UA to Offer MPH in Health Services Administration

October 31st, 2013 by Will Humble No comments »

To help meet the growing demand for health care administrators the Mel and Enid Zuckerman College of Public Health at the U of A (in Phoenix) will begin offering a new accredited Master of Public Health in Health Services Administration program in fall 2014.

The health services administration program will provide students with the knowledge of how health care services function and the business and leadership skills needed to manage them effectively in health care services organizations. The curriculum is comprised of both public health and health administration courses.  Courses will be offered through a hybrid of online and classroom teaching at both the Phoenix and Tucson campuses.  The “Priority” application date is January 3, 2014 with a Secondary application deadline of March 1.  


Trauma System Part 3

October 30th, 2013 by Will Humble No comments »

A couple of weeks ago I wrote about the basics of evaluating a trauma system and last week I posted about over &  under triage.  This week is about a tool we use to measure whether we’re striking the right balance- the “Z Statistic”.

Back in 1990, there was a famous study published (Major Trauma Outcomes Study) that reviewed thousands and thousands of trauma patient records to develop a statistical formula to benchmark the risk of dying from blunt (crushing or fractures) or penetrating injuries (gun shots, or cuts).  That formula has been updated and today serves as the basis for the Z Statistic evaluation that we use to look at how many folks are/are not surviving based on their particular set of injuries.  We look at our survival rates compared to that statistical formula and we provide that information to each of the level I trauma centers so that they can look at their results against the (blinded) aggregate information for the other hospitals. 

When we wrote our trauma rules a number of years back we did a good job of making sure that the trauma hospitals had to have performance improvement teams in place including what are called morbidity and mortality reviews to look at key cases that can serve as an opportunity for learning and improving care.  Next week I’ll share the results for these Tools (Over & Under Triage, Z Statistic) plus a few others that we’re regularly tracking and provide an overview of how we use the data to move our system forward.

Another Reason to Get a Flu Shot

October 30th, 2013 by Will Humble No comments »


Investigators of a new study published this week in the Journal of the American Medical Association discovered another reason that some people may benefit from getting the flu shot.  The study found that getting an annual flu vaccine puts the person at lower risk of having a heart attack, stroke, heart failure, or death from a heart-related event. The study used a meta-analysis- which means it used statistical methods to compile data across multiple studies in order to draw a conclusion based on a larger pool of data.  The authors reviewed 6 randomized control trials with a total of 6,735 participants to determine whether there was an association between flu vaccine and cardiovascular events.

They found that the folks who got an influenza vaccine were about 50% less likely to develop a bad cardiovascular event within one year of getting a flu shot compared with patients who were treated with a placebo or control. They also found that influenza vaccination reduced the risk of cardiovascular events even more for patients with recent acute coronary syndrome (like a heart attack). 

There are multiple theories about why flu vaccination can reduce the risk of cardiac events. Basically, when you get sick from the flu, you have a harder time breathing, your blood pressure can drop, and you can get secondary infections like pneumonia. All of these things make your heart work harder, which can cause a cardiac event-especially if you’ve recently had a heart attack. Bottom line… get the flu shot. It could protect you from more than just the flu.

Ambulance Service Enhanced Surveillance

October 29th, 2013 by Will Humble 1 comment »


This past summer I blogged about Rural Metro failing to meet a bond payment and having some issues with an ambulance service contract in California. They subsequently filed for bankruptcy and are in the process of negotiating with their creditors.  This is important- because they’re a big provider of 9-1-1 and hospital to hospital ambulance service in Arizona and we’re in charge of approving ambulance services operations in Arizona.  You can read more about it in these two blogs (August 5 and September 9).

We’re also concerned because Rural Metro wasn’t meeting their response times in 5 different service areas in AZ (called CONs) over the summer…  so we opened up an investigation.  Late last week they responded to our investigation by sending us response reports and the raw data.  Our investigation will likely take a while, so we also asked them to provide us with month by month response time data for each of the CONs.  We received that information this week and are looking at it right now. 

While we can’t draw definitive conclusions from a couple month’s response time data, it does appear that that their response times have marginally improved.  We’ll continue to actively monitor their performance during the bankruptcy process.  By being proactive, we’ll be able to identify early signs of performance slippage and intervene before the system is at risk

New Vaccine Exemption Form Being Used this Year

October 28th, 2013 by Will Humble 2 comments »

Arizona law requires kids to receive certain vaccines in order to attend school unless a doctor signs a medical exemption form or a parent signs a religious or personal beliefs exemption form.  There has been an increasing number of parents who are signing exemption forms- putting herd immunity at risk in some parts of the state.  We updated the vaccine exemption forms this school year in order to make sure parents are aware of the importance and of vaccinating their kids and the consequences if they don’t.

The new form asks parents to initial and date after each exempted vaccine to indicate that they’ve been informed of the risks of the vaccine-preventable disease.  The form also makes it clear that if there’s an outbreak of a vaccine-preventable disease in a school and their child isn’t vaccinated, he or she may not be allowed to attend school for up to 3 weeks or until the risk period ends.

