A Day in the Fields

Today was a reality check, and reality changing. Not to be grandiose, but tiny changing and solid reality.

The day started with a drive from Peoria (where I stayed with a friend and colleague) to the smallish building, literally in the middle of cornfields, also the geographic center of the county and chosen as the best location in terms of county politics. The fields are being plowed and planted; the dust makes a faint light brown haze that hangs near the horizon. I was there to speak to a group of public health nurses about the KRISP grant. I wasn't sure what to expect, and was prepared to ad lib a lot.

The room was full, with a line going toward the breakfast brought by the director. Food surely gets staff to an 8:30am meeting. I spent 1.5 hours talking about the project, about the public health core functions, about the relationship of quality improvement to nurse recruitment and retention, etc. The questions were good, including the one of "what does health care reform mean for public health?"  Answer: LOTS!  I left feeling hopeful that these public health nurses would be engaged and grow professionally over the next two years.

Then we drove back to Peoria and met with a small group of supervisors at that health department. Again, spending 1.5 hours talking about the KRISP project, answering questions that were thoughtful and beginning to move toward taking action steps. Baby steps, and that's fine.

After a brief lunch, we headed back to the first health department to meet with the health administrator. We talked for an hour, addressing questions, giving explanations, and finding common ground. 

And, why the hell don't we have a national immunization registry, instead of state by state?! What century is this country in anyway? Why not have a web-based system that all providers and parents can access? It's a no-brainer. We have the technology, but not the collective will. How can the health departments do true quality improvement processes without having current data? It's mind boggling. Yes, 2 minutes on this soap box brought knowing but resigned smiles and nods from everyone. After all, they were the choir....

The reality checks were: unions must be included in planning and brought along in a positive way; the state has not paid counties for services and that means hardship for the county health departments; everyone has a boss that needs to be attended to; people are in public health out of passion and commitment rather than for the money, I love getting involved, and the whole experience is better when shared and mutually supported by a colleague.