an academic health department: everyone wins
TRANSCRIPT
An Academic Health Department:
Everyone Wins Kent County Health Department
Michigan Premier Public Health Conference
October 7, 2015
Presentation Objectives
• Identify what an Academic Health Department is and how it relates to public health practice.
• Learn key elements needed to transition from the conventional public health department to an Academic Health Department.
• Understand the many benefits and challenges related to partnering with educational institutions.
• Discuss the Kent County Health Department’s journey toward becoming an Academic Health Department.
Before… there was chaos.
Pre-AHD at KCHD
• The Academic Health Department concept is new for KCHD.
• Before 2015: • There was no formal process for taking on interns.
• There was no formal process for partnering with local colleges and universities on grant applications or other projects.
• There was no formal process for engaging in formal research.
Students would decide they wanted to intern
with the Health Department.
A person or persons at the Health Department
would receive the request.
The Health Department would do everything in its
power to accommodate the student, sometimes at
the expense of the preceptor.
Pre-AHD Internships at KCHD
Pre-AHD Partnerships at KCHD
• We worked with healthcare and academic institutions on numerous projects. • Subcontractor roles for provision of public health services. • Community health needs assessments and improvement
planning. • Others.
• There has never been formal affiliation agreements with these types of organizations, except when it comes to KCHD taking on student interns. • MOUs and/or contracts have been executed with colleges and
universities.
Pre-AHD Research at KCHD
• Contributions by KCHD to the evidence-base of public health was cited as a weakness in our national public health accreditation review.
• We do not regularly originate or participate in formalized research processes.
• KCHD contributions to the evidence-base of public health have typically come through practice-based excellence, not academic research.
Seizing Opportunities & Addressing Challenges
In Kent County…
There are numerous healthcare entities…
… And there are many academic institutions.
Which means… there are a lot of
opportunities, but they do not come
without challenges.
• Endless undergraduate and graduate interns.
• Competing priorities and agendas.
• Territorialism. • Who gets the credit for doing
what?
• Blurred lines regarding roles and responsibilities for public health within the community. • Who ensures the core functions
and essential services are being provided within the community?
• Endless undergraduate and graduate interns.
• Collaboration and teamwork.
• Teaching opportunities for staff – both at the schools and within the health department.
• Increased resources, expertise and “manpower”. • We can do things we otherwise
wouldn’t have the capacity to do.
• Better alignment between academia and public health fieldwork/practice.
Challenges Opportunities
To address some of these challenges and to leverage some of the opportunities, KCHD decided to begin the
journey toward being an Academic Health
Department (AHD).
What is an Academic Health Department?
“Academic Health Departments are defined as formal affiliations between
academic institutions and public health practice organizations.”
- Archer, Cary, & Malone (2014)
Academia Healthcare
Never enough resources to do
everything we want to do… and do it
well.
Partnership, collaboration,
resource sharing to better accomplish
shared goals.
Key Characteristics
• A formalized written agreement between the two entities.
• Shared personnel, resources, and compensation.
• Collaborative education and training for students and staff.
• Joint research, grants, projects, and services.
• Shared provision of public health services.
• A shared role in executing the three PH core functions.
Benefits
• Increased awareness of and appreciation for public health practice and respect for public health professionals.
• Increased capacity for performing core PH functions and meeting community needs.
• An ability to maximize and target the use of scarce resources.
• Additional, better-qualified professionals providing public health services.
• Public health graduates that are better prepared to enter the workforce with a solid foundation and skills in public health theory and practice.
Benefits
• Enhanced career opportunities and broader career options for public health graduates.
• Enhanced opportunities for recruitment of public health graduates and professionals into practice environments and public health practitioners into academic environments.
• Better integration of public health principles in health sciences curricula.
• Lifelong learning opportunities for public health professionals.
• Increased opportunities for applied research addressing local public health issues, as well as access to communities and community-based data for research purposes.
Benefits
• Enhanced opportunities for grant funding.
• Increased access to academic resources and expertise to improve the provision of public health services.
• The exchange of fresh ideas and perspectives.
• A broader and more cohesive communication network for disseminating information relevant to public health.
• Advances in the science of public health and an expansion in the knowledgebase for public health decisions and policies.
