Earlier this month, I attended the state public health association meeting. The location changes each year, moving around the state in a effort to engage a broader audience of individuals who work in local health departments. Attendees included dental assistants, directors and administrators of the health department, environmental engineers, public health nurses, medical directors, and health educators; to name a few.
I've now been to such meetings in three different states over my career. These state meetings are interesting in several ways.
The ratio of practitioners to academics favors practitioners, unlike many large public health conferences. What that means is the conversation differs from what you hear at the large academic conferences. The conversation stays close to "what does this mean for agency and my clients?" The desire and inclination to mimic a successful neighbor creeps into the thinking. While this maybe helpful, it may not be completely thoughtful. It does reflect the reality that the most visible evidence is likely to be what my immediate peers are doing, rather than the latest RCT published in an expensive, inaccessible academic journal.
The scope of problems stays local, not national or global. Local epidemiological data guide attention mainly to health conditions for which the local situation is near the bottom (worst). The thinking takes the form of: If the problem is not in my backyard, I don't have the energy, resources, or time to worry about it. This is by no means a critique. When resources are tight, it's a practical approach.
The other interesting angle centers around an underlying desire to find "what works." This might include finding ways to leverage connections to academics. Across the nation the culture has been shifting away from "ivory tower vs real work" toward "let's collaborate." Naturally, such a culture shift take time for complete uptake. But, I view the shift as a positive one, and one that I tried to help along.
Going to such meetings is always humbling for me. I enjoy being reminded of what the details really look like. And, I have multiple opportunities to silently practice empathy.
Showing posts with label health departments. Show all posts
Showing posts with label health departments. Show all posts
26 September 2014
18 March 2011
On the road, literally
Wow, the past month has whizzed past from spending hours on the freeway and days making Powerpoint presentations. For the KRISP Project (see the blog list for a link), I've been creating and then delivering weekly 2-3hour "trainings" for employees at two of the local health departments that are participating in the project. The amount of effort needed equals that for teaching a graduate course, but more intense in terms of the effort needed to meet the health department "where they are".
Our customer-focus and accommodating approach has resulted in weekly trips to deliver the trainings. The trip is 6 hours, round-trip, through two of the five Cook County collar counties, and then the cornfields of Illinois. There is no bus or train that goes were we need to be. So, I'm becoming familiar with where the highway patrol like to wait for the speeders.
We briefly covered doing community assessment via MAPP. Most of the effort has been on teaching the staff how to do quality improvement. When I wrote the grant, I had not imagined the amount of effort it would take to gain access to the public health nurses, nor did I imagine the need for so much face-to-face teaching time. I naively thought I'd just step and and things would get done. Not so. These are slow moving, if not well intending, organizations with lots of competition for their attention.
Over the past couple of weeks, overseeing and managing this project has again brought up the awareness of the timing as both a curse and a blessing. On the cursed side, I wrote the grant before the economy went bad, before the H1N1 outbreak, before the states failed to make payments to the local health departments, and before the health departments had to lay off half of the staff. How, under those conditions, can I possibly make any difference in the empowerment and valuing of public health nurses? How can I possibly meet my grant objectives? Will all these trainings really translate into improvement in health?
On the bright side, the project has been a blessing. We are able to be a compassionate sounding board and give moral support to the nursing directors. We are able to validate that the nurses are important enough to receive this special attention. We have given hope to public health nurses throughout Washington state and rekindled their enthusiasm for who they are and what they do. We have acknowledged the nurses as lifelong learners facing a strange new work landscape.
In writing the non-competing grant renewal, I did realize that we have done a lot in the past year. Naturally, I tend to see the work ahead and the gas bills staying high. But, to be honest, there's a part of me too that's renewed and rekindled.
Our customer-focus and accommodating approach has resulted in weekly trips to deliver the trainings. The trip is 6 hours, round-trip, through two of the five Cook County collar counties, and then the cornfields of Illinois. There is no bus or train that goes were we need to be. So, I'm becoming familiar with where the highway patrol like to wait for the speeders.