Maricopa County RBHA Update

October 25th, 2013 by Will Humble No comments »

The formal protest process regarding our award of the Regional Behavioral Health Authority contract in Maricopa County is finally winding down.  The oral part of the hearing in front of the Administrative Law Judge was completed a couple of weeks ago.  The final legal filings are due next week and the responses to those filings are due October 29.  At that point, the judge will have everything. After 10/29 the hearing will be completely in the hands of the judge and she’ll determine what her recommendation will be to the AZ Department of Administration.  

We expect the recommendation to go to the ADOA sometime in November, but that remains at the discretion of the judge based on all the filings that are received.  Once the recommendation from the judge is issued, the ADOA will examine the result (and the evidence) and make a determination about whether the procurement decision stands or not.


New Public Health Blog

October 25th, 2013 by Will Humble No comments »

Our new Public Health Blog is now live!  The goal of the blog is for our Prevention Services to promote our work with the public and with our partners through better use of social media.  We’ll also be adding some new features, such as an interactive info-graphic tool and video clips highlighting selected blog posts.  Now it’s up to us to make it work!  If you did not get a chance to attend one of the training sessions, you can download the presentations on the Sharepoint site or on the Marketing and Communications Co-Op Intranet Site.  Special thanks to Sharon Sass, Dyanne Herrera, Ben Palmer, Michael Abbott, Chris Minnick and the Web and New Media Team for their work in developing and launching the blog.


Infection Prevention Week

October 24th, 2013 by Will Humble No comments »

This week is International Infection Prevention Week (IIPW), which started in 1986 under a proclamation from President Reagan. For the 4th year in a row, October 20-26, 2013 is Arizona Infection Prevention Week. Since it started, the week has been used to spread awareness about interventions that promote safe healthcare practices and prevention of healthcare-associated infections (HAI). Arizona public health and healthcare professionals have been battling HAIs, in partnership with the CDC, through many activities to prevent healthcare-associated infections. HAIs are also one of our agency’s winnable battles. This week is a great opportunity to celebrate the hard work of the people who work every day to help control infections and to educate the community and healthcare professionals on infection prevention. 

In the past five years or so, ADHS has addressed infection prevention through the formation of the HAI program, Advisory Committee, and subcommittees. These committees have spearheaded interventions to battle HAIs with things like the Interfacility Infection Prevention Transfer Tool, Clostridium difficile Toolkit, and educational pamphlets on things like MRSA, C. diff, and VRE.  Check out to get more information about past IIPW events in Arizona or to get involved.

Sitting is the new smoking

October 23rd, 2013 by Will Humble No comments »

Public health embarked on a smoking revolution over the last few decades, kicking it into high gear to provide programs and policies to help Arizonans change their smoking habits. While by no means has the tobacco battle been won, America is currently undergoing another revolution—a walking revolution. Physical activity is not new territory in public health. Public health professionals have been encouraging adults to achieve at least 150 minutes of moderate or vigorous physical activity per week.  Now, though, the public health world is taking a step back and promoting the simplest of physical activities: walking or biking. A recent study from Kansas State University looked at the association between sitting time and chronic diseases. The study found that people who sat for more than four hours per day were significantly more likely to report having a chronic disease such as cancer, diabetes, heart disease and high blood pressure. 

The Surgeon General has started the “Everybody Walk” campaign, releasing a document entitled “A Walking Revolution: The moving making Americans Happier and Healthier,” developing a free App that tracks all aspects of your walk, and hinting at writing a call to action on walking. This call-to-action is being compared to the famous 1964 Surgeon General’s Report on the dangers of smoking, translating that message into the dangers of sitting. 

Here at ADHS we take an innovative approach to promote more walking and less sedentary behavior. Our focus is to create environments where the healthy choice, walking, is the easy choice. Our Empower program establishes policies in child care centers that decrease sedentary time and screen time, and increases physical activity of youngsters. The Arizona Nutrition Network has been infusing traditional nutrition education with physical activity. Community design initiatives have worked to establish environments where walking or riding a bike are the predominant means of transportation in a community, rather than driving a car. With walking being so simple, the question remains: how will you walk or bike today?


Guide to Community Prevention Services

October 22nd, 2013 by Will Humble 1 comment »

Every so often- you run into a resource guide that stands above the rest.  I discovered one of those awhile back called the Guide to Community Preventive Services – and it’s a free resource to help you choose programs and policies to improve health and prevent disease in communities.  The easy-to-read resource guide answers questions like: 1) Which program and policy interventions have been proven effective; 2) Are there effective interventions that are right for my community; and 3) What might effective interventions cost and what’s the return on investment?  

There are modules on different public health topics- and the evidence-based information is printed in colorful, easy-to-read formats.  Subjects include much of our core strategic plan activities in health and wellness including: Adolescent Health; Alcohol; Asthma; Birth Defects; Cancer; Cardiovascular Disease; Diabetes; Emergency Preparedness; Health Communication; Health Equity; HIV/AIDS,STD’s, Pregnancy; Mental Health; Motor Vehicle Injury; Nutrition; Obesity; Oral Health; Physical Activity; Social Environment; Tobacco Use; Vaccines; Violence; and Worksites.  Learn more about The Community Guide, collaborators involved in its development and dissemination, and methods used to conduct the systematic reviews.