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Roger s Fortune Cookie July 1988

QUALITYASSURANCE. EPIDEMIOLOGY. STRATEGICPLANNING. SERVICE. SCIENCE. POLICY. . . . Parallel Tracks. The Medical Model (Service). SICK WELL. Treatment. . The Quality Assurance Model (Process). NOTSO GOOD. . BETTER. Q. TQM CQI. The Planning Model (Regu

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Roger s Fortune Cookie July 1988

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    1. Roger’s Fortune Cookie (July 1988) Put the data you have gathered to beneficial use.

    2. Parallel Tracks

    3. The Medical Model (Service)

    4. The Quality Assurance Model (Process)

    5. The Planning Model (Regulation)

    6. The Research Model (Science)

    7. The Epidemiolgy Model (Modified Science)

    8. The Public Health Model (Classic Version)

    9. The New Public Health Model?

    10. Use Data Persuasion Assessment Monitoring Planning Evaluation Research

    11. Sources of Information CDC, NCHS State Health Departments IHS Headquarters East IHS Area Offices Tribes

    12. Existing sources: US Census Reservation and Tribal community data Includes social and economic indicators 1990 Census data are old and inaccurate 2000 Census data not yet available

    14. Existing sources: Tribal Census More complete than US Census Includes members away from community ?May miss members of other Tribes living in community

    15. Existing sources: Vital Statistics (birth and death records) Rarely specific to Indian communities Rarely Tribe specific Indian identification may be inaccurate Only superficial view of community’s health

    17. Infant Mortality Rates, 1973-1993

    18. NM AI/AN Infant Mortality 1993-1997 (communities with > 200 births/5 years)

    19. Existing sources: IHS Clinical Data Tribe and community specific Reports on people and health problems Data only on patient visits to IHS Cost accounting not yet available

    21. Existing sources: IHS Program Data Specific data on specific issues Similar reports available at many sites Sometimes narrowly technical Sometimes bureaucratic

    23. Existing sources: Tribal Programs Local perspective Data and reports for the Tribe May need to develop capacity Capacity for statistics and analysis are developing

    24. Existing sources: Special Surveys Can only be performed by community You can get what you really want Lots of work difficult, time consuming Requires developing expertise

    25. Surveillance Data Adapt data that already exists Pay someone to collect data Collect data yourself Require someone to fill out a form

    26. Parting Shots No data are perfect. Make it better. Use it anyway. Data don’t make decisions. People do. Data may be lacking. Use common sense, imagination, and good science to fill in the blanks. Data is as data does. (Forrest Gump-ian.) Use data to make a difference. Do public health. Success in prevention comes in small victories. Persistence is very powerful.

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