SBHC

Levels of Involvement with Envision NM's SBHC Quality Improvement Initiative

We are offering 3 levels of involvement to choose from.  The Core Topics Webinar Program offers training via telehealth for those with limited time for participation. The Demonstration level quality improvement project (DQI) offers your SBHC team experience in using QI methodology.  Your team can choose one of two fundamental clinical practices to address:  administration of the Student Health Questionnaire (SHQ), or completion of the EPSDT (annual exam).  The Demonstration level includes site visits from ENM staff, participating in improvement activities, and attending webinar sessions.  The Advanced QI level (AQI) is for sites that are ready to take QI wherever you need it to go and includes all of the above, and then some! 

 

Who Can Participate?

The levels described above are for people who work at School-based Health Centers anywhere in New Mexico.  The Core Topics Webinar Program is open to anyone in NM involved in pediatric healthcare.  The DQI and AQI levels involve SBHC Teams that have the time and interest to pursue quality improvement. 

 

When Does This Happen?

The Core Topics Webinars will be starting in November of 2009 and will be offered throughout the school year.  The DQI and AQI projects will also start up in November, and will also have a “rolling enrollment” option.  That is, some SBHCs may start later if that’s what works best for your site and ENM.

 

What Do I Get if I Participate?

You get free training in clinical best practices, access to specialists, technical support, and a place to go to develop relationships with colleagues facing similar challenges.  We also offer CME/CEU credits for attendance. 

 

Content Areas

Envision NM staff includes experts in primary care, behavioral health, pediatric overweight, nutrition, and community collaboration.  We also offer specialized training in the Model for Improvement and Motivational Interviewing.  We will be collaborating with other experts who will present specialized topics, and we will continue to develop training courses based on the interests of our participants. Individuals involved in the Core Topics Webinar Program can take any of the courses we offer.  Individuals in the DQI or AQI can also take any courses they are interested in, but will be expected to take courses including the Model for Improvement and certain courses specific to the content area they will be doing QI on.

 

How Do I Get This Training?

Envision NM uses Go To Webinar, which is a secured, hosted, web-based meeting technology.  We offer training and support without the time and expense of travel for each training event.  Follow the “Telehealth” link on this website for more information.

There is no fee and no requirements to attend ENM courses.   We also have technical support available before and at each event to assist individuals with signing in to meetings, making the experience as stress-free as possible!

 

Core Topics - Webinar Training

As part of our ongoing effort to provide opportunities for training for as many SBHCs around the state as possible, ENM is presenting opportunities for training and professional development to providers and staff at School-based Healthcare Centers around the state.  The courses listed here are open to everyone.  You can participate as an individual or as a team.  While we do hope that being exposed to Envision NM will cultivate your interest in doing quality improvement with ENM as a team at your SBHC, there are no strings attached. 

 

Demonstration Level QI

The purpose of the Demonstration level of QI is to help you master the tools of the Model for Improvement by practicing them on a foundational element of SBHC patient care.  This work is considered fundamental for your progression into the Advanced QI.  You’ll be introduced to “Aim” statements, PDSA cycles, and basic medical record reviews, and use these tools to improve some small but significant areas of your SBHC’s healthcare delivery system. The key word at this level is “practice,” and we’ll give you plenty of opportunity to demonstrate to us (and yourselves) your grasp of the Model for Improvement tools. Your site will identify members of an “Improvement Team” who will participate in team meetings and make decisions about the improvement process at your site.  You will turn in de-identified medical record review data and other process/improvement measures. 

 

Advanced Level OI

The purpose of the Advanced QI initiative is to enable you to use the tools you have acquired at the Demonstration Level, and apply them to a much more comprehensive project at your SBHC.  The focus will be on measuring practice improvements in your chosen area, rather than on tool mastery.  By definition, these projects are much wider in scope than the previous level, and will give you a deeper understanding of and more intense practice in, the content area of your choice. You will learn to use the data generated at your site to identify areas that need improvement, make needed changes, and sustain these changes over time. The Envision NM content area specialists will provide advanced level webinars addressing relevant topical information, and will offer much coaching and support in helping you incorporate this knowledge into your clinical practice, and will make sure you know how to measure and show your progress. AQI Teams may be asked to participate in webinars as presenters.

