Tools and Strategies for Building a Sustainable Accreditation Infrastructure Webinar

MELISSA TOUMA:
I think we're going to go ahead and get started.

So good afternoon, everyone.

It's 3:00 so Eastern Time, so it should be afternoon for everyone here.

Welcome to today's webinar, Tools and Strategies for Building a Sustainable Accreditation Infrastructure.

My name is Melissa Touma, I'm the Director of the Public Health Infrastructure Program here at ASTHO, and I'll be facilitating our session today.

And thank you so much for making time to join us as we explore, you know, some practical strategies and peer insights to help health department sustain accreditation efforts over time.

I know there is a lot going on in everybody's weeks and days and so appreciate everybody making time to join us today.

So as we begin, let's let's just frame the challenge first.

You know, many health departments face several challenges in sustaining public health accreditation.

And what brought us here today is that over the years, particularly since COVID, we heard from dozens of health departments through PHIG.

Power TA request our accreditation sustainable learning community that several factors have affected health department's ability to continue and build off each accreditation cycle.

So health departments often face periods of changing resources, limited funding, leadership turnover, staff changes.

All of these factors can disrupt momentum in accreditation processes, shifts priorities away from accreditation related activities, and it could also result in the loss of institutional knowledge about accreditation practices in the history of accreditation for for the agency.

However, we know that accreditation is really more than than a milestone that you look to achieve every five years.

It's really a continuous journey and each cycle is designed to build on the progress of the previous one as part of its own ongoing improvement process.

So planning intentionally for sustainability really helps embed accreditation into the daily operations of your agency, helps protect progress through transitions, and it also evenly distributes the workload across the five year cycle instead of back loading all of the work in the last two years before you have to reapply for accreditation.

And that makes for a much more sustainable accreditation initiative.

So with this sort of background in mind, our goals for today and this webinar are really to share some some tools and some guidance that we put in the ASTHO's Guide for Sustainable Public Health Accreditation.

It's a resource that's available online and we'll be sure to share it with you all today.

We'd also, we also hope that you identify some strategies for building and maintaining your own accreditation infrastructure in your agencies.

And most importantly, we are looking forward to hearing directly from your peers about their own experiences implementing sustainability planning and accreditation practices in their own health departments.

So in the chat and before we dive in, it would be great to learn a little bit of who's in the room in the chat.

Could you please share your health department's name and then one lesson that your agency learned from its last accreditation cycle that now supports A sustainability today or maybe informs sustainability thinking today.

And if you're new to your, your role and you weren't around for the last accreditation cycle, what is 1 lesson that you are learning from that previous cycle? Maybe there aren't enough documents that were left behind.

There were no plans from the original accreditation cycle.

What are some things that you're learning along the way that you hope to put in place after you achieve accreditation again, as the accreditation coordinator or accreditation team for your agency? And so as folks are thinking about that and, and dropping into the chat, just a few housekeeping notes, closed captioning is enabled.

This webinar is going to is being recorded and it will also be posted to our website along with the slides and the tools that we share today.

So you'll have access to all of that as questions come up.

Please drop your questions into the Q&A box or the comment box, either is fine.

You know, at any time during the conversation, I'll hold on to those questions until the last 15 or 20 minutes of our agenda and we'll be able to have a conversation with with our speakers and our panelists.

All right.

So we're excited to welcome our speakers today.

We will start off with David Stone, who is the Public Health Infrastructure Specialist at ASTHO.

He will talk to us about some tools and resources that are available for health departments to develop their own sustainability plans or strategies within their own health departments.

And then we will pass the mic over to our peers at the Montana Department of Public Health and Human Services, Marilyn Trevino, who is the Performance Excellence Coordinator and Richard Knecht, who is the Accreditation coordinator.

They will share their journey developing an accreditation sustainability plan that is really setting their agency up to strategically navigate the next five years of the reaccreditation cycle.

And then our peer at the Southern Nevada Health District, Rich Hazeltine, the department's Quality Improvement and Accreditation Manager, will bring us home with a dive into his agency's plans for internal communications, which we all know is a really critical component in managing change and also sustaining accreditation efforts.

So I'm really excited for our panelists today and I thank them so much for joining us.

All right, so I'm going to go ahead and pass the mic over to David Stone to kick us off and talk to us about the guide for Sustainable public health Accreditation.

DAVID STONE:
Thank you, Melissa.

And yes, wanted to give a quick overview.

I know many of our participants have already seen and used this guide.

As we put this together last year, we wanted to think about it in a way that helps a health department think through some of the issues that need to be considered when you are both maintaining accreditation and preparing for the next cycle.

So while the document is divided into these three sections, really there's a flow and a use where you can connect all three of them.

