News

From the President’s Desk

Arkansas was well represented in October at the annual NAHQ conference in Louisville, Ky.! The national theme,” The Triple Crown of Quality: Communication, Collaboration, and Connection”, emphasizes the importance of developing professional collaborations, expanding your resource library and making connections to strengthen the profession and prepare “… to serve as apt and agile leaders of change,” states Lee Hamilton, NAHQ president. Stephanie Iorio-Minnis, Sandy Grinder and I participated in the leadership session and our AAHQ booth in the exhibit hall received many kudos for the “little rocks” and energy bars distributed. Many of us attended the CPHQ reception and the NAHQ President’s reception. We also tried on hats in true Louisville tradition at the HQF fund-raiser, “Off to the Races,” where we were entertained by a bugler from the Kentucky Derby. Our AAHQ president-elect was honored as the recipient of the Claire Glover Distinguished Member award.
There were many enlightening education offerings on a wide range of quality professional topics of varying complexity – novice through expert! What should quality professionals be focused on? The answer was loud and clear at the NAHQ conference: If you are a quality professional, your key focus must be reducing avoidable adverse events, first and foremost. The closing general session speaker of the conference was Julie Ginn Moretz from UAMS in Little Rock, who shared her story for integrating and engaging patient and family voices to improve health care outcomes.
It is not too early to save the dates of next year’s 39th annual NAHQ conference, to be held in Nashville, Tenn., September 7-10, “Quality in Harmony Across the Continuum.” I hope many of you will plan to be there!

Best regards,
Susan J. Hapner RN, BSN, CPHQ
President, AAHQ

Regional Risk Manager Baptist Health System

ADN launches ‘Tip Clips’ to foster quality, safety and performance improvement

American Data Network has released the first in a new series of videos called “Tip Clips”, developed to provide easily accessible information regarding industry innovations and implementation of best practices proven to enhance quality, combat patient safety issues and improve performance in hospitals. Packed with practical information and applicable processes, these one- to three-minute videos are handy tools for quick reference as well as staff training and refreshing.

View Video Here

The first Tip Clip, made available by ADN via YouTube, explains the 90-Second Post-Fall Patient Assessment, which provides an immediate and clear starting point for nurses when falls occur. The assessment helps guide clinicians to an overall initial impression in determining the cause of the fall, the initial priority for patient care interventions and prevention of repeat falls.

“These assessments typically need to be quick and comprehensive,” said Phyllis Ragland, patient safety program leader at ADN. “The easier it is for us to collect and organize relevant information, the easier it is to communicate with the physician. And that’s key if we’re going to deliver appropriate care and prevent repeat falls.”

ADN will regularly release new Tip Clips. Topics to be covered in future videos include:

● Defining critical information when a medication error occurs
● How to benefit from TeamSTEPPS
● Inter Rater Reliability – What can it do for you?
● What is a patient safety evaluation system (PSES)?
● Risk, quality and safety: Overlaps, collaboration and comprehensive programs
● Understanding and analyzing length of stay and cost opportunity

If you have an idea for a Tip Clip you feel would be helpful for you and your staff, submit your recommendation to: jwalden@americandatanetwork.com.

AAHQ member spotlight: Mandy Palmer

By Susan Hapner, RN, BSN, CPHQ
AAHQ President

If you have ever had an opportunity to visit with Mandy Palmer, RN, CPHQ, you will immediately be drawn to her engaging smile! Mandy has 16 years of experience in nursing, including caring for cardiac, ICU, burn and hospice patients, as well as experience in utilization review and most recently, quality improvement. Mandy has been at the Arkansas Foundation for Medical Care (AFMC) for the last four years as a specialist and manager on the hospital team. She started her health care career as a CNA in a nursing home in her hometown of El Dorado. She is a graduate of University of Arkansas at Little Rock and also benefitted from a six-month ICU fellowship at St. John’s Mercy Hospital in St. Louis, Mo., early in her nursing career. She describes her most memorable patients as being two young burn victims (brothers) whom she cared for over a year and who ultimately recovered and are both “God’s walking miracles.” (We know the loving care of a dedicated nurse went a long way in contributing toward that recovery, too!)

