Denver Public Health. Strategic Plan

Transcription

1 Denver Public Health Strategic Plan

2 Contents: MESSAGE FROM THE EXECUTIVE DIRECTOR...2 EXECUTIVE SUMMARY...3 STRATEGIC PLANNING PROCESS:...5 CORE STRATEGIC PLANNING TEAM... 5 LEADERSHIP TEAM ENGAGEMENT... 5 STAFF ENGAGEMENT... 5 PARTNERS AND KEY INFORMANTS... 5 THE CONTEXT FOR STRATEGIC PLANNING...6 THE CHANGING HEALTH CARE LANDSCAPE... 6 NATIONAL PUBLIC HEALTH ACCREDITATION... 7 WORKFORCE DEVELOPMENT... 8 COMMUNITY HEALTH ASSESSMENT AND THE COMMUNITY HEALTH IMPROVEMENT PLAN... 9 VISION, MISSION AND CORE VALUES STRATEGIC PRIORITY AREAS ALIGNMENT Goal 1: Organize Denver Public Health to achieve our mission Goal 2: Increase Sustainable Funding COMMUNICATION Goal 3: Provide clear, consistent, communication about Denver Public Health COLLABORATION Goal 4: Expand and strengthen our relationships and partnerships to further our mission POPULATION HEALTH Goal 5: Continually assess and respond to community needs Goal 6: Improve the health of Denver residents APPENDIX 1 STRATEGIC PLANNING PROCESS OVERVIEW APPENDIX 2 KEY INFORMANT QUESTIONS APPENDIX 3 SWOT ANALYSIS P a g e

3 Message from the Executive Director This is a time of change and opportunity in health care and public health. The Affordable Care Act (ACA) provides an unprecedented opportunity to expand access to health care. At the same time, there is increased emphasis on primary prevention through place-based (community-level) activities. Prevention is increasingly recognized as being a key part of the solution to the central paradox of the American health care system poor health outcomes despite the highest medical expenditures in the world. The Denver Public Health Strategic Plan for will guide our department s strategic direction and priorities during this time of unprecedented change. It highlights key areas where Denver Public Health seeks to make targeted efforts and measurable improvements. The plan not only sets forth what we will strive to achieve, it provides a road map for how we plan to achieve it. As public health professionals and decisionmakers, we find ourselves in a unique moment: poised to reaffirm the value of our clinical services while expanding into population-based services. This plan does not offer a comprehensive listing of all of the essential activities that Denver Public Health conducts. Rather, it highlights key cross-departmental initiatives for the next three years. We will invest in population-based approaches, help implement the Denver Community Health Improvement Plan, redefine our role in the delivery and assurance of quality clinical and community-based services, work more closely with governmental and community partners, and continue to invest in our talented workforce. In order to fulfill our mission and align with current public health best practice, Denver Public Health will consistently: Increase our leadership and engagement role for healthy communities. Focus on health beyond clinical health care services. Implement and contribute to public health best practice research. Incorporate communication planning into all programs and activities. Strive for health equity. Through this strategic plan, Denver Public Health will help make Denver a community where all people can be healthy. William Burman, MD Director 2 P a g e

4 Executive Summary This plan lays out the initial steps we will take in order to achieve our vision: Denver will be the healthiest community in which to live, learn, work, and play. This plan is to be carried out in an organizational culture that reinforces the following core values: Denver Public Health Core Values Continuous Improvement Fostering Innovation Dedicated to Excellence Compassionate Service Strength Through Collaboration During the next three years, Denver Public Health plans to focus on six strategic goals across our four priority areas (Alignment, Communications, Collaboration, and Population Health). The six goals in the four priority areas for the next three years are: Priority Areas Goals Alignment 1. Organize Denver Public Health to achieve our mission 2. Increase sustainable funding Communications 3. Provide clear, consistent communication about Denver Public Health Collaboration 4. Expand and strengthen our relationships and partnerships to further our mission Population Health 5. Continually assess and respond to community needs 6. Improve the health of Denver residents 3 P a g e

