1. Creating an Action Plan Jennifer Woodward, MD, MPH Kansas Health Institute

2. "People don't plan to fail. Instead they fail to plan."  • Objectives • Review CHIP framework • Describe action plans • Outline components of an action plan • Review sample action plans

3. CHA Describe health status of community OVERVIEW • Priority setting exercise  priority areas • Investigate root causes of the problem • Set goals for each priority area • Write SMART objectives for each goal • Choose evidence-based intervention strategies that address the root cause of priority area • Develop action plan to assign tasks to members and ensure timely completion • Implementation, evaluation, adjustments CHIP Strategic Plans

4. What is an action plan? • Detailed work plan that guides the implementation of the CHIP • Gets people organized and adds structure to the details needed to get things done • Early organization and structure can save time, energy, and resources

5. Functions of an action plan • Helps us think through why we are doing things instead of just jumping in • Provides framework to a complex project with multiple moving parts • Clarifies responsibilities

6. Action Plan Benefits • A comprehensive action plan can have positive side effects • Maximizes probability of a successful CHIP • Can help justify funding requests • Adds credibility to your CHIP process • Contributes to transparency

7. Components of an action plan • Associated goal, objective, and intervention strategy • Planned activities • Individual/organization responsible for each activity • Timeline for each activity • Resource needs • Status report and results of actions taken, monitoring system

8. Three Cs of action plans • Complete • List all action steps or changes to be sought in all relevant parts of the community (health department, schools, government) • Clear • Make sure everyone knows who will do what by when • Current • Update and re-update

9. PHAB Requirements • “The tracking process must specify the strategies being used, the responsible partners involved, and the status of the effort or results of the actions taken. • Documentation could be, for example, a narrative, table, spread sheet, or a combination. This may look like a work plan that includes the status of the implementation of the work plan.”

10. Process measures • Answers the question: are we doing what we said we were going to do in our action plan? • Evidence of whether or not the activities in the action plan were carried out • Completed action steps can be listed as process measures • Example • Action step: Plan meeting with school board • Process measure: Meeting planned for 7/28/14

11. Pre-plan considerations • What are the existing resources, assets, and strengths for this work? • Who is already engaged in this work? What are they doing? Can we partner? • Who else needs to be engaged in this work? • What are the barriers and how can they be overcome?

12. Pre-plan considerations • More work on understanding the problem may be necessary • Good time to think about why you have chosen this particular strategy • What is it about your CHA, root cause analysis, additional investigation that makes you sure completion of these action steps will lead to change?

13. Immunization example • Due to low immunization rates in your county which is reflected in your CHA data, you have chosen immunizations as a priority area • Goal: Increase immunization rates in your community • Objective #1: Increase the percentage of kindergarten age children immunized to the HP2020 goal of 95% by 2017 • Outcome measure: 95% of kindergarten age children will be appropriately immunized by 2017 [school immunization survey data] • Intervention strategy: Develop/promote an educational campaign to increase awareness about immunizations in the community • Before developing action steps and getting started on the work, cycle back to think about why you know an educational campaign is going to increase immunization rates in your community

14. Example #1 • Priority area: Decrease obesity • Goal: Increase consumption of healthy foods by County residents • Objective: Increase the percent of children and teens (ages 2-17) who consume five or more servings of fruits and vegetables daily to 22% by 2017 • Outcome measures: measures of F/V intake, # of schools with healthy vending policy, healthy vending sales, decrease % of children consuming sugary beverages • Intervention strategy #1: Healthy vending machines - work with school board to create and implement healthy vending policy

15. Worksheet #9

18. Example #2 • Priority area: Address needs of elderly in county • Goal #1: Reduce preventable injuries to elderly adults • Objective #1: Reduce the number of fall-related injuries to elderly residents of county by 20% by 2016 • Outcome measure: Number of ED visits due to preventable fall-related injury to elderly residents decreases from approx. 425/year to 340/year (20% decrease) by 2016 [ED data] • Intervention strategy #1: Develop educational campaign to bring awareness to issue of elderly falls in the community • Intervention strategy #2: Provide CDC’s STEADI (Stopping Elderly Accidents and Injuries) toolkit to health care providers in county and offer education for its use

19. Worksheet #9

22. Tips to ensure action • Make sure individuals responsible for action items in the plan are involved in its creation • Identify a responsible organization for each action item • Everyone with an assigned task receives a copy of the action plan with his/her role is clearly defined

23. Tips to ensure action • CHIP leaders regularly make friendly, supportive contact to check in • Add reports on accomplishments to meeting agendas • Acknowledge and commend those who complete activities • Think about adding things that have the potential for quick, highly visible results • Ongoing monitoring, evaluation, and adjustments

24. Conclusion • Action plans are detailed work plans that guide the most important part of the CHIP process – implementation • Organization early can save resources and maximize the possibility of success • Be specific • Communicate with members, celebrate accomplishments • Adapt action plan as needed

25. References • Information adapted from several sources: • Connecticut Department of Public Health: Guide and Template for Comprehensive Health Improvement Planning • KU Community Toolbox: Developing an Action Plan • Beginning with the End in Mind: Supporting the Development of Health Improvement Plans Designed for Action. IPHI, MPHI – available on NACCHO website