Enhancing MCH Leadership Skills Through Professional Development in Core Competencies Laura Kavanagh, MPP Cathy R. Taylor, DrPH, MSN, RN Michael D. Warren, MD, MPH, FAAP Session Objectives Review current state of MCH workforce (trends and challenges) Outline core competencies in MCH Leadership and Public Health Complete core competency self-assessments Identify strategies for incorporating professional development in job planning and performance evaluation Highlight professional development resources available for MCH professionals Introductions Laura Kavanagh, MPP Department of Health and Human Services Health Resources and Services Administration (HRSA) Maternal and Child Health Bureau (MCHB) Division of Research, Training and Education Cathy R. Taylor, DrPH, MSN, RN Dean, College of Health Sciences and Nursing, Belmont University Former Assistant Commissioner, TN Department of Health Michael D. Warren, MD, MPH, FAAP Director, Title V/MCH, TN Department of Health 1
Introductions Turn to the other attendees in your row Introduce yourselves and discuss: What is the most difficult challenge related to workforce development? What do you hope to get out of this session? One person from group will introduce everyone briefly and share one point from the group discussion Current State of the MCH Workforce Context Resource squeeze: national state local Beyond financial squeeze, pressure to do less within government, further limits options Impacts; cuts in staff and programs, furloughs, and reassignments, atmosphere of discouragement, difficult environment in which to develop staff Pressure for Accreditation 2
Need for Workforce Development Top Three Training Needs of Title V Program Staff 100 90 82 Percent of State Programs 80 70 60 50 40 30 20 27 32 22 39 36 33 49 48 49 45 47 41 60.5 54 67 75 68 10 0 1 2 0 No Training Family Centered Communication Public Health/Title Management Leadership Critical Thinking Needs Care, Medical V Knowledge Development Home Base Title V Programs Combined (N=93) CYSHCN (N=44) MCH (N=49) Grason, H., Kavanagh, L., Dooley, S., Partelow, J., Sharkey, A., Bradley, K.J., & Handler, A. (2010) Findings from an Assessment of State Title V Workforce Development Needs. Maternal and Child Health Journal, [electronic publication ahead of print]. doi: 10.1007/s10995-010-0701-9 NACCHO MCAH Sentinel Network Source: Laura Snebold What national level, capacity building support would be useful for your local MCAH work? 1 Training on program design, implementation, evaluation, and sustainability 2 Training on policy, systems, and environmental changes 3 Strategic Planning 4 Creation and management of a topic specific Community of Practice Online repository of tools and resources to address capacity building 5 need 6 Training on framing public health messages 7 Training on public health business planning 8 Training on story-telling to educate others about public health November 2, 2011 Barriers to Professional Development Travel restrictions (69%) Difficult to take time away from work (63%) Cost (61%) Geographic barriers (23%) Grason, H., Kavanagh, L., Dooley, S., Partelow, J., Sharkey, A., Bradley, K.J., & Handler, A. (2010) Findings from an Assessment of State Title V Workforce Development Needs. Maternal and Child Health Journal, [electronic publication ahead of print]. doi: 10.1007/s10995-010-0701-9 3
2010 Needs Assessment Findings Key workforce Development Needs & Challenges State MCH programs need a competent workforce Standardized and ongoing workforce training, including funding Strategies to address capacity shortages Strategies for succession planning State MCH programs are challenged by Aging workforce Retirement incentives Retention of staff Technology limitations Limited access to training (geography, funding) Source: Lauren Raskin Ramos, The MCH Workforce: Developing Our Base and Building for the Future, Presentation at American Public Health Association, 2011. 2010 Findings, Cont d 9 states/territories identified workforce capacity and training needs as a priority area including: identifying training needs, securing adequate funds for training, leadership development and mentoring, measurement of efforts competencies and skills around data analysis and program evaluation State Priority Examples TN Design and implement a workforce development program MD Focus on leadership development and mentoring next generation of public health leaders OK - Invest in existing MCH workforce leadership competencies - data analysis, program evaluation Source: Lauren Raskin Ramos, The MCH Workforce: Developing Our Base and Building for the Future, Presentation at American Public Health Association, 2011. Public Health Essential Functions Source: Public Health Essentials. CDC. http://www.cdc.gov/nphpsp/essentialservices.html 4