So the first section is where we think about some of those infrastructure elements that you need to consider and some of the overall aspects that you need to think about as you become accredited organization, as you build that culture of accreditation.

And then we have a section where we focus in a little bit more on the maintenance throughout the cycle of your accreditation and then planning for that next cycle.

So I'm going to break that down just a little bit and hit on two or three things.

In that infrastructure section, we're looking at some of, again the overall aspects.

So part of it is thinking about the value and the benefits for your organization.

And I'm going to tie that into the boundary spanning leadership in just a second.

We do introduce the foundational public health system thinking as well since PHAB is taking some of their measures and they have looked at it from what would they would consider to be a foundational public health service element and that's one of the aspects that they focus on during the cycle.

Then we talk a good bit about communications and that's spread throughout the guide.

And as we've had two learning communities around accreditation, sustainability, that has been a big topic that keeps coming up as well as the different ways that resources can help.

And I'm glad that a couple of our peers will talk about some of the ways that they've been using their resources to sustain a credibility accreditation, the boundary spanning leadership that we integrated into the guide.

We really look at that from the three aspects of direction and then alignment and then commitment.

When I was at PHAB, what we heard a lot was that to be successful in accreditation, there's three things.

Knowing that, why and then knowing that the leadership in the department supports this effort and then having the resources to go through it and that aligns well with that aspect of direction.

Are we committed to moving in this goal together, the alignment, Are we supporting it? Are we ready to make this and then the commitment which gets that, also the support and then the resources that go with it.

As we move into the maintenance section, we are looking at some of the aspects of the process.

Now also that organizational piece, you can look at some of the history around what you have done for accreditation in the process in previous cycles, if you have that. If not, then you can look at it as you go from that initial process to re accreditation.

And one important thing that we've learned is it is really key to keep that momentum going throughout the cycle.

You won't be doing a lot perhaps in those first couple of years after you're accredited, nothing extensive, but there are elements that you can keep up with and track throughout that cycle so that you're not doing a rush right at the end.

In that last 18 months or so before you apply for reaccreditation annual reports, and I've had some conversations with PHAB, they're going to elevate the purpose for the annual reports, but that's a good way to keep a track of what's going on each year of your cycle.

What is it that you are accomplishing? What is it that you're having PHAB help you with and giving you some feedback? And then a couple of other really important things is to keep keep that documentation on track throughout those five years.

Remember to keep a check on all your major plans.

Are you updating and revising as you need to make sure that you're implementing those plans, recording your results, keeping tracks reports, etcetera.

And then for documents in general, we've worked with a couple of states where there have been staff turnovers and different priority changes, etcetera.

But when it's time to look at the next cycle, there is no history of the process, the documents that were used before, they have been misplaced, what have you.

So having a document management system where you're storing your documents, you're tracking them and you're keeping them up to date throughout that cycle, again is an element of the maintenance that's really good to stay on top of.

And then finally, the section we have on re accreditation planning gives you an idea of, OK, here are some of those same elements that you can use from the earlier sections.

What's your approach? What's your mindset around it? How are you going to look at how you allocate staff, how you set up your accreditation teams? How are you going to look at the roles of folks, encourage them to help in becoming the subject matter experts that will help provide the documentation how you can engage them? How will you help them to see that this is a part of what the department does as public health and it's not an add on that everyone despises having to do? And then what's the timelines that you're going to follow as you go through that cycle to maintain your documents, keep folks involved, educate new folks as they come online? And then finally, we do go through each of those accreditation steps to go, OK, as you go through these five years of your accreditation cycle, what do we need to be thinking about? Because although they are linear in appearance, they're really not because that documentation piece, you keep maintaining, the plan piece you keep maintaining, you get ready for the reapplication process towards the end of that.

So you have that and you can think about the different elements within those steps and how all of that ties together during that cycle to help you be prepared when it comes time to reapply for read accreditation.

And then also in the guide, we have some different templates, some appendices that look at change.

This is a change process.

Look at the communication elements, look at some possible staffing types of frameworks that you can use.

So there's some resources there that could you can use as well.

So with that, I'll turn it over to the next portion of our webinar.

TOUMA:
Yeah, great.

Thanks so much, David.

And as David was sharing a little bit more about the guide, I was looking through the chat and seeing some of the lessons learned that folks have from their initial or their previous accreditation cycle.

And I think everybody else on the call could definitely relate to a lot of these.

Organization is a big thing, documentation, keeping a way, having a way to keep all the documents together.

So the the goal of this guy that David described is also to help build that sort of infrastructure around keeping your accreditation initiative organized and coordinated through any of the challenges that a health department experiences.

So if you have any questions for David, please drop them in the chat or in the Q&A box and I'll be sure to get to them at the end of the call.

So at this point, I'm excited to hand the mic over to our Montana team.

