Transcript No Slide Title

The Ten Essential Services
A standard framework for public health
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Structure of the Course
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Why the Essential Services ?
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New Applications
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Performance Measurement
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Workforce Development
Examining the Ten Essential
Services
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A developmental course - i.e. We need your
participation and comments !
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Ten three hours sessions to examine the ten essential
services.
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Each session conducted by University faculty and
IDPH practitioners
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Concludes with individual reports
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E-mail connection - [email protected]
Individual Reports
At the final class each participant will have 10
minutes to explain:
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How the 10 essential services fits into their
work situation
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Identify at least one other unit or agency
which would share responsibility for each
of the 10 services.
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Evaluate how effective each service is
being implemented.
What is Health?
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The absence of Disease or Disability
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The “complete physical, mental and
social well being and not merely the
absence of disease or infirmity”.
(W.H.O.)
What is Public Health ?
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Governmental Services (Especially
Medical Care for the Poor)
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The Methods (Knowledge and Techniques)
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The Profession
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The System and Social Enterprise
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The Health of the Public
Bernard J. Turnock
Public Health
What we as a society, do collectively to
assure the conditions in which people can
be healthy.
Institute of Medicine
Institute of Medicine
The Future of Public Health
- How we do it Public health practice is based on
scientifically sound strategies
for improving the quality of life and
reducing morbidity and premature
mortality.
Organizational Strategy
The pattern of major
objectives, purposes, or goals,
and essential policies and plans for achieving
those goals,
stated in such a way as to
define what business the organization is in or is
to be in and
the kind of organization it is or is to be.
- In the Beginning Core Functions and a Division of
Responsibility
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The Institute of Medicine - The Future of
Public Health
Assessment, Policy Development and
Assurance
The Roles of State, Local and National
Government
The Emergence of Non-Governmental
Public Health e.g. Managed Care
Assessment
The Process of Understanding
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Population Health Status
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Threats to Health
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Community Health Resources
Kristine Gebbe
Policy Development
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Reduce the threats to health
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Support positive resources
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Reduce disease
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Advance overall community health
Assurance
The process of assuring:
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Availability
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Accessibility
Quality
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IOM Report
- Federal Responsibilities
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Support knowledge development and
dissemination
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Establish national health objectives and
priorities
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Provide technical assistance
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Provide funding for capacity development
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Assure the public interest, nationally
IOM Report
- State Responsibilities -
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Assess needs based on statewide data
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Assure a statutory base
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Establish state health objectives
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Assure appropriate services
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Support local service capacity
IOM Report
- Local Responsibilities
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Assess and monitor for local health
problems and solutions
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Provide leadership for local involvement
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Assure high quality services
The Future of Public Health
Public Health in America
Vision:
Healthy People in Healthy Communities
Essential Public Health Services
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Monitor health status
Diagnose and investigate health problems and health hazards
Inform, educate, and empower people about health issues
Mobilize community partnerships to identify and solve health problems
Develop policies and plans that support individual and community health
efforts
Enforce laws and regulations that protect health and ensure safety
Link people to needed personal health services
Assure a competent public health and personal health care workforce
Evaluate effectiveness, accessibility, and quality of personal and
population-based health services
Research for new insights and innovative solutions to health problems
1. Monitor Health Status
Kinds of Activities
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disease and injury registries
epidemiology - surveillance, disease reporting,
sentinel events
population-based/community health needs
assessments
state/community report cards/development of health
status indicators
vital statistics
environmental epidemiology
immunization status tracking
data sets
2. Investigate Health Problems and Health
Hazards
Kinds of Activities
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communicable disease, chronic disease and injury
detection
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outbreak investigation and control
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contact tracing
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population-based screening services
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HIV/AIDS prevention
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environmental risk assessment and sampling
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investigation of toxic substances
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diagnostic and environmental laboratory services
3. Education
Kinds of Activities
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school health education
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school campaigns
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population-wide health promotion/risk reduction
programs
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nutrition education
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substance abuse prevention
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worksite health promotion
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HIV education
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education related to enforcement of laws and
regulations
4. Mobilize Community Partnerships to Solve
Health Problems
Kinds of Activities
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coalition building
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collaboration
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community partnerships
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advocacy and budget justification
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technical assistance to communities
5. Legal and Policy Initiatives
Kinds of Activities
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agenda setting
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development of policies and guidelines
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legislative activities
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planning models
6. Enforce Laws and Regulations
Kinds of Activities
 air
quality
 sanitation
 housing
 substance control/product safety
 vector/rodent control
 fluoridation services
 hazardous materials management
 occupational health and safety
 environmental hazards
 waste
management
 water quality control
 emergency response
 toxicology and forensic
medicine
 youth access to tobacco
 enforcement of
quarantine and
mandated supervision of
medication
7. Manage and Coordinate Health Care
Kinds of Activities
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case management/care coordination services
outreach services
transportation and other enabling services
development of primary care services in underserved communities
personal health services
clinical preventive services
school-based clinical services
management of client-based data systems
8. The Public Health and Personal Health Care
Workforce
Kinds of Activities
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professional education and training
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recruitment and retention of health professionals
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continuing education
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licensing of health and environmental
professionals
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leadership training/programs
9. Evaluate Personal and Population-Based
Health Services
Kinds of Activities
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facilities licensing
health care systems monitoring
personal health services monitoring
program evaluation
data systems
laboratory regulation
regulation of EMS personnel/services
quality improvement programs
evaluation of outcomes data
10. Research Initiatives
Kinds of Activities
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biomedical, preventive, and clinical investigations
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health services research and research grants
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research and monitoring about the effects of the
changing healthcare environment
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demonstration programs
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methods development
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innovative technologies
The Essential Services
reflect public health practice
The Washington E-Coli Example
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Physician notes HUS
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ER reports of bloody diarrhea
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Labs id cause as E.coli
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State epidemiologists locate source
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New lab tests confirm case links
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250,000 hamburger patties recalled
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Media campaign alerts public
Why make the use of the Ten
Essential Services Routine?