• A rethinking of the division within public health in which academic institutions focus on education and research, while practice institutions focus on service.
AHDs as Learning Centers for Health Professionals
KCHD has made a commitment to educate and
provide professional development opportunities to the broader Kent County community in the area of
public health.
Continuing Education
• KCHD is an approved provider of continuing education. • Units for nurses through Wisconsin Nurses Association.
• Health Educators who must get credit for CHES recertification can submit a request for our relevant educational events to be considered for CHES approval.
Continuing Education
• Over the past three years we have offered four in-services per year, each lasting 2 hours.
• Topics are selected based on feedback from KCHD staff as well as availability of speakers.
• There is no cost to KCHD employees and they are paid to attend. • Non KCHD employees pay $10.
• Attendance is typically between 80-100 people, with about 60-70 being KCHD employees.
Continuing Education Topics
• Homelessness in West Michigan.
• The Teenage Brain.
• Sexual Exploitation and Human Trafficking.
• Hoarding.
• West Michigan Gangs and Safety.
• Methadone and Pregnancy.
• Motivational Interviewing.
• The ACE study.
• New Street Drugs.
• Nutrition and Ethnic Groups.
• Mental Illness in Pregnancy.
• Autism.
Benefits to KCHD Staff
• In a recent Employee Satisfaction Survey, staff identified the availability and quality of continuing education opportunities at KCHD as adding to their overall job satisfaction.
• They also identified these educational opportunities as providing them with the resources they need to do their job.
Benefits to Employer
• KCHD employees are knowledgeable and considered subject matter experts on a variety of broad public health topics.
• The Kent County community looks to the Health Department to keep them up to date and informed on new trends and topics in public health.
Nursing Students at KCHD
• BSN programs are required to offer a public health/community health clinical rotation to students.
• We have five local universities with nursing programs plus other universities from outside Kent County that seek clinical placements at KCHD.
• Students from online BSN programs also seek clinical placements at KCHD.
• A faculty member must accompany a group of students.
• BSN or BSN completion students only.
• Contract is established with university and shifts the responsibility for the following to the school: • HIPAA training and confidentiality.
• Immunizations.
• Background checks.
• Identification.
Criteria for Nursing Students at KCHD
Nursing Student Projects
• Most community/public health nursing students who come to KCHD in groups want to complete a project.
• Examples of projects: • Researched and developed a texting policy and tracked whether
policy implementation decreased not home/not found rates for home visiting programs like MIHP and NFP.
• Developed culturally appropriate and graphically attractive educational material for our lead program.
• Researched and developed a road map of resources for families who have a child with autism.
Kent County Health Department’s Journey
Original Charge
• This transition began in 2014…
• KCHD’s Health Officer tasked a group of staff to: • Identify the current internship-related processes and make
improvements, where possible.
• Develop a streamlined and organized system for KCHD internships.
• First, the current internship “process” was assessed.
• Through many discussions, four different, but simultaneous processes were identified and mapped. • “Job shadowers”.
• Medical students/residents.
• Student-initiated practicum experiences.
• University-initiated practicum experiences.
Understanding the Current Process
Note that none of the current
processes included the KCHD initiating
internship experiences!
1. Appoint an AHD Administrative Specialist.
2. Assign an AHD Liaison.
3. Create an AHD webpage.
4. Create and maintain a list of projects for internship/ practicum students.
5. Launch a time-limited application period for internship/ practicum students.
6. Discontinue job shadowing opportunities.
Original AHD Workgroup Recommendations
• The Senior Administrative Specialist position in the Administration Division of the Health Department serves in this role.
• She has access to a generic email address that receives all student applications and supporting materials and forwards them to the Liaison.
Appoint an AHD Admin Specialist
Assign an AHD Liaison
• The Academic Health Department Liaison: • Builds and fosters partnerships with colleges, universities, and
medical education programs.
• Is responsible for communicating the Health Department’s vision for becoming an AHD.
• Promotes learning opportunities for students.
• The Quality and Performance Manager serves in this role for KCHD.
Create an AHD Webpage
• The KCHD AHD webpage went live May 1, 2015.
• Includes: • List of available internships for the upcoming semester.
• Required documents and training.
• Instructions for application and a application form.
