Transcript Document

THE ROLE OF SACCHOS IN
BUILDING CAPACITY FOR
ACCREDITATION AND QI
Linda Wagner, New York State Association of County Health
Officials
Tami Dillman, North Dakota State Association of County and City
Health Officials
ACCREDITATION
PREPARATION
& STRATEGIC PLANNING
NYS Association of County Health Officials
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Accreditation Context in NYS
NYSACHO: includes NYC Dept. of Health and Mental Hygiene, serving
8.2 million people, & 57 County Health Departments serving
populations ranging from 5,000 (Hamilton) to 1.5 million (Suffolk).
PHAB accreditation requires:
• Strategic Plan: NYS Department of Health (NYSDOH) has just
completed one. NYSACHO survey: Few LHDs in NYS have one.
• Community Health Assessment (CHA): NYS gathers health data
statewide; LHDs must complete CHA every four years, next due in
2013; Hospitals must coordinate Community Service Plan with LHDs.
• Community Health Improvement Plan: NYSDOH now developing a
State Health Improvement Plan (SHIP) to guide LHDs in developing
their CHAs and CHIPS in accordance with five Prevention Agenda
Priorities, based on CHA data.
NYSDOH is seeking PHAB accreditation as a state agency.
Several LHDs in NYS have begun accreditation application process.
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NYSACHO supports accreditation efforts
• Oct. 2010 Session at NYSACHO’s Annual Leaders
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Summit featured PHAB and NYS LHDs that participated
in beta testing either as a site or site visitor
Aug. 2011 all-day session on Accreditation and Strategic
Planning featured PHAB, NACCHO, LHDs, NYS Health
Department and Academic Partners
Feb. 2012 Workshop explained Accreditation to local
elected officials at statewide counties conference
March 2012 Session at NYSACHO meeting featured QI
efforts at one LHD and State Health Department
NYSACHO applied for and received NACCHO Accred.
Support Initiative focused on LHD Strategic Planning
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NYSACHO’s Local Health Department
Strategic Planning Initiative
• Goal: Assist LHDs in accreditation readiness
• NYSACHO facilitated a strategic planning process in four
model counties:
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Herkimer – Pop. 62,236
Chautauqua – Pop. 133,503
Dutchess – Pop. 293,562
Westchester – Pop. 955,962
All LHDs in NYS were polled for
interest and willingness to meet
project goals by June 2012
deadline; these four were selected
as representative in location, population
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Project Work Plan – Facilitator Role
• NYSACHO hired Strategic Planning Consultant (NY
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Council on Nonprofits-NYCON) to facilitate for each LHD
Staff & consultant held planning call with the 4 LHDs
Consultant collected/reviewed LHD documents (CHAs,
budgets, org charts, governance structure)
Survey tool developed with input from participating LHDS
Consultant administered customized surveys and
provided key findings for each LHD
Additional stakeholder data gathered
Consultant met with each LHD to identify key issues
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Facilitator Role (continued)
• NYCON planned and facilitated retreats with each
LHD
• Retreat results summarized and distributed
• Based on all input, consultant drafted strategic
plans
• LHDs reviewed, revised, finalized drafts in
collaboration with facilitator
• FOUR LHDs completed strategic plans by May
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Westchester - Process
• Administered survey to division
directors, supervisors, Board of
Health members; allowed for
anonymous feedback
• Key issues:
• Organizational Structure,
Internal Communications
• External Communications,
Collaboration
• Data & Information
Management
• Facilities
• Participants met to give more
feedback, discuss mission/vision,
key issues & goals.
• Four workgroups developed
strategic goals
FAST FACTS
“Extra Large” County
Urban/Suburban
430.5 sq.miles
2,204.7 people per sq. mile
68.1% White
14.5% Black
21.6% Hispanic
5.4% Asian
> 1% Native American/Alaska
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Westchester - Outcomes
Benefits:
• Opportunity to participate in open process
• Expertise of facilitator moved process forward
• Development of strategic plan will help focus
organizational efforts, inform Quality Improvement (QI)
and position department for accreditation
Next steps: Develop and implement specific action
plans that focus on operationalizing the strategic
actions and objectives identified in the plan so that
concrete activities can be monitored and tracked to
expand departmental quality improvement efforts.
