Using Healthy People 2020 in Performance Improvement at Local … · 2020-03-12 · 7/22/2014 1...
Transcript of Using Healthy People 2020 in Performance Improvement at Local … · 2020-03-12 · 7/22/2014 1...
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Using Healthy People 2020 in Performance Improvement at Local
Health Departments
Healthy People 2020-National Association of County and City
Health Officials Partnership
• Health department must provide documentation of a collaborative process
• Examples of tools and processes that may be adapted for the community assessment include MAPP and Healthy People 2020
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Accreditation Preparation
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PHAB Standards and Measures Version 1.5
PHAB Standards and Measures Version 1.5
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PHAB Standards and Measures Version 1.5
PHAB Standards and Measures Version 1.5
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Performance Improvement Initiatives
• Accreditation
• Strategic Planning
• Community Health Assessment and Improvement Planning
• Quality Improvement
• Performance Management
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PREPARE
SET GOAL
ASSESS
PLAN
ACT
TRACK
IMPROVE
Prepare information, people, and resources
Set goals for your process
Assess your current state
Plan how you are going to achieve your goal given
your current state
Implement the plan
Track how well you’re achieving
your goal
Improve work to better meet goals
All performance improvement initiatives involve these seven steps.
The focus of each type of performance improvement, however, differs.
The Seven Steps of Performance Improvement Initiatives
PREPARE SET GOAL ASSESS PLAN ACT TRACK IMPROVEPrepare
information, people, and resources
Set goals for your process
Assess your current state
Plan how you are going to achieve your goal given
your current state
Implement the planTrack how well
you’re achieving your goal
Improve work to better meet goals
Prepare AIM Statement Current Knowledge Plan Do Study Act
Organize for Success
VisioningAssessments of the
Community
Identify Strategic Issues, Formulate
Goals & Strategies, Action Planning
Implement Evaluate Action Cycle
Quality Improvement
Community Health Assessment & Improvement Planning
Prepare Vision and Mission
Environmental Scan, Situational
Awareness, SWOT Analysis,
Performance Measurement
Develop Strategic Directions, Objectives,
Indicators, & Activities
ImplementPerformance Monitoring &
Reporting
Performance Improvement
Strategic Planning
PrepareSet Accreditation
TimelineSelf-Assessment/
Gap Analysis
Address Unmet Standards &
Measures; Collect Documentation
Apply for Accreditation
Monitor Standards & Measures;
Annual Reporting; QI
CQI & Reaccreditation
Accreditation
Prepare Big Picture VisualDetermine Needs and Requirements
Plan Performance Management
System
Implement Performance Management
System
Performance Measurement
Performance Improvement
Performance Management
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Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Healthy People 2020 and Performance Improvement• Healthy People 2020 is an easy-
to-use tool for a variety of Performance Improvement Activities, from accreditation to quality improvement to strategic planning to community health assessment and improvement planning.
• Healthy People can provide material for each of the seven steps of performance improvement.
Step One: Prepare
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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• Engage stakeholders and build commitment with Healthy People 2020 measures and objectives
• Where does your community stand?
• What health topics are important to your community?
Use the Healthy People website to begin conversations on community health
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
• Examples and success stories can help recruit organizations and individuals
• NACCHO’s Implementing Healthy People website page http://www.naccho.org/topics/infrastructure/healthy-people/index.cfm
• Healthy People (healthypeople.gov/2020) website provides “field notes” with examples of how Healthy People is being used across the country
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Learn How Other Communities Are Using Healthy People
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• Leading Health Indicators (LHIs) are a smaller set of Healthy People objectives selected to communicate high priority health issues
• LHIs can help communicate the importance of Public Health to your community
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Mobilize Partners with the Leading Health Indicators
“The Healthy People data is helpful when you’re trying to engage or capture the attention of non-traditional local partners, while you’re working to educate them on their role in the greater local public health system.”
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Story from the field: Clay County Health Department (FL)
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Step Two: Set Goal
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
“A society in which all people live long, healthy lives”
Healthy People 2020 Vision
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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• That’s what Healthy People is all about!
• Overarching goals of Healthy People 2020:– Attain high-quality, longer lives free of preventable
disease, disability, injury, and premature death
– Achieve health equity, eliminate disparities, and improve the health of all groups
– Create social and physical environments that promote good health for all
– Promote quality of life, healthy development, and healthy behaviors across all life stages
Creating a Picture of the Future You Wish to Create
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Access to Health Services
Clinical Preventive Services
Environmental Quality
Injury and Violence
Maternal, Infant, and Child Health
Mental Health
Visioning with the Leading Health Indicators:What topic areas resonate with your community?
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Nutrition, Physical Activity, and Obesity
Oral Health
Reproductive and Sexual Health
Social Determinants
Substance Abuse
Tobacco
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Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Step Three: Assessment
• Find potential indicators and/or data sources for specific health topic areas
• Some may only have national statistics, but many have state and local data as well
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Using Healthy People Topic Areas for Assessment
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• Each Healthy People topic area includes an overall goal and specific, measurable objectives
– The number of objectives ranges from 2 (Healthcare-Associated Infections) to 43 (Injury and Violence Prevention)
Target-setting
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
National Objective: D1: Reduce the annual number of new cases of diagnosed diabetes in the population.- Target: 7.2 new cases per
1,000 population aged 18 to 84 years.
