PHAB Accreditation Impact Series

Transcription

1 PHAB Accreditatin Impact Series Tpic #1: Accreditatin strengthens engagement in quality imprvement (QI) and perfrmance management in rder t imprve health departments ability t serve cmmunity. What has PHAB Learned abut Accreditatin s Impact n Quality Imprvement and Perfrmance Management? Read hw health departments describe hw accreditatin has advanced their quality imprvement: Quality Imprvement: The New Way f Ding Business PHAB accreditatin is fueling a culture f perfrmance management and cntinuus quality imprvement thrughut Tarrant Cunty Public Health in Frt Wrth, Texas. Hw Accreditatin is Transfrming Wd Cunty Health Department In Wiscnsin Rapids, a culture f cntinuus quality imprvement is n lnger just anther thing: It s a part f everything, as it shuld be. Belw are additinal findings abut the link between accreditatin and QI. 96% f health departments that had been accredited fr ne year agreed r strngly agreed that accreditatin stimulated quality imprvement and perfrmance imprvement activities. 96% f health departments that had been accredited fr ne year agreed r strngly agreed that they use r plan t use infrmatin frm QI prcesses t infrm decisins. 91% f health departments that had been accredited fr ne year agreed r strngly agreed that As a result f the accreditatin prcess, ur health department has a strng culture f QI. One health department said accreditatin acts as a stimulus fr cntinuus quality imprvement and perfrmance management in ur daily practice. In their Annual Reprts, health departments describe a wide range f QI prjects that they believe have led t imprved efficiency and effectiveness. Here are selected prjects: Decrease human-resurces prcessing time fr new applicatins Respnd mre efficiently t requests fr prpsals Develp prcess t share surveillance data with surveillance sites, partners, staff Respnd mre quickly t requests fr envirnmental health infrmatin Imprve utreach and crdinatin f services fr breastfeeding wmen Increase the prprtin f knwn animal bites reprted within 48 hurs Decrease frequency f a particular fd establishment vilatin Imprve prcess fr gathering/analyzing custmer satisfactin surveys T read mre abut the link between accreditatin and QI, see: Beitsch LM, Riley W, Bender K. Embedding quality imprvement int accreditatin: evlving frm thery t practice. Jurnal f Public Health Management and Practice, 2014, 20(1), Findings frm the nging evaluatin f accreditatin being cnducted by NORC at the University f Chicag. As f December 2016, 69 health departments had respnded t the survey ne year after they were accredited. Fr mre infrmatin n the evaluatin, see:

2 Accreditatin strengthens engagement in quality imprvement and perfrmance management in rder t imprve health departments ability t serve cmmunity. Messaging The table belw summarizes sme f the key messages related t the link between accreditatin and QI and their ptential audiences. Message HD Directrs HD Staff Gverning Cmmunity Plicymakers Entities Partners Funders As public health resurces have grwn increasingly scarce yet demand fr services has increased, strengthening engagement in QI helps health departments d mre with less. Engaging in QI can enable HDs t prvide expanded and imprved services t the cmmunity at the same, r at a ptentially reduced, cst, since prcesses are mre efficient and effective. Engaging in QI can help health departments identify ways t imprve hw they deliver services t the cmmunity. Engaging in QI imprves management prcesses used by the leadership team. Infrmatin frm QI prcesses can be used t infrm plicy implementatin. Having perfrmance data can help the health department identify key areas fr imprvement. Strengthened engagement in QI and the achievement f measurable imprvements identifies critical areas (strengths and weaknesses) n which t fcus. Engaging in QI and perfrmance management helps develp a strnger custmer fcus by making prcesses mre efficient and effective. Fstering a culture f quality imprves the capacity f the health department t better serve its cmmunity, which may result in an increase f cmmunity partnerships and funding. QI imprves the credibility and accuntability f the HD within the cmmunity and thus assures cmmunity partners that cllabrating with the health department is desirable and valuable. The Media The Overall Cmmunity CDC Transitin PHAB Accreditatin Impact Series Tpic # 1 May 2016, updated January 2017 Page 2

3 Accreditatin strengthens engagement in quality imprvement and perfrmance management in rder t imprve health departments ability t serve cmmunity. Message HD Directrs HD Staff Strengthened engagement in QI and the achievement f measurable imprvements tells the cmmunity that the HD is cmmitted t imprving the delivery f services by achieving measurable imprvements in efficiency, effectiveness, perfrmance, and accuntability. Engaging in QI can help health departments perate mre efficiently and effectively (time saved, reduced number f steps), and increase effectiveness f prgrams, services r prcesses. Engaging in QI helps health departments perate mre efficiently and effectively, which can help yu knw that yur investment in the health department is likely t get the biggest bang fr the buck. Engaging in QI imprves cmmunicatins acrss all departments, breaks dwn sils, encurages teamwrk, sparks innvatin and increases staff mrale. Engaging in QI mtivates staff; PHAB standards require training and hands-n practice in ding QI. QI empwers staff by giving each staff member a vice in identifying ways t strengthen the HD. Gverning Entities Plicymakers Cmmunity Partners Funders The Media The Overall Cmmunity CDC Transitin PHAB Accreditatin Impact Series Tpic # 1 May 2016, updated January 2017 Page 3

