WORKFORCE DEVELOPMENT: Key to Public Health Infrastructure

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WORKFORCE DEVELOPMENTKey to Public Health
Infrastructure
Plan for Success 19th National Conference on
Health Education Health Promotion April 25,
2001 Kristine M. Gebbie, DrPH, RN Columbia
University School of Nursing
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Rationale for workforce development

• If you have competent workers . .
• Essential public health services are delivered .
  .
• Programs are effective . .
• People and communities get healthier

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It is not sufficient to

• Assume initial professional education is adequate
• Identify with and learn a single programmatic
  area
• Passively wait for education to arrive

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Essential public health services

• Not specific to any population or program area
• Developmental over time

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Public health infrastructure
Prepared Workforce
Data and Information
Systems and Relationships
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The Public Health Workforce an Agenda for the
21st Century

• National leadership
• State and local leadership
• Workforce composition
• Curriculum development
• Distance learning
• Not addressed as yet
• increase in minority composition

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Workforce development plan

• enumeration
• competency identification
• curriculum development
• delivery systems and methods
• habit of life-long learning
• research and evaluation

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Partners in workforce development

• The Workforce Collaborative
• CDCs Strategic Plan
• Callaway Gardens participants
• National and regional leadership institutes
• Training centers

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Public health professionals share perceptions

• In the changing work world, many of key skills
  arent valued
• Previous specialty training doesnt match todays
  needs
• Future may hold even less job security
• Wide geographic distribution makes education a
  challenge

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Health educators say they need

• Advocacy skills
• Business management and finance
• Communication
• Community health planning and development

• Coalition building and leadership
• Computing and technology
• Cultural competency
• Evaluation
• Strategic planning

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Individual competencies

• Complex combination of knowledge, skills and
  abilities demonstrated by organization members
  that are critical to the effective and efficient
  function of the organization (Center for Public
  Health Practice, Emory University).

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Or . . .

• Combination of observable and measurable skill,
  knowledge, performance behavior and personal
  attributes that contribute to enhanced employee
  performance and organizational success
  (American Compensation Association).

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Competency statements have many uses

• Updating/revising job descriptions
• Does each job description include reference to
  emergency responsibilities and tasks?
• Employee orientation and training
• The agency plan, organizational size chart, and
  individual place in the jurisdictional plan make
  these competencies meaningful.
• Self-assessment by workers
• Am I able to

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Levels and layers

• Some competencies apply to all, but are assessed
  differently at different levels of worker
• Generic competencies are assessed differently in
  different programs or professions
• Some competencies are specific to a profession or
  a program area

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Competencies can be

• Documented in established practice areas,
  professions or program
• Developed prospectively in emerging areas of
  interest

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Sample core analytic professional competencies

• Defines a problem
• Partners with communities to attach meaning to
  data
• Makes relevant inferences from data
• Applies ethical principles to the collection,
  maintenance, use, and dissemination of data
  Understands how data illuminates PH issues
• Obtains/interprets information on risks and
  benefits to the community

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The example of genomics

• An emerging area of public health practice
• Requires major development of workforce
• Impact on 21st century may equal that of
  infectious diseases in the 20th

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Draft competencies for ALL workers

• Demonstrate basic knowledge that genomics has a
  role in individual and public health
• Identify the limits of his/her genomic expertise
• Make appropriate referrals to those with more
  genomic expertise

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Draft competencies for ALL professionals

• Always applied within professional field and
  program
• Apply the basic public health sciences, and the
  goal of disease prevention to studies of and
  issues in genomics and genetic testing utilizing
  a common vocabulary of terms for genomics

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Professionals, cont.

• Identify ethical and medical limitations to
  testing, including potential misuse
• Maintain knowledge of genetic advances and
  technologies
• Identify cultural, social, behavioral,
  environmental and genetic factors in disease,
  disease prevention, health promoting behaviors,
  and their impact on service organization and
  delivery

• Participate in strategic development related to
  genetic testing or genomic programs
• Collaborate with agencies and organizations
  including genomic-related businesses to identify
  and solve genomic related problems
• Participate in the evaluation of personal and
  population-based genomic services in public health

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Draft competencies for the public health educator

• Always modified as appropriate to agency,
  discipline or program
• Translate current information about social and
  cultural environments, (including community
  needs/ interests/ societal value systems) for use
  in population based scientifically sound genomic
  health education programs

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Health educators, cont.

• Determine factors (learning styles, literacy) and
  barriers thatb influence learning about genomics.
• Differentiate genomic education and genetic
  counseling
• Facilitate genomic education for agency,
  community groups

• Utilize social marketing to develop a plan for
  incorporatinggenomics into health education
  services
• Provide critical analysis of current and future
  needs in genomic education for the community
• Advocate for genomic education and/or genomic
  components of education

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Another example emergency preparedness

• Extension of the mission of public health
• Readiness for bio-terrorism
• Response to emerging infections
• Based in agency performance standards
• Overlap with competencies in other areas of
  practice

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Core competencies in emergency preparedness

• Describe the public heath role in emergency
  response in a range of emergencies that might
  arise.
• E.g.This department provides surveillance,
  investigation and public information in disease
  outbreaks and collaborates with other agencies in
  biological, environmental, and weather
  emergencies.

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Core competencies 2

• Describe the chain of command in emergency
  response
• Identify and locate the agency emergency response
  plan.
• Describe his/her functional role(s) in emergency
  response and demonstrate in regular drills.
• Demonstrate correct use of all communication
  equipment used for emergency communication
• Describe communication role(s) in emergency
  response (within agency, media, public, personal)

• Identify limits to own knowledge/ skill/authority
  and identify key system resources for referring
  matters that exceed these limits.
• Apply creative problem solving and flexible
  thinking to challenges and evaluate effectiveness
  of all actions taken.
• Recognize deviations from the norm that might
  indicate an emergency and describe appropriate
  action (e.g. communicate clearly within the chain
  of command).

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Additional competencies for professionals

• Demonstrate readiness to apply skills to a range
  of emergency situations during regular drills
• access, use, interpretation of surveillance data
• access to and use of lab resources
• access to and use of science-based investigation
  protocols and risk assessment
• selection/use of appropriate protective equipmt

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Professionals 2

• Maintain regular communication with partner
  professionals in other agencies involved in
  emergencyresponse
• includes contributing to effective community wide
  response through leadership, team building,
  negotiation and conflict resolution

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Professionals 3

• Participate in continuing education to maintain
  up to date knowledge in areas relevant to
  emergencyresponse
• emerging infectious diseases, hazardous
  materials, diagnostic tests, etc.

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Remember. . .

• If you have competent workers
• essential public health services are delivered
• programs are effective and
• people and communities get healthier

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Columbia University School of Nursing
630 West 168th Street New York, New York 10032
www.nursing.hs.columbia.edu