Sustaining Accreditation Through Smart Documentation Systems

MELISSA TOUMA:
All right, good afternoon, everyone. My name is Melissa Touma, I'm the Director of the Public Health Infrastructure Program here at ASTHO, and welcome to our second installment of our two-part webinar series on accreditation sustainability.

Each session in this series is designed to stand alone, so you… if you weren't able to join us for that first webinar last week, no worries, you won't miss a beat today. We'll be sharing the recording of the first session on our website, and you'll also receive it in a follow-up resource email after today's webinar. The first webinar was all about developing accreditation sustainability and communication plans, and it highlighted the, sort of ongoing sustainability efforts of two health departments: the Montana Department of Public Health and Human Services, and Southern Nevada Health District. So you'll have access to those after today if you didn't get a chance to attend last week.

Today, we're here to discuss, sustaining accreditation through smart documentation systems, because we know from technical assistance requests and also what we heard from our, accreditation Sustainability Learning Community members over the last year that having a reliable system to track progress and documentation, to engage staff and leadership in the process can really help accreditation programs weather some of those common challenges that health departments face in sustaining accreditation, you know, including staff and leadership turnover, changing agency priorities, and of course, shifting, or limited funding. So before we get started, diving a little bit deeper into the why for today, we, you know, we see that robust project and documentation management systems allow agencies to preserve institutional knowledge, especially those lessons learned and best practices from previous accreditation cycles. They help enhance staff engagement and accountability by clarifying roles and responsibilities, and also encouraging shared ownership of accreditation tasks, which you'll see some examples of today. These systems also help improve coordination, facilitate communication, and also align efforts across programs in the health department. They streamline processes, such as documentation review and editing, and they also support ongoing reaccreditation readiness, really by keeping documentation organized and up-to-date, and also linking accreditation efforts to broader agency goals.

So with this background in mind, our goals for today are for you all to, sort of understand the role of project and documentation tracking systems in supporting sustainable public health accreditation and reaccreditation readiness. And also to explore some real-world examples from our speakers today that have developed and implemented project and documentation systems to streamline accreditation processes And help maintain that institutional knowledge and accreditation readiness in their agencies.

So, before I introduce our amazing speakers for today, let's take a moment for introductions. In the chat, if you could please share your health department's name, and also what system, if any, do you use to manage documents and your accreditation initiative for your agency? Really curious to see what people are using. And while… while you all do that, just a few housekeeping notes. Closed captioning is enabled for this webinar. The webinar is being recorded, and it will be posted to our website later, we'll send a link. If you have any questions that come up, please don't hesitate to drop them in the Q&A box or the comment box at any time during the conversation. I will hold onto those questions until the last 15 minutes of our agenda, and make sure those questions get elevated so we can ask our panelists.

All right. So now for the highlight of our day. I am excited to welcome today's speakers, who will each share some project management tools and documentation management systems that have worked for them, in their accreditation journeys. And our first speaker is Leah Moser, Senior Specialist of Public Health Systems and Services at PHAB. Leah has been providing some technical assistance to health departments around accreditation readiness, and today we'll be spotlighting PHAB's Accreditation project management tool. We'll also drop a link to that for everybody in the chat.

And then we'll hand the mic over to our peers at the Tennessee Department of Health, Jason Howes, Director of Business Intelligence, and Mary Beth Davis, Deputy Director of Quality and Performance Management. Jason and Mary Beth will share how they've been integrating systems to support their own initial accreditation efforts, and also plan for accreditation sustainability, really from the start of their own accreditation journey.

And then lastly, rounding us out, we have our peers from the Pima County Health Department, Sarah Rojas, the Accreditation Coordinator, and Latifa Duhar, the Strategic Initiatives Program Manager. They are both joining us today to share their great work developing Pima County's reaccreditation plan and document storage system to coordinate staff, track process, the process and progress, and also manage the document versions.

Alright, so with that, I am happy to dive into our content today. So, Leah, I will hand the mic over to you.

LEAH MOSER:
Awesome, thanks so much, Melissa. Really excited to be here with you all today. I'm going to be walking through PHAB's new accreditation project management tool, which was released earlier this summer, around July, and then we actually are in the process of adding two new tabs to it right now, so when I do the walkthrough, I'm going to actually show a draft of the two new tabs, but if you go onto our website, you won't see those tabs. They should be posted within the next month or so.

So, first to give a little bit of background around what the tool actually is. So, this tool was developed to help health departments plan and manage the work towards either pathways recognition, initial accreditation, or re-accreditation through PHAB. Because accreditation is such a detailed and lengthy process, we really wanted to create a simple Excel-based resource to help teams stay grounded, organized, and on track. When I was first thinking about how we could approach this. I worked with a lot of health departments in Missouri. I used to work with the Missouri Public Health Institute, and I kind of realized that there wasn't really anything to help manage the accreditation process. I know that there's performance management systems, but there wasn't anything that I knew of that kind of approached it with project management principles. So that is why we created this tool. We did try to make it as simple as possible, but it is the first iteration of the tool, so as you access it and go through it, if there are certain things that you would like added to the tool, or ways to make it easier, please let us know, because we are wanting to continue to update it and make it, better.

So, I also want to note that this tool is not meant to replace your documentation, trackers, or your file system. Instead, this is a project management tool with accreditation as the project. It's really designed to help support strategic coordination, internal accountability, and cross-team communication throughout your process. So, I would use this tool in tandem with whatever, documentation tracker system that you use. PHAB also has to Excel-based documentation tracker system tools that you can use if you don't currently have one. Also, I want to note that departments can adapt the tool to fit your specific process, staffing, and timeline. It's flexible enough for really any size team, so a department with only, like, 5 staff has used this before. A department with hundreds of staff could use this. You can really customize it to what you need. And I also want to note that it is primarily for internal use, so it's not necessarily something that you will… would share out with, like, your partners unless you wanted to. It really is more for your accreditation coordinator and your core accreditation team.

So, I am going to do a quick walk-through of the tool today, but we don't have enough time for me to get really in-depth. So, I would definitely recommend, reading through our user guide that's posted on the website. That'll tell you exactly what each of the tabs are for, and how to access the instructions on the tool. So if anything that I make… that I say today doesn't make a ton of sense, of course. Feel free to ask questions, but also visiting the user guide and just looking through the tool will definitely help.

I also want to mention real quick how to access the tool, so you would just go to our website, PHABboard.org, you would go at the top, there's a menu, you would go to Products and Services, and then under that is a drop-down that says Complementary Tools, where there will be a square called Accreditation Project Management Template, and you can access the user guide and tool there. And then Melissa also just dropped links in the chat.

