Transcript The National Public Health Performance Standards 201: Tips and

The National Public Health
Performance Standards 201: Tips and
Tricks for Successful Implementation
Christine Abarca, Florida Department
of Health
Teresa Daub, CDC
Learning Objectives
Following this session, you will be able to:
• Describe the framework and concepts that
underpin the three assessment tools of the
NPHPS
• Discuss the similarities and differences between
Versions 2 and the re-engineered Local NPHPS
• Identify at least one option for conducting an
NPHPS assessment
• List three or more tips for implementing the
NPHPS assessment
Understanding NPHPS Key
Concepts and Tools
3
NPHPS Vision
A partnership effort
to improve the
quality of
public health practice
and
performance of
public health systems
Four Concepts Applied in NPHPS
1.
Based on the ten Essential Public
Health Services
2.
Focus on the overall public health
system
3.
Describe an optimal level of
performance
4.
Support a process of quality
improvement
1. The Essential Public Health Services
1. Monitor health status
2. Diagnose and investigate health
problems
3. Inform and educate
4. Mobilize communities to address
health problems
5. Develop policies and plans
6. Enforce laws and regulations
7. Link people to needed health
services
8. Assure a competent health
services workforce
9. Evaluate health services
10.Conduct research for new
innovations
2. Public Health System
Civic Groups
Schools
Neighborhood
Organizations
EMS
Nursing Homes
Community
Centers
Non-Profit
Organizations
Home
Health
Hospitals
Drug Treatment Public Health
Agency
Doctors
Laboratories
Fire
Law
Enforcement
CHCs
Faith Institutions
Tribal Health
Employers
Corrections
Mental
Health
Elected Officials
Transit
3. Optimal Level of Performance
• Each performance standard
represents the “gold standard”
• Provide benchmarks to which state
and local systems can strive to
achieve
• Stimulate higher achievement
4. Stimulate Quality Improvement
• Standards should result in identification of
areas for improvement
• Link results to an improvement process
• NPHPS Local Instrument - used within the
MAPP planning process
Act
Plan
Study
Do
NPHPS Materials
• Assessment Instruments
– State public health system
– Local public health system
– Local governance
• User Guidance
• Glossary
NPHPS Version 2.0 (2007)
and Re-Engineered (2012)
• Both versions:
– Are grounded in the 10 Essential Public Health Services
– Use a semi-qualitative rating scale
– Can contribute to health improvement planning as well
as strategic planning activities
• Re-engineered:
– Has fewer scored questions
– Incorporates plain language principles
– More discussion-focused (relies more heavily on
facilitation)
– Has increased quality improvement focus
Version 2 Instrument Format
Essential
Service
Model
Standard
Version 2 Instrument Format
Measures
or
Questions
Discussion
Toolbox
Re-engineered NPHPS – Fall 2012
• Streamlined the assessment tools
• Enhanced systems building aspects of the
assessment process
• Increased quality and performance
improvement activities
• Strengthened linkages with accreditation
Essential
Service
Description
•
Includes
list of
potential
system
partners for
each
Essential
Service
Field Test DRAFT
16
Model
Standard
Description
•
Uses plain
language
Field Test DRAFT
17
Model
Standard
Discussion
Questions and
Performance
Measures
•
•
More
discussion
Fewer
scored
questions
Field Test DRAFT
18
Essential Service
Summary Notes
Page
Framework for
identifying:
• Strengths
• Weaknesses
• Opportunities
• Priorities
Field Test DRAFT
19
Supplemental Questionnaires
Both Versions
• Priority Questionnaire (optional)
– “On a scale of 1 to 10, what is the priority of this model standard?”
• Agency Questionnaire (optional)
– “What best reflects the contribution of the agency to this model
standard?”
Planning for the Assessment
21
Planning for the Assessment
1.
2.
3.
4.
5.
6.
Assess readiness
Select assessment option
Determine timeline and create project plan
Identify and invite system partners
Select and train facilitators and recorders
Prepare orientation and assessment materials
Assess Readiness
• Determine Who Will Lead the NPHPS process
• Assess Readiness
•
•
•
•
Leadership Commitment
Purpose and Benefits
Resources
Strategic Fit
• Move Forward
Select Assessment Option
• Common Options
– Large Meeting/Retreat
– Small Group Activities
– Series of Meetings
• Choose the option that
best meets needs of
participants
Large Meeting/ Retreat
• Generally 1-2 days
• Advantages:
– Short timeframe
– Maintains momentum
• Drawbacks:
– Requires time commitment
– Can be overwhelming
Small Group Activities
• Advantages:
– Allows for expertise, as needed
– Less overwhelming
• Drawbacks:
– Less cross-learning
– Less consistency in response development
Tip! Many larger sites use small breakout groups
during a large meeting process!
Series of Meetings
• Advantages:
– Allows for expertise, as needed
– Gets the work done in small pieces
• Drawbacks:
– Participation changes with meeting attendance
– Process may seem to “drag on”
Tip! This option works especially well for boards of
health, which can address one or two Essential
Services at each board meeting.