• Parameters of application periods.
• Overview of what an AHD is and reasons why KCHD is pursuing this designation.
• KCHD staff propose projects.
• Projects are posted to webpage.
• Database of projects is maintained by Quality & Performance Manager.
• Any projects not filled during a given semester are rolled over to the next application period if the project’s originator wants it to be.
Create and Maintain a List of Projects
Project Proposal Form • Submitted by KCHD staff.
• Contains key information about the project, including a description and deliverables.
• Project proposer must also identify which core competencies will be addressed through the project.
Examples of Student Projects
• Kent County Oral Health Assessment.
• Kent County Health Literacy Assessment.
• Surveillance, Infectious Disease, and Community Health Improvement.
• Emergency Preparedness Planning with Kent County Pharmacies.
• Reducing Barriers to WIC Program Access.
• Determining Causal Effects of Increased STI Cases in Kent County.
• Policy and Intervention Options for Addressing County Health Rankings.
Students and KCHD Preceptors
Project Database
• Students must go online and submit an application within the set application timeline.
• We also require: • Registration for course credit.
• Resume.
• Cover letter.
• Copy of preceptor handbook/manual from academic program.
Launch a Time-Limited Application Period
Projects Submitted
to AHD Liaison
Projects Uploaded to AHD
Webpage
Student App.
Period Opens
Student App.
Period Closes
Preceptor/ Student
Interviews Begin
Students Notified of Internship
Student Begins
Internship
May 7
May 14
May 15
June 15
June 15
July 30
Aug. 30
Intern Orientation
Sept.
Sample Timeline for Fall Semester
Student Begins PH
Boot Camp
Sept.
Student Application Form
Discontinue Job Shadowing
• The cost-benefit of offering job shadowing opportunities does not support continuing this activity.
• Rather, the AHD Workgroup proposed that each Division have a primary and secondary point-person to discuss KCHD and Division-specific programs and services. • Coordinated through the AHD Admin Specialist.
• Job shadowing will be offered to long-term interns as a component of the Public Health Boot Camp.
Public Health “Boot Camp”
KCHD’s Boot Camp
• First day(s) – all students are required to participate.
• All “onboarding” activities are completed during these sessions.
• Series of 9 “Learning Sessions”.
• The session topics were derived from student-identified deficiencies, or gaps, between academic learning and public health practice experiences.
Boot Camp Sessions
1. Policy, Procedures, and Logistics.
2. Overview of the Health Department.
3. The Public Health System.
4. CHNA and CHIP.
5. Public Health Accreditation.
6. Epidemiology Overview.
7. Quality Improvement in Public Health.
8. Grant Writing and Seeking Funding Sources.
9. Health Equity.
CHNA-CHIP Learning Session, Fall 2015
Boot Camp Sessions - Competencies
Planning to Action
• First-ever Boot Camp was held on September 1, 2015.
• We had 10 students participate.
• Seven staff served as presenters for the learning sessions.
• An evaluation was conducted to identify opportunities for improvement.
Fall 2015 Boot Camp Evaluation
• 100% of students strongly agreed that: • The Boot Camp was informative.
• Having the Boot Camp as a requirement for internship opportunities within the KCHD is appropriate.
Fall 2015 Boot Camp Evaluation
Fall 2015 Boot Camp Evaluation
Fall 2015 Boot Camp Evaluation
Fall 2015 Boot Camp Evaluation
0
2
4
6
8
10
12
Policy,Procedures
and Logistics
Overview ofthe HD
Public HealthSystem
CHNA PHAccreditation
Epi Overview QI in PublicHealth
Grant Writing Health Equity
Student Evaluation of Presenter Knowledge and Engagement by Topic, Fall 2015
Strongly Agree Agree Disagree
Improvement Opportunities
• Split the Boot Camp into two, half-day sessions.
• Consider more “hands-on” activities.
• Add more group interaction and discussion.
• Simplify/shorten some of the sessions.
• Include a session about public health communications.
Chelsey Chmelar, BA, MPH Quality & Performance Manager Academic Health Dept. Liaison
Joann Hoganson, RN, MSN Division Director,
Community Wellness [email protected]
Adam London, RS, MPA Administrative Health Officer