnerships with PC/Radiology, QI Patient Feedback and Survey on BAA/Staff Experience Process and Outcome Measurement : Capacity, Referral and Show rates Review membership and engage additional stakeholders Root Cause Analysis: Innovation and Human Centered Design Thinking End User Feedback Definitions Validation and Standardization of Race/Ethnicity Definitions in AC Intervention, Countermeasures Implementation Ongoing Evaluation and Testing Engage Clinics with lowest performing rates and high numbers of BAA patients, Trainings, scripts Initial Pilots Sustainability Drop In Appts Saturday Appts Leverage Mammova Monthly review of measures at health center, provider level Review first PHASE Interventions: Development of priority and high yield interventions for PHASE 2 engagement of BAAHI Think Tank membership Sustainability of initial clinics, tool kit development Engage clinics with current lowest screening rates 3
2014 Focus: Breast Cancer Screening Improvement and Sustainability SOUTHEAST HC: 77% B: 78% (765) POTRERO HILL HC:78% B:74% (602) MAXINE HALL HC:76% B:73% (1111) ASN = 85% (81), BLK = 78% (486), HSP = 81% (62), WHT = 67% (49) A P R - 14 A P R - 15 SEP-15 ASN = 87% (128), BLK = 74% (151), HSP = 84% (161), WHT = 69% (108) Apr-14 Apr-15 Sep-15 ASN = 86% (384), BLK = 73% (282), HSP = 78% (88), WHT = 71% (256) 2014 Focus: Breast Cancer Screening Improvement and Sustainability FHC:75% B: (2529) GMC: 75% B: 69% (1962) ASN = 79% (908), BLK = (172), HSP = 78% (928), WHT = 66% (315) N= Asian 77% (732), Black 69% (290), Hispanic 81% (577), White 67% (252)
Focus: Breast Cancer Screening Improvement and Sustainability CMHC: 71% B: 63% (988) CSC: 54% B: 58% (356) 30% N= Asian(91), Black (56), Hispanic (534), White (217) N= Asian(134), Black (43), Hispanic (32), White (131) Focus: Breast Cancer Screening Improvement and Sustainability TWUHC: B: 42% (788) White Total 30% 20% N= Asian 56% (68), Black 42% (275), Hispanic (84), White 32% (304)
Main steps CAGE baseline follow up Provider alcohol skills baseline incidence and prevalence metrics Provider BAA skills Logistics Workgroup task setting BAAHI, Behaviral Health priority area dashboard, Jul '15 Aug '15 Sep '15 Oct '15 Nov '15 Dec '15 Owner(s) BAAHI, overview dash provider and input on CAGE measure Provider and input on CAGE measure Discuss likert scale, discuss with s Discussion with key informants Choose members, Literature review, gather information create workgroup, and questions for WG QM discussion,? survey IT meeting to ask for metrics workgroup questions on BAA skill set invite, set up room and workplan Frame interaction Set up and provider input Metrics dash Discuss CAGE with workgroup discuss provider skills with workgroup ICD 9 and 10 codes to Noah inform survey with WG input Survey Workgroup dash Meetings Meetings, feedback Decide up or down on CAGE Decide up or down on skills metric Decide up or down on BAA skills Ongoing support Adjustments based on feedback Root cause/change theory Collect theory statements, first draft refine draft First training, group humble inquiry Ongoing trainings Judy, Darlene Judy, Deborah Judy, Darlene, Deborah Darlene, Judy Judy, Darlene Judy, D, Israel Special workgroup task stigma-free title for our priority area's work Judy, Darlene timeline elements discuss with training director gather input on content Training dash Design training elements Schedule at begin trainings Judy, training team designee
BAAHI: Chlamydia Screening General Project Plan Overview Activity Key Person Partners/ Resources Design data tracking system Trang IT Denominator Platform Timeframe ecw evaluation for data and care needs Shivaun, Ayanna, Trang Noah, Susan Fischer-Owens J A S O N D J F M A M J J Establish Workgroup, meet monthly or more Establish Advisory Committee, invited to Workgroup, +on-call Document current best practices and barriers in youth clinics Pilot system changes in population testing and reporting at 3 rd St Document current best practices and barriers in select primary care clinics Document out-of-clinic resources available Craft recommendations for changes in practice in clinics and outside resources to bring in Darlene, Ayanna Darlene, Ayanna Ayanna, Shivaun Susan, Ayanna Ayanna, Shivaun Ayanna, Susan, Shivaun Core group + advisors 3 rd St YCC MCAH, Pop, 3 rd St YCC, Advisors, SFUSD,
BAAHI: Hypertension (HTN) Control Jan March June Sept Oct-Dec Feb 2016 Analytics Frame Equity as QI Engage Stakeholders Clarify problem Identify Interventions Propose Recommendations Train Analysts to use i2i database to track HTN control by race over time Introduce Equity as QI Framework with clinics and key stakeholders Kickoff of Workgroup in July! Frontline staff from 6 PC clinics Root cause analysis Lit search Brainstorm and prioritize potential interventions Propose AIM statement and best practices to SFHN PC clinics