Performance Management and Quality Improvement Training Agenda

Similar documents
Central Valley Health Policy Institute Central California Center for Health and Human Services California State University, Fresno

4/14/2014. Agenda. Building & Improving a Performance Management System. Public Health Foundation. Workshop Objectives

NEW JERSEY 2/17/15. Welcome! Gaining Ground Performance Management Pre- Workshop Webinar February 18, :00 pm 3:30 pm

Public Health Performance Management Systems Organized as Quality Improvement Cycles

Oneida County Health Dept Performance Management. Learning Objectives. Public Health Performance Management

Kotter and Bridges handouts for participants who did not attend Workshop 1.

National Public Health Performance Standards Program Frequently Asked Questions

Developing a Strong Public Health Workforce For California and Health Departments

WV School Counseling Program Audit

Setting Standards in Public Health Training. The Australian Experience Asia-Pacific Academic consortium for PH Accreditation in PH Education

Behavioral Health Action Team Meeting Tuesday, January 12, :30 4:00 PM

WV School Counseling Program Audit

Impact of Financial Aid on Student College Access & Success:

Performance Management Process Overview Elements of the Performance Management Process

Case Study A - Discussion Questions

PERFORMANCE MANAGEMENT Planning & Goal Setting

What is Public Health Accreditation? Ron Chapman, MD, MPH Director and State Health Officer California Department of Public Health

St. Charles School District. Counselor Growth Guide and. Evaluation Documents

ACS WASC Accreditation Status Determination Worksheet

Performance Management

INTER-TRIBAL COUNCIL OF NEVADA, INC.

Management Strategy Development Work Session

Alabama Department of Public Health Strategic Plan

Building a Business Analyst Competency & Training Program. Presented by Tom Ryder

National Center for Healthcare Leadership SUMMARY. Health Leadership Competency Model

Ohio School Counselor Evaluation Model MAY 2016

Oakland County Wellness Coalition 10 Steps for Creating a Successful Health Management/Wellness Program

2020 Strategic Plan. WVU School of Public Health. WVU School of Public Health: 2020 Strategic Plan

MPR 1 Use a performance management system to monitor achievement of organizational objectives.

Rubric for Evaluating Colorado s Specialized Service Professionals: School Nurses

Creating accountable Results - The 5 Steps to Success

Logic Models in Public Health Program Management

Consensus Framework for Advancing Public Health Informatics

Results-based Performance Management System (RPMS) EMPLOYEE S MANUAL

Application Information

Presented by: Allison Dunn, Accreditation Coordinator Central Michigan District Health Department March 25, 2014

EMPLOYEE PERFORMANCE REVIEW GUIDELINES

Team Dynamics in Process Simplification. Introduction to Process Improvement Slide 1

LEADERSHIP DEVELOPMENT PROGRAMME

Public Health Solutions Through Changes in Policies, Systems, and the Built Environment

The Performance Management Process How to establish goals, objectives and KPI s

University Reviews: Exploring a New and Coordinated Approach

Report of the Quality Assurance Review Team for Big A Elementary School Route 2, Box 384 Sorrells Road Eastanollee, Georgia United States

Washington County Public Health Division. Performance Management and Quality Improvement Plan

REQUEST FOR PROPOSAL Website Design, Development & Hosting

5/11/2015. Seven Benchmarks of a Successful Worksite Wellness Program. Benchmark #1 Capturing Senior Level Support

Health Authority Abu Dhabi

GUIDE TO EFFECTIVE STAFF PERFORMANCE EVALUATIONS

Sustainable Jersey for Schools Small Grants Program

Overview of the HLA Competency Directory

Illinois Professional School Leader Standards [29.100]

New and Prospective Managers: Competency Development and Learning Plan

Developing Population Health Competencies Among Public Health Nurses in Georgia

Breakout Session 15 Using HER Data for Community Health Assessment

Board Development. Evaluating Your Executive Director s Performance

Preparing the Self-Study Report for Engineering

Kotters Eight Steps of Change

Useful Business Objectives and the Agile BA

Executive Performance Appraisal FY15

Budget & Finance Certificate Program - A Review

Choosing The Right Evaluation Questions

Rubric for Evaluating Colorado s Specialized Service Professionals: School Nurses

