2/17/15  

1  

Welcome!    Gaining  Ground  

Performance  Management    ‘Pre-­‐Workshop’  Webinar  February  18,  2015              2:00  pm  –  3:30  pm  

Please  Dial  in  from  your  land-­‐line:  210-­‐339-­‐7212      ParLcipant  code:  4146073  

NEW  JERSEY    

Performance Management February 18, 2015

 

“Star&ng  where  you  are,  with  what  you  have”  

3  

2/17/15  

2  

Welcome and Introductions

Meeting Purpose  

4  

 Performance Management

5  

Why Performance Management? What Are Some of the Challenges Facing Public Health Today?

•  Funding •  Recognition for who we are and what we do •  Understanding our Mission & Communicating

that to stakeholders and funders •  Need to define our work and justify the resources

invested

6  

2/17/15  

3  

Why Performance Management?

•  Do you know the quality of your agency’s work?

•  Do you know how well your agency is performing?

•  Do you know what you are trying to accomplish?

•  Are you making progress?

7  

Why Do Performance Management? }  In order to improve something you have to be able to change

it. In order to change it you have to be able to understand it. In order to understand it you have to be able to measure it. And if you can count it you can measure it.

} What gets measured gets done. An effective performance management system gives you useful, credible information for assessing:

1)  Your capacity to undertake your work. 2)  The quality of your efforts. 3)  The outcomes of your efforts.

8

Performance Management An Overview

 What is Performance Management?

Performance management is a forward looking practice of using data to improve agency performance.

 

9  

2/17/15  

4  

A Performance Management System

A performance management system is driven by state and local needs and is designed to align closely with a public health organization’s vision, mission, strategic goals and public health priorities.

 

10

 Performance Management System Framework Components

1. Visible Leadership 2. Performance Standards 3. Performance Measures 4. Reporting Progress 5. Quality Improvement  

11  

Performance Management Framework This practice involves strategic use of Goals, standards, targets, measures, data collection, reporting, and Quality Improvement

Performance Management Outer Ring

•  Customer Focus •  Transparency •  Strategic Alignment •  Culture of Quality

12  

Continuous

2/17/15  

5  

This Sounds Like a Lot of Work. What’s in it for Us and Our Agency?

PM helps answer these types of questions } How well is our health department performing? } Do we all know where we are headed? } Are we all pulling in the same direction? } Are we making progress as an organization? } Are we achieving what we set out to do? } Are we accountable and demonstrating results? } Do we need to do something different?    

13

Where do We Start?

14  

 A MODEL FOR PERFORMANCE

MANAGEMENT •  Performance Management

provides a roadmap and a set of tools that help guide you along the right path toward improving your agency and programs.

•  The model for Performance Management in public health was created by the Turning Point Performance Management Collaborative in the 1990s. It comprises four parts:

Turning  Point  Model-­‐Refreshed-­‐PHF   15  

2/17/15  

6  

 A MODEL FOR PERFORMANCE

MANAGEMENT •  Identification and use of

performance standards, •  Identification and collection

of performance measures, •  An ongoing process and

timeline for reporting of progress, and

•  Use of a quality improvement process to respond to identified needs.

Turning  Point  Model-­‐Refreshed-­‐PHF   16  

PERFORMANCE STANDARDS: STAGE 1

•  Under the Turning Point model, there are four steps to identify performance standards.

•  1.Identify relevant standards starting with agency goals as described in your vision, mission, and strategic plan, and looking to generally accepted standards for performance to find standards that align.

•  2.Select indicators of performance that align with each standard that can be tracked over time.

•  3.Set targets for the performance of your agency related to each indicator. •  4.Communicate expectations for performance with agency staff and

stakeholders to build awareness and gain buy-in.

PERFORMANCE STANDARDS: WHERE TO LOOK

•  There are many sources for identifying public health performance standards. Examples of these sources are listed on the right.

•  Keep in mind that a performance management system should cross all health department functions. It should not just focus on health determinants and outcomes.

Health Determinants & Status • Healthy People 2020 • National Prevention Strategy

• Resources & Services • PHAB Standards, including those under Domains 2, 3, 7, and 10 • National Public Health Performance Standards Program (CDC) • Michigan Local Public Health Accreditation Minimum Program Requirements  

Community Engagement  • PHAB Standards, including those under Domains 1, 4, 5, and 6 • •CDC Principles of Community Engagement • •Scotland National Standards for Community Engagement • •CDC Public Health Preparedness Capabilities, National Standards for State and Local Planning  

Workforce  • Core Competencies for Public Health Professionals (PHF) • •PHAB Standards, including those under Domain 8

 

2/17/15  

7  

 PERFORMANCE MEASUREMENT: STAGE 2 •  Your performance measures should be “quantitative measures of capacities,

processes, or outcomes relevant to assessment of your performance indicators.” •  Selected measures should let you know if you’re getting closer to achieving

your performance standards.

•  For example, if your agency is pursuing the Healthy People 2020 performance standard of a 10% improvement in the percent of live births that were preterm you might include performance measures such as:

•  The percentage of live births that were preterm in your county in the calendar year.

•  The percentage of women served by the tribal health clinic who receive prenatal care in the first trimester.

•  The percentage of OB/GYN providers receiving educational information from the health department about preventable preterm birth.

Turning  Point  Performance  Management  NaLonal  Excellence  CollaboraLve,  2004     19  

 CREATING PERFORMANCE MEASURES

•  There are often many different ways to measure progress toward any one performance standard.

•  Start by looking at your performance standard, or goal for

performance, and brainstorm a list of things you could count or observe that would help you determine how well your agency is achieving that standard.

•  Gather information on how others are measuring their

performance in that area. No need to reinvent the wheel!

