Injury Prevention Report Cards

State: UT Type: Promising Practice Year: 2015

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Evaluation of an injury prevention initiative is critical. Any evaluation should include reporting data in an understandable format, be engaging to stakeholders, and wherever possible show comparisons to state and national standards. 

Injury prevention report cards are serving as working documents to measure progress, reporting data to existing partners, and engaging the interest of potential partners. The report card concept is a simple method used to collect numerous data sources and then present this data in a user friendly format to stakeholders.

Currently, report cards have been developed for the following areas: Child Passenger Safety, Bike Safety, and Teen Driving. The areas of senior fall prevention and outreach by the Salt Lake County Safe Kids are examples to be developed in the future.

 

 

 

 

 

 

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Salt Lake County Health Department
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Injury Prevention Report Cards
Brief Description of LHD Salt Lake County Health Department (SLCoHD) serves a population of over 1.08 million.  SLCoHD is located in the most populated county in Utah, home to the state capitol, and one of four counties known as the Wasatch Front that comprises over 70% of the state population.  As of the 2010 census, there were 343,218 households, and 291,686 families residing in the county. The largest racial makeup was 81.2% White followed by 17.09% of Hispanic or Latino origin.  In the county, 30.50% of the population was under age 18, 12.90% from 18 to 24, 30.60% from 25 to 44, 18.00% from 45 to 64, and 8.10% who were 65 years of age or older. The median age was 29 years. The average family size was 3.53. The median income for a household was $48,373, and the median income for a family was $54,470. About 5.70% of families and 8.00% of the population were below the poverty line. Describe Public Health Issue Evaluation of local injury prevention programs is critical. Decreases in emergency department visits and mortality are a few of the most common reasons. On a program level, answering to funders, supervisors, and community partners are other examples of invested stakeholders. Clear evaluation measures must be established and data collected in a format easy to understand.    Goals & Objectives Goal 1:            Assess community health status related to injuries. Objective:       Collect and maintain reliable, comparable, and valid data on key injury indicators and outline efforts addressing  these indicators. Goal 2:            Engage community partners in addressing injury issues. Objective:       Use data in addressing injury problems through collaborative initiatives. Objective:       Foster teamwork among stakeholders on how together they are addressing an injury indicator.  Goal 3:          Implement quality improvement processes Objective:       Integrate and maintain an ongoing method to report on injury prevention efforts to stakeholders. Objective:       Institute critical thinking around injury prevention strategies among all stakeholders. How was practice implemented / activities? In the fall of 2013 injury prevention staff of SLCoHD learned of a template used to report pool sampling. The template sparked ideas of how to better present injury data. The Child Passenger Safety (CPS) report card was first to be developed and shown to the Salt Lake County Safe Kids Coalition members on how their activities were impacting families. The CPS report card would later be used as one reporting method to state funding agencies. In the spring of 2014 a Teen Driving and Bike Safety report cards were also developed. All of these report cards have been posted on the web and shared across the health department as an example of a quality improvement process. The report card format continues to be referenced as one possible example of how to track other key health department indicators. The injury prevention report cards was also presented at the national 2014 Safe States Alliance Conference and positive comments were received from state and local injury prevention practitioners.        Results / Outcomes   Injury prevention report cards by themselves are not saving lives or decreasing emergency department visits. The intent of the report cards is to collect data that assesses health status and interventions on injury issues, use this report to engage stakeholders, and institutionalize an ongoing quality improvement process.  The report card is a work in progress and to date all of the associated objectives are being met. The quantitative measure of these report cards, on how they are being used, will continue to expand. Other report cards planned include senior fall prevention and outreach by the Salt Lake County Safe Kids Coalition.  Public Health Impact Injury prevention report cards address four of ten of the Essential Public Health Services. These include: Monitor health status to identify and solve community health problems. Inform, educate, and empower people about health issues. Mobilize community partnerships and action to identify and solve health problems. Evaluate effectiveness, accessibility, and quality of personal and population-based health services.  Report cards also address three domains and the associated standards outlined in local public health accreditation. These include: Domain 1: Assess Standard 1.2: Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population. Domain 3: Inform & Educate Standard 3.1: Provide health education and health promotion policies, programs, processes, and interventions to support prevention and wellness.      Domain 4: Community Engagement Standard 4.1: Engage with the public health system and the community in identifying and addressing health problems through collaborative processes.   Website  http://slcohealth.org/programs/injuryPrevention/index.html  