Driving Change through Clinical Informatics Dorothy DuSold, MA 1

[BEAUMONT HEALTH PHYSICIAN LEADERSHIP ACADEMY] Beaumont Health Physician Leadership Academy

Role 1 Leader The Exceptional Nurse Leader in Long Term Care:

Grant Writing Fundamentals: Positioning Your Organization for Success

Specific Measurable Achievable. Relevant Timely. PERFORMANCE MANAGEMENT CREATING SMART OBJECTIVES: Participant Guide PROGRAM OVERVIEW

End User Guide to Starfish CONNECT Contents

UWG Student Externship Program Sample Itinerary

SMART GOALS. Franklin Public Schools. Fall 2012

TOWSON UNIVERSITY College of Business and Economics Department of Accounting. ACCT 497 Internship

Self assessment tool. The Leadership Framework. Leadership Academy

Kenosha County Division of Health Performance Management System Quality Improvement Plan

Accreditation Support Initiative (ASI) for Large Metropolitan Local Health Departments

MA Department of Public Health

Champlain College Performance Management

Strategic Plan: A How-To Guide

REQUEST FOR QUOTES (RFQ) HEALTH COVERAGE ANALYST/PROJECT MANAGER

Why do you want to launch a business analyst career? Some possibilities include:

February 2014 Implementation Progress Report

Becoming Agile: a getting started guide for Agile project management in Marketing, Customer Service, HR and other business teams.

Management Fundamentals in Healthcare Organizations

SBEC/TExES Framework for Principal Certification

The Four Stages in Building and Sustaining a Service Culture

IDOL Outcomes and Competencies (ibstpi) 2

SACSCASI. August 21-22, Joe Smith, Principal, Sample School Mary Anderson, Chairperson, SAIS - SACS Team

How To Be A Successful Supervisor

Guide to Effective Staff Performance Evaluations

Innovation Fund Grants 101. Innovation Fund Technical Assistance Day August 13 and 14, 2014

Table of Contents. Summary of Changes

The IEP is written by a Team. The Team works together, collaborates, and decides by consensus not by vote. Everyone on the team has an equal voice.

SMARTer goals for career success

NAAS - inacol Standards for Quality Online Programs

Chapter Three: Challenges and Opportunities

JOB DESCRIPTION. Macmillan Haematology Clinical Nurse Specialist (Leukaemia Team) Bridgewater Suite, outpatient department. Belfast City Hospital

POSITION DESCRIPTION

Getting to strong Leading Practices for value-enhancing internal audit By Richard Reynolds and Abhinav Aggarwal - PricewaterhouseCoopers LLP

Guide to Effective Staff Performance Evaluations

The Future of Public Health Nursing: An Update on Standards and Credentialing

Submitted for Review and Approval Florida Department of Education 5/1/2012

Transcription:

Performance Management and Quality Improvement Training Agenda Friday, April 5, 2013, 10:00 a.m. 12:00 p.m. Fresno County Department of Public Health, Room 120 NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 1) Pre-Training Survey 2) Project Overview 3) Quality Improvement Overview 4) Public Health Accreditation Board (PHAB) 5) Project Requirements 6) Performance Management System 7) Performance Measure Development 8) Review/Renewal of Department Strategic Aims 9) Assign Homework Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Measurement and Quality Improvement Pre Survey 1. Which of the following is NOT a component of a performance management system? Performance Standards Performance Measurement Performance Targets Reporting of Progress Quality Improvement Process 2. In performance management, an indicator is the same as a goal. True False 3. What Public Health Accreditation Board (PHAB) domain relates to quality improvement? Domain 2 Domain 5 Domain 7 Domain 9 4. Performance measurement helps managers identify the causes of poor performance. True False 5. S.M.A.R.T. is an acronym for which of the following? Standard, Measure, Aims, Reporting Out, Tracking Progress Specific, Measureable, Availability, Reliability, Time Bound Setting Aims, Measuring Progress, Assigning Accountability, Reporting Out, Tracking Progress Specific, Measurable, Aggressive/Attainable, Results Oriented, Time Bound 6. What type of goal is the following statement? "Increase the number of trained epidemiologists available to investigate outbreaks to 2 per 100,000 population". Process Outcome Capacity Availability