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Dutchess - Process
• Created a Strategic Planning
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Team (SPT) and a Strategic
Advisory Response Team (StART)
Administered separate SWOT
analysis surveys to staff members
and community stakeholders
Reviewed existing mission, vision,
values, goals and objectives from
previous planning process
SPT held retreat to review SWOT
data and revised mission, vision,
goals and strategies;
StART reviewed information from
SPT and came up with objectives
and activities for each goal.
FAST FACTS
“Large” County
Rural to urban communities
795.63 sq. miles
373 people per sq. mile
80.1% white
9.9% Black
10.5% Hispanic/Latino
3.5% Asian
> 1% Native American/Alaska
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Dutchess - Outcomes
Benefits
• Prior knowledge of steps needed for successful
implementation due to previous strategic planning experience
• Engaged staff through volunteers from cross-section of
department programs
• StART allowed a safe venue to brainstorm, identify salient
issues for future planning
Next Steps: Use strategic plan to align Department for
organizational and funding changes and for accreditation.
Present plan to staff in smaller division meetings. Involve top
leadership in implementation. Develop learning opportunities for
staff related to accreditation and create action teams to move LHD
towards accreditation-readiness.
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Chautauqua - Process
• Administered a single
survey to staff, Board of
Health members,
community partners &
county legislators
• Reviewed findings with
division managers and
junior planner
• In-person meeting
w/facilitator to finalize
plan and develop
strategic goals
FAST FACTS
“Medium” County
Rural/Small Urban
1065 sq. miles
127.2 person per sq. mile
92.4% White
2.2% Black
6.2% Hispanic
>1% Asian, Native American/Alaska
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Chautauqua - Outcomes
Benefits:
• High survey participation rate provided important
feedback
• Redefined mission
• Focus on prevention is reshaping community health and
environmental health programs
• Renewed focus on need for health education
• Good preparation for accreditation and quality
improvement
Next steps: Establishing and implementing employee and
community communications plans, and planning strategies
to address need for focus on health education
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Herkimer - Process
• Herkimer is a “partial service”
county, i.e. State Health Dept.
provides Environmental
Health services
• Administered single survey to
staff, Professional Advisory
Board members, community
partners, county legislators
and select state health
department staff.
• Held retreat to develop
strategic plan
• Completed draft plan
FAST FACTS
“Small” Rural County
1414.5 sq. miles
48.5 person per sq. mile
96.4% white
1.1% Black
1.6% Hispanic
>1% Asian, Native American/Alaska
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Herkimer - Outcomes
Benefits:
• Helped plan for significant restructuring of department
after major change in funding and services provided
• The process helped create a new respect for one
another’s commitment to the work of the department
Next steps: Do not plan to pursue accreditation during
restructuring period. Plan to solidify tangible markers
of quality achievement, and work to present
accomplishments within the department and to local
legislators
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Results - Values
We value: (Dutchess)
• The pursuit of innovation
• Adherence to ethical principles
• Expertise in all areas of public
health practice
• Efficient and dedicated service
Our Traits are: (Westchester)
• Teamwork
• Respect
• Accountability
• Innovation
• Transparency
• Service
Our Values (Herkimer)
• Respect
• Integrity
• Quality
• Caring
Draft Values Statement
(Chautauqua)
• With integrity and compassion,
our department will apply best
practices to provide safe and
efficient services and assistance
to the public, as driven by the
needs of the community.
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Results – Mission Statements
• The mission of Dutchess County Department of Health
is to assess, protect, and promote the health of our
communities and our environment.
• The mission of the Westchester County Department of
Health is to protect health, reduce environmental risks,
prevent disease, and promote access to care and a
healthy lifestyle for people of all ages.
• Our mission is to protect and promote our residents’
health and well-being in all phases of the life cycle.
(Herkimer)
• The Chautauqua County Health Department will protect
and promote the health and environment of County
residents.
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Results - Vision
• The Dutchess CDOH will be a trusted leader, advocate and
partner with the community to prevent risks and promote public
health.
