Madison County MAPP Committee March 12, 2008

Madison County

MAPP CommitteeMarch 12, 2008

Introductions

MAPP Team Name, Agency, Interest for being on MAPP Team Expectations Assets and Contributions

Meeting Objectives

Share update of activities from the Visioning Sub-committee

Provide in-depth information about the four assessment components

Establish assessment subcommittees and review charge

Agenda

Welcome & Agenda Review Introductions Visioning Subcommittee - Update The Four Assessments - Presentations Assessment Subcommittees Meeting Resources – Survey Closing Adjourn

Visioning Visioning

Sub-committeeSub-committee

Visioning Visioning

Sub-committeeSub-committee

Community Themes

&

Strengths

Local Health SystemHealth Status

Forces of Change

The Four Assessments

The Four Assessments

National Public Health Performance Standards Program (NPHPSP)

Local Public Health System Assessment

MAPP (Mobilizing for Action through

Planning & Partnerships)

Includes 4 assessments:

1) Community Health Status Assessment

2) Community Themes and Strengths Assessment

3) Forces of Change Assessment

4) Local Public Health System Assessment = (National Public Health Performance Standards Program)

National Activities

What is the Public Health System Assessment?

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.

Incorporates 4 Concepts:

GOAL:GOAL:

A tool designed to assess and improve the quality of public health practice and performance of public health systems by:

1. Monitor health status

2. Diagnose and investigate health problems

3. Inform, educate and empower people

4. Mobilize communities to address health problems

5. Develop policies and plans

6. Enforce laws and regulations

7. Link people to needed health services

8. Assure a competent workforce

9. Evaluate health services

10. Conduct research for new innovations

Defines all of the health activities that are required in a community health system

1. The 10 Essential Services as a Framework

SchoolsSchools

Community Community CentersCenters

EmployersEmployers

TransitTransit

Elected Elected OfficialsOfficials

DoctorsDoctors

EMSEMS

Law Law EnforcementEnforcement

Nursing Nursing HomesHomes

FireFire

CorrectionsCorrections

Mental Mental HealthHealth

Faith Instit.Faith Instit.

Civic GroupsCivic Groups

Non-ProfitNon-Profit

OrganizationOrganizationss

Neighborhd.Neighborhd.

Orgs.Orgs.

LaboratoriesLaboratories

Home HealthHome Health

CHCsCHCs

HospitalHospitalss

Tribal HealthTribal Health

Drug Drug TreatmentTreatment

Local Public Local Public Health Health AgencyAgency

2. Focuses on the Public or Community Health System

3. Optimal Level of Performance

Each performance or model standard represents the “gold standard”

4. Stimulate Quality Improvement

Standards should result in identification of areas for improvement

““What gets measured gets done.” What gets measured gets done.”

If you don’t measure results, you can’t tell success from failure.

If you can’t recognize failure, you can’t correct it.

If you can’t see success, you can’t learn from it

Link results to an improvement process

10 Essential Services

Definition of Essential Service

Example of Model Standard & Ratings

Model or “gold”

Standard

Measurement Questions

Key Steps in the Process

How is the NPHPSP Implemented?

Identifying, Recruiting & Orienting Participants

Key questions: Who plays a role in the public health system or

providing the Essential Services? What expertise is needed? How many people should participate? A lot of work! (Phone calls, letters, promotional

activities)

Orient to NPHPSP, 10 Essential Services, Health System and purpose of assessment Importance of participation

Planning and preparation is key to commitment and success

Facilitator & Recorder Roles

Facilitator Review model standards, questions and obtain response decision Strong skills in leading group discussions Lead a group to consensus (manage disagreements,

draw out dissenting opinion) Validate participants and get input from everyone Recognize and manage dominant personalities and those that need to

be drawn out Keep focus on health “system” Keep process moving Trusted, assertive, patient, neutral Identify early and orient

2 Recorders: Record group responses to measurement questions Record key issues and qualitative information that shape group responses Assist the facilitator to manage time Parking lot issues

Retreat

Generally 1-2 days

Advantages: Short timeframe Maintains

momentumDrawbacks: Requires time

commitment Can be

overwhelming

Small Group Activities

Advantages: Allows for

expertise, as needed

Less overwhelmingDrawbacks: Less cross-learning Less consistency in

response development

Series of Meetings

Advantages: Allows for expertise,

as needed Gets the work done in

small pieces Allows for more

dialogue which is keyDrawbacks:

Participation changes with meeting attendance

Process may seem to “drag on”

Meeting Structure

Create a Comfortable Environment Stick to the timeframe

Process for Facilitating Discussions & Voting

1. Walk through questions one by one with follow up voting with color-coded cards

2. Discuss model standards for set period of time with follow up voting using color-coded cards

3. Discuss model standard for set period of time with facilitator and recorder judgment on responses

Oneida County Experience: Discussed EPHS & Model Standard Smaller groups discuss and score some of the

questions Planning team judgment on responses for remaining

questions.

