By Beth Blevins
Teaching rural providers to be better advocates for their patients and their communities was the goal of an innovative program conducted recently by the Colorado Rural Health Center (CRHC) in partnership with the Center for Creative Leadership (CCL).
“Through the Rural Colorado Primary Care Leaders (RCPCL) program, we worked to educate 48 rural primary care providers on how to create grassroots advocacy efforts in their community,” said Michelle Mills, CEO of CRHC. “The ultimate goal of the program was to create a peer network of rural providers in the state.”
“CCL approached us after they received a grant from the Colorado Health Foundation (CHF),” said Sara Leahy, CRHC Director of Business Development. “Some of CCL’s staff members had worked with another State Office of Rural Health, and one of CCL’s headquarters is in Colorado Springs,” Leahy explained. “With this program, their goal was to work with primary care providers—MDs, DOs, advanced practice nurses, physician assistants, dentists, and dental hygienists—who practice in rural areas of Colorado.”
The CHF grant covered the $10,000 tuition for each participant, as well as travel expenses, lodging, and meals, Leahy said.
CRHC helped find the program participants. “We started off with targeted marketing to clinics and practices that were engaged with CRHC, then expanded our marketing to a broader outreach to all our membership,” Leahy said.
The participants met in three different learning sessions over the course of a year, Leahy said. “Each session was divided into two cohorts, so that two providers from the same practice could participate.”
The first session, held July 2018, focused on participants’ communication styles, teaching them practice tools like giving and receiving feedback, Leahy said. The second session, held November 2018, worked to improve their ability to lead others and to work collaboratively, she said. The third session, which took place over two days in March, helped the providers develop policies to lead their community, she said.
At that last session, Kelly Erb, CRHC Policy Analyst, spoke about public policy in Colorado. “We discussed the budget and the big bills that are currently moving through the legislature,” Erb said. “Then we discussed how providers can actually participate—whether through developing grassroots activities, writing letters to the editor, hosting community meetings, or testifying at the capital. We explored all the opportunities they have to interact with the political system both locally and on a state level.”
By the third session, participants also had completed a Capstone project, Leahy said. “The aim of the Capstone project was for them to make an impact on policy that affected their own local town and community—something that would affect not just themselves, not just their practice, but everyone that they touched base with.” Each participant had a coach who worked with him or her a few times a month on those projects, Leahy said.
On the second day of the third session, participants were able to put their Capstone projects—and all they had learned in the RCPCL program—into action. “We brought all the providers to the state capital, where we set up meetings with their local representatives and with the state health committee,” Mills said. “It really gave them an opportunity to use those leadership skills they had learned in the program.”
In addition, Leahy said, the group was split into house districts, and within those small groups they brought forward three to five talking points to discuss with their policymakers. “They did a great job of planning who would talk, and making sure they went in there with ideas and objectives,” Leahy said. The topics they discussed that day included increasing access to quality broadband in rural areas, support of more equitable and adequate payment to rural facilities from Medicaid, and integrated care barriers with telehealth, Leahy said.
“Ultimately we prepped them to say, ‘this is the beginning of a relationship, and we’re going to be resources for one another,’” Leahy said. One provider was so comfortable with the visit that he ended up taking his state senator out to lunch, Leahy added.
Though the RCPCL sessions are over, Leahy said the effects of the program will continue. “That last day, even though the program had wrapped up, folks talked about how they can continue to work collaboratively with one another,” she said. “They want to stay engaged.”
“The providers have created a relationship with their local policymakers and are now empowered to use that relationship in advocating for issues important to them,” Leahy continued. They also can use those skills locally, with their own colleagues, she said, “in activities like building short-term and long-term strategic plans for their clinics.”
“This program was super helpful in engaging the providers, and I think that it will trickle down to the community level, giving them more of a presence within their communities,” Mills concluded.
Does your SORH have a “Promising Practice”? We’re interested in the innovative, effective and valuable work that SORHs are doing. Contact Ashley Muninger to set up a short email or phone interview in which you can tell your story.
Michelle brings substantial experience and working knowledge of rural health issues and has worked closely with rural communities and providers to make a positive impact on rural health delivery. Michelle is responsible for building relationships that the Center has established with other organizations, funders, and rural healthcare leaders and is dedicated to collaboration.
How do you promote creativity in your office? We do several things. First we do lots of brainstorming and tons of ideas come from that. Secondly, we set the vision for our office and of course we have work plans and timelines to adhere to, but we really let people do their job and not dictate how each step is done and this helps encourage creative approaches.
How do your recognize the accomplishments of your team?
We have a brag board in our kitchen for both personal and work recognition. We also have each area of our focus as a part of thermometer for people to visualize and we color in where we are to goal. We like to keep an open and transparent environment showing where we are and what are we working on to create a healthy competition and camaraderie.
What is a fun thing you do to promote leadership within your team?
We host a book club once a quarter with the leadership team and emerging leaders in our office that pertains to work or an area of growth. We incorporate aspects of the learning into our work, which helps creativity flow, builds skill sets and creates future leaders.
NOSORH’s Educational Exchange Program offers support for SORH staff to meet with another SORH to develop or enhance their expertise or knowledge, leadership skills, adopt a promising practice, or improve effectiveness of program management, strategy planning and implementation. This is an excellent opportunity for SORHs to learn from each other and enhance their ability to better serve their rural constituents.