Okay, so before I do the walk-through, I'm just gonna go over a few things on how you would navigate and use the tool. Each tab within the tool includes built-in guidance and instructions using light yellow comment boxes. You would hover over the small red triangle in the top right corner of a cell to view quick instructions for what you would enter into that cell. So, for example, on one of the tabs, you could click a column header labeled Readiness Assessment Project Details or a blank task cell to see guidance specific to that section. We tried to include, details for what each tab and table is for, and how you would use it. And then we also included some examples of what you could enter into the cell to try… when you first open the tool, and when I go through it, it might seem a little bit overwhelming at first, but again, if you utilize those instructions and comment boxes. It really explains how to use every single aspect of the tool.

Something I want to note is the two new tabs that we are working on are a Staffing and Budget tab. I would actually recommend using these tabs first and filling them out first before you do any other part of the tool. But again, we're working on them right now, so they are not currently available, but they will be available soon.

From there, I would go to the Project Overview tab. This really helps to define your scope and goals. Then you can build out the work breakdown structures. There's a timeline and a Gantt chart, domain action planners, and a meeting agenda and communication plan. And again, I'm going to walk through those pretty quickly, but that's just an overview of what it involves.

So… Let's see… So here's an overview of the tabs, and then I'm actually going to share my screen so you can actually view the tool.

Alright, so everyone should be able to see this Excel document. So, when you first download the tool, as of now, the first tab that pops up is going to be this Accreditation, project overview tab. However, I am going to show this is a draft of what we're working on right now. We have a budget planner here, and then a staffing plan. So these will help you identify available capacity, roles, and funding before you start mapping out your accreditation project. So here you can list your team members, your estimated time allocations, and projected costs. This will help give you a realistic foundation before you start the accreditation process and before you start assigning tasks or timelines.

Next, we have the project overview tab. This is really just a high-level summary of your accreditation process. And this would be a good tab to share with leadership or with all staff. You definitely do not want all staff involved in every single tab. That would get a little too crazy, but if you are wanting to share some high-level details, I think this is a great tab to share with them.

Next, we have this readiness assessment work breakdown structure, which is for departments that have not yet completed their readiness assessment. I want to note that whether you are pursuing pathways, initial accreditation, or reaccreditation, you can utilize this tab. There actually is a reaccreditation readiness assessment that you can fill out for those pursuing reaccreditation, if you weren't aware of that. So here you will see there is some process steps listed here, which details every single step that you will need to accomplish as you're pursuing the readiness and training process.

With this tool, I really wanted to incorporate basically everything that you could need, or that you would need to think about into one tool. So it is very robust, but that is because it includes, like, everything that you're gonna need all into one place. So, the recommendation here is that once you receive the readiness assessment from PHAB, you would fill out the project details section at the top, and then you would use the SWOT analysis table down below to think through your department's capacity and potential barriers. And then there's also a progress tracker that helps you monitor completion and who's responsible for each section. Then moving on to a work breakdown structure if you are pursuing either initial accreditation or pathways recognition. This tab looks really similar to the last one, but it is for when you are actually ready to apply, and you have already received your results from the readiness assessment back from FAT.

So, again, you would start by filling out or following the application process steps. You would then hold a accreditation team meeting to complete a gap analysis based on your readiness assessment results, and then you would update your SWOT analysis to reflect the upcoming year of preparation and documentation submission. And then you could use this domain project management section, or the core plan project management section at the end to assign responsibilities and timelines across your team. And again, I know I'm going over this very fast, but if you go to the little red triangle and hover over, it will tell you how to use each table and what you might enter into there. So, definitely check this out a bit more, later.

And then the reaccreditation tab is basically the exact same as the last one, but it is just tailored for those pursuing reaccreditation. Then we have the domain action planners. So these are designed for your domain leads, if you have them, to work inside of this tab. So the entire tool, I would say that your accreditation coordinator should manage that. And then this specific tab should be for your domain leads. If you don't have domain leads, then I would assign someone from your core accreditation team to manage, whatever domain they're in charge of, and then they would manage this tab. You would start by actually duplicating this tab so that you have one for each domain. If you don't want one from each domain, that's also okay.

This MOCA chart at the top helps define roles. MOCA stands for Manager, Owner, Consultant, Helper, and Approver. And this just really helps give you some clear ownership and accountability for different tasks. If you aren't familiar with this framework, it gives a little bit of instruction, and then you can also just look up this framework on Google, and it gives you a bit more information on that as well. And then this is just a really great way to really get into the weeds of certain, aspects of a domain that you want to work on, or gaps that were lifted up in your readiness assessment. Then we have an accreditation process Gantt chart. This tab gives you a visual timeline of your accreditation work. You can enter tasks, start dates, and durations, and then this chart will automatically populate where your activities overlap. This is just a good way to plan ahead and make sure that your workloads are balanced throughout the process. Right now, it is, filled with example tasks, so you would actually delete all of these and input your specific tasks and start dates for this.

Then we have a communication plan tab. This helps you plan how you'll communicate progress with leadership, staff partners, and your board of health. For each audience, you would want to identify your communication goals, your key messages, frequency, and method of communication. And I think this is important because it's something that you might not think about at the start, like, how do you plan for communication? But it's one of the most important aspects of the accreditation process.

And then lastly, we just have a template for your accreditation team meeting agendas. You could simply just duplicate this table for every meeting that you have, and then you have a running history of your agendas and any notes and updates that you go over for each meeting. And then we can go ahead and go back to the slides for a moment. Awesome.

So, I want to go over just a few last things about customizing the tool and some tips. So, this tool is really meant to work for you. Do not feel like you need to use every single tab. You can definitely choose to not use some of the tabs. You can switch around tabs, add rows, add other tables, delete tables. We really want to make sure that you are utilizing this for you. However, I will say that I've done… I've introduced this tool to a few different health department groups and they said that they have gone through the accreditation process, some of the things that are incorporated into the tool, they did in a different way, but it was nice to hear from them that everything that is incorporated into this tool was something that they had to think about, and that they had to do when it came to the accreditation process, so that was some nice feedback to hear, but obviously we're really open to other feedback, and if there's ways to make it easier and more approachable, again, please let us know.

And then I have a couple of tips for getting started. If your team has not used a project management tool before, it can feel a little overwhelming at first, and that's totally normal. The key here is just to start somewhere and build momentum. I think a great low-stakes place to begin is just to fill out the project overview tab. Just fill that first tab out, and then, like, slowly decide how you can, and move forward from there.