Submitting Responses for a CDC Report

1. Electronic Submission of responses to CDC:

2. Automated analysis begins after all data is submitted

3. Report is available within 2 hours4. Respondent accesses final report and

downloadable data files from web scores for all Essential Services model standards several charts and graphs displaying the data raw data any data limitations

Oneida County Results

Summary of Performance on Model Standards

1.3 Maintenance of Population Health Registries

1.2 Access to and utilization of current technology

1.1 Population-based community health profile

Monitor Health Status

2.4 Laboratory support for investigation of health threats

2.2 Plan for public health emergencies

Diagnose and investigate Health Problems

Model Standar

d Not Met

Model Standard

Partially Met

Model Standard

Substantially Met

Model Standard

Met

EPHS

Get results to participants immediately – build on momentum

Reminder!

Data from the assessments reflects the system system

performanceperformance and are not intended to judge or compare

organizations and public health agencies. This assessment is intended to assist in quality

improvement.

Participant Comments & Lesson Learned

Pros/Positives: Interactive process that engaged

broad spectrum of participants Visuals and presentation of

materials very helpful Facilitation Structured in a way that sparked

good discussions Well-organized ; focused with clear

expectations Small group discussions were non-

threatening Combination of large group and

small group discussions and activities

Networking opportunities; learning about different organizations

Better understanding of the “public health system”

Expanded membership of the Health Coalition

NPHPSP TOOLS

Several resources to assist with each step of the process

User Guide Frequently-Asked-Questions, that can help you

to think about the entire process. Lessons Learned from Other Counties/States

Recommendations for structuring participation Sample Orientation Presentations Sample Recruitment and Follow-up Letters Time and costs Other Helpful Hints

Performance Improvement Resource Guides Monthly Teleconference for users of the NPHPSP

–Program Partners and Nationwide Users

The Community Themes and Strengths AssessmentThe Community Themes

and Strengths Assessment

Answers the question

“What is important to community members and what assets do

we have?”

Benefits Community members become more vested in

the process when they have a sense of ownership in and responsibility for the outcomes. This occurs when their concerns are genuinely considered.

The impressions and thoughts of community residents help pinpoint important issues and highlight possible solutions.

The themes and issues offer additional insight into the findings uncovered in other assessments.

Three Levels of Information

Open discussion to elicit community concerns, opinions, and comments

Perceptions regarding community quality of life

A map of community assets

Gather Information Meetings Focus groups Forums Door to door/intercept surveys Mail surveys Interviews

Utilize existing community groups and organizations

Promote broad participation Select the best combination of techniques

What’s important?

Focus on:opportunities vs. problems investment vs. charitypeople vs. programscommunity organizations vs.

government agenciescitizens vs. “clients”

Help to organize and identify key themes Assists in addressing cross-cutting issues

from other assessmentsUseful for reporting back to MAPP

CommitteeGuides work when identifying strategic

issues

Findings

Ensure community involvement and empowerment is sustained

Document conversations, discussions and meetings

Develop a master list of contacts

Health Health Status Status

AssessmentAssessment

Health Health Status Status

AssessmentAssessment

Answers the questions:

How healthy are our residents?

What does the health status of our community look like?

Information regarding health status, quality of life, and risk factors in the community

Basis for analyzing and identifying community health issues

Useful for comparison to peer communities, state and national data.

Data Collection

Identify and collect data for core indicators Access existing databases, recent assessments

or reports Organizational or Agency data State, National, and local data Identify new data sources/needs (social

determinants) Tailor to local needs and or issues Identify and partner with research organizations Build on what community has already done

Health Profiles

Based on data analysis and findings Life-course based, e.g., Adult Health Profile Develop visual aids that display data in an

understandable and meaningful way Recognize and appreciate difference between

data are statistically significant and those that are important to the community

Disseminate and share with community

Monitoring

Establish a system to monitor the indicators over time

Ensures continuing health monitoringEstablishes baseline data upon which

future trends can be identifiedInstrumental in identifying the results of

the MAPP process and evaluating success of MAPP activities

Findings

Provides a list of key challenges and opportunities related to community health status

Identify major health problems or high risk behaviors, cross-cutting issues, and opportunities for improving trends

Top 10-15 issues examined during strategic issue development

Summarized reports & profile development

Forces Forces of Changeof ChangeForces Forces of Changeof Change

Answers the questions:

“What is occurring or might occur that will affect the community or public health system?”

“What specific threats or opportunities are generated by these occurrences?”

Forces of Change…

State and federal legislation, Rapid technological advances, Changes in the organization of health care

services, Shifts in economic forces Migration in and out of community Changing family structures One-time events e.g. disaster Discrete elements – e.g., proximity to a major

waterway or highway

Identifying Forces of Change

Brainstorm to identify forces MAPP Committee Small groups Community forum (s)

Newspaper clippings, national demographics, reports, recent events, etc.

Develop list and discuss Consolidate like forces Identify threats and opportunities Summarize and report findings

Assessment Sub-CommitteesAssessment Sub-CommitteesAssessment Sub-CommitteesAssessment Sub-Committees

Review project summaries and charge

Identify subcommittee members and appoint chairperson

Meeting Resources Survey

Meeting Resources Survey

Closing: What worked? What can be

improved? Next Meeting – April 9 Agenda for next meeting

Adjourn