-- Please note Cover Page is required --
Total Budget / EXPENDED
(Progress Reports Only) /
A. Salaries (Include position & FT or PT) /
8 hr/week Instructor x 50 weeks x $25/hr / ----
Sub-total A / ----
B. Expendable Supplies
Office Supplies / 500.00
Sub-total B / 500.00
C. Equipment
Centering Handbook / $150.00
Facilitator’s Guide / $125.00
120 Mom’s Notebooks / $2400.00
Brochures/Magazines/Education supplies & Models / $6200.00
Sub-total C / $8875.00
D. Other Expenses/Fees
5 Laminated posters / $35.00
Incentives for group participants / $1200.00
Snacks / $400.00
Centering Staff education / $0
Sub-total D / 2035.00
TOTAL COSTS (Sub-total A+B+C+D) / 27410.00
Indirect Costs 10% (Only for $50,000 or over)
Total Amount Requested / -----
PLEASE CHECK TOTALS & ROUND TO NEAREST DOLLAR
______
Signature - Executive Director Date Signature-Director of Operations Date
Two signatures are required.
II. Project Narrative
A. Project Abstract
“Tiny Toes” is a comprehensive maternity program that begins in the primary care physician’s office, moves to the hospital during hospitalization, and follows the patient upon discharge at a yearly birthday party. The primary goal is to reduce infant morbidity and mortality by providing a comprehensive program aimed at providing prenatal education to the pregnant woman and their support persons that will increase availability and quality of health care and/or prevention services for pregnant women. The secondary goal is to provide additional education to pregnant women to include a variety of topics including effects of smoking and drugs, the need for increasing folic acid and multi-vitamins, and the birthing process. This process will allow not only for pregnant women to be educated in these processes but will educate the nursing staff as they prepare themselves to become more competent in providing care to this population.
Tiny Toes will be introduced to pregnant women when they present to the primary care physician office. The physician’s office staff will begin scheduling patients with similar gestational age women who sign up for the program to be scheduled for their next appointment at a time where “Centering” can begin. A nurse will coordinate the program at this point and provide education from the Centering Module Handbook. This will continue throughout the patient’s pregnancy until delivery.
ACOG’s “5 A’s” approach will be used in smoking cessation classes along with other specific information. The information obtained from this class will hopefully lead to a conversion of the woman to a non-smoker. If successful, this may lead not only to a healthier infant outcome, but may reduce harmful effects of secondary smoke to others living in the same household.
In the third trimester these women will be introduced to the Childbirth classes where reinforcement education will be provided. During this time, the instructor will provide a review of topics studied during the Centering program. A question and answer period will always be conducted before the class ends.
The target population for Tiny Toes is pregnant women and their support persons who have limited knowledge or poor health habits that may contributed to a high infant morbidity or mortality including smoking, alcohol or other drug use, poor nutritional and lack of folic acid and vitamin intake. This comprehensive program will reward pregnant women who attend 80% of all meetings with a bag. Inside the bag will be different incentives such as a baby bib, an outfit, baby bottle, and so forth. Chesterfield General Hospital had discovered that in many instances this target population will only attend events if they are given something free.
B. Description
1. Which of the funding priorities is the project addressing?
Tiny Toes will address the March of Dimes funding priority “A, E, F, G, and I”. As a comprehensive program, Tiny Toes is designed to target these high risk populations.
2. What needs or problems would be addressed through this initiative?
Being a comprehensive program, Tiny Toes begins by address the need of centering care on similar gestational aged populations. Once the patient is involved in centering, additional high risk problems to include smoking cessations, drug use, folic acid and proper nutrition are included.
3. How will the project have an impact on these needs or problems?
Chesterfield County has a high premature birth rate. This project will help reduce premature births by providing a coordinator who will be responsible for providing an environment in which pregnant women want to be a part. If during the project we are successful with only a few women the outcome for these infants has improved. In this area unfortunately, we have a high prevalence of smoking, drug abuse, and improper nutritional intake. This project will have a positive impact by reducing the negative problems mentioned above and increase the number of normal term pregnancies.
4. Who will be the primary beneficiaries of this project and numbers to be
reached?
The primary beneficiaries of this project are the pregnant women that participate in the Tiny Toes Program. Currently we deliver approximately 15-20 babies per month. Our goal for this year is to enroll 12 women per month into the program.
5. What is the capacity of the applicant to carry out the project (include
experience working with the primary participant group)?
Chesterfield General Hospital has the capacity to carry out the Tiny Toes program. Space will be donated by the physician’s office and hospital. Current staff will oversee the grant process; however an 8 hour a week RN will be needed to coordinate the weekly and monthly activities. The primary physician practices of the OB/GYN’s are owned by the hospital and the physicians are hospital employees. As such, the physician practice manager is able to provide input and direction into the type of care administered at the physician’s office. Chesterfield General has experience working with pregnant women and their support persons in both a primary care setting as well as during an observation or acute care in-patient stay.
6. How will the project be announced to the community?
Tiny Toes will work with the marketing and public relations office at Chesterfield General Hospital to announce the program using a variety of media outlets. The program will be introduced to various agencies throughout the county with emphasis on those programs that work with pregnant women such as DHEC, DHHS, and the Chesterfield County Coordinating Council. The program will also be shared at a variety of specialty events such as health fairs and faith based organizations.
7. How will the project results be shared?
Statistical data will be shared with agencies such as DHEC, DHHS, and the Chesterfield County Coordinating Council. This will allow these agencies a window so they can see how both Chesterfield General Hospital and the March of Dimes have worked together to provide better outcomes for babies being born in our community. The data will also be shared internally through the quality improvement process.