We briefly covered doing community assessment via MAPP. Most of the effort has been on teaching the staff how to do quality improvement. When I wrote the grant, I had not imagined the amount of effort it would take to gain access to the public health nurses, nor did I imagine the need for so much face-to-face teaching time. I naively thought I'd just step and and things would get done. Not so. These are slow moving, if not well intending, organizations with lots of competition for their attention.
Over the past couple of weeks, overseeing and managing this project has again brought up the awareness of the timing as both a curse and a blessing. On the cursed side, I wrote the grant before the economy went bad, before the H1N1 outbreak, before the states failed to make payments to the local health departments, and before the health departments had to lay off half of the staff. How, under those conditions, can I possibly make any difference in the empowerment and valuing of public health nurses? How can I possibly meet my grant objectives? Will all these trainings really translate into improvement in health?
On the bright side, the project has been a blessing. We are able to be a compassionate sounding board and give moral support to the nursing directors. We are able to validate that the nurses are important enough to receive this special attention. We have given hope to public health nurses throughout Washington state and rekindled their enthusiasm for who they are and what they do. We have acknowledged the nurses as lifelong learners facing a strange new work landscape.
In writing the non-competing grant renewal, I did realize that we have done a lot in the past year. Naturally, I tend to see the work ahead and the gas bills staying high. But, to be honest, there's a part of me too that's renewed and rekindled.
22 January 2011
Living the C-Change
This week was a record for me: 5 flights in 50 hours, with two presentations, consultation, lunches and a little shopping at the Portland airport. The flights took me to Spokane and Vancouver, WA for the KRISP grant.
I flew to Seattle, met up with Betty. From there we flew to Spokane for the night. In the morning, we would do a 3 hour presentation-workshop with the public health nurses at the Spokane Regional Health Department. Betty and I got to the auditorium early. While we awaited our turn, the nursing director was giving staff an update on the state budget and possible scenarios for budget and program cuts. Then some of the nurses added changes (read decreases) to the TANF support for mothers.
Betty and I looked at each other, shook our heads, and sighed. These nurses will be the front line workers who see the consequences of our national economy doldrums. This reality gives our work urgency, but also an irrelevance. We were there to help the public health nurses learn about using data to improve their programs and to think about populations, not just individual clients. Asking nurses to not get personal satisfaction from interactions with their clients is asking them to change their identity. A huge ask. But, that is all the more necessary given the changes occurring all through the public health system and the national economy.
In the afternoon, we spent a couple of hours with a small group talking about how to evaluate a creative, community-based and community-directed initiative. It was the type of discussion with no single correct answer and certainly no easy answer. In the end, I had flipped their outcome of "decrease child abuse" to the positive of "infants meet developmental milestones." Why do we (evaluators, practitioners) seem so determined to focus on what we don't want? The group liked the change. It still requires head scratching to figure out how to get "good" data, but it has greater potential to generate enthusiasm and participation from the neighborhood.
The next day we did a 2 hour version of that presentation-workshop for the public health nurses of the Clark and Cowlitz health departments. Not nearly enough time, but far better than none.
During the lunches Betty and I had with the nursing directors, we talked openly and honestly. We talked about the future of health programs for various high risk groups, about the realities of union seniority systems and what that could mean for how programs would be implemented, about the need for more academe-practice collaboration for a wide variety of activities that would be good learning opportunities for nursing students, about the nature of the support from their health administrators, about how local politics of an interpersonal nature affects major health department decisions, and about the way things used to be but never will be again.
As Betty and I said good-bye at SeaTac, we agreed that it had been a good two days. Not perfect, but on balance, good. We both felt committed to doing our parts in moving this segment of the public health system forward, going boldly into a future that has only been outlined. It remains our collective responsibility to give that outline life, texture, success, doing so collaboratively and with a hint of utopian longing.
I flew to Seattle, met up with Betty. From there we flew to Spokane for the night. In the morning, we would do a 3 hour presentation-workshop with the public health nurses at the Spokane Regional Health Department. Betty and I got to the auditorium early. While we awaited our turn, the nursing director was giving staff an update on the state budget and possible scenarios for budget and program cuts. Then some of the nurses added changes (read decreases) to the TANF support for mothers.
