The National Public Health Performance Standards Overview for Mineral County

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The National Public Health Performance
StandardsOverview for Mineral County
Yellowstone County May, 2005
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Brief History of Causal Theory How weve
explained our health status.

• Gods will
• Miasma and humors
• Poor living conditions, immorality (sanitation)
• Single disease, single cause (germ theory)
• Single disease, multiple causes (CVD)
• Single cause, multiple diseases (tobacco)
• Multiple causes, multiple diseases, but no
  feedback dynamics (multiple determinants of
  health)
• Dynamic feedback among afflictions, living
  conditions, and multiple stakeholders (syndemic
  perspective)

1840
1880
1950
1960
1980
2000
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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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Program Vision and Goals
To improve the quality of public health practice
and performance of public health systems by

• Providing performance standards for public health
  systems and encouraging their widespread use
• Engaging and leveraging national, state, and
  local partnerships to build a stronger foundation
  for public health preparedness
• Promoting continuous quality improvement of
  public health systems and
• Strengthening the science base for public health
  practice improvement.

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NPHPSP

• Partners
• CDC, APHA, ASTHO, NACCHO, NALBOH, NNPHI, PHF
• Assessment Instruments
• State public health system
• Local public health system
• Local governance
• International
• History
• Began in 1998
• Instruments released in 2002

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Four Concepts Applied in NPHPSP

• Based on the ten Essential Public Health Services
• Focus on the overall public health system
• Describe an optimal level of performance
• Support a process of quality improvement

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The Essential Public Health Services

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

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

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1. The Essential Services as a Framework

• Provides a foundation for any public health
  activity
• Describes public health at both the state and
  local levels
• Instruments include sections addressing each ES

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2. Focus on the System

• More than just the public health agency
• Public health system
• All public, private, and voluntary entities that
  contribute to public health in a given area.
• A network of entities with differing roles,
  relationships, and interactions.
• All entities contribute to the health and
  well-being of the community.

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Public Health System
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The goal is an integrated system of partnerships
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3. Optimal Level of Performance

• Each performance standard represents the gold
  standard
• Provide benchmarks to which state and local
  systems can strive to achieve
• Stimulate higher achievement

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Using Data for Performance Improvement
There must be a better way to make decisions.
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4. Stimulate Quality Improvement

• Standards should result in identification of
  areas for improvement
• Link results to an improvement process
• NPHPSP Local Instrument - used within the MAPP
  planning process

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A Reminder about the Importance of Planning
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User Benefits to NPHPSP

• Improves organizational and community
  communication
• Promotes cohesion and collaboration among system
  members
• Provides a systems view of public health
  activities
• Provides a benchmark for public health practice
  improvements
• Provides information for policy development,
  program evaluation and grant-writing

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Instrument Format
Essential Service
Indicator
Model Standard
Measures
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Measures
Summary Questions
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Local Public Health System Instrument

• 2-4 indicators per Essential Service (31 Total)
• Indicator titles change depending on local
  activities for each Essential Service
• Example for ES 5
• 5.1 Governmental Presence at the Local Level
• 5.2 Public Health Policy Development
• 5.3 Community Health Improvement Process
• 5.4 Strategic Planning and Alignment with the
  
• Community Health Improvement
  Plan

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Approaches in Determining Responses

• Walk through questions one by one
• Discuss the model standard with
  facilitator/recorder judgment on responses
• Discuss model standard with follow-up voting

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Determining Responses

• Think about the focus of the question
• Dispersion through program areas
• Participation among many system partners
• Frequency of activity
• Quality of activity
• All responses should be consensus

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Determining ResponsesQuartile Scale
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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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Report Out Summary of Findings

• Overview of the EPHS strengths and weaknesses
• Insights that shaped group judgments
• Impressions on improving the system

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Public Health Performance Standards

• THE FINAL STEP
• Collectively discuss scores results
• Refer to comments and idea made during the
  assessment completion process
• Identify priority areas to address
• Collectively develop strategies to priorities

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Why Is this Important?
Healthy People - Protected - in Healthy
Communities
Served by high-performing public health systems
that use evidence-based methods to improve
community health
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QUESTIONS
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