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Local Public Health Local Public Health Performance Standards Performance Standards Assessment & the MAPP Assessment & the MAPP
ProcessProcessTransitioning Your Community Transitioning Your Community
From Perception to RealityFrom Perception to Reality
Stephanie R. Paulmeno MS, RN, NHA Director, Community Health Planning
Greenwich Department of HealthGreenwich, CT
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Performance Standards in Performance Standards in Public HealthPublic Health
The Core Public Health Steering Core Public Health Steering
CommitteeCommittee of the CDCCDC, the American
Public Health Association (APHAAPHA),
NACCHONACCHO and other major national
public health agencies initiated the
process of identifying performance identifying performance
standards for public healthstandards for public health in 1994.
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Greenwich: A long Greenwich: A long tradition tradition
of Community of Community partnershipspartnerships• Public health infrastructure is strong
& visible in Greenwich• Partnerships have existed for
decades• Public health leadership and visibility
was dramatically increased with the appointment of a designated Community Health Planner who works within the Town, Region and State
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The Community Health The Community Health PlannerPlanner
• Assessment based planning focus
• Outcome focused planning strategies
• Works to develop, support, or work
within partnerships and coalitions
• Focuses on the use of resources,
identifying/filling gaps and avoiding
unnecessary duplication of services
• Provides introduction to Town services
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Survey Purpose & Survey Purpose & ProcessProcess
The process evaluatesevaluates
public, private and
municipal service deliveryservice delivery
programs that impact
healthhealth and emergency emergency
preparednesspreparedness within a
town or city, and not not
merely the capacity of their merely the capacity of their
Local Departments of Local Departments of
Health. Health.
The process is a
partnership effortpartnership effort to
improve public
health practicepractice and
performanceperformance as well
as the infrastructureinfrastructure
that supports these
efforts.
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Is Perception Reality?Is Perception Reality?
The survey is a perceptual toolThe survey is a perceptual tool
It can reflect either the knowledge It can reflect either the knowledge
base of the participants or provide base of the participants or provide
an accurate depiction of the various an accurate depiction of the various
assessment componentsassessment components
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Pre-Planning IssuesPre-Planning Issues
The benefit of group
evaluationThe traditional vs. “fast
track” processAdvance Preparation
Time saving pre assessment strategies
Rapid visual depiction of the community
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Pre-Planning IssuesPre-Planning Issues
Designing pre-assessment participant worksheets
The benefits of charts and posters
Getting the right partners to the table
Explaining the 10 Essential Services of Public Health
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Building Community Building Community Ownership Of The Ownership Of The
Assessment ProcessAssessment Process Buy-in is important to the quality & Buy-in is important to the quality & level of participation & to the outcomelevel of participation & to the outcome
The view is different from different agency
levels
All participants have equal standing
All opinions are important and valid
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Pre-Assessment Pre-Assessment PreparationPreparation
• Draft information letters/make follow-up phone calls seeking participants
• Develop display charts for review areas
• Pre-distribute the 10 Essential Services of Public Health
• Design/Distribute work sheets for pre-analysis
• Conduct Town website review
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Letters & Phone CallsLetters & Phone Calls
• Explain the rationale and process
• Define a “public health systempublic health system” as opposed to the core functions of a health department
(“all public, private & voluntary entities that contribute (“all public, private & voluntary entities that contribute to the delivery of essential public health services to the delivery of essential public health services within a jurisdiction”) within a jurisdiction”)
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10 Essential Services of Public 10 Essential Services of Public HealthHealth
Monitor Health
Diagnose/Investigate
Inform, educate, empower
Mobilize partnerships
Policy Development
Enforce laws & regs
Link people/health care
Assure a competent workforce
Evaluate quality
Research for new insights
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Developing Charts to Educate Developing Charts to Educate the Public Health System the Public Health System