So Marilyn and Richard, I will hand the mic over to you.

RICHARD KNECHT:
Awesome. Thank you.

Hi everybody. My name is Richard Knecht.

I'm the state accreditation coordinator for the state of Montana.

I've been in public health for a few years now, but just started my role here in helping with the PHAB accreditation.

MARILYN TREVINO:
And my name is Marilyn Trevino and I am the performance management and quality improvement coordinator for the state of Montana.

And I have been in this role for about 10 years now.

And every minute of the day I've learned more.

And this opportunity has been superior.

Launching pad to learn a whole bunch or at least to get all my ducks in a row so that we can elevate not only the sustainability of PHAB and the work that we do throughout the five years to get to reaccreditation again, but also the performance management and quality improvement.

KNECHT:
Thank you and yeah, Marilyn, this you could take this one Yep.

TREVINO:
So, so as you, as you can tell by this slide, we just introduce ourselves and our tag line for the performance excellence program is building a culture of excellence where PHAB standards, data and strategy unite for community health.

And before we're the whole it's us, me and Richard or I support Richard.

Richard is the main guy for this.

And so with that, what happens in a rural or frontier health department in a very large state, funding was minimalistic priority for staffing for this sort of body of work.

But it really is so foundational and so important.

But luckily, I think the two of us make quite a Dynamo to get these things rolling along.

So before the previous years, there was no funding for this this this body of work.

And so there was funding out of the PHHS block grant awarded in 2023-24 year and every year subsequent.

We've had been blessed with the ability to have a little bit of funding, pays for those PHAB fees and then also pays for some training and travel where where we can get into those items.

And then also was elemental in standing up a transition from our homegrown performance management system called Health stat, if anyone remember that one to our new achievement platform.

And when we talk about that document coordination and and one stop shop accountability transparency, that particular platform has elevate as they'll also elevated our ability to showcase a credibility, performance management and quality improvement and really reinforce and legitimize the the need for documentation of all those items.

And so we're we're looking forward to allocate our funds to those those sorts of endeavors moving forward.

KNECHT:
OK.

And this is just something we have here essentially kind of what our what our goal is and what of our vision is and what we're moving forward, essentially the strength in Montana's public health system by going through our program before performance excellence program.

And I do lean a lot on you, Marilyn.

I appreciate your expertise as well.

So we're, we're a team, but you're definitely helping with that and really just embedding the PHAB standards into our everyday practices, our work, our QI projects, PMQI, things like that.

And again, building trust with the communities.

And right now actually to sideline a little bit, we're going through a communication program, Qi and a revamp and doing all that.

But essentially we're just trying to guide our work through communication transparency and you know, continuous QI.

TEVINO:
And this one is just the improved community health outcomes, sustained PHAB accreditation, readiness and measurable increases in stakeholder trust and system transparency.

It pretty much speaks for itself, I think.

So the leading metrics are really important and it's hard to find those leading metrics where you're just not being counting, you're counting something that's really measurable and really actionable.

And so the strategic direction that we have is to foster a PHAB accredited culture of performance excellence within public Health and safety division.

And then our, you can see by the slide, there are 4 performance measures that we're looking at the percent of achievement initiatives linked to PHAB standards.

And within that particular software program, I don't want to sound like a salesman, but I love this this program mainly because when you have laggers or people that don't want to move into documentation, this particular software helps elevate them and get them into the right into the right path.

So also the number of QI projects demonstrating improvement outcomes.

We've also just recently implemented our PDSA in achievement form in a template form so we can track all of our QIs.

And we can also move folks toward identifying quality improvement where they feel like they can get away with.

Like I didn't know that was QI, I didn't document it.

So we can move those into that and then also link them into the other pieces and then.

Of course, a number of communication campaigns linked to the PDSA improvements and the percent of employees assigned indicated the process was easy to follow and understand.

And the methodology of course that we use here is the PDSA cycle data analysis, implementation planning and communications campaigns.

And so that's we will be leveraging, we want to ensure that that software will be leveraged with the sustainability plan so that we can track everything in there.

Everything will be documented inside the achievement platform.

We have Gantt charts that show progress.

We'll have work groups that just discover and determine time frames to make sure that we get reporting and progress reviews from those.

And well, that way we'll be also able to manage staff expectations and hold folks accountable.

And then this one is that expected outcome, which is that improved community health outcome, sustained PHAB accreditation, readiness, not doing everything at the last minute and measurable increases in stakeholder trust and system transparency.

There we go.

There's our first fun slide.

There you go, Richard.

KNECHT:
Yeah.

So just touching base on this for accreditation readiness, I've moved into this position sort of towards the end of the cycle for accreditation.

And there was, it was really difficult to kind of get the documentation together.

