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Improving Public Health in Washington State August 2009 Presenter: Deborah Allwes

Improving Public Health in Washington State August 2009 Presenter: Deborah Allwes. Overview. 35 independent health departments/districts Local Boards of Health About 50% of LHJ funding is local (taxes, fees) - Remainder is state and federal – various sources

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Improving Public Health in Washington State August 2009 Presenter: Deborah Allwes

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  1. Improving Public Health in Washington StateAugust 2009Presenter: Deborah Allwes

  2. Overview • 35 independent health departments/districts • Local Boards of Health • About 50% of LHJ funding is local (taxes, fees) - Remainder is state and federal – various sources - Huge variation among LHJs: $11 to $107 per capita • State authority is limited • Economic conditions for state and local are currently declining

  3. History of Improvement Processes • PL 43.70.520 - Public Health Improvement Plan • 1994-1998 developed standards • 1999-2000 field tested standards • 2002 Baseline assessment • 2005 assessed state and local health • 2008 statewide assessment

  4. Our Goal • A predictable level of public health protection throughout the state “What every person has a right to expect.”

  5. The Measurement Process • Self study and documentation, completed in advance • Training provided • All 35 LHJs plus DOH programs reviewed • Independent consultants, some peers • Inter-rater reliability tested • Reports available online • Individual site reports annotated • Exemplary practices www.doh.wa.gov/phip/Standards/BestPractices/ StandardsExemplaryPractices.htm

  6. Standards Assessment Results • Participation of all 35 health departments • Participation of all divisions in State DOH • Overall approach is quality improvement methods • Demonstrated improvement in Standards from 2002-2005, 2008 results in fall • Demonstrated improvement in results of public health work • Provides overall system results (snapshot)

  7. Basic Building Blocks for Improvement Performance • Health Indicators • - How healthy are we? • How does our health compare to • others? • What specific problems could we • address? • Population level data • Quality Improvement Efforts – Program/ • Service Based • How can we improve the work • we do -- that will result in • better health or protection? • This is generally applied at the • program or service level. • There are many distinct • programs/ services. Examples: • TB, Immunizations, WIC, Food • safety. • Service-level data • Standards and Measures • What should a health department be • able to do? • Do we provide basic expected • functions? • - How do we compare to others? • - Where do we need to improve? • System/organization level data

  8. Multi-State Learning Collaborative III • Increase statewide understanding of Quality Improvement approaches and skills • Develop alignment with National Accreditation • Inform the PHAB through input from WA • Develop evaluation processes

  9. Selected Targets • Reduce the incidence of vaccine preventable disease • Reduce preventable risk factors that predispose to chronic disease • Reduce infant mortality rates • Health improvement planning • Program planning and evaluation • Culturally appropriate services

  10. Mini Proposals • Request for proposals in development • Selections by September • Proposals begin by October

  11. Connections to Other Initiatives • LJHs received funding in 2008 for selected targets - Many overlap with MLC-3 work • Group Health Foundation - grants for immunizations • Joint funding with Maternal Child Health for prenatal care work

  12. Accreditation Activities • Washington participation on PHAB Committees • Table of Washington system gaps • Discussion paper in development

  13. Summary of Washington Gaps in Accreditation Approaches • Modifications to the standards • Develop and modify accreditation survey processes • Develop accreditation entity and status • Integrate health indicators to accreditation processes • Develop appeals process

  14. Evaluation-Feedback Survey • Feedback survey developed for 2008 Standards Assessment - Sent to all LHJs and DOH • Feedback on all aspects of the process were requested • Results in August

  15. Long Term Goals • Consistent public health services throughout the state • Data driven decision making - Good data for all counties • Improvement in selected targets • Long term sustainable funding • Adequate workforce

  16. Important Websites • Public Health Improvement Plan www.doh.wa.gov/phip • Standards for Public Health www.doh.wa.gov/phip/PerfMgmt/07stds/main.htm • Local Public Health Indicators www.doh.wa.gov/phip/khi/lphi/overview.htm • Exemplary Practiceswww.doh.wa.gov/phip/documents/PerfMgmt/05EP/ EPreport.pdf • Everybody Countswww.doh.wa.gov/phip/communications/tools/survey/ everybodycounts/default.htm

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