I also would recommend assigning a coordinator or a point person to maintain the tool. You don't want to have multiple people in the tool trying to fix it. I would have, like, only a couple people that maybe have access to the tool. However, this does not mean that they should be carrying the weight alone. I would definitely have discussions and revisit the tool at your accreditation team meetings, and make sure that it is a group discussion, and you're talking about how you will fill it out. But then just one person, whether that's your accreditation coordinator or the domain lead, is actually the one in the tool adding in content. And then also, just remember that this is not a one-time setup. It's really meant to evolve with your process, and as you move throughout your accreditation process, you'll find new ways to adapt it that make sense for your team.

If you do have questions about the tool and how to navigate it, you can always reach out to PHAB's technical assistance team at that email on screen. We also offer the option for PHAB staff to facilitate this process and walk through the tool directly with your team, which could include helping you adapt it to your department staffing, structure, and timeline, or guiding a team meeting where you set up your project plan together. We're also in the process of launching new accreditation project management packages, which will offer different levels of hands-on support, depending on your department's needs. These packages will include access to the tool, a facilitator guide, and then optional implementation sessions that are led by PHAB staff. So, your team can either set this all up independently, or you can have a bit more structured guidance from our team. If you're interested in learning more or piloting a package, just send us an email at PHABta at PHABboard.org, and we will share some more details as they become available.

But thank you for letting me go through the tool today, and thanks for everything you're doing to strengthen public health in your community. We're hoping that this tool helps bring some more structure, clarity, and confidence to your accreditation process. And if you have questions, again, feel free to reach out to me, and I'd be happy to talk through the tool a bit more. Thank you.

TOUMA:
Amazing. Thank you, Leah. I'm actually going to ask you two questions, just because they are very similar, and technical in a sense. One, can you confirm again when those new tabs will be live for everyone's use?

MOSER:
Yeah, so we're actually working on them right now. They're almost done, and then our communications team will need to upload them, so I'm thinking, like, within a month at most, but maybe even before that.

TOUMA:
Sure. Okay, awesome. And then I'm just looking at the Q&A, there was a related question, so I'm gonna tag it on. If folks have been using this tool prior to these new tabs being added, would they have to download the tool again, or is… do you have a suggested way to move forward, maybe in combining the two spreadsheets? I'm not sure.

MOSER:
Yeah, so I think what they could do is if they already have the tool, like, on their computer downloaded, when the new one comes out, all you would have to do, I believe, is just copy that tab, and then paste into your tool, and then it… I think that would probably be the easiest way.

TOUMA:
Yep, that makes sense. The ease of using Excel, too, for something like this. That helps. Wonderful. Thank you so much, Leah. So if anybody else has some questions for Leah, please drop them in the Q&A or the chat box. We'll get to them at the end of our presentation.

Alright, so next, I am excited to move the spotlight over to our Tennessee Department of Health colleagues, Jason Howes and Mary Beth Davis. Jason, the mic is yours.

JASON HOWES:
Thank you. You probably expected a banjo on my knee, but unfortunately, I don't have a banjo on my knee today. But, my name is Jason Howes, I'm with the Tennessee Department of Health. Mary Beth is my colleague, she's also with me, she's gonna help present here shortly, and thank you, Melissa, and thank you, Leah. Thanks, ASTHO and PHAB, because honestly, Melissa's been super helpful throughout this entire process, and been a lifeline to us, and so we're eternally grateful to you, and to PHAB for giving us the framework to do this work in. So, yeah, we're the Office of Quality and Performance Management at the Tennessee Department of Health.

Our challenge, we are doing initial accreditation, accreditation, and, our challenge is not… it's not really unique to us. Anybody going through this, has this same challenge, so hopefully this is applicable to folks here, the challenge is that it's a giant… it's a lot of work. There is a ton of work in here. There's a lot of documents, there's a lot of things to do, and how do we do that, and how do we sustain that, just not… not just now, but in the future. And so, you know, PHAB gives us the direction, kind of gives us a framework to work towards, but we wanted to make sure that we could do this and have accountability and have ownership and scalability into the future.

If I look at the problem, that we… it's not really a problem. Accreditation as a project, there's sort of four granular pieces we needed to solve for, with this work, and the… probably the biggest one that a lot of people undertake is the… there's fragmented evidence, right? There's documents everywhere that we need to collect, and the scope of accreditation is wide, so there's HR stuff, there's health stuff, there's… it's all over the place, right? And, TDH, Department of Health, Tennessee doesn't have, like, a spine for our… our documents. There's no document system, so we had to deal with that. Also, reactive cycles, right? There's a tendency when a big chunk of work comes on people to, like, jump on it like it's a fire, and, like, wrangle it, and then put it out, and then… We're done with it. We wanted to make sure that we were not just reactive, but we were kind of planning for the future.

And also, you know, there's, as I mentioned, I think the third time now, the PHAB gives us a framework, but they don't give you necessarily an execution plan, nor could they, right? Because every Department of Health is different, right? And so your… how you're going to go after this, how you're going to execute this work is going to be different. So how do we build that out on our end? How do we actually operationalize this work?

And then lastly, and Mary Beth will speak more to this, like, the lost knowledge, right? So how do we deal with, you know, Susie Q had this document over here, great, but Susie Q could leave. How do we handle that? How do we make that document TDHs instead of Susie? So, I'm gonna do… I'm gonna do a walk-through of, kind of, my thinking… my personal thinking around the systems here. So I'm gonna share my screen and show you… This… y'all can see my...

MARY BETH DAVIS:
We can.