There was a lot of back and forth with different departments and Marilyn was instrumental in helping transition for that 'cause there was QI projects, we're looking for, PM projects, just everything that PHAB was looking for at the last minute.

So thankfully through cat herding and kind of just thinking outside the box, we're able to cross that finish line.

And we successfully were re accredited in May.

But right after our accreditation, Marilyn and I were thinking, you know, that can't happen again.

It was really difficult doing that.

It's just us kind of working together.

So we started thinking outside the box and thankfully, we had the opportunity to join ASTHO and the sustainability cohort.

And there's a template or a plan.

I don't know if you want to share that now, Melissa.

It was, it's huge.

And what we're going to do in the next 5 years because what we've noticed happened before to no fault to anyone else.

But the five year cycle seems like it kind of picked up on the fourth year for us at the state.

And we didn't have a lot of time to get the documentation together and make sure it kind of really represented it represented the great work that we're doing every day.

So we're starting year one and we're using this plan to guide our work through the five years.

And Marilyn has done a great job in using achieve it as well, which is the program that we're using to track the domains, assign folks into that and make sure that this work is happening throughout the whole five years, so we're not scrambling towards the end again.

So if you want to go to the next slide, please.

And again, yeah, so here's our opportunity.

We needed a plan and thanks to Asso for doing that.

And we're in the very early stages of this.

But the way that we have it planned out really by quarter through the years, we have a really great idea of what we're going to do as well As for even our annual plans that we need our annual reports for PHAB that we need to do.

And a great thing with the sustainability plan is I think it also has site visit information that you could do on that, ACAR information for PHAB.

Just the easy way to just plan everything out.

And if there is any change or turnover or anything in the next 5 years, it's a plan that can be handed to anybody in the department and they know exactly where they are, where the work finished and what's the next steps through the five year cycle for for reaccreditation.

So yeah, it resulted in real sustainability planning.

So the first things first was Marilyn and I took the took that sustainability template, we started putting our own information into that.

And of course we needed to get leadership buy in.

So working with our new administrator because we also did have a transition there.

She's great.

She trusts what we're doing.

She sees the importance of this work.

So it's really easy for us because we've, we've been given the, the freedom to kind of create the plan as we see fit since we do the work and we understand the work.

So that's been really great.

And again, we're doing a communication campaign to sort of change some of that information and, and make sure we're getting valuable and, and transparent information out to everybody.

Another great thing this plan is allows us to do is have the, the roles, the structure responsibility.

So we have our accreditation team, essentially we're going to have people that are responsible for specific domains and that'll be attached into PHAB or attached into achieve it and a way for them to document on those forms, documentation forms, how to store the forms and how to send them to me for review to make sure that they're that they're meeting those those standards and measures.

And yeah, it has a timeline and staff engagement and training as well.

So for our recreation timeline and activities, essentially what our communication campaigns going to do is awareness and assignments, training for the documents, progress reviews, which were on our next step now in reviewing timeline COP resources.

And this is important because there are so many different staff that are coming in different roles and maybe don't understand how their work ties into PHAB.

So we're going to really try to reach out to them, help them understand the sustainability plan where they fall into that and in the larger scope where their work falls into PHAB as well.

Do you want to touch on the Achieve It, Marilyn? Just on the Achieve It documentation?

TEVINO:
Sure.

The Achieve It documentation.

There's training of course, for Achieve It.

There's leadership, leadership training, assigned staff and then subject matter expert document support.

And so there, these are the three levels that are in the sustainability plan, but also tie back over into the assignments.

And so in order for folks in there to get an e-mail that tells them when something is due, those assigned staff segments are really important.

And then staff that are listed as access to the plan that will do contributions like upload documents of any sort that are needed to fill out that that required document or that PHAB piece will be really important.

It also will, we believe it's going to actually provide those staffers with their own sense of linkage and ownership to accreditation or re accreditation.

That particular platform is going to have the, it has the ability to do visualization or dashboarding and that is going to be instrumental for our leadership.

Where they're going to be able to go to the dashboard and see where we are with their progress is see where we're behind and some of the items and be able to ask if there's any barriers to success that we need to rectify right now.

Really helping with that change management feature that happens periodically as we're doing our work because nothing ever just goes completely smooth.

And then of course, adhere to those timelines because we've got those automatic reminders inside the platform already.

And then resources where we're we, the primary thing that most people want to know is I want a single source, a single location.

So that affords us a single location that uploads all the documents.

And then it provides us a space for final required documentations or, and, or the templates.

And then also a place where we can provide those examples because examples are really important as well.

KNECHT:
OK.

And our success is 100% utilization of the sustainability plan and communications campaign, making sure that submission ready documents meet the deadlines.

And the great thing about doing this early is PHAB does have some documentations that need to be a two year or three-year.