7. Which of the following statements defines reliability of an indicator? Captures the essence of what it professes to measure A high likelihood of yielding the same results in repeated trials, so there are low levels of random error in measurement Unlikely to be used against that which is, or those who are, measured Easily understood by all, with minimum explanation 8. Goals are not required for every aim. True False 9. Which of the following is an example of an aim statement? By the end of the event, 90% of participants will be able to identify at least three techniques that can lead to successful smoking cessation By 2020, the rate of smoking in the seven county metro area will decrease by 25% Improve access to health services and ensure the integrity of the nation's health entitlement and safety net programs By the third year of the grant period, program staff will have trained 80% of school nurses on the selected train the trainer curriculum 10. Which of the following is an example of a goal? Over the next 6 years, increase the percentage of the nation's children and adults who have health insurance coverage To enhance the well being of Americans by providing for effective health and human services All residents in Fresno County have access to a healthier lifestyle Fresno County is prepared to respond to emergencies that impact public health and safety

Performance Management and Quality Improvement NACCHO Accreditation Support Initiative for Fresno County Department of Public Health Central Valley Health Policy Institute Dr. John Capitman, Donna DeRoo, Ashley Hart Consultant, Allison Hensleit Friday, April 5, 2013 Introductions Facilitators Please introduce yourself answering the following questions Name Position/Role Prior experience with performance management Name a feeling you have when you hear performance management 1

Outline of Presentation Project Overview Quality Improvement Overview Public Health Accreditation Board (PHAB) Project Requirements Performance Management System Performance Measure Development Review/Renewal of Department Strategic Aims Project Overview Grant Funding from the National Association of County and City Health Officials (NACCHO) to create and implement an electronic performance management system and provide performance management training to staff and connector sites, Madera and Merced Departments of Public Health. 2

Quality Improvement Quality improvement is an integrative process that links knowledge, structures, processes and outcomes to enhance quality throughout an organization. Working to do the right things right. Quality improvement processes ask given our resources and authority, are we improving the health of the public in the most efficient way possible? And if not, how can we do it better? Journey of continuous improvement, allowing organizations to maximize their impact and outcomes. Foundations for Quality Improvement in Public Health National Public Health Performance Standards Program (NPHPSP), launched in 1998, guides work towards improving public health systems. Version 2 released in 2007 Public Health Accreditation Board (PHAB), started accepting applications for their voluntary accreditation program in 2011, standards for public health agencies. 3

Public Health Accreditation Board There are 12 Domains, each including two to four standards, all require documentation. Domain 9: Quality Improvement: Evaluation and Continuously Improve Processes, Programs and Interventions. Standard 9.1 Use a Performance Management System to Monitor Achievement of Organizational Objectives Standard 9.2 Develop and Implement Quality Improvement Processes Integrated into Organizational Practice, Programs, Processes, and Interventions PHAB Project Requirements To most effectively and efficiently improve the health of the population, it is important to monitor the quality of performance of public health processes, programs, interventions and other activities. To achieve this goal, we need A performance management system that is completely integrated into health department daily practice at all levels including: Setting organizational objectives across all levels of the department. Identifying indicators to measure progress toward achieving objectives on a regular basis. Identifying responsibility for monitoring progress and reporting Identifying areas where achieving objectives requires focused quality improvement processes. 4

Performance Management System A performance management system is the continuous use of all the practices so that they are integrated into an agency s core operations. A successful system is driven by state and local needs and designed to closely align with a public health agency s mission and strategic plans. Terms to Know Performance Term Definition Example Performance Standard Performance Measure Performance Indicator Performance Targets Objective standards or guidelines that are used to assess an organization s performance. Quantitative measures of capacities, processes, or outcomes relevant to the assessment of a performance indicator. Summarize focus of performance goals and measures, often used for communication purposes and preceding the development of specific measures. Specific and measureable goals related to agency or system performance. One epidemiologist on staff per 100,000 population served. 80 percent of all clients who rate health department services as good or excellent. Number of trained epidemiologists available to investigate Percentage of clients who rate health department services as good or excellent. Workforce capacity Customer service Targets may be the same as, exceed, or be an intermediate step toward the standard. 5