 

Pediatric Overweight Prevention, Identification, and Treatment
Initiative Leader: Suzanne Gagnon, CFNP (sgagnon@salud.unm.edu)

Obesity is associated with significant health problems in childhood and is an important early risk factor for many adult diseases. Providers in School-Based Health Centers (SBHC) are in a unique position to effectively identify, prevent, and treat pediatric overweight among their students.
The Expert Committee on the prevention, identification, and treatment of pediatric overweight has created an evidence-based approach to this health problem. The goal of this quality improvement initiative is to train SBHC providers to incorporate the Expert Committee Guidelines into their practices. It is hoped that improving providers’ skills and increasing their comfort level will help them give the best possible evidence-based care to students who are overweight or at risk for becoming overweight.

 

Improved Clinical Practice in Annual EPSDT, Asthma, Bronchitis, Upper Respiratory Infections
Initiative Leader: Paula LeSueur, CFNP (plesueur@salud.unm.edu)

Nine million children in the United States have been diagnosed with asthma, which causes more school absenteeism than any other chronic disease. Bronchitis and upper respiratory infections such as otitis, pharyngitis, and sinusitis account for the majority of acute illnesses seen in an SBHC setting. These infections share common symptoms, physical findings, and treatment.
An annual risk assessment and physical exam are essential to detecting and addressing students’ important health concerns. It can be a challenge to integrate preventive services into routine medical care. However, SBHC practitioners are in a unique position to use routine clinic visits to provide a range of preventive services. Clinical encounters such as sports physicals offer an opportunity to identify high-risk behavior and disease, update immunizations, and offer anticipatory health guidance. The preventable nature of most physical and behavioral health conditions provides a clear mandate to providers in SBHCs.


The Improved Clinical Practice Quality (ICP) Initiative will provide training in evidence-based clinical guidelines and develop operating procedures to improve clinical practice in the following areas:

The SBHC will eventually use the tools of Quality Improvement to build on its successes on the initial measures and begin to address other student health concerns.

 

Behavioral Health: Screening, Assessing, and Providing Interventions for Students with Behavioral Health Issues
Initiative Leader: Carmen Martinez-Tittmann, LMSW, LPCC (CMartinez-Tittmann@salud.unm.edu)

Envision NM recognizes the need for enhanced knowledge and skills in SCBH providers relative to the range of behavioral health issues in children and youth. With increased knowledge and skill development, both primary care and behavioral health providers can be instrumental in providing anticipatory guidance to help prevent the exacerbation of problem behaviors into higher-end mental health disorders, identifying risk factors and emerging mental health issues in children and youth, and partnering with other mental health specialists, school personnel and outside agencies to plan for the care of children and youth with behavioral health issues.  ENM strives to improve the quality of behavioral health services and supports in SBHCs by supporting a comprehensive approach to the identification and treatment of children and youth with commonly experienced social and emotional problems. Our SBHC QI will help your SBHC develop the capacity to support healthy development, and provide care to children and youth with depression and anxiety. The QI process will give you an expanded knowledge base, new patient skills, and a set of tools to be able to make improvements in your SBHC systems to manage your practice and support improved service delivery.

 

Additional Training
Though the following program areas are technically not considered quality improvement, they are popular and essential SBHC supports:

 

Community Collaboration
Initiative Leader: Chenoa Bah Stilwell-Jensen (cjensen@salud.unm.edu)

The Community Collaboration Quality Improvement Initiative will support SBHCs in medical and behavioral health issues by utilizing the resources and strengths of School Health Advisory Councils. Functioning councils will enhance the SBHC's work with children and teens by using the coordinated school health program approach.

This initiative will focus on the councils’ development, implementation, and sustainability. The main goals are:

 

Teen Lifestyle Change Program
Initiative Leaders: Carole Conley, MSW (cconley@salud.unm.edu) and Kirsten Bennett, MS, RD, LD (kdbennett@salud.unm.edu)


Teen Lifestyle Change is a psycho-educational program that offers overweight teens the opportunity, in a small group setting, to explore feelings, knowledge, and lifestyle behaviors impacting overall health. SBHC personnel, trained by Envision NM, lead each group through the eight-week program. Sessions will cover modifiable behaviors associated with teen overweight, and present real-life strategies that teens can use to be successful with weight management. Data collection, intake, and consent processes will be outlined for the facilitators. Training and support for facilitators is provided through site visits and telehealth and includes group development strategies, nutrition education, experiential activities, and skills for working with emerging challenges.