One Local’s Perspective Torney Smith, Administrator

1. Getting from Here to Accreditation . . . And Beyond: Institutionalizing Performance Management and QI One Local’s PerspectiveTorney Smith, Administrator

2. In the Beginning and Early Years • 1995 – Washington State law requiring public health standards and accountability • Expertise was available via contract • Marnie Mason, Barbara Mauer, State DOH • Public Health Improvement Partnership • Standards committee • Multistate Learning Collaborative (MLC) • RWJF facilitated learning and sharing • Exploring accreditation

3. Washington State Standards • Results • Learned our strengths and shortcomings • Leadership commitment to improvement • Dialogue on systematizing • Adoption of PHAB Standards Version 1.0 for Washington • State systemization

4. Engagement of all staff • Initially • Educate about the opportunities • Training was critical to success • Recognition and acclaim • Currently • Ongoing training • From idea to Logic models to Variation Theory to Storyboards and publication • Recognition and team building • Use of Logical Decisions for Windows

5. Quality Council • Home of agency QI • Foundation for PHAB Domain 9 • Monitor Achievement of Organizational Objectives – QI plan updated annually • Quality Improvement Processes Integrated Into Organizational Practice – Center for Excellence • Membership from all levels in agency, including our board of health • Divisional reports annually to QC and BOH • Waiting list for rotational members

6. Institutionalization of QI then QM Process design Quality Improvement QI Process control Process improvement Joseph Juran, 1950s Juran on Leadership for Quality, Free Press, 1989

7. Organization/Transition of our work • Becoming electronic • Microsoft SharePoint and Great Plains • Developing filing systems • Docuware • Useful tools for us include: • Microsoft Office – Excel and File Explorer • MindManager • PolicyTech • SharePoint

8. Value of PHAB Accreditation • A great milestone • Structure that matures to remain current • Drives national focus for public health QI • Foundation for public health relationships • A basis to increase revenues

9. Recognition of Vision & Leadership • RWJF • NNPHI • ASTHO • NACCHO • APQI • PHAB • CDC - OSTLTS

10. Questions? • Thank you Torney Smith Spokane Regional Health District 1101 W College Ave Spokane, WA 99201 tsmith@srhd.org 509-324-1518

11. Presented by Joyce Marshall, MPH Director, Office of Performance Management Oklahoma State Department of Health COPPHI Open Forum Meeting June 12, 2013 GETTING FROM HERE TO ACCREDITATION…AND BEYOND: INSTITUTIONALIZING PERFORMANCE MANAGEMENT AND QI

12. Increases alignment of strategic initiatives Provides accountability to stakeholders Systematically defines and measures success Optimizes human capital potential Encourages continuous and ongoing cycle of improvement Why are Performance Management and Quality Improvement Important?

13. Getting Started • Leadership Support • Staff Involvement and Buy-In • One Page Visual Model/Schematic • Right Tools and Technology for Organization • PHAB Standards Alignment • Continuous Communication • Plan for Institutionalization

14. National State Agency Service Area & County Health Department Individual Employee OSDH Performance Management Model Quality Improvement Service Area/CHD Strategic Plans Tool – Step Up Healthy People 2010/2020 Oklahoma Health Improvement Plan Tool – State of the State’s Health Report Strategic Plan Tool – Strategic Map Individual Contribution Tool – Agency Individual Performance Management Process (PMP) Evaluations 3 Core Functions/10 Essential Services Strategic Targeted Action Teams/Plans Tool – Step Up Turning Point PM Framework NPHPSP Community Health Improvement Plans Tool – Mobilizing for Action through Planning and Partnerships (MAPP) Turning Point & Step UP Accreditation Core Services Document Tool – Business Plan United Health Foundation & Commonwealth Fund Community

15. Step UP Performance Management System 2013 State of Oklahoma Quality Crown Award Winner

16. Step UP 5 STEPS 3 Templates Performance ManagementSystem Annual Review Action Plan Strategic Plan Overview Nat’l, OK & County Framework

17. Public Health Alignment & Overview Template • County Demographic Information or Service Target Population Information • Alignment to Oklahoma & Nat’l Framework • Quality Improvement • Customer Satisfaction • Community Assessment/HIP • Emergency Preparedness • Funding Sources • FTE

18. Strategic Plan Template • 2-5 Goals • 2-5 Objectives • 1-5 Performance Measures • Alignment to state strategic plan/health improvement plan • Baseline/Target and Trend Information • Data Sources and Formulas • Uniform and County Specific Performance Measures/Standards

20. Sample Action Plan

21. Annual Review Template • Report Actual Data to Target • Scorecard • Barriers/Lessons Learned • Success Factors

23. LOOKUP tools

26. Performance Alignment ExampleNational: HP 2010/2020, Accreditation, UHF & Commonwealth Fund ReportsState: Oklahoma Health Improvement Plan (Tobacco Flagship Issue) County Health Department

27. Accreditation Domain 9 Documentation • Leadership/staff engagement in PM system establishment • Self-assessment and team responsible for implementation/oversight • Written time-framed goals and objectives • Monitoring process • Progress analysis, results, and next steps

28. Accreditation Domain 9 Documentation • Customer feedback process • Staff development and participation opportunities • Technical assistance provision • QI Plan • QI Activities tied to plan • QI Plan linked to strategic plan

29. Worth of Performance Management & QI • PI/QI Itself • Snowball Effect • Accreditation • Institutionalization and Culture • Better, More Effective Organization • Accountability/Operational & Service Efficiency • Better Services to our Customers/Oklahomans!

30. QUESTIONS