HOWES:
Yes, cool, cool. You can see my spreadsheet. So, it's not my spreadsheet. This is a spreadsheet some of you would be familiar with. This is the PHAB accreditation tracker sheet for the documentation, right? There's some, tracking here in this first tab, and then there's different… all the domains, right? Different colors. I'm not entirely sure where people are at in this process, if they're here at all, but each one of these rows is a document that you need to get, or a piece of data that you need to have, and you need to show these number of examples; each one of these tabs is the domain, you get it. There's a bunch of related data points here on those documents. And so, when I see this, personally, my background, I'm the Director of Business Intelligence, but my background is in, like, systems and web development. It's kind of nerdy. And so when I see spreadsheets like this, which I see often in public health, is this is visually aligned, right? This is a tool, it's a very good tool if you have one tool, and you have Excel as your resource, this is a great tool to be able to do this work, right? But from my perspective, it isn't a very programmatic… it's not… it's not nerdy enough. And so, I needed to essentially take this dataset that is visually aligned and turn it into a programmatic, machine data set where I can take the data and manipulate it. And so what I did is I took all of those data points out of each one of those tabs and pulled them into a singular data set with, you know, with sort of normalized columns and data types so that I could manipulate it. From my perspective, it all… everything starts with data, right? And so I needed a really good data set, one that I could wrap my head around. And so I… I created this dataset, and why do I show you this? Because you can do cool things when you have data in a structured way that machines can understand. So, I was able to take this dataset, I used AI and some other tools to, import it as a project into our project management platform, which I think will be a common theme today. This is Asana. If you haven't used project management platforms before, they are simply a way to manage your work. They're, work management systems, each one of these rows is a task. It also is one of those document types. And over here, I have all of these custom fields and fun stuff, essentially, I made… I took all of the data points out of that spreadsheet and put them into Asana programmatically. And, you know, that's great, right? I just replaced a spreadsheet, so what other… it brings more value. Because it has things like, I can assign work. So you can see, you know, we've assigned these things to Mary Beth. I can set due dates. Typical project management things, Asana has a built-in dashboard as well. So you can generate custom reports and build whatever you want, right? So it's really great to have all of this laid out, in a project platform where we can actually solve that project framework problem, right? That was one of the four problems I mentioned earlier.

I'm gonna show you… we also need to solve for the document storage, right? All this fragmented evidence across the Department of Health. How do we fix that issue? And so I'm going to show you how we connected that… we have a folder structure that we created in SharePoint, which is our enterprise-wide, storage solution. I think that's probably… a lot of folks in government will have that same solution. It's a great solution, there's a lot of, functionality that's great. But… so what I've done is linked, this is one of those document types that you need to get. I have linked, to the specific SharePoint folder, right from the Asana task. So, the workflow is, you know, you find that document, you've got it, you need to, put it in this folder, you put it in this folder, you copy a link, and you put it back into SharePoint, that gives you access, on the programmatic side, I have access to both the folder that the stuff's stored in, and also the specific file itself. And so that's really giving me a spine, a technical spine, to all of… where all of this information is stored, how to access it, and then for the future, where we… where we need to go after to get it, to update it, and so on. Another benefit you'll see here is that, you know, you can communicate in this project management platform at the task level. So, essentially, we're leaving ourselves breadcrumbs for the future, right? When we need to get reaccredited, we can go back here and reference… what did… what was that? What did, what did Susie Q say about that document? Where did we get that document? So it's a really good way to leave breadcrumbs. And lastly, and a cool anecdote about the programmatic work, and I'm gonna get nerdy here, is that, when we were going through this work and actually, specific with me, when I was going through this work, I didn't quite know the, I didn't know the language and how… I needed to know the specific PHAB documentation for what the document actually has to show. Like, this document, I know the name of it, but what is it trying to prove? And so. After the fact, because this was all programmatically laid out.

I took that PHAB document, the PDF, it's giant, and went, wrote a little bit of code in Python, and posted into Asana's API, the specific, documentation for that measure. So, at every document, you can just go and click on it and pull up the specific documentation. And that's… I just tell you that anecdotally because it's important to know why these systems things matter, because they're so scalable, and you can do so much cool stuff with them. So, if we can go back to the presentation… And so… the… so to kind of follow up there, we have that database structure, right? We have, we parsed all the data, we have Asana as our project management platform, we're solving for that problem, and we have a SharePoint repository to be able to store all these files, and we share, we have a solution for that fragmented evidence bit.

And… and why does that matter? Well, it… it takes us from sort of episodic to continuous. We can… If we need to… when we win, we need to, to reaccreditation, we can spin that same project back up and go look at our history. It's already there. We have built-in accountability, which is critical. We can assign those tasks out and say, we can track our project now and see where things are at. And it's, as I mentioned, the scalable foundation. That is critical, and… Really good, technical systems are kind of sometimes lacking, I've seen, and so it was really fun to stand that up. The thing I did not solve for, and that the systems can't really do on their own, is that historical knowledge, taking Susie Hughes' document, and making it the Department of Health's. And so Mary Beth will speak to that, and what kind of structures we need to build to make sure that that happens. Go right ahead, Mary Beth.

DAVIS:
And… there you go. Well, we are very thankful for Jason, as you can imagine, and we're also thankful for Asa for linking us up to a lot of the different states, and we listened to you all about, you think accreditation's tough, wait till re-accreditation. So, we started thinking about, how we were going to be, reaccreditation-ready, PHAB ready, from the time that we're hopefully accredited. So, we stood up our Quality Council, which again, many of you, helped me… help us to, you know, kind of get that started, or, you know, the best practices in getting that started. And we have 25 members now of our Quality Council. It's very active. We are excited to have 75% of our offices and divisions are represented on our Quality Council. So we have decided to, have a PHAB readiness work group, which will help in making sure that we keep those document… documents updated in each domain, ready.

Next slide.

So, how we're going to do that? Many of the council members are already, you know, asking, how can we help now? And they have been wonderful in making sure that we have the documentations, but the documentation that we have now may not always be the best representation of that domain, you know, as we improve some of our processes. So, this, council, because it is made up of, across the state offices and divisions, they will… we will work in that work group to… to update that and… and, continue using what system is already there, project management system is already there. We will, develop a cadence to keep that, going, where we check in we look at when the documents are starting to need to be updated, you know, there will be a process in play, for us to do that. So, the Health Council will… I'm sorry, the Quality will be, will be responsible for helping us with reaccreditation, and we are… that takes away, because it is actually the position on the Quality Council, not the, not the name of the person that's on the Quality Council, will, will be responsible for keeping those updated and communicate with, with each other.

Back to you, Jason.

HOWES:
Thank you, Mary Beth. Yeah, those structures and that… all that organizational work is so critical to this, and… and you can't… it's the yin to the yang for these technical systems, so, this is built to scale, right? It's all database-driven. We can repeat this. And we're very excited about, because I have all… we have all those locations of all those files, and we have this structure, it's going to be really fun and easy to make a SharePoint accreditation site hub where we can spin that up pretty quickly and have all of our stuff available to everyone across the Department of Health, so… Yeah, again, Melissa, thank you, and thank you, Fav and Leah. Appreciate you.

TOUMA:
Amazing. Thank you, Jason and Marybeth. I was just looking at the chat. You got a couple of, kudos in the chat there for your work. It is really exciting to see how you've taken, sort of this opportunity in initial accreditation to already start thinking system-wide and operationalize, you know, sustainability through technology, by other… by engaging other agency staff and leadership in the process. That's really forward-thinking, that's really exciting to see, so thank you so much for jumping on today and sharing that with us.

