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Common Terminology in Operational Definition
Domain I: “Monitor health status and understand health issues facing the community”
Standard I-A “Obtain and maintain data that provide information on the community’s health…….”
Measure I-A:4 “LHD has an electronic linkage with local and statewide databases”
What Every Community Should Expect
Operational Definition of a Functional Local Health Department
Penney Davis, MPH Program Associate, NACCHO Staff
NACHO versus NACCHO
NACHO Definition: [NAH-choh] A crisp tortilla chip topped with melted cheese (usually cheddar) and chopped chiles, usually served as an appetizer or snack. Nachos sometimes appear on menus as "Mexican pizza," in which case they generally have additional toppings such as cooked, ground chorizo, onions and sometimes olives. NACCHO Definition: [NAY-choh] An association of dedicated public health professionals who represent over 3,000 local public health agencies (including city, county, metro, district, and Tribal agencies).
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Importance of the Standards
“..government public health agencies at federal, state, and local levels are the backbone of this public health system and must be strong.”
“The Future of the Public's Health in the 21st Century”,
Institute of Medicine, 2002
The 10 Essential Public Health Services…
use cartoon here
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NACo, USCM NCSL, NGA
Iterative Process
SHDs
CDC, HRSA
LHDs LBOH
- 1. Monitor health status and
understand health issues facing the community.
health problems and health hazards.
- 3. Give people the information they need to make
healthy choices.
- 4. Engage the community to identify
and solve health problems.
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policies and plans.
health laws and regulations.
receive health services.
public health workforce.
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programs and interventions.
- 10. Use and contribute to the
evidence base of public health.
Final Recommendations of the Exploring Accreditation Project
“NACCHO’s Operational Definition of a Functional Local Health Department should serve as the foundation of standards (and associated measures) for local health departments.”
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Prototype Metrics Your Role: Feedback for PHAB
- Individual LHD Demo Grants
- Collaborative LHD Demo Grants
- KS Regionalization Pilot Sites
“Public health is a complex concept, but the Operational Definition can help dispel the mystery. Eventually public health can be recognized and valued even when— particularly when—things are going well.”
Director, Arizona Department of Health Services
Closing Note
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Using the Operational Definition Prototype Metrics Assessment Tool to Conduct Local Health Department Internal Capacity Assessments
Janan Wunsch-Smith Janan Wunsch & Associates 515-490-6222 jananwunsch@mchsi.com
Performance Standards Under Each Essential Service
- Generally accepted objective standard of measurement
against which an organization’s level of performance can be compared
- Provide measurable standards that public health systems
can use to ensure the delivery of essential public health services
Operational Definition Prototype Metrics
- Provided Indicators under each standard that local public
health department’s could use to assess whether they were meeting the standards
- Provided illustrative evidence to assist in identifying
whether the indicators were being met
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Operational Definition Prototype Metrics Self- Assessment Tool
- Based on the Prototype Metrics-Revised
- Indicators are scored on a scale of 0-4
– Measurement of the capacity, either internal or through contract, to meet the indicator – Not every local health department will have the internal capacity to perform all indicators. They may need to contract
- r partner with another health department or entity to assure
their public has access to the services.
Scoring Directions…..
- Using the scale, score each indicator based on the capacity
within your Local Health Department (LHD). In your assessment, include both the capacity provided by your health department staff and through contracts and/or agreements with other entities.
- Note: To meet the standards, your department must assure
that the essential services are met, but does not have to provide all of them from within your agency.
Scoring Directions Continued….
- In the comment section, following each focus area please identify
partners (non-contract) at the local, regional, or state level that provide capacity to fulfill indicators in the section. – Other public health partners may provide the public health service as part of their mission/activities but without a formal contract/relationship with the LHD (Public Health System)
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Scoring Directions Continued….
- The items in the column labeled “Documents and/or Activities
That Demonstrate the Indicators Have Been Met” provide various documentation and types of activities that, if completed, demonstrate that the LHD meets that indicator. – These activities/products provide evidence that the LHD has the capacity to meet the indicator. There may be other evidence that will also demonstrate the capacity. These are not meant to be exclusive.
Scoring Continued…
Color Code Description Score Optimal capacity: There is significant planning, staffing and resources and significant to optimal activity and/or documentation to fulfill the indicator. 4 Significant capacity: There is significant planning, staffing, and
- ther resources and a moderate amount of activity and/or
documentation. 3 Moderate capacity: There is moderate planning, staffing and other resources to fulfill the indicator but only minimal activity and/or documentation. 2 Minimal capacity: There is minimal planning and staffing capacity to fulfill the indicator but no implementation activity or documentation. 1 No capacity: There is no capacity, planning, staff, resources, activities, or documentation to fulfill the indicator.
Scoring Instructions
- Any indicator that has a score of 0 — 2 is identified as in need of
increased capacity.
- Any indicator that has a score of 3 — 4 is indentified as having
adequate capacity.
- The only exception is if the indicator with a score of 0 — 2 has
another non-contract entity identified in the comment section as providing that service for the population, then that indicator would be considered covered by the other entity’s capacity.
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Performing the Assessment….Who Should Complete the Assessment?
LHD can select who will complete the assessment: – Recommend, where possible, a cross section of the department, representing all services areas – Some departments may only have a few staff and they may all choose to complete the assessment – One person may choose to complete the assessment, but should be the director or high level of management who knows all the activities of the department.
Performing the Assessment…. How should we perform the assessment?
- Each selected person completes the on-line assessment
independently and the scores for all those taking the assessment are averaged to get the score for each indicator.
- Each selected person completes the on-line assessment
independently and then the results are discussed and a consensus is reach as to the final score for each indicator.
