City and County of San Francisco DEPARTMENT OF PUBLIC HEALTH San Francisco Department of Public Health Black/African American Health Initiative (BAAHI) Attachments
• Increase Breast Cancer Screening for Black/African American Women Collective • Increase Chlamydia Screening in Black/African American young Impact women Working • Increase Cage Assessment in Groups African American Men in mental health clinics • Increase hypertension control and Black/African Americans City and County of San Francisco DEPARTMENT OF PUBLIC HEALTH
BAAHI: Breast Cancer Screening General Project Plan Overview Proposed Work plan 2014 2015 2016 Workgroup Membership Creation of Workgroup, Review membership and engage partnerships with additional stakeholders PC/Radiology, QI Problem Analysis Patient Feedback and Root Cause Analysis: Innovation Survey on BAA/Staff and Human Centered Design Experience Thinking End User Feedback Performance Measure and Process and Outcome Definitions Dashboard Development Measurement : Capacity, Validation and Standardization of Referral and Show rates Race/Ethnicity Definitions in AC Intervention, Engage Clinics with lowest Review first PHASE Interventions: Countermeasures performing rates and high Development of priority and high yield interventions for numbers of BAA patients, PHASE 2 engagement of BAAHI Think Tank membership Trainings, scripts Implementation Initial Pilots Sustainability of initial clinics, tool Sustainability kit development Drop In Appts Engage clinics with current lowest Saturday Appts screening rates Leverage Mammova Ongoing Evaluation and Monthly review of Testing measures at health center, provider level 3
2014 Focus: Breast Cancer Screening Improvement and Sustainability SOUTHEAST HC: 77% B: 78% (765) MAXINE HALL HC:76% B:73% (1111) POTRERO HILL HC:78% B:74% (602) Asian Black Hispanic Asian Black Hispanic Asian Black Hispanic White Total Target White Total Target White Total Target 90% 90% 90% 80% 80% 80% 70% 70% 70% 60% 60% 60% 50% 50% 50% 40% 40% 40% A P R- 14 A P R- 1 5 S E P - 15 A P R- 14 A P R- 15 S E P - 15 Apr-14 Apr-15 Sep-15 ASN = 87% (128), BLK = 74% (151), HSP = 84% (161), WHT = ASN = 85% (81), BLK = 78% (486), HSP = 81% (62), WHT = 69% (108) ASN = 86% (384), BLK = 73% (282), HSP = 78% (88), WHT 67% (49) = 71% (256) 2014 Focus: Breast Cancer Screening Improvement and Sustainability FHC:75% B:70% (2529) GMC: 75% B: 69% (1962) Asian Black Hispanic Asian Black Hispanic White Total Target White Total Target 90% 90% 80% 80% 70% 70% 60% 60% 50% 50% 40% A P R- 14 A P R- 15 S E P - 15 A P R- 14 A P R- 15 S E P - 15 ASN = 79% (908), BLK = 70% (172), HSP = 78% (928), WHT = 66% N= Asian 77% (732), Black 69% (290), Hispanic 81% (577), White 67% (252) (315)
2015 Focus: Breast Cancer Screening Improvement and Sustainability CSC: 54% B: 58% (356) CMHC: 71% B: 63% (988) Asian Black Hispanic Asian Black Hispanic White Total Target White Total Target 90% 80% 80% 70% 70% 60% 60% 50% 50% 40% 40% 30% A P R- 14 A P R- 15 S E P - 15 A P R- 14 A P R- 15 S E P - 15 N= Asian(91), Black (56), Hispanic (534), White (217) N= Asian(134), Black (43), Hispanic (32), White (131) 2015 Focus: Breast Cancer Screening Improvement and Sustainability 2015 Focus TWUHC: 40% B: 42% (788) Asian Black Hispanic White Total 70% 60% 50% 40% 30% 20% A P R- 14 A P R- 15 S E P - 1 5 N= Asian 56% (68), Black 42% (275), Hispanic 60% (84), White 32% (304)
BAAHI, Behaviral Health priority area dashboard, 2015 Jul '15 Aug '15 Sep '15 Oct '15 Nov '15 Dec '15 Owner(s) BAAHI, overview dash provider and consumer create Set up input on workgroup, consumer First training, CAGE and questions and provider consumer Ongoing Main steps measure for WG input Survey group trainings Judy, Darlene Metrics dash Provider and consumer input on Discuss CAGE Decide up or CAGE with down on CAGE baseline follow up measure workgroup CAGE Judy, Deborah Discuss likert discuss scale, discuss QM provider skills Decide up or with discussion,? with down on skills Judy, Darlene, Provider alcohol skills baseline consumers survey workgroup metric Deborah ICD 9 and 10 incidence and prevalence IT meeting to codes to metrics ask for metrics Noah Discussion workgroup Decide up or with key questions on inform survey down on BAA Provider BAA skills informants BAA skill set with WG input skills Workgroup dash invite, set up Choose room and Ongoing Logistics members, workplan Meetings support Darlene, Judy Literature review, Adjustments gather Frame Meetings, based on Workgroup task setting information interaction feedback feedback Judy, Darlene consumer humble Root cause/change theory Collect theory statements, first draft refine draft inquiry Judy, D, Israel Special workgroup task stigma-free title for our priority area's work Judy, Darlene Training dash discuss with Design training gather input training Judy, training team timeline elements director on content elements Schedule at begin trainings designee
BAAHI: Chlamydia Screening General Project Plan Overview Activity Key Person Partners/ J A S O N D J F M A M J J Resources Design data tracking system Trang IT Denominator Platform Timeframe eCW evaluation for data and Shivaun, Ayanna, Noah, Susan care needs Trang Fischer-Owens Establish Workgroup, meet Darlene, Ayanna monthly or more Establish Advisory Committee, Darlene, Ayanna invited to Workgroup, +on-call Document current best practices Ayanna, Shivaun and barriers in youth clinics 3 rd St YCC Pilot system changes in Susan, Ayanna population testing and reporting at 3 rd St Document current best practices Ayanna, Shivaun and barriers in select primary care clinics Document out-of-clinic resources Ayanna, Susan, MCAH, Pop, 3 rd St YCC, available Shivaun Advisors, SFUSD, Craft recommendations for Core group + changes in practice in clinics advisors and outside resources to bring in
BAAHI: Hypertension (HTN) Control Jan March June Sept Oct-Dec Feb 2015 2015 2015 2015 2015 2016 Propose Frame Clarify Engage Identify Analytics Recommen- Stakeholders Interventions Equity as QI problem dations • Train Analysts • Introduce • Kickoff of • Root cause • Lit search • Propose AIM • Brainstorm to use i2i Equity as QI Workgroup in analysis statement database to Framework July! and prioritize and best • Frontline staff track HTN with clinics potential practices to control by and key from 6 PC interventions SFHN PC race over stakeholders clinics clinics time
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