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1 Importance of the Standards ..government public health agencies - PDF document

Dec 15, 2022 •311 likes •704 views

Common Terminology in Operational Definition Domain/Essential Service Domain I: Monitor health status and understand health issues facing the community Standard Standard I-A Obtain and maintain data that provide information on

  1. Common Terminology in Operational Definition • Domain/Essential Service Domain I: “Monitor health status and understand health issues facing the community” • Standard Standard I-A “Obtain and maintain data that provide information on the community’s health…….” • Measure/Indicator Measure I-A:4 “LHD has an electronic linkage with local and statewide databases” What Every Community Should Expect Operational Definition of a Functional Local Health Department Penney Davis, MPH Program Associate, NACCHO Staff NACHO versus NACCHO NACHO Definition: [NAH-choh] A crisp tortilla chip topped with melted cheese (usually cheddar) and chopped chiles, usually served as an appetizer or snack. Nachos sometimes appear on menus as "Mexican pizza," in which case they generally have additional toppings such as cooked, ground chorizo, onions and sometimes olives. NACCHO Definition : [NAY-choh] An association of dedicated public health professionals who represent over 3,000 local public health agencies (including city, county, metro, district, and Tribal agencies). 1

  2. Importance of the Standards “..government public health agencies at federal, state, and local levels are the backbone of this public health system and must be strong.” “The Future of the Public's Health in the 21st Century”, Institute of Medicine, 2002 The 10 Essential Public Health Services… use cartoon here �������������� �������������������������������������������������� ��������!��"��#�$��%�!��&����'"��������(%��������)�#� 2

  3. Iterative Process NACo, USCM SHDs LHDs LBOH CDC, HRSA NCSL, NGA 1. Monitor health status and 2. Protect people from understand health issues health problems and facing the community. health hazards. 3. Give people the information they need to make healthy choices. 4. Engage the community to identify and solve health problems. 3

  4. 6. Enforce public health laws and regulations. 5. Develop public health policies and plans. 7. Help people receive health services. 8. Maintain a competent public health workforce. 4

  5. 9. Evaluate and improve programs and interventions. 10. Use and contribute to the evidence base of public health. Final Recommendations of the Exploring Accreditation Project “NACCHO’s Operational Definition of a Functional Local Health Department should serve as the foundation of standards (and associated measures) for local health departments.” 5

  6. Prototype Metrics Your Role: Feedback for PHAB • Individual LHD Demo Grants • Collaborative LHD Demo Grants • KS Regionalization Pilot Sites Closing Note “ Public health is a complex concept, but the Operational Definition can help dispel the mystery. Eventually public health can be recognized and valued even when — particularly when — things are going well. ” -Susan Gerard Director, Arizona Department of Health Services 6

  7. Using the Operational Definition Prototype Metrics Assessment Tool to Conduct Local Health Department Internal Capacity Assessments Janan Wunsch-Smith Janan Wunsch & Associates 515-490-6222 jananwunsch@mchsi.com Performance Standards Under Each Essential Service • Generally accepted objective standard of measurement against which an organization’s level of performance can be compared • Provide measurable standards that public health systems can use to ensure the delivery of essential public health services Operational Definition Prototype Metrics • Provided Indicators under each standard that local public health department’s could use to assess whether they were meeting the standards • Provided illustrative evidence to assist in identifying whether the indicators were being met 7

  8. Operational Definition Prototype Metrics Self- Assessment Tool • Based on the Prototype Metrics-Revised • Indicators are scored on a scale of 0-4 – Measurement of the capacity, either internal or through contract, to meet the indicator – Not every local health department will have the internal capacity to perform all indicators. They may need to contract or partner with another health department or entity to assure their public has access to the services. Scoring Directions….. • Using the scale, score each indicator based on the capacity within your Local Health Department (LHD). In your assessment, include both the capacity provided by your health department staff and through contracts and/or agreements with other entities. • Note: To meet the standards, your department must assure that the essential services are met, but does not have to provide all of them from within your agency. Scoring Directions Continued…. • In the comment section, following each focus area please identify partners (non-contract) at the local, regional, or state level that provide capacity to fulfill indicators in the section. – Other public health partners may provide the public health service as part of their mission/activities but without a formal contract/relationship with the LHD (Public Health System) 8

  9. Scoring Directions Continued…. • The items in the column labeled “Documents and/or Activities That Demonstrate the Indicators Have Been Met” provide various documentation and types of activities that, if completed, demonstrate that the LHD meets that indicator. – These activities/products provide evidence that the LHD has the capacity to meet the indicator. There may be other evidence that will also demonstrate the capacity. These are not meant to be exclusive. Scoring Continued… Color Code Score Description 0 No capacity: There is no capacity, planning, staff, resources, activities, or documentation to fulfill the indicator. 1 Minimal capacity: There is minimal planning and staffing capacity to fulfill the indicator but no implementation activity or documentation. 2 Moderate capacity: There is moderate planning, staffing and other resources to fulfill the indicator but only minimal activity and/or documentation. 3 Significant capacity: There is significant planning, staffing, and other resources and a moderate amount of activity and/or documentation. 4 Optimal capacity: There is significant planning, staffing and resources and significant to optimal activity and/or documentation to fulfill the indicator. Scoring Instructions • Any indicator that has a score of 0 — 2 is identified as in need of increased capacity. • Any indicator that has a score of 3 — 4 is indentified as having adequate capacity. • The only exception is if the indicator with a score of 0 — 2 has another non-contract entity identified in the comment section as providing that service for the population, then that indicator would be considered covered by the other entity’s capacity. 9

  10. Performing the Assessment….Who Should Complete the Assessment? LHD can select who will complete the assessment: – Recommend, where possible, a cross section of the department, representing all services areas – Some departments may only have a few staff and they may all choose to complete the assessment – One person may choose to complete the assessment, but should be the director or high level of management who knows all the activities of the department. Performing the Assessment…. How should we perform the assessment? • Each selected person completes the on-line assessment independently and the scores for all those taking the assessment are averaged to get the score for each indicator. • Each selected person completes the on-line assessment independently and then the results are discussed and a consensus is reach as to the final score for each indicator. • All those selected to complete the assessment discuss the scoring and one score is entered on-line. Performing the Assessment…..How long will it take? • For individual LHDs to complete the assessment, it will take around 2 hours • To discuss the results from multiple scores and to come to consensus on those that differ, it will take 4 or more hours • To discuss each indicator and come to one agreed upon score that is then entered on line, it will take 4 or more hours 10

  11. Data…How do we use it??? Aggregate the data by topic area (Individual LHD Project) • Prioritize the topic areas and select the one/s that you want to address for you QI project: – Establish a goal/s for the topic area – Put the indicators into categories and use the categories to write objectives – Use the individual indicators under the topics to help identify activities that would become components of a work plan to meet the objectives. Data…How do we use it??? Aggregate the data according to the indicators under the standards that fall below an average score of 2.5 points capacity. – Identify the standards with the least capacity. – Prioritize the standards needing the most improvement. – Create a goal for increasing capacity for the standard and use the indicators without adequate capacity for identifying objectives and work plan components for the QI plan. If we have a collaborative application, how do we use the data? • Aggregate your individual health department data by topic areas and/or standards that need the most improvement. • Whether to work with the topic data or the standards needs to be determined by the partnering health departments 11

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