Magnolia Place Project
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Magnolia Place Project

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The Magnolia Place Initiative is a collaboration of faith-based and community groups within a 500-block portion of Los Angeles that crosses Pico Union, West Adams and the North Figueroa Corridor, west ...

The Magnolia Place Initiative is a collaboration of faith-based and community groups within a 500-block portion of Los Angeles that crosses Pico Union, West Adams and the North Figueroa Corridor, west of downtown. This project used smartphones to help a group of Magnolia Place residents record images and information from their neighborhoods in ways that may contribute to meaningful change while building community capacity for research. We developed a "Holiday Campaign" around Halloween, which involved taking snapshots and mapping the observations, and created a rating scale for measuring holiday spirit. We also wrote a Spanish-language guide for the project.

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Magnolia Place Project Magnolia Place Project Presentation Transcript

  • Magnolia Community InitiativeVision: All 35,000 children in the Magnolia catchment area willbreak all records of success in their education, health, and thequality of nurturing care and economic stability they receivefrom their families and community.
  • About the Magnolia Community Initiative• Voluntary network of 70 organizations• Involves government and regional organizations – including Los Angeles County Chief Executive Office – to influence infrastructure that affects many residents, and to facilitate spread of what works beyond the catchment geography• Emphasizes sustainable, scalable, evidence-based strategies: (1) increase access, use and quality of family-desired services, activities, resources and support; (2) strengthen social ties among residents; and (3) improve economic opportunities and development.• Connects diverse programs and providers (including physicians, child care and preschools, and mental health) to shared accountability and a common change process
  • Achieving Population Outcomes1. Work as a system to achieve population outcomes2. Use design ideas that increase synergy/alignment of all sectors, at all levels (policy, practice, families)3. Increase expectations of, and accountability for, impact for a population4. Combine expertise on “what to try” with expertise on “how to change”5. Use tests and prototypes to implement promising ideas that customize to work consistently, across settings, and under all conditions6. Use networks to produce and accelerate innovation, learning and spread
  • EDSI.Measuring Progress for the Population Magnolia Community Dashboard EDSI . EARLY DEVELOPMENTAL June 2012 SCREENING AND INTERV INITIATIVE ENTION Developmental Progress of Children Entering Kindergarten % of 3rd Grade Children Vulnerable Very ready Who Are Proficient inDevelopmental 18% 23% 32% 29% 23% 20% Reading Reading 13% 13% 15% 18% 13%progress, by 9% 27% proficiency,kindergarten Communica on Physical Language & cogni ve Social competence Emo onal maturity Has at least 2 areas of vulnerability Has IEP third grade % Parents of Children 0-5 With Protective Factors % Parents Achieving Family Goals 100% 100% 80% 80% 60% 60% Family and At least 1 neighbor ! " #$ (&))&%$ personal problem ( , -. +$/ % &"1% could discuss a with whom youProtective &"( #*+% Flexible when life ! "#$% $#()($$) when needed *+& )#$% ,"#,/) medical care doesn’t go as 40% ! "#$% $)% 40% 0*% ( " )$ $ +)$ Can get planned ! " " #$ $ %& community . *+( " %& & 20% 20%factors for ,- 0% 0%families Social Connec ons (% with 2 of 2) Concrete Supports (% with 6 of 6) Resilience (% with 5 of 5) Social Condi ons Parent Health Economic Stability Paren ng conditions % Parents Reading With Their Child Daily % Parents Repor ng Ties to Neighbors 100% Parent Experiences in Magnolia Partner 80% Settings, and in the Community Overall 60% Goal 40% In doctor offices In child care 20% In family support programs 0%Parent Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012 In linkage organizations In the community overall Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012activities and 100% % Parents Repor ng Posi ve Rela onship with Child % Parents Helped with Family Income/ Finances % Parents Receiving Empathic Carebehaviors 80% 60% 40% 20% 0% Measures of Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul