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Performance Improvement Processes

Performance Improvement Processes. Survey of Tools and Approaches. Heidi Deutsch, MA, MSDM MAPP Program Manager. Overview. Defining Terms APEX PH MAPP Performance Standards PACE EH PATCH Performance Measurement. Terms. Performance Standards Performance Measurement

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Performance Improvement Processes

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  1. Performance Improvement Processes Survey of Tools and Approaches Heidi Deutsch, MA, MSDM MAPP Program Manager

  2. Overview • Defining Terms • APEXPH • MAPP • Performance Standards • PACE EH • PATCH • Performance Measurement

  3. Terms Performance Standards Performance Measurement Vs. Community Health Assessment Performance Monitoring Performance Management

  4. Terms 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.

  5. Terms Performance Monitoring: Quantifying progress over time. Performance Management or Performance Improvement: The process of using standards, measures, monitoring progress, towards performance improvement.

  6. APEXPH - Overview • Part 1 – Organizational Capacity Assessment • Part 2 – The Community Process • Part 3 – Completing the Cycle

  7. 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

  8. APEXPH – Limitations • LHD focused • Measures may be out of date • Part 3 not well developed • Did not provide adequate attention to EH Part 3

  9. MAPP - Origins

  10. MAPP - Overview

  11. The MAPP Assessments

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

  13. MAPP - Challenges • Time • Investment • System Approach

  14. 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.

  15. NPHPS/LPHSA - Overview • 3 instruments - local, state and governance • Measures the capacity of the local public health system to conduct essential public health services

  16. Four Concepts Applied inNPHPS 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

  17. NPHPS/LPHSAThe Instrument Essential Service Indicator Model Standard Measures

  18. NPHPS/LPHSA - Limitations • Time • Systems focused • Not a complete performance improvement tool

  19. 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

  20. PACE EH - Overview Protocol 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

  21. Key Objectives of PACE EH • Evaluate Environmental Health Conditions • Target Populations at Risk • Set Priorities • Support Health Equity and Social Justice

  22. PACE EH - Outcomes • 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

  23. PACE EH - Limitations Know your limitations • EH focused • Time/investment • Does not use the 10 EPHS framework

  24. 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

  25. 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

  26. PATCH –How It Compares Similarities: • Community-based • Data driven • Looks to increase community capacity Differences: • Focus on health promotion and traditional health • Not systems based • Uses a typical health assessment approach • Not based on 10 EPHS

  27. Performance Measurement • Is progress being made toward desired goals? • Are appropriate activities being undertaken to promote achieving those goals?

  28. Performance Measurement • What are our priority issues? • What are the existing reporting requirements? • What measures do other local agencies have to report on?

  29. What to Measure • Capacities • Processes • Outcomes

  30. 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?

  31. Tools for Performance Measurement • Sterling Criteria for Organizational Performance Excellence www.floridasterling.com • Public Health Infrastructure Resource Center (PHIRC) www.phf.org • Virginia Excelswww.vaexcels.governor.virginia.gov, click on “agency performance information”.

  32. 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

  33. Performance MeasurementLimitations Need long-term vision, objectives, and indicators of performance in order to provide appropriate direction for agency plans and measures.

  34. Key Differences

  35. 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.

  36. Resources • APEXPH, MAPP, NPHPSP www.naccho.org/topics/infrastructure/MAPP.cfm • PACE EHwww.naccho.org/topics/environmental/CEHA.cfm • Performance Measurementwww.phf.org/infrastructure/ , click on “Performance Management”

  37. Questions: MAPP/NPHPSP Heidi Deutsch 202-783-5550 x252 hdeutsch@naccho.org PACE EH Jonathan Schwartz 202-783-5550 x250 jschwartz@naccho.org Performance Management Stacey Baker 202-218 -4416 sbaker@phf.org Importance of Planning

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