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WELCOME! NPHPSP User Teleconference. Please mute your line by pressing *6 You can un-mute your line by pressing *7 Do not put your phone on hold. December 15, 2009 Call in Information: 1-800-504-8071, code 8422006. The NPHPSP as a Performance Improvement Tool for State and Local Practice.

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  1. WELCOME!NPHPSP User Teleconference Please mute your line by pressing *6 You can un-mute your line by pressing *7 Do not put your phone on hold. December 15, 2009Call in Information: 1-800-504-8071, code 8422006

  2. The NPHPSP as a Performance Improvement Tool for State and Local Practice The Illinois Experience Elissa J. Bassler CEO, Illinois Public Health Institute NPHPSP User Call – December 15, 2009 2

  3. SHIP Act – MAPP in mind • IPHI advocated for SHIP Act, passed and signed in Aug. 2004 • The Plan recommends: • priorities and strategies to improve the Illinois public health system and health status • Considering: • national health objectives (e.g. HP 2010) • National public health system standards (e.g. National Public Health Performance Standards.) • IPLAN, regional plans 3

  4. SHIP Act – MAPP in Mind • The Plan examines and makes recommendations on: - the contributions and strategies of the public and private sectors in improving health status and the public health system • The Plan must also make recommendations regarding reducing health disparities, including: - racial, ethnic, gender, age, socioeconomic and geographic disparities 4

  5. SHIP Act – MAPP in Mind • The Director of IDPH appoints a planning team consisting of the range of public, private and voluntary sector stakeholders in the public health system. • Secretary of IDHS and Directors of state agencies with public health responsibilities • Representatives of local health departments • Representatives of local community health partnerships • Representatives of organizations and constituencies engaged in public health improvement and prevention 5

  6. Illinois NPHPSP& SHIP Timeline June, 2004 Conducted NPHPSP v.1 August, 2004 SHIP Act requiring state health improvement plan signed August, 2005 – NPHPSP Prioritizing Retreat October, 2005 – 1st SHIP Team meeting May, 2007 – 1st SHIP Published 6

  7. Illinois NPHPSP& SHIP Timeline March 2009, NPHPSP v. 2 October, 2009 – 1st meeting, second SHIP 7

  8. SHIP – State MAPP Adaptation • Followed the MAPP framework: • Organize for Success • Partnership Development • Visioning • Four MAPP Assessments • Statewide Themes and Strengths • Forces of Change • State Health Profile • State Public Health System Assessment (NPHPSP) 8

  9. SHIP – State MAPP Adaptation • Followed MAPP Framework (cont.) • Identify Strategic Issues • Formulate Goals and Actions • Action Cycle 9

  10. NPHPSP for Performance Improvement thru SHIP • 2004 Assessment Retreat • ~ 80 System participants • Govt. PH, health care, business, insurance; non-profit health advocacy groups; CBOs, minority health advocates • 2 Day retreat • Intro/orientation • Five breakouts (2 ES each) • Summary session 10

  11. NPHPSP for Performance Improvement thru SHIP • NPHPSP Prioritizing Retreat • August, 2005; prep for SHIP • Online survey • 91 System partners • Five breakouts/2 EPHS each • Review survey results • Use prioritizing criterial • Prioritize five measures from each EPHS as focus areas for SHIP 11

  12. NPHPSP for Performance Improvement thru SHIP • Prioritizing decision criteria: • widespread activity; • in need of special attention; • systems issue that needs partner involvement; • high importance, but rated at low or inadequate performance levels; • related to other issues and can be a foundation for other improvements. 12

  13. NPHPSP for Performance Improvement thru SHIP • SHIP Public Health System Assessment: • Team reviewed NPHPSP and results of the prioritizing retreat • Developed findings by reorganizing from EPHS to “Action Statements” • Each Action Statement refers to measures from various EPHS that were deemed priorities at the retreat 13

  14. NPHPSP in SHIP/MAPP • New “action” statements from NPHPSP results • Collect Data and Use Information Effectively • Garner, Leverage and Manage Resources for a More Proactive Public Health System • Integrate State and Local Action • Continuously Improve the Quality of the Public Health System • Infuse Cultural Competency throughout the System • Invest in the Public Health and Personal Health Care Workforce 14