Betty and I looked at each other, shook our heads, and sighed. These nurses will be the front line workers who see the consequences of our national economy doldrums. This reality gives our work urgency, but also an irrelevance. We were there to help the public health nurses learn about using data to improve their programs and to think about populations, not just individual clients. Asking nurses to not get personal satisfaction from interactions with their clients is asking them to change their identity. A huge ask. But, that is all the more necessary given the changes occurring all through the public health system and the national economy.
In the afternoon, we spent a couple of hours with a small group talking about how to evaluate a creative, community-based and community-directed initiative. It was the type of discussion with no single correct answer and certainly no easy answer. In the end, I had flipped their outcome of "decrease child abuse" to the positive of "infants meet developmental milestones." Why do we (evaluators, practitioners) seem so determined to focus on what we don't want? The group liked the change. It still requires head scratching to figure out how to get "good" data, but it has greater potential to generate enthusiasm and participation from the neighborhood.
The next day we did a 2 hour version of that presentation-workshop for the public health nurses of the Clark and Cowlitz health departments. Not nearly enough time, but far better than none.
During the lunches Betty and I had with the nursing directors, we talked openly and honestly. We talked about the future of health programs for various high risk groups, about the realities of union seniority systems and what that could mean for how programs would be implemented, about the need for more academe-practice collaboration for a wide variety of activities that would be good learning opportunities for nursing students, about the nature of the support from their health administrators, about how local politics of an interpersonal nature affects major health department decisions, and about the way things used to be but never will be again.
As Betty and I said good-bye at SeaTac, we agreed that it had been a good two days. Not perfect, but on balance, good. We both felt committed to doing our parts in moving this segment of the public health system forward, going boldly into a future that has only been outlined. It remains our collective responsibility to give that outline life, texture, success, doing so collaboratively and with a hint of utopian longing.
17 December 2010
Roller Skate Week
Looking forward to a week is always different than looking back on it. Nonetheless, the week from December 9 through December 17 was what I call a "roller skates" week. Skating, which is slightly faster than running and takes less effort, from task to task, from location to location, from meeting to meeting.
The highlight of December 10 was the little holiday party we had for the KRISP project. We managed to have about an hour of sweets, small present exchange, and photo ops. (see the KRISP blog for the group photo) It was also a day of problem solving with a couple of my MPH advisees. A mix of paperwork, encouragement and a little hand holding. All in all, a busy, productive, fun, smiling day.
Monday and Tuesday (December 13 and 14) were more unique. For the past month, I served as chair for a search committee to hire a new faculty into our department. After vetting a few applications, we invited the two best candidates to visit with us. The daylong process involves interviews, a presentation, and informal lunch in the commons area. Making the process public and inclusive made the faculty feel as though this was a real opportunity to hire a junior faculty. This may seem obvious, but in these economically bad times in Illinois, hiring a faculty feels like an sweet treat. The foresight and planning of our department chairperson made this hire possible. Each day with the candidate went smoothly. My own preference for one of the candidates was aligned with the consensus of the search committee and faculty who met the candidates.
Right after the last of the meetings with the candidate, I hopped in the car and drove 3 hours to Peoria. I needed to do this because on Wednesday morning Kathy and I were doing a training session with the public health nurses at Tazewell County. I arrived at Kathy's house as she was finishing baking the goodies for the morning meeting. The feds prohibit any purchase of food, so the treats of baked good and fresh fruit will come out of our personal pockets. (I understand the the restriction, but really...) The public health nurses seemed engaged and ready to have us come back next month. As soon as that meeting was finished, I had to drive back to Chicago and attend to the candidate selection.
I spent Thursday and Friday in the office working on KRISP budget, trainings and meetings. Whew....
The highlight of December 10 was the little holiday party we had for the KRISP project. We managed to have about an hour of sweets, small present exchange, and photo ops. (see the KRISP blog for the group photo) It was also a day of problem solving with a couple of my MPH advisees. A mix of paperwork, encouragement and a little hand holding. All in all, a busy, productive, fun, smiling day.