Public Health Challenges Infant Mortality Obesity Tobacco Use Cancer Teen Pregnancy Injury Infectious Disease Emergency Preparedness And the list goes on Call to Action How do we Fulfill the Public Health Essential Functions? Meet the critical health needs of children and families? Function effectively as MCH/Public Health leaders? CORE COMPETENCIES FOR MCH AND PUBLIC HEALTH PROFESSIONALS Core Competencies in MCH and Public Health 5
MCH Leadership Competencies April 2004 Future of MCH Leadership Training Fall 2004 MCHB All-Grantee meeting Early 2005 MCH Competencies Working Group formed Fall 2005-Spring 2006 Revised draft shared, comments solicited Winter 2007 Comments from field reviewed by workgroup Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_comp_3-0.pdf MCH Leadership Competencies Spring 2008 Delphi Process Panel of MCH experts, 2-phase validation process Final set: 12 competency domains, 72 items Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_comp_3-0.pdf MCH Leadership Competencies Conceptual framework for competencies includes developmental progression of leadership Self Others Wider Community Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_comp_3-0.pdf 6
MCH Leadership Competencies I. SELF 1. MCH Knowledge Base 2. Self-reflection 3. Ethics & Professionalism 4. Critical Thinking II. OTHERS 5. Communication 6. Negotiation & conflict resolution 7. Cultural Competency 8. Family-Centered Care 9. Developing Others Through Mentoring & Teaching 10. Interdisciplinary Team Building III. WIDER COMMUNITY 11. Working with Communities and Systems 12. Policy/Advocacy Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_comp_3-0.pdf Completing the Assessment For each item, consider level of experience you currently possess when selecting appropriate response Provide example of situation that has given you experience Identify items noted to be of high importance If understanding of or strength in competency was low or none, circle competency to indicate that this is an area for you to work on Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_skills_self-assessment_v3.0_june_2009.pdf Completing the Assessment I compared preterm birth rates among women in several TN counties. Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_skills_self-assessment_v3.0_june_2009.pdf 7
Scoring the Assessment Identify items noted to be of high importance If understanding of or strength in competency was low or none, circle competency to indicate that this is an area for you to work on Source: http://leadership.mchtraining.net/mchlc_docs/mch_leadership_skills_self-assessment_v3.0_june_2009.pdf Public Health Core Competencies Developed by the Council on Linkages Between Academia and Public Health Practice Linked to 10 essential public health services Released in 2001 Source: http://www.phf.org/resourcestools/pages/the_new_look_in_public_health_practice.aspx Public Health Core Competencies Eight domains: Analytic/Assessment Basic Public Health Sciences Cultural Competency Communication Community Dimensions of Practice Financial Planning and Management Leadership and Systems Thinking Policy Development/Program Planning Source: http://www.phf.org/resourcestools/pages/the_new_look_in_public_health_practice.aspx 8
Public Health Core Competencies Self-assessment tools for public health professionals Systematic assessment of individual skills related to each of the core competencies Based on current level within public health organization Public Health Core Competencies Tier 1 Tier 2 Tier 3 Day-to-day tasks of public health organizations Not in management positions Responsibilities may include: Basic data collection and analysis Fieldwork Program planning Outreach activities Programmatic support Other organizational tasks Program management and/or supervisory responsibilities Responsibilities may include: Program development Program implementation Program evaluation Establishing and maintaining community relations Managing timelines and work plans Presenting arguments and recommendations on policy issues Senior/management level and leaders of public health organizations Responsible for: Major programs or functions of an organization Setting a strategy and vision for the organization Building the organization s culture Typically have staff who report to them Completing the Assessment Select self-assessment tool most appropriate for your level (Tier 1, 2, or 3) For each item, mark score of 1-4 1=I I am unaware, or have very little knowledge of the item 2=I have heard of it; limited knowledge and/or ability to apply the skill 3=I am comfortable with knowledge or ability to apply the skill 4= I am very comfortable, an expert; could teach this skill to others Source: http://www.ncpublichealthacademy.org/ 9
Completing the Assessment Source: http://www.ncpublichealthacademy.org/ Scoring the Assessment Add total for each section Divide by number of items in section Focus attention on domains in which you scored 1 (no awareness) or 2 (limited knowledge and/or ability) Source: http://www.ncpublichealthacademy.org/ BREAK 10 Minutes 10