4 Accreditatin strengthens engagement in quality imprvement and perfrmance management in rder t imprve health departments ability t serve cmmunity. Researcher Addendum: Ptential Data Surces The table belw describes data that are currently being cllected that can increase ur understanding f the link between accreditatin and QI. It als includes sme examples where instruments have been develped that can measure this tpic, but where there is n current effrt t cllect data n a natinal basis. Data cllectin: Starting in 2013, HDs have been surveyed after registratin, after ntificatin f accreditatin, and 1 year after accredited (verlap acrss surveys in sme, but nt all questins); sme questins edited/added in 2016 Ppulatin: HDs in prcess/accredited HDs Evaluatin f PHAB cnducted by NORC at the University f Chicag Health departments are asked t reprt the degree t which they agree with the fllwing statements n a Likert scale: Because f ur participatin in the accreditatin prcess, ur health department has implemented r plans t implement new strategies fr quality imprvement. Because f ur participatin in the accreditatin prcess, ur health department has implemented r plans t implement new strategies t mnitr and evaluate ur effectiveness and quality. As a result f the accreditatin prcess, ur health department has implemented strategies fr quality imprvement t demnstrate cntinued cnfrmity with the PHAB standards and measures. As a result f the accreditatin prcess, ur health department has a strng culture f quality imprvement. Accreditatin has stimulated quality and perfrmance imprvement pprtunities within ur health department. As a result f being accredited, ur health department s awareness f r fcus n QI effrts has imprved. As a result f being accredited, ur health department cmpares ur prgrams, prcesses, and/r utcmes against ther similar health departments as a benchmark fr perfrmance. In 2016, NORC added the fllwing questins (many f which were adapted frm the evaluatin f the Natinal Public Health Imprvement Initiative): Currently, the health department staff Has n knwledge f QI Subset f staff has familiarity with QI Majrity f staff has familiarity with QI Subset f staff is knwledgeable and practices QI Majrity f staff is knwledgeable and practices QI Majrity f staff rutinely practices/uses QI Dn t Knw Currently QI in my agency is Nt practiced anywhere in the agency Talked abut but nt required Cnducted infrmally; spradic prgram effrts Cnducted frmally in specific areas Cnducted frmally and agency-wide Our culture Participates in multi-rganizatinal QI Initiative Dn t Knw Apprximately what percent f staff in yur rganizatin have received training in perfrmance management and/r quality imprvement? Because f participatin in the accreditatin prcess, has yur health department established an rganizatin-wide prcess fr QI? Yes, established while participating in the accreditatin prcess (after submitting the SOI/registering in e-phab) Yes, established prir t participating in the accreditatin prcess, but updated while underging the prcess PHAB Accreditatin Impact Series Tpic # 1 May 2016, updated January 2017 Page 4

5 Accreditatin strengthens engagement in quality imprvement and perfrmance management in rder t imprve health departments ability t serve cmmunity. Yes, established prir t participating in the accreditatin prcess and nt updated while underging the prcess N, but under develpment N, nt wrking n it The QI culture in my agency has... (Select all that apply) Decreased time, cst, r imprved prcess quality Imprved public health utcmes achieved Strengthened ur perfrmance management system Made us better prepared fr public health accreditatin Nt made much impact agency-wide Data cllectin: Distributed every 2-3 years. Questins may change ver time. Ppulatin: All state and lcal health departments (NACCHO mdule nly sent t a sample f lcal HDs) ASTHO/NACCHO Prfiles NACCHO 2013/2016 Prfile mdule/astho 2012/2016 Prfile: Which f the fllwing statements best characterizes yur [HD s] current quality imprvement activities? [HD] has implemented a frmal quality imprvement prgram agency-wide Frmal quality imprvement activities are being implemented in specific prgrammatic r functinal areas f the [HD], but nt n an agency-wide basis [HD s] quality imprvement activities are infrmal r ad hc in nature [HD] is nt currently invlved in quality imprvement activities. NACCHO 2013/2016 Prfile mdule: In the past 12 mnths, hw many frmal prjects has yur LHD implemented t imprve the quality f a service, prcess r utcme? [Fr the purpses f this questin, a prject is defined as a systematic quality imprvement initiative that includes an aim statement; a wrk plan with tasks, respnsibilities and timelines; interventin strategy(ies); and measures fr tracking change.] NACCHO 2013/2016 Prfile mdule/astho 2012/2016 Prfile: Which f the fllwing elements have been used in yur [HD s] quality imprvement effrts in the past year? Mapping a prcess Identifying rt causes Obtaining baseline data Setting measurable bjectives Testing the effects f an interventin Analyzing the results f the test Frmally adpting a tested interventin [NACCHO nly] Nne f the abve NACCHO 2013/2016 Prfile mdule/astho 2012/2016 Prfile: Which f the fllwing elements f a frmal agency-wide QI prgram are currently in place at yur [HD]? Agency QI Cuncil r ther cmmittee that crdinates QI effrts Staff member with dedicated time as part f their jb descriptin t mnitr QI wrk thrughut the agency Agency-wide QI plan Agency perfrmance data is used n an nging basis t drive imprvement effrts Leadership dedicates resurces (e.g., time, funding) t QI QI is incrprated in emplyee jb descriptins QI is incrprated in emplyee perfrmance appraisals PHAB Accreditatin Impact Series Tpic # 1 May 2016, updated January 2017 Page 5