Monday and Tuesday (December 13 and 14) were more unique. For the past month, I served as chair for a search committee to hire a new faculty into our department. After vetting a few applications, we invited the two best candidates to visit with us. The daylong process involves interviews, a presentation, and informal lunch in the commons area. Making the process public and inclusive made the faculty feel as though this was a real opportunity to hire a junior faculty. This may seem obvious, but in these economically bad times in Illinois, hiring a faculty feels like an sweet treat. The foresight and planning of our department chairperson made this hire possible. Each day with the candidate went smoothly. My own preference for one of the candidates was aligned with the consensus of the search committee and faculty who met the candidates.
Right after the last of the meetings with the candidate, I hopped in the car and drove 3 hours to Peoria. I needed to do this because on Wednesday morning Kathy and I were doing a training session with the public health nurses at Tazewell County. I arrived at Kathy's house as she was finishing baking the goodies for the morning meeting. The feds prohibit any purchase of food, so the treats of baked good and fresh fruit will come out of our personal pockets. (I understand the the restriction, but really...) The public health nurses seemed engaged and ready to have us come back next month. As soon as that meeting was finished, I had to drive back to Chicago and attend to the candidate selection.
I spent Thursday and Friday in the office working on KRISP budget, trainings and meetings. Whew....
25 August 2010
Disaster in Progress
It's mind boggling. The Illinois state budget deficit even warranted an article in the Wall Street Journal. The economics aside, my concern naturally is for the health of the people of the state. In my work with the local health departments, they are saying that county budgets have been hard hit because the state has not paid for services rendered. No one feels confident that the state will pay its bills, for services given in the past fiscal year, not to mention the current fiscal year.
From the point of view of public health, it feels like an economic disaster for which no preparedness training could help. Many county governments are making some really deep cuts into programs and services most of us have taken for granted for decades. The state funds support mostly health promotion programs and screenings for early detection and prevention. In contrast, federal dollars generally support direct clinical services, like primary care. At least in Illinois, most local health departments have gotten out of the business of providing primary care. Instead, they focus on the health promotion, disease prevention for which reimbursement does not exist.
As the programs are cut because there is no money to pay staff to do the programs, questions arise. What will happen to the health statistics for conditions like sexually transmitted diseases (STDs), breast and cervical cancer, and child abuse? How will health departments reconfigure and reconceptualize themselves in this new economic landscape? What new or old skills are needed by the remaining workforce to actualize this new reality?
I don't worry about those few organizations that are trendsetters, enlightened, prospectors (in the language of Miles and Snow) that can turn this crisis into an opportunity. But, not all organizations have that ability. Those that can't survive or adapt or morph, what will happen to the health of the people they once served?
From the point of view of public health, it feels like an economic disaster for which no preparedness training could help. Many county governments are making some really deep cuts into programs and services most of us have taken for granted for decades. The state funds support mostly health promotion programs and screenings for early detection and prevention. In contrast, federal dollars generally support direct clinical services, like primary care. At least in Illinois, most local health departments have gotten out of the business of providing primary care. Instead, they focus on the health promotion, disease prevention for which reimbursement does not exist.
As the programs are cut because there is no money to pay staff to do the programs, questions arise. What will happen to the health statistics for conditions like sexually transmitted diseases (STDs), breast and cervical cancer, and child abuse? How will health departments reconfigure and reconceptualize themselves in this new economic landscape? What new or old skills are needed by the remaining workforce to actualize this new reality?
I don't worry about those few organizations that are trendsetters, enlightened, prospectors (in the language of Miles and Snow) that can turn this crisis into an opportunity. But, not all organizations have that ability. Those that can't survive or adapt or morph, what will happen to the health of the people they once served?
18 May 2010
Monday Morning
As I was walking toward the elevators to get the week started, a colleauge was coming in to work. I started the ususal chit chat for such circumstances; "So, how was your weekend?" "I'm glad it's over." Huh? She was not forthcoming with an explanation, but we chuckled nonetheless on the irony of her response. That pretty much set the tone for the day, a bit whacky but good.
The day consisted of faculty meeting, a teleconfernece for the AHRQ grant, meeting with project staff, meeting with student to map out a publication, responding to emails (including another Doodle), and working on the promotion papers. Here's the grumble ~ data are collected by the Office of Reseach but not in a format nor with the same information required for the promotion forms. Looks to me like a pretty big communication gap at the university level which results in at least 6 hours of silly work for me. I don't mind working, but this copy and pasting and retyping and having to track down information is such a waste. And, inefficiencies really push my buttons.
