Local Public Health Performance Standards Assessment

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Local Public Health Performance Standards
Assessment the MAPP ProcessTransitioning Your
Community From Perception to Reality

• Stephanie R. Paulmeno MS, RN, NHA
• Director, Community Health Planning
• Greenwich Department of Health
• Greenwich, CT

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Performance Standards in Public Health

• The Core Public Health Steering Committee of
  the CDC, the American Public Health Association
  (APHA), NACCHO and other major national public
  health agencies initiated the process of
  identifying performance standards for public
  health in 1994.

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Greenwich A long tradition of Community
partnerships

• Public health infrastructure is strong visible
  in Greenwich
• Partnerships have existed for decades
• Public health leadership and visibility was
  dramatically increased with the appointment of a
  designated Community Health Planner who works
  within the Town, Region and State

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The Community Health Planner

• Assessment based planning focus
• Outcome focused planning strategies
• Works to develop, support, or work within
  partnerships and coalitions
• Focuses on the use of resources,
  identifying/filling gaps and avoiding unnecessary
  duplication of services
• Provides introduction to Town services

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Survey Purpose Process

• The process evaluates public, private and
  municipal service delivery programs that impact
  health and emergency preparedness within a town
  or city, and not merely the capacity of their
  Local Departments of Health.

• The process is a partnership effort to
  improve public health practice and performance as
  well as the infrastructure that supports these
  efforts.

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Is Perception Reality?

• The survey is a perceptual tool
• It can reflect either the knowledge base of
  the participants or provide an accurate depiction
  of the various assessment components

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Pre-Planning Issues

• The benefit of
• group evaluation
• The traditional
• vs. fast track process
• Advance
• Preparation

• Time saving pre assessment strategies
• Rapid visual depiction of the community

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Pre-Planning Issues

• Designing pre-assessment participant
  worksheets
• The benefits of charts and posters

• Getting the right partners to the table
• Explaining the 10 Essential Services of Public
  Health

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Building Community Ownership Of The Assessment
Process

• Buy-in is important to the quality level of
  participation to the outcome
• The view is different from different agency
  levels
• All participants have equal standing
• All opinions are important and valid

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Pre-Assessment Preparation

• Draft information letters/make follow-up phone
  calls seeking participants
• Develop display charts for review areas
• Pre-distribute the 10 Essential Services of
  Public Health
• Design/Distribute work sheets for pre-analysis
• Conduct Town website review

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Letters Phone Calls

• Explain the rationale and process
• Define a public health system as opposed to the
  core functions of a health department
• (all public, private voluntary entities
  that contribute to the delivery of essential
  public health services within a jurisdiction)

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10 Essential Services of Public Health

• Monitor Health
• Diagnose/Investigate
• Inform, educate, empower
• Mobilize partnerships
• Policy Development

• Enforce laws regs
• Link people/health care
• Assure a competent workforce
• Evaluate quality
• Research for new insights

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Developing Charts to Educate the Public Health
System Evaluators

• Collaborations Coalitions Partnerships
• Community Assessments
• Disaster Preparedness
• Task forces/projects

• Health Surveillance Activities
• Agencies/Town Depts. that had under gone
  evaluations
• Advocacy Groups
• Emergency Equipment

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Collaboration Posters

• Senior Provider Network Advisory Boards
  United Way Youth Planning Councils Senior
  Health Fair Team Late Life Issues Committee
  Underage Drinking Coalition Greenwich Health
  Improvement Partnership Committees Time for
  Lyme Task Force Regional B-T Group Assessment
  Committees Disease-based Advisory Councils

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Community Assessments Posters

• Greenwich Department of Health
• Latino Study
• Public Health Systems Assessment
• United Way
• Community Needs Assessment
• Statistical Portrait (w/GDoH)
• Greenwich Hospital Advisory Board
• Community Health Assessment

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Disaster Preparedness Posters

• B-T Coordinator/Team Disaster Plans
  Mass Immunization Protocols Communication
  modalities
• Incident Command Training Mock Disasters
• PPE/Training Broadcast Fax Radiology
  Meters Decontamination Units SARS Avian Flu
  monitoring/tracking Highest of certified
  Hazmet Techs in CT (96) 50 MOP II test kits
  Decon trailer portable unit 50 docemeters
  Fully equipped Hazmat truck w/ mobile command
  unit, picture transmission on order

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Other Poster Displays

• Policy and planning forums/collaborators
• Towns Surveillance System Components
• Equipment Monitoring Partners
• Training Capacity Drills
• Essential Services of Public Health
• Agencies that had undergone internal studies or
  major reviews within 5 years

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Pre-Assessment Worksheets
List each of the 10 Essential Services of Public Health Pre-Identify some specific examples within your community Pre-Identify some agencies involved in fulfilling each essential service Members provide additional input based on their own experience
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Pre-Assessment Website Review

• Assessments conducted
• Data gathering and report sharing
• Research studies/Findings
• Linkages/Collaborations

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Pre-Assessment Preparation

• Identify The Invitees/Construct Your Mix
• Local Hospital, nursing homes, practitioners,
  etc.
• 1st Responders (police, fire, ambulance, E.R.)
• Red Cross
• School and business representatives
• Town health social service provider agencies
• Consumers, local government, funding sources
• Clergy, service organizations

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Pre-Assessment Preparation

• Two Breakout sessions were designed
• 1) Greenwich Department of Health
• 2) 1st Responders
• Information gathering sessions were held with key
  people who could not attend

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Pre-Assessment Preparation

• Seek representation that reflects your
• cultural and ethnic groups and various
• age groups and special needs populations
• Seek participation from people at various
  
• levels of organizations
• Seek people from Town government

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Assessment Day

• On site monitor
• Orientation AM and PM
• Breakout sessions
• Model standard vs. Town performance
• Facilitating the discussion
• Scoring the group responses

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Post Assessment

• Entering the response Scores
• Getting the report results
• Drafting the final report
• Community Forum
• Using the report findings

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Utilizing Report Results 1 of 2

• Even good results can offer opportunities for
  improvement
• The standard may be met but individual indicators
  may be lacking
• The raters perception may be erroneously positive
• Intra/inter agency communications may be
  editorialized in a group setting

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Utilizing Report Results 2 of 2

• Community forums and press releases
• Guide the development or revision
• of a strategic or operating plan
• Guide the development of outcome
• based budgeting
• Motivate a workforce capacity study
• Enhance communication of data,
• research findings, and surveillance

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Don't be Intimidated!