Mandy’s work with AFMC has brought her into contact with QI directors around the state as well as Infection Preventionists, and she says she has a great respect for their dedication to providing the best care to Arkansans as possible. Her work has supported quality and infection prevention professionals with the Inpatient and Outpatient Reporting Programs, Medicaid Inpatient Quality Improvement Program, the Critical Access Hospital quality program, and most recently the health care-acquired infection (HAI) reduction program. Mandy also serves on the Arkansas Department of Health HAI Advisory Board.

Mandy became a Certified Professional in Healthcare Quality (CPHQ) in 2010, and attended her first NAHQ conference this October in Kentucky. She says she loves quality improvement and often finds herself teaching her family about improvement methodology! She joined the AAHQ board last year and is serving on the communication team.

On a personal note, Mandy is married to “a diehard Cardinal fan from St. Louis,” Justin. They have two children, Elizabeth, 14, and Jake, 10. Mandy stays busy keeping up with homework and spending time at the football field. She likes to exercise, read about nutrition/wellness topics and loves the outdoors. Mandy describes herself as “passionate about health!” Family vacations to the beach, tinkering with indoor and outdoor plants, and crafting with her daughter (both are avid Pinterest followers) round out Mandy’s free time. Mandy and her husband also co-teach a Sunday school class of 4-year-olds at their church.

Mandy is always open to suggestions for ways to improve communication among AAHQ members and we hope you will get a chance to meet her soon, if you haven’t already.

Calculating Quality: The Return on Investment for Improvements

Presenter: Sarah Pavekla, MHA, OTR/L, CPHQ

By Susan Hapner, RN, BSN, CPHQ
AAHQ President

Sarah Pavelka, MHA, OTR/L, CPHQ, presented, “Calculating quality: The return on investment for improvements,” at NAHQ, and reminds quality professionals how important it is to make the time to calculate return on investment (ROI) for performance improvement. If you have never made ROI calculations, it may not be as difficult as you think! Sarah reviewed the categories of costs, ways to approach the ROI calculations and quality tools you already have to help present the ROI in a visually memorable manner.

First, do a little homework. Get to know your organization’s cost accountants. Learn what it costs to provide care – per surgery, per special procedure or per each ICU day, for example. What is the cost of square footage? Include the costs to keep that square footage clean, warm/cool, dry. Always bring facts, not hunches. What does it cost the organization in penalties if value-based purchasing targets are not met, or what does a fall with a fracture cost the organization, or a stage 3 pressure ulcer, or a medication error? Yes, learn what it costs to NOT make an improvement. The approach with senior leaders is first and foremost: “This is about safe patient care and doing what is best for the patient”, supplemented with “this is the projection of how much it will cost us to get better at X-Y-Z process,” and “this is how much it will cost to NOT make the improvement.” The key is to use finance as a resource, not an outcome!

The ROI ratio is the dollar value of the benefits of the improvement divided by the money spent for the improvement. Some leading organizations strive for a 5:1 ratio, meaning the benefit is five times the dollars spent on the improvement, when prioritizing which improvement projects to approve. When calculating the dollar value of the benefit of improvement, include applicable items such as saved rental costs for equipment, saved space (the space could be rented or sold), saved costs for supplies/materials, overtime saved and reduced unwanted turnover costs.

Lean process improvements may result in savings in employees’ time, so be sure to calculate the cost of that time savings. For example, if you save 10 minutes on a process that is done three times a day, seven days a week, 52 weeks a year, then based on a $20 per hour salary, the time savings equals $3,640 annual savings, multiplied by the number of staff doing the process. Reducing falls from four falls a year to zero falls a year saved one organization $152,000. Increasing market share from 26 percent to 44 percent resulted in $6.5 million in revenue for one organization. Sarah reminded us that “soft” savings (or qualitative savings) may not hit the bottom line, such as the improvements made to keep employees satisfied and engaged, but reducing unwanted turnover and saving costs to recruit and train another employee can be a huge savings to the organization. Another soft savings example is saving physical space for more value-added activities.

When calculating the costs of the improvement, include money spent on labor, such as the estimated time improvement teams will spend in meetings, workout sessions, implementing and monitoring the new process, etc.; and the cost of materials, supplies and overhead. Use tools such as fishbone diagrams, translating the fishbone diagram items into dollars. Use time studies (before and after implementation) to collect needed data. Always quantify how the time saved is to be used elsewhere for more value-added activities. Use value-stream mapping to map a process, calculate time, identify wastes and move to more value-added steps. Use charts such as histograms before and after, which could show the money being spent because services didn’t meet customer requirements, for example. Last, and most important, show how the improvement is aligned with your organization’s strategic plan.