In continuation of the Educational Exchange that happened in the Fall of 2014 between the 3 non-profit SORHs (MI, SC, and CO), Sherri Cox visited the Colorado Rural Health Center to learn new communications and marketing skills. She learned how to produce story telling marketing videos, improve social medial skills, event planning tips, and how to develop a communications plan. She also learned some integrated marketing best practices, how to utilize data and produce infographics, email marketing campaign tips and website design. They discussed SCORH’s future goals and how to practically apply all of the educational resources learned over the two day period.
Sherri feels the trip was very beneficial and says, “The staff at the Colorado Rural Health Research Center went to great lengths to make sure I made the most of my trip and their mentorship was invaluable to me. I am extremely grateful to NOSORH for letting me have this opportunity to visit with them and am already applying many of these new skills here at the SC Office of Rural Health.
Do you want to learn more about an activity another SORH is working on? Are you interested in the NOSORH Educational Exchange program? Travel scholarships may be used by NOSORH members to visit another SORH in order to:
Click here to access the application.
Back to Branch
Americans are watching increasing numbers of videos online. According to comScore, this number has jumped over 43% to 100 million daily views (that’s roughly one-third of the U.S. population watching a video online each day). Many companies are using videos in a variety of ways to reach broader audiences in more impactful ways.
The CO SORH has embraced this technology and uses video and digital media in a number of ways to reach constituents. The CO SORH website hosts a number of examples of digital media including infographics, legislator packets, and videos. Videos range from National Rural Health Day promotion to their Annual Report. This was the first year the CO SORH decided to transform the paper annual report into a video report, and it has reinvigorated it in the process.
This 7-minute long video goes through the programs and numbers provided by the CO SORH. It has all the same information provided in a paper report; however, the updated format has been extremely well received. Michelle Mills, CEO of the Colorado Rural Health Center, explains, “We recognize that the world is changing and people don’t have the time to read tons and tons of information anymore. Video is a new way to get your message out.” Michelle continues, “The board loved it and it helped create an open dialogue to new ideas. We also received many tweets and comments about our report on social media. Some have called this our best annual report ever.”
The CO SORH is also using this video and others as a marketing tool to raise awareness about what they are doing at the SORH. Several times throughout the year they create a video to recognize a hospital or clinic in a monthly Member Update publication. The same is true for their weekly listserv updates highlighting a new issue or topic for their constituents to pay close attention to. They even offer a service to create videos for members and organizations.
The idea to use videos to transform the SORH communication strategy came from a brainstorming session that are used often to create new ideas and promote creativity throughout the office. While brainstorming for the annual report, they questioned if a paper report was boring and if anyone actually reads it. They wondered what they could do to get people’s attention and acknowledged that everyone watches YouTube videos. The CO SORH has embraced this idea fully.
Putting together an annual report is always a challenging task. You need to capture all of the required elements, yet you want to make it appealing to your board, members and constituents. How do you make it innovative and eye-catching each year? If you need a little inspiration, look to the Colorado SORH’s innovative use of video and digital media to depict their accomplishments and get their message out.
Back to March Branch
The Colorado Rural Health Center (CRHC) is helping rural health clinics (RHCs) in the state improve business operations and move into quality improvement activities with their Healthy Clinic Assessment (HCA) program.”
With HCA, we go in and do a basic assessment of operations of the clinic,” said Michelle Mills, CRHC CEO. “Then we put together an action plan on where they need to make improvements, and what they are doing well. This strengthens the foundation of the clinic and allows them to focus on bigger, greater things like quality improvement, collecting data in disease registries, or focus on gaining patient-centered medical home (PCMH) status and other care transitions. We’re trying to create synergy for all the things we do for folks. It’s exciting.”
Three CRHC staffers are assigned to work specifically with the clinics. The HCA is a four-to-six hour process that is done on-site. CRHC staffers interview all clinic staff and providers, and then present a de-briefing at the end of the workday about what they have heard and seen. Mills said that CRHC staffers later return to the clinic, going over their findings and helping them put together an action plan.
“So far we’ve done 80 HCAs over the last four years,” Mills said. “We have a little over 50 federally-certified RHCs and over 50 rural clinics in Colorado—so we still have a ways to go. It’s a voluntary process—clinics don’t have to take part. And they don’t have to do anything with the data we provide them. It’s a free service, an initial touch to help them move forward. But our hope is that they will want to move forward—for the betterment of the clinic and the community itself.” Mills said that the HCA supports the goals of the Affordable Care Act because it focuses on making sure that rural communities there are prepared to move toward the Triple Aim (increased access, improved quality and reduction in cost).
Clinics that want to can go on to the next step, CRHC’s iCare (Improving Communications and Readmissions) project, which has the goal of reducing readmissions. Right now, Colorado hospitals and clinics enrolled in iCare are concentrating on collecting data and putting systems and processes in place to improve quality.
“Of those we’ve helped make improvements with HCA, 15 are participating in iCare,” Mills said. “And two in our state have achieved PCMH status. We hope that all clinics sometime in the future will move toward PCMH, but it’s a long road and takes a huge amount of commitment. But while they’re doing this, we’re also helping all the clinics and hospitals achieve Meaningful Use Stage 1 status.”
John Gardner, CEO of Yuma District Hospital and Clinics, said that the HCA helped his organization make big improvements in the last four years. “CRHC approached me asking if we would be interested in participating in the Safety Net PCMH project funded by the Commonwealth Foundation,” Gardner said. “Honestly, I really did not have much knowledge of the PCMH movement and determined that it was worth exploring. After much work, and significant changes in our organizational culture, we were certified as an NCQA Level 2 Medical Home. This has been a great opportunity for our two clinics. I am thankful that CRHC invited us to participate in the project.”
Mills will be presenting information on the HCA program at an Institute for Healthcare Improvement conference on improving patient care in March.