Strategy Overview - Montana

Strategy Overview - Montana

March 14, 2012 Mesa Institute for Leadership 1 Public Health and Safety Division Integrated Management System - Introduction to Logic Model - March 14, 2012 2 Why Integrated Management System? PHAB Accreditation Recognition Enhance Funding Opportunities Improve Performance Budgetary Cuts Greater Need to Demonstrate Effectiveness Unsympathetic Public & Policy Makers March 14, 2012 PHSD Performance Management System 3 Why Integrated Management System? Coordinated Chronic Disease Prevention and

Health Promotion Program develop organizational capacity and management approaches to deal with chronic diseases holistically, not just as separate conditions. Dr. Thomas Frieden March 14, 2012 PHSD Performance Management System 4 PHSD Integrated Management System Are We On Track? Tasks Dollars Outcomes Define the Problems and Priorities Have We Attained High Level Outcomes? Why or Why Not? Decide How To Attain Desired Outcomes Performance Management System Do The Work

Plan Required Work Tasks & Resources Allocate Dollars To Do Planned Work Support Build Capacity To Do Work March 14, 2012 PHSD Integrated Management System 5 Integrated Management System Documents State Public Health Improvement Plan State Public Health Assessment Strategic Objectives & Metrics PHSD Program/ PHSD Activity Program/

PHSD Operational Activity Program/ PHSD Plan Operational Activity Program/ PHSD Plan Operational Activity Program/ PHSD Plan Operational Activity Program/ Plan Operational Activity Plan Operational Plans PHSD Program/ PHSD Activity Program/ PHSD Operational

Activity Program/ PHSD Plan Operational Activity Program/ PHSD Plan Operational Activity Program/ PHSD Plan Operational Activity Program/ Plan Operational Activity Plan Operational Plans Performance Management System Program/ Activity Metrics PHS

Division Strategic Plan PHS Division Budget Support March 14, 2012 PHSD Integrated Management System 6 Program Definition Groupings of activities that provide certain products or services with a common purpose. A set of activities undertaken to realize one common purpose with an identifiable end result or outcome. March 14, 2012 PHSD Performance Management System 7 Built On Logic Model Need to Subdivide Work

Programs are too large to manage easily Common practice is to break the work down into a structure of more manageable, smaller pieces Each subdivision of the work to be done focuses on smaller pieces of the work with more detail March 14, 2012 8 Bureau Chronic Disease Subdividing Work Into More Manageable Pieces Emergency Medical Services Healthcare Provider Education Cardiovascula r Disease School and Childcare

Training Asthma MT Asthma Home Visiting Tobacco Prevention Asthma Care Monitoring System Diabetes Program March 14, 2012 Core Activity (Project or Process) Makes a very complicated life much easier to manage! PHSD Performance Management System 9 Core Activity Definition A discrete unit of work with a common purpose One-Time Project or Continual Work Process Budgetary unit

Requires a Work Plan (Operational Plan) Program: Asthma March 14, 2012 versus Core Activity: Asthma Home Visiting Provider Education School & Childcare Training PHSD Performance Management System 10 Linked Cascading Chain of Cause-And-Effect Example Desired Outcomes Chronic Disease Bureau Montanans possess the highest possible level of health. Diabetes Program Individuals avoid diabetes complications and maintain quality of life.

Asthma Program Quality of life of all Montanans with asthma is improved. Fewer individuals contract HIV. Collective Intermediate Results March 14, 2012 Children with asthma and their families selfmanage asthma in the home environment. Asthma Care Monitoring System Clinics follow EPR-3 guidelines in their clinical care. School & Childcare Training HIV Program Bureau Result Meets a Public Need or Solves a Public Problem MT Asthma Home-Visiting (MAP)

PHSD Integrated Management System School and childcare staff use evidence based practices in managing asthma. Core Activity Tasks: Provide asthma training to staff of 25 middle schools. Provide asthma assessment training to 30 school nurses. 11 Linked Cascading Chain of Cause-And-Effect MT Asthma Home-Visiting (MAP) Diabetes Program Example Metrics Chronic Disease Bureau Average Years of Potential Life Lost Number of school days missed in last 6 months by program participants. Number of individuals per 100,000 population

who develop diabetes monthly Asthma Care Monitoring System Asthma Program Percent of active patients receiving education on at least 3 of 4 ASME topics in the last year. Number of statewide asthma related emergency department visits. School & Childcare Training Communicable Disease High level outcome metric ( Impact ) Number of days from outbreak initiation until notification of jurisdictions / public Intermediate outcome metrics

March 14, 2012 Number of school staff or child care providers who received training during the past calendar year. Detailed, operational and tactical metrics PHSD Performance Management System Activity C Tasks: Provide asthma training to staff of 25 middle schools. Provide asthma assessment training to 30 school nurses. 12 Linked Cascading Chain of Cause-And-Effect Example Desired Outcomes Chronic Disease Bureau Montanans possess the highest possible level of health.

