In Practice: Schaffer Helps "Work Out" An Important Social Issue

In Practice: Schaffer Helps "Work Out" An Important Social Issue

High infant mortality rates, a grave issue facing many cities today, continue to present a host of complex challenges for local and state governments given the ever-changing face of the population and demands on an already overwhelmed system. Several months ago, the Onondaga County Health Department (OCHD) and Syracuse Healthy Start (SHS) contracted Schaffer Consulting to help them tackle issues related to high infant mortality rates and other associated contributors of poor perinatal outcomes. Working closely with OCHD to design and implement a WorkOut – a process that brings together a large group of people to pursue an urgent and challenging business goal – focused on achieving measurable results in just 100 days, Schaffer Consulting provided the organization with a springboard for developing local capacity to drive significant improvements over time.

Onondaga County Health Department: How to Improve Maternal Child Health in Just 100 Days

Since the 1980s, Onondaga County (located in Syracuse, NY) had been plagued by one of the highest infant mortality rates for a similar sized county in the country. Since then, the County Health Department has made a number of significant improvements while implementing a broad array of services to better support enhanced maternal and infant health, but it was still eager to close the disparity between a number of health outcomes for specific populations.

Schaffer Consulting worked with OCHD to design and implement a WorkOut focused on achieving measurable results in just 100 days to provide a springboard for developing local capacity to drive significant improvements over time.

The objectives of the WorkOut included:

  1. Translate the long-term goal of decreasing infant mortality into short-term goals that allowed for OCHD to build momentum, confidence, and competence.
  2. Achieve tangible results in 100 days.
  3. Engage community stakeholders in making successful and sustainable change.


Although infant mortality is tracked on a three-year rolling basis, OCHD and SHS were able to make significant progress in several areas in just 100 days. The group was segmented into four teams focused on making progress on different dimensions of the infant mortality challenge. The 100-day goals that each team set and the results they were able to achieve are below.

Team 1:

  • Increase prenatal referrals for home visitation and related services by 50% (from 33 to 50) during the month of July. Baseline: 33/month
  • Result: 57 prenatal referrals were received in the month of July, a 73% increase.
  • Achieve 100% of appropriate referrals from Child Protective Services (CPS) for pregnant women and families with a child under the age of 1, living in Syracuse. Baseline: 1.75/month
  • Result: Healthy Families received 21 referrals from CPS in the month of July. This one month total is equal to the total number of referrals received in all of 2009.

Team 2:

  • Increase successful visits and acceptance of ante partum home visitation services. Increase successful prenatal visits by 40% (from 40% – 56%).
  • Result: Successful home visits increased from 40% to 61.7%.

Team 3:

  • Enhance the OCHD/SHS image and develop culturally appropriate messaging and engagement strategies.
  • Result: Developed a new community-friendly logo; marketing plan; delivered cultural sensitivity training; developed a Facebook page and capability to text clients; added nine new referral sources.

Team 4:

  • Utilizing the NY State Department of Health prenatal care risk screening form at the University Health Care Center, secure 10 referrals in the month of July (baseline 2 per month). Target = all pregnant women.
  • Result: Healthy Families received 33 referrals in the month of July; exceeding the total of 31 referrals received in all 2009.

Despite the complex challenges associated with improving maternal child health issues in economically and racially diverse communities, significantly improved outcomes are possible in 100 days.

OCHD and SHS are now working to institutionalize a number of new behaviors to ensure the sustainability of these results in addition to expanding these results to other parts of the community.

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