the national public health performance standards 201: tips and tricks for successful implementation...
TRANSCRIPT
The National Public Health Performance Standards 201: Tips and Tricks for Successful
ImplementationChristine Abarca, Florida Department
of Health Teresa Daub, CDC
Learning ObjectivesFollowing this session, you will be able to:•Describe the framework and concepts that underpin the three assessment tools of the NPHPS•Discuss the similarities and differences between Versions 2 and the re-engineered Local NPHPS•Identify at least one option for conducting an NPHPS assessment•List three or more tips for implementing the NPHPS assessment
Understanding NPHPS Key Concepts and Tools
3
NPHPS VisionA partnership effort
to improve the quality of
public health practice and
performance of public health systems
Four Concepts Applied in NPHPS
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
1. The Essential Public Health Services1. Monitor health status2. Diagnose and investigate health
problems3. Inform and educate4. Mobilize communities to address
health problems5. Develop policies and plans6. Enforce laws and regulations7. Link people to needed health
services8. Assure a competent health
services workforce
9. Evaluate health services10.Conduct research for new
innovations
2. Public Health System
Schools
Community Centers
Employers
Transit
Elected Officials
Doctors
EMS
Law Enforcement
Nursing Homes
Corrections
Faith Institutions
Civic GroupsCivic Groups
Non-Profit Organizations
Neighborhood Organizations
Laboratories
Home Health
CHCs
Hospitals
Tribal Health
Drug Treatment
Public Health Agency
Mental Health
Fire
3. Optimal Level of Performance • Each performance standard
represents the “gold standard”
• Provide benchmarks to which state and local systems can strive to achieve
• Stimulate higher achievement
4. Stimulate Quality Improvement• Standards should result in identification of areas for improvement
• Link results to an improvement process
• NPHPS Local Instrument - used within the MAPP planning process Plan
DoStudy
Act
NPHPS Materials• Assessment Instruments
– State public health system– Local public health system– Local governance
• User Guidance• Glossary
NPHPS Version 2.0 (2007) and Re-Engineered (2012)• Both versions:
– Are grounded in the 10 Essential Public Health Services
– Use a semi-qualitative rating scale– Can contribute to health improvement planning
as well as strategic planning activities
• Re-engineered:– Has fewer scored questions– Incorporates plain language principles– More discussion-focused (relies more heavily on
facilitation)– Has increased quality improvement focus
Version 2 Instrument Format
ModelStandard
Essential Service
Version 2 Instrument Format
DiscussionToolbox
Measuresor Questions
Re-engineered NPHPS – Fall 2012• Streamlined the assessment tools• Enhanced systems building aspects
of the assessment process• Increased quality and performance
improvement activities • Strengthened linkages with
accreditation
16
Essential ServiceDescription
•Includes list of potential system partners for each Essential Service
Field Test DRAFT
17
Model StandardDescription
•Uses plain language
Field Test DRAFT
18
Model StandardDiscussion Questions and Performance Measures
•More discussion•Fewer scored questions
Field Test DRAFT
19
Essential Service Summary Notes Page
Framework for identifying:•Strengths•Weaknesses•Opportunities•Priorities
Field Test DRAFT
Supplemental QuestionnairesBoth Versions•Priority Questionnaire (optional)
– “On a scale of 1 to 10, what is the priority of this model standard?”
•Agency Questionnaire (optional)– “What best reflects the contribution of the agency to this
model standard?”
Planning for the Assessment
21
Planning for the Assessment1. Assess readiness 2. Select assessment option3. Determine timeline and create project
plan4. Identify and invite system partners5. Select and train facilitators and recorders6. Prepare orientation and assessment
materials
Assess Readiness• Determine Who Will Lead the NPHPS
process• Assess Readiness
• Leadership Commitment• Purpose and Benefits• Resources• Strategic Fit
• Move Forward
Select Assessment Option• Common Options
– Large Meeting/Retreat– Small Group Activities– Series of Meetings
• Choose the option that best meets needs of participants
Large Meeting/ Retreat• Generally 1-2 days• Advantages:
– Short timeframe– Maintains momentum
• Drawbacks:– Requires time commitment– Can be overwhelming
Small Group Activities• Advantages:
– Allows for expertise, as needed– Less overwhelming
• Drawbacks: – Less cross-learning– Less consistency in response
developmentTip! Many larger sites use small breakout Tip! Many larger sites use small breakout groups during a large meeting process!groups during a large meeting process!
Series of Meetings• Advantages:
– Allows for expertise, as needed– Gets the work done in small pieces
• Drawbacks:– Participation changes with meeting
attendance– Process may seem to “drag on”
Tip! This option works especially well for Tip! This option works especially well for boards of health, which can address one or boards of health, which can address one or
two Essential Services at each board two Essential Services at each board meeting.meeting.
Timeline and Project Plan
• Varies depending upon assessment approach
• Allowing 3-5 months is reasonable• Find sample project plans online
Tip! Engage a small planning team of Tip! Engage a small planning team of agency or system representatives to plan agency or system representatives to plan
the process. the process.
Identify Participants• Key questions:
• Who plays a role in the public health system or providing the Essential Services?
• What broad, cross-sector participation is needed?
• What expertise is needed?• How many people should participate?
• Ensure consistency or a core group among respondents
• Agency and system participants are both important!Tip! Existing coalitions or committees can Tip! Existing coalitions or committees can
be a starting point for diverse be a starting point for diverse representation!representation!
