Public Health Performance Improvement: How National Performance Standards Make the Difference (Part...
-
Upload
roland-quinn -
Category
Documents
-
view
216 -
download
0
description
Transcript of Public Health Performance Improvement: How National Performance Standards Make the Difference (Part...
Public Health Performance Improvement:
How National Performance Standards Make the Difference (Part II)
Got Skills?
How To Build Your Public Health System
Performance Assessment
APHA 132nd Annual MeetingSession 3247
Washington, DC
Recap of Session ISession II Objectives
identifying the benefits of using the performance standards
learning different methods for structuring the assessment process
gaining knowledge on using assessment results for performance improvement
Structuring a Performance Standards Process
Liza Corso, MPACenters for Disease Control and Prevention
NPHPSP Partners
CDC, APHA, ASTHO, NACCHO, NALBOH, NNPHI, PHF
Assessment Instruments State public health system Local public health system Local governance International
Four Concepts Applied in NPHPSP
1. Based on the ten Essential Public Health Services
2. Focus on the overall public health system
3. Describe the “gold standard” for performance
4. Results drive performance improvement
Indicator
ModelStandard
Measures
Essential Service
Instrument Format
Measures
SummaryQuestions
Key Steps in the Process Identify, recruit and orient participants Complete the instrument
Use facilitators and recorders Gain consensus responses
Submit responses to CDC Discuss CDC report with participants Determine challenges and opportunities Develop and implement improvement plans
Identifying Participants Key questions:
Who plays a role in the public health system? Who provides the Essential Services? What broad, cross-sector participation is needed? What consumers can be included? Who else needs to be included (e.g., to assure
expertise in certain areas) How many people should participate?
Ensure consistency or a core group among respondents
The “Public Health System” More than just the public health agency
“Public health system” All public, private, and voluntary
entities that contribute to public health in a given area.
A network of entities with differing roles, relationships, and interactions.
All entities contribute to the health and well-being of the community.
Structuring Participation:Different Approaches
Retreat (1 – 2 days)
Small Group Activities
Series of Meetings
Retreat Generally 1-2 days Advantages:
Short timeframe Maintains momentum
Drawbacks: Requires time commitment Can be overwhelming
Small Group Activities Advantages:
Allows for expertise, as needed Less overwhelming
Drawbacks: Less cross-learning Less consistency in response
development
Series of Meetings Advantages:
Allows for expertise, as needed Gets the work done in small pieces
Drawbacks: Participation changes with meeting
attendance Process may seem to “drag on”
Approaches in Determining Responses
Walk through questions one by one Discuss the model standard with
facilitator/recorder judgment on responses
Discuss model standard with follow-up voting
Coordinated Statewide Process
Use of multiple NPHPSP instruments in a coordinated approach
Benefits: Coordinated orientation, training, and
technical assistance opportunities Aggregate reports of assessment
results Coordinated improvement planning
Statewide Activities
Pilot / Field Test States Currently using or planning for use statewide
Lessons Learned through the Use of the NPHPSP Performance
AssessmentEvelyn A. Knight
F. Douglas ScutchfieldAnn V. Kelly
Michelyn W. BhandariMiriam Fordham
University of Kentucky College of Public Health
Method First step in three phase project 1-1.5 hour interviews with state and
local users selected to represent broad cross-section of users 10 state assessment users 12 state coordinators of local
assessments 5 local assessment users
Incorporated results of earlier study of 9 local public health systems in Kentucky
Interviews with users Description of public health system in
state or local area How performance assessment carried out Benefits/barriers of carrying out the
performance assessment
Results Why complete the assessment? Planning the assessment Planning for facilitation Recruiting system partners Planning assessment sessions Planning for performance
improvement Benefits of assessment
Why complete the assessment? State and Local Assessment
Initiated coordinated quality improvement process for state and local levels
Local Assessment Only Part of MAPP process; extension of Turning Point
activities Statewide effort to assess level of public health
performance across all jurisdictions; justify need for full time staff in all jurisdictions
State Assessment Initiate coordinated planning across the state To educate state health department staff
Planning the Assessment Allow for steep learning curve inside the
sponsoring organization Consider carrying out a trial assessment
inside the sponsoring PH agency Take advantage of training and technical
assistance –Partners websites Plan for training and orientation of
assessment leaders and facilitators Keep performance improvement in mind
Planning for facilitation Professional facilitation can help, but not
necessary if training available Have a plan for coming to consensus Capture key issues for later discussion Facilitators and recorders MUST be neutral Pacing is imperative, which can be difficult
for less experienced facilitators
Recruiting System Partners Build on existing relationships—establish a
steering committee a la MAPP If existing relationships are thin, allow more
time and effort for recruitment Help potential new partners see their public
health role Be selective
Planning assessment sessions
Carefully orchestrate assessment retreats Single or multiple If multiple sessions are used, do not extend out
over too long a time period Divide the group or not….both seem to work
If divided, assure good representation across EPHS groups
Provide some advance orientation as well as at the assessment itself
Planning for performance improvement
Consider how results will be used How to share with partners How to prioritize EPHS – develop importance
ratings How to gather supporting information
Revisit the model standards and the instrument
Know who will be responsible PR
Benefits of Assessment for PH System Performance
Improvement Building knowledge and greater understanding
of public health across the community/system The conversation and system learning
Identifying system strengths and areas to be changed
Establishing new networks Building system identity
Summary Plan the assessment process to:
meet your system’s needs transition into a performance
improvement process
Greatest benefits include Education about public health Sharing and networking Building the public health system
The National Public Health Performance Standards
Resources to Assist Users
Chris KinabrewNational Network of Public Health Institutes
Useful Products from NPHPSP Partners
Assessment Instruments (online, binder, standards only)
User Guide Frequently Asked Questions Reports with data
For each respondent Aggregate statewide data
Tri-fold brochures Posters Performance Improvement Resources available at
http://www.phf.org/Tools-Resources.htm#NPHPSP
NPHPSP Activities Training Workshops Statewide Kickoffs User Teleconferences Ongoing technical assistance
Training Workshops Annual event Topics covered include:
Orientation to 10 Essential Services Using the Instruments Coordination of Statewide Approach Facilitation and Consensus Building Data Submission and Reports Developing and Implementing Improvement Plans
CD-ROM from April, 2004 workshop available Sign up now for info re Spring, 2005 training workshop
Statewide Kickoffs
Colorado New Mexico Florida
NPHPS User Network Monthly conference calls with:
Jurisdictions that have completed assessments
Interested Parties Partner organizations
Sharing information about: Implementation Strategies Performance improvement processes Tools Resources
Questions to Consider How does our state/local public health structure affect
our planning? Which tools do we want to use? What leadership can sponsor the process and create
buy-in? What approaches will be most successful? Should this connect with other current or past
activities? What resources exist to support the effort?
Exercise
“The Local Public Health System and the Essential
Services”
Scott Fisher, MPHNational Association of County and City Health Officials
Questions?
Please stay tuned for additional info re 3rd Annual Training Workshop in
Spring 2005