real-time Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012 2011 2012 2011 2012 % Parents Discussing Resources for Families % Parents Asked About Child % Parents Asked About Family Stressors 100% Development Concerns improvement 80% 60% in servicesPotential and 40% 20% and supports 0%actual reach to Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012 Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012 Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012 % Parents Discussing Resources for Social % Parents Asked About Depressionchildren in the 100% Support Current & Potential Reach to Children % receiving care in this system % reached by network doctorcommunity 80% 60% % reached by network child care 0% 100% 40% Number of questionnaires per month Health 7 31 9 35 24 15 15 22 19 31 9 5 20% Child care 20 - - - 33 39 40 40 - 40 - - Family support 51 50 57 68 70 44 60 59 33 25 48 38 0% Linkage orgs - - - - - - - - - - - - Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Community 127 - 106 - - - 96 - 97 - - 86 Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul J A S O N D J F M A M J J 2011 2012 2011 2012 2011 2012
  • Counts of residents in contact with partner 100 150 200 250 300 350 50 0 WIC St Thomas CBSC Hoover Rec Toberman Magnolia El Normandie Red Shield St Johns LA County Camino Nuevo All Peoples PACE CNI Leo Politi Best Start Network Reach to Residents Hope St NAC the past year Esperanza Crystal Stairs Pathways Pan American Angelica Public Counsel most common network partners Welcome Baby 89% of survey respondents had CFRC 75% had contact with at least one of 5 SAJE contact with at least one partner in 1736 centerMagnolia Community Survey, October 2011 (790 residents; all ages) 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Cumulative %
  • children provider Counts of seeing the 0 50 100 150 200 250 300 Ei Cl Cli sn in ni St er ica ca Jo M Sa hn s Cl acA n Ju in rt da ica hu s Sa r P n ar Past 12 Months Ka P Mig k ise ic ue rP oC l e lin Te rma ica M res ne Ca sr O a M nte lif sc e or ar di ni c W a Rom al Fa om m ero en Ch S ily C an i a a Ce d C ldre n M re nt hil ns ig ro dr u M en Hos el e d s p i ica We tal Ar lln th es s Qu ur P ee ar ns k Cl in c provider in the network ica Al are de tam la ed M Dr uje Ho . G r Ce ra h nt Te cio alili ur re Lo y W sa p e om Me z Cl e di c in Ca ns al ica sa Cl About 19% of children saw a health care de de inic Lo Sa s A lud ng el e Ot s he rs 0%parent surveys completed on 632 children); cumulative percentages include some duplicate counts 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Health Care Providers Seen by Children Ages 0-5 inPRELIMINARY DATA. Parents surveyed in WIC centers within Magnolia catchment, 2010-12. N=682 (of
  • How to Generate Ideas That Will AchieveSystem Level ResultsNew is known Little Known Best scienceIdeas or published History of Ideas success Evidence based Test Pilot Prototype Reliability (consistency) Scale and spread Peter Margolis, EDSI Pacoima Collaborative Design Meeting, 3 November 2009
  • A Recipe for Population Impact Model for ImprovementEvidence-Based Programs andContent What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? Act Plan Study Do Network for Continual Learning Change Concepts Select Topic Participants Version 2.0 CQN Asthma Project Practice Key Driver Diagram Interventions Key Drivers   Form a 3-5 person interdisciplinary QI Team Formally communicate to entire practice the importance and goal of this Prework GLOBAL CQN AIM Engaging Your QI Team and project We will build a sustainable quality Your Practice  Meet regularly to work on improvement  improvement infrastructure within our practice to achieve measurable improvements in *The QI team and practice is active and engaged in improving practice processes and patient outcomes  All physicians and team members complete QI Basics on EQIPP Collect and enter baseline data Change P P asthma outcomes  Generate performance data monthly  Specific Aim From fall 2009 to fall 2010, we will achieve  Communicate with the state chapter and leaders within the organization Turn in all necessary data and forms Concepts A D A D measurable improvements in asthma  Attend all necessary meetings and phone conferences outcomes by implementing the NHLBI guidelines and making CQN’s key practice changes Using a Registry to Manage  Select and install a registry tool S S Measures/Goals Your Asthma Population *Identify each asthma patient at every visit *Identify needed services for each patient *Recall patients