5 Public Health Infrastructure in the City and County of Denver Denver Public Health provides a wide range of services that promote, improve and protect the health and well-being of the residents of Denver and beyond. We partner with Denver Environmental Health, a department of the Denver City and County government to provide the 10 Essential Public Health Services. Much of the work we do is in partnership with community organizations located throughout Denver s diverse communities. Our services include the following: Birth and Death Records Clinical Care Community Health Data Educational Opportunities Health Promotion Activities Outbreak Detection and Investigation Services Public Health Emergency Preparedness About Denver Public Health and Denver Health Denver Public Health is a department of Denver Health, an integrated health system whose mission is to provide care for all Denver residents, regardless of ability to pay. Denver Health includes an acute care hospital (Denver Health Medical Center) and emergency response system, community-based clinics in Denver s low-income areas, medical and surgical specialty clinics, behavioral health services (including the city s detoxification unit), school-based health centers, and the Rocky Mountain Poison and Drug Center. 4 P a g e

6 Strategic Planning Process: Overview: The strategic planning process began in August of 2013 and spanned through to December A diagram of the process, which followed five steps (organization, assessment, facilitated planning sessions, action plans, and implementation), can be found in Appendix 1. Core Strategic Planning Team The following members were appointed by the Director, Bill Burman, to serve as the core strategic planning team: Mark Thrun, Director, HIV/STD Prevention and Control (chair) Heather Weir, Quality Improvement Coordinator Carol McDonald, Nurse Program Manager Jessica Forsyth, Health Promotion Division Manager Robert Belknap, Director, Denver Metro Tuberculosis Program Sarah Rodgers, Immunization Clinic Administrator Terri Olivieri, Supervisor, Grant Administration Jeffrey Eggert, Denver Metro Health Clinic Administrator Chris Lindley, Move Consulting Leadership Team Engagement The Denver Public Health Core Leadership team was engaged throughout the entire process. Each member of the leadership team participated in a key informant interview, a facilitated discussion of the planning process and the review of drafts throughout the process. Staff Engagement All staff of Denver Public Health were encouraged to participate in an electronic survey, which aimed to capture the strengths, weaknesses, areas of opportunity and potential threats of the organization as seen through their eyes. This information was summarized and used by the core strategic planning team and was shared with the leadership team. Furthermore, the department s program managers and directors participated in two lengthy discussions of the strategic plan, initially with the results of the external and internal stakeholders feedback and then after the identification of the plan s key strategies. Partners and Key Informants Key partners were individually interviewed for insights and suggestions as to what Denver Public Health should focus on in the next 3-5 years. Appendix 2 lists the key informant 5 P a g e

7 interview questions and individuals that were interviewed. Appendix 3 summarizes common themes from these interviews. The Context for Strategic Planning The Changing Health Care Landscape Like no time in the past, US clinical care services and public health programs have an opportunity to overlap and complement one another to truly benefit community health. Expansions in access to care through the Affordable Care Act will support preventive care, non-existent just a few years ago. As more persons are covered under insurance plans, more Denverites will be able to access preventive services, such as cancer and blood cholesterol screening, through their primary care provider. For persons already with adequate insurance, new rules require health insurance plans to cover preventive services, making screening tests more readily available. In the context of shifting traditional clinical care and public health service roles, we have undertaken this strategic planning process. We feel it important to align our structure and resources with the future of health care, toward more comprehensive clinical care systems and community priorities that emphasize broad engagement with partner organizations, and focus on population-level outcomes. With new and exciting public health opportunities in this shifting landscape, come several new challenges. The prolonged recession has drained public program resources for years. Though the economy is improving, the need to fund parts of the Affordable Care Act expansions in Medicaid in particular will likely result in ongoing pressures to divert ACA-defined public health resources to personal care settings. Public health departments will necessarily spend time in the near future defining which services are best provided where, by whom, and how safety net services will be maintained. For health departments providing clinical services, as ours does, the need to maximize revenue while maintaining a public health mission poses additional challenges. We at Denver Public Health recognize that shifting our traditional work from provision of clinical services to more community-level interventions will be no easy task. In addition to internal restructuring and prioritization, it will necessitate growing our clinical and non-clinical community partnerships. Our plan will need to be led by up-and-coming leaders, who may not yet even work with us. It will 6 P a g e