How You Can Use Performance Management Identify aspects of the work that have and have not resulted in satisfactory results. Identify trends. Further investigate the nature of particular problems. Set targets for future periods. Motivate managers and staff to improve performance; increase their interest in better serving clients. Hold managers and staff accountable. Develop and improve programs and policies. Help design policies and budgets to explain these to stakeholders. Key Attributes of a Performance Measure Validity: captures the essence of what it professes to measure. Reliability: a high likelihood of yielding the same results in repeated trials, so there are low levels of random error in measurement. Functionality: directly related to aims and goals. Responsiveness: should be able to detect change. Credibility: supported by stakeholders. Understandability: easily understood by all, with minimum explanation. Availability: readily available through the means on hand. Abuse-proof: unlikely to be used against that which is, or those who are, measured. 6

Sample Performance Measures The number of trained epidemiologists available to investigate outbreaks (capacity measure). The percentage of notifiable disease reports submitted within the required time lines (process measure). Percentage of clients who rate health department services as good or excellent (outcome measure). Why do Performance Measurement? 1. Setting Aims, Developing Goals 2. Assigning Accountability 3. Improving Work Quality 4. Tracking Progress 5. Reporting Out 7

1. Setting Aims, Developing Goals Compels you to reassess your overall aims and specific goals. Aims: describe where you want to go and how it looks when you get there. Goals: define specific results that will show movement towards your goals. S.M.A.R.T. Goals Specific Action oriented; providing clear direction; easily understood Measureable Quantifiable and/or verifiable Aggressive, but Attainable Challenging and realistic Results-Oriented Focused on outcomes; not methods Time Bound Having a reasonable, yet aggressive, time frame 8

Sample Aims and Goals Strategic Aim 3: Improve community access to smoking cessation programs in order to decrease the rate of smoking. Goals 3.1 By the third year of the grant period, program staff will have trained 80% of school nurses on the selected train-the-trainer curriculum. 3.2 By the end of the event, 90% of participants will be able to identify at least three techniques that can lead to successful smoking cessation. 3.3 By 2020, the rate of smoking in the seven-county metro area will decrease by 25%. 2. Assigning Accountability A performance management system allows all public health department leaders and staff be clear about what goals are being sought and which staff are responsible. A performance management system also makes it clear what the public health department believes it can influence and what is beyond its influence 9

3. Improving Work Quality Opportunity to assess the quality or effectiveness of your work right now. Opportunity to identify those areas where you want to improve and have ready access to the tools you need to make it happen. Opportunity to track changes in quality and effectiveness in these areas over time. 4. Tracking Progress Opportunity to assess and improve on practices, processes, activities, and systems. Track your progress towards achieving your aims and meeting your goals. Help identify problem areas, but not tell you why these aren t working as effectively, only where the problems might be. Reveal where you are having success. 10

5. Reporting Out A key goal of performance measurement is to report progress back to those in your organization responsible for carrying out the work. You cannot improve what you don t know needs improving. Positive, constructive feedback from this process leads to success for everyone. Performance Measure Development Fresno County Department of Public Health Mission Statement Strategic Plan Division: Aims and Goals Units: Goals Identify indicators and measures Pilot test use of measures 11

Strategic Aims Break into triads Review assigned aims Is this still appropriate? What else would you add or delete? Is a different aim needed? Report out and consensus Review/Renewal of Department Strategic Aims Department Strategic Actions 2-21-07 All residents in Fresno County have access to a healthier lifestyle. Healthy Improve access to a healthy lifestyle for the residents of Fresno County Health in all policies: Fresno County creates conditions that support healthy lifestyles (healthy school, work, hospital, restaurant environment), dept focused not resident focused, partners in community Access, want to ensure 12

Fresno County prepared to respond to emergencies that impact public health and safety. Leave as is Maintain, sustain current levels, maintains capacity to respond Prepared is a more flexible word County add is Department of Public Health is recognized as the leader in public health. Leave as is Remove Goals can come out of this aim; Keep recognized; educate people to recognize the dept Who recognize us Not define a level, board, community, state didn t know breadth of what the PHD does Public support for the whole dept not one program Marketing, doing the work but not recognized as the leader Community leaders and voice of the community related to public health, credibility ACA: changes to the PHD, involved in changes 13

Effective and efficient organization. Delete last two, one aim Dept PH workforce is responsive to the ever-changing community and health care climate Flexible, forward thinking, innovative, community focused Need workforce to evolve with changing times Effective and efficient administration of public health resources External vs Internal: 4 and 5 Last two, how PHD is a leader in public health Assess internal capacity of the PHD, improve internal flow of operations Give employees resources they need to do work Effective and efficient stewardship of public health assets Less collaborative Workforce excellence. 14

