Assessing Hill Countys Public Health System: An Introduction

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Assessing Hill Countys Public Health System An
Introduction

• Jane Smilie, MT DPHHS
• Robert W. Moon, NW Health Partners
• July 8, 2004

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Public Healths Mission

• assuring conditions in which people can be
  healthy
• organized community efforts aimed at the
  prevention of disease and the promotion of
  health.
• Institute of Medicine, The Future of Public
  Health, 1988

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What public health does

• Prevent epidemics and spread of disease
• Protect against environmental hazards
• Prevent injuries
• Promote and encourage healthy behaviors
• Respond to disasters and assist communities in
  recovery
• Assure the quality and accessibility of health
  services

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How public health does its work
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The Essential Public Health Services

• Monitor health status
• Diagnose and investigate health problems
• Inform and educate
• Mobilize communities to address health problems
• Develop policies and plans

• Enforce laws and regulations
• Link people to needed health services
• Assure a competent health services workforce
• Evaluate health services
• Conduct research for new innovations

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This is a misperception of Montanas Public
Health System
? Federal DHHS ? Montana State Dept of PHHS ?
Local Health Departments ? Tribal Health ?
Indian Health Service
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S C O P E O F T H E S Y S T E M
Community Coalitions
Schools
Churches
Police
Community Service Organizations
Government Tribes As the Core of the Public
Health System
Court System
Health Care System
Environmental Health Advocacy Groups
State Government/ Public Health
Local Government/ Public Health
Mental Health Service Providers
Community Non-Profits
Federal Government/ Public Health
Tribal Health Organizations/ Public Health
Philanthropies
Social Service Providers
Professional Associations
Individuals Families
Substance Abuse Service Providers
Private Business/ Industry
Media
Labor Unions
Public Health System Partners
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A broad definition of health
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Health care is vital to all of us some
of the time, but public health is vital to all of
us all of the time.C. Everett Koop

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Public Health Accomplishments1900-1999

• Control of infectious disease
• Motor-vehicle safety
• Safer workplaces
• Fewer deaths from cardiovascular disease stroke
• Safer and healthier foods
• Healthier mothers and babies
• Recognition of tobacco as a health hazard

MMWR Weekly, CDC, Series of articles published in
1999
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Life expectancy at birth,1900, 1950, 1998, U.S.
Adapted from Health United States, 1999,
National Ctr for Health Statistics, PHS
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Benefits of conducting this assessment?

• Improves organizational community communication
• Promotes cohesion collaborative work among
  system members
• Provides a systems view of public health service
  delivery
• Provides a benchmark for PH practice
  improvements
• Create a system of accountability

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Essential Public Health Services
Basic Capacity/ Infrastructure
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Public Health Performance Standards

• BACKGROUND
• Vision Excellence in Public Health Practice
  defined by recognized Performance Standards.  
• Mission To improve the quality of public health
  practice and performance of public health
  systems.  
• Goals
• Provide performance standards for public health
  systems
• Encourage partnerships to build a stronger
  foundation for public health preparedness
• Promote continuous quality improvement of public
  health systems
• Strengthen the science base for public health
  practice improvement

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Public Health Performance Standards

• PUBLIC HEALTH SYSTEM
• Focus On
• All entities that contribute to the health and
  well-being of the community
• All public, private, and voluntary entities that
  contribute to public health in a given area

Assessing more than just
the local health department !!!
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Public Health Performance Standards

• CONCEPTS
• Based on the Ten Essential Public Health Services
• Provides a foundation for any public health
  activity
• Describe an optimal level of performance
• Each performance standard represents the gold
  standard
• Support a process of quality improvement
• Standards should result in identification of
  areas for improvement

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Public Health Performance Standards

• CONDUCTING THE ASSESSMENT
• Think about the focus of the question - is the
  question asking about
• Number of partners that contribute
• Extent of activity
• Frequency of activity
• Quality of activity
• A comprehensive picture of everything

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Determining Responses

• Think about response options as a spectrum

Low Partial
High Partial
No
Yes

• Where along the spectrum does
• your current level of activity fall?

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Instrument Format
Essential Service
Indicator
Model Standard
Measures
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Instrument Format
Measures
Summary Questions
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Public Health Performance Standards

• REPORTS
• Narrative
• Chart of Summary Scores
• Bar Charts by Essential Service
• Table of indicators ranked by
  Met,
  Substantially Met,
  Partially Met, Not Met
• Pie Charts

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Public Health Performance Standards

• THE FINAL STEP
• Moving Toward Quality Improvement!!!!
• Collectively discuss scores results
• Refer to comments and ideas made during the
  assessment completion process
• Identify priority areas to address
• Collectively develop strategies to
  address priorities

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QUESTIONS