I had a breif, pleasant conversation with one of the directors of nursing at a local health department. She had received an email from NACCHO regarding their recommendations for allocation of health reform funds. Fine. Except that public health nurses were not included in a brief list of needed health professionals. YIKES! What were they thinking? At a point in time when health deparrtments are really strapped for funding and looking to cut expenses, nurses are easy targets because they cost so much. Never mind the high rate of return for thier work. I immediately though how can I mobilize the public health nursing associations to take some action? I sent out a email to a listserve and will keep the pressure up. This could get interesting....
The day consisted of faculty meeting, a teleconfernece for the AHRQ grant, meeting with project staff, meeting with student to map out a publication, responding to emails (including another Doodle), and working on the promotion papers. Here's the grumble ~ data are collected by the Office of Reseach but not in a format nor with the same information required for the promotion forms. Looks to me like a pretty big communication gap at the university level which results in at least 6 hours of silly work for me. I don't mind working, but this copy and pasting and retyping and having to track down information is such a waste. And, inefficiencies really push my buttons.
I had a breif, pleasant conversation with one of the directors of nursing at a local health department. She had received an email from NACCHO regarding their recommendations for allocation of health reform funds. Fine. Except that public health nurses were not included in a brief list of needed health professionals. YIKES! What were they thinking? At a point in time when health deparrtments are really strapped for funding and looking to cut expenses, nurses are easy targets because they cost so much. Never mind the high rate of return for thier work. I immediately though how can I mobilize the public health nursing associations to take some action? I sent out a email to a listserve and will keep the pressure up. This could get interesting....
12 May 2010
Federal Funding
Let me quasi-quote myself (from a forthcoming editorial) ~
Within the U.S. Department of Health and Human Services (DHHS), five agencies are likely to address health care management: the Agency for Health Care Research and Quality (AHRQ), the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration’s (HRSA), and the Centers for Medicare and Medicaid Services (CMS). These five, I’ll call them the Big 5, receive considerable federal funding for research, health care reimbursement, and training. The NIH budget of $30.6 billion (FY 2009 Budget) is nearly four times CDC’s $8.8 billion and HRSA’s $7.5 billion budgets for Fiscal Year 2010, and dwarfs AHRQ’s $372 million budget request for fiscal year 2010. The CMS 2010 Fiscal Year budget was $818 billion, of which $811 billion was earmarked for health insurance and long term care.
These numbers are profoundly staggering. Except for CMS, which is essentially federal health insurance for the elderly and the poor, the agencies focus on improving health care services. I don't quibble with the amounts, but only wish that more of the funds would be for prevention of disease rather than for treatment. I also wish that more of the money would go toward services and programs that are population-focused. One could argue that is the case with Medicaid, but it boils down to reimbursement for individual care.
These issues are on my mind as I struggle with the local health departments to figure out how to aligng funding with prevention and population-focused practice. When I look at the budget numbers, I see possibilities but not motivation. I can only wonder what the future will hold and how much of the future I might be able to shape.
Within the U.S. Department of Health and Human Services (DHHS), five agencies are likely to address health care management: the Agency for Health Care Research and Quality (AHRQ), the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration’s (HRSA), and the Centers for Medicare and Medicaid Services (CMS). These five, I’ll call them the Big 5, receive considerable federal funding for research, health care reimbursement, and training. The NIH budget of $30.6 billion (FY 2009 Budget) is nearly four times CDC’s $8.8 billion and HRSA’s $7.5 billion budgets for Fiscal Year 2010, and dwarfs AHRQ’s $372 million budget request for fiscal year 2010. The CMS 2010 Fiscal Year budget was $818 billion, of which $811 billion was earmarked for health insurance and long term care.
These numbers are profoundly staggering. Except for CMS, which is essentially federal health insurance for the elderly and the poor, the agencies focus on improving health care services. I don't quibble with the amounts, but only wish that more of the funds would be for prevention of disease rather than for treatment. I also wish that more of the money would go toward services and programs that are population-focused. One could argue that is the case with Medicaid, but it boils down to reimbursement for individual care.