Diabetes Program Individuals avoid diabetes complications and maintain quality of life. Asthma Program Quality of life of all Montanans with asthma is improved. Children with asthma and their families selfmanage asthma in the home environment. Asthma Care Monitoring System Clinics follow EPR-3 guidelines in their clinical care. School & Childcare Training HIV Program Fewer individuals contract HIV. March 14, 2012 MT Asthma Home-Visiting (MAP) PHSD Integrated Management System School and childcare staff use evidence

based practices in managing asthma. 13 Linked Cascading Chain of Cause-And-Effect Diabetes Program Example Metrics Chronic Disease Bureau Average Years of Potential Life Lost MT Asthma Home-Visiting (MAP) Number of school days missed in last 6 months by program participants. Number of individuals per 100,000 population who develop diabetes monthly Asthma Program Number of statewide asthma related emergency department visits. Asthma Care Monitoring System Percent of active patients

receiving education on at least 3 of 4 ASME topics in the last year. School & Childcare Training Communicable Disease Number of days from outbreak initiation until notification of jurisdictions / public March 14, 2012 PHSD Performance Management System Number of school staff or child care providers who received training during the past calendar year. 14 Can You Understand What Asthma Program Does? Take two minutes to read the Asthma Program Logic Model Can you describe two things the Asthma Program does and why? How will we know if their work is successful? What is the value of quickly communicating

what we do, why, and how effective we are? To legislators? To budget committees? To CDC? To front line employees? To the public (e.g. Independent Record, etc.)? March 14, 2012 PHSD Integrated Management System 15 Summary Performance Management System Support March 14, 2012 16 Division Wide Implementation Not changing what work is done

refining how work is managed System built on logic models Each program Construct program logic model Develop one work plan for each Core Activity Initiate regular Performance Review Meetings Sharepoint Coordinate work plans with CDC requirements March 14, 2012 PHSD Integrated Management System 17 Logic Model & Work Plan Development Brainstorm Session Tasks One 3 hr Identify Core Activities Logic Model Training Refine Program Session Logic Model Two 2-3 hr

Work Plan Training Select Core Activity to Develop First Work Plan Develop Program Logic Model Prepare First On Own Work Plan Time Independently Learning Session Exercise: Three Review First Work Plan 1 hr March 14, 2012 Complete Other Work Plans Independently PHSD Integrated Management System 18 Logic Model & Work Plan Development After Bureau Chief

Reviews Plans All Plans And Authorizes Finished After Bureau Logic Model Establish Schedule for Program/ Activity Review After Revise Annual Division Work Plan for Strategic Next Fiscal Year Plan Develop Bureau Desired Outcomes and Metrics Revise Program Logic Models Outcomes and Metrics Program/ Activity Mgrs. Update Work Plans

Initiate Program/ Activity Review Meetings Finalize Work Plans Through Budget Process Produce Bureau Logic Model Continue The Cycle Performance Management System Support March 14, 2012 PHSD Integrated Management System 19 Why are we doing all this? Performance Management System

Support March 14, 2012 PHSD Integrated Management System 20 Performance Management System PHAB Standard Definition A fully functioning performance management system that is completely integrated into health department daily practice at all levels includes: 1. setting organizational objectives across all levels of the department 2. identifying indicators to measure progress toward achieving objectives on a regular basis 3. identifying responsibility for monitoring progress and reporting Performance Management System 4. identifying areas where achieving objectives requires focused quality improvement processes. (Public Health Accreditation Board. Standards and Measures Version 1.0. Alexandria, VA, May 2011).

March 14, 2012 PHSD Integrated Management System Support 21 Performance Management System Processes, information, and systems used by managers to: Set strategy Develop plans Monitor execution Forecast performance Report results Performance Management System Support March 14, 2012 PHSD Integrated Management System 22 Why manage systematically? Integrated Management System Systematic approaches ensure sustained high

performance by design not chance. Every system is perfectly aligned to achieve the results it creates. Process determines performance. The results of an aligned system far exceed a system that fights against itself. Performance Management System Support March 14, 2012 PHSD Integrated Management System 23 The End March 14, 2012 PHSD Integrated Management System 24

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