Setting Priorities Jean Caldwell Regional Consultant Karen Ramsey, Nash County Health Department Carolyn King, Wayne County Health Department Sissy Lee-Elmore,
Post on 29-Mar-2015
217 Views
Preview:
Transcript
Setting PrioritiesJean Caldwell Regional Consultant
Karen Ramsey, Nash County Health DepartmentCarolyn King, Wayne County Health Department
Sissy Lee-Elmore, Executive Director, WATCH
CHA Institute: 2/11/10 Greenville, N.C.
This session will cover:
Standards for health department accreditation and Healthy Carolinians certification
Criteria for setting prioritiesWho sets priorities and howDiscussion of the process in Nash and
Wayne County from their 2008 CHA
North Carolina Community Health Assessment Process
Phase 1 Establish a Community Health Assessment Team
Phase 2 Collect Community DataPhase 3 Analyze the County Health
Data BookPhase 4 Combine Your County’s Health
Statistics With Your Community Data
North Carolina Community Health Assessment Process
Phase 5 Report to the CommunityPhase 6 Select Health PrioritiesPhase 7 Create the CHA DocumentPhase 8 Develop the Community
Action Plan
Health Dept Accreditation
Community Health Assessment (CHA) 1.1.k: Identify leading community health problems
List community health priorities based on CHA findings
Include a narrative of assessment findingsInclude community action plans to
address the priority issues
CHA Action Plans
Due the first Friday in June following CHA, action plans must:
1. Be on OHCHE form (same as for HC certification)
2. Address priorities identified in CHA (an action plan is required for each priority listed in CHA)
3. Target identified at-risk groups
4. Align with 2010 objectives
5. Have multi-level interventions
HC Partnership CertificationAction plans must:1. Have objectives based on 2010 objectives2. Be SMART: Specific, Measurable with a baseline,
Achievable, Relevant, include realistic Timelines3. Include multi-level interventions 4. Demonstrate collaboration:
Show a lead agency for each intervention Engage multiple partners and define their roles
5. Address health disparities6. Be proven effective7. Evaluate impact and outcomes 8. Successful interventions expanded to reach more
members of the priority population
Selection Criteria
1. Issue meets the criteria: Lends itself to collaborative work Lends itself to multi-level interventions Aligns with 2010 objectives (at least 2) Disparities exist
2. Data driven: Issue affects many residents and is severe
3. More resources are needed for this issue4. Feasible:
There is political will to address the issue There’s a good chance that the problem could be reduced if
given attention
5. People are interested in working on it (current volunteers or stakeholders to be recruited)
Recommended Criteria for Selecting Health Priorities
Rate Health Problems
Magnitude
Seriousness of the Consequences
Feasibility of Correcting
How Many Priorities?
At least 2 for Healthy Carolinians certification (more for experienced partnerships)
Not so many it will be hard to manage multi-level interventions for all of them
Who Sets Priorities
CHA team, partnership board, and/or BOH
Participants at a community forumBroad-based groupCommunity
How to Set Priorities
Majority voteNominal group technique (“dotmocracy”)ConsensusDelphi processRate and rank
Rate Health Problems
Who should do this ?
Problem Importance Worksheet
Use this worksheet to determine which issues are of the greatest magnitude, are the most serious health issues and the most feasible to correct.
Rank Health Problems
Problem Prioritization Worksheet
Use this worksheet to rank from highest to lowest.
The team should then review the ranking & concensus reached about the ranking
Limit the health problems to the Top 3-6
May need to refer back to ranking list if there are significant barriers to a top choice
Nominal Group Technique Procedures
Generate Ideas/IssuesRecording Ideas/IssuesDiscussing Ideas/IssuesVoting on Ideas/Issues
Nominal Group Technique
Silent Generation of Ideas/Issues in Writing
Round-robin Recording of Ideas/IssuesSerial DiscussionPreliminary VoteDiscussionFinal Vote
Nominal Group Technique
Preparation
The Meeting Room
Supplies
Opening Statement
Outline of Statements prior to each step
Nominal Group Technique
Benefits
Balances Participation
Balances influence of individuals
Produces more creative ideas than interacting groups
Produces great number of ideas
Greater satisfaction for participants
Reduces conforming influence
Leads to a greater sense of colusre and accomplishment
Review Your Priorities
Have the team review the priorities
Ask yourself…………Will the community support your
choices ?Will you be able to develop an Action
Plan that will make a difference ?
If your answer is “NO” revisit the process and consider making changes in your choices.
Dotmocracy
An equal opportunity facilitation process for generating and prioritizing proposals amongst a large group of people
www.dotmocracy.org/steps
What would work in your county?