These issues are on my mind as I struggle with the local health departments to figure out how to aligng funding with prevention and population-focused practice. When I look at the budget numbers, I see possibilities but not motivation. I can only wonder what the future will hold and how much of the future I might be able to shape.
07 May 2010
Collegial Work
For 24 hours, I had in-person time for working with my colleague from Seattle. Our focus was on the KRISP grant, which is clearly at at developmental milestone. And, as milestones go, this one requires careful coordination of activities to make it successfully to the next milestone. Working via distance with only hour long monthly meetings was clearly not getting to the level of detailed planning that we now need.
I need to mention that as we sat in the restaurant, I toasted to our productivity and having fun. So, there was a fair amount of deeper getting to know each other, as happens when the intellectual task ahead requires an unshakable friendship foundation.
We spent time focused on planning what to do about our research assistants, the interested doctoral student, the budget and future manuscript preparation. But mostly, we came to the realization that the health departments were in need of training and support. I had envisioned that the health departments would, by now, be deeply engaged in quality improvement efforts. But, they are are struggling with how to transition the public health nurses from individual and family care to population-focused practice. Not an easy transition by any reckoning. This was not the intent of the grant, but must be addressed in the spirit of the grant in order to maintain the trust and cooperation of the health departments. We both become reluctantly resigned to what the next year would likely be like; travel to the local health departments and trainings.
Oh, new blazing new trails is such hard work on so many levels. I just pray I can make a path that is passable to those behind me and of use to those who have not yet ventured out.
I need to mention that as we sat in the restaurant, I toasted to our productivity and having fun. So, there was a fair amount of deeper getting to know each other, as happens when the intellectual task ahead requires an unshakable friendship foundation.
We spent time focused on planning what to do about our research assistants, the interested doctoral student, the budget and future manuscript preparation. But mostly, we came to the realization that the health departments were in need of training and support. I had envisioned that the health departments would, by now, be deeply engaged in quality improvement efforts. But, they are are struggling with how to transition the public health nurses from individual and family care to population-focused practice. Not an easy transition by any reckoning. This was not the intent of the grant, but must be addressed in the spirit of the grant in order to maintain the trust and cooperation of the health departments. We both become reluctantly resigned to what the next year would likely be like; travel to the local health departments and trainings.
Oh, new blazing new trails is such hard work on so many levels. I just pray I can make a path that is passable to those behind me and of use to those who have not yet ventured out.
05 May 2010
The universe answered my plea for help with Spring Fever. The answer was meetings. The first meeting was with a graduating doctoral student who now faces career choices and corresponding angst about which choice to make. The best I could do was listen and confirm that all points had been considered. There really isn't much in life that prepares us for making such life course altering decisions. Another student needed guidance on the structure of the MPH essay and support in standing ground so as to not be abused by other faculty. (Sometimes I can't believe my colleagues, nor non-colleagues.) Then I met with and hired a doctoral student to be my new RA for the AHRQ grant. In mix was also meetings being canceled and rescheduled, and meetings in the process of being scheduled. The last meeting was the most interesting. And, in between I did a little of this and that. The hallways were very quiet now that classes are over.
The last telephone meeting was with one of the local health departments. We talked about public health nursing and the very real and very big changes that are facing public health nursing. The shift from an individual and family focused public health care delivery system to a population focused mindset requires new skills of everyone. This shift is a welcomed change on one hand, but dreaded on the other. It's dreaded by the managers because their funding is still program specific and the programs are individual level care programs. This creates a fiscal bind for the health departments; neither the states nor the feds seem to shifting their requirements for funding or reimbursing health promotion or protection programs. While the conversation was good, it left me feeling a bit like Atlas ~ carrying the weight of how to make all this happen on behalf of public health nurses.
The last telephone meeting was with one of the local health departments. We talked about public health nursing and the very real and very big changes that are facing public health nursing. The shift from an individual and family focused public health care delivery system to a population focused mindset requires new skills of everyone. This shift is a welcomed change on one hand, but dreaded on the other. It's dreaded by the managers because their funding is still program specific and the programs are individual level care programs. This creates a fiscal bind for the health departments; neither the states nor the feds seem to shifting their requirements for funding or reimbursing health promotion or protection programs. While the conversation was good, it left me feeling a bit like Atlas ~ carrying the weight of how to make all this happen on behalf of public health nurses.