All right. So, folks, if you have any questions, please drop them in the chat, drop them in the Q&A box, we'll be sure to get to them.

I am very excited to introduce our next set of speakers from the Pima County Health Department: Sarah Rojas and Latifa Duhart, they were, participants in ASTHO's learning community, over the past, I don't know, 4 months, and have been, very active members, doing some really, really great work, and so we're very excited to be able to, to share some of what the Pima County team has been doing to sustain accreditation, in their agency. So, Latifa, I will hand the mic over to you.

LATEFA DUHART:
Great, thank you so very much for giving us this opportunity to share out how Pima County Health Department handles the awesome task of remaining PHAB-accredited. We, are in the state of Arizona. We talk about Pima County all the time, as if everybody knows exactly where we are, but do want to point that out. We're in the state of Arizona, kind of, in the southern region. And we were first, oh, you can go to the next slide, please.

We were first accredited in 2016, and after a short delay due to the pandemic, we were re-accredited, in 2023. We are currently working on our reaccreditation for 2028. And, we have about, give or take, 300 employees. It's very fluctuating at this time. And our health director is Dr. Theresa Cohen. Next slide. Who is extremely supportive of our, efforts with accreditation, and that is golden, to have someone who is 100% behind what needs to be done, because it helps with engagement and, ensuring that, you know, we get cooperation from all of our divisions. But with all of that in mind, we still encounter lots of pitfalls during the submission at 2023, outside of COVID and, the daunting task of handling the public needs during that time. But it was like we were scrambling. We were trying our best to, get everything done and meet the deadlines, and divisions felt overburdened by the volume of submission requests that they had to provide, and, there were tons of issues surrounding recruitment and retention and sustainability. As Jason mentioned, when people leave, we may lose some work, we may lose some knowledge, and so now we have to recoup that and start all over again. So it caused a lot of problems, and with that, we decided that we needed to create an annual assignment schedule, kind of spread the things… the assignments throughout the years, and then we also needed a centralized storage platform, and both of those things shaped our new approach. So you can go to the next slide.

So at that time, we put together a schedule of assignments, and we broke up the assignments, or all of the measures that were required, 94 of them, and we broke them up through the 5 years based on things like when the document had to be dated within, or how many documents were being requested from a specific division. So we wanted to make it a little bit more easy for everyone to, handle the workload. We also made sure that on our last year, or on our submission year, that we're doing the least amount of work, or at least new work, and that gives us an opportunity, if something is delinquent, we'll have time to work on that, or if you know, heaven forbid, 2027 version is something that, is extremely drastic from what it was in the past. We can work on making sure that, we're up to stuff on… to the changes that needed to be made.

But as you can see, and if you were paying attention to the last slide, what I did mention was that we're a totally new staff. And with the totally new staff. you would think that we would have to start over from ground one, or ground zero, for that matter, and unfortunately, we did not. We just simply had to augment what they had left for us. As… no documents were received before we got on… on track. However, there were lots of communications that happened, which allowed us to, you know, reschedule everything, and then as we started communicating with people, those documents are going to fly in, or have been flying in. And so, with that, we scheduled 54 documents for this year, so we're having lots of fun as we start this process. You can go ahead to the next slide.

So, as I mentioned, we decided to, plan out each year. I think that that platform that Jason showed us was amazing. It had every single one of the measures in there, and I'm not that type of a nerd, I'm a different type of nerd, and that was too much. So, we took bite-sized, chunks, and so we have a planner for each year, and the planner we used was Microsoft Planner, if you can go to the next slide.

So, we liked the idea of Microsoft Planner. It's free, and so we didn't have to put in that much more of an investment than what we already have in using Microsoft 360 in our day-to-day work. And then, it gave us the opportunity to build this out with a domain for each bucket, and then for each year, it only contains the assignments that are due within that year. And so it's bite-sized, and as you can see, in Domain 4 and 5, there's nothing there, because in 2025, we did not ask for any Domain 4 and 5, submissions. This tool is great because not only is it used by us, it's kind of visually appealing, and it's used by every person who has an assignment. And there are some amazing, features that are contained within Microsoft Planner that allows this to be a very engaging, planner. And so you can go to the next slide. We'll talk about some of those features when it comes to communication and engagement, you get to assign the members to each of the measures. As you saw, there were little cards that were there, and with each card, we created a system that Sarah will show you a little bit later that allows us to assign people to that specific task, and then you get to control who has access to it, and who does not have access, and what kind of access they have to help, to ensure the integrity of the system.

There's also this great filter function for those outside of the accreditation team who need to, make sense out of this planner, and may want to only see what they're doing, and so there's a filter function where they can search for themselves, or search for their division. When it comes to process tracking, there's amazing due date reminders that goes out automatically to, assigned staff members who you've listed on the cards. There's a priority feature. If you change it from important to urgent, or important to medium, there's a message that goes out to those individuals who are assigned to the task. And then also, there is a chart form. There's also a, a list form, so it looks a lot like what you saw with Jason. Our team tends to stay away from that. We like… we like pictures and, you know, things to look different than, like, a spreadsheet, and so, but it's great because you can see how much of that year is completed, how much of that year hasn't been started, how much of that year is in progress. And then it breaks it down for each division as well. And then also for our document storage, we also use, SharePoint, and SharePoint allows us to hold those documents, so we think of our Microsoft Planner as a table of contents, it kind of, like, helps you to navigate through everything that's needed, and then SharePoint is linked to that Microsoft Planner through the attachments in order to, hold the documents. And being that centralized platform we don't have to worry about the things being left on someone's desktop, things being left, on someone's drive, or the Cloud Drive, it's all put into the SharePoint, and so if that person was to leave the department or take a new position, then we would still have all of the work that was, previously done by that individual, as well as previous years, because we currently have all of our submissions from 2020 three that we, supplied, which helps us to reference a lot, like, Jason was talking about in his program. Next slide.

So, when you set up your SharePoint, you can share… set it up in multiple ways, and, we've actually done both of these. You can set it up so that your attachments are linked to, folders by domain, or by… to folders by division. Basically, the ones that are attached to Microsoft Planner are by division, and it's set up that way because we want to make it user-friendly for those individuals who are helping us to get those submissions, our subject matter experts. And so… it's set up that way, but we also have one folder that's set up by domain for Sarah to use that is kind of locked away and nobody can really touch it, so… and it's organized for us so that we know exactly what we have and what we're missing, in the… in the big picture, because remember, these are annual. Now, you can use Microsoft Planner and do it for all four, or all five years, and have all 94 of them in one screen, but like I said, we chose to do it differently. Next slide.