• Westchester CDH is the valued leader, partner, and resource
in preventing and responding to public health issues that affect
the health and well being of our community.
• Herkimer County residents and business will turn to our
Department for valuable health resources, information, and
support.
• The Chautauqua County DOH will be a trusted, respected
leader for protecting the health of all in Chautauqua County
and for providing essential human services, especially for those
least able to help themselves.
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SWOT Analysis – Internal (all)
Selected Strengths
Selected Weaknesses
•Highly qualified, dedicated
and experienced staff
•Quality services
•Good leadership; diverse
workforce
•Ability to set and achieve
goals
•Strong multi-disciplinary
approach to service delivery
•Strong community
partnerships.
•Multiple locations throughout
the county
•Department, at times, is fragmented and
silo’d across units
•Internal communication is not as smooth
or timely as it could be
•Aging workforce
•Decreasing and limited resources/
decreased staff capacity
•Frequent policy changes and/or lack of
policies to guide staff
•Not utilizing technology effectively
•Limited resources for marketing and
promotion of services
•Staff cuts have lead to decreased morale
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SWOT Analysis – External (all)
Selected Opportunities
Selected Threats
•Increase staff training and education
•Enhanced collaborations with
community partners
•Strengthen network of NYS County
Health Departments and related
government entities to enhance
technology efficiency
•Better use of media, particularly
electronic and social media, for
information dissemination and
engagement
•Ongoing funding cuts
negatively impacting
effectiveness
•Loss of staff
•Natural and other disasters
•Changes in state mandates
•Overall economy
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Lessons Learned
• Strategic Planning can be a positive opportunity to pro•
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actively engage staff and community partners.
Where possible, engage staff who want to be involved
further
May tend to serve as a forum to address immediate
issues or address unresolved concerns
Don’t overdo program-specific data collection (i.e. SWOT
of 10 essentials).
Assigning responsibilities can be challenging and require
creativity.
LHDs express confusion and uncertainty about
accreditation in general and about the expectations for the
Community Health Improvement Plan.
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Sharing our Results
• May 24th webinar for all 58 LHDs in NYS shared the
similarities and differences in approach taken by each
locale participating in the project; identified common
themes and challenges, and provided an opportunity for
questions and discussion.
• Strategic Plan Templates (de-identified plans)
and survey tools posted on NACCHO
and NYSACHO web sites.
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Discussion/Questions
• For more information, contact Linda Wagner,
[email protected]; 518-456-7905
Many thanks to NACCHO for funding and
supporting this project, and to PHAB and
NACCHO for providing other tools to facilitate
accreditation of local health departments.
NACCHO Accreditation Support
Initiative
“Moving the Needle in North
Dakota on Public Health
Accreditation Preparation”
June 20, 2012
ND Public Health Structure:
28 LHD’s – urban & rural
 majority (75%) serve single,
county, city or combined
city/county jurisdictions
(Eastern ND)
 25% serve multi-county
jurisdictions (Western ND)
 State population – 672,591
(2010 U.S. Census)
Project Partners:
 Collaborative effort
between state and local
public health
North Dakota State Association of City &
County Health Officials (ND SACCHO)
Project Goal: Apply for Accreditation!
To HERE!
Three
required
components
Community health assessment
Community health improvement plan
Agency strategic plan
Go from here
Accreditation process
1. Appoint accreditation coordinator
2.Complete PHAB’s orientation to PH
accreditation
3.Work on the Prerequisites
4.Prepare documentation for the Standards
and Measures.
Project Activities:
Form a State Health Department Accreditation Team
2. Review of PHAB Standards and Measures
(State/Local/Tribal)
3. Prioritize Health Status Areas for six local public
health departments
4. Develop a State Health Department Performance
Improvement Plan
1.
Implementation Strategies:
 ND utilized a core team of state and local representatives
(with subject matter expertise).
 Clearly identified participation criteria and deliverables.
 Scheduling was coordinated directly by the facilitators.
 Report templates and materials were provided.
 Built on what works (roundtables) and tools already in
place (NACCHO document tracker).
“The most effective leaders forever
alter the course of your life.”