Statement of Problem It’s not that local injury prevention initiatives are not evaluated but more commonly community practitioners are so busy implementing interventions that evaluation is often an afterthought. Process measures and the associated data (i.e. # of individuals reached, # of events, # of policies developed, etc.) is the  first to be captured and most common. More difficult is to measure the long term outcomes of an intervention by data (i.e. motor vehicle crash data, Emergency Department visits, mortality, etc.) that may be captured by other data sources indirectly or even data (i.e. seatbelt/helmet observations, knowledge/attitude pre and post- tests, etc.) collected by those stakeholders involved in the intervention.  A good starting place however is always to identify the process and outcome measures ahead of any proposed intervention. Second engage stakeholders in the evaluation process by identifying a reporting template to monitor how activities will be measured in the short term and how they measure up against any long term outcomes. This is where an injury prevention report card format can help.   What target population is affected? The injury prevention report cards are intended to inform all stake holders interested in reducing injuries and premature deaths due to injuries in Salt Lake County. The primary audience for these report cards is community partners involved with the SLCoHD collaboratively at the local, state and federal level. A secondary audience is the general public who at any time can see the big picture with what is happening in Salt Lake County on a specific cause of injury and what is being done to address this concern.   What has been done in the past to address problem? There is no history of reporting process or outcome data like this within the Injury Prevention Program of SLCoHD or even outside the health department with partners. The only time that data has been shared like this by SLCoHD staff with community partners is when a discussion has been conducted on selecting strategic priorities or in a written year-end report. The problem with sharing data in this manner is that there is no engaging partners in the evaluation discussion as much as there is simply a reporting out. The nature of the injury prevention report cards is to be as dynamic in nature as possible in collecting process data and doing the same with outcome data sources from other sources.   Why is current/proposed practice better? The use of injury prevention report cards is a much better way to inform, educate, and empower people about health issues. The collection of data from multiple data sources and the use of this report to engage stakeholders in an ongoing discussion to identify and solve injury problems is extremely critical. Both of these reasons are also two of the Ten Essential Public Health Services. Injury prevention report cards are also serving as an ongoing quality improvement process for the Injury Prevention Program.   Is current practice innovative? The development of an injury prevention report card is innovative. The content in each of the report cards may not be unique but the collection of the multiple data sources, connecting these data sources to established benchmarks at any appropriate local, state or federal level, and status updates on ongoing interventions by the LHD is innovative. The only other comparison to use of data like this in public health is the use of a “dashboard concept” which appears to be coming up in discussions associated with national standards involving local public health department accreditation.   Creative use of existing tool or practice? At this time no other tool is known to report local injury prevention data combined with interventions in this format in Utah or nationally.   Is current practice evidence-based? The injury prevention report card practice is evidence based as it meets requirements of several national standards. As outlined in the Standards and Indicators for Local Health Department Injury and Violence Prevention Programs, developed by NACCHO and the Safe States Alliance, the injury prevention report cards specifically addresses the following standards: Standard V      The local health department uses data to inform and strengthen capacity to address the cause of injury and violence across the lifespan. Standard VII   The local health department injury and violence prevention program raises community awareness of the causes of injury and violence and prevention across the life span and local prevention efforts. Standard X      The local health department injury and violence prevention program evaluates the effectiveness of its efforts to address the causes of injuries and violence across the lifespan.  Injury prevention report cards also address four of ten of the Essential Public Health Services. These include: ·       Monitor health status to identify and solve community health problems. ·       Inform, educate, and empower people about health issues. ·       Mobilize community partnerships and action to identify and solve health problems. ·       Evaluate effectiveness, accessibility, and quality of personal and population-based health services. Report cards also address three domains and the associated standards outlined with local public health accreditation. These include: Domain 1: Assess Standard 1.2: Collect and maintain reliable, comparable, and valid data that provide information on conditions of public health importance and on the health status of the population. Domain 3: Inform & Educate Standard 3.1: Provide health education and health promotion policies, programs, processes, and interventions to support prevention and wellness.           Domain 4: Community Engagement Standard 4.1: Engage with the public health system and the community in identifying and addressing health problems through collaborative processes    