- Baseline: 8 new cases of diabetes per 1,000 population aged 18 to 84 years occurred in the past 12 months, as reported 2006-2008
- Target setting method: 10 percent improvement
Your Objective: Reduce the number of new cases of diagnosed diabetes in the county population– Target: 9 new cases per 1000
population aged 18 to 65 years.
– Baseline: 10 new cases per 1,000 population aged 18 to 65 years in the past 12 months.
– Target setting method: 10 percent improvement
Adapting Healthy People for local use
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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• Use the LHIs as a starting point for collecting data and choosing indicators
• What are the challenges for your community?
• What are the successes?
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Leading Health Indicators and Assessment
“We are using Healthy People to assist in the identification of community indicators for our community health assessment”
Story from the Field: Partnership for a Healthier Alexandria (VA)
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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Step Four: Plan
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
• Do any assessment findings stand out? Are there indicators that are significantly far off from Healthy People targets?
• Explore how the Healthy People topic areas relate to one another to help brainstorm potential strategic issues
Making sense of all the data
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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• Where does your community rank nationally?
• Identify strategic issues based on which topic areas your community falls behind on
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Compare assessment findings with Healthy People national data
• Healthy People guidance on starting a dialogue about the underlying causes of poor health or quality of life in your community
• Explore the social determinants of health topic area
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Address the social determinants
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“We’re comparing our community health assessment data to where Healthy People 2020 is at [to figure out goals for our community]”
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Story from the Field: RiverStone Health (MT)
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Step Five: Act
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• Each Healthy People topic area includes an overview of why it’s an important issue in public health
• “Related topic areas” helps link together strategic issues from Healthy People to assessment data
Identifying strategic issues
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
• The LHI topic areas aim to consolidate related priority issues
• Example: Clinical Preventive Services– Access issues?
– Quality of care issues?
– Low rates of recommended immunizations?
– Other social determinants related to this LHI:• Educational attainment
• Stable employment
• Safety of neighborhoods
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Identifying strategic issues with the Leading Health Indicators
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“We use Healthy People 2020 at our agency as a resource for selecting strategic directions and determining priorities.”
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Story from the Field:Sedgwick County Health Department (KS)
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Step Six: Track
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• Establish a system to monitor the indicators over time
• Healthy People releases progress reports for most topic areas every 2-4 years
Monitoring the indicators over time
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
“Healthy People has always been a national tool we’ve looked at for setting baselines and targets.”
– Brandon Skidmore, KS State Health Department
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Story from the Field: Kansas State Health Department
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Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Step Seven: Improve
• Healthy People’s Intervention and Resources tab for each topic area includes:– Clinical recommendations
– Community interventions
– Consumer information
• Overview tab includes:– Description, references and sources for peer-
reviewed journal articles related to each topic area of interest
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Make the action cycle manageable with topic-specific materials
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Clinical, community, and consumer information and recommendations from:The U.S. Preventive Services Task Force, an independent panel of experts in
primary care and prevention that systematically reviews the evidence of effectiveness and develops recommendations for clinical preventive services. Sponsored since 1998 by the Agency for Healthcare Research and Quality (AHRQ), the Task Force is the leading independent panel of private-sector experts in prevention and primary care.
The Task Force on Community Preventive Services, established by the U.S. Department of Health and Human Services (DHHS) in 1996 to develop guidance on which community-based health promotion and disease prevention interventions work and which do not work, based on available scientific evidence. The Centers for Disease Control and Prevention (CDC) is the DHHS agency that provides the Task Force with technical and administrative support.
Healthfinder.gov, a government agency sponsored by the Office of Disease Prevention and Health Promotion and its health information referral service to provide information and tools to consumers.
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Make the action cycle count with evidence-based practices
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Topic specific interventions and resources
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• Get the data
• See how you measure up
• Connect to something larger
• Identify new stakeholders and partners
• Plan a strong public health program
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Make the case for funding
“After spending many years in Illinois with a primary care association, I used Healthy People constantly for writing and managing grants”
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Story from the Field: West Virginia Association of Local Health Departments (WV)
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Healthy People 2020 Resources for Performance
Improvement
• A list of potential public, private, and volunteer organizations
• Questions to consider when organizing a coalition
• www.healthypeople.gov/2020/implementing/mobilize.aspx
Map-It Resource –Mobilizing Partners
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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• Brainstorm about community strengths and assets
• How do you prioritize issues in your community?
• www.healthypeople.gov/2020/implementing/assess.aspx
MAP-IT Resources: Assess & prioritize
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
• What is our goal?
• How will we know when we have reached our goal?
• www.healthypeople.gov/2020/implementing/plan.aspx
MAP-IT Resources: Formulating strategies
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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• Assessing community needs and resources module
• Analyzing community problems and solutions
• Useful for multiple phases of MAPP
• http://ctb.ku.edu/en/default.aspx
Community Toolbox Resources
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
• Subscribe to newsletters to hear about what’s going on in the world of public health and what may affect you locally
• “Who’s Leading the Leading Health Indicators?”
Stay connected with Healthy People
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
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Barbara Laymon
Lead Program Analyst, Assessment and Planning
202-507-4240
Healthy People 2020-NACCHO Partnership, National Association of County and City Health Officials, http://www.naccho.org/healthypeople (2014)
Many thanks!