8 require expanded, but stable, funding streams to assure success. And it will be dependent upon ongoing community input in order to guarantee that we are meeting the true health needs of the community. Over and above this shifting context, this strategic plan was informed by several other external forces detailed below. National Public Health Accreditation In conjunction with Denver Environmental Health, Denver Public Health is seeking accreditation from the Public Health Accreditation Board, a national organization that accredits state, tribal, and local public health agencies. Accreditation provides a means for health departments to identify performance improvement opportunities, improve management, develop leadership, and improve relationships with the community. This process will challenge us to think about improving public health practice, quality and performance, and have greater accountability and transparency. Additionally, it will not be a static process. Rather, accreditation will require ongoing, consistent, and high quality public health practice and deliverables. The Impact of Chronic Disease The key challenges to health in the 21st century are those related to chronic disease prevention, not the acute communicable diseases which served as our focus in the last 100+ years. To address this challenge, we must retool our approaches and strategies. Chronic disease prevention requires a focus on systems, policy, and environmental changes. We must embrace new tools and retrain our workforce to meet these new challenges. It will require building strategic partnerships with the reforming health care system, and building wider networks of partners in the community. Developing policy, using integrated data sets, communicating more effectively with the public, mobilizing our communities, providing leadership, and stepping up our accountability are all examples of the public health work of our present and future. An Emphasis on Health Equity We desire a future where every person in Denver attains his or her full health potential, regardless of socially determined circumstances. Local epidemiological data suggest that the burden of disease and related health inequalities are due in large part to the conditions in which people are born, grow, live, work and age. As a result, our programs will shift their focus away from primarily individual clinical interventions to broader population-based approaches. This is clearly illustrated in 7 P a g e

9 the five-tiered pyramid below. We understand that until we begin to work on upstream factors such as the built environment, racism, poverty, educational attainment, and environmental etiologies of disease, our work will not be fully effective. As such, we will build alliances with other governmental and nongovernmental agencies to develop policy solutions that address health equity and the social determinants of health. Graphic adapted from Tom Frieden s Health Impact Pyramid Workforce Development Just as our organization is challenged to identify a clear path to address changing and future public health needs, we as a workforce must also rise to meet these challenges. We must assess our existing knowledge, skills and abilities, and implement a plan to develop the skills needed for the future. In an effort to meet the changing health needs of the community, it will be necessary to expand our workforce capacity to offer both direct service delivery and population-based public health practice. Denver Public Health is fortunate to employ skilled, dedicated and diverse staff. These individuals, who personify our values, will need to learn new skills to help us bridge our present with our future. 8 P a g e

10 A Greater Reliance on Partners For many years, the Denver Public Health department served as an end recipient of programmatic funding. This led to an insular approach to problem solving that might not have been as impactful as it could have been if done in collaboration. We recognize that we have strengths, but so do our partners. We have recently begun to more effectively engage with partners, to share resources and skills. We must effectively expand those efforts to share strengths with others to improve the health of the community through collaboration. Community Health Assessment and the Community Health Improvement Plan The Colorado Public Health Act of 2008 required health departments to conduct assessments of capacity of the broader public health system to address prioritized health needs. In 2011, we conducted a community health assessment. Data from this assessment was then used to inform 6 community input meetings in which the health issues of access to care and healthy eating, active living were prioritized by our fellow Denverites. In collaboration with Denver Environmental Health and many community partners, we just completed our Community Health Improvement Plan. This plan is reflected in this plan and will be further refined by existing workgroups. The Future is Now The subsequent plan is the convergence of the aforementioned factors toward one focal point. We look forward to partnering with others to further refine and update this plan. While we recognize the small role we play in the health of all Denverites, we see enormous opportunity to impact that health through leveraging our strengths with numerous partners. It will take all of us public health, personal health care systems, schools and universities, government and regulatory agencies, funders, community non-profits, and the business community working collectively in the same direction to create meaningful and lasting health impacts. We look forward to the work. 9 P a g e