Goals and objectives of practice   Goal 1:            Assess community health status related to injuries. Objective: Collect and maintain reliable, comparable, and valid data on key injury indicators and outline efforts addressing these indicators. Goal 2:            Engage community partners in addressing injury issues. Objective: Use data in addressing injury problems through collaborative initiatives. Objective: Foster teamwork among stakeholders on how together they are addressing an injury indicator. Goal 3:            Implement quality improvement processes Objective: Integrate and maintain an ongoing method to report on injury prevention efforts to stakeholders. Objective: Institute critical thinking around injury prevention strategies among all stakeholders.   What did you do to achieve goals and objectives? In the fall of 2013 injury prevention staff of SLCoHD learned of a template used to report pool sampling. The template sparked ideas of how to better present injury data. The Child Passenger Safety (CPS) report card was first to be developed and shown to the Salt Lake County Safe Kids Coalition members on how their activities were impacting families. The CPS report card would later be used as one reporting method to state funding agencies. In the spring of 2014 a Teen Driving and Bike Safety report cards were also developed. All of these report cards were shared across the health department as an example of a quality improvement process. The report card format continues to be referenced as one possible example of how to track other key health department indicators. A presentation on the injury prevention report cards was also given at the national 2014 Safe States Alliance Conference and positive comments were received from state and local injury prevention practitioners.   Any criteria for who was selected to receive the practice? The injury prevention report cards are not an intervention by themselves. Instead the injury prevention report cards are intended to inform all stake holders interested in reducing injuries and premature deaths due to injuries in Salt Lake County. The primary audience of these report card are community partners involved with interventions at the local, state and federal level. A secondary audience is the general public who at any time can see the big picture in what is happening in Salt Lake County with regard to a specific injury and what is being done to address this concern.   Timeframe for Practice  The first injury prevention report card (Child Passenger Safety)was developed in the fall of 2013 and the other tow report cards (Bike Safety & Teen Driving) were developed in the spring of 2014. Other injury prevention report cards are currently being developed as this is on ongoing project.   Were other stakeholders involved? What was their role in the planning and implementation process? The injury prevention reports cards are not a community injury prevention program that involves stakeholders in the implementation of strategies. The report cards instead serve to inform numerous local, state and federal stakeholders of the status of injuries and LHD strategies in Salt Lake County. The report cards are still a work in progress however in the future plans are to have all stakeholders provide ongoing feedback on what else needs to me measured by the report card format. The report cards then serve to empower all invested stakeholders in identifying injury prevention priorities and selecting a best or promising practice to address a concern.  Currently injury prevention report cards have been shared with the following stakeholders:   Local             Salt Lake County Department of Health Administration             Salt Lake County Safe Kids Coalition members             Salt Lake County Bike Advisory Council              State             Utah Department of Health             Utah Highway Safety Office             Utah Teen Driving Safety Task Force             Utah Local Association of Community Health Educators (Utah’s 12 LHD’s)              National             Presentation to attendees at 2014 Safe State Alliance conference             NACCHO Injury and Violence Prevention Work Group             Safe States Injury Alliance Local Injury Prevention Special Interest Group   What does the LHD do to foster collaboration with community stakeholders?   The injury prevention program is involved with many community coalitions, task forces, and special initiatives as are other programs within the health department. Community collaboration is an assurance role of public health in addressing a community health concern.   Describe the relationship(s) and how it furthers the practice goal(s) Injury prevention report cards help to inform partners on issues they have a vested interest in, engage them and others in the discussion on strategies, and serves as meaningful feedback back on how collectively everyone in the collaboration is making a difference.   Any start up or in-kind costs and funding services associated with this practice?  Please provide actual data, if possible. Else, provide an estimate of start-up costs/budget breakdown. The only startup costs at this time was the hours necessary to develop a template and enter various data collected by other local, state or national sources. Plans are in the future that once a template is developed to further automate updates by simply capturing new data in a table format or a data feed. No estimated or actual costs are available at this time as this is still a work in progress.    
