Us Using ing Qu Qualit ality Imp y Improveme ement t nt to o Pr Preven ent t Ch Childh ildhoo ood d Inj Injurie uries: s: Strategies from the Child Safety Collaborative Innovation and Improvement Network May 11, 2017, 3:00 – 4:00 p.m. ET
Tec ech Tips h Tips Download resources Audio is broadcast through computer from File Share pod speakers If you experience audio issues, dial (866) 835- You are muted 7973 and mute computer speakers This session is Use the Q & A to ask being recorded questions at any time www.ChildrensSafetyNetwork.org 2
Agenda genda & Obje & Objectiv ctives es • Project Purpose • The Approach • Team Stories • Q&A Ob Objec jectiv tives es • Explain the purpose and goals of the CS CoIIN • Explain the CS CoIIN methodology, including the fundamentals of Continuous Quality Improvement • Describe innovative strategies and results from Cohort 1 www.ChildrensSafetyNetwork.org 3
Pr Present esenter ers Jenny Stern-Carusone, M.S.W. Jen Leonardo, Ph.D. Bekah Thomas, M.P.A. Technology Director Improvement Advisor CS CoIIN Director Jessica Schultz, M.P.H Kaci Wray, M.B.A. Laurin Kasehagen, Ph.D. Injury Prevention Epidemiologist Child Passenger Safety Program CDC Assignee/Lead Epidemiologist Consultant Vermont Departments of Health and Mental Manager Division of Trauma and Injury Prevention Indiana Criminal Justice Institute Health Indiana State Department of Health (ICJI). www.ChildrensSafetyNetwork.org 4
Pr Projec oject Pur t Purpose pose Bekah Thomas, M.P.A. CS CoIIN Director www.ChildrensSafetyNetwork.org 5
Th The P e Proble oblem More children and adolescents ages 1-19 die from injuries and violence than from all diseases combined. (National Center for Health Statistics, Multiple Cause of Death Data, 2010.) De Deaths aths 12 12,4 ,483 83 Hospital Ho spitalizations izations 441,202 ,202 ED ED Vi Visit sits 7, 7,95 954, 4,167 67 2014 (Source: CDC WISQARS query April 2017) www.ChildrensSafetyNetwork.org 6
Le Leading ading Causes Causes Rank ank Dea eaths ths Ran ank ED ED Vi Visit sits Ran ank Hospi ospitalizati talizations ons Falls Falls Motor Vehicle Overall 1 1 1 (42,364) (2,437,301) (3,817) Motor Vehicle Overall Struck By/ Against Homicide 2 2 2 (39,376) (1725409) (2,289) Self-Harm Motor Vehicle Overall Suicide 3 3 3 (31,839) (783,402) (2.262) Struck By/ Against Cut/Pierce Suffocation / Inhalation 4 4 4 (15,102) (447,214) (1,220) Drowning Assault Assault 5 5 5 (892) (13,984) (275,988) www.ChildrensSafetyNetwork.org 7
Evi Evidence dence Exists Exists www.ChildrensSafetyNetwork.org 8
De Death T ath Tre rend nd Da Data ta Cru rude de ra rate pe per r 100 00,0 ,000 00 16 14 12 10 8 6 4 2 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Child Passengers Teen Occupants Suicide and Self Harm Intpersonal Violence Falls Source: WISQARS Fatal, April 13th, 2017 www.ChildrensSafetyNetwork.org 9
Hospitalizat Hospitalization ion Tre rend nd Da Data ta Cru rude de ra rate pe per r 100 00,0 ,000 00 160 140 120 100 80 60 40 20 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Child Passengers Teen Occupants Suicide and Self Harm Intpersonal Violence Falls Source: WISQARS Non-fatal, April 13th, 2017 www.ChildrensSafetyNetwork.org 10
ED V ED Visit isit Tre rend Data nd Data Cru rude de ra rate pe per r 100,0 ,000 4000 3500 3000 2500 2000 1500 1000 500 0 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Child Passengers Teen Occupants Suicide and Self Harm Intpersonal Violence Falls Source: WISQARS Non-fatal, April 13th, 2017 www.ChildrensSafetyNetwork.org 11
Rat Rate e of of In Injur jury y Ho Hosp spitaliz italizati ations, ons, Age ges s 10-19 19 by Se y Sex, x, 20 2013 120 Female 100 Male 80 60 40 20 0 Unint. Falls Unint. Struck Unint. Unint. Motor Self-Inflicted Assault By/Against Poisoning Vehicle Occupant Source: : 2013 Healthcare Utilization Project, Nationwide Inpatient Sample www.ChildrensSafetyNetwork.org 12
Rat Rate e of of In Injur jury y Hos Hospitaliz pitalizations, ations, Urban Urban vs vs Rural ural for or se sele lect ct ca cause ses s by a y age grou oup, p, 20 2013 90 80 70 60 50 40 30 20 10 0 Age: 0-9 10-19 0-9 10-19 0-9 10-19 0-9 10-19 0-9 10-19 0-9 10-19 Falls Struck By/Against Poisoning Motor Vehicle Self-Inflicted Assault Occupant Urban/Metro Rural Source: : 2013 Healthcare Utilization Project, Nationwide Inpatient Sample www.ChildrensSafetyNetwork.org 13