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By Definition - Public Health requires
collective action
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From our Strategic Plan - We must not be
in disarray
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Our base - Public Policy new levels of
organization and integration
Public Policy Developments
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Performance Measurement
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Workforce Design
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New Demands on Public Health
Government-wide Forces
for Change
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Budgets will continue to shrink substantially
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Demands and requirements will continue to
grow
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Diminishing public confidence in
government's ability to deliver services
Performance Measurement
The
selection
and
use
of
quantitative
measures of capacities, processes, and
outcomes
to
develop
information
about
critical aspects of activities, including their
effects on the public and other customers.
Benefits of Performance Measurement
QUALITY IMPROVEMENT
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Objective performance measures will define performance
expectations, provide data for benchmarking, and become an
impetus for action.
ACCOUNTABILITY
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Performance measures will provide objective data for defining the
value of public health, initiating community action, and
highlighting best practices.
INCREASED SCIENCE BASE FOR PUBLIC HEALTH PRACTICE
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Performance measurement data will provide a scientific basis for
better decision-making, useful comparative data for evaluation,
and will strengthen external leverage in partnership.
Why Measure Public Health
Performance?
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The need to effectively measure public health
performance is urgent.
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The lack of focus on population based services
which prevent disease and disability has led to
outbreaks of infectious and chronic diseases that
weaken the health of communities.
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A performance measurement system will provide
information to advocate for public health at state
and local levels, shape policy decisions, and
target resources to ultimately improve the health
of the public.
Performance Measures
National Purpose
The National Public Health Performance Standards
Program (NPHPSP) is a partnership effort to:
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Develop performance standards for public
health practice as defined by the Essential
Services of Public Health,
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collect and analyze performance data, and
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improve system-wide performance.
PHPPO
Performance Measurement
National Activities
Comprehensive performance measurement tools for the
assessment of public health practice at both the state
and local levels are being designed in partnership with
other national public health organizations.
Additionally,
a
surveillance
instrument
has
been
prepared as a rapid assessment tool to provide local,
state, and federal public health officials with a snapshot
of local public health capacity and performance.
U.S. D.H.H.S.
Healthy People 2010
Examining the Public Health
Workforce
“The objective of sound health workforce
policy is to assure that there is an
adequate, affordable supply of competent
personnel to provide needed health
services to a given population.”
Virginia Kennedy et. al
Public Health Mgt. and Practice
May 1999
Why Understanding the Workforce
is important?
“The challenges facing public health today
are enormous and require a workforce in
governmental, voluntary, and interested
private health agencies that is skilled not
only in the technology of public health but
also in its philosophy and framework.”
Kristine Gebbe
Public Health Mgt. and Practice
May 1999
Cross Cutting Competencies for The
Public Health Workforce
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Analytic
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Communication
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Policy Development
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Cultural
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Basic P.H. Science
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Leadership and Systems Thinking
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Management and Information
Management
Task Force on Public Health Workforce
Development
A working model for the Public Health Workforce
Competencies
Essential
Services
Analysis
Monitor
Investigate
Educate
Mobilize
Develop Policy
Enforcement
Personal Care
Workforce
Evaluation
Research
Communication
Policy and
Program
Cultural
Basic
Science
Finance/
Mgt
Organization
Capacity-Process-Outcome Links
Process
Capacity
Outcomes
(Essential Public Health Services)
Outputs
Key Processes
System Inputs
Workforce
Information
Organization &
Relationships
Facilities
Funding
Assess
Develop
Policy
Assure
Programs and
Services
consistent with
mandates and
community
priorities
Improved
organizational
performance
Improved program
performance
Improved
Outcomes
Dr. Bernard Turnock
The Dynamic Nature of Public
Health
The fact that health problems emerge mainly in
response to conditions of life requires that
public health remain highly adaptive, especially
when living conditions are changing rapidly.
Afifi and Breslow
Annu. Rev. Public Health
1994
The Evolving Agenda of Public
Health
Determinants of Health
Chronic Disease
Infections
Hygiene
The Determinants of Health
Social
Environment
Physical
Environment
Genetic
Endowment
Individual
Response
•Behavior
•Biology
Health
and
Function
Disease
Health
Care
Well-Being
Prosperity
Evans and Stoddart
Executive
Strategies
Healthy
Iowans
Results
Budgets
Program
Infrastructure
Staff and other
Professional Services
Legislative
Community
Empowerment
Tactics
Essential
Services
Indicators
Performance
Measures
Fiscal Policy Studies Institute