Transcript NPHPSPstock-UsingtheStateInstrument2008

National Public Health
Performance Standards
Program
Using the State Assessment Instrument
NPHPSP
Partners
CDC, APHA, ASTHO, NACCHO, NALBOH,
NNPHI, PHF
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Assessment Instruments
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State public health system
Local public health system
Local governance
History
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Began in 1998
Instruments released in 2002
Instrument update 2005-07
Four Concepts Applied in NPHPSP
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Based on the ten Essential Public
Health Services
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Focus on the overall public health
system
3.
Describe an optimal level of
performance
4.
Support a process of quality
improvement
NPHPSP Use in the Field
Coordinated statewide approach
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Benefits in technical assistance and coordinated
improvement planning
Individual System / Board Use
Common Catalysts for Use
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Statewide interest in improvement planning
Interest in performance improvement
Bioterrorism and emergency response planning
Use within the MAPP process
Interest in accountability
NPHPSP Use in the Field
Reasons for Using NPHPSP – State and Local
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Establish a baseline measure of performance
Wanted a national developed & recognized assessment
tool to help improve performance
NPHPSP the best tool available for improving public
health system effectiveness
Was part of the MAPP process (local users only)
*State evaluation data gathered through ASTHO survey 10/05-1/06 –
80% response rate (9 respondents reporting completion of State
NPHPSP). Local evaluation data gathered through NACCHO survey
to known NPHPSP and MAPP users in 01/06 – 05/06; 212 total
respondents (149 respondents reporting completion of Local
NPHPSP).
NPHPSP Version 2 Instruments
Updates guided by peer-driven work groups
Utilized a variety of subject matter experts
Limited field testing in Summer and Fall 2006
To be released later in 2007 pending OMB
clearance
Version 2 - Key Changes
Modernized and updated the
content
Streamlined and identified
opportunities for greater userfriendliness
Added “discussion boxes” feature
Altered response options
Included optional priority and
agency contribution questionnaires
Reviewed and Updated Content Areas
Preparedness
Informatics
Communications and health
marketing
Partnerships
Workforce
Public health law
Laboratory issues
Social Justice
State / local public health agency roles
Instrument Format
Essential
Service
Model
Standard
Instrument Format
Measures
or
Questions
Discussion
Toolbox
State Public Health System Instrument
Same 4 model standards for
each of the ten Essential
Services (40 model
standards total)
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1 – Planning and Implementation
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2 – State-Local Relationships
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3 – Performance Management
and Quality Improvement
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4 – Public Health Capacity and
Resources
State Public Health System Instrument
Planning and Implementation
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The State Public Health System (SPHS)
collaboratively plans and implements services,
programs and initiatives to accomplish the Essential
Service
80
70
60
50
40
30
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10
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2.1
2.2
2.3
2.4
State Public Health System Instrument
State-Local Relationships
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The SPHS provides assistance, capacity building,
and resources to local public health systems to
enhance local efforts to implement the Essential
Service
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70
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40
30
20
10
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2.1
2.2
2.3
2.4
State Public Health System Instrument
Performance Management and Quality
Improvement
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The SPHS reviews the effectiveness of its
performance and uses these reviews to manage and
improve its performance of the Essential Service
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70
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40
30
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10
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2.1
2.2
2.3
2.4
State Public Health System Instrument
Public Health Capacity and Resources
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The SPHS invests in and utilizes its human,
information, organizational and financial resources
to carry out the Essential Service
80
70
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40
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10
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2.1
2.2
2.3
2.4
Key Steps in the Process
Prepare for the NPHPSP Assessment
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Become familiar with the assessment instruments
Determine how the assessments will be structured and
facilitated
Identify and invite participants
Conduct the NPHPSP Assessment
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Orient participants
Complete the assessment instrument
Complete supplemental questionnaires
Submit assessment data
Facilitate Post-assessment and performance
improvement activities
Preparing for the NPHPSP
Identify a lead and/or coordinating organization
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State or local public health agency, public health institute,
university, other
Assess readiness
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Commitment, resources, connection with related efforts
Consider a statewide coordinated approach
Think through how you will use the results in an
improvement process
Recruit and orient facilitators
Move forward!
