June 2010

From the director:
It's all about the people

It's all about the people

Since joining the North Carolina Institute for Public Health in 2003, I have been consistently impressed by the dedication of the Institute's extraordinary staff. Whether they are involved in training public health workers across North Carolina, managing programs that promote and protect health, or executing a range of support functions that are essential to the Institute's success, I have found our staff to be highly competent and a true pleasure to work with. As a result, our many partners consistently pay compliments to those who make the North Carolina Institute for Public Health such a special place.

No one in the Institute exemplifies this extraordinary level of dedication to service more than our business manager, Judy Beaver, who will be retiring on June 30, 2010.

Through over 38 years of dedicated service to the School of Public Health, Judy Beaver has consistently and creatively solved difficult problems and crafted innovative solutions to complex issues. Throughout her career, Judy has managed a diverse array of programs and projects within the NC Institute for Public Health (NCIPH) and its antecedent organizations, including the School's Center for Public Health Practice. The business office which she directs manages multiple contracts and grants from over 100 funding sources with a range of partners and providers like the North Carolina Division of Public Health, the Centers for Disease Control and Prevention, Robert Wood Johnson Foundation, and the Health Resources and Services Administration. The NCIPH business office is the central point of contact with a wide range of practice partners across North Carolina, including local health departments and North Carolina foundations (such as the Duke Endowment), with which the Institute does business.

In addition to an extraordinary range of technical skills, Judy is the consummate "people person". She has seen her job as consistently helping others do their jobs. Her exceptional commitment to service is unparalled, and her "can do" attitude is totally refreshing and inspiring. Not only does she do her job exceptionally well, she inspires all who work with her to do so as well.

We will all miss Judy greatly and I can say with complete confidence that it won't be the same without her. We wish her all the best and thank her from the bottom of our hearts for all she has done and for setting such an inspiring example for all of us to follow.

Edward L. Baker, MD, MPH
Director, North Carolina Institute for Public Health
Professor, Health Policy and Epidemiology
UNC Gillings School of Global Public Health

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Pfaender retires from the Institute

Sheila Pfaender, assistant director for program and resource development, retired from the Institute in April of this year.

Pfaender, a native of Minnesota, worked first for the SPH's Center for Public Health Practice, which later became the NC Institute for Public Health. She wore many hats over the course of her career at the SPH, but one had the broad brim to oversee grant proposal development within NCIPH and with partners such as local health departments and public health incubators. She estimates that she wrote or directed proposals resulting in over $20 million in awards during her twelve years with the university.

Pfaender wore her research associate hat when she led community assessments and other research projects. With assistance from a number of current and former SPH students, she developed community health, environmental, and mental health service assessments for 25 NC counties.

Rachel Stevens, NCIPH's first deputy director, said, "With degrees in biology and ecology and evolutionary biology, I thought here was an evidence-based scientist who would complement the Institute's big picture mission, and she did."

In retirement, Pfaender, who is married to SPH Environmental Sciences and Engineering Professor Fred Pfaender, plans to enjoy her Roaring Gap, NC, mountain retreat and its golf course, visits with her family (especially grandson Alexander), and keeping her hand in public health practice via consulting projects.

High tech options to impact public health

In North Carolina, local public health plays an important role as a healthcare provider to Medicaid recipients and to those who are uninsured. In 2008, local health departments provided care to 395,000 uninsured North Carolinians.

The Southern Piedmont Partnership for Public Health, one of six public health incubator collaboratives, is completing the NC Telehealth Network for Public Health (NCTN-PH). NCTN-PH is building the essential network infrastructure that will provide dedicated, high-speed, redundant data transmissions for local public health. Leveraging $6.1 million in Federal Communications Commission funding, the network will enable public health departments to adopt a common EHR and to rapidly and reliably exchange patient information with one another and with other healthcare providers.

In addition, the Southern Piedmont Partnership has, with assistance from the Robert Wood Johnson's Common Grounds funding, developed a comprehensive set of EHR business requirements. The Common Grounds project trained public health clinicians in business process analysis techniques, and then engaged them in a thorough review and redesign of public health clinical workflows. As a result, local public health departments now have a comprehensive set of business requirements that can be mapped against EHR vendor solutions to determine which options will best satisfy their clinical needs.