And as you can see, when you get to that, you use that attachment to get to your place, in SharePoint, it can be organized even further to make sure that you have a place to, store that document in a very, you know, real and tangible way that everybody that needs it can access it. So, at this time, I'm gonna let Sarah take over the screen and, share her screen and show us a little bit of the tool as, in real life.

SARA ROJAS:
Okay. I think it popped up. Cool. So, as Latifah was mentioning, this is, what Microsoft Planner looks like, and so if you have the Teams application, and even after today, after this webinar, if you want to mess around with it, you can actually go to the Plus Apps application within Microsoft Teams to add Planner to your taskbar. And so, when you start building your plans into Microsoft Planner, as she was mentioning, you know, we have 94 measures. You can build it out for the fiscal year, as well as if you're maybe like me and you want to see the bigger picture, you can build it out into subsequent years and kind of see how much of a workload you're going to have, so that if you run into any issues, you can say, oh, we're gonna move this task to the next year because of such and such issue or date. So, I understand that when you go into Microsoft Planner, it kind of looks a little chaotic, but I guarantee that if you take it step by step, it becomes much easier to keep track of everything, and you can certainly change this to how you would like to use it, but we are going to show you in the way that has kind of worked for us so far.

And so starting from the top down, the reason why it's scratched out is because we actually completed this task, but you would go in and put in the measure. you know, create community health assessment, and then here, you would assign persons to the task card, and I will show you in ways that this can be beneficial, but all you need would be the email address within, your department. Then, the next set is we have labels, and again, you can use this to how you would like, but we have created domains. We have also included the foundational capability that's within the standards and measures, as well as, you know, if the measure is on time, or if it's delayed. We've also included our divisions and their specific colors, so it really helps for when we assign people to tasks, they can go in and identify, where they're at in the plan. And so this next set of labels, you have your bucket, to which, again, if, you know, you're creating these cards, and maybe there's a mistake or something happens, you can move cards, to where you see fit, or where it falls best in the domain progress, you have, you know, not started, in progress, completed, keep track of it.

A priority for us, we have kept it as important because this helps with the email reminders that it sends out after we have set the due dates. And because this card's completed at the moment, this is why this is grayed out, but when it's not completed, you can schedule, like, a daily or a weekly reminder, but we kept it to, I think, I believe, monthly, just so that, you know, we're in everyone's inboxes, but we're not bogging them down.

Yeah, the next part of this card is the notes, and for us, we have kind of condensed the PHAB guidelines into the required document, kind of gave the brief overview, as well as the bottom for us. We kept kind of for tracking purposes, a chosen document, an assignment lead, the main point of contact being myself, and if I'm ever out of the office, a supporting contact being my manager, Matifa. And so, then moving down, this next feature you could use however you would like is a checklist, whether it's scheduling a meeting or scheduling a follow-up. I have also started to use these in order to help keep track, of where I'm at in certain tasks. But the very key feature here is the attachments. And so, as Tifa was mentioning kind of how we've used SharePoint and how we've linked things. Again, we've included, the actual PDF of the PHAB guidelines. We've included our past submissions that's housed within our SharePoint, as well as the most important add-first draft here, to where I direct a lot of the assignment leads to drop in their drafts so I can review, and everything can be done in real time, as well as submitting any comments.

And then I have also included here, because our divisions still like their Excel sheets, and so, of course, we've linked the Excel sheets that put out the assignments and other important tasks, as well as any meeting notes. So if I had a meeting with the division and they want a copy, they can always come to this card.

And last but not least, comments. So, you can put a comment on here, and it will immediately email, again, as I was mentioning, everyone that's assigned to this card, so that everyone can kind of be kept on the same page, whether edits were made, or a meeting was just scheduled, or, you know, when the task has been completed. And so, once you have done the whole process, you've done the reviews and everything, you can go back in and actually hit completed, and it won't scratch it off your plan completely, but rather from the domain bucket, it will move it to the bottom, and as you can see here, once you have finished your tasks, that have been scheduled, it will actually appear as completed tasks, to kind of removes it off your plate, per se, but it doesn't get rid of it completely.

And so, I want to say, too, that I actually did not create this. A previous coordinator created this. I actually joined the department probably about 4 months ago, and I certainly was able to pick up what was already here, and certainly use the comments to be able to kind of see where the gaps were, if there was a document that wasn't turned in, or if it hadn't been reviewed yet, and so I was able to really, pick up the torch and keep going with it, so…

DUHART:
So if you stop sharing your screen, we can go back to the, presentation, which just has some contact information on us. We knew that we went through this extremely quickly, and so, when you receive this in your emails, then you'll be able to get in touch with us. The additional person on there, Topanga, is actually the person who built out the first planner for us, and she has been promoted to our Quality and Process Improvement Program Manager, who is also staying very close to us and a valuable member of our team, although not in an official capacity. But we really appreciate and thank you for this opportunity, and if you get in touch with us, we'd be happy to explain more of what we do and show in greater detail.

TOUMA:
Amazing. Thank you both. Lots of kudos to you two, and I love a good visual management tool, that you guys just shared. And it looks like, in the chat, I was reading Pennsylvania may have used the same, same tool as well, so lots of validation there.

I… we will hop into the questions, so folks, if you have, questions, please drop them in the Q&A box. We do have some time. Very rarely do our speakers manage to fit all their content in the time that we gave them, and today they did a fantastic job doing that. So we have 15 minutes for questions and answers, if we need it.

So I'm just gonna start in the Q&A box. I have a couple of other questions as well, but, this question is for the Pima County team. How did Pima County chunk out the documentation? How did you decide what was going to be due in 2025, 2026, or whatever annual, you know, calendar that you used?