Developing Division and Unit Aims Identify overall department aims and how they relate to the division or unit. Articulate how the division or unit contributes to accomplishing department aims. Develop specific aims for the division or unit. Review and adjust aims to reflect accurate assessment of unit or division resources and scope of authority. Let s Work an Example Together 15

Introduction to Homework We are going to give you two worksheets to be completed for each division and unit Aims Worksheet Goals Worksheet The OPPC and PHN will be the first divisions to meet On April 29, 2013 please come with your first, approximate, working draft of a completed aims statement for the division and each unit you supervise and some initial thoughts on specific goals, measures and indicators We will work in teams with each division to develop more final drafts of the aims and goals Dates for all other divisions will be scheduled soon; please start on these worksheets as soon as possible Contact Us for Help Dr. John Capitman jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo dderoo@csufresno.edu; (559) 228-2160 Ashley Hart ahart@csufresno.edu; (559) 228-2140 Allison Hensleit allison@hensleit-hss.com; (415) 702-7373 16

Aim Statement Worksheet We aim to: (What are we trying to accomplish? Use words like improve, reduce, and increase to identify the overall goal. Make it specific, measurable, aggressive, and results-oriented, and timebound.) Because: (Why is it important? Answer the so what question and describe the rational and reasons to work on this improvement project. How does this goal relate to the overall mission and goals of the Department?) To what extent: Is achieving this aim dependent on the actions of others, how will our specific actions take this into account? For: (Who is your specific target population/customer?) By when: (specific time frame, i.e. month/year in which you intend to complete the improvement We will achieve this by: (How will you carry out the work and reach your overall aim? Think of the resources at your disposal.) Our goals include: (What are our measurable goals? Think of the key changes you need to make. State them as numeric goals that are specific, measurable, aggressive, and results-oriented, and time-bound.)

Relating Performance Measures to Aims and Goals Use one worksheet for each goal Aim Goal Performance Measures Indicators

Performance Management and Quality Improvement Training Agenda Wednesday, April 17, 2013, 10:00 a.m. 12:00 p.m. Fresno County Department of Public Health NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 1) Pre-Training Survey 2) Project Overview 3) Quality Improvement Overview 4) Public Health Accreditation Board (PHAB) 5) Project Requirements 6) Performance Management System 7) Performance Measure Development 8) Assign Homework Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Measurement and Quality Improvement Pre Survey 1. Which of the following is NOT a component of a performance management system? Performance Standards Performance Measurement Performance Targets Reporting of Progress Quality Improvement Process 2. In performance management, an indicator is the same as a goal. True False 3. What Public Health Accreditation Board (PHAB) domain relates to quality improvement? Domain 2 Domain 5 Domain 7 Domain 9 4. Performance measurement helps managers identify the causes of poor performance. True False 5. S.M.A.R.T. is an acronym for which of the following? Standard, Measure, Aims, Reporting Out, Tracking Progress Specific, Measureable, Availability, Reliability, Time Bound Setting Aims, Measuring Progress, Assigning Accountability, Reporting Out, Tracking Progress Specific, Measurable, Aggressive/Attainable, Results Oriented, Time Bound 6. What type of goal is the following statement? "Increase the number of trained epidemiologists available to investigate outbreaks to 2 per 100,000 population". Process Outcome Capacity Availability

7. Which of the following statements defines reliability of an indicator? Captures the essence of what it professes to measure A high likelihood of yielding the same results in repeated trials, so there are low levels of random error in measurement Unlikely to be used against that which is, or those who are, measured Easily understood by all, with minimum explanation 8. Goals are not required for every aim. True False 9. Which of the following is an example of an aim statement? By the end of the event, 90% of participants will be able to identify at least three techniques that can lead to successful smoking cessation By 2020, the rate of smoking in the seven county metro area will decrease by 25% Improve access to health services and ensure the integrity of the nation's health entitlement and safety net programs By the third year of the grant period, program staff will have trained 80% of school nurses on the selected train the trainer curriculum 10. Which of the following is an example of a goal? Over the next 6 years, increase the percentage of the nation's children and adults who have health insurance coverage To enhance the well being of Americans by providing for effective health and human services All residents in Fresno County have access to a healthier lifestyle Fresno County is prepared to respond to emergencies that impact public health and safety