Core Competency Self-Assessment Self-Assessments Complete self-assessment if you have not already done so Identify the three domains on which you need to focus Place a sticker dot in three domains Identify common needs related to professional development Provide valuable feedback to ongoing development of MCH Navigator Inclusion of Professional Development in Core Competencies in Job Planning and Performance Evaluations 11
Key Elements for Change VISION SKILLS INCENTIVES RESOURCES ACTION =CHANGE PLAN SKILLS INCENTIVES RESOURCES ACTION =CONFUSION PLAN VISION INCENTIVES RESOURCES ACTION =ANXIETY PLAN VISION SKILLS RESOURCES ACTION =RESISTANCE PLAN VISION SKILLS INCENTIVES ACTION =FRUSTRATION PLAN VISION SKILLS INCENTIVES RESOURCES =TREADMILL Adapted from Knoster, T (1991). How do you get there from here? VISION What is our vision for building a competent MCH workforce? SKILLS What skills are needed? RESOURCES What resources can support workforce development? INCENTIVES Who benefits if you achieve your vision? ACTION PLAN How will you accomplish this vision? Vision Healthy People 2020 Objectives PHI-1: Increase the proportion of Federal, Tribal, State, and local public health agencies that incorporate Core Competencies for Public Health Professionals into job descriptions and performance evaluations Baseline: 15% of local health agencies incorporated core competencies into job descriptions in 2008 Target: 25% Source: HealthyPeople.Gov, Objectives PHI-1 and PHI-2. http://www.healthypeople.gov/2020/default.aspx 12
Vision Healthy People 2020 Objectives PHI-2: Increase the proportion of Tribal, State, and local public health personnel who receive continuing education consistent with the Core Competencies for Public Health Professionals Source: HealthyPeople.Gov, Objectives PHI-1 and PHI-2. http://www.healthypeople.gov/2020/default.aspx Skills MCH Leadership Core Competencies Core competencies available at: http://devleadership.mchtraining.net/mchlc_docs/mch_ docs/mch leadership_comp_3-0.pdf Self-assessments available at: http://leadership.mchtraining.net/mchlc_docs/mch_le adership_skills_self- Assessment_v3.0_June_2009.pdf Skills Public Health Core Competencies Core competencies available at: http://www.phf.org/resourcestools/pages/core_publicpublic _Health_Competencies.aspx Self-assessments available at: http://www.ncpublichealthacademy.org/ 13
Incentives Professional development Employment opportunities Promotion New opportunities Improvement in health and well-being of those who will benefit from your enhanced leadership skills Resources Stay tuned--details in just a few slides! Action Plan Elements of action plan: Focus area Which core competencies need developing? Action items How will you address your learning need? Completion Date Include in your annual job planning and performance evaluation process Also build this in to the planning and evaluation process for those whom you supervise 14
Key Elements for Change VISION SKILLS INCENTIVES RESOURCES ACTION =CHANGE PLAN SKILLS INCENTIVES RESOURCES ACTION =CONFUSION PLAN VISION INCENTIVES RESOURCES ACTION =ANXIETY PLAN VISION SKILLS RESOURCES ACTION =RESISTANCE PLAN VISION SKILLS INCENTIVES ACTION =FRUSTRATION PLAN VISION SKILLS INCENTIVES RESOURCES =TREADMILL Adapted from Knoster, T (1991). Practical Applications in Tennessee Personal Development Job Plans Performance Measurement and Feedback Students, Recruitment, and Succession Planning Inter- and Intra-departmental communication and planning Public Health Accreditation Practical Applications in Tennessee Personal Development Individualized training and development plan Job Plans Personal development plan linked to job plan Performance Measurement and Feedback Annual evaluation + Personal development and accomplishments linked to Performance Measures and Department goals Students, Recruitment, and Succession Planning 15
Practical Applications in Tennessee Work with other programs and divisions Re-organization and consolidation Budgeting and planning Quality Improvement and Public Health Accreditation Domain 8 maintain a competent public health workforce Domain 10 contribute to and apply the evidence base of public health Domain 8: Maintain a competent public health workforce Effective public health practice requires a well prepared workforce. A multi-disciplinary workforce that is matched to the specific community being served facilitates the interdisciplinary approaches required to address the population s public health issues. The manner in which services are provided to the public determines the effectiveness of those services and influences the population s understanding of, and appreciation for, public health. Continuous training and development of health department staff is required