DUHART:
So, first thing we did was, and I say we loosely because I was not a part of the team at the time, but I do know what they did. And so, first thing they did was they, divided everything, all the measures, into when it was due, like, within 5 years, within 3 years, within 2 years, and category… and had them all in categories so that they knew what year was possible for it to land. Those things that are current cannot be put in 2025 when you're first starting out. You have to put it in 2028 when you're about to submit. So that was an easy way to stratify it, but there are a heavy load of them that are within 5 years, and so we can't use all of them that are within 5 years and assign them to, the first year that we start the the process. So, we, strategically looked at who would be the holders, or who would be the leads on those, documents, and made sure that it wasn't too voluminous for any one team. And so, if, like our EMAP team, they get hit really hard, and that's our emergency, emergency preparedness team, and so they get hit really hard with accreditation, and they are valuable to us, and we treat them like, you know, golden, for sure. But we wanted to make sure we didn't give them all of them in one year. We also wanted to reward them for the wonderful work that they do to, like, coast on the last year the same way we want to coast on the last year. And so that's how we kind of sparsed out which… who does what in what year. So it's… it was like a puzzle piece, and… and having lots of fun with that. Sometimes it depends on when a document's going to be ready. We knew that our Chennai was going to be ready in 2025, we knew that our strategic plan had to be recreated for 2026, and so those types of things also helped us to drive what year those, documents were required or assigned to.

TOUMA:
Yeah, wonderful. Thank you, Latifa. If there's a follow-up question to that, please go ahead and drop it into the Q&A there.

I think this is… this question is probably for all of our panelists, but there are lots of health departments that are still trying to figure out where to start when you're, like, starting to conceptualize what this project management or documentation management system might look like for your agency. Wondering if we could just go around and see if you have any… each have any advice, or, like, where would you start? A lesson learned that you would pass on to a fellow health department.

So, Pima County, since you were just talking, maybe I'll start with you, then we'll pass it over to Tennessee, and Lee, if you have anything to add, that'd be great, too.

DUHART:
I don't know, Sarah, has been with us for 4 months. I do consider her a subject matter expert at this point. She just told me recently, she's like, you don't have to be in any one of my meetings. So I'm really proud of her, and that does… that is a testament to, what this process can do. It can really give you an advantage to be, you know, ready to go in a very short period of time.

So… just getting organized, just, you know, taking a moment to say, what do we want to do? How do we want to do this? How do we want to look at it? So the different… they all seem pretty much the same, the platforms. They all have lots of capabilities, and so choosing a platform, and then… based on what you want to do. So if you want to see everything all at once, there's some that are more catered to that. And then, if you want to break things down more, there's others that are more catered to that. Just look at the different systems and see which one fits best with what your plan of action is. And there's no magic bullet for a plan of action. action. It's getting the work done. So, however you choose to get the work done, you get the work done. I… I will say. I love this way of spreading it out over the years. Our divisions love this way of spreading it out over the years. Most of them were here in 2023, and they are very appreciative. We're also very relaxed. We're not rigid. It's not 2028, and so if, you know, a document was scheduled to be done, like our COOP document was scheduled to be done this year, however. It's not, and it's pushed, to next year. So we just push that agenda to next year. So being flexible, and not so rigid, allowing for things to happen the way… organically sometimes is a good thing as well, because this is your opportunity to tell your story. It's… I know that, it… yeah, I got the smile from Sarah, because that's my whole thing all the time, is like, let's tell the best story we can, because we're an amazing organization, and we do amazing things. Let's get, you know, give ourselves the opportunity to tell the story the best we can, and in doing that, you have to be a little bit more flexible. So, don't stress, be flexible, and choose tools that work for what you want to do.

TOUMA:
Yeah, that's a great answer. Thank you, Latifah.

Tennessee team, anything to add?

DAVIS:
I think for us, the… the most helpful was to reach out to the other states and… and ask, because we… this is our first, accreditation processing, so ASSA was really… that was crucial for us, you know, to kind of get the lessons learned and kind of think through. But I use the same selling point of, hey, this is your chance to… to elevate your work, so I think that's cute that… or… interesting that we use the same words.

TOUMA:
I'm trying to… Mary Beth Davis: elevate it, but definitely. And then, of course, hiring a BI guy.

DAVIS:
Irene, Jason.

HOWES:
Well, I was gonna say that on the technical side, I honestly, like, that… I don't know anything about public health. And, so, like, literally, this is… it's, like, the same thing. Like, the process and the systems are the same everywhere, right? Like, as far as I'm concerned, like, that's sort of… like, just how I think, and so it was easy to do that bit, but the public, like, the work is so incredibly hard, and so, my part was easy, but the… yeah, getting… eating that elephant one bite at a time is really all you can do, I think, as far as getting started. I was gonna mention, I think AI is a tremendous resource if you're allowed to use it, for getting a framework, like, getting an outline, just some kind of structure. For you to think about something, and then you can go in and be like, that's dumb, that's great it just is a really good starting point, so I highly recommend using that as sort of a thought partner to get you started, and then you can you know, don't use it as is, but take it and review it and iterate, and it's a really good starting point. If you're having a hard time getting started, even on the technical side, actually, especially on the technical side, if you're having a hard time thinking about, how am I going to operationalize this, it's a very good resource if you're… if you have it available to you.

TOUMA:
Yeah, that's great advice, too. Leah, I don't know if you have anything to add from working with, other health departments. But I wanted to make sure you had the floor.

MOSER:
Yeah, I feel like everyone else touched on some of the... I have. But I do think that trying to, like, plan as much as you can, like, have a plan for what you're going to do, beforehand, I know I kind of talked about, like, just start, but I think even the tool that I went over, it incorporates so much, but that's because that's kind of, like, everything that you would want to think of before you, like, really dive in. So I think, like, lightly planning out timeline, lightly planning out who's gonna be involved in which domains and things like that. I think that, even though it might be overwhelming at first, I think that helps the entire process go a lot more smoothly. And then you can identify… I didn't really talk about, like, the and gap analysis, which, even if you don't use the tool, I think those are still good, tools you could use for anyone going through...

TOUMA:
Impossible...

MOSER:
...To identify, like, okay, what are some things that could come up this year that might, like, interfere with our timeline, or that...

TOUMA:
Good news.

MOSER:
...hard, and how can we plan for those ahead of time, so it's not like this huge surprise and stressful thing if it does happen. So yeah, that's what I would say. Just as much planning you can do on the front end is gonna make your life a lot easier during the, the year of initial accreditation, or the 5 years that you're waiting to then do the next reaccreditation cycle.

TOUMA:
Yeah, that's a great point, Leah, and that's actually a good segue, too. ASTHO has the Guide for Sustainable Public Health accreditation resource that I'm just going to share that can help with that planning from the front end. Because you're right, when you can plan your 5 years from the very beginning, that's a lot less stress than those last two years when you're scrambling to get your documents and systems in place. Wonderful, thank you all. So, I'm gonna take a look at the Q&A box. I know a couple of them, have been answered, so I'm just gonna start with the one that's… the ones that are still there.

So for the Pima County team, how did Pima County handle organizing by divisions versus organizing by years in terms of document redundancy or duplication? That's a good question.