Nash County Health Department 2008 Community Health
Assessment
FACTS…
Quantitative Data
2006 Chronic Health Conditions2006 Leading Causes Deaths in Nash County compared to North Carolina
0
50
100150
200
250
Heart
Dis
ease
Str
oke
Tota
l
Cancer
Bre
ast
Cancer
Lung
Cancer
Pro
sta
te
Cancer
Dia
bete
s
Pneum
onia
/ In
fluenza
Moto
r
Vechic
le
Inju
ries
Oth
er
Inju
ries
Suic
ide
Hom
icid
e
Alz
heim
er's
Dis
ease
Nash County
North Carolina
Source: North Carolina State Center for Health Statistics
Total cancer rate, which included all types of cancers, was the leading cause of death reported. The total cancer rate was 214.4; higher than the state’s average of 194.9.
Among the different types of cancer, lung cancer ranked higher than other cancers such as breast cancer and prostate cancer.
Heart disease was the second leading cause of death with a rate of 199.5; slightly higher than state’s average of 194.0.
Cerebrovascular disease / stroke was the third leading cause of death with a rate of 59.6; higher than state’s average of 51.4.
Diabetes ranked as fourth leading cause of death with a rate of 34.7; higher than state’s average of 25.2. The rate for deaths due to “other injuries” was also 34.7.
Motor vehicle related deaths were lower when compared to other injuries, ranking as 5th leading cause of death for Nash County.
2006 BRFSS Data for Nutrition and Physical Activity (survey data)
In Franklin/Nash/Wilson Counties, 68.4% reported that they increased their physical activity during the past month, 67.7% reported trying to increase their vegetable consumption per day and 61.9% reported increasing their fruit consumption per day.
Mental Health
During 2005 to 2006, Nash County reported a lower rate for alcohol and drug abusers served through treatment centers (21.6) compared to the state’s rate of to 45.3, The decrease in services was due to the reforming of mental health services from public to private providers.
Through collaborative partnerships, during 2004 to 2008, Nash County improved resident access to care by establishing medical, dental, medication and transportation assistance for the uninsured population.
Services were made available from Nash County Health Department, Med-Link, Harvest Family Health Center, Tar River Mission Clinic and Downeast Partnership for Children.
Access to Care
Community Concerns/Priorities
Qualitative Data
DEPC Assessment
Barriers to receiving services: lack of knowledge about services, rules that exclude people, long waiting lists, transportation problems, and inconvenient locations
Health Concerns: need for affordable health insurance, prescription drug costs, inadequate medical services, dental care, mental health services, health education.
Health issues: HIV/AIDS, Teen Pregnancy, Diabetes, Obesity, Heart Disease/HBP, Cancer, Cold/flu, Smoking
United Way Community Needs Assessment
Six Most Pressing Problems in our community: Needs of the Youth Population: Educational, Physical & Emotional Citizen Education & Intervention in cycle of poverty, teen pregnancy,
etc. Needs of the Elder Population Economic Conditions and Related Health and Human Service
Needs Mental Health Care Problems Access to Health Care (Affordability and Funding)
Community Health Survey
Survey Demographics(Survey Methods)
NCHD Community Survey
491 responses, reflecting our county’s population
Community Assessment Team
Nash-Rocky Mount Public Schools Angie Miller Cooperative Extension Janice Latour/Sandy Hall Nash County Planning Rosemary Dorsey Nash County Health Department Patricia Artis, Amy Doughtie, Jerome Garner Nash County Sheriff Sara Wiggins Down East Partnership for Children Jason Rochelle Department of Social Services Melvia Batts The Beacon Center (mental health) Karen Salaki Eastern NC Medical Group Nadine Skinner, MD Nash County Parks and Rec. Sue Yerkes United Way Jenny Mohrbutter Hospira Dianne Brutton Crossworks Debra Long Nash Health Care Cindy Worthy Medlink Prescription Assistance Teri Taylor Nash County Health Department Bill Hill
Setting Priorities...
ProblemSize of
ProblemSeriousness of Consequences
Feasibility of Correcting Total
Heart Disease/Stroke
Diabetes
Flu/ PneumoniaMental Health
Issues
Homicide
Teen Pregnancy
Infant Mortality
STD
Cancer
Other injuriesMotor Vehicle
Injuries
Access to Care Obesity
Obesity Heart Disease Access to Care Cancer Diabetes Sub. Abuse *** STD *** HIV/AIDS Mental Health Homicide Infant Mortality Teen Pregnancy Flu MV Other Injuries
Top Five!
Action Planning…
INTERVENTION COMMUNITY PARTNERS
Priority Issue:
www.health.co.nash.nc.us
Web Page…….
Community Health Assessment 2008
Health Departments in N.C. are required to complete a comprehensive Community Health Assessment every four years.Consists of analyzing Primary & Secondary DataCommunity input essential to this process
Sources of Data:
Secondary Data: Data available through the State Center for Health Statistics
Primary Data: Data collected by the Health Department to describe the health status of the community:
1. Youth Risk Behavior Survey2. Behavior Risk Survey/Community
Opinion Survey
Process of CHA
Health Department Completes assessment with the assistance of community partners
Share findings with communityPrioritize health needs based on findingsCommunity Input essential to determining prioritiesWhy you are here today – to assist in determining
the health needs of Wayne County. Refer to materials mailed to you in your packet for CHA findings.
top related