Download - Performance Improvement Processes
Performance Improvement Processes
Survey of Tools and Approaches
Heidi Deutsch, MA, MSDMMAPP Program Manager
Overview
Defining Terms APEXPH MAPP Performance Standards PACE EH PATCH Performance
Measurement
Terms
Performance Standards
Performance Measurement
Vs. Community Health
Assessment
Performance Monitoring
Performance Management
Performance Standards: Generally accepted, objective standard of measurement against which an organization’s level of performance can be compared.
Performance Measures: Analyzes the success by comparing data on what actually happened to what was planned or intended.
Community Health Assessment: type of performance measure.
Terms
Performance Monitoring: Quantifying progress over time.
Performance Management or Performance Improvement: The process of using standards, measures, monitoring progress, towards performance improvement.
Terms
APEXPH - Overview
Part 1 – Organizational Capacity Assessment
Part 2 – The Community Process
Part 3 – Completing the Cycle
APEXPH - Benefits
Assess organization and management of LHD
Provide framework for working with community
Link internal assessment with community’s priority areas
Establish the leadership role of the LHD
APEXPH – Limitations
LHD focused
Measures may be out of date
Part 3 not well developed
Did not provide adequate attention to EH
Part 3
MAPP - Origins
APEXPH MAPP
Build LHD leadership Build LHD leadership, AND promote community responsibility for Public Health
Assess LHD capacity for delivering public health services
Assess capacity of entire local public health system
Operational planning Strategic planning
Focus on health statusFocus on health status, community perceptions, forces of change, and system capacities
Develop plans to address needs
Strategically match needs, resources, ideas, and actions
MAPP - Overview
The MAPP Assessments
Local Public Health System
MCOs
Home Health
Parks
Economic Development
Mass Transit
Employers
Nursing Homes
Mental HealthDrug
Treatment
Civic Groups
Laboratory Facilities
Hospitals
EMS
Community Centers
Doctors
LHD
Churches
Philanthropist
Elected Officials
Tribal Health
Schools
Police
Fire
Corrections
Environmental Health Urban
Planners
MAPP - Challenges
Time Investment System
Approach
MAPP - Benefits
Increases visibility of public health.
Creates advocates for public health.
Anticipates and manages change.
Creates a stronger public health infrastructure.
Builds stronger partnerships.
Builds public health leadership.
NPHPS/LPHSA - Overview
3 instruments - local, state and governance
Measures the capacity of the local public health system to conduct essential public health services
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
NPHPS/LPHSAThe Instrument
Indicator
ModelStandard
Measures
Essential Service
NPHPS/LPHSA - Limitations
Time Systems focused Not a complete
performance improvement tool
Improves organizational and
community communication
Brings partners to same table
Promotes cohesion and collaborative
Provides a systems view of public health services delivery
Provides a benchmark for improvements
NPHPS/LPHSA - Benefits
PACE EH - OverviewProtocol for Assessing Community Excellence in
Environmental Health
A tool offering local health officials guidance in conducting a community-based environmental health assessment and creating an accurate profile of a community’s environmental health status
Key Objectives of PACE EH
• Evaluate Environmental Health Conditions
• Target Populations at Risk
• Set Priorities
• Support Health Equity and Social Justice
Constituency-building Assessment function Match resources to
needs Power-sharing with the
community Focus on local
situations and solutions Ground-up policy
development process Database development
PACE EH - Outcomes
PACE EH - Limitations
EH focused Time/investment Does not use the 10
EPHS framework
Know your limitations
PACE EH - Benefits Improved environmental health
New and improved leadership role in community regarding EH issues
Fosters new professional partnerships
Fosters confidence to take on other large initiatives
New relationship between LHD and community, from “clients” to “partners”
Fosters local EH database development
community members increased sense of ownership for the EH of their community
PATCHPlanned Approach to Community
Health
Community planning model to assess and improve the health
and quality of life in their communities.
www.cdc.gov/nccdphp/patch
PATCH – How It Compares
Differences: Focus on health
promotion and traditional health
Not systems based
Uses a typical health assessment approach
Not based on 10 EPHS
Similarities: Community-
based Data driven Looks to increase
community capacity
Performance Measurement
Is progress being made toward desired goals?
Are appropriate activities being undertaken to promote achieving those goals?
Performance Measurement
What are our priority issues?
What are the existing reporting requirements?
What measures do other local agencies have to report on?
What to Measure
Capacities Processes Outcomes
Design Criteria forPerformance Measurement Public contact information? Community/ stakeholder involvement
process? Governance process? Policies/ protocols/ procedures for services? Program Plan/ goals/ objectives/ evaluation? Key indicators of performance, tracking, &
reporting? Workforce development/ credentials/
training? Quality improvement plan?
Tools for Performance Measurement
Sterling Criteria for Organizational Performance Excellence www.floridasterling.com
Public Health Infrastructure Resource Center (PHIRC) www.phf.org
Virginia Excels www.vaexcels.governor.virginia.gov, click on “agency performance information”.
Performance MeasurementPitfalls
Too many measures Measurement time frames too long (the
population-based health outcome measure)
Measure process rather than outcome (“plan to plan”)
Applied in silos rather than systems Marginal approach, not related to core
business
Performance MeasurementLimitations
Need long-term vision, objectives, and indicators of performance in order to
provide appropriate direction for agency plans and measures.
Key Differences
APEXPH / PATCH
MAPP/ PACE-
EH
NPHPS PM
System x xStrategic Planning
x
PI/QI tool x x 1/2 1/2
Traditional x xMeasures for LHD
x x
Key Differences Cont.
APEXPH: Internal LHD and Community Health Assessments
PACE EH: Environmental health improvement process with a broad definition of environmental health
MAPP: A community health improvement process with a broad definition of public health
NPHSP: A performance measurement tool for the local public health system
Performance Measures: Internal LHD performance linked with health outcomes.
Resources
APEXPH, MAPP, NPHPSP www.naccho.org/topics/infrastructure/MAPP.cfm
PACE EH www.naccho.org/topics/environmental/CEHA.cfm
Performance Measurement www.phf.org/infrastructure/ , click on “Performance Management”
Questions:
Importance of PlanningImportance of Planning
MAPP/NPHPSPHeidi Deutsch202-783-5550 [email protected]
PACE EHJonathan Schwartz202-783-5550 [email protected]
Performance ManagementStacey Baker202-218 [email protected]