Transcript Evolving the Mindset: Public Health Data Management at the

Evolving the Mindset: Public Health
Data Management at the Local Level
L I S A S W A N S O N , E N V I R O N M E N T A L H E A LT H
OFFICER
B L A C K H A W K C O U N T Y H E A LT H D E P A R T M E N T
WATERLO O, IOWA
COHORT IV GRADUATION
F E B R U A R Y 2 4 th, 2 0 0 9
Project Background
 Black Hawk County, Iowa
 Population ~128,000
 Health Department, recently reorganized
 Enforcement, Surveillance & Preparedness
 Schools, Outreach and Clinic
 Health Promotion, Planning & Development
 Environmental Health Department
 9 County region
 9 Health officers
Project Background
• Transition from paper based
to digital record keeping
• Focus on daily workflow, not
“big picture”
• Each department manages
data pertaining to their
programs in isolation from the
other departments and agency
Problem Statement & Focusing Questions
Focusing Questions:
Why don’t we have a system in place for management of
public health data that can effectively respond to our
questions in a timely and flexible manner?
Problem Statement
No system is in place to ensure that public health data is
managed to most effectively support the Department’s
functional decision-making and future data.
Key Variables
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recognition of need
amount of data generated
number of events that require data management
willingness to collaborate
number of decisions that are based on real data
funding opportunities that require measurability
number of programs that require data
sharing/coordination
complexity of generating necessary statistics
security/protection issues with sensitive information
current level of inefficiency
duplication of effort
timeliness and ease of accessibility
ability/flexibility to update
Behavior Over Time
Causal Loop Diagram
Quick fix: Put
together stand alone
database and tables
to address specific
data needs as they
arise.
Step
2
B
Pressure to access
data needed for
decision making.
Step
1
Step
3
PLANNING
B
Long term:
R
Fragmented
data program silos
of information
Complexity of data
manageability
(impacts adapting)
Effort required
making
changes in the
system
Commitment/inve
stment in data
management
planning.
Same Direction Causal Relationship
Opposite Direction Causal Relationship
Breaking out of “Business as Usual”
PATH OF LEAST
RESISTENCE
Breaking down old mind-sets
o we don’t have time for this….
o what is wrong with how we always do it?
o we need a solution fast!
o there are no resources to change now…
o this data is only important to my program
Recognize the Consequences of Inaction
o fragmented silos of information
o system complexity becomes a barrier to flexibility/accessibility
Logic Model
Project Plan
 Event: Stakeholder Involvement
MIS committee
 Division, program and project managers involved in data decisions
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 Event: Inventory of Current Datasets
 Event: Alignment with Future Data Needs
Quality assurance, (agency)
 ESAWP indicators (local)
 Community Health Needs Assessment and Health Improvement Plan
(CHNA & HIP) measures (state)
 Healthy People 2010 indicators, Accreditation (national)
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 Event: Development of Templates
Department Goals
 Essential Services Annual Work Plan (ESAWP)
 Match essential services with measurable indicators
 Standardized to public health standards
 Customized tracking for showing outcomes
 Community Health Needs Assessment
 2010 is a re-evaluation year
 Ability to query database
 Focus on the agency level rather than small program data
Essential Public Health Services
ASSESSMENT
• Monitor health status to identify community health problems
• Diagnose and investigate health problems and health hazards in
the community
POLICY DEVELOPMENT
• 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 and ensure the
provision of health care when otherwise unavailable
ASSURANCE
• Ensure 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 problems
The ability to compare, trend, aggregate and analyze data in our
field is a very important way to get valuable insight into the work we
do. All of the data we collect should be deliberate and in line with
specific, meaningful goals. When this is accomplished, the data is
more valuable to us and is a vehicle for answering questions and
helping to truly monitor health indicators and understand the true
status of the community.
Data is a fundamental basis for understanding health status in our
community, an important part of being able to effectively match
policies to target populations, study the effectiveness of policies and
program efforts.
Closely monitoring how data is managed will ensure that we will be
able to take a more intelligent, informed look at services and
outcomes with the flexibility to adapt the system to meet evaluation
needs.
When a strategy is in place for effective data management, it is
possible to gain a greater insight into how indicators and program
information (and the “real world” indices that the data describes)
relate to other datasets and how they change over time. This
flexibility means that we will have a more accurate way to evaluate
program effectiveness (Are we getting the expected outcome? Can
we measure progress and success as a direct result of our use of
resources?). Data is the backbone of being able to support evidencebased environmental health programs.
Health Protection Goals
 Integrate and enhance the existing surveillance systems at the local,
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state, national, and international levels to detect, monitor, report, and
evaluate public health threats.
Support and strengthen human and technological epidemiologic
resources to prevent, investigate, mitigate, and control current,
emerging, and new public health threats and to conduct research and
development that lead to interventions for such threats.
Enhance and sustain nationwide and international laboratory capacity
to gather, ship, screen, and test samples for public health threats and to
conduct research and development that lead to interventions for such
threats.
Assure an integrated, sustainable, nationwide response and recovery
capacity to limit morbidity and mortality from public health threats.
Expand and strengthen integrated, sustained, national foundational and
surge capacities capable of reaching all individuals with effective
assistance to address public health threats.
Environmental Competency Project
 Data Analysis and Interpretation: The capacity to analyze data, recognize
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meaningful test results, interpret results, and present the results in a
meaningful way to different types of audiences.
Evaluation: The capacity to evaluate the effectiveness or performance of
procedures, interventions, and programs.
Managing Work: The capacity to plan, implement, and maintain fiscally
responsible programs/projects using appropriate skills, and prioritize
projects across the employee's entire workload.
Computer/Information Technology (IT): The capacity to utilize information
technology as needed to produce work products.
Reporting, Documentation, and Record-Keeping: The capacity to produce
reports to document actions, keep records, and inform appropriate
parties.
Communication: The capacity to effectively communicate risk and
exchange information with colleagues, other practitioners, clients, policymakers, interest groups, media, and the public through public speaking,
print and electronic media, and interpersonal relations.
Next Steps…
 Complete and continue dataset inventory
 Integrate database systems
 Continuous stakeholder involvement
 Data management needs to become a natural part of
strategic planning
 Prove mindset change by responding to data needs with a
deliberate strategy
Acknowledgements
Kristi Campbell and Russell Hadan, my supportive team
Joy Harris, my wonderful mentor
Bruce, Tom and Eileen…Black Hawk County Managers
Michael Goodman, our personal systems thinking expert
.....staff from the Heartland Center for PH Leadership
National Center for Environmental Health at the Center for
Disease Control and Prevention for making this opportunity
possible.