11 Vision, Mission and Core Values Vision: Denver will be the healthiest community in which to live, learn, work, and play. Mission: Denver Public Health will collaborate with partners to inform, educate, offer services, and promote policy change to create communities where all people can be healthy. Core Values: Continuous Improvement Fostering Innovation Dedication to Excellence Compassionate Service Strength Through Collaboration Core Value Continuous Improvement Fostering Innovation Dedication to Excellence To establish a culture that reinforces these values we will: use accurate and timely information to guide and support decisions. implement promising evidence-based practices. inform change through adoption of best practices and qualitative and quantitative research. develop and implement new treatments, information systems, communication techniques, interventions, and ways to frame issues. lead in the public health field. achieve Public Health Accreditation in collaboration with Denver Environmental Health. target those in greatest need. address social determinants of health through populationbased interventions. 10 P a g e

12 Compassionate Service Strength Through Collaboration serve all communities according to their needs. assure the delivery of culturally and linguistically responsive health services. advocate for and define public policy to achieve health equity. work to effectively collaborate with government, private, non-profit and community partners. establish trusting relationships with partners dedicated to improving health. Strategic Priority Areas Alignment Communication Collaboration Population Health Alignment Goal 1: Organize Denver Public Health to achieve our mission. Strategy: Assess the current organizational structure, resources and workforce talent to increase efficiency and effectiveness Analyze Denver Public Health s ability with the current structure and resources to achieve our strategic priority area goals. Complete a departmental gap analysis of workforce talent and resources (staffing and fiscal) needed to achieve our mission and cross-departmental initiatives (including policy development, external relationship building, workforce development and community engagement). Analyze the cost/benefits of moving direct service areas to Denver Health Ambulatory Care Services. Strategy: Identify and empower specific staff members to address population health priorities Identify key population health priorities. 11 P a g e

13 Define leadership roles and responsibilities for each health priority. Allocate or hire personnel for all population health priority areas. Develop and publicly share results of population-level plans using the Results Based Accountability framework. Strategy: Create a culture that supports and develops employees Develop a process to identify and invest in future leaders. Provide ongoing career mentorship and guidance for all employees. Strategy: Develop a culture of quality improvement (QI) throughout the department Achieve Public Health Accreditation recognition in partnership with Denver Environmental Health. Utilize the performance management system, onfocus, throughout the department to track plans and program performance. Ensure the availability of training and coaching and provide the time, resources, and support necessary to execute QI projects per the Performance Improvement Plan. Goal 2: Increase Sustainable Funding Strategy: Obtain funding to achieve our mission Prioritize, establish and obtain sustainable funding for core departmental positions. Prioritize, establish and obtain sustainable funding for core population health positions. Strategy: Complete economic analysis of select programs, projects, and services Participate in the Colorado Public Health Practice Based Research Network s project focused on the cost of implementing local public health services. Make training, support, and resources available within the department to conduct cost-analysis (such as return on investment). 12 P a g e

14 Communication Goal 3: Provide clear, consistent, communication about Denver Public Health Strategy: Communicate the Denver Public Health mission Develop consistent Denver Public Health messaging across a variety of communication platforms. Educate staff on the availability of messaging tools for use in external communications. Strategy: Involve the workforce in key departmental activities and collaborations Tactic: Routinely provide opportunities for staff to learn and share about public health topics and inform staff on a regular basis of department/program efforts, challenges and accomplishments (e.g. town halls, lectures, , and presentations). Strategy: Efficiently and effectively use marketing, public relations, and social media Create standard work around producing and disseminating publically available communications (e.g. brochures and public reports). Provide training and clarification on when and how to utilize Denver Public Health public relations/marketing staff and services. Develop and implement a media strategy. Train staff on public relations and marketing best practices. Collaboration Goal 4: Expand and strengthen our relationships and partnerships to further our mission. Strategy: Document the relationship of Denver Public Health and Denver Environmental Health Develop a coordinated description for Denver Environmental Health and Denver Public Health. Develop user-friendly communication tools/documents to explain the relationship. 13 P a g e

