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Public Health Performance Standards District System Assessment. www.cdc.gov/od/ocphp/nphpsp/ Karen O’Rourke, MPH Joan Orr, CHES 2009. Part 1: The National Performance Standards Program. To improve the quality of public health practice and performance of public health systems by: - PowerPoint PPT Presentation
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Public Health Performance Standards
District System Assessment
www.cdc.gov/od/ocphp/nphpsp/Karen O’Rourke, MPH
Joan Orr, CHES
2009
Part 1:The National Performance
Standards Program
To improve the quality of public health practice
and performance of public health systems by:
• Providing performance standards for public health systems;
• Promoting continuous quality improvement;• Engaging and leveraging partnerships;• Strengthening the science base for public
health practice improvement
Program Vision and Goals
• Began in 1998
• Partnership effort between CDC and five national public health organizations– APHA, ASTHO, NACCHO, NALBOH, NNPHI, PHF
• National launch in June 2002
• Tool revised in 2008
Background
HISTORICAL
BACKGROUND
• State public health system
• Local public health system
• Local governance
The Assessment Instruments
Four Key Concepts
1. Based on the ten Essential Public Health services
2. Focus on the overall public health system
3. Describe an optimal level of performance
4. Support a process of quality improvement
• Provides a foundation for any public health activity
• Describes public health at both the state and local levels
• Instruments include sections addressing each essential service
Key Concept 1: The Essential Services
1. Monitor health status2. Diagnose and
investigate health problems
3. Inform and educate4. Mobilize communities
to address health problems
5. Develop policies and plans
6. Enforce laws and regulations
7. Link people to needed health services
8. Assure a competent health services workforce
9. Evaluate health services
10. Conduct research for new innovations
10 Essential PH Services
• “Public Health System”– A Network of…
• Public entities• Private entities• Voluntary entities
• All entities contribute to the health and well-being of the community
Key Concept 2: Focus on the “System”
The Public Health System
MCOs
Home Health
Parks
Economic Development
Mass Transit
Employers
Nursing Homes
Mental Health
Drug Treatment
Civic GroupsCHCs
Laboratory Facilities
Hospitals
EMS Community Centers
Doctors
Health Department
Churches
Philanthropist
Elected Officials
Tribal Health
Schools
Police
Fire
Corrections
Environmental Health
• Each performance standard represents the “gold standard”
• Provide benchmarks to which state and local systems can strive to achieve
• Stimulate higher achievement
Key Concept 3: Optimal Performance
• Standards should result in identification of areas for improvement
• Link results to an improvement process
Key Concept 4: Quality Improvement
• Improves organizational and community communication
• Provides a benchmark for public health practice improvements
• Brings partners to same table
• Promotes cohesion and collaboration
• Provides a systems view of public health• Provide a baseline for Maine’s emerging District
Public Health System
User Benefits
Part 2:The National Public Health
Performance StandardsLocal Assessment
The Tool
•Focus is on the District Public Health System
•10 Chapters• Based on essential services
•Each Essential Service• Indicators (components, activities)• Model standards (optimal performance)• Measures (questions)
Structure
Structure
•10 Essential Services
•30 Model Standards
•325 Total Questions (109 questions, 216 sub-questions)
Response Options
•Response Options• No activity•Minimal (>0 and 25% or less)•Moderate (>25% but no more than 50%)•Significant (>50% but no more than 75%)•Optimal (Greater than 75%)
Scoring Option Definitions
Score Definition
No No activity.
Minimal Some activity by an organization or organizations within a single service/geographic area. Not connected or minimally connected to others in or across the District.
Moderate Activity by one or more agency or organization that reaches across the District and is connected to other organizations in the District but limited in scope or frequency.
Significant Activity that covers the entire District [is dispersed both geographically and among programs] and is connected to multiple agencies/organizations within the District Public Health System.
Optimal Fully meets the model standard for the entire District.
The Data
Quantitative • Scores assigned based on responses• Algorithm developed by CDC
Qualitative• Comments captured• Themes developed
Reports
Reports include: • Overall Score for each Essential
Service• A summary score for each
indicator • A score for each component
ExampleESPH #7: Link People to Needed Health Services
Overall Score : 81.93
Indicator 3:
Assuring Linkage of People to Personal Health Services
Score57.42
Assure the provision of needed personal health services 33.33
Provide outreach and linkage services for the community 39.17
Initiatives to enroll eligible beneficiaries in state Medicaid or medical assistance programs
100.00
Assure the coordinated delivery of personal health services 47.92
Conducted an analysis of age-specific participation in preventive services
66.67
ExampleESPH #1: Monitor Health Status
Overall Score: 62.23
Indicator 2: Access to and Utilization of Current Technology
Score40.25
State-of-the-art technology to support databases? 62.50
Access to geo-coded health data? 0.00
Use geographic information systems (GIS)? 0.00
Use computer-generated graphics to identify trends and/or compare data?
100.00
Community Health Profile available in electronic version? 38.75
Recording Information
• While not an inventory of activities, we will record comments to identify themes and provide a context for the scores
• Specific programs, projects or organizations will generally not be included in the final report.
Activities & Timeline
2009
Maine Center for Public Health
March -June
Conduct5 District
Assessments
AnalyzeFindings
Conduct 3 District
Assessments
July -August Sept. - Oct Fall
Analyze Findings
&Present Reports
The Process
At each of the 3 meetings, we will:• Review the Essential Service Model Standard.• Discuss what each organization does with regard
to the model standard within the District.• Identify strengths, weaknesses, gaps and
recommendations for improvement or collaboration for the District.
• Facilitators will suggest a score upon completion of discussion. This will help ensure consistency across the 8 Districts.
Roles and Responsibilities
• Facilitators: – Guide participants through the process– Keep time– Allow everyone to speak– Suggest a score– Record results
• Participants– Participate fully in discussion from your organization’s
perspective – Keep comments brief (no more than 3 min)– Focus comments only on the indicator being discussed– Help identify strengths, weaknesses, gaps and
recommendations