Timeline and Project Plan
• Varies depending upon assessment approach
• Allowing 3-5 months is reasonable
• Find sample project plans online
Tip! Engage a small planning team of agency or
system representatives to plan the process.
Identify Participants
• Key questions:
• 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
• Agency and system participants are both
important!
Tip! Existing coalitions or committees can be a
starting point for diverse representation!
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
Invite Participants
• Set the tone
– 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 information as orientation
• Use personal or leadership connections to gain interest
– Extend invitations to participate via personal letters, email, or
phone calls.
– Best extended by the local health director or other senior HD
staff.
Select and Train Facilitators & Recorders
• Number needed may vary
• Training should cover:
– Orientation to NPHPS
– Assessment Materials and Process
– Expectations of Role
Facilitator Roles
• General responsibilities
–
–
–
–
–
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
• NPHPS responsibilities:
–
–
–
–
–
Keep the focus on the “system”
Review model standards and facilitate open discussion
Discuss key questions and gather group responses
Re-open discussion where needed
Obtain a decision on the final response
Recorder Roles
• Record group responses
– Different votes (optional)
– Final consensus response
Tip! Consider using flip charts
or a laptop/projector so that
everyone can see the
responses and comments!
• Record key ideas and comments from the discussion
– Note issues and qualitative information that shape group
responses
– Strengths and weaknesses
– Areas for immediate improvement
– Priorities
• Assist the facilitator to manage time
Preparing for the NPHPS
• The Online Tool Kit includes sample:
– Participant Selection Table
– Recruitment / Invitation Letters
– Preparations Checklist
– Pre-Assessment Press Releases
– Meeting Agendas
Tip!
www.cdc.gov/nphpsp/
Use samples from
other sites and revise as
needed!
Conducting the Assessment
• Convene and orient participants
• Assess and document system performance
• Submit assessment data
Orient Participants
• Advance and/or on-site orientation
• Key topics:
–
–
–
–
–
Essential Services
Public Health System
Purpose of the assessment
The process
What next? Using Tip!
the results
tousing
improve!
Consider
the Essential Services
brainstorming exercise – 10 flip charts around the
walls – as both orientation and input!
“Customized Egg Chart”
Peninsula Health District, VA
YC/Poquoson
Social Services
Wmbg Dept of
Human Services
YC Dept of
Community Services
JCC Social
Services
Alzheimer’s
Association
Center for Excellence in
Aging & Geriatric Health
Senior Services
Coalition
Care Options
Home
Instead
Senior Care
JCC Gov’t
Medical Reserve
Corp, Virginia
Department of
Health
Peninsula Health
District
(PHD)
Riverside
Health
System
United Way Riverside School
of Greater of Health Careers Foundation
Wmbg
Salvation
Army of
Wmbg
Bay Aging
AARP
JCC Dept of
Emergency
Management
JCC Parks & Rec
Historic Triangle
Substance Abuse
Coalition
Child
Development
Resources, Inc
Wmbg/JCC
Public Schools
YC Gov’t
Wmbg Gov’t
YC Division of
Housing and
Neighborhood
Revitalization
YC Children’s
Services
Wmbg
Community
Health
Foundation
Thomas Nelson
Community College –
Center for Workforce
Development
PHD Emergency
Preparedness and
Response
Historic Triangle
Senior Center
Respite Care of
Wmbg United
Methodist Church
Peninsula Agency
on Aging
Bayada Nurses
Sentara Wmbg
Regional Medical
Center
Eastern State
Hospital
Comfort
Keepers
Lackey Free
Clinic
Olde Towne
Medical Center
Patriot’s Colony
at Wmbg
(Riverside)
Assessment Process
•
•
•
•
•
Review and Discuss Model Standard
Read and Discuss Questions
Preliminary Vote
Consensus Building
Essential Service Wrap-Up
Tip! Use an Audience Response System (ARS) if
available. Color-coded cards are a more low-tech
way to gather votes from all participants – template
cards are on-line!
Submitting Version 2 Assessment Data
• Obtain a User ID
• Enter and Submit Data
• Download Reports All at: www.nphpsp-results.org
Immediately after the Assessment
• Report out the summary of findings
– Overview of the EPHS strengths and weaknesses
– Insights that shaped group judgments
– Impressions and early ideas for improving the
system
Tip! If groups compile opportunities for
improvement and next steps as they go through
each section, this can easily be collected into a
master draft that can jumpstart immediate
performance improvement!
Conducting the Assessment
• Assessment Instruments and Model Standards
• User Guide
• The Online Tool Kit includes sample:
– Assessment Agendas
– Assessment Meeting Guide
– Ground Rules
– Evaluation Forms
www.cdc.gov/nphpsp/
NPHPS User Experiences
• Tips from our most successful users:
– Involve broad system participation
– Ensure visible leadership
– Conduct assessment within context of broader
state/community health improvement process or
performance improvement effort
– Provide strong facilitation, which is critical to a
positive experience and building momentum
Contact Information
Christine Abarca
Florida Department of Health
[email protected]
850-245-4444 ext. 2071
Teresa Daub
Centers for Disease Control and Prevention
[email protected]
404-498-0317