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KARI ELLINGSTAD: I did want to acknowledge HRSA and NICHQ for advancing a tremendous
framework for a collaborative, and a collaborative approach, that really helped our community
organize our obesity prevention efforts. I wanted to take a minute to, you can go to
the next slide please. To touch upon some of the characteristics
of the collaborative that I feel really helped our team achieve focus and move forward. We
know that with this work achieving focus can be difficult and so this was really helpful.
First, the Healthy Weight Collaborative approach provided the strategic framework that we needed.
We didn't need to build it ourselves. Goals and strategies and expectations were
outlined from the beginning and we had to sort of buy into that. It might seem prescriptive,
but the framework really helped our team focus and implement strategies in a way that aligned
with the assets in our community. So there was flexibility within that framework. We
had to next define a small multi-sector team. I think we had four sectors: public health,
primary care, community, and consumer sectors. And we were told that we couldn't have more
than 11 or 12 people on our core team. As a team lead I had to be really thoughtful
about who we would involve. Would they be active participants, committed to the goals?
Would their spheres of influence align with what we needed? Did they have the authority
and ability to impact change in their respective sectors? All of those were considerations
as I pulled together the team. As a team lead, it was easier to define the roles for each
team member and the smaller team was easier to coordinate. And, I have learned that you
can have a small, focused team, while still maintaining broad community partnerships.
Next, the focus on quality improvement was so important. We didn't have to come up with
the perfect plan before testing small changes. This meant that our team was doing things
all along. Even if what we were doing needed to be adjusted down the road, still we felt
like we were making progress and learning all the time.
The learning collaborative approach meant that our team had access to the Healthy Weight
Collaborative faculty as well as other teams. We just felt like we were connected to something
bigger and that was really important for us. We learned a lot, together, during the learning
sessions and webinars that we participated in. But we were also put in a position of
teaching from time to time, and that, that helped build capacity for our team.
Next, we had to define a clear target population at the outset, a population that we would
be able to measure on a monthly basis. We had a think smaller than we would have had
we been left to our own devices. But having the defined population allowed us to get the
data we needed, because finally the measurements that were expected of us were clarified from
the outset and we needed to develop a habit of getting and giving data on a regular basis.
We were collecting or proving data on message reach, process steps, policy change, and even
the nature of our collaborative. Just as there was a strategic framework, there was a corresponding
measurement framework. And collecting the data regularly helped our team see progress
-- which was encouraging -- but we were also able to share that data with key stakeholders
later, so that they could better understand our goals and the progress we'd made. So the
measurement really helped us set ourselves up to be sustainable. Next slide, please.
And this is just an example of the strategy map that we put together to help us organize
our thinking and figure out which strategies needed to be implemented or could be implemented
in each of the sectors that we were working in. Next slide.
As Shaila mentioned, there were, we were required
to select a core message to use throughout,
to support our efforts. And like San Diego we also selected the 5210 message. This common
message linked the work in all of the sectors and helped create more of a community movement.
And I'll describe how that transpired in a bit but the message has really been vital
for giving our efforts a "stickiness factor" and has been a great tool for engaging partners.
Next slide, please. So I wanted to touch a little bit on the work
that has been done in each sector. In the primary care sector we've been working with
a pediatric clinic managed by our local health department. And here we've implemented some
new processes and workflows to support improved assessment and follow-up in addressing healthy
weight. One of the biggest changes that we've made was to develop and implement a healthy
weight plan. This is a standardized tool which helps our physicians navigate that somewhat
difficult conversation about healthy weight and also facilitates goal-setting among patients
and families. This plan aligns with the 5210 message and was recently included in our new
EHR. We've done some early evaluation on the plan
utilization and effectiveness and we found that among patients who have completed the
plan there have been some significant improvements in BMI which is very encouraging. We have
also had some great feedback from the physicians and staff regarding the plan. They were engaged
in the process of developing and testing this tool and they are now very receptive to actually
using it, which of course is important. In our primary care site we've also implemented
obesity-focused group visits and these provide an opportunity for physicians to provide additional
guidance, but also for patients and their families to discuss challenges and successes.
As a policy target we're looking to embed the use of the Healthy Weight plan into all
of our clinical sites under our health department and expand the group visits as well. And we're
hoping we can have some influence on other primary care practices in our broader community
as well.