Starting it early enough we can start populating some of those documentation in, update them as needed.

And if it's there already, there's an example of what would work.

So we just need to find an updated version of that versus just starting from zero on year four, which we don't want to go through again.

So we're, it takes some time to get to the template, fill it out, but it, it'll definitely serve you and help you and get leadership involved with that.

Let them know the importance of that.

And for us going through a site visit, we, we went through ACAR.

All that leadership was definitely bought into the idea of getting some of this done earlier on the importance of having a plan to get us through the finish line.

Any questions?

TOUMA:
Awesome, thank you both.

If folks have questions, please drop them in the chat or in the Q&A box and we'll definitely get to them.

Marilyn and Richard, thank you so much for sharing all that.

I, I think this is a good time to mention that our next webinar is going to be by the documentation management systems and using those effectively to coordinate staff in the accreditation project.

So it's really great, Marilyn and Richard, that you were able to touch on that as part of your own sustainability planning currently because it is such an instrumental part of being able to organize your accreditation program and sort of look forward to the next, you know, few years of the accreditation cycle.

All right, great.

Looks like the slides are back up.

Thank you, Victoria.

So at this point, I'd love to be able to hand it over to Rich Hazeltine.

He is with the Southern Nevada Health District and will be sharing about their own sustainability planning, especially around the communication of re accreditation and an and accreditation for their agency.

Thanks, Rich.

RICH HAZELTINE:
Thank you, Melissa.

And just a quick time check.

When do you want me to stop talking? You can use your full 15 minutes if you'd like.

12:51, watch out.

All right, thank you.

Welcome, everybody coming to you from Las Vegas.

Southern Nevada Health District doesn't always make sense to folks, but Las Vegas, we have a little over 2 and a half million people plus 41 million annual visitors.

So that fuels our health department of about 800 full time employees.

Las Vegas holds 73% of the state population and 0.13% of the square miles of the state.

So there's a lot of desert, a lot of things like Area 51 that take up some room and most of the people are right here with us.

Just a a warning of some trauma I carry with me.

I came into PHAB.

I didn't know what PHAB was until I was handed an ACAR, which I was told after our initial accreditation site visit and a consultant told me that that was the longest a car they've ever seen.

So we turned in a little over 7000 pages.

I had 90 days.

A lot of that work was done, but getting it together and I can really appreciate, you know, Marilyn and Richard talking about cat herding did a lot, a lot of cat herding.

And I think it may have been Marilyn.

So, you know, we can't let this happen again.

It was either Marilyn or Richard and that's how I approach it.

So you'll see that throughout this presentation.

Put this together.

We didn't get much of a break.

We got our initial accreditation in March of 2022 and about 6 to 8 months later we started assigning measures and owners for each single area again.

From what I heard with with our Montana presentation before mine about getting stuff early, there's no need to wait.

Some of this stuff can be 5 years old and work on it as soon as you can.

I leveraged COVID because I was still fresh in a lot of our contributors minds and you know, hey, you've got the stuff, you've got people.

It's kind of a slow time.

We haven't lost COVID funding.

We have this extra staffing.

Let's get to work on this.

So we pretty much held to this.

This is the design I put in right after accreditation.

We're in the headed towards December with an internal review and getting ready for our mock site review.

After that we should have about 6 to 9 months to work on any feedback we get from the mock site visit and be fully prepared in January of 2027 for our first reaccreditation.

There should be no nothing is surprising on this slide what a PHAB coordinator does providing some leadership even though I don't have direct authority over anyone documents communicating between all of us with leadership with whoever may hold resources that we need as well as with PHAB.

And then echoing again what Richard and Marilyn talked about with the, I think Richard more on the continuous improvement, what are the tips and traps? What can we share with each other about what's going on here? A little bit about data, even though there's a section coming up on that, we're a VMSG shop, we use that for, that's the tool we use to track our strategic plan.

And I don't have enough licenses for that tool to cover the strategic plan contributors as well as the accreditation contributors.

So I'm not using VMSG for that, but you could use it as document repository and a dashboard for that project if you wanted to.

The PHAB also has a pretty nice one that's kind of a condensed 10 tabs on an Excel sheet that you can use.

I use that to assign or make sure I had assigned all of the measures within the 10 domains.

But what got me on that is that it didn't have a, a breakdown for every cover sheet.

So as I'm looking at all the documents and knowing if we're really done or not, yes, standards and each measure is under there is fine.

But you know, sometimes when there are multiple examples under one measure.

So I've got a, a spreadsheet that color codes, you know, is it 100% or where is it between 0 and 100? That's what I'm using to track the completion of my teams because it's visual and that's how I, how I manage things.

We do use Microsoft Teams as a repository for all our documents.

Also, that's our communication hub for any training narratives.

