Minnesota TIGER Summit: Together We Can Do IT… June 16, 2010 Northland Inn – Brooklyn Park, MN...
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![Page 1: Minnesota TIGER Summit: Together We Can Do IT… June 16, 2010 Northland Inn – Brooklyn Park, MN 1:00 pm - 5:00 pm Meaningful Use of the Omaha System for.](https://reader036.fdocuments.in/reader036/viewer/2022062713/56649cda5503460f949a3d3b/html5/thumbnails/1.jpg)
Minnesota TIGER Summit:Together We Can Do IT…
June 16, 2010Northland Inn – Brooklyn Park, MN
1:00 pm - 5:00 pm
Meaningful Use of the Omaha System
for Program Evaluation in Public Health Nursing
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Vision: Evidence-based Program Evaluation• CHS Administrators envisioned using electronic
health records to gather data for program evaluation, starting in the 1990’s
• 3 software programs adopted in CHS agencies – CareFacts– CHAMP– PH DOC
• Common denominator: the Omaha System
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Minnesota Omaha System Users Group
• By 2000, 87% of counties in Minnesota had a public or private agency using one of the 3 software systems
• Users began to recognize the potential to work together
• Minnesota Omaha System Users Group started in 2001, led by state and county public health nurses
• omahasystemmn.org
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Diverse Stakeholders
• Over 200 participants – state and local public health– private home care & hospice– Universities (faculty & students)– Software industry– Metro, central MN, southeastern MN– Wisconsin– Washington State
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Diverse Programs
• Using the Omaha System to support programs – Family home visiting– Disease prevention and control– Waiver programs– Home care– Hospice– Healthy Communities
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Results
• Grass roots collaboration– Internationally recognized leaders– Documentation and practice quality– Dissemination of tools – Two scientific publications– A national American Public Health Association
award– International visitors
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Panelists/Topics
• Overview– Karen Monsen, PhD, RN, University of Minnesota
School of Nursing, [email protected]• Implementation
– Katie Halder, MS, RN, PHN, Douglas County Public Health [email protected]
• Quality– Jill Timm, JD, RN, PHN, Program Manager, Maternal Child
Health, Washington County Department of Public Health & Environment, [email protected]
• Using Data– Diane Thorson, MS, RN, PHN, Director/CHS Administrator, Otter
Tail County Public Health, [email protected]
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Software
• Learning curve for implementation– Computer literacy– Unique attributes of each program– Always adapting and changing– Gets easier with time and software
improvements
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The Omaha System
• Learning curve for the Omaha System– The Omaha System is the standardized
language within the software – Provides structure
• Client assessments• Client outcomes• Practitioner interventions
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Mysteries
• Learning curve for both software and terminology– What is a software mystery?
• Have a great relationship with vendors to solve these• Examples: Entering dailies and Omaha Interventions
– What is an Omaha System terminology mystery?• Use Omaha System resources to solve these
– Book
– Web sites
– Meetings
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Efficiencies
• Documentation efficiency– Keeps improving– Initial charting time
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Outcomes
• For all 3 software programs, it is the Omaha System that allows us to work together, describe our practice, and show our outcomes
• Software implementation needs to include Omaha System training and support
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Quality
• Vision to use data to demonstrate outcomes relies on having quality data
• Omaha System users share this vision and have developed tools– Manuals– Pathways– KBS rating guides
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Manuals
• Supporting documentation efficiency and quality– Provided by vendors– Adapted & edited by local agencies– Updated periodically to reflect changes– Utilized during orientation and early use of an
electronic documentation system
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Pathways
• Started in 2001 to describe practice – Helped with documentation efficiency and
convenience– MOSUG pathways web page – Now developing evidence-based, peer
reviewed pathways
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Inter-rater Reliability
• Started in 2002 in Ramsey County– Based on the information in the Omaha
System book– Expanded definitions for improved accuracy– Revised every 1-2 years– This summer’s revision will include
Washington State Omaha System users
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Commitment
• See the results transforming practice– Knowing standards of care– Incorporating evidence into practice– Valuing reliability and avoiding bias– Confidence in the quality of our programs as
well as our data
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Otter Tail County Program Evaluation
• Nurse-Family Partnership evaluation
• Otter Tail County uses the PHDOC software program
• Omaha System data
• Can analyze Problems, Signs and Symptoms, Targets, and Knowledge, Behavior, and Status outcomes
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The Future of Omaha System Program Evaluation
• LTBI
• Breastfeeding
• Obesity
• Early Childhood Screening
• MSHO
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Challenges
• Assessment forms required with other programs do not match with the Omaha System
• Working with other agencies and state officials to resolve issues in data collection
• Starting to see the benefits of using standards (meaningful use of data)
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Nurse-Family Partnership
• Serves high risk pregnant women and children ages 0-2
• Program has been carefully tested
• Omaha System pathways will support our nurses
• Omaha System outcomes will allow us to evaluate our local program and results
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Developing Standards of Care
• Surveillance/Assess: Signs/Symptoms Physical: pregnancy discomforts, danger signs…
• Teaching: Anatomy/Physiology: prenatal classes, childbirth preparation
• Case Management: other community resources such as Quit Line, WIC
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Looking at the NFP data
• Most Frequent Problems were Pregnancy and role Change
• Most Frequent Signs/Symptoms were low income, loss of previous role, and difficulty with prenatal exercise/rest/diet/behaviors
• Most Frequent Category is Teaching
• Most Frequent Targets are signs/symptoms and feeding procedures
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Outcomes Evaluation
• KBS rating data
80.1380.1380.38Role Change
100.310-0.11101.1Pregnancy
ClientsAv ChgClientsAv ChgClientsAv ChgOmaha System Problem
StatusBehaviorKnowledgeKBS Ratings
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Thank you! Questions?