A New Public Health for the 21 st Century

A New Public Health for the 21st Century

Kaye Bender, RN, PhD, FAANPresident and CEO, PHAB

Session Objectives• Describe the national trend toward

performance and quality improvement in public health.

• Discuss the key public health elements included in the health reform discussions.

• Recognize the potential future scenarios for public health practice.

What Was Wrong with the Old Public Health?

• Public health in disarray—governmental only (Institute of Medicine Report,1988)

• Public health in disarray—broader public health (Institute of Medicine Report, 2003)

• Accountability and performance (Blueprint for a Healthier America, 2008)

• Accountability, performance, and QI (Lessons Learned from the MLC Projects, 2007)

Poll Question

Click on the down arrow if you can’t see the response choices.

A. Yes

B. No

Do you agree with the comments about the problems of the old public health?

Increasing emphasis on performance and quality improvement

Decreased funding and overall economic pressures

More programs focused on health promotion

Emergency preparedness

What’s Changed Over the Past Decade?

What’s next for public health?

Congressional Interest in Public Health Reform

• Not health care reform

• Not about funding streams

• Prevention and wellness (focus of Senate and House bills)

• Interested in prevention and wellness (Policy makers comments)

APHA’s Health Reform Suggestions

Invest in population-based services

Address chronic underfunding

Have more fiscal accountability

Require methods to study impact of federal policies & programs on public health

APHA’s Health Reform Suggestions

Develop, expand, and monitor programs aimed at reducing health disparities

Have the healthiest nation in one generation

Provide health care coverage for all

Report of PHLS/NACCHO Session on Health Reform

• What part of health reform should public health not be interested in?

• Some public health programs are best coordinated statewide.

• Population-focused public health programs increase the likelihood of success in clinical programs.

Report of PHLS/NACCHO Session on Health Reform

• Public health programs can reach populations not covered in health care reform.

• The public health infrastructure has to also prepare itself for a new day in public health if health care reform occurs as planned.

PHAB Board of Directors Vision for the Future

• High performing health departments contributing to a healthier nation!

• 60% of the population will be covered by accredited health departments by 2015.

RWJ Foundation

PHAB’s Partners

Developmental Work

Standards development & vetting

Beta test

Assessment process

Information systems development

Research & evaluation

Fees & incentives

Why Accreditation for Public Health?

PHAB is planning a system that blends the two

Baldrige for health systems and businesses

Joint Commission for Health Systems

• Improved public health outcomes

• A tool for quality and performance improvement

• Accountability

• Credibility

• Recognition of excellence

• Clarification of expectations

• Increased visibility

• Improved community health status

The Value of Accreditation:Agency Benefits & Public Benefits

Which Public Health Departments Are Affected?

Organizational structure does not matter!

Three required

components

Community health assessment

Community health improvement plan

Agency strategic plan

Potential Vision for the New Public Health Department• No longer the safety net

• Stronger links to the health care system for assuring the health of the public

• Focus on high performance, accountability, and a culture of improvement

• Increase visibility

• Improved recruitment and retention

Poll Question

Click on the down arrow if you can’t see the response choices.

A. Strongly agree

B. Agree

C. Disagree

D. Strongly disagree

This national picture that we’ve just discussed has a lot to do with the daily work of health departments.