 

AAHQ welcomes new CPHQ member

By Martha Chamness, MNSc., RN, CPHQ

Arkansas and AAHQ has their second CPHQ mother/daughter team — Chelsea Davidson and her mom Pam Brown are following in Lynnette Jack’s and Mary Kallenbach’s footsteps. An interesting tidbit is that both moms are RNs; the daughters have found their way to health care quality through non-clinical paths.

Chelsea is one of Arkansas’ newest CPHQs. Her bachelor’s of science degree is in public administration with a focus on health care. While attending the University of Central Arkansas, she interned at Conway Regional Medical Center in the quality department; her senior project was redesigning the patient complaint process. She still maintains an interest in this process. After finishing college, she worked in the hospital’s nursing department as an analyst. Chelsea attributes her interest in patient issues and patient safety and quality to her family. Her uncle and sister both had life-long illnesses; she spent lots of time in and around hospitals and has heard many health care issues discussed all of her life.

Chelsea says she has always been interested in “what went wrong” or right in health care and has been fascinated by the process and how to improve or change outcomes. Commenting on the CPHQ exam, she says it was the toughest test she has ever taken. Her mother, Pam, was always supportive and never told her that traditionally, non-nursing professionals did not do as well on the exam. Pam is very proud of her daughter’s accomplishments and enjoys their common interest in quality.

Chelsea has big plans. A newlywed, she and her husband are building a house in Conway. Professionally, she is looking forward to the challenge of earning certification in patient safety and she wishes to start classwork for a master’s degree in public health with a focus on health care policy. Chelsea is a quality coordinator in the quality management department at UAMS.  Her mother is the vice president of quality and patient safety at the Arkansas Hospital Association.

38th Annual NAHQ Virtual Conference

By Elisabeth Yacobac, CRA, BSRT, CPHQ, CCA

Imagine this: The year is 2113, and the 48th annual NAHQ conference being held in Louisville, Ky. As has been the norm, not only is the conference a live event but it is also virtual. At this point in time, everything is virtual, even your physician visits can be if you want. This is a big celebration for NAHQ because it is 10 years today that the conference went virtual.

Well maybe that is what we will read 10 years from now. I felt privileged to be one of the ones chosen to attend the conference in this way. It was awesome. I’m sure they will continue to do this for the membership who just can’t leave home or work to attend the

live conference. I had a bit of technical difficulty at first because of the firewalls at work, but all it took was a quick call to our IT department and everything was resolved. The quality of the stream was excellent — at times it felt like I was sitting right there. But what I found even better was being able to answer my phone when an important call came in and still have the speaker on. I’m also happy that did not occur.

The speakers were all interesting. They helped me see a different aspect of quality. We all get absorbed in our area of work and sometimes forget that quality is everywhere. That is the awesome side of a conference; it takes you out of your comfort zone.

The education session I found most interesting was the last one: “Patients as Experts…..Patients as Partners”. It also was the one that touched me the most. Becoming a patient advocate seems to be just another way of working in quality. The reminder that our patients are people is one we all seem to forget at times. A person can become a procedure or a number. Quality can mean so many different things.

I truly enjoyed this experience. It gave me a chance to hear excellent speakers and learn more about other aspects of quality. The only thing I missed was the networking part of the conference. Being around other quality professionals and discussing the day’s sessions is one of the great parts of being at a conference.
This was an excellent experience. I hope it will continue and I will try to support it as much as I can. Maybe I will go to the conference one year, and then attend virtually the next. Sounds like a quality plan to me.

 

 

 

 

 

Speed and Pace: Keys to Innovation

Presenters: Marcie Cochran, RN, CPHQ; Kathy Luther, MPM, RN

By Sandy Grinder, AAHQ President-Elect

This session was presented in collaboration by Cedars-Sinai Medical Center (CSMC) and the Institute of Healthcare Improvement (IHI). CSMC is among several elite health care facilities in the country highlighted in the news media for adverse events that occurred at their facility. The most famous case related to the newborns of a Hollywood celebrity. Their reality was that “despite current approaches to prevention, analysis and improvement, Cedars-Sinai, like other hospitals continues to experience serious adverse events.” Based on this realization, the facility understood a different approach was needed, and CSMC reached out to IHI for assistance.