01 May 2010
Last Class
Every semester ends. Some have easier, simpler, more gratifying ends than others. This semester ends on a high note: one doctoral student finished and who will be hooded next week, one master's student overcame a huge hump toward completion of her essay, and a class with students who praised the course as meeting their needs. A faculty member can't ask for much more.
The final assignment of the course was for the student to give a brief book report on the biography or autobiography of a scientist . I saw two themes across the lives: following passion and intuition is linked to success, and personalities can affect the level of recognition received. Both lessons relevant to yesterday...
The rest of the day was taken up with telephone meetings, in-person planning, and email. As I was packing up my briefcase with work for the weekend, I looked over the to-do list. And, felt disappointed in myself. I could not cross one item. Yet, I has spent the full 8 hours at task. Things come up. I've learned that it's easier to get it done just then. Once it's on the to-do list, it could be weeks.
And were was the public health part today? One of the calls was with one of the local health departments participating in my intervention project. We talked about the workforce needs and how we might best address them. Quality improvement is the new focus and requires that everyone in the health departments learn new skills and change attitudes about change. It was the type of conversation that helps me stay connected to the real, the daily, the practice. And, challenges me to find ways to make useful, little-by-little changes.
The final assignment of the course was for the student to give a brief book report on the biography or autobiography of a scientist . I saw two themes across the lives: following passion and intuition is linked to success, and personalities can affect the level of recognition received. Both lessons relevant to yesterday...
The rest of the day was taken up with telephone meetings, in-person planning, and email. As I was packing up my briefcase with work for the weekend, I looked over the to-do list. And, felt disappointed in myself. I could not cross one item. Yet, I has spent the full 8 hours at task. Things come up. I've learned that it's easier to get it done just then. Once it's on the to-do list, it could be weeks.
And were was the public health part today? One of the calls was with one of the local health departments participating in my intervention project. We talked about the workforce needs and how we might best address them. Quality improvement is the new focus and requires that everyone in the health departments learn new skills and change attitudes about change. It was the type of conversation that helps me stay connected to the real, the daily, the practice. And, challenges me to find ways to make useful, little-by-little changes.
30 April 2010
The Unanticipated
Some days seem to be plodding along, moving down the to-do list, but are suddenly blow apart. The flow stopped, screeching-breaks stopped, and the to-do list become irrelevant. Sure, we all know that these things happen, but we can never anticipate when or in exactly what form. Today was one of those days.
I'll outline the issue and protect the innocent, as the saying goes.
A huge part of public health is working with public health professionals, while being steadfast to our agendas and intentions. We all try to do our best. We try to be clear communicators and excel at listening. We try to compromise and negotiate new paths toward the goal. We try to create and invent optimal solutions without stopping as we move forward. We try to cooperate with each other and still get done what we need done. But, we are all human and we sometimes fail at one or more of these. And, therein lies the bad chemistry, the frustrations, and the pitfalls.
Mix that with dis-synchronized timing, and there is no alternative but to stop and regroup. This can be a good thing, even while it feels really bad. Unfortunately, the addition of caffeine and adrenaline only exaggerate the negatively.
So, to keep everyone pleased, on-board, one engages in humility, attempts behavior change, does a fair amount of backhoeing, and strategizes next steps.
I'll outline the issue and protect the innocent, as the saying goes.
A huge part of public health is working with public health professionals, while being steadfast to our agendas and intentions. We all try to do our best. We try to be clear communicators and excel at listening. We try to compromise and negotiate new paths toward the goal. We try to create and invent optimal solutions without stopping as we move forward. We try to cooperate with each other and still get done what we need done. But, we are all human and we sometimes fail at one or more of these. And, therein lies the bad chemistry, the frustrations, and the pitfalls.
Mix that with dis-synchronized timing, and there is no alternative but to stop and regroup. This can be a good thing, even while it feels really bad. Unfortunately, the addition of caffeine and adrenaline only exaggerate the negatively.
So, to keep everyone pleased, on-board, one engages in humility, attempts behavior change, does a fair amount of backhoeing, and strategizes next steps.
21 April 2010
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.
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.
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