Prepare: Determine How the Assessment
will be Structured
Different Approaches
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Large meeting /
Retreat (1 – 2 days)
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Small Group Activities
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Series of Meetings
Prepare: Identifying Participants
Key questions:
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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
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
Prepare: Invite Participants
Set the tone
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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 info as
orientation
Use personal or leadership
connections to gain interest
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Extend invitations to participate via personal
letters, email, or phone calls.
Best extended by the health director or high
level leader.
Preparing for the NPHPSP
(Online Resources)
The Online Tool Kit includes sample:
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Participant Selection Table
Recruitment / Invitation Letters
Preparations Checklist
Pre-Assessment Press Releases
Meeting Agendas
Orientation Materials
Conducting the Assessment
Orient participants
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Focus on the Essential Services
Focus on the public health system
Encourage advance review of instrument
Complete the assessment
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Recommended assessment approach
Use facilitators and recorders
Determine when or if optional questionnaires will be
completed
Submit assessment data and obtain your
report!
Conduct: The Assessment Process
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Review and discuss model standard
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Open discussion of local activities (e.g., 15
minutes)
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Facilitator assures discussion hits key points
in MS
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After MS is discussed, read and vote on
the questions.
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Have further discussion where
differences appear.
Use discussion toolboxes where
appropriate.
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Participants should be aware of the final
response for all questions.
Determining Responses
Think about the focus of the question:
▲ Dispersion through program areas
▲ Participation among many system partners
▲ Frequency of activity
▲ Quality of activity
Use discussion toolboxes if available
One final set of responses should be developed
Using Discussion Toolboxes
1.1.3 Does the SPHS publish or disseminate healthrelated data into one or more documents that
collective describe the prevailing health of the state’s
population (i.e., a state health profile)?
1.1.3 Discussion Toolbox
In considering 1.1.3, does the profile use data to:
 Identify emerging health problems?
 Report trends in health status?
 Report changes in the prevalence of health risk factors?
 Report changes in health resource consumption?
Using Discussion Toolboxes
Serve as “prompting points” related to the
question above
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Clarify the intent of the question
Prompt the group to consider all facets of the topic
Discussion toolbox items can be answered as
the group wishes (no set responses!)
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Some boxes might trigger more discussion than others
However, don’t ignore the boxes – they include important
points!
Facilitator Roles
General responsibilities
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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
NPHPSP responsibilities:
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Keep the focus on the “system”
Review model standards and facilitate open discussion
Review questions and gather votes
Re-open discussion where needed
Obtain a decision on the final response
Recorder Roles
Record group responses
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Different votes (optional)
Final consensus response
Record key ideas and comments from the
discussion
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Note issues and qualitative information that shape group
responses
Strengths and weaknesses
Areas for immediate improvement
Priorities
Assist the facilitator to manage time
Supplemental Questionnaires
Priority Questionnaire (optional)
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“On a scale of 1 to 10, what is the priority of this model standard?”
Use throughout the assessment or after
Recommend completion by consistent group
Agency Questionnaire (optional)
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“What best reflects the contribution of the agency to this model
standard?”
Use throughout the assessment or after
Recommend completion by consistent group (can be agency-only or
include system partners)
Respondent information form (required)
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Completed only by lead agency to accompany the on-line data
submission
Immediately after the Assessment…
Report out the summary of findings
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Overview of the EPHS strengths and weaknesses
Insights that shaped group judgments
Impressions and early ideas for improving the system
Proceed into next steps for performance
improvement
Conducting the NPHPSP
(Online Resources)
Assessment Instruments
User Guide
The Online Tool Kit includes
sample:
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Assessment Agendas
Assessment Meeting Guide
Ground Rules
Evaluation Forms
www.cdc.gov/od/ocphp/nphpsp