Finally, the Partnership has initiated work on the Southern Piedmont Health Information Exchange (SoPHIE.) SoPHIE will enable local health departments and other healthcare providers to exchange digital patient information. SoPHIE use cases and a technical architecture have been developed, and an RFI is being drafted currently to establish vendor interest and preliminarily evaluate vendors' capacity.

To quickly and effectively respond to the rapidly changing health information technology landscape, specifically to emerging HITECH funding opportunities, the Division of Public Health (DPH) and the North Carolina Association of Local Health Directors have established the Public Health Information Technology Steering Committee (PHITSC). Composed of representatives from both organizations and staffed by the Institute and DPH Information Technology Services, PHITSC engages in a number of activities to allow local public health to leverage the HITECH funds. Most importantly, PHITSC has developed proposal submissions to secure support for training and technical assistance for EHR adoption, to evaluate and select an Health Information Exchange vendor and develop SoPHIE, to automate key communicable disease case reporting functions, to develop EHR interfaces with NC-CATCH (a community assessment data warehouse), and to select and fund an EHR for local public health.

The Institute's John Graham, who is working with these projects, says, "A great deal of work has yet to be done, but for now, North Carolina public health is a leader in this new and dynamic arena."

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Network delves into practice-based research

The North Carolina Public Health Practice-Based Research Network (NC PBRN) is designed to stimulate and support new research based on the work of nine local health departments of the Central North Carolina Partnership for Public Health, part of a state incubator initiative that fosters regional collaboration. The network allows the health departments and their research partners to study the implementation and impact of practice innovations designed through the incubator initiative.

 The network is administered through the NC Institute for Public Health and includes collaboration with the NC Division of Public Health and with research partners at the UNC Center for Health Promotion and Disease Prevention. The project director and principal investigator is the Institute's Dr. Ed Baker; the co-PI is Rosemary Summers, DrPH, MPH, of the Orange County Health Department.

Utilizing a model developed by several of the local health department partners, NC PBRN is researching public health infrastructure improvement via workforce development. Focus groups were conducted with local public health staff supervisors to voice key issues and questions to identify strategies for improving the organization, financing and delivering public health services in real-world community settings, and bridging the gap in communication and collaboration between practice and academia.

Using NC Quick Strike funds and led by Jen Horney, PhD, with the NC Center for Public Heath Preparedness, NC PBRN conducted a community-based rapid needs assessment of seasonal and novel influenza vaccines. Based on 207 interviews in Orange and Alamance Counties, the study found that knowledge of and intention to receive both novel and seasonal vaccines was high. The findings were used by the NC Division of Public Health in the design of the H1N1 immunization program. Read the results in the CDC's Morbidity and Mortality Weekly Report.

The NC PBRN is also evaluating the effects of a recent change in state policy that reduces Medicaid funding for maternity outreach and postpartum services to low-income women and their children. A research team composed of faculty at the Gillings School of Global Public Health and staff at the Institute are working with the NC PBRN and other local and state public health leaders to determine how the cuts affect service provision, as well as outcomes and local health department core capacity in other service areas. Once secondary data has been analyzed, the research team will create and administer a survey to be administered to health directors this summer. The survey will assess the extent to which the LHD has been affected by the reimbursement cuts. For more information, please contact Principal Investigator Rebecca Wells at rwsells@email.unc.edu.

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NC public health social workers gather for leadership forum

On March 19 and 20 in Burlington, NC, approximately 25 public health social workers, academic partners and sponsors from across the state came together to develop a response to extensive funding cuts to public health social work services and other programs over the past several years. As a first step, they decided to create an opportunity for current and future leaders to convene and strategize ways to build capacity for change.

Participants examined the current scope of public health social work practice in North Carolina and how it may transform communities and improve health in the future. They developed personal and collective leadership skills through facilitated discussions and working sessions with colleagues. The group also identified ways to advance the profession of public health social work and increase the visibility of the role public health social workers play in addressing critical challenges facing the state and nation.

As an initial step, participants plan to identify roles for public health social workers in each of the recommendations from the NC Institute of Medicine’s Prevention Action Plan. Three priority areas for action will be selected for further development and implementation. In addition, they will continue to develop their leadership and advocacy roles through networking, mentoring, and individual coaching.