for follow-up    Determine staff workflow to support registry use Populate registry with patient data Routinely maintain registry data Expert LS 1 LS 2 LS 3 Group Outcome Measures:  Use registry to manage patient care & support population management  >90% of patients well controlled Process Measures Using a Planned Care  Select template tool from registry or create a flow sheet  >90% of patients have “optimal” asthma care (all Approach to Ensure Reliable  Determine workflow to support use of encounter form at time of visit of the following) Asthma Care in the Office  Use encounter form with all asthma patients  assessment of asthma control using a * CQN Encounter Form * Care team is aware of patient needs and  Ensure registry updated each time encounter form used validated instrument work together to ensure all needed  Monitor use of encounter form  stepwise approach to identify treatment services are completed options and adjust therapy  written asthma action plan  Select & customize evidence-based protocols for your office Developing an Approach to  patients >6 mos. Of age with flu shot  Determine staff workflow to support protocol, including standing orders Employing Protocols (or flu shot recommendation) * Standardize Care Processes  Use protocols with all patients * Practice wide asthma guidelines  Monitor use of protocols  >90% of practice’s asthma patients have at least implemented an annual assessment using a structured encounter form Providing Self management  Obtain patient education materials Support  Determine staff workflow to support SMS * Realized patient and care team  Provide training to staff in SMS relationship  Assess and set patient goals and degree of control collaboratively  Document & Monitor patient progress toward goals  Link with community resources Peter Margolis, CCHMC; Ed Wagner, MD, MPH: MacColl Institute; Associates in Process Improvement; Institute for Healthcare Improvement
  • PDSA Example – Texting for Daily ReadingDrivers Support parents to manage their child’s needs & promote developmentCurrent % of third grade children proficient in reading: 27% Can we increase theoutcomes: % of children entering kindergarten frequency of daily with communication vulnerability: 18% book-sharing byParent practice: 100% % Reading daily introducing texting, 80% 60% to prompt reading 40% 20% and to enable parents 0% Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012 to share theirSystem practice: % Discussing importance of reading successes with each 100% 80% other, in real time? 60% 40% 20% 0% Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul 2011 2012
  • Collaboration with the CTSI – Year 2Aim 1: Test the impact of several key functions ofpartnered infrastructure for translational research, toincrease the volume and breadth of partnered researchactivities and funding, and to accelerate the timing ofpopulation impact• Using MCI Research and Evaluation group to identify common priority topics, and link researchers and network partners• CERP staff support of data visualization for community residents• Biostatistics consulting to facilitate impact evaluation
  • Collaboration with the CTSI – Year 2Aim 2: Identify effective, scalable applications of mobilehealth technology that improve population health•Feasibility pilot with Center for Embedded NetworkedSensing (CENS) to identify effective uses of smartphones forhelping residents describe their neighborhoods and dailylives in ways that contribute to meaningful action forneighborhood change – Offer residents access to Ohmage, which is an open-source, mobile to web platform that records, analyzes, and visualizes data from prompted experience samples entered by residents – “Holiday survey” to develop positive neighborhood asset measures – Storytelling narratives about “a day in the life”
  • Neighborhood ObservationHoliday Micro-Community Participation Survey Checklist Team Leader________________________________Date:_ 12/________/2011 Start-Time:_____:_____ End-Time:_____:_____ Team Members:_____________________________ SINGLE OR IF MULTIPLE, HOLIDAY WRITE TYPE OF UNIT PHOTO PHOTOAddresses MULTIPLE HOW MANY DÉCOR DECORATION & LOCATION NUMBER TAKEN? # UNIT UNITS? RATING STRING OF LIGHT AROUNDExample: 1234 14th Street M 4 A 4 YES 1 ROOFLINEExample2: 1234 14th Street M 4 B 1 YES 2 WREATH 1. S OR M 2. 3. 4. 5. Key: Decorations - 0=None, 1= one holiday item, 2= two items, 3= 3 items, 4= four or more itemsHow to number units if number not listed or visiblePage ___ of ______