C. Project Objectives
1. What Planning activities will take place before project startup?
Prior to starting Tiny Toes, staff will develop a program calendar for the year. Staff will need to be trained on Centering concepts and how the flow of the program will function. Criteria for hiring a nurse to coordinate the program 8 hours a week will be developed. Physician office staff will be included in how to promote, enroll, and schedule new pregnant women into the program.
2. How will progress be monitored?
Progress of the program will be monitored by class attendance. We will use a zip code identifier to determine the service area of the program. At the end of each class an evaluation tool will be used to determine comprehension of covered material. Collection and analysis of these records will be part of the coordinator’s responsibilities.
3. What are the staff responsibilities?
Tiny Toes will involve several members of the staff at Chesterfield General Hospital. Jeff Reece, Chief Nursing Officer will serve as program oversight and grant management. Maryann Reava, Physician Office Practice Manager, will oversee the staff education in the OB/GYN’s office as well as the enrollment and scheduling of patients for centering care. Shannon Peyton, Marketing Director, will be responsible for promoting the program to media outlets. Once hired the coordinator will be responsible for the operations of the program on a week to week basis and will report to Jeff Reece. The coordinator will work closely with Linda Wymbs, Chief Quality Officer to develop and report progress of the program through the quality improvement process. Vance Reynolds, Chesterfield General Hospital’s Chief Executive Officer, has overall responsibility.
4. What is the role of collaborating organizations (if applicable)?
Collaborating organizations such as DHEC, DHHS, The Chesterfield County Coordinating Council and faith based organizations will be used as routes to disseminate information about Tiny Toes. Currently Chesterfield General already has an established working relationship with all three of these agencies.
5. List Project’s measurable objectives, activities, person responsible and
due dates.
Please see attached form for measurable objectives, activities, person responsible and due dates.
D. Evaluation Plan
1. How will the successes, challenges, and impact of the project be
evaluated?
Tiny Toes will be evaluated through an evaluation tool that will be used to measure comprehension of material. Participants will be asked to indicate the successes and challenges they encountered during the program. Once information is obtained from the participates, the coordinator will analyze the data and present the information to the quality improvement department where it will be presented to the perinatal and quality improvement committees and then to the medical executive staff and board of directors. Information obtained from members of these vital hospital committees and board members will then be analyzed to determine if any changes need to be made to the program. If any of the high risk women are transferred to a higher level of care hospital or delivers at another hospital, the coordinator will make every effort to collect data such as birth weight and gestational age.
2. Who will design and carry out the project evaluation?
The Tiny Toes Coordinator, MaryAnn Reava, and Linda Wymbs will be responsible for carrying out the project evaluation. Linda Wymbs serves as the Chief Quality Officer and is the expert in performance improvement activities which incorporates project evaluation.
E. Project Impact
1. How will the project make a difference in the lives of participants?
Tiny Toes will help improve infant mortality and morbidity by providing education to the pregnant woman on habits they can change early in the pregnancy that may improve the outcome of their baby. The Tiny Toe program will provide social and emotional support during the centering meetings, during the child birth classes, and during the yearly birthday party for our new one year olds.
2. Describe the potential for sustainability beyond the March of Dimes
funding period through alternate sources of funding or a change in
organizational systems or procedures that will sustain the project’s
impact.
Chesterfield General Hospital hopes that the program will be sustainable beyond the first year. Grant proposals will be submitted to other organizations whose mission and priorities match those of Tiny Toes. As we share our outcome data with other organizations we hope they will see the positive impact this program provides to high risk pregnant women.
F. Budget
A. Salaries
The Tiny Toes Coordinator will work 8 hours per week providing education to staff, coordinating and teaching the centering classes and child birthing classes. She will also be responsible for collecting data and performing the analysis of the data as well as reporting the data to various committees. We have a candidate in mind that already works on an as needed basis, and therefore, is not already considered full time. She will be paid --- per hour and will work 50 weeks of the year which equates to ---.
B. Expendable Supplies
Tiny Toes will need basic office supplies such as paper, pens, stamps, paper clips, and pencils to operate during the year. We have allocated $500.00 for these items as we can not anticipate all the materials that may be needed.
C. Equipment
Educational Material is very important to a comprehensive program such as Tiny Toes. As this is the start up year, the majority of cost will be incurred this year. Currently we have no models, brochures, or video’s to instruct neither staff nor pregnant women about complications or child birth procedures. Since this is the start up year and we anticipate 120 pregnant women to join Tiny Toes. Mom’s Notebooks cost $2400.00, the Centering Handbook cost $150.00 and the Facilitator’s Guide is $125.00. Models, brochures, magazines, and education supplies cost $6200.35. We are requesting $8875.35 to cover the cost of these items.
D. Other Expenses/Fees
In order to attract women and their support persons to the centering meetings and prenatal classes, we will provide the pregnant woman a bag filled with a variety of items such as a babies bib, outfit, a toy, bottle, and so forth. The bag will be given to the woman when 80% of the classes are complete. At a cost of $10 per person we are requesting $1200.00 to allow some incentives for the pregnant women to participate in the centering care and prenatal classes. We would like to provide snacks at some of these meetings. We anticipate a cost of $50.00 for snacks for each meeting and will also attempt to attain donations for food and beverage at group meetings throughout the year. We are requesting a total of $400.00 for snacks. We are requesting 5 March of Dimes laminated posters to post in our physician practice offices. These cost $7 each for a total cost of $35.00.
Education will need to be provided to the current staff on centering. Original amount per Jessica Mullen was $6000.00 for staff education, but this has been eliminated since training on the Centering Pregnancy Model of Prenatal Care will be provided in Columbia South Carolina on February 22 & 23, 2008. Total amount for other expenses and fees is $2035.00.