IHI had a team visit CSMC. A multidisciplinary team from CSMC joined three defect identification experts and visited several areas/departments in the facility. The areas visited included: clinical engineering, radiation oncology, OR/PACU, CVIC, microbiology and MRI. The visit resulted in the outcome that a potential for another event was present due to “missteps” CSMC staff described as normal. CSMC realized that in order to achieve world-class performance in safety, a new level of understanding was needed about the risk associated with small, continuously occurring defects, which in many cases become part of the daily work in the hospital. These small defects represent thousands of Swiss cheese holes that line up and contribute to the next catastrophic event.

IHI had a team visit CSMC. A multidisciplinary team from CSMC joined three defect identification experts and visited several areas/departments in the facility. The areas visited included: clinical engineering, radiation oncology, OR/PACU, CVIC, microbiology and MRI. The visit resulted in the outcome that a potential for another event was present due to “missteps” CSMC staff described as normal. CSMC realized that in order to achieve world-class performance in safety, a new level of understanding was needed about the risk associated with small, continuously occurring defects, which in many cases become part of the daily work in the hospital. These small defects represent thousands of Swiss cheese holes that line up and contribute to the next catastrophic event.

 

The culture at CSMC is changing – normalized deviance is being recognized in real time and the tests of change are being implemented in real time. Tools* were provided to the teams to help identify and track the projects. Reduction in these defects leads to improved patient safety, increased patient and employee satisfaction, and financial savings. A win-win for everyone!

*The presenters provided a copy of their tools for the audience and include instructions provided to the staff, tracking tools and the last tab is a safety huddle tool developed by their staff.

Please No More Green, Yellow and Red! Displaying Key Organizational Measures More Effectively

Presenter: Sandra Murray, MA

By Gina Reeves, AAHQ Secretary

I attended the Please No More Green, Yellow and Red session by Sandra Murray at the NAHQ annual education conference in Louisville, Ky. The session objectives were to identify why tabular or color-coded methods of displaying key measures to senior leaders are inadequate for learning and improvement, identify the key design elements of a great vector of measures (VOM), and be able to analyze a VOM. Murray did an excellent job in meeting these objectives in her presentation.

Concepts of an organization’s family of measures are the following: understanding the performance of an organization (at a macro, meso, or micro level) requires the use of multiple measures; no single measure is adequate to inform leadership of performance of a complex system; the collection of measures used for this purpose has been called family of measures, balanced scorecard, report card, dashboard, clinical value compass, instrument panel, and VOM.

The concept of VOM is like the various dials on a car: some measures describe the past (odometer reading), some describe the present (speedometer), some are there to indicate problems (oil pressure light) and some describe the future (gas gauge). The VOM brings together information from all parts and perspectives of the organization and thus provides a tool for leaders to focus on learning, planning and decision-making for the whole system. Examples of potential measures for a hospital would be employees (sick time, overtime, employee injury rate); safety (adverse events, falls, total infections); patient perspective (patient satisfaction); finance (operating margin, cost per adjusted patient day, days in accounts receivables); clinical excellence (unplanned readmissions, core measures); operational (average LOS, average occupancy, number of surgical procedures); and community (media coverage, community service). These are just a few examples in each category. Most VOM reports contain approximately 15-20 measures, depending on the organization’s focus.

The current challenges our organizations have on presenting data to senior leaders is the use of tables of numbers, comparing current values to a goal and color coding for each measure often has no focus on prediction, and may lead to erroneous conclusions. We need to move from these views to one where each measure is displayed on an appropriate Shewhart chart and all the Shewhart charts are on the same page to see the whole system. These help to accurately assess progress of changes in the system, become aware of system interrelationships, appreciate dynamic complexity and detail complexity, and predict performance. A Shewhart chart is used to display data over time and most often in time order. They will include a center line (mean), data points for measure, and statistically calculated upper and lower three sigma limits. Limits are typically created with 20 or more subgroups. When developing the appropriate Shewhart chart, there are two types of data: attribute data and variable data. Depending on which data you are measuring, there are several types of Shewhart charts that can be developed to present the results.

Shewhart charts allow us to distinguish two types of variation: common cause and special cause variation. The common cause variation is causes inherent in the process that affect everyone working in the process over time and affect all outcomes of the process. The process, however, is stable and predictable.