Were new to us in our first year of reaccreditation, our first cycle, so did some things like that.

And this allows us to hold everything in one place.

So when I start assigning people to review someone else's work, we'll be able to do that easily.

I didn't realize until we started, you know, really working with as to on this handbook for sustainability about how what a great asset my internal communications team is.

They worked with us on this project that that I'm talking about today.

And our two folks there that helped with this are not able to be on the on this call, but Rosanna and our communications team was a pivotal person in the help.

And what we're doing is using their design capabilities, their ability to give us new channels to communicate.

It's been really helpful.

And so part of this is for the executive group executives meet there about 12 of them that that's a direct reports of our district health officer and they meet every two weeks.

I get in there once a quarter to give some cheerleading, recognize some of the teams or individuals groups that are doing really well with accreditation, some that are done.

Also asking for some support, seeing if they've got any feedback and reminding them of why we're doing this.

Here's the value in it.

Here's what we're doing it and you know, what challenges might you have? So showing some support, but reminded them of why we do it with our PHAB.

I do all hands for a virtual all hands meeting for them.

We started out once a year doing it with a kick off and and then slowly increase the frequency of those.

This is not a check in for everybody of tell me how you're doing on, you know, domain 5 standard, this measure that we don't go that deeply.

It's just sharing the global things that are important to us.

We also invite senior leadership to every one of these all hands.

So when they're there, they're showing their support.

And also when we can, you know, call out some folks for really going above and beyond in this area, it's great to have senior leaders there to kind of carry that torch and, and, and pile on to that.

There's continuing improvement.

Again, it's not going to go away.

I get to oversee improvement for our district too.

After that comes the fun work of checking in by a team and contributors, making sure that they're on track.

You know, we started out quarterly in year #2 of five of us as we're working towards re accreditation, that frequency is increasing over time and it's really just checking up and holding people accountable.

And it's not my favorite job or function of my job, but I'm I'm, I'm fairly good at it.

Something else that our communications department helps us with is putting together what we're going to present to our board.

Again, they're tech support and able to help us keep a consistent message.

So we talk about presenting to the executive committee, We're talking about now the governing board, the content, the message is fairly is very similar.

But for my executive board, they may care about something else the the governing board cares about.

Well, what can they brag about to their constituents, to the people that vote for them and put them in office.

So trying to give them some a slant on what's going on so that it's more meaningful to them and that they can take away and share that with some of the folks they work with.

More about our internal communications team.

That's not quite in the spot I would hope for it.

But moving forward, another group that gets the same kind of messaging.

This is our, our, we have our 84 managers meet every month and I insert myself in there for just a couple of minutes each time to update them on progress.

Congratulate the folks that are doing well so they know it and see if the leaders or managers are sensing any problems or, or barriers.

And again, it's short and sweet, but making sure they know the work's going on, that it's important and here's why.

So the managers channel of this communication might include something around funding because that's what's important to them.

How does PHAB affect my funding? You know, how does doing the work now save us time from having to do extra work later and take people off of projects, that sort of thing.

So tailoring the same essential message for each group.

And the com internal coms team is helping quite a bit with that.

They've also enlightened us to different channels we have available for communication.

This is something we put on.

It's not a PHAB announcement that's under construction right now, but this is an example.

We have about a dozen 70 inch TV screens turned on their side.

So we've got a vertical screen that's as tall as some people, right? So able to use that space for something exciting.

This was happened to be AQI project on behavioral health.

But being able to get that out and they're looking for good content.

And you may have seen similar channels like this where you work that they're just hungry for content.

You see the same thing over and over again, or maybe a screen hasn't stopped and so long you wonder if it's broken.

So I'm taking advantage of that and getting the word out and places like this wherever we can about new Qi items.

This is an example on the left side of every time we log into our computers.

We have a bubble message that comes up.

It may be about vaccine, it may be, you know, about something going on with our federal government.

This is a great place for messages about PHAB.

It's like brand awareness.

I think I heard, I was doing some reading on, you know, about UPS and before Amazon came around, they wanted you to hear their name eight times a year that that was enough for them and they would advertise as much and that was their ideal state As for everybody in the US to have seen a truck, seen an advertisement or just heard UPS eight different times.

So I, I look at that in a similar way with PHAB of just making sure that it's top of mind for people.

They understand what we're doing and most importantly why we do it.

So we uncovered some PHAB messages that were concocted in where am I 2017, 2018 when the the agency first applied for accreditation and every about out of 15 of them, there was only one that really wasn't relevant.

14 are already ready to go, so those are in rotation regularly with us.

What have we learned since we started this journey? Something I learned, I first structured the communication from a project management standpoint.

You know, I'm great at checking boxes.

I'll run you over to accomplish a goal if I'm not careful.