DUHART:
I should truly let Sarah take this one, because she's our redundancy police. We have had a few people who've, like, hey, can I give you this one, and for this one, and this… the same one for that one? And, and she's like, absolutely not. We're not doing that, and PHAB doesn't want that anyway. So don't blame me. Blame the dog. But at the same time, yeah, so she, is very diligent over looking at what is being submitted, if there's two different, you know, divisions that are trying to submit the same thing. There's group meetings and things of that nature, so that we could sit down and talk about what's the best course of action. But that's really what it is. It's a communication thing. Even though you may not be on a specific card, we may pull, like two cards together and have a meeting with, both of the divisions together. I mean, Teams is a wonderful tool to use so that we can always, you know, let's just jump on a meeting and hash it out, so to say who's gonna use what? We take a stance of, you know, we're not… We're not the dictators here, we're… you guys are the subject matter experts, you guys get to choose. We're just here making sure that we follow the guidelines. I'm sorry, I talked a lot. Sarah, did you want to add to that?

ROJAS:
I think to add to that as well, because when I first joined, we fortunately had someone that already knew a lot of the work that the divisions were doing, and so that person had Sara Rojas - Pima County: assigned things out already for, the next couple of fiscal years, but even then, when we would reach out to those divisions, they would say, this is not us, we just should go to this person. So… I mean, even if you have a plan, even if you've written it out on a whiteboard, even if you've developed Microsoft Planner, like, you just have to be prepared that things are gonna change, and you have to, still continue the constant communication. So even if you have the initial scheduled meetings, just say, hey, I'm gonna check in again in a month, and just keep that line of communication open, especially if, you know, there are divisions that might be behind on documents, and they don't want to be in trouble for being behind, but you tell them, it's okay, I'll work with you. So yeah, it's a constant moving puzzle piece, but it ends up working out in the end.

DUHART:
Yeah, I didn't even think about one of the things that she talked about is that our previous, division manager that's over accreditation, just knew the department. back and forth, so he could look at a measure and tell you which depart… which division, would be responsible, or the best division for it. I told, Sarah that, yep, in 2028, that's gonna be us. We're gonna be able to look at it and know exactly what everything is, and so just, getting a good handle on your department and all the things that they're doing will help you to help them not choose the same documentation.

TOUMA:
Yes, great, thank you both.

Just looking at the Q&A box, Tennessee team, would you say your management process is replicable even if an agency does not have the ability to code and work in Asana's API? In other words, could someone carry out that step manually if they don't have the tech skills and still end up with the same end result management process?

HOWES:
I… yeah, I think, the other team demonstrated that. I mean, it… like, without… I don't think you guys used APIs and things to… yeah, so, I mean, you could certainly do it. I think the API stuff and the text stuff, and that stuff that I talked about, the parlor tricks, honestly, is kind of… the parlor tricks are useful when you actually need to do something, and it… for me to go in and put all those documents attached on all of those tasks would take a very long time. Like, to parse that out manually, to go in and, like, post a comment and post those files would take days to do for one person, and it took me a couple hours to do programmatically with code. So, I mean, yeah, honestly, those are kind of… they're parlor tricks until they're not, until you need to do something like that, but the management of it and the… this, like, you can take that data set that I pulled in from PHAB, it was just already there from PHAB, I just had to reorganize it. And doing a Asana import is very easy, and frankly with… if you have access to AI, you have the skills to do the things that I did. You just need to… you'll just have to practice them. You can do it. It's a lot… like, AI makes things way more approachable than they've ever been before. You should be careful, but, yeah. So, I mean, at the core of it, it's the same stuff. It's just the parlor tricks maybe you can't pull off at first, but you can get there. Yeah.

DUHART:
Sarah placed in the chat that she agreed with you, Jason, about the manual work, and yes, we did manually put in our comments, we did manually put in our notes, we did manually put in the measures. But it didn't take as long as we thought. I mean, we… we got lucky and got a couple of days where we weren't doing anything but that, and so, we… it's doable. I really wish we had a Jason at that time, I'm not gonna lie, but… but it is doable, and it really isn't… I mean, it's, like I said with, you know, accreditation in general, get started, start doing it, and you just take it one step at a time, and before you know it, it's done.

HOWES:
Yeah. That's, podcast and headphones work. Sometimes I want that kind of work, honestly, so, yeah.

TOUMA:
Yep. Well, thank you all. I know we're… oh, I'm sorry, Mary Beth.

DAVIS:
I was just going to say, you also have a… we have a very dedicated team, and a very patient PHAB coordinator, you know, so I think that that also is important, you know, that you all rally around each other, because you're going to have to… You know, all have to have the same stance about how important this work is, and our team is really wonderful in that sense, so…

HOWES:
100%. I was gonna say, Mary Beth, like, the folder structures… I didn't make those folder structures, the team made those manually, and they built out that entire structure. And, they saved all the information around it, so I had it as a way that I could link to it and stuff, but, you know what I mean, it takes a village, you can't do this. I, yourself, and the def… our team is incredible. So, yeah, they're doing the… They're doing the real work, honestly, so… Yeah.

TOUMA:
Accreditation is a massive team effort, definitely...

HOWES:
100%.

TOUMA:
...Agency-wide, within your own internal group, across partners, yeah, definitely a team.

HOWES:
Mmm…

TOUMA:
...A more project. So I do… I recognize that we're a little bit over time, so just, to be mindful of everybody, and respectful of everyone's time, I want to really thank our panelists for joining us today. This was an absolutely fantastic webinar. I think folks got a lot out of it. I'm looking forward to posting the recording, to the website so folks have, access to this if you want to share it with your colleagues or team members.

I know we had a last question in the Q&A that we didn't get to about buy-in from members, team members who are already stretched thin in their current work, and I do just want to put a plug in that we're hoping to have some, resources coming up over in the next couple months, highlighting some, some practices, that could help, you all get buy-in from, from those team members that have a lot on their plate, and it's a little bit more difficult to get documentation from them. So, we have some resources coming out, about that. But please, I dropped the evaluation link into the chat. Please take a moment to evaluate our webinar today, we'd love to hear from you. We will also follow up after, in a resource mailer, so that you have that link, and all these resources. So thank you all, thank you to our panelists, thank you to our attendees, really appreciate you all. I hope everyone has a great rest of your day.

DAVIS:
Thank y'all.

TOUMA:
Bitcoin.

DAVIS:
Take care.

HOWES:
Thanks, Melissa, thank you to you.

DAVIS:
Bye. Bye.

HOWES:
Hi, y'all.