Looking Toward the Looking Toward the Horizon: A Public Health Horizon: A Public Health
PerspectivePerspective
An Overview of An Overview of Tools/Platforms for Public Tools/Platforms for Public
Health ImprovementHealth Improvement
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
22
Tools/PlatformsTools/Platforms• Public Health Accreditation Board (PHAB) Public Health Accreditation Board (PHAB)
http://www.phaboard.org/http://www.phaboard.org/
• National Public Health Performance Standards National Public Health Performance Standards Program (NPHPSP) Program (NPHPSP) http://www.cdc.gov/od/ocphp/nphpsp/http://www.cdc.gov/od/ocphp/nphpsp/
• Mobilizing for Action through Planning and Mobilizing for Action through Planning and Partnership (MAPP) Partnership (MAPP) http://www.naccho.org/topics/infrastructure/MAPPhttp://www.naccho.org/topics/infrastructure/MAPP/index.cfm/index.cfm
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
33
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
44
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
55
PHABPHAB
The goal of the national public health The goal of the national public health accreditation program is to improve and accreditation program is to improve and protect the health of the public by protect the health of the public by advancing the quality and performance of advancing the quality and performance of allall health departments in the country – health departments in the country – state, local, territorial and tribal. state, local, territorial and tribal. Accreditation will drive public health Accreditation will drive public health departments to continuously improve the departments to continuously improve the quality of the services they deliver to the quality of the services they deliver to the community.community.
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
66
PHABPHAB• Voluntary accreditation of local and Voluntary accreditation of local and
state health departmentsstate health departments• Focuses on the department, but looks Focuses on the department, but looks
for evidence of system involvementfor evidence of system involvement• Sets a common or threshold standard Sets a common or threshold standard
for local and state public healthfor local and state public health• Assessed both by a self assessment and Assessed both by a self assessment and
peers in the fieldpeers in the field• Requires documentary evidenceRequires documentary evidence
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
77
NPHPSPNPHPSPTo improve the quality of public health practice
and performance of public health systems by:1.1. Providing Providing performance standardsperformance standards for public for public
health systems and encouraging their health systems and encouraging their widespread use;widespread use;
2.2. Engaging and leveraging national, state, and Engaging and leveraging national, state, and local local partnershipspartnerships to build a stronger to build a stronger foundation for public health preparedness; foundation for public health preparedness;
3.3. Promoting continuous Promoting continuous quality improvementquality improvement of of public health systems; and public health systems; and
4.4. Strengthening the Strengthening the science basescience base for public for public health practice improvement.health practice improvement.
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
88
NPHPSPNPHPSP
• Systems approachSystems approach• Voluntary assessment of the local health Voluntary assessment of the local health
department, local public health governance, or department, local public health governance, or the state public health systemthe state public health system
• Compares to a gold or optimal standardCompares to a gold or optimal standard• Provides a benchmark for state and local Provides a benchmark for state and local
systems can strive to achievesystems can strive to achieve• Self assessed by system partnersSelf assessed by system partners• Based on the opinions of the system partners Based on the opinions of the system partners
presentpresent
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
99
The System…well, some of The System…well, some of itit
Schools
Community Centers
Employers
Transit
Elected Officials
Doctors
EMS
Law Enforcement
Nursing Homes
Fire
Corrections
Mental Health
Faith Institutions
Civic GroupsCivic Groups
Non-Profit Organizations
Neighborhood Organizations
Laboratories
Home Health
CHCs
Hospitals
Tribal Health
Drug Treatment
Public Health Agency
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1010
MAPPMAPP
Mobilizing for Action through Planning and Mobilizing for Action through Planning and Partnerships (MAPP) is a community-driven Partnerships (MAPP) is a community-driven strategic planning tool for improving community strategic planning tool for improving community health. Facilitated by public health leaders, this health. Facilitated by public health leaders, this tool helps communities apply strategic thinking tool helps communities apply strategic thinking to prioritize public health issues and identify to prioritize public health issues and identify resources to address them. MAPP is not an resources to address them. MAPP is not an agency-focused assessment tool; rather, it is an agency-focused assessment tool; rather, it is an interactive process that can improve the interactive process that can improve the efficiency, effectiveness, and ultimately the efficiency, effectiveness, and ultimately the performance of local public health systems.performance of local public health systems.
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1111
MAPPMAPP
Four assessments are used for Four assessments are used for strategic planning and strategic planning and evaluation:evaluation:
•Community themes and Community themes and strengthsstrengths
•Local public health systemLocal public health system•Community health statusCommunity health status•Forces of changeForces of change
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1212
MAPP ModelMAPP Model
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1313
What do these performance What do these performance improvement tools have in improvement tools have in common?common?
• Based on a framework of the 10 Based on a framework of the 10 Essential Public Health FunctionsEssential Public Health Functions
• Systematic approach to improve Systematic approach to improve performanceperformance
• Rely on existing relationships both Rely on existing relationships both internal and externalinternal and external
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1414
ProsPros
• Tangible method of assessing Tangible method of assessing performance – sets a baselineperformance – sets a baseline
• Examines both quantitative and Examines both quantitative and qualitative informationqualitative information
• Documentation of accountabilityDocumentation of accountability
• Raises the standard of public healthRaises the standard of public health
• Improves performanceImproves performance
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1515
ConsCons
• Time and labor intensive – expensiveTime and labor intensive – expensive
• It is an on-going processIt is an on-going process
• Should be driven by leadershipShould be driven by leadership
• It is a It is a waste of timewaste of time if you do not use if you do not use the informationthe information
• Forces an organization to be more Forces an organization to be more evidence-basedevidence-based
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1616
Deciding which instrument to Deciding which instrument to useuse
• Decide what you want to Decide what you want to assess (e.g. community, assess (e.g. community, city county, department, city county, department, etc.)etc.)
• Determine the resourcesDetermine the resources
• Evaluate the Evaluate the commitment of commitment of leadershipleadership
• Assess the will to use Assess the will to use the informationthe information
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1717
After the assessmentAfter the assessment
• Analyze the informationAnalyze the information
• Community plan or a strategic planCommunity plan or a strategic plan– Vision/mission/philosophyVision/mission/philosophy– Performance improvement , strategies, Performance improvement , strategies,
goal, objectives and activitiesgoal, objectives and activities
• Evaluate, evaluate, evaluateEvaluate, evaluate, evaluate
• Assess againAssess again
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1818
Guidance for planningGuidance for planning
• Establish your scope and stick to itEstablish your scope and stick to it
• Keep it simpleKeep it simple
• Go for early success…low-hanging Go for early success…low-hanging fruitfruit
• Use both quantitative and qualitative Use both quantitative and qualitative measuresmeasures
• Celebrate successCelebrate success
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
1919
Guidance for preparing public Guidance for preparing public health performance measureshealth performance measures
• Follow the definition of what you will Follow the definition of what you will measuremeasure
• Link to an essential public health function Link to an essential public health function (EPHF)(EPHF)
• Identify significant tasks or functions to be Identify significant tasks or functions to be measuredmeasured
• Begin by writing for perfect performanceBegin by writing for perfect performance• Make the majority of measures quantifiableMake the majority of measures quantifiable• Ensure that the measures adequately Ensure that the measures adequately
represent the work requiredrepresent the work required
Performance ImprovementPerformance Improvement Tools Tools
Division for Regional and Local HealDivision for Regional and Local Health Servicesth Services
2020
Questions?Questions?