to ensure continued competence in a field that is making constant advances in collective knowledge and improved practices. Standard 8.1 Encourage the Development of a Sufficient Number of Qualified Public Health Workers Standard 8.2 Assess Staff Competencies and Address Gaps by Enabling Organizational and Individual Training and Development Opportunities Source: PHAB Standards and Measures (2011). Accessed December 28, 2011. http://www.phaboard.org/wp-content/uploads/phab-standards-and-measures-version-1.0.pdf Domain 10: Contribute to and apply the evidence base of public health The role health departments play in building and advancing the science of public health Public health is strengthened when its practitioners continually add to the body of evidence for promising practices -- those practices that have the potential to become evidence-based over time. Health departments should Employ evidence-based practices for increased effectiveness and credibility Contribute to developing new evidence Apply innovation and creativity in providing public health services appropriate for the populations they serve. Standard 10.1 Identify and Use the Best Available Evidence for Making Informed Public Health Practice Decisions Standard 10.2 Promote Understanding and Use of Research Results, Evaluations, and Evidence-based Practices with Appropriate Audiences Source: PHAB Standards and Measures (2011). Accessed December 28, 2011 at http://www.phaboard.org/wp-content/uploads/phab-standards-and-measures-version-1.0.pdf 16
Tools for Professional Development http://navigator.mchtraining.net MCH Navigator 17
New resource for MCH professionals working in state agencies and at the community level who seek to advance their learning and skills mastery Resource for undergraduate and graduate public health program faculty and students seeking to enrich and expand their learning portfolios and tools links individuals to existing open-access courses, organized in areas consistent with nationally endorsed public health and MCH leadership competencies Drawing from existing resources. Online Training Resources: Archived webcasts and webinars Instructional modules Self guided short courses Video and audio recordings Materials posted have undergone academic review and vetting by the primary MCH target audiences. Thank you to all the diverse partners who participated p in this labor of love Visit: http://navigator.mchtraining.net/ 18
Maternal and Child Health Leadership Skills Development http://www.jhsph.edu/wchpc/mchlds/index.html Next Steps: Moving Ahead with Workforce Development Activities Individual Development Plans Action plan is essential step in improving workforce competency Individual development plan (IDP) should include: Specific goal Action steps Resources needed Markers of success/completion Target date for completion 19
Individual Development Plans My First Major Goal: Knowledge to Gain/Skills to Build/Attitudes to Develop (What must I acquire/ improve?) 1. Proof (How will I know I did it?) Development Activities (How will I actually gain/build/ develop these?) Potential Mentors (Who might help me with my development?) Targeted Completion Date (When will I be there? 2. 3. Source: The Mentoring Group. Available at: http://www.mentoringgroup.com/html/articles/mentee_3.html Individual Development Plans My First Major Goal: Build basic data skills needed to perform basic program analysis. Knowledge to Gain/Skills to Build/Attitudes to Develop (What must I acquire/ improve?) 1. Identify data knowledge needs 2. Perform basic program data analyses 3. Proof (How will I know I did it?) List of relevant knowledge needs for job Able to create basic program data report Development Activities (How will I actually gain/build/ develop these?) Discussion with supervisor Coaching session with epidemiologist Potential Mentors (Who might help me with my development?) Supervisor, other program directors Department epidemiologist Targeted Completion Date (When will I be there? End of first month End of first quarter Source: The Mentoring Group. Available at: http://www.mentoringgroup.com/html/articles/mentee_3.html Success Stories/ Lessons Learned In your workforce development initiatives, what resources have you found to be helpful? D h t i f t t i Do you have any success stories for strategies to promote workforce development? 20
Contact Information Laura Kavanagh, MPP Director, Division of Research, Training and Education Maternal and Child Health Bureau Email: lkavanagh@hrsa.gov Web: http://www.mchb.hrsa.gov/training Cathy R. Taylor, DrPH, MSN, RN Dean, College of Health Sciences and Nursing, Belmont University Email: cathy.taylor@belmont.edu Web: http://www.belmont.edu/healthsciences/index.html Michael D. Warren, MD MPH FAAP Director, Title V/MCH, Tennessee Department of Health Email: michael.d.warren@tn.gov Web: http://health.tn.gov/mch 21