 CREATING PERFORMANCE MEASURES

•  Look at each possible measure and consider what data you already have collected, what data are readily available through other sources, or what data you could realistically collect.

•  If a possible measure just doesn’t have a reliable source and couldn’t realistically be tracked consistently over time, drop it from the list.

•  Determine which measures are related to your activities and are within your agency’s control or influence. Eliminate measures that are outside your agency’s scope.

2/17/15  

8  

CREATING PERFORMANCE MEASURES

Your final list of possible measures should be:

•  Clearly and logically related to your standard, •  Feasible to collect over time, and •  Within the scope of your influence.

At this point you can use all the measures on your list (you may have just a few left), or select the measures that you think best reflect performance related to your standard.

 

REPORTING OF PROGRESS: STAGE 3 Reports on progress should:

• Compare performance measures with their target and they should link to overall goals; • Provide context and be targeted to the audience – the content depends on the purpose and intended users; • Be routine – reports should be produced on a schedule; • Be created in a way that is straightforward, easy to produce, and easy to understand; and • Be communicated and shared across the agency.

QUALITY IMPROVEMENT: STAGE 4

•  Quality improvement is where a performance management system creates opportunity for meaningful improvement within your public health agency. It is about learning to use data on how you are performing to drive activities that lead to true improvement.

2/17/15  

9  

How About an Example

•  Our Strategic Plan lists under Strategic Goals the following Department Goal.

ENHANCE THE CUSTOMER SERVICE EXPERIENCE BY 12/31/15

25  

Performance Standards

80% of clients rate health department services as “good” or “excellent.”

26

Performance Measures

% of clients that rate health department services as “good” or “excellent.”

27

2/17/15  

10  

Reporting of Progress

In 2013, 50% of clients rated health department services as either “good” or “excellent.”

28

Quality Improvement

“Increase client satisfaction of health department services to 70% by December 2014”

29

Reporting of Progress

If client satisfaction of health department services doesn’t reach 70% by 2014 the PDSA cycle will be repeated (continuous quality improvement)

30

2/17/15  

11  

Performance Management Ties it All Together

32

Performance Management

Your Strategic Plan } Defines where your department is going }  Provides a definition of the mission, goals, and objectives } Defines via template for employees and stakeholders to make

decisions to move the organization forward }  Provides an assessment of the department’s capacity to

respond to its mission Tells the community what the department is capable of and how

it operates

PHAB acronyms and glossary of terms version 1.0 33

2/17/15  

12  

The Community Health Assessment } Examines the health status indicators for a

given population (Department) } Identifies key problems and assets } Contains strategies to address the

department’s health needs and identified issues

} A collaborative process involving the department and many stakeholders

PHAB acronyms and glossary of terms version 1.0 34

Community Health Improvement Plan } Long term, systematic effort to address public health

problems on the basis of the results of health assessment activities and the health improvement process.

} Used to set priorities and coordinate and target resources. } Serves as a pre-cursor for the development and defining

actions to target efforts to improve health. } Defines the vision for the health of the population. } Lists strengths, weaknesses, challenges, and opportunities

that exist to improve the health status of the population.

PHAB acronyms and glossary of terms version 1.0 35

And Quality Improvement is the Thread woven Throughout These

Components

It is a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the population.  

36

2/17/15  

13  

To Summarize •  If we must define our work and justify the

resources we consume (tell the public health story) then..

•  Quality Improvement will help us improve our processes to get the results we need.

•  Performance Management will help us determine what results are needed and measure our progress toward meeting our goals that were defined in our Strategic Plan and Action Steps.

37  

RECAP  There are four pieces to an effective performance management system:

1.    Performance Standards •  Identify relevant standards •  Select indicators •  Set targets •  Communicate expectations •  2. Performance Measures •  Refine indicators •  Define realistic measures •  Develop data systems •  Collect Data

 

•  3. Reporting of Progress •  Analyze data •  Report results broadly •  Develop a regular cycle of

reporting •  4. Quality Improvement •  Use data for decisions •  Manage changes •  Create a learning organization  

Useful Links •  Turning  Point  Overview  &  Documents          

h[p://www.phf.org/resourcestools/Pages/Turning_Point_Project_PublicaLons.aspx  

•  Turning  Point  Performance  Management  Revised  Framework    h[p://www.phf.org/programs/PMtoolkit/Pages/Turning_Point_Performance_Management_Refresh.aspx  

 •  Public  Health  AccreditaBon  Board  

 h[p://www.phaboard.org/    

 Michigan  Public  Health  InsBtute  –  PM  Free  on-­‐line  Training    h[p://mphiaccredandqi.org/PMQITraining/Login.aspx  

NACCHO-­‐Guide  to  CommunicaBng  about  Performance  Improvement  h[p://www.naccho.org/topics/infrastructure/accreditaLon/picommunicaLons.cfm?

utm_source=MagnetMail&utm_medium=email&utm_term=jbutlerassoc@voyager.net&utm_content=2013_10_01CONNECT&utm_campaign=NACCHO%20Connect,%20Oct.%201  

 

   

39

2/17/15  

14  

Materials,  handouts  and  Power  Point  slides  adapted  from    

• North  Carolina’s  Center  for  Public  Health  Quality  -­‐  Quality  Improvement  101  Program    • James  Butler  &  Associates    • Michigan  Public  Health  InsLtute  • The  Public  Health  FoundaLon    

 Acknowledgements    

MeeLng  Closure  

•  QuesLons?  •  Next  Steps  

•  Closing  Comments    

ChrisLna  Harrington    989  482-­‐0520  chrisLnaharrington@hotmail.com  

 Jim  Butler  517  614-­‐1654  jbutlerassoc@voyager.net      

     

Contact Information  James Butler & Associates

42