cdc/od/ocphp/nphpsp/ Karen O’Rourke, MPH Joan Orr, CHES 2009

1. Public Health Performance StandardsDistrict System Assessment www.cdc.gov/od/ocphp/nphpsp/ Karen O’Rourke, MPH Joan Orr, CHES 2009

2. Part 1:The National Performance Standards Program

3. To improve the quality of public health practice and performance of public health systems by: Providing performance standards for public health systems; Promoting continuous quality improvement; Engaging and leveraging partnerships; Strengthening the science base for public health practice improvement Program Vision and Goals

4. HISTORICAL BACKGROUND Background • Began in 1998 • Partnership effort between CDC and five national public health organizations • APHA, ASTHO, NACCHO, NALBOH, NNPHI, PHF • National launch in June 2002 • Tool revised in 2008

5. The Assessment Instruments • State public health system • Local public health system • Local governance

6. Four Key Concepts • Based on the ten Essential Public Health services • Focus on the overall public health system • Describe an optimal level of performance • 4. Support a process of quality improvement

7. Key Concept 1: The Essential Services • Provides a foundation for any public health activity • Describes public health at both the state and local levels • Instruments include sections addressing each essential service

8. Monitor health status Diagnose and investigate health problems Inform and educate Mobilize communities to address health problems Develop policies and plans Enforce laws and regulations Link people to needed health services Assure a competent health services workforce Evaluate health services Conduct research for new innovations 10 Essential PH Services

9. Key Concept 2: Focus on the “System” • “Public Health System” • A Network of… • Public entities • Private entities • Voluntary entities • All entities contribute to the health and well-being of the community

10. The Public Health System Police EMS Corrections MCOs Health Department Philanthropist Churches Community Centers Nursing Homes Home Health Parks Doctors Schools Elected Officials Hospitals Mass Transit Environmental Health Civic Groups CHCs Fire Tribal Health Employers Laboratory Facilities Economic Development Drug Treatment Mental Health

11. Key Concept 3: Optimal Performance • Each performance standard represents the “gold standard” • Provide benchmarks to which state and local systems can strive to achieve • Stimulate higher achievement

12. Key Concept 4: Quality Improvement • Standards should result in identification of areas for improvement • Link results to an improvement process

13. Improves organizational and community communication Provides a benchmark for public health practice improvements Brings partners to same table Promotes cohesion and collaboration Provides a systems view of public health Provide a baseline for Maine’s emerging District Public Health System User Benefits

14. Part 2:The National Public Health Performance StandardsLocal Assessment

15. Structure The Tool Focus is on the District Public Health System 10 Chapters Based on essential services Each Essential Service Indicators (components, activities) Model standards (optimal performance) Measures (questions)

16. Structure • 10 Essential Services • 30 Model Standards • 325 Total Questions (109 questions, 216 sub-questions)

17. Response Options Response Options No activity Minimal (>0 and 25% or less) Moderate (>25% but no more than 50%) Significant (>50% but no more than 75%) Optimal (Greater than 75%)

18. Scoring Option Definitions

19. The Data Quantitative Scores assigned based on responses Algorithm developed by CDC Qualitative Comments captured Themes developed

20. Reports Reports include: • Overall Score for each Essential Service • A summary score for each indicator • A score for each component

21. Example ESPH #7: Link People to Needed Health Services Overall Score : 81.93

22. Example ESPH #1: Monitor Health Status Overall Score: 62.23

23. Recording Information • While not an inventory of activities, we will record comments to identify themes and provide a context for the scores • Specific programs, projects or organizations will generally not be included in the final report.

24. Activities & Timeline 2009 March -June July -August Sept. - Oct Fall Conduct 5 District Assessments Analyze Findings Conduct 3 District Assessments Analyze Findings & Present Reports Maine Center for Public Health

25. The Process At each of the 3 meetings, we will: • Review the Essential Service Model Standard. • Discuss what each organization does with regard to the model standard within the District. • Identify strengths, weaknesses, gaps and recommendations for improvement or collaboration for the District. • Facilitators will suggest a score upon completion of discussion. This will help ensure consistency across the 8 Districts.

26. Roles and Responsibilities • Facilitators: • Guide participants through the process • Keep time • Allow everyone to speak • Suggest a score • Record results • Participants • Participate fully in discussion from your organization’s perspective • Keep comments brief (no more than 3 min) • Focus comments only on the indicator being discussed • Help identify strengths, weaknesses, gaps and recommendations

27. For More Information: www.cdc.gov/od/ocphp/nphpsp/