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Improving investments in community health

At a statewide public health and hospital collaborative meeting in Chapel Hill in March, 32 stakeholders, including local public health directors, hospital CEOs, the NC State Health Director, academic partners, representatives from the NC Hospital Association, and leaders from nonprofit organizations and funding agencies met to inform and engage leaders in the examination of collaborative strategies to enhance community health through strategic alignment of community benefit resources.

The NC Institute for Public Health, in collaboration with the NC Division of Public Health, the NC Hospital Association, and the NC Association of Local Health Directors, conducted the meeting. It was supported with funding from Dennis and Joan Gillings, the Centers for Disease Control and Prevention, and the National Network of Public Health Institutes.

The meeting successfully engaged leaders in sharing strategies and lessons learned from state and national community research and practice designed to invest in community-based prevention. Participants agreed to pursue specific action to build on accomplishments from existing public health and hospital collaborations.

The proceedings from the meeting were presented to the NC Public Health and Hospital Collaborative Steering Committee in April. The committee agreed to convene regional public health/hospital meetings over the next six months to further explore ways to implement the recommendations from the meeting.

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An early look at Healthy North Carolina 2020

While the specific objectives will not be officially released until later this year, the Healthy North Carolina 2020 Steering Committee has been reaching out to involve local health departments, community leaders, health organizations, and public health experts to create a ten-year action campaign for "A better state of health".

Healthy NC 2020 will focus on tobacco use, nutrition and physical activity, STDs/unintended pregnancy, substance abuse, environmental risks, injury, infectious disease/foodborne illness, mental health, oral health, maternal and infant health, social determinants of health, and chronic disease prevention. Each of these areas will have measurable goals.

In addition, Healthy NC 2020 will include tips, tools, and resources for various groups, such as employers, legislators, schools, individuals, insurers, health care providers, communities and hospitals to help implement the plan.

The NC Institute of Medicine is leading the project at the request of the Governor's Task Force for Healthy Carolinians. The NC Division of Public Health and Healthy Carolinians are actively involved. The Institute's Dorothy Cilenti is on the steering committee.

Healthy NC 2020 is posting meeting summaries on their website and your feedback is welcomed.
 
To be a success and advance the state up from its current health ranking of 37, Healthy NC 2020 will need broad awareness and participation across the state. If you would like to have someone speak about this program to a group in your county, contact Laura Edwards, NC DPH prevention specialist and campaign committee chair, at laura.edwards@dhhs.nc.gov.

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Public Health Business Planning on the road

Five county-based teams in Florida started revenue-generating public health business plans this month, with help from the Institute. St. Lucie, Orange, Seminole, Brevard, and Osceola counties will develop their business plans based on public health needs from their community health assessment work, using the template from Public Health Business Planning: A Practical Guide. Co-authors Steve Orton from NCIPH and Pamela Santos from Kenan Institute (Kenan-Flagler Business School) spent a full day getting the teams started. Each team will develop a feasibility plan and then a full business plan over the next three months. The 75 participants included health directors and program directors from public health departments and a wide range of community partners from the non-profit sector, healthcare, academics, and foundations. The effort is supported by the Florida Department of Health.

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No square peg in a round hole: NCIPH offers customized training workshops and courses

While the Institute offers dozens of courses--face-to-face, video, and online--many of our partners have specific training needs that might not match our catalog. Using curricula designed by our continuing education specialists, the Institute can customize workshops and courses for health partners, both for-profit and non-profits.

An example is the Leadership Novant program. Working with NCIPH, the senior leadership of Novant Health, a not-for-profit, integrated healthcare system that serves primarily Virginia and the Carolinas, has developed an innovative nine-month leadership development program for their high tier directors. Leadership Novant addresses the challenge of developing leaders with a global view of the organization that can help Novant meet the demands of an increasingly complex health care industry. It focuses on the future success of the healthcare system in achieving superior outcomes in quality, physician satisfaction, customer satisfaction, employee satisfaction, and financial viability.

The goals of the program are long term individual development and application of skills and concepts, and long term organizational development and culture change.

For more information about customized courses for your organization, contact Dr. Stephen Orton at stephen_orton@unc.edu.

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