6 Accreditatin strengthens engagement in quality imprvement and perfrmance management in rder t imprve health departments ability t serve cmmunity. QI resurces and training pprtunities are ffered t staff n an nging basis Nne f the abve ASTHO 2012/2016 Prfile: Check each framewrk r apprach t quality imprvement that yur state/territrial health agency has used in the past year. Balanced Screcard Baldrige Perfrmance Excellence Criteria (r state versin) Lean Plan-D-Check-Act r Plan-D-Study-Act Six Sigma N specific framewrk r apprach Other specific framewrk r apprach ASTHO 2012/2016 Prfile: In what ways des yur agency supprt r encurage staff invlvement in quality imprvement effrts? (Select all that apply) We prvide training t staff in QI methds We recgnize utstanding QI wrk with emplyee recgnitin award(s) Participatin in QI effrts is included as part f emplyee perfrmance gals We prvide mnetary incentives Quality imprvement is included in jb descriptins fr sme emplyees We have frmed a QI cmmittee that crdinates QI effrts We prvide funding t supprt QI effrts Other - specify: We d nt actively encurage staff invlvement in quality imprvement effrts ASTHO 2012/2016 Prfile: Des yur state/territrial health agency have a frmal perfrmance management prgram in place that includes ALL f the fllwing: perfrmance standards, perfrmance measures, reprting f prgress, and a quality imprvement prcess? Yes, fully implemented department-wide Yes, partially implemented department-wide Yes, fully implemented fr specific prgrams Yes, partially implemented fr specific prgrams N ASTHO 2016 Prfile asks if HDs have already experienced; anticipate they will experience; r d nt anticipate that they will experience these accreditatin benefits: Stimulate quality and perfrmance imprvement pprtunities within ur agency. Strengthen the culture f quality imprvement in ur agency. Increase the extent t which infrmatin frm perfrmance management system infrms decisins. Data cllectin: First survey in 2015; future data cllectin planned Ppulatin: Staff at sme state and lcal health departments Public Health Wrkfrce Interests and Needs Survey (PHWINS) Asks the fllwing questins abut Applying quality imprvement cncepts in my wrk : Hw imprtant is this item in yur day-t-day wrk? What is yur skill level? Asks the fllwing questins abut Fstering a culture f quality imprvement : PHAB Accreditatin Impact Series Tpic # 1 May 2016, updated January 2017 Page 6

7 Accreditatin strengthens engagement in quality imprvement and perfrmance management in rder t imprve health departments ability t serve cmmunity. Hw much, if anything, have yu heard abut the fllwing trends in public health? Please rate the fllwing trends in terms f imprtance, impact n yur wrk, and perceived level f emphasis Data cllectin: Accredited HDs are required t cmplete Annual Reprts each year after they are accredited Ppulatin: Accredited HDs PHAB Annual Reprts As part f the annual reprting prcess, health departments describe implementatin/updates t their QI plans and perfrmance management system and prvide an example QI prject. Health departments are als asked which f the fllwing mst accurately characterizes the QI culture in the health department? (Health departments are referred t fr a descriptin f these phases.) Phase 1: N knwledge f QI Phase 2: Nt invlved with QI activities Phase 3: Infrmal r ad hc QI Phase 4: Frmal QI implemented in specific areas Phase 5: Frmal agency-wide QI Phase 6: QI Culture Data cllectin: Currently, there is n natinal data cllectin effrt that uses these tls. (Sme states, like Minnesta, have deplyed a versin f the QI Maturity Index in their lcal HDs) Tls HDs can use t Measure the Impact f QI and their QI Culture As part f the Natinal Public Health Imprvement Initiative (NPHII) evaluatin, CDC develped a framewrk fr cllecting standardized infrmatin abut the effects f individual QI prjects. Data n effectiveness imprvements Increased custmer / staff satisfactin Increased reach t a target ppulatin Disseminatin f infrmatin, prducts r evidence-based practices Quality enhancement f services r prgrams Quality enhancement f data systems Organizatinal design imprvements Increased preventive behavirs Decreased incidence/prevalence f disease Data n efficiency imprvements Time saved Reduced number f steps Revenue generated due t billable services Csts saved Csts avided In additin, ASTHO has develped a tlkit fr measuring the Return-n-Investment f QI prjects. There are several tls that health departments can use t assess their QI culture (sme f which have been adapted fr use in different states), including NACCHO s Radmap t a Culture f Quality Imprvement and the QI Maturity Tl. PHAB Accreditatin Impact Series Tpic # 1 May 2016, updated January 2017 Page 7