And I'd structured that with check insurance for the individual work with just small teams or individuals and did not have many all hands meetings, virtual all hands meetings in the plan.

And I got feedback from more than a couple people that they really missed having that large group feel and to see what other folks are doing.

And so with that, I tried it and a good, you know, PDSA cycle and got really good feedback on that.

Again, putting people together but keeping those messages or the the agenda short.

It's not going over the whole list of how we're doing on every single measure.

It's celebrate some wins.

Let's work through some barriers if you have them.

Let's recognize some great behavior.

And then if senior leadership has the time and they are there, give them a spot to, you know, to do it.

30 minutes is plenty of time for something like that.

So we've been incorporating those just about quarterly now, and we'll probably continue that all the way until January 2027 when we submit our final documentation.

Something I've learned recently, and I kind of felt this intuitively, but I finally heard what Parkinson's Law was when it was defined.

And essentially, it tells us that work expands to fill the time available.

So if I give you 3 weeks to do a project, some people will take until the last day and then they'll start it and finish it and get it turned in just in time or maybe even a day late.

You know, they, that whole, you know, 2.8 weeks ahead of that was just a buffer for them.

So I've been experimenting and trying not to be the one to set the deadline and asking, OK, you, you know, you blew the, you blew the deadline.

You told me on this particular thing, when are you going to have the community health improvement plan written up ready, submitted, camera ready? As soon as ready and they'll give me a date.

And then I use my best coaching procedures and say, OK, can you commit to that date to, you know, February 1st, whatever it might be.

And then that goes in my notes.

And they know me well enough by now that I will check on that.

But by not picking out your own deadline often can have really good effects and getting more done faster.

Another part of Parkinson's law is that projects never finish early.

So that's just something to think about that I've tried to incorporate as I go through.

Next up for us, I mentioned an internal review, so we're farming that out.

So if one team or individual submitted, let's say five cover sheets, then they're going to get five cover sheets from another area to review.

Not as a subject matter expert, but more as is it readable? Does are the documentation rules followed? Will it make sense to PHAB and that's just one step we're doing of having everybody review about the same number of of cover sheets or or measures that they submitted to keep it as fair as we can and just to give us one set of eyes so we can get as much value out of that mock site visit as we can.

We want those documents to be as clean as as possible, understandable as possible and that'll be our next piece.

Another thing that's on our on our road map is to build and launch a 3 minute PHAB explainer video for new hire orientation.

We're in a hiring freeze right now for due to funding, funding fun and but it is still important and I think it's going to help us as we go into the next cycle.

There will be some new people coming in to work on PHAB documentation that haven't done it before and I think that's going to help us in that area too.

And that just talks about that, again, thanks to the two folks that that helped me a lot.

We're on a lot of meetings, not a lot, but enough meetings with David and Melissa from ASTHO, that great work that they're doing, Rosanna in our office communications and Malcolm, who's a senior health educator in the Office of Chronic Disease and Public Health Promotion, which is a real mouthful.

And then lastly, thank you, folks.

And while I think about sustainability, I think about the year I ran our laboratory, the height of COVID and how do we sustain our energy.

Wednesday afternoons after lunch, productivity started to dip a little bit in the middle of the week.

Hump day is Wednesday, so about two or three in the afternoon, we'd get everybody into the hallway.

We'll have a boom box and play like about 3 minute song, old disco song or James Brown or something.

Just one song and everybody sat against the wall facing each other to do wall sits and tried to hold that for the full length of the song.

It's just one way we got people together.

Shake off the the the hard, semi monotonous work you may be doing at the time.

Get out, see each other, know we're all in this together.

So I think anything you can do to bring your accreditation team together as one to feel like, you know, it's not just me busting my tail doing all this work, but it's me plus others.

Damn it, one minute over.

Sorry folks.

Thank you, Rich.

TOUMA:
That was impressive.

Thanks, Rich.

Yeah.

And I love how you ended on not only that staff engagement, but sort of building those relationships with staff and leadership across the agency, that this is not just your project, but this is everyone.

Everyone has a role in accreditation.

And sometimes in order to break down those silos, we have to build different relationships with people so that we can get them to the table so that they can see the why behind accreditation, that it's just, it's not just another to do on their on their list.

And communication play, intentional communication plays a huge role in that.

Wonderful.

Thank you.

Thank you to all of our speakers.

We have about 5 minutes for some questions.

So please go ahead and drop them in.

I see we do have one question in the in the chat there for the Montana team about achieve it.

Did you select achieve it core plus or pro package?

KNECHT:
Hi, I'm not exactly sure which achieve it we chose.

I think Marilyn might have that answer so it hers.

TREVINO
I'm sorry, what was the question again?

TOUMA:
Did you select achieve it core plus or pro package?

TREVINO:
I really am not sure.