– Tom Rath & Barry Conchie, from “Strengths Based
Leadership”
Project Partners:
 Collaborative effort
between state and local
public health
North Dakota State Association of City &
County Health Officials (ND SACCHO)
ND Department of Health
Accreditation Team
ND SACCHO PHAB Standards & Measures
Videoconference – 3/21/2012
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PHAB standards and
measures reviewed by
local public health
departments
 20 of 28 LHDs
(71%)
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PHAB application process
described
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Training for LHDs on
NACCHO documentation
tracker for acceptable
documentation
CVHD PHAB Beta Site Visit – June 2010
Domain 1 –Conduct and disseminate assessments focused on population health status
and PH issues facing the community.
 Data management system – Ahlers – provides data.
 Disease surveillance and investigation – State
function no need MOU with Disease Control
 Community Assessment documentation and the
Community Improvement Plan
Domain 12 – Maintain capacity to engage the PH governing entity.
 Board of health bylaws
 How do you inform your board of health –
narrative reports
 Minutes of board meetings
CVHD PHAB Beta Site Visit -Lessons Learned
 Review documents before submitting!
Important to date everything!
Important to sign everything!
Stick to official documents when possible
 Apply only if you are able to have evidence
for everything
 100% Support and Engagement of the
facility is key.
ND Public Health Roundtables (6)
• 23 counties
represented
• 121 participants
• 68 organizations
 Documentation
for Standard 1.1
and Standard 5.2!
http://www.ndhealth.gov/HealthData/Coun
tyHealthProfiles/
County Health
Data
• Concerning/
Alarming?
• What is Going
Well?
• Organize into
Health Status Areas
- THEMES
Southwestern District Health Unit –
Dickinson, ND
 “The process helped bring the group
together and gave us the direction
needed to come up with a plan.”
– Sherry Adams, Executive Officer
Wells County District Health Unit – Fessenden, ND
President City Council
– engaging restaurants
county wide for weekly
messaging for placemats, napkins etc. with
Character Counts
Hospital CEO – LED
sign with weekly
message.
School Supt. – sporting
activities beginning
with weekly message
announcement and
program with
recognition.
Radio Stations – weekly
message promotion and
“Student spotlight”
Banks – “Good
Neighbor” recognition.
Brenda Stallman (Left), ND SACCHO Chair
Karen Volk (Right), Nurse Administrator
Wells County District Health Unit
Overall Health Status Areas:
 Consistent overall with 2010 statewide data:
 Infrastructure
(housing, emergency services,
etc.)
 substance abuse (including alcohol abuse and
tobacco use)
 emotional health (including bullying and
suicide)
 access to healthcare
 chronic disease
Simply discussing the data with a key
group of partners can lead to action!
ND Department of Health:
 Determine the level to
which the department is
conforming to the
measures.
 Identified
documentation that
demonstrated
conformity.
 Created Performance
improvement plan from
a gap analysis based on
section reviews.
Brenda Stallman (Left), ND SACCHO Chair
Kelly Nagel (Right), ND Local Public Health Liaison
– [email protected]
Challenges:
 Coordinating schedules – facilitator and roundtable
site partners.
 Maintaining focus on health issues and not the quality
or access to care issues.
 Creating buy-in from the section chiefs and other key
staff to see the value and roles in accreditation.
Outcomes and Impact:
 Made progress in completing community health
assessments and community health improvement
plans.
 Established and dedicated groups (local and state
levels) devoted to working on the health improvement
plan and implementation strategies. (ex., State Health
Department Performance Improvement Plan)
Next Steps (July – Dec 2012):
 Complete requirements to apply for public health
accreditation in 2013.
 Continue developing the community health
improvement plan by formulating goals, objectives
and strategies.
 Carry out components of the State Health
Department’s Performance Improvement Plan.
ND Department of Health:
 Complete a State Health Assessment
 Implement a State Health Improvement Plan
 Implement the Strategic Plan
 Develop a State Health Assessment Process
 Create a QI plan
Contact:
Tami Dillman
ND SACCHO Director
(701)952-8184
[email protected]
ND SACCHO
PO Box 880
Jamestown, ND 58402
http://www.centralvalleyhealth.org/ND
SACCHO.htm
Questions/Comments . . .
Thank You!