EvaluatorsEvaluatorsCollaborations
Coalitions & Partnerships
Community Assessments
Disaster Preparedness
Task forces/projects
Health Surveillance Activities
Agencies/Town Depts. that had under gone evaluations
Advocacy Groups
Emergency Equipment
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Collaboration PostersCollaboration Posters
Senior Provider Network ~ Advisory Boards ~ United
Way Youth & Planning Councils ~ Senior Health Fair
Team ~ Late Life Issues Committee ~ Underage
Drinking Coalition ~ Greenwich Health Improvement
Partnership & Committees ~ Time for Lyme Task
Force ~ Regional B-T Group ~ Assessment
Committees ~ Disease-based Advisory Councils ~
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Community Assessments Community Assessments PostersPosters
Greenwich Department of Health:– Latino Study– Public Health Systems Assessment
United Way:– Community Needs Assessment – Statistical Portrait (w/GDoH)
Greenwich Hospital Advisory Board:– Community Health Assessment
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Disaster Preparedness Disaster Preparedness PostersPosters
B-T Coordinator/Team ~ Disaster Plans ~ Mass Immunization Protocols ~ Communication modalities ~
Incident Command Training ~ Mock Disasters ~
PPE/Training ~ Broadcast Fax ~ Radiology Meters ~ Decontamination Units ~ SARS & Avian Flu monitoring/tracking~ Highest # of certified Hazmet Techs in CT (96) ~ 50 MOP II test kits ~ “Decon” trailer & portable unit ~ 50 docemeters ~ Fully equipped Hazmat truck w/ mobile command unit, picture transmission on order
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Other Poster DisplaysOther Poster Displays
• Policy and planning forums/collaborators
• Town’s Surveillance System Components:Equipment Monitoring Partners
Training Capacity Drills
• Essential Services of Public Health
• Agencies that had undergone internal
studies or major reviews within 5 years
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Pre-Assessment Pre-Assessment WorksheetsWorksheets
List each of the 10 EssentialServices of Public Health
Pre-Identify some specific examples within your community
Pre-Identify some agencies involved in fulfilling each essential service
Members provide additional input based on their own experience
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Pre-Assessment Website Pre-Assessment Website ReviewReview
• Assessments conducted
• Data gathering and report sharing
• Research studies/Findings
• Linkages/Collaborations
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Pre-Assessment Pre-Assessment PreparationPreparation
Identify The Invitees/Construct Your MixIdentify The Invitees/Construct Your Mix
• Local Hospital, nursing homes, practitioners,
etc.
• 1st Responders (police, fire, ambulance, E.R.)
• Red Cross
• School and business representatives
• Town health & social service provider agencies
• Consumers, local government, funding sources
• Clergy, service organizations
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Pre-Assessment Pre-Assessment PreparationPreparation
Two Breakout sessionsBreakout sessions were designed:
1) Greenwich Department of Health 2) 1st Responders
Information gathering sessions were Information gathering sessions were held with key people who could not held with key people who could not
attend attend
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Pre-Assessment Pre-Assessment PreparationPreparation
Seek representation that reflects your
culturalcultural and ethnicethnic groups and various
age groupsage groups and special needsspecial needs populations
Seek participation from people at various various
levels of organizationslevels of organizations
Seek people from Town governmentTown government
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Assessment DayAssessment Day
On site monitor
Orientation AM and PM
Breakout sessions
Model standard vs. Town
performance
Facilitating the discussion
Scoring the group responses
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Post AssessmentPost Assessment
Entering the response Scores
Getting the report results
Drafting the final report
Community Forum
Using the report findings
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Utilizing Report Results Utilizing Report Results 1 1
of 2of 2
Even good results can offer Even good results can offer opportunities for opportunities for
improvement:improvement:
• The standard may be met but individual indicators may be lacking
• The raters perception may be erroneously positive
• Intra/inter agency communications may be editorialized in a group setting
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Utilizing Report Results Utilizing Report Results 2 2
of 2of 2
Community forums and press releases Guide the development or revision of a strategic or operating planGuide the development of outcome based budgeting Motivate a workforce capacity studyEnhance communication of data, research findings, and surveillance
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