Performance Management and Quality Improvement NACCHO Accreditation Support Initiative for Fresno County Department of Public Health Central Valley Health Policy Institute Dr. John Capitman, Donna DeRoo, Ashley Hart Consultant, Allison Hensleit Wednesday, April 17, 2013 Introductions Facilitators Please introduce yourself answering the following questions Name Position/Role Prior experience with performance management Name a feeling you have when you hear performance management 2 1

Outline of Presentation Project Overview Quality Improvement Overview Public Health Accreditation Board (PHAB) Project Requirements Performance Management System Performance Measure Development 3 Project Overview Grant Funding from the National Association of County and City Health Officials (NACCHO) to create and implement an electronic performance management system and provide performance management training to staff and connector sites, Madera and Merced Departments of Public Health. 4 2

What is Quality Improvement? An integrative process linking.. Knowledge Structures Processes Outcomes throughout an organization. Allows us to ask, given our resources and authority, are we improving the health of the public in the most efficient way possible? And if not, how can we do it better? Ultimately, it is a journey of continuous improvement, allowing organizations to maximize their impact and outcomes. Working to do the right things right 5 Who are the leaders for Quality Improvement in Public Health? CDC s, National Public Health Performance Standards Program (NPHPSP). Launched in 1998 to guide work towards improving public health systems. Public Health Accreditation Board (PHAB). Now accepting applications for their voluntary Accreditation Program in 2011. Provides standards for Public Health Agencies. Only Public Health Accreditation program out there. 6 3

What is the Public Health Accreditation Program? PHAB program has 12 Domains. 1 2 3 4 5 6 Assess Investigate Inform & Educate Community Engagement Policies and Plans Public Health Laws 7 8 9 10 11 12 Access to Care Workforce Quality Improvement Evidence- Based Practices Admin & Mgmt Governance Domains included 2 to 4 standards All require documentation. 7 Domain 9: Quality Improvement Focuses on using and integrating performance management quality improvement practices and processes to continuously improve the public health department s practice, programs, and interventions. Standard 9.1 Standard 9.2 Use a Performance Management System to Monitor Achievement of Organizational Objectives Develop and Implement Quality Improvement Processes Integrated into Organizational Practice, Programs, Processes, and Interventions To achieve this goal, we need A performance management system that is completely integrated into the health department daily practice at all levels including: Setting organizational objectives across all levels of the department. Identifying indicators to measure progress toward achieving objectives on a regular basis. Identifying responsibility for monitoring progress and reporting. Identifying areas where achieving objectives requires focused quality improvement processes. 8 4

What is a Performance Management System? The continuous use of all the practices so that they are integrated into an agency s core operations. A successful system is driven by state and local needs and designed to closely align with a public health agency s mission and strategic plans. 9 Terms to Know Performance Term Definition Example Performance Standard Performance Measure Performance Indicator Performance Targets Objective standards or guidelines that are used to assess an organization s performance. Quantitative measures of capacities, processes, or outcomes relevant to the assessment of a performance indicator. Summarize focus of performance goals and measures, often used for communication purposes and preceding the development of specific measures. Specific and measureable goals related to agency or system performance. One epidemiologist on staff per 100,000 population served. 80 percent of all clients who rate health department services as good or excellent. Number of trained epidemiologists available to investigate Percentage of clients who rate health department services as good or excellent. Workforce capacity Customer service Targets may be the same as, exceed, or be an intermediate step toward the standard. 10 5

How You Can Use Performance Management Identify aspects of the work that have and have not resulted in satisfactory results. Identify trends. Further investigate the nature of particular problems. Set targets for future periods. Motivate managers and staff to improve performance; increase their interest in better serving clients. Hold managers and staff accountable. Develop and improve programs and policies. Help design policies and budgets to explain these to stakeholders. 11 Key Attributes of a Performance Measure Attribute Importance Attribute Importance Validity Reliability Captures the essence of what it professes to measure. High likelihood of yielding the same results in repeated trials, with low levels of random error in measurement. Credibility Understandability Supported by stakeholders. Easily understood by all, with minimum explanation. Functionality Directly related to aims and goals. Availability Readily available through the means on hand. Responsiveness Should be able to detect change. Abuse-proof Unlikely to be used against that which is, or those who are, measured. 12 6

