SRCH: Sustainable Relationships for Community Health
Program Evaluation
Coraggio Group
503.493.1452 | coraggiogroup.com
SRCH Background
Vision
Develop innovative sustainable hypertension, pre-diabetes and diabetes prevention, early detection and
self-management models through greater communication, collaboration, and coordination.
Consortium Partners
• County Public Health Departments
• Coordinated Care Organizations
• Self-management program provider organizations
• Community clinics (participant for some consortiums and for some institutes)
Consortium Participants (Listed By Lead Fiscal Agent)
• AllCare CCO
• Clackamas County
• Deschutes County
• IHN CCO
• Lane County
SRCH Approach
ESTABLISH A SHARED VISION
FOR THE RELATIONSHIP
COORDINATE A PLAN
FOR THE RELATIONSHIP
COMMIT TO THE
RELATIONSHIP
1
Evaluation Purpose
Designed to determine the impact of SRCH on its three
goals:
• Serve as a learning and doing cooperative for local
consortium members
• Co-design local initiative to improve cross-sector
partnerships
• Develop tools and techniques that enhance and sustain
community health partnerships
2
Evaluation Approach
Evaluation Methodology
• CDC program evaluation framework
• The evaluation was focused on the SRCH process
and approach. It did not focus on specific health
outcomes.
Evaluation Activities
• Review of primary documents from the Consortium Teams
i.e., Grant Applications, Self Evaluations, Project
Management Tools, Meeting Notes
• Group Interviews with all five consortium teams
• One-on-one interviews with the TA Leads and Facilitators
• Web-based survey of scaled multiple-choice and open
ended questions
3
Question
WHEN THINKING ABOUT THE GOAL OF BUILDING SUSTAINABLE RELATIONSHIPS FOR
COMMUNITY HEALTH, WHAT ASPECTS OF THE PROGRAM…
Strengths: Were most helpful /
impactful?
Weaknesses: Were least helpful /
impactful?
Are sustainable?
Opportunities: Could be added /
improved upon?
Threats: Could fail or negatively
impact other community health
initiatives?
5
Question
WHEN THINKING ABOUT THE GOAL OF BUILDING SUSTAINABLE RELATIONSHIPS FOR
COMMUNITY HEALTH, WHAT ASPECTS OF THE PROGRAM…
Strengths: Were most helpful / impactful?
• Dedicated time and space to bring the right partners to the table.
• Tools (30-60-90).
• Developing relationships and finding common goals and solutions.
• Outside Facilitation, Technical Assistance, and Project Management
Resource.
6
Question
WHEN THINKING ABOUT THE GOAL OF BUILDING SUSTAINABLE RELATIONSHIPS FOR
COMMUNITY HEALTH, WHAT ASPECTS OF THE PROGRAM…
Weaknesses: Were least helpful / impactful?
•
Tools were sometimes confusing and duplicative.
•
Unclear roles, goals and expectations.
•
Not having the key decision makers involved.
•
Short timeline.
7
Question
WHEN THINKING ABOUT THE GOAL OF BUILDING SUSTAINABLE RELATIONSHIPS FOR
COMMUNITY HEALTH, WHAT ASPECTS OF THE PROGRAM…
Opportunities: Could be added / improved upon?
•
A pre-SRCH meeting to begin relationship building and outline clear
goals, roles and expectations.
•
More consolidated and simplified forms, tailored to help participants
understand intent and purpose.
•
Longer project time frame.
•
Involve clinical expertise from the beginning
8
Question
WHEN THINKING ABOUT THE GOAL OF BUILDING SUSTAINABLE RELATIONSHIPS FOR
COMMUNITY HEALTH, WHAT ASPECTS OF THE PROGRAM…
Threats: Could fail or negatively impact other community health
initiatives?
•
Lack of funding and time.
•
Insufficient data & payment models.
•
Lack of engagement and motivation.
•
Failing to identify a champion to ensure the adoption of this approach.
•
Inconsistent or lack of referrals.
9
Accomplishments Table
Methodology
• The accomplishment table was developed based on the activities outlined in the Logic
Model.
• Each consortium was ranked on the level of activity in each area from 0 (No Activity) to 3
(Full Activity).
• All of the consortiums’ individual activity levels were aggregated on the following table to
show an average activity level as well as maximum and minimum levels.
Limitations
• The Logic Model was not developed until after the completion of the third SRCH Institute.
• No performance criteria were defined at the time the Logic Model was developed.
• Success criteria and expectations were not outlined at the beginning of the process.
• Since the performance criteria and goals were not established at the beginning of the
process, there is no way to objectively state whether the activity level of the teams met
expectations or not.
10
Question
WHAT DID THE SRCH TEAMS ACCOMPLISH DURING SRCH?