The special cause variation, on the other hand, is causes not part of the process all the time or do not affect everyone, but arise because of special circumstances. The process is unstable and not predictable, and indicates predictions cannot be made on how the organization will do in future quarters on this particular measure. There are five rules in detecting a special cause, which are: a single point outside the control limits, a run of eight or more points in a row above or below the centerline, six consecutive points increasing (trend up) or decreasing (trend down), two out of three consecutive points near (outer one-third) a control limit, and 15 consecutive points close (inner one-third of the chart) to the centerline. Special cause variation can be good or bad; it may indicate new processes put into place are beginning to take hold, but have not quite yet reached a stable, consistent level.

As leadership looks at a dashboard, for example, and the color is red one quarter, yellow for the next quarter and green in the third quarter, it would be their perception is process is stable, but this could be deceiving. The third quarter being in green could have been a special cause variation that has begun to affect the process, and the process still needs to be focused on. The VOM gives us a better look at the whole picture. Can you identify some special cause variations below? Common cause variations?

Examples:

1. Chart number 7 (Percent Eligible Patients Given Perfect Care): is this a special cause or common cause variation? It’s a special cause variation because there is a run of eight or more points in a row above or below the centerline. This is a good special cause variation.
2. Chart number 3 (Safety Error Rate per 10,000 Adj. Bed Days): is this a special cause or common cause variation? It’s a common cause variation.
3. Chart number 9 (Average Employee Satisfaction): is this a special cause or common cause variation? It’s a special cause variation because there are two out of three consecutive points near (outer one-third) a control limit.
4. Chart number 12 (Average Physician Satisfaction): is this a special cause or common cause variation? It’s a special cause variation because there is a single point outside the control limits.

New Demands, Greater Challenges

Infection Preventionists Try to Balance Patient Safety, Reporting Requirements

By Janie Ginocchio
Arkansas Foundation for Medical Care

Reducing patient harm is the mission for hospital staff who work in quality and infection prevention, but the reality is accomplishing this task can take a back seat to data reporting demands from hospital administration and state and federal regulations. It’s a delicate balance between revenue considerations and actually taking care of patients, one that all too often seems impossible to achieve.

While quality professionals have been responsible for reporting core measures to Medicare and Medicaid for various incentive and payment programs, Infection Preventionists (IPs) are now seeing a heavier reporting

workload due to the addition of health care-associated infections measures to the Hospital Inpatient Quality Reporting Program, a pay for reporting program. As well as added to the Value Based Purchasing (VBP) program, a pay for performance program, (central line-associated blood stream infection reporting began for the fiscal year 2015 program, while catheter-associated urinary tract infection and surgical site infection measures are expected to be added for FY 2016). Medicare will also begin the hospital-acquired condition (HAC) reduction program beginning in FY 2015, which could penalize Inpatient Prospective Payment hospitals 1 percent of their Medicare reimbursement if they rank among the lowest-performing 25 percent with regard to HACs, which includes health care-associated infections.

What was once a behind-the-scenes aspect of patient safety now has an impact on a hospital’s bottom line, both in regard to payment and penalties, but also because the measures are publicly reported. In hospitals where there is one IP — who may only work part-time or have other duties such as employee health – essential tasks such as staff education and process monitoring fall by the wayside in favor of making sure the reporting (into as many as six different programs) gets done.

“The workload has tripled, but the staff has not increased at all for most facilities across the state,” Patricia Gould, RN, an IP at Mercy Hot Springs and president of the Arkansas chapter of the Association for Professionals in Infection Control and Epidemiology, said in a recent interview. “The biggest thing everyone wants is the data – where are we at? – but the preventive part is not being tracked. The process measures – there’s no way to really see if you’re really impacting the processes [for infection prevention during patient care]. To have the most impact, [IPs] need to be in front of staff, working with them, but there are too many reporting requirements that have to be met every month. There needs to be more current staffing guidelines for Infection Prevention which takes into consideration all new reporting requirements.”

Gould said it’s imperative that hospital administration invest in infection prevention.  “We need the support to prevent infections and harm in patients,” she said, adding it makes no sense to “pay a nurse’s salary to sit and put things in the computer” when support staff could be used to help with data entry, which would allow IPs to spend more time on staff education and daily assessments.

