Data, Data, Data

1. Data, Data, Data An Introduction to Performance Measurement for Community HealthCorps Members

2. Agenda • Performance Measurement Defined • The Logic Model & Components • Our Philosophy & Assumptions • Our Performance Measures • Practice scenarios • Documenting Data • What Happens to Data

3. I Came to Serve Not Collect Data! If it wasn’t measured, It didn’t happen.

4. What is Performance Measurement?

5. The AmeriCorps Logic Model Intended Results Program Planning

6. Logic Model Nuts & Bolts: Program Planning

7. Nuts & Bolts (cont): Intended Results

8. The Mission of Community HealthCorps … is to improve health care access and enhance workforce development through community health center sponsored AmeriCorps including VISTA (Volunteers in Service to America), and related programs. 

9. Our Philosophy: Social Determinants of Health • Most Responsible for • Health Inequities • Access to services • Access to resources (e.g., grocery stores) • Discrimination by social grouping (e.g., race, gender, or class) • Employment • Education • Health insurance coverage • Housing • Socioeconomic status -income • Transportation • Social or environmental stressors “Social determinants of health are the circumstances in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources…which are themselves influenced by policy choices.” (World Health Organization)

10. Our Logic Model: Assumptions • Community health centers will serve the needs of people very well with adequate capacity. • The Community Health Worker role is an example of a major way members serve the needs of community and health center organizations. • Members positively impact an organizations’ capacity to serve patients/clients. • Member service housed in Enabling Services should be the priority placement within health centers in adequately address social determinants of health. • People need assistance with adopting self-care practices, and navigating health and social services.

11. Favorite and share Save your favorite photos, share with a friend, add a tag, and more. Key Service Activity to be Measured Delivery of Health Services Health Education Assist health centers in increasing knowledge and helping to change unhealthy lifestyles of recipients, focusing on topics such as general wellness, preventive disease management, or other goals to improve overall health. Enroll new people in a health insurance, health services, or health benefits program. Provide language translation services. Reducing Childhood Obesity Volunteer Generation Recruit and coordinate new non-AmeriCorps volunteers to participate in health center activities, such as distributing health promotion material around communities or health fairs. Encourage children/youth to participate in physical activities that are designed to target childhood obesity.

12. Performance Measures by Type

13. Delivery of Health Services

14. Delivery of Health Services: Definition of Key Terms • Uninsured: An individual who does not have insurance coverage. • Economically disadvantaged individuals: Those who meet income eligibility for Medicaid or SCHIP within the state they live. • Medically underserved: An individual who lives in a medically underserved area as defined by Health & Human Services (HHS). • Healthcare services: Accessible, comprehensive, continuous, & coordinated care to preserve health within the community. • Preventative health care services: Any activity that is conducted with a goal of preventing/detecting illness. • Primary health care: The basis of health care and is defined as an individual’s essential form of health care. • Translation vs. Interpretation: Translation is the written conversion of one language to another, and Interpretation is the spoken conversion of language to another.

15. Delivery of Health Services: How to Measure Clients receiving language translation services (output): Count unduplicated new clients who receive the language translation services (can be either written or verbal). If an encounter involves more than one person (e.g., family members), count each individual separately. Enrolling patients in health insurance / FQHC programs (output): Count unduplicated new clients who were newly enrolled in a health insurance, health services, or health benefits program as a result of grantee activities. Count each client only once. Example: Enrolling an unduplicated client in health insurance and then enrolling that same client in a health service would count as one client. Included - records or data (application and follow-up) on client enrollment and health insurance status. Individuals utilize preventive / primary health care services & programs (intermediate outcome): Count unduplicated new individuals who actually use the preventive and primary health care services and programs, as a result of the grantee’s activities.

16. Delivery of Health Services: Tools Examples of instruments (tools) that can be used to track this information. • Electronic enrollment logs • Electronic interpretation logs • Electronic translation logs • Electronic medical records • Practice management system

17. Health Education OUTPUT New unduplicatedclients participate in health education programs. STRATEGY: Whether focused on the importance healthy oral health habits or educated teens recovering from substance abuse on the importance of fitness and nutrition, members will assist health centers in increasing knowledge and helping to change unhealthy lifestyles of service recipients. Members will most often assist certified health educator staff to deliver set curricula (or design new curricula) to populations that are not currently served in this capacity by existing resources. KEY TERM: Health Education Programs: An educational process where information is given to individuals about community health status, health care needs, positive health behaviors and health care policy issues.