Potential Participants• Board of Health
Members• State / Local
Governmental agencies• Hospitals• Statewide associations
(e.g., medical, nursing, hospital)
• Primary care clinics and physicians
• Social service providers• Civic organizations• Professional
organizations• Faith institutions• Transportation providers
• Educational institutions• Public safety and
emergency response organizations
• Environmental or environmental-health agencies
• Non-profit organizations/advocacy groups
• Appointed or elected officials / state or community leaders
• Other state or community organizations
Invite Participants• Set the tone
– Invite participants to a meeting for understanding and improving the public health system (not to complete a questionnaire)
– Establish expectations that this is for improving performance right from the start!
• Consider sending some brief information as orientation
• Use personal or leadership connections to gain interest– Extend invitations to participate via personal letters, email,
or phone calls.– Best extended by the local health director or other senior HD
staff.
Select and Train Facilitators & Recorders
• Number needed may vary• Training should cover:
– Orientation to NPHPS– Assessment Materials and Process– Expectations of Role
Facilitator Roles• General responsibilities
– Establish and adhere to ground rules– Manage group process – set the pace– Get input from everyone– Draw out different points of view– Reflect and check group opinion
• NPHPS responsibilities:– Keep the focus on the “system”– Review model standards and facilitate open discussion– Discuss key questions and gather group responses– Re-open discussion where needed– Obtain a decision on the final response
Recorder Roles• Record group responses
– Different votes (optional)– Final consensus response
• Record key ideas and comments from the discussion– Note issues and qualitative information that
shape group responses– Strengths and weaknesses – Areas for immediate improvement– Priorities
• Assist the facilitator to manage time
Tip! Consider using flip Tip! Consider using flip charts or a charts or a
laptop/projector so that laptop/projector so that everyone can see the everyone can see the
responses and comments!responses and comments!
Preparing for the NPHPS• The Online Tool Kit includes sample:
– Participant Selection Table– Recruitment / Invitation Letters– Preparations Checklist– Pre-Assessment Press Releases– Meeting Agendas Tip! Use samples from Tip! Use samples from
other sites and revise other sites and revise as needed!as needed!www.cdc.gov/nphpsp/
Conducting the Assessment• Convene and orient participants
• Assess and document system performance
• Submit assessment data
• Advance and/or on-site orientation• Key topics:
– Essential Services– Public Health System– Purpose of the assessment– The process– What next? Using the results to improve!Tip! Consider using the Essential Services Tip! Consider using the Essential Services
brainstorming exercise – 10 flip charts brainstorming exercise – 10 flip charts around the walls – as both orientation and around the walls – as both orientation and
input!input!
Orient Participants
Thomas Nelson Community College –
Center for Workforce
Development
Center for Excellence in Aging & Geriatric
Health
Peninsula Health District(PHD)
Wmbg Gov’t JCC Gov’t
PHD Emergency Preparedness and Response
Wmbg Dept of Human Services
Medical Reserve Corp,
Virginia Department of
Health
YC/Poquoson Social
Services
YC Dept of Community
Services
YC Gov’t
JCC Dept of Emergency Managemen
t
Alzheimer’s
Association
JCC Parks & RecYC Division of
Housing and Neighborhood Revitalization
Historic Triangle Substance Abuse
Coalition
United Way of Greater
Wmbg
Wmbg Community
Health Foundation
Riverside Health System
Foundation
Salvation Army of Wmbg
Sentara Wmbg Regional Medical
Center
Eastern State HospitalRiverside School
of Health Careers
Lackey Free Clinic
Olde Towne Medical Center
Wmbg/JCC Public Schools
YC Children’s Services
Child Development Resources,
Inc
JCC Social Services
Historic Triangle Senior
Center
Care Options
AARP
Respite Care of Wmbg United
Methodist Church
Bayada Nurses
Peninsula Agency on
Aging
Comfort Keepers
Bay Aging
Patriot’s Colony at
Wmbg (Riverside)
Home Instead
Senior Care
Senior Services Coalition
“Customized Egg Chart”Peninsula Health District, VA
Assessment Process• Review and Discuss Model Standard• Read and Discuss Questions• Preliminary Vote• Consensus Building• Essential Service Wrap-Up
Tip! Use an Audience Response System Tip! Use an Audience Response System (ARS) if available. Color-coded cards are a (ARS) if available. Color-coded cards are a more low-tech way to gather votes from all more low-tech way to gather votes from all participants – template cards are on-line!participants – template cards are on-line!
Submitting Version 2 Assessment Data• Obtain a User ID• Enter and Submit Data
• Download Reports All at: www.nphpsp-results.org
Immediately after the Assessment• Report out the summary of findings
– Overview of the EPHS strengths and weaknesses
– Insights that shaped group judgments– Impressions and early ideas for
improving the system Tip! If groups compile opportunities for Tip! If groups compile opportunities for improvement and next steps as they go improvement and next steps as they go through each section, this can easily be through each section, this can easily be collected into a master draft that can collected into a master draft that can
jumpstart immediate performance jumpstart immediate performance improvement!improvement!
Conducting the Assessment• Assessment Instruments and Model
Standards• User Guide• The Online Tool Kit includes sample:
– Assessment Agendas– Assessment Meeting Guide– Ground Rules– Evaluation Forms
www.cdc.gov/nphpsp/
NPHPS User Experiences• Tips from our most successful users:
– Involve broad system participation– Ensure visible leadership– Conduct assessment within context of
broader state/community health improvement process or performance improvement effort
– Provide strong facilitation, which is critical to a positive experience and building momentum
Contact InformationChristine AbarcaFlorida Department of Health [email protected] 850-245-4444 ext. 2071
Teresa DaubCenters for Disease Control and [email protected] 404-498-0317