public health workforce development louis rowitz, ph.d mid-america regional public health leadership...
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PUBLIC HEALTH PUBLIC HEALTH WORKFORCE WORKFORCE
DEVELOPMENTDEVELOPMENT
LOUIS ROWITZ, Ph.D
MID-AMERICA REGIONAL PUBLIC HEALTH LEADERSHIP
INSTITUTE
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The Public Health Workforce The Public Health Workforce (PHS)(PHS)
All those providing essential public health services, regardless of the nature of the employing agency.
Promotion of individual and organizational excellence is the only standard acceptable to the public and decision makers who play a vital role in realizing the vision of Healthy People in Healthy Communities.
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The Professional The Professional Obligations (Curry et al.)Obligations (Curry et al.)
All professionals are obligated to both acquire and maintain the expertise needed to undertake their professional tasks and all are obligated to undertake those tasks that are within their competence.
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Competence is a professional Competence is a professional and and moralmoral obligation oriented obligation oriented to the highest standards of to the highest standards of performance and not to a low performance and not to a low minimal one.minimal one.
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The determination of high The determination of high performance standards as performance standards as well as the minimal ones must well as the minimal ones must be determined by the public be determined by the public health professions, the policy health professions, the policy makers, community needs, makers, community needs, and societal values.and societal values.
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The Public Health Worker’s The Public Health Worker’s Social ResponsibilitySocial Responsibility
Throughout the public health system, the social and moral responsibility of all individuals involved in the promotion of the health of the public is to put learning and experience into future practice.
This is what competency concerns are all about.
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Educators and Educators and TrainersTrainers
Give the Public Health Worker the tools but the worker must take the responsibility of using these tools
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Competency = Competency = Knowledge + Knowledge +
Understanding + Understanding + PracticePractice
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Public Health leaders need do Public Health leaders need do be held to the highest be held to the highest
standards of competencystandards of competency
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National Public Health National Public Health Leadership NetworkLeadership Network
Created in 1994 Funded by CDC and housed at St. Louis
University School of Public Health Supports the growth of state and regional public
health leadership development opportunities in all 50 states
Provide formal mechanisms for academic and practice to work together to promote leadership at all levels of the public health system
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The Leadership CompetencyThe Leadership CompetencyProjectProject
Began in 1994 Ongoing Identification of competency requirements for
public health leadership due to multidisciplinary nature of public health
Competencies are tied to performance standards Built upon the core public health
functions/essential public health services
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Four Major Leadership Four Major Leadership Competency areas were Competency areas were
defined by NLNdefined by NLNTransformational competenciesPolitical competenciesTransorganizational competenciesTeam Building Competencies
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Core Transformational Core Transformational CompetenciesCompetencies
VisionarySense of MissionEffective change agent
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Core Political CompetenciesCore Political Competencies
Understanding of political processNegotiationEthics and PowerMarketing and education
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Core Transorganizational Core Transorganizational CompetenciesCompetencies
Understand organizational dynamics
Interorganizational collaborating mechanisms
Social forecasting and marketing
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Core Team Building Core Team Building CompetenciesCompetencies
Develop team oriented structures and systems
Facilitate development with teams and work groups
Serve in facilitator and mediator role
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Estimated 500,000 individuals Estimated 500,000 individuals currently employed by a range currently employed by a range of organizations involved in of organizations involved in public health practice and public health practice and providing the ten essential providing the ten essential services services
Public Health Workforce
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Workforce CompositionWorkforce Composition
89
66
42
36
32
27
0 20 40 60 80 100
Nurses
Adminstrators
Sanitarians
Environmental HealthSpecialists
Dietitians/Nutrionists
Public InformationSpecialists/Helath
educators
Percentage
Percentage of local health departments having at least one full-time employee in the listed job classification, U.S., 1992-1993
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An estimated 80% of the An estimated 80% of the workforce has no formal workforce has no formal training in public healthtraining in public health
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GAPGAP
Current capabilities and future needs continue to widen
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WHO IS MISSING ?WHO IS MISSING ?