18. Health Education: How to Measure New clients in health education programs: Count unduplicated new clients who participate in the health education program. If the health education program has multiple sessions, topics, etc., count the client once. Do not count clients by number of sessions. For example, if a health education program meets once a month for one year, and has 12 participants who complete, then only report 12 (not 144). (Photo: HealthCorps 2005 Health Fest)

19. [Practice] Counting “New Clients”: Help for Mrs. Juanita Garcia Juanita is counseled one-on-one about how to make healthier food choices in the grocery store, on a budget. She usually shops and cooks for the household. You also learn that Juanita's mother-in-law, four children and husband live with her. Question: How many should you count as a new client?

20. Reducing Childhood Obesity OUTPUT Unduplicatedchildren and youth participating in in-school or after school physical education activities with the goal of reducing childhood obesity. STRATEGY: Members will engage children and youth in physical activities as part of a comprehensive set of health service activities that, in concert are designed to address childhood obesity. For example, physical activity will be combined with the provision of healthier choice snacks and drinks, and nutrition health education that includes caregivers of participating children and youth. (Photo: East Boston Neighborhood Health Center End of Year Celebration)

21. Reducing Childhood Obesity: How to Measure & Key Terms Reducing childhood obesity: Count of the number of unduplicated children actively participating in the activities. Not just the number enrolled or even the number attending, but rather the number who engage in the activities. Count each child only once. KEY TERMS: • Physical Education: An physical activity that is in addition to any school or after-school provided activities that aim to reduce obesity and to maintain a healthier lifestyle.

22. Volunteer Generation OUTPUT Unduplicated non-AmeriCorps volunteers recruited & coordinated. STRATEGY: Members mobilize and support individuals in one-time and ongoing needs such as arranging transportation, facility improvements, volunteer readers, organizing health fairs and neighborhood distribution of health promotion materials. For example, members can assist with recruiting patients or clients to serve on the Board of Directors or other take on volunteer roles. (Photo: AmeriCorps Week 2008)

23. Volunteer Generation: How to Measure Recruiting & Coordinating Volunteers: Count unduplicated new Non-AmeriCorps volunteers, which are individuals who use their time and talent(s) to benefit or impact gaps in community services under no formal obligation to do so and without receiving external rewards such as monetary or insurance benefits. Do not count volunteers by number of service activities. For example, if a service activity occurs once a week for one month, and has 10 volunteers who were engaged, then only report 10 (not 40).

24. OnCorps Service Reporting Tool(s) You Use (These tools will be available at the end of October, 2010) • Direct Service Report • Member Development Report • Capacity Building Report

25. Stories Are Data Too! • Share your great stories. • Highlight your service experiences that you think express the impact that: • You have on others • The program has in the community • The program has on you

26. The Anatomy of a Great Story • Completely true • Beginning • Middle • End (the peak) • Descriptive – Create pictures using words

27. Examples: Word Images • Sight “After the third time I helped Jason find help, he no longer walked into the health center with slumped shoulders and bewildered eyes.” • Sound “I could barely think with all the loud clamor of the construction outside.” • Sight, Smell and Sound Combined “The neighborhood seemed like a place that once was, but the sweet scent of flowers and laughter carried by the summer wind gave me a sense of possibility, hope for this place, and the people in it. So then I asked myself, ‘what can WE get done’.”

28. The Habit of Documenting Stories: • Seize the Moment: The best time to write down your thoughts is as they come to mind – not always possible. • Reflection Logs in OnCorps: Establish a routine of recording each day. Editing can come later. These logs could help build a Great Story. • Ask for Help: Receiving constructive feedback strengthens over time. • Share your stories in OnCorps and at www.communityhealthcorps.org.

29. OnCorps Story Reporting Tool(s) You Use • Log in to OnCorps • Under Reporting in the main header, there are options to enter ‘Reflection Logs’ and ‘Great Stories’. • Reflection Logs: These should act as a daily or almost daily journal. Entries should be should capture your most recent activities. • Great Stories: These are all-encompassing stories that should reflect your immense impact in the program using the tips described earlier. • Reflection Logs & Great Stories can be saved for later edits.

30. What happens to all the information I collect? • For monitoring the progress of local HealthCorps programs • For publicizing our successes – telling the story • For responding to requests for information from Congress and other stakeholders • For identifying trends and issues that may lead to opportunities for improving: • peer learning; • policy; and • training and technical assistance.

31. Accuracy is the Key to Good Data • Never Guess or Estimate

32. Key Points about Information Tracking for Reports • Gather data in designated area as a daily routine such as at the end of each day • The program coordinator and the organization you serve with are there as support • So ask for help as needed. • Most important for information to be accurate • The longer you wait the more you will forget – the detail gets lost - even the things we do or use often (utilize the Reflection Logs to aide your Great Story). • Point to remember: • Data collection for measuring success is simply “taking a closer look”