What did you find out? The report card format was simple to design and easily replicated across other injury prevention areas. Gathering all the relevant data sources and inputting the data however was very time intensive. Often the manner in which data was reported from another sources had to be simplified even further for lay readers which again required a good amount of time. An example would be to change a table of data to a much more visual depiction such as a pie chart.   To what extent were your objectives achieved? At this point in time the three developed injury prevention report cards (i.e. child passenger, teen driving, and bike safety) are meeting all the outlined objectives for the project. Positive feedback from stakeholders is also what is pushing the expedited development of other injury prevention report cards.   Please re-state your objectives from the methodology section. Objectives:     Collect and maintain reliable, comparable, and valid data on key injury indicators and outline efforts addressing these indicators. Use data in addressing injury problems through collaborative initiatives. Foster teamwork among stakeholders on how together they are addressing an injury indicator. Integrate and maintain an ongoing method to report on injury prevention efforts to stakeholders. Institute critical thinking around injury prevention strategies among all stakeholders.   Did you evaluate your practice?    The report card has not been formally reviewed at this time as it is still a work in progress. Qualitative feedback from stakeholders however is being encouraged at all times. The data listed below simply outlines the content of information listed in the various injury prevention report cards.   List any primary data sources, who collected the data, and how (if applicable) SLCoHD – Injury Prevention Program observational (outcome) data (i.e. teen seatbelt use, bicycle helmet use) SLCoHD – Injury Prevention Program pre and posttest knowledge (outcome) surveys (i.e. car seat class surveys) SLCoHD – Injury Prevention Program basic demographics (i.e. residence of clients served by zip code - car seat inspection form) SLCoHD – Injury Prevention Program sales of low cost car seats to client served (i.e. health department software for sales transactions) SLCoHD – Injury Prevention Program quantitative (process) data (i.e. # of people reached, # of car seat inspections, etc.)   List any secondary data sources used (if applicable) State observational (outcome) data (i.e. teen seatbelt use, car seat restraint use, bicycle helmet use) IBIS-PH Utah’s Indicator-Based Information System for Public Health (Emergency Department visits and mortality) Utah Highway Safety Crash Reports (Outcome) Healthy People 2020 (Outcome)   Describe how results were analyzed Again because the injury prevention report cards are still a work in progress, all internal stakeholders to the health department and external community stakeholders will continue to be urged to provide feedback.               Were any modifications made to the practice as a result of data findings? The injury prevention report cards are still a work in progress and as such no significant modifications have been made at this time.    
Lessons learned in relation to practice The report card format was simple to design and easily replicated across other injury prevention areas. Gathering all the relevant data sources and inputting the data however was very time intensive. Often the manner in which data was reported from another source had to be simplified even further for lay readers which again required a good amount of time. An example would be to change a table of data to a much more visual depiction such as a pie chart. Anyone thinking about developing a template like this should set aside a good deal of time to critically think about what data sources are available and what is relevant to all stakeholders.    Lessons learned in relation to partner collaboration (if applicable) Nothing at this at time   Did you do a cost/benefit analysis? If so, describe. No   Is there sufficient stakeholder commitment to sustain the practice? Yes        Describe sustainability plans Currently this in an internal project to the Injury Prevention Program of the health department. The Injury Prevention Program Manager has a working goal of updating all report cards at least twice a year. This will be done in conjunction with mid-year and end of year reporting for state and federal funding partners. Plans will continue to be explored to further automate updates with data feeds from other sources or simply inputting new data in a web reporting software that will be uploaded to an existing template.  
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