“You hear all the time about how more people die from HACs than from plane crashes,” she said. “The FAA is not going to let people fly if they think the plane is going to crash – the hospitals need to be the same way. Many have made great strides in this direction, but more work is still needed across the state.”

For more information about Value Based Purchasing and the HAC reduction program, as well as worksheets and other tools, visit the AFMC website at qio.afmc.org.

Our Sponsors

 

 

 

Julie Kettlewell, RNP, AVP of Quality Programs

1020 West 4th Street, Suite 300
Little Rock, AR 72201 Phone 501-212-8740
E-Mail jkettlewell@afmc.org Website www.afmc.org

 

The Arkansas Foundation for Medical Care (AFMC) was incorporated in 1972 as a private, nonprofit educational organization dedicated to the evaluation and improvement of health care. We are the federally designated quality improvement organization (QIO) for Arkansas. Our staff includes physicians, nurses, statisticians, educators, communicators – professionals with widely varied expertise, at various stages of life and career, who have been on both sides of the health care system. We work with staff in every health care setting and offer free tools and resources, such as educational materials for patients and providers and help with Medicare and Medicaid issues. We review certain types of health care paid for by Medicare and Medicaid to ensure high-quality, cost-effective care and to resolve beneficiary concerns. We help find evidence-based ways to improve preventive care as well as treatment and management of specific illnesses and conditions. We are also a health information technology regional extension center (HITREC), federally funded to provide technical assistance to health care providers as they make the transition to electronic health records. Our roles and responsibilities are constantly evolving, but they all serve the purpose of building support systems and partnerships, and helping focus the efforts of the health care community, agencies and organizations toward common goals. Together, we’re working to make health care safer, more effective and more efficient.

BANCORPSOUTH INSURANCE SERVICES, INC.
Tom Hesselbein, CPCU, Executive VP, Healthcare (Ramsey, Krug, Farrell & Lensing)
8315 Cantrell Road, Suite 300 Little Rock, AR 72227 Phone 501-614-1134
Email Tom_Hesselbein@rkfl.com

AMERICAN DATA NETWORK
Jamie Walden, Public Relations Manager
10809 Executive Center Dr., Searcy Building Suite 300 Little Rock, AR 72211 Phone 501-225-5533
Email jwalden@americandatanetwork.com

Website www.americandatanetwork.com

Founded in 1994, American Data Network provides clinical, quality, safety and financial data applications and services to healthcare executives, allowing them to better manage costs and care quality, influence physician practice patterns and meet demands for public accountability and disclosure.
AAHQ

2013 Board of Directors

Officers

President
Susan Hapner
501-202-4999
501-202-6469
susan.hapner@baptist-health.org

President- Elect
Sandra Grinder
501-257-6187
501-257-6179
sandra.grinder@va.gov

Secretary
Gina Reves
870-262-1925
870-262-1050
greves@wrmc.com

Past- President
Martha Chamness
501-526-6913
501-603-1908
chamnessmarthac@uams.edu

Action Team Leaders

Protocol
Phyllis Dorrough
501-202-1276
501-202-1304
Phyllis.Dorrough@baptist-health.com

Professional Dev.
Lynnette Jack
501-407-9232
501-407-4533
mqrs@comcast.net

Co-Leader
Terry Anderson
501-257-6166
501-257-6179
terry.anderson3@med.va.gov

Membership Srv.
Karen Donaldson
870-382-7657
870-460-3597
kdonaldson@deltamem.net

Finance
Louise Hickman
870-541-7773
870-541-7204
hickmanl@jrmc.org

Communication
Connie Taylor
501-380-3291
501-380-2342
cstaylor@wcmc.org

Co-Leader
Mandy Palmer
501-212-8736
501 375-5705
mpalmer@afmc.org

Members at Large

Sujay Kola
501-552-3578
501-552-4533
skola@stvincenthealth.com

Nancy Lowe
501-364-1778
501-364-4655
lowenj@archildrens.org

AHA Liaison

Cindy Harris
501-224-7878
501-224-0519
charris@arkhospitals.org

Editor

Mandy Palmer, RN, CPHQ
Arkansas Foundation for Medical Care Little Rock, Arkansas

NAHQ Award for Association Excellence

2001 Bronze Level Award Winner

2002 Silver Level Award Winner

2003 Gold Level Award Winner

2006 NAHQ Award for Support of CPHQ Certification

2007 Gold Level Award Winner