15 Provide Denver Public Health staff with information and training on the collaborative services provided at Denver Environmental Health and Denver Public Health. Strategy: Coordinate with metro-area local public health departments, educational institutions, governmental entities, community based organizations, associations, coalitions, and boards on public health issues Engage with community and partners to assist with the Community Health Assessment, Community Health Improvement Plan and Strategic Plan. Identify key public health priorities and opportunities for synergy and collaboration. Population Health Goal 5: Continually assess and respond to community needs Strategy: Develop a long-term plan to actively assess and respond to community health needs Report on population-level key health indicators to the community. Goal 6: Improve the health of Denver residents. Strategy: Promote healthy eating and active living (HEAL) Assist with implementation of the HEAL components of the Community Health Improvement Plan. Develop infrastructure with partners to achieve the HEAL goals and objectives. Strategy: Improve access to health care Assist with implementation of the access to health care components of the CHIP. Develop infrastructure with partners to achieve access to health care goals and objectives. 14 P a g e

16 Appendix 1 Strategic Planning Process Overview 15 P a g e

17 Appendix 2 Key Informant Interview Questions What do you think are the top two public health concerns within the City and County of Denver? When you hear someone say Denver Public Health, what is the first thing that comes to mind? Over the next three to five years, what do you think will be the emerging and new issues for public health to tackle? If appropriate: Please briefly talk about Denver Public Health s strengths. What separates them from other public health departments, either in state or nationally? If appropriate: Please briefly talk about any weaknesses you see with, or associated with, Denver Public Health. How could they improve? If appropriate: In your opinion, are there any essential services Denver Public Health provides to the community that absolutely need to be continued? Is there anything about Denver Public Health you or your organization would like to know more about? Is there anything else you would like to share with the strategic planning committee? 16 P a g e

18 Key Informants Denver Public Health Bill Burman, Director Judy Shlay, Associate Director Andrew Yale, Administrative Director Art Davidson, Director of Informatics/Epidemiology/Preparedness Ed Gardner, Director of the Infectious Disease Clinic All members of the Core Strategic Planning Team (listed on page 5) Denver Environmental Robin Valdez, Director of Community Health Division Health Denver Health Dr. Paul Melinkovich, Director Community Health Services Denver Health Board Susan Powers, President at Urban Ventures, LLC Irene Aguilar, Colorado State Senator Funders Khanh Nguyen, Senior Program Officer at The Colorado Health Foundation Ned Calonge, President and CEO of The Colorado Trust Colorado Department Larry Wolk, Executive Director and Chief Medical Officer of Public Health and Kathleen Mathews, Office of Planning and Partnerships Director Environment Local Public Health Jeff Zayach, Director of Boulder Public Health Agency Directors Mark Johnson, Director of Jefferson County Public Health John Douglas, Executive Director of Tri-County Health Department 17 P a g e

19 Appendix 3 SWOT Analysis Strengths Weaknesses Informatics Excellent at clinical delivery of care Epidemiology Emergency Preparedness Research Great HIV/STD/TB clinical experience and operations Critical Infectious Disease services Caring for those with HIV and TB Service to the community Expertise/reputation/integrity Often confusing relationship with Denver Environmental Health Brand tied to clinical expertise not population-level public health Communication both internally and externally Perceived culture that is very Denver Health centric Alignment with metro public health departments lacking or not evident Limited interactions and collaboration with metro hospitals Opportunities Threats Evidence driven Being future focused and recognition of changes needed in the future Address Denver Environmental Health relationship Expand population based services Billing for services is a new opportunity for public health More informatics to drill down on the problems Start working more on mental health Address health disparities Historically chasing funding and have an organizational structure that follows the funding streams Cultural divide within Denver Public Health clinical and non-clinical programs The public does not know what public health is or does While a national leader in a lot, locally mainly known only for clinical work Future funding within the changing public health landscape 18 P a g e