Welcome! Gaining Ground Performance Management Pre- Workshop Webinar February 18, 2015 2:00 pm 3:30 pm Please Dial in from your land- line: 210-339- 7212 ParLcipant code: 4146073 NEW JERSEY Performance Management February 18, 2015 Star&ng where you are, with what you have 3 1
Welcome and Introductions Meeting Purpose 4 Performance Management 5 Why Performance Management? What Are Some of the Challenges Facing Public Health Today? Funding Recognition for who we are and what we do Understanding our Mission & Communicating that to stakeholders and funders Need to define our work and justify the resources invested 6 2
Why Performance Management? Do you know the quality of your agency s work? Do you know how well your agency is performing? Do you know what you are trying to accomplish? Are you making progress? 7 Why Do Performance Management? } 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. And if you can count it you can measure it. } What gets measured gets done. An effective performance management system gives you useful, credible information for assessing: 1) Your capacity to undertake your work. 2) The quality of your efforts. 3) The outcomes of your efforts. 8 Performance Management An Overview What is Performance Management? Performance management is a forward looking practice of using data to improve agency performance. 9 3
A Performance Management System A performance management system is driven by state and local needs and is designed to align closely with a public health organization s vision, mission, strategic goals and public health priorities. 10 Performance Management Framework This practice involves strategic use of Goals, standards, targets, measures, data collection, reporting, and Quality Improvement Performance Management System Framework Components 1. Visible Leadership 2. Performance Standards 3. Performance Measures 4. Reporting Progress 5. Quality Improvement 11 Performance Management Outer Ring Continuous Customer Focus Transparency Strategic Alignment Culture of Quality 12 4
This Sounds Like a Lot of Work. What s in it for Us and Our Agency? PM helps answer these types of questions } How well is our health department performing? } Do we all know where we are headed? } Are we all pulling in the same direction? } Are we making progress as an organization? } Are we achieving what we set out to do? } Are we accountable and demonstrating results? } Do we need to do something different? 13 Where do We Start? 14 A MODEL FOR PERFORMANCE MANAGEMENT Performance Management provides a roadmap and a set of tools that help guide you along the right path toward improving your agency and programs. The model for Performance Management in public health was created by the Turning Point Performance Management Collaborative in the 1990s. It comprises four parts: Turning Point Model- Refreshed- PHF 15 5
A MODEL FOR PERFORMANCE MANAGEMENT Identification and use of performance standards, Identification and collection of performance measures, An ongoing process and timeline for reporting of progress, and Use of a quality improvement process to respond to identified needs. Turning Point Model- Refreshed- PHF 16 PERFORMANCE STANDARDS: STAGE 1 Under the Turning Point model, there are four steps to identify performance standards. 1.Identify relevant standards starting with agency goals as described in your vision, mission, and strategic plan, and looking to generally accepted standards for performance to find standards that align. 2.Select indicators of performance that align with each standard that can be tracked over time. 3.Set targets for the performance of your agency related to each indicator. 4.Communicate expectations for performance with agency staff and stakeholders to build awareness and gain buy-in. PERFORMANCE STANDARDS: WHERE TO LOOK There are many sources for identifying public health performance standards. Examples of these sources are listed on the right. Keep in mind that a performance management system should cross all health department functions. It should not just focus on health determinants and outcomes. Health Determinants & Status Healthy People 2020 National Prevention Strategy Resources & Services PHAB Standards, including those under Domains 2, 3, 7, and 10 National Public Health Performance Standards Program (CDC) Michigan Local Public Health Accreditation Minimum Program Requirements Community Engagement PHAB Standards, including those under Domains 1, 4, 5, and 6 CDC Principles of Community Engagement Scotland National Standards for Community Engagement CDC Public Health Preparedness Capabilities, National Standards for State and Local Planning Workforce Core Competencies for Public Health Professionals (PHF) PHAB Standards, including those under Domain 8 6
PERFORMANCE MEASUREMENT: STAGE 2 Your performance measures should be quantitative measures of capacities, processes, or outcomes relevant to assessment of your performance indicators. Selected measures should let you know if you re getting closer to achieving your performance standards. For example, if your agency is pursuing the Healthy People 2020 performance standard of a 10% improvement in the percent of live births that were preterm you might include performance measures such as: The percentage of live births that were preterm in your county in the calendar year. The percentage of women served by the tribal health clinic who receive prenatal care in the first trimester. The percentage of OB/GYN providers receiving educational information from the health department about preventable preterm birth. Turning Point Performance Management NaLonal Excellence CollaboraLve, 2004 19 CREATING PERFORMANCE MEASURES There are often many different ways to measure progress toward any one performance standard. Start by looking at your performance standard, or goal for performance, and brainstorm a list of things you could count or observe that would help you determine how well your agency is achieving that standard. Gather information on how others are measuring their performance in that area. No need to reinvent the wheel! CREATING PERFORMANCE MEASURES Look at each possible measure and consider what data you already have collected, what data are readily available through other sources, or what data you could realistically collect. If a possible measure just doesn t have a reliable source and couldn t realistically be tracked consistently over time, drop it from the list. Determine which measures are related to your activities and are within your agency s control or influence. Eliminate measures that are outside your agency s scope. 7
