The King County Asthma Forum (KCAF)

1. The King County Asthma Forum (KCAF) Kimberly Wicklund, MPH Coalition Coordinator/AAA Project Manager Phone: (206) 296-4570 kimberly.wicklund@metrokc.gov

2. King County Asthma Forum • Mission- To bring together individuals and organizations to establish an ongoing asthma network to communicate about, collaborate on, and coordinate projects that improve and support asthma prevention, diagnosis, and management in King County.” • Convened in May 1998 • Target population- anyone in KC concerned with asthma • Membership- 60 active members/150 in network who represent clinics and hospitals, public health, research, community-based organizations, caregivers of children with asthma, schools, health plans, and others.

3. KCAF Coalition Structure

4. KCAF Projects Endorsed- coordinate and affiliate with the KCAF, but are autonomous Sponsored- projects of the KCAF that receive its oversight • Allies Against Asthma (RWJ) • Better Homes for Asthma (HUD) • Healthy Homes II- (NIEHS) • ACT- Asthma Care Training (CDC)

5. Service Integration The KCAF is attempting to develop a seamless system of care for children with asthma by integrating systems and services in the community. An integrated system will provide: • A coordinated, comprehensive “menu of options” that ensures that children with asthma and their families are linked with the services that best fit their needs. • Expanded reach of services by building on other programs’ work. • Consistent and accurate messages to patients and providers about asthma and services available in the community. • Coordinated communication so that programs can accurately promote each other’s work, and avoid turf issues, “tripping over each other”, and duplicating efforts.

6. Service IntegrationStrengths of the coalition approach • Multidisciplinary group provides broad expertise for developing strategic, creative approaches to integrate services • Collective knowledge contributes to decisions and intervention designs that are well informed • Establishes a common vision and culture of collaboration to work together to achieve a common goal • Brings people out of silos and one dimensional thinking, and enhances their ability to create linkages between programs • Provides a transparent forum to work out turf issues • Involvement of community partners opens doors and lends credibility to the work

7. Service IntegrationChallenges of coalition approach • High level of cooperation needed in communication, coordination and planning • Requires time, patience and commitment • Consistent participation can be difficult because people have other primary responsibilities. • External constraints (IRB, funding) can complicate service integration • Partners must make sacrifices, and balance compromise and cooperation with their own agendas and timelines • Modification of procedures and tools may be needed for integration with other services • Requires expertise in programs in addition to your own

8. Service IntegrationStrategies implemented by KCAF • Cross Project Coordination Group Ad-hoc committee that meets regularly to work out issues of integration and coordination, such as recruitment, referrals, and project details. • Standing Committees Serve as feedback loops to inform the KCAF of gaps in services as they relate to their particular areas of expertise. • Building trusting relationships with diverse partners opens doors to organizations and brings credibility

9. Service IntegrationStrategies implemented by KCAF • Make an effort to fit programs together: (AAA) • Ensure staff are trained in service integration and know other programs well • Screening tools and project protocols incorporate referrals to other services and programs • Community Health Workers serve as the hub of the service integration wheel

10. Standardization A priority of the KCAF has been the standardization of educational messages, care guidelines, and asthma management tools. This work toward standardization has been in an effort to: • promote accurate, consistent educational messages about asthma, • maximize impact of services, • use existing resources to avoid reinventing the wheel, and • promote best practices

11. Standardization of messages, tools & guidelinesStrengths of the coalition approach • Multidisciplinary input makes them higher quality and more appropriate for broader audiences • Involving multiple stakeholders creates buy-in and contributes to adoption and dissemination • Coalition endorsement gives credibility • Provides greater reach when promoting their use • Strengthens the development of a common vision

12. StandardizationChallenges of coalition approach • People or others in their organization have a vested interest in their own way of doing things- resistance to change • Credit must be shared by all who contributed to their development • Organizations/agencies may want ownership • Sacrifices must be made to adopt the standardized approaches • Time needed to adopt them and achieve consensus (process oriented)

13. StandardizationStrategies implemented by KCAF • Development of key asthma messages used in: • CHW educational protocols for HHII and AAA • Puget Sound ESD’s peer educator program • Seattle Public School’s Health Services • Child immunization and developmental education registry • Development of common asthma action plan for use by families, schools, clinics, childcare providers, etc. • Clinic Learning Collaboratives to standardize care • Standardized instruments, protocols and educational materials are utilized by projects when appropriate

14. Conclusion • Coalitions provide an indispensable framework for integrating services and standardizing approaches. • Can service integration and standardization be accomplished without a coalition? • Coalitions provide accountability for adhering to an integrated model.