Transcript Module 1: MAPP - What and Why?

Madison County
MAPP Committee
March 12, 2008
Introductions
MAPP Team
Name,
Agency,
Interest for being on MAPP Team
Expectations
Assets and Contributions
Meeting Objectives
Share update of activities
from the Visioning Subcommittee
Provide in-depth
information about the four
assessment components
Establish assessment
subcommittees and
review charge
Agenda
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Welcome & Agenda Review
Introductions
Visioning Subcommittee - Update
The Four Assessments - Presentations
Assessment Subcommittees
Meeting Resources – Survey
Closing
Adjourn
Visioning
Sub-committee
Health Status
Local Health System
The Four
Assessments
Community Themes
&
Strengths
Forces of
Change
National Public Health Performance Standards
Program (NPHPSP)
Local Public Health System Assessment
MAPP
(Mobilizing for Action through
Planning & Partnerships)
Includes 4 assessments:
1) Community Health Status Assessment
2) Community Themes and Strengths
Assessment
3) Forces of Change Assessment
4) Local Public Health System Assessment =
(National Public Health Performance
Standards Program)
National Activities
What is the Public Health System Assessment?
GOAL:
A tool designed to assess and improve the quality of public health practice and
performance of public health systems by:

Providing performance standards for public health
systems and encouraging their widespread use;

Engaging and leveraging national, state, and local
partnerships to build a stronger foundation for public
health preparedness;

Promoting continuous quality improvement of public
health systems; and

Strengthening the science base for public health practice
improvement.
Incorporates 4 Concepts:
1. The 10 Essential Services
as a Framework
Defines all of the health activities that are required in a community
health system
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Monitor health status
Diagnose and investigate health problems
Inform, educate and empower people
Mobilize communities to address health problems
Develop policies and plans
Enforce laws and regulations
Link people to needed health services
Assure a competent workforce
Evaluate health services
Conduct research for new innovations
2. Focuses on the Public or Community Health
System
EMS
Schools
Neighborhd.
Civic Groups
Non-Profit
Orgs.
Nursing
Homes
Organizations
Home Health
Hospitals
Drug
Treatment
Local Public
Health Agency
Laboratories
Doctors
CHCs
Community
Centers
Mental Health
Faith Instit.
Law
Enforcement
Tribal Health
Employers
Corrections
Elected Officials
Fire
Transit
3. Optimal Level of Performance
Each performance or model standard represents the “gold
standard”
4. Stimulate Quality Improvement
 Standards
should result
in
identification
of areas for
improvement
 Link results to
an improvement
process
“What gets measured gets done.”
If you don’t measure results, you can’t tell success from failure.
If you can’t recognize failure, you can’t correct it.
If you can’t see success, you can’t learn from it
10
Essential
Services
Definition of Essential Service
Example of Model Standard & Ratings
Model or
“gold”
Standard
Measurement
Questions
How is the NPHPSP Implemented?
Key Steps in the Process
Identifying, Recruiting & Orienting
Participants
 Key questions:
 Who plays a role in the public health system or providing
the Essential Services?
 What expertise is needed?
 How many people should participate?
 A lot of work! (Phone calls, letters, promotional activities)
 Orient to NPHPSP, 10 Essential Services,
Health System and purpose of assessment
 Importance of participation
Planning and preparation is key to commitment and success
Facilitator & Recorder Roles
Facilitator
 Review model standards, questions and obtain response decision
 Strong skills in leading group discussions
 Lead a group to consensus (manage disagreements,
draw out dissenting opinion)
 Validate participants and get input from everyone
 Recognize and manage dominant personalities and those that need to be drawn
out
 Keep focus on health “system”
 Keep process moving
 Trusted, assertive, patient, neutral
 Identify early and orient
2 Recorders:
 Record group responses to measurement questions
 Record key issues and qualitative information that shape
group responses
 Assist the facilitator to manage time
 Parking lot issues
Meeting Structure
Small Group
Activities
Retreat
Advantages:
Generally 1-2 days
Advantages:
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Short timeframe
Maintains
momentum

Allows for
expertise, as needed
Less overwhelming
Drawbacks:


Drawbacks:

Requires time
commitment

Can be
overwhelming

Less cross-learning
Less consistency in
response
development
Series of
Meetings
Advantages:
 Allows for expertise,
as needed
 Gets the work done in
small pieces
 Allows for more
dialogue which is key
Drawbacks:
 Participation changes
with meeting
attendance
 Process may seem to
“drag on”
Create a Comfortable Environment
 Stick to the timeframe
Process for Facilitating Discussions &
Voting
1. Walk through questions one by one with follow up voting with
color-coded cards
2. Discuss model standards for set period of time with follow up
voting using color-coded cards
3. Discuss model standard for set period of time with facilitator
and recorder judgment on responses
Oneida County Experience:
 Discussed EPHS & Model Standard
 Smaller groups discuss and score some of the questions
 Planning team judgment on responses for remaining questions.
Submitting Responses
for a CDC Report
1. Electronic Submission of responses to
CDC:
2. Automated analysis begins after all data is
submitted
3. Report is available within 2 hours
4. Respondent accesses final report and
downloadable data files from web
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scores for all Essential Services
model standards
several charts and graphs displaying the data
raw data
any data limitations
Oneida County Results
Summary of Performance on Model Standards
EPHS
Model
Standard
Met
Model Standard
Substantially
Met
Model Standard
Partially Met
Monitor
Health
Status
1.1
Populationbased
community
health profile
1.2 Access to and
utilization of
current
technology
1.3 Maintenance
of Population
Health Registries
Diagnose
and
investigate
Health
Problems
2.2 Plan for
public health
emergencies
Model
Standard
Not Met
2.4 Laboratory
support for
investigation of
health threats
Get results to participants immediately – build on momentum
Reminder!
Data from the assessments reflects
the system performance and are
not intended to judge or compare
organizations and public health
agencies. This assessment is
intended to assist in quality
improvement.
Participant Comments & Lesson Learned
Pros/Positives:
 Interactive process that engaged
broad spectrum of participants
 Visuals and presentation of
materials very helpful
 Facilitation
 Structured in a way that sparked
good discussions
 Well-organized ; focused with clear
expectations
 Small group discussions were nonthreatening
 Combination of large group and
small group discussions and
activities
 Networking opportunities; learning
about different organizations
 Better understanding of the “public
health system”
 Expanded membership of the
Health Coalition
Cons/Areas for
Improvement:
 Challenging coming to consensus
 Mix up work groups, make more
diverse
 Wording and phrasing of CDC questions
ambiguous
 Round tables to facilitate discussions
 More discussion about the “public
health system”
 Better understanding of assessment
questions and rating system
 Send out assessment tool before
meeting
 Process seemed a little rushed
 Assign a member from planning team
to each table
 More diverse community
representation.
NPHPSP TOOLS
Several resources to assist with each
step of the process
 User Guide
 Frequently-Asked-Questions, that can help you to
think about the entire process.
 Lessons Learned from Other Counties/States
 Recommendations for structuring participation
 Sample Orientation Presentations
 Sample Recruitment and Follow-up Letters
 Time and costs
 Other Helpful Hints
 Performance Improvement Resource Guides
 Monthly Teleconference for users of the NPHPSP –
Program Partners and Nationwide Users
The Community Themes
and Strengths Assessment
Answers the question
“What is important to
community members
and what assets do
we have?”
Benefits
 Community members become more vested in
the process when they have a sense of
ownership in and responsibility for the
outcomes. This occurs when their concerns are
genuinely considered.
 The impressions and thoughts of community
residents help pinpoint important issues and
highlight possible solutions.
 The themes and issues offer additional insight
into the findings uncovered in other
assessments.
Three Levels of Information
Open discussion to elicit
community concerns, opinions,
and comments
Perceptions regarding community
quality of life
A map of community assets
Gather Information
Meetings
Focus groups
Forums
Door to door/intercept surveys
Mail surveys
Interviews
Utilize existing community groups and
organizations
Promote broad participation
Select the best combination of techniques
What’s important?
Focus on:
opportunities vs. problems
investment vs. charity
people vs. programs
community organizations vs.
government agencies
citizens vs. “clients”
Findings
Help to organize and identify key themes
Assists in addressing cross-cutting issues
from other assessments
Useful for reporting back to MAPP
Committee
Guides work when identifying strategic
issues
Ensure community involvement
and empowerment is sustained
Document conversations, discussions
and meetings
Develop a master list of contacts
Health
Status
Assessment
Answers the questions:
How healthy are our
residents?
What does the health status
of our community look like?
Information regarding health status,
quality of life, and risk factors in the
community
Basis for analyzing and identifying
community health issues
Useful for comparison to peer
communities, state and national data.
Data Collection
 Identify and collect data for core indicators
 Access existing databases, recent assessments
or reports
 Organizational or Agency data
 State, National, and local data
 Identify new data sources/needs (social
determinants)
 Tailor to local needs and or issues
 Identify and partner with research organizations
 Build on what community has already done
Health Profiles
 Based on data analysis and findings
 Life-course based, e.g., Adult Health Profile
 Develop visual aids that display data in an
understandable and meaningful way
 Recognize and appreciate difference between
data are statistically significant and those that
are important to the community
 Disseminate and share with community
Monitoring
Establish a system to monitor the
indicators over time
Ensures continuing health monitoring
Establishes baseline data upon which
future trends can be identified
Instrumental in identifying the results of
the MAPP process and evaluating success
of MAPP activities
Findings
Provides a list of key challenges and
opportunities related to community health
status
Identify major health problems or high risk
behaviors, cross-cutting issues, and
opportunities for improving trends
Top 10-15 issues examined during
strategic issue development
Summarized reports & profile development
Forces
of Change
Answers the questions:
“What is occurring or might
occur that will affect the
community or public health
system?”
“What specific threats or
opportunities are generated by
these occurrences?”
Forces of Change…

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State and federal legislation,
Rapid technological advances,
Changes in the organization of health care
services,
Shifts in economic forces
Migration in and out of community
Changing family structures
One-time events e.g. disaster
Discrete elements – e.g., proximity to a major
waterway or highway
Identifying Forces of Change
 Brainstorm to identify forces
 MAPP Committee
 Small groups
 Community forum (s)
 Newspaper clippings, national demographics,
reports, recent events, etc.
 Develop list and discuss
 Consolidate like forces
 Identify threats and opportunities
 Summarize and report findings
Assessment Sub-Committees
 Review project summaries
and charge
 Identify subcommittee
members and appoint
chairperson
Meeting
Resources
Survey
Closing:
 What worked? What can be
improved?
 Next Meeting – April 9
 Agenda for next meeting
Adjourn