I think it could, it probably most most likely it was the, it might have morphosized a little bit, but we have unlimited users.

And so it would probably be the pro package where we're more on a enterprise level package.

But the functionality, yeah, it would be, yeah, would I'm pretty sure it's pro.

It would be, yes.

It's pro package is what we selected and I highly recommend that.

And then I also highly recommend thinking of it because we started the achievement with our program management as a program management tool, so we can ensure that programs were meeting their programmatic standards.

And then we have also like I said, we've got the PHAB accreditation in there and that came from the fine folks at Achieve It.

They built that in for us.

And then we've got those dashboards that are invaluable.

And I think like you know everyone is totally on a budget and you can only afford what you can and that is totally true.

But the where we always like kind of cheap out on stuff is in performance and quality.

We performance management and quality improvement is where we always feel like just a spreadsheet will do.

And I do not hold true with that fact, though I am a penny pipe penny miser, I tell you.

But I don't hold true to that fact because for someone who's tried for the last 10 years to increase engagement and increase the quality culture in our organization, organizational change sometimes is best served with a data modernization that just can't be topped.

And we're finding that now people are more enthusiastic about documenting, which everyone knows that's a huge problem and and accountability.

No one wants to be held accountable for documenting or pushing, pushing the envelope a little farther that that Rd.

doesn't actually need to be to Richard by a certain time or what have you.

And it is the way that work is performed.

And if we're going to really change organizational infrastructure and really make things more manageable and meaningful and really transform the trust with public health in our communities as that data-driven action data drives action.

That's why this platform for us is the main thing, if you can, if you can get through that same feel of being on top of the roller coaster instead of being drug by the roller coaster.

I feel like that's why this particular platform of achieve it and achieve it pro suits Montana the best.

So it is a great investment and that was that leadership buy in.

TOUMA:
Yeah, thanks for that answer, Marilyn.

And I know you guys have been using it for years now.

So and multiple uses, use case scenarios.

So definitely something that seems to work for you all.

Yep.

TREVINO:
And we're also even starting to utilize it for some project management.

And so we're dealing with the QI, but the you know, so it's multifaceted.

So I'm, I'm not peg, I'm not one to peg it into just one thing, but all of it ties together.

So that's why it was good.

Thanks for the question.

TOUMA:
Thank you, Marilyn.

Looks like we have another question in the chat, this one for Rich.

How frequently were you meeting with your teams and how frequently were you meeting with your leaders to keep them informed?

HAZELTINE:
Hi, thank you.

Good to see you here on this call with the team's quarterly and that was from pretty much the end of Year 1 all the way through to now, which is now increasing in frequency for those who we're about 85% with all my documentation, you know in its first draft form.

So that 15, those 15 percenters are getting calls from me.

As you know, we keep setting new deadlines and give me the new stuff.

And so it some of them I'm checking in with every week like you said you would do this.

So that's for the contributors.

As far as leadership, senior leadership in my district, the ones that roll up to the district health officer once a quarter get into those meetings and then for our board, we update them.

They get something every month in written form, but then they get an actual audible either for myself or for my district health officer at least once a year on, on our progress on that.

So trying to tailor the got a communication plan of, you know, from kickoff all the way to we've already planned the celebration and we got a re accreditation, but kind of who needs to know what and when and what the messaging looks like.

And then as I kind of touched on during that, just a few slides that we tailor that to the audience, then the message is probably the same, but we tailor to make sure that resonates with the folks that we're sending it to.

Thanks.

TOUMA:
Thanks, Rich.

All right, if folks have other questions, please don't hesitate to drop in the in the chat.

I'm just going to sort of wrap us up, but we can always answer questions via e-mail or afterwards or even through peer connections.

So Victoria, as you pulled the slides back up, I just want to really thank our speakers again.

You stepped away from your busy day to days and you, you prepared for today's presentation and shared with us that your strategies for, for sustaining accreditation.

We know it's not an easy task.

So thank you very much for, for, for doing that for us today.

Next week Is that next week, November 6th, is our second webinar.

This one is going to dive a little bit more into those documentation systems.

Both Rich and Marilyn and Richard had talked about their documentation systems and platforms today.

We know that's a critical part about for sustaining accreditation.

So we have another conversation featuring other peers next week.

So we hope that you'll join us and the registration link is right there in the chat.

Try that again.

And lastly, running us out.

I know we're at the hour.

Please complete the evaluation for us.

Let us know what you liked.

Let us know what you don't you didn't like.

We would love to hear from you all about what you want to see in these in these webinars.

And I'm going to drop this in the chat as well.

We will follow up with like a resource mailer with all the resources that you saw today and also this evaluation link.

So thank you all for joining us.

Really appreciate your time, and I hope you have a great rest of your day.

Thank you all.