Sample Performance Measures Capacity Measure The number of trained epidemiologists available to investigate outbreaks. Process Measure The percentage of notifiable disease reports submitted within the required time lines. Outcome Measure Percentage of clients who rate health department services as good or excellent. 13 Why do Performance Measurement? In order to improve something you have to be able to change it. In order to change it you have to be able to understand it. In order to understand it you have to be able to measure it. 1. Setting Aims & Developing Goals 2. Assigning Accountability 3. Improving Work Quality 4. Tracking Progress 5. Reporting Out 14 7

1. Setting Aims & Developing Goals Compels you to reassess your overall aims and specific goals. Aims Describe where you want to go and how it looks when you get there. Goals Define specific results that will show movement towards your goals. 15 Develop S.M.A.R.T. Goals Specific Action oriented; providing clear direction; easily understood Measureable Quantifiable and/or verifiable Aggressive, but Attainable Challenging and realistic Results-Oriented Focused on outcomes; not methods Time Bound Having a reasonable, yet aggressive, time frame 16 8

Sample Aims and Goals Strategic Aim 3 Goal 3.1 By the third year of the grant period, program staff will have trained 80% of school nurses on the selected train-the-trainer curriculum. Improve community access to smoking cessation programs in order to decrease the rate of smoking. 3.2 By the end of the event, 90% of participants will be able to identify at least three techniques that can lead to successful smoking cessation. 3.3 By 2020, the rate of smoking in the sevencounty metro area will decrease by 25%. 2. Assigning Accountability Allows all public health department leaders and staff be clear about what goals are being sought and which staff are responsible. Clarifies what the public health department believes it can influence and what is beyond its influence 18 9

3. Improving Work Quality Opportunity to assess the quality or effectiveness of your work right now. After establishing your baseline, there are two more performance management opportunities. Opportunity to identify those areas where you want to improve. Opportunity to track changes in quality and effectiveness in these areas over time. 19 4. Tracking Progress Provides the opportunity to assess and improve on practices, processes, activities, and systems. Track your progress towards achieving your aims and meeting your goals. Reveal where you are having success. Help identify problem areas. Will not tell you why these aren t working as effectively, only where the problems might be. 20 10

5. Reporting Out A key goal of performance measurement is to report progress back to those in your organization responsible for carrying out the work. You cannot improve what you don t know needs improving. Positive, constructive feedback from this process leads to success for everyone. 21 Performance Measure Development Fresno County Department of Public Health Mission Statement Strategic Plan Division: Aims and Goals Units: Goals Identify indicators and measures Pilot test use of measures 22 11

Developing Division and Unit Aims Identify overall department aims and how they relate to the division or unit. Articulate how the division or unit contributes to accomplishing department aims. Develop specific aims for the division or unit. Review and adjust aims to reflect accurate assessment of unit or division resources and scope of authority. 23 Let s Work an Example Together 24 12

Introduction to Homework We are going to give you two worksheets to be completed for each division and unit Aims Worksheet Goals Worksheet The OPPC and PHN will be the first divisions to meet On April 29, 2013 please come with your first, approximate, working draft of a completed aims statement for the division and each unit you supervise and some initial thoughts on specific goals, measures and indicators We will work in teams with each division to develop more final drafts of the aims and goals Dates for all other divisions will be scheduled soon; please start on these worksheets as soon as possible 25 Contact Us for Help Dr. John Capitman jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo dderoo@csufresno.edu; (559) 228-2160 Ashley Hart ahart@csufresno.edu; (559) 228-2140 Allison Hensleit allison@hensleit-hss.com; (415) 702-7373 26 13

Performance Management and Quality Improvement Work Group Agenda Monday, April 29, 2013, 9:00 a.m. 12:00 p.m. Fresno County Department of Public Health Office of Policy, Planning and Communication NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 9:00-9:30 Introductions, Guidelines and Exercise 9:30-10:00 Review Department Strategic Aims 10:00-10:30 Relate Division Aims to Department Aims 10:30-10:45 Break 10:45-11:30 Review Division Aims in Depth 11:30-12:00 Example of S.M.A.R.T. Goals for One Aim Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Guidelines for Public Conversation 1 Try on It s okay to disagree; it is not okay to blame, shame, or attack, self or others Confidentiality Practice self-focus Practice both/and thinking Notice both process and content Be aware of intent and impact Informal approach---do what you need for comfort 1VISIONS, Inc. 2002. (www.visions-inc.com)