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Present SOC Public Health Present SOC Public Health OccupationsOccupations
Public Health PhysicianPublic Health NursePublic Health DentistPublic Health Dental WorkerPublic Health VeterinarianPublic Health NutritionistPublic Health Pharmacist
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Standard Occupations Standard Occupations ContinuedContinued
Public Health Laboratory Scientist Public Health Laboratory Technician and
Technologist Public Health Attorney or Hearing Officer Health Information System/Computer Specialist Public Relations/Public Information/Health
Communications/Media Specialist Biostatistician
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New Recommended SOC New Recommended SOC Public Health OccupationsPublic Health Occupations
EpidemiologistEnvironmental EngineerEnvironmental Engineering Technician and
TechnologistEnvironmental Scientist and SpecialistEnvironmental Scientist Technician and
Technologist
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ContinuedContinued
Occupational Safety and Health Technician and Technologist
Health EducatorPublic Health Policy AnalystHealth Service Manager/Health Service
AdministratorPublic Health and Community Social
Worker
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ContinuedContinued
Mental Health and Substance Abuse Social Worker
Psychologist, Mental Health ProviderAlcohol and Substance Abuse Counselor,
including Addiction CounselorMental Health Counselor
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BARRIERSBARRIERS
Inventory of the workforce does not existNo consensus on the competencies or
curricula needed for the workforceIntegrated delivery system for lifelong
learning does not existInadequate incentives for participation in
training and continuing education
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BARRIERS(2)BARRIERS(2)
No uniform approach or commitment to evaluation
Financing of workforce development is unclear as well as a coherent training policy
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PROBLEMS IN PROBLEMS IN ENUMERATIONENUMERATION
Lack of clear public health professions classification/schemes
An absence of consistent public health credentialing requirements
A professional workforce educated in specific disciplines but without formal public health training
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ENUMERATION(2)ENUMERATION(2)
Standard occupation classifications based on population-based occupations
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HRSA Action StepsHRSA Action Steps
National LeadershipState and Local LeadershipWorkforce CompositionCurriculum DevelopmentDistance Learning
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National Leadership Action StepsNational Leadership Action Steps
Organize national forum of key stakeholders to examine human resource allocation and public health trends
Develop Leadership modules for training to assess roles in a changing public health environment
Involve frontline practitioners from all sectors in training
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State and Local State and Local Leadership Action StepsLeadership Action Steps
Ensure that workforce planning takes place in all appropriate jurisdictions
Work with other health professionals in the jurisdiction to achieve mutual goals in public health workforce development
Develop partnerships with the State to quantify the supply and demand of public health personnel
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Workforce Composition Workforce Composition Action StepsAction Steps
Identify lead agency to provide leadership in determining workforce needs for implementing the essential services of public health
Examine methods used by professional organizations to classify their respective workforces. DON’T REINVENT THE WHEEL
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Workforce Composition(2)Workforce Composition(2)
Develop a standard taxonomy based on essential services to qualitatively characterize the public health workforce
Use the SOC to track shifts in the movement of the workforce in the public, private, and voluntary sectors
Ensure cultural and ethnic diversity in the workforce
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Curriculum Development Curriculum Development Competencies(Action Steps)Competencies(Action Steps)
Verify that identified competencies are necessary for efficient and effective P.H. practice
Identify competencies critical to all P.H. practice and those critical to practice in specific settings
Improve long range planning to update competencies
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Curriculum Action StepsCurriculum Action Steps
Ensure that the practice community has a substantial role in curriculum development
Determine the current status of competency of the workforce
Develop measurable performance indicators for identified competencies
Survey P.H. training centers to ensure that competencies are part of the curriculum
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Curriculum Action Steps(2)Curriculum Action Steps(2)
Conduct analysis of competency statements and make revisions in curriculum
Identify gaps between high priority competencies that are needed and those already present in the workforce
Translate competencies into discrete didactic and field-based learning experiences
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Curriculum Action Steps(3)Curriculum Action Steps(3)
Create a matrix of addressed and unaddressed competencies based on public health organizational needs
Support a curriculum development process that is sensitive to the needs of the local community
Recommend to CEPH that competency-based approaches be included in academic programs
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Distance Learning Distance Learning Action StepsAction Steps
Utilize DL in training, education, and communications
Directly link DL systems and program development
Routinely gather input from key partners regarding training needs and technological capabilities
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Distance Learning (2)Distance Learning (2)
Develop agency expertise in DLProvide access to information about public
health DL programsOrganize a mechanism for pooling and
accessing resources and expertise on DL across all of public health
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CDC/ATSDR STRATEGIC CDC/ATSDR STRATEGIC PLAN FOR WORKFORCE PLAN FOR WORKFORCE
DEVELOPMENTDEVELOPMENT
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VISIONVISION
A competent workforce able to perform the essential public health services
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PremisePremise
Use the essential services as a framework for identifying workforce competency requirements
Assume a multidisciplinary, multisector, diverse and geographically dispersed public health workforce
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Premise(2)Premise(2)
Design a cohesive learning system to develop and deliver a comprehensive P.H. practice curriculum which build basic, cross cutting(core) competencies and technical skills
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Six Strategic System Six Strategic System ElementsElements
Monitor workforce compositionIdentify competencies/Develop curriculumDesign integrated learning systemUse incentives to assure competencyConduct evaluation and researchAssure financial support
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Implementation(Guiding Implementation(Guiding Principles)Principles)
Build upon existing resources of CDC and partners
Focus on the needs of the front line public health worker
Strengthen competency certification and credentialing system
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Focus AreasFocus Areas
Centers for Public Health PreparednessGlobal training development and delivery
system using state of the art technologyCertification and credentialing systems in
public healthApplied research and evaluation
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KNOWLEDGE IS THE KNOWLEDGE IS THE SECRET TO FUTURE SECRET TO FUTURE
SUCCESSSUCCESS