Rat Rate e of of In Injur jury y Ho Hosp spitaliz italizati ations, ons, Age ge 10-19, 19, by Race/Ethnic y Race/Ethnicity ity for or se sele lect ct ca causes uses, , 20 2013 80 70 60 50 40 30 20 10 0 Unint. Falls Unint. Struck Unint. Unint. Motor Self-Inflicted Assault By/Against Poisoning Vehicle Occupant White Black Hispanic Native Am Source2013 Healthcare Utilization Project, Nationwide Inpatient Sample www.ChildrensSafetyNetwork.org 14
Percen cent t Ch Chan ange ge in F in Fat atal In al Injur jury y Rat Rates s betw between een 2007-2009 2009 an and 2 d 2013-20 2015 15 40 35 -52% -28% -5% 30 -0% 25 -5% -28% -6% -26% 20 -7% -31% 15 10 5 0 District of Maryland New Nebraska Wisconsin Ohio Michigan Indiana South Montana Columbia Mexico Dakota 2007-2009 2013-2015 Source ce: : NCHS HS, , Multipl tiple Cause of f Deat ath h File les www.ChildrensSafetyNetwork.org 15
To Mo o Move e th the Nee e Needle, dle, th the Field e Field Nee Needs ds to. o. . . Integrate evidence-based Forge collaborative child safety practices into partnerships across silos relevant care settings and state lines Increase the adoption of Streamline child safety effective child safety messages and activities interventions at state and local levels www.ChildrensSafetyNetwork.org 16
Ch Child Saf ild Safety ety Co Collab llabor orat ativ ive In Inno novat ation ion & & Im Impro provemen ement t Netw Network ork Boldly Focusing on Leading Causes of Injury Child Teen Driver Passenger Falls Prevention Safety Safety Interpersonal Suicide and Violence Self-Harm Prevention Prevention www.ChildrensSafetyNetwork.org 17
Approac Approach Jen Leonardo, Ph.D. Improvement Advisor www.ChildrensSafetyNetwork.org 18
Model f Model for or Imp Improvement ement Aim What are we trying to accomplish? How will we know that a Measures change is an improvement? What change can we make that Changes will result in improvement? Act Plan Study Do www.ChildrensSafetyNetwork.org 19
Wh What are w at are we T e Trying t ying to o Accom ccomplish? plish? Aim By May 2018, we will reduce deaths, hospitalizations, and emergency department (ED) visits resulting from child passenger safety, falls, interpersonal violence, suicide and self harm and teen driving, in children ages 0 through 9 and in adolescents ages 10 through 19. Our goals are to: Decrease the rate of injury-related mortality among 0-19 year Deaths olds by 5.83% 3% relative to the participating state/jurisdiction baseline rate for the CS CoIIN topic areas. Hospitalizatio Decrease the rate of injury-related hospitalizations among 0-19 year olds by 3.81% 1% relative to the participating state/jurisdiction ns baseline rate for the CS CoIIN topic areas. Decrease the rate of injury-related ED visits among 0-19 year ED Visits olds by 3.74% 4% relative to the participating state/jurisdiction baseline rate for the CS CoIIN topic areas. www.ChildrensSafetyNetwork.org 20
Ho How W w Will W ill We Kno e Know t w tha hat t a C a Cha hang nge Is Is an an Impro Im provem ement ent? Outcome Measures Fatalities Hospitalizations ED Visits Process Measures 5-7 measures From the Topic Team measurement strategy Flexibility to create new measures PDSA Measures Relate to the cycle www.ChildrensSafetyNetwork.org 21
Wh What at Cha Chang nge Ca Can W n We Ma Make e th that at W Will R ill Resul sult t in I in Imp mprovemen ement? t? Develop a theory of change using the Change Packages & your current Strategic Plan(s). Changes Primary Driver Outcome If I want to _______I need to focus on ________, one way(s) to do that is _________ Source: National Board for the Certification of Teachers, Lisa Clark www.ChildrensSafetyNetwork.org 22
Sa Sample mple Th Theor eory y of of Ch Change ange If I want to reduce teen fatalities from motor vehicle crashes, I need to focus on enforcing graduated drivers licensing policies. One way to do that is to leverage incentives for completion of teen driver safety programs/interventions. www.ChildrensSafetyNetwork.org 23
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