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PDA Project Highlight: Case Studies on Tobacco Health Systems Change

Written by Heather Zook

ClearWay MinnesotaSM awarded two-year grants to three health systems in Minnesota between 2014 and 2016. The purpose of these grants was to increase the health systems’ capacity to address tobacco use with patients. Each health system utilized multiple strategies to conduct systems change, and these strategies varied across grantees. Strategies included: utilizing a team-based approach; building system-level support; implementing tobacco screening, treatment, and referral protocols; modifying electronic health record (EHR) systems; training staff; and reporting and monitoring progress.


PDA conducted a process evaluation of the systems change grants. Evaluators held semi-structured, in-person interviews with key staff from each health system at three points in time (baseline, mid-point, and end of project). We also reviewed grantee documentation, including progress reports, meeting notes, and presentations. At the end of the two-year grant cycle, PDA developed a case study for each of the funded health systems (see links at end of post).



Include grantees in developing the final product

When developing a public-facing document for a health system, you will likely need to get final approval from multiple levels within the organization. This takes time, particularly if you include images such as an EHR screenshot or workflow that may be proprietary. It is important to include health system staff (in this case, the grant coordinator) in case study development to ensure that the wording accurately reflects the project activities. Along these lines, it is helpful to establish relationships with health system staff, especially when evaluating grant-funded projects, because staff may leave the organization once the grant ends.

Finalize all text in Word before moving to PowerPoint

This was PDA’s first time using PowerPoint to create case studies, and it was a great learning experience. We were inspired by Nancy Duarte’s Slidedoc, which is a document that falls somewhere in between a PowerPoint presentation and a report written in Word. First, we learned (the hard way) the importance of finalizing all text in a Word document before working in PowerPoint. This is especially key if you have multiple people reviewing and editing the text. Although you can add comments, PowerPoint does not currently have an easy method to track changes; therefore, it is difficult to see what edits other people have made. In addition, most edits to the text impact the formatting and spacing of other objects on the page. Thus, all formatting should be done after the text is finalized.

PowerPoint provides flexibility for designing case studies

On a positive note, we learned that PowerPoint is an excellent platform for designing case studies! It provides a lot of flexibility for adding images, shapes, and colors. PowerPoint makes it easy to add visual variation to each page, which is especially helpful when working with a lot of text. Even something as simple as a background image can draw in the reader and bring life to a text-heavy page.

Working in PowerPoint also encouraged us to focus the content of each page on a couple of key points, creating digestible chunks of information for our client. In Word, it’s easy for a section to bleed onto the next page or span across multiple pages. The format of PowerPoint helped us to focus our message and incorporate a visual to emphasize that point.


Links to case studies:

Hennepin County Medical Center

Mille Lacs Band of Ojibwe

CentraCare Health


Posted in General, Qualitative Methods, Systems Change