CREATING PERFORMANCE MEASURES Your final list of possible measures should be: Clearly and logically related to your standard, Feasible to collect over time, and Within the scope of your influence. At this point you can use all the measures on your list (you may have just a few left), or select the measures that you think best reflect performance related to your standard. REPORTING OF PROGRESS: STAGE 3 Reports on progress should: Compare performance measures with their target and they should link to overall goals; Provide context and be targeted to the audience the content depends on the purpose and intended users; Be routine reports should be produced on a schedule; Be created in a way that is straightforward, easy to produce, and easy to understand; and Be communicated and shared across the agency. QUALITY IMPROVEMENT: STAGE 4 Quality improvement is where a performance management system creates opportunity for meaningful improvement within your public health agency. It is about learning to use data on how you are performing to drive activities that lead to true improvement. 8
How About an Example Our Strategic Plan lists under Strategic Goals the following Department Goal. ENHANCE THE CUSTOMER SERVICE EXPERIENCE BY 12/31/15 25 Performance Standards 80% of clients rate health department services as good or excellent. 26 Performance Measures % of clients that rate health department services as good or excellent. 27 9
Reporting of Progress In 2013, 50% of clients rated health department services as either good or excellent. 28 Quality Improvement Increase client satisfaction of health department services to 70% by December 2014 29 Reporting of Progress If client satisfaction of health department services doesn t reach 70% by 2014 the PDSA cycle will be repeated (continuous quality improvement) 30 10
Performance Management Ties it All Together Performance Management 32 Your Strategic Plan } Defines where your department is going } Provides a definition of the mission, goals, and objectives } Defines via template for employees and stakeholders to make decisions to move the organization forward } Provides an assessment of the department s capacity to respond to its mission Tells the community what the department is capable of and how it operates PHAB acronyms and glossary of terms version 1.0 33 11
The Community Health Assessment } Examines the health status indicators for a given population (Department) } Identifies key problems and assets } Contains strategies to address the department s health needs and identified issues } A collaborative process involving the department and many stakeholders PHAB acronyms and glossary of terms version 1.0 34 Community Health Improvement Plan } Long term, systematic effort to address public health problems on the basis of the results of health assessment activities and the health improvement process. } Used to set priorities and coordinate and target resources. } Serves as a pre-cursor for the development and defining actions to target efforts to improve health. } Defines the vision for the health of the population. } Lists strengths, weaknesses, challenges, and opportunities that exist to improve the health status of the population. PHAB acronyms and glossary of terms version 1.0 35 And Quality Improvement is the Thread woven Throughout These Components It is a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the population. 36 12
To Summarize If we must define our work and justify the resources we consume (tell the public health story) then.. Quality Improvement will help us improve our processes to get the results we need. Performance Management will help us determine what results are needed and measure our progress toward meeting our goals that were defined in our Strategic Plan and Action Steps. 37 1. Performance Standards Identify relevant standards Select indicators Set targets Communicate expectations 2. Performance Measures Refine indicators Define realistic measures Develop data systems Collect Data RECAP There are four pieces to an effective performance management system: 3. Reporting of Progress Analyze data Report results broadly Develop a regular cycle of reporting 4. Quality Improvement Use data for decisions Manage changes Create a learning organization Useful Links Turning Point Overview & Documents h[p://www.phf.org/resourcestools/pages/turning_point_project_publicalons.aspx Turning Point Performance Management Revised Framework h[p://www.phf.org/programs/pmtoolkit/pages/ Turning_Point_Performance_Management_Refresh.aspx Public Health AccreditaBon Board h[p://www.phaboard.org/ Michigan Public Health InsBtute PM Free on- line Training h[p://mphiaccredandqi.org/pmqitraining/login.aspx NACCHO- Guide to CommunicaBng about Performance Improvement h[p://www.naccho.org/topics/infrastructure/accreditalon/picommunicalons.cfm? utm_source=magnetmail&utm_medium=email&utm_term=jbutlerassoc@voyager.net&u tm_content=2013_10_01connect&utm_campaign=naccho%20connect,%20oct.%201 39 13
Acknowledgements Materials, handouts and Power Point slides adapted from North Carolina s Center for Public Health Quality - Quality Improvement 101 Program James Butler & Associates Michigan Public Health InsLtute The Public Health FoundaLon MeeLng Closure QuesLons? Next Steps Closing Comments Contact Information James Butler & Associates ChrisLna Harrington 989 482-0520 chrislnaharrington@hotmail.com Jim Butler 517 614-1654 jbutlerassoc@voyager.net 42 14