Performance Management and Quality Improvement Work Group Agenda Monday, April 29, 2013, 1:00 p.m. 4:00 p.m. Fresno County Department of Public Health Public Health Nursing NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 1:00-1:30 Introductions, Guidelines and Exercise 1:30-2:00 Review Department Strategic Aims 2:00-2:30 Relate Division Aims to Department Aims 2:30-2:45 Break 2:45-3:30 Review Division Aims in Depth 3:30-4:00 Example of S.M.A.R.T. Goals for One Aim Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Guidelines for Public Conversation 1 Try on It s okay to disagree; it is not okay to blame, shame, or attack, self or others Confidentiality Practice self-focus Practice both/and thinking Notice both process and content Be aware of intent and impact Informal approach---do what you need for comfort 1VISIONS, Inc. 2002. (www.visions-inc.com)

Performance Management and Quality Improvement Work Group Agenda Tuesday, May 14, 2013, 1:00 p.m. 4:00 p.m. Fresno County Department of Public Health Public Health Nursing NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 1:00-1:30 Introductions and Guidelines for Public Conversation 1:30-2:00 Review Department Strategic Aims 2:00-2:30 Review Division Aims in Depth: Is everything covered? 2:30-2:45 Review Division Aims in Depth: Choose top 5 aims 2:45-3:30 Finalize Division Aims: Choose 3 aims for year one 3:30-4:00 Create S.M.A.R.T. Goals for Division Aims Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Management and Quality Improvement Work Group Agenda Thursday, May 16, 2013, 9:00 a.m. 12:00 p.m. Fresno County Department of Public Health Office of Policy, Planning and Communication NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 9:00-9:30 Introductions and Guidelines for Public Conversation 9:30-10:00 Review Department Strategic Aims 10:00-10:30 Review Division Aims in Depth: Is everything covered? 10:30-10:45 Review Division Aims in Depth: Choose top 5 aims 10:45-11:30 Finalize Division Aims: Choose 3 aims for year one 11:30-12:00 Create S.M.A.R.T. Goals for Division Aims Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Management and Quality Improvement Work Group Agenda Thursday, May 23, 2013, 8:30 a.m. 11:00 a.m. Fresno County Department of Public Health; Room B03 Office of Policy, Planning and Communication NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 8:30-10:30 Finalize Division Aims, Goals, Actuals, Targets, Datasources 10:30-11:00 Choose Aims and Goals to Pilot in the Performance Management System Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Management and Quality Improvement Work Group Agenda Thursday, May 30, 2013, 1:00 p.m. 4:00 p.m. Fresno County Department of Public Health; Room 120 Public Health Nursing NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 1:00-3:30 Finalize Division Aims, Goals, Actuals, Targets, and Data sources 3:30-4:00 Choose Aims and Goals to Pilot in the Performance Management System Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Management and Quality Improvement Work Group Agenda Tuesday, June 25, 2013, 9:30 a.m. 11:00 a.m. Fresno County Department of Public Health; Room B03 Office of Policy, Planning and Communication NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 9:30-10:00 Explain the Electronic Performance Management System, including the dashboard 10:00-11:00 Choose Red Zone Targets to Pilot in the Performance Management System Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373

Performance Management and Quality Improvement Work Group Agenda Tuesday, June 25, 2013, 11:00 a.m. 12:30 p.m. Fresno County Department of Public Health; Room B03 Public Health Nursing NACCHO Accreditation Support Initiative for Fresno County Department of Public Health 11:30-12:00 Explain the Electronic Performance Management System, including the dashboard 12:00-12:30 Choose Red Zone Targets to Pilot in the Performance Management System Contact Information Dr. John Capitman o jcapitman@csufresno.edu; (559) 228-2157 Donna DeRoo o dderoo@csufresno.edu; (559) 228-2160 Ashley Hart o ahart@csufresno.edu; (559) 228-2140 Allison Hensleit o allison@hensleit-hss.com; (415) 702-7373