Logic Model Activity
Develop, implement, and monitor
sustainability plans, agreements, and
partnerships between organizations at
institutes
Activity Level
Average
Min
Max
Level Description
1.6
1
2
Plans implemented and
agreements in place
Identify performance measures and
monitor progress
1.6
1
2
Performance Measures developed
but not used to monitor progress
Identify and share progress, lessons
learned, and outcomes of SRCH
1.8
1
2
Progress, Outcomes, and Lessons
Learned identified with limited
sharing
Participate in TA and monitor planning
tools
2.6
2
3
All organizations actively
participate
Develop, manage, and implement plans,
processes, and best practices for selfmanagement models
2.0
2
2
Plans, processes, or best
practices developed, partial
implementation but not actively
managed
Get buy-in and participation from all
representative organizations
2.4
2
3
Some participation with limited
buy-in from representative
organizations
Perform gaps analysis/ current state
documentation
2.0
1
3
Current and Future State
documented
Perform data collection, entry, and
monitoring
1.2
1
2
Data Collected
0
1
2
3
11
Insights & Recommendations: Pre-Institutes
Insight
• Struggled with getting alignment on the goals and
expectations of SRCH.
• Went into the first SRCH Institute unsure of what was
expected.
• Did not have all the appropriate people at the table.
Recommendation
• Meet with each team locally, at least once, prior to the
start of the Institutes, to help the local teams better
understand the expectations and answer any questions.
12
Insights & Recommendations: Pre-Institutes
Insight
• The Formative Evaluation tool was used to guide the
progression of the work of the Consortiums, but the preinstitute, institute and post-institute activities were not
necessarily designed to enable that consortium
progression.
Recommendation
• Establish and clearly communicate expectations and
milestones with clear evaluation criteria at the
beginning of the SRCH process.
13
Question
WHEN ASKED HOW SIGNIFICANT OF AN IMPACT PERCEIVED BARRIERS HAD ON THE SRCH
EXPERIENCE, SURVEY RESPONDENTS FELT THAT LACK OF PROVIDER EDUCATION AND
INCONSISTENT REFERRALS, WHICH ARE DIRECTLY LINKED, WERE THE MOST SIGNIFICANT
Lack of Provider Education and Awareness
95%
Inconsistent Referrals
95%
Internal Resource/Capacity
94%
Sustainable Funding
89%
Inconsistent EMR Data/Records
89%
Lack of Patient Education and Awareness
89%
Provider/Staff Turnover
79%
Insufficient Standard Practices/Procedures
72%
Inconsistent Programs
68%
Consortium Engagement
63%
Somewhat Significant & Significant
14
Insights & Recommendations: Pre-Institutes
Insight
• Focus on referrals and funding was critical to the
success of the process.
• In most cases these were the largest potential barriers
to the sustainability of their programs, and were very
often the pieces of the puzzle that were largely
unknown.
Recommendation
• Continued focus on these program elements is critical
to launching these programs and ensuring their
sustainability.
15
Question
SURVEY RESPONDENTS SAID SRCH WAS MOST HELPFUL IN OVERCOMING THE BARRIERS
OF CONSORTIUM ENGAGEMENT WHICH ALLOWED THEM TO ADDRESS OTHER BARRIERS
Consortium Engagement
89%
Inconsistent Referrals
83%
Insufficient Standard Practices/Procedures
82%
Sustainable Funding
78%
Lack of Provider Education and Awareness
67%
Lack of Patient Education and Awareness
61%
Provider/Staff Turnover
56%
Inconsistent EMR Data/Records
56%
Inconsistent Programs
Internal Resource/Capacity
44%
11%
Somewhat Helpful & Helpful
16
Insights & Recommendations: Institutes
Insight
• Teams felt that they had just began the work after the
conclusion of the third Institute, and much more work
was needed before reaching sustainability.
Recommendation
• Extend the SRCH process over a longer time frame to
stay engaged longer and make more progress
towards long-term sustainability.
.
17
Question
WHEN ASKED, WHAT ELEMENTS WORKED WELL TO HELP BUILD SUSTAINABLE
RELATIONSHIPS, RESPONDENTS SAID THAT THE INSTITUTES AND THE BASIC LOGISTICS
ASSOCIATED WITH GETTING THE VARIOUS PARTIES TOGETHER WERE THE MOST EFFECTIVE
100%
100%
83%
78%
71%
56%
The Institutes
Basic Logistics
TA Calls
Tools
Learning Modalities
Webinars
Somewhat Effective & Effective
18
Insights & Recommendations: Institutes
Insight
• Dedicated time, and a place away from other
distractions, to work collaboratively and develop
approaches was the most valuable part of SRCH.
Recommendation
• Future programs should continue to include this
dedicated group work time.
19
Insights & Recommendations: Pre & Post-Institutes
Insight
• Technical Assistance Leads played a key role in
maintaining the momentum between Institutes.
Recommendation
• A dedicated and consistent TA Lead to help with
facilitation during the institutes, project management
between institutes, and provide specific selfmanagement technical assistance.
• More outside technical expertise early in the process
may help formulate and execute their plans.
20
Q&A
21
HPCDP Self-Management Next Steps Discussion – PART 2 - RECAP
Facilitated by Coraggio Group