  15. NPHPSP In SHIP SHIP Team synthesized results of system assessment with FOC, Health Profile, and Statewide Themes and Strengths Developed ten strategic issues 15

  16. NPHPSP In SHIP • Ten Strategic Priorities • Access; • Data and Health IT; • Health Disparities; • Measure, Manage and Improve the PH System; • Workforce Preparation/Distribution; • Workforce Diversity/Cultural Competency; • Priority Health Conditions • ATOD, • Physical Activity; • Obesity, • Violence 16

  17. NPHPSP In SHIP SHIP Priorities: Data; Measure, Manage and Improve the PH System; Workforce Preparation; Workforce Diversity/Cultural Competency all can be related directly back to NPHPSP findings. All NPHPSP findings except “state/local integration” had analogies in other assessments, ended up in Strategic Priorities 17

  18. SHIP & Performance Improvement • Somewhat disappointing, because little organized action on SHIP since publication • System plan: who “owns” it? Who is accountable? • How to maintain oversight & momentum? • Some improvement initiatives that have occurred include: 18

  19. SHIP & Performance Improvement • Initiatives that specifically mentioned SHIP: • Illinois Health Data Dissemination Initiative - IDPH • Health Data Task Force Legislation - Un-resourced • CDC Grant to build a Web-Query System • Health Disparities • Language Access Legislation • Cultural Competency Grant Program (un-funded) 19

  20. SHIP & Performance Improvement • SHIP Summit – July 2008 • Reported on various initiatives, most coincidental to SHIP 20

  21. SHIP & Performance Improvement • Summit called for specific immediate action steps • Obesity/Physical Activity • Hearings in 2010 (legislation) • Workforce • Physician workforce institute • Disparities • Concept: Health Equity and Health Disparities commission • Access 21

  22. NPHPSP Measuring Results • Challenges: • Differences in v. 1 and v. 2 of NPHPSP tool • Different participants in measurement; • Attribution to SHIP is difficult because SHIP is a MAPP plan, not a NPHPSP improvement plan • “Big” QI vs. “Little” QI • Nonetheless: 22

  23. NPHPSP Results In Illinois 23

  24. NPHPSP Results in Illinois 24

  25. NPHPSP in Illinois • V. 1 implemented in anticipation of a SHIP, though none yet conducted • V. 1 EPHS 5 score reflected lack of a SHIP • V. 2 EPHS 5 reflects implementation of SHIP (as well as changes in the tool) 25

  26. Next Steps • SHIP 2009 – first meeting 10/21/09 • MAPP Action Cycle • Refine, focus and prioritize existing SHIP • Review assessments, including new NPHPSP-March ‘09 • Build ‘09 assessment findings on ‘07 findings (use same Action Statements, synthesize new data) 26

  27. NPHPSP & MAPP Challenges • Synthesizing assessments to identify strategic issues • Different types of data in 4 assessments • e.g. a disease trend and a system function • Action Statements help, especially with synthesizing Forces of Change/Themes & Strengths/NPHPSP • Conceptually link action statement: garner & coordinate resources (health promotion) + increasing obesity rates. 27

  28. Lessons & Conclusions • SHIP • Strong desire to make next iteration more actionable/efforts that will ensure implementation • Plan for implementation in planning process • Who “owns” a system plan • Funding of ongoing engagement and action • Implementation committee 28

  29. Lessons & Conclusions 29 • SHIP • Synthesis of multiple assessments into a strategic plan that achieves buy-in from partners is challenging • MAPP allows for systems focused plan • Ongoing oversight/promotion and measurement is critical

  30. Lessons & Conclusions • NPHPSP is built into state law • Regular engagement of system partners in EPHS • Inclusion of system improvements in planning • Helps with being strategic • Build in ongoing oversight & action into law • Philanthropy at the table from beginning 30

  31. NPHPSP & State MAPP • Complex process • Yields plan for system: • Multi-sectoral • Building the system, not just health status • Tool for performance management • Standards, data, measurement • Creates QI priorities, with periodic review and reporting 31

  32. Questions

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