Why It Matters
Just as health care providers can apply quality improvement methods to health care, social service programs can use QI to address social determinants of health.
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How Communities Benefit from Tapping Local Quality Improvement Experts

By IHI Multimedia Team | Tuesday, June 19, 2018
How Communities Benefit from Tapping Local Quality Improvement Experts

Photo by Chris Rand from Wikimedia Commons

Health care teams have benefited for many years from learning how to use quality improvement (QI) methods and tools to improve their care. Likewise, nonprofit social service agencies can also gain from learning about QI to improve their services.

For example, the Poverty Outcomes and Improvement Network Team (POINT) initiative used the IHI Breakthrough Series Collaborative model to bring teams from around their community together to learn from each other and subject matter experts. The POINT initiative is a multiyear regional effort to reduce poverty in Northeast Wisconsin. Their goal is to raise people out of poverty and help them find good jobs, stable housing, and other resources needed to become self-sufficient.

A recently published case study on the POINT initiative’s first results-oriented project describes how using QI methods helped participants improve the services they provide. One of the case study’s key findings was that the initiative benefitted from continuous improvement coaches, on loan from local manufacturers. Drawn mostly from the region’s many manufacturing companies, the 35 volunteer coaches were engineers, quality improvement experts, or others with experience in improvement methodology.

Tim Murphy, Quality and Continuous Improvement Education Manager at Oshkosh Corp., which manufactures trucks and equipment for the military, construction, and other uses, coached three nonprofits, including COTS (Community Outreach Temporary Services). An Appleton nonprofit, COTS offers shelter to people experiencing homelessness as well as services like addiction recovery and money management to help them live independently. In 2016, COTS and Partnership Community Health Center, a federally qualified health center (FQHC), launched a satellite health clinic for residents of the shelter, people experiencing homelessness, and those receiving transitional housing services. But the clinic was having trouble ensuring that people took advantage of its free services.

With coaching from Murphy, Amber Price, a health advocate who first worked for COTS and now for the FQHC, experimented with various ways of educating people about the clinic services and filling the appointments. Murphy helped Price make her run charts more useful by looking at overall results rather than provider-specific outcomes, enabling her to see more clearly which of the approaches worked best (e.g., use of flyers/health literacy materials or on-site appointment scheduling). The run chart data revealed that sending clinical staff to warming shelters to provide blood pressure checks and other basic services was particularly effective, as it forged bonds between providers and residents and thus helped staff fill appointments at the new clinic.

Steve Cole, Continuous Improvement Director at Pierce Manufacturing, an Oshkosh Corp. subsidiary that makes fire and emergency department vehicles, had as a student volunteered in a homeless shelter. Cole coached seven housing nonprofits involved in POINT, helping them explore ways to better understand the demand for housing and more quickly move people experiencing homelessness into shelters and then to supportive or other more permanent housing.

Many of these nonprofits had been working to adopt the Housing and Urban Development–mandated coordinated entry system, which was implemented in 2016 to track homeless clients, triage their needs, and refer them to the most appropriate programs (i.e., for rapid rehousing, transitional living programs, or permanent supportive housing). As part of that effort, Cole helped staff members map the coordinated entry process and leverage their ideas to improve the system while also making their jobs easier. “The team leader for this effort, Chris Lashock, put it this way: instead of this being something they have to do, let’s make it a best practice that people want to do,” Cole says.

In their coaching role, both Murphy and Cole found ways to translate the continuous improvement concepts they used in manufacturing to a nonprofit audience. “With nonprofits, you can’t come in and say we’re going to help you be a better problem solver,” Murphy says. “[The concept of] waste doesn’t mean anything.” Murphy says he made progress when he talked about how he could help staff achieve their mission. Cole found the same: “If you can get people to understand the value to them and to their clients, they’ll embrace change a bit more,” he says.

How Communities Benefit from Tapping Local Quality Improvement Experts

How Communities Benefit from Tapping Local Quality Improvement Experts

To learn more of the lessons learned from the POINT initiative, download the free case study.

You may also be interested in:

The Breakthrough Series College (October 9-11, 2018 in Boston, MA) – To learn more, join a free informational call on Wednesday, August 15 from 1:00-2:00 PM Eastern Time.

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