- All those selected to complete the assessment discuss the
scoring and one score is entered on-line.
Performing the Assessment…..How long will it take?
- For individual LHDs to complete the assessment, it will take
around 2 hours
- To discuss the results from multiple scores and to come to
consensus on those that differ, it will take 4 or more hours
- To discuss each indicator and come to one agreed upon score
that is then entered on line, it will take 4 or more hours
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Data…How do we use it???
Aggregate the data by topic area (Individual LHD Project)
- Prioritize the topic areas and select the one/s that you want to
address for you QI project: – Establish a goal/s for the topic area – Put the indicators into categories and use the categories to write objectives – Use the individual indicators under the topics to help identify activities that would become components of a work plan to meet the objectives.
Data…How do we use it???
Aggregate the data according to the indicators under the standards that fall below an average score of 2.5 points capacity. – Identify the standards with the least capacity. – Prioritize the standards needing the most improvement. – Create a goal for increasing capacity for the standard and use the indicators without adequate capacity for identifying
- bjectives and work plan components for the QI plan.
If we have a collaborative application, how do we use the data?
- Aggregate your individual health department data by
topic areas and/or standards that need the most improvement.
- Whether to work with the topic data or the standards
needs to be determined by the partnering health departments
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If we have a collaborative application how do we use the data?
- Analyze the data from the partnering LHDs to determine the
common topic areas and/or standards that are in need of increased capacity for all involved LHDs.
- Prioritize the topic areas/standards and identify one area to
address through a collaborative plan.
- Use a planning process to establish a formal mechanism to use
in collaborating to increase capacity for all the partnering health departments
Topic Areas vs. Standards
- Aggregated data by topic area gives a broader impact on the
capacity of the health department/s involved
- One topic area may cover capacity under multiple standards. i.e.
Community Health Assessment and Improvement Plan
- Standards that need increased capacity may involve multiple
topics making it more difficult to prioritize and plan
- Press *1 on your touch-tone phone to ask a
live question OR
- Type your question in the “questions” box
located on the lower left side of your screen
Questions for Janan
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Online Self-Assessment Software Module
Bill Barberg InsightFormation, Inc. billb@insightformation.com 763-521-4599 x13
Addressing Multiple Needs for Software (Part 1)
- Flexible On-line Scorecard
–Secure and personalized for each Local Health Departments (LHD) –Visualize Performance
–Easy Data Entry (with an audit trail) –Calculate and Report Averages
- Average score for a Standard
- Average score for a collaborative peer group
–Comments –Ability to upload supporting information
Addressing Multiple Needs for Software (Part 2)
- Integrated Survey Capabilities
–Provide feedback for each question –On-line tool that can be revisited throughout the project –Secure and linked in with the assessment tool –Reporting capabilities
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Addressing Multiple Needs for Software (Part 3)
- File Upload and Collaboration
– Secure and personalized by Local Health Departments – Option to provide upload files related to specific standards – Able to share files with NACCHO – Uploaded files may support multiple indicators – Version Control for Documents (view older versions) – Optional additional capabilities
- Messages (with “threaded” replies)
- To-Do Lists
Use of this functionality is not required for the self-assessment process
AND…
- Must be rapidly deployed
- Must be easy to use
- Must be economical for deploying to at least 50 LHDs
Integrating Three Applications
Flexible On-Line Scorecard Integrated Survey Capabilities File Upload and Collaboration
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Logging In to InsightVision Logging In Logging In
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Home Page Home Page Home Page
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Home Page Home Page Scoreboard
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Scoreboard Scoreboard Click to view Standard “InfoSheet”
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Scoreboard View Operational Definition Indicator “InfoSheet” View Operational Definition Indicator “InfoSheet”
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View Operational Definition Indicator “InfoSheet” Scoreboard
Collapsed to 10 Essential Services
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Collapsed to 10 Essential Services Collapsed to 10 Essential Services
Data Entry Screen
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Selecting a Measure Selecting a Measure Selecting a Measure
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Selecting a Measure Adding New Actual Value Adding New Actual Value
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Adding New Actual Value Adding New Actual Value After a Value is Added
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After a Value is Added Adding a Comment After a Value is Added
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ScoreBoard with Data ScoreBoard with Data ScoreBoard with Data
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ScoreBoard with Data Selecting a Different Scorecard Selecting a Different Scorecard
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Summary Scorecard Summary Scorecard Color Band Thresholds for Calculated Averages
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Summary Scorecard Drill-down to Details Drill-down to Details
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Responding to the Survey Project Screen
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Survey Landing Page Scrolling Down Scrolling Down
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Scrolling Down Scrolling Down Scrolling Down
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Checking the Section to Jump To Checking the Section to Jump To Checking the Section to Jump To
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Survey on Metrics for a Standard Survey on Metrics for a Standard Second Question for Standard IV-A
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Bottom of the Survey Page Bottom of the Survey Page
Use << Prev not the Back Button on your Browser to Save your Responses!
Survey Landing Page (Close the Window when Done)
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Magnifying Glass Links Link to Upload Documents Basecamp File Upload
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Basecamp File Upload Uploading a file to Basecamp Uploading a file to Basecamp
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Uploading a file to Basecamp
- Press *1 on your touch-tone phone to ask a
live question OR
- Type your question in the “questions” box
located on the lower left side of your screen
Questions for Bill and NACCHO
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Thank you for joining today Thank you for joining today’ ’s s webcast webcast! !
If you have additional questions, contact Penney Davis at If you have additional questions, contact Penney Davis at pdavis@naccho.org or (202) 783
- r (202) 783-
- 5550, Ext. 265
5550, Ext. 265
