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2014: New Domains, New Measures, New Data

Briefing Slides

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Contents

• NHSPI™ Overview and Background

• The 2014 NHSPI™

• 2014 NHSPI™ Results

• Using the NHSPI™ Results

• Future Direction and Next Steps

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What is the National Health Security Preparedness Index™ (NHSPI™)?

A first of its kind tool to annually measure and advance our preparedness

Examines health security preparedness of the nation by collectively looking at states

Evolving focus on public health, healthcare, and more

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Why an Index?

• Evaluates levels of complex things – economy (e.g., Consumer Price Index), health (e.g., Well-Being Index), etc.

• Provides more meaningful information groupings than sum of individual parts or measures

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Why is the Index Important?

Provides the most

comprehensive set of measures

to date

Assesses how well we are

prepared for emergencies

Guides improvement

efforts

Enhances understanding of what health security entails

• Before NHSPI™, many different benchmarks measured numerous aspects of preparedness

• No composite picture on topic existed

• Complexity of preparedness has made understanding and assessing it confusing to most audiences

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Why the Index is UniqueGuiding Principles for DevelopmentOn Health Security:

1. Includes many influencing factors of our nation’s health security

2. Emphasizes shared responsibility for our nation's health security among the whole community, including all sectors and jurisdictions

3. Uses broad PPD-8 preparedness definition

4. Incorporates fundamental disaster risk reduction and primary prevention concepts

On Index Development:

5. Is practical and of greater use than what we currently have

6. Builds on public-use data; no added data collection burdens to practitioners

7. Aligns with existing national health security and preparedness capabilities / frameworks

8. Aims to reflect health security preparedness of states and the nation

9. Includes a transparent process of continuous improvement, stakeholder involvement, and real-world experience

On Index Use:

10. Groups information into more meaningful picture than sum of its parts

11. Advances the science of measuring health security preparedness

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MethodologyCalculate Values and

Produce Annual NHSPI™

Input from Stakeholders;

Refinement of Model

Develop Structure, Incorporate New Areas

Identify and Evaluate Measures

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Practice Experts + Academic Experts + Policy Experts

Stakeholder Review and Engagement

Refined and Expanded Index

Structure

Vetted Candidate Measures

through Expert Groups

Populated Index Structure with

Applicable Measures

State PreparednessDirectors and

Colleagues

NHSPITM Workgroup

Members

Representatives from 48 National

Associations

Commitment to thoroughness, transparency, and stakeholder engagement.

2014 NHSPI™ Development Process

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Contents

• NHSPI™ Overview and Background

• The 2014 NHSPI™

• 2014 NHSPI™ Results

• Using the NHSPI™ Results

• Future Direction and Next Steps

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2014 NHSPI™: What’s New

The NHSPI™ has expanded in both scope and depth

Updated and new data to better reflect the current cycle of protection, mitigation, preparedness, response, and recovery

2014 Index has 6 domains, 18 sub-domains, and 194 measures building upon 2013 structure

Major structural changes:

New domain:Environmental & Occupational Health

Overhaul: Healthcare Delivery (previously Surge

Management) domain

New sub-domain: Legal & Administrative

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2014 NHSPI™ Structure

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Contents

• NHSPI™ Overview and Background

• The 2014 NHSPI™

• 2014 NHSPI™ Results

• Using the NHSPI™ Results

• Future Direction and Next Steps

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2014 NHSPI™:Results for the Nation

Domain Sub-domain National Results State RangeHealth Security Surveillance 7.8 6.0 – 9.2

Health Security Surveillance & Epi Investigation 7.9 5.8 – 9.9Biological Monitoring & Laboratory Testing 7.6 5.8 – 9.3

Community Planning & Engagement 6.7 5.3 – 8.8

Cross Sector / Community Collaboration 6.4 2.0 – 10Children & At-Risk Populations 5.8 2.4 – 8.4Management of Volunteers During Emergencies 6.0 4.4 – 9.6Social Capital & Cohesion 8.4 7.1 – 9.6

Incident & Information Management 8.1 6.6 – 9.5

Incident Management & Multi-Agency Coordination 8.2 6.3 – 9.7Emergency Public Information &Warning 8.0 5.1 – 9.7Legal & Administrative 8.1 5.9 – 10

Healthcare Delivery 6.5 5.5 – 7.4Pre-hospital Care 6.6 3.2 – 8.7Inpatient Care 5.8 3.5 – 7.3

Long-Term Care 6.2 4.3 – 7.7Mental & Behavioral Healthcare 6.0 4.3 – 7.9Home Care 8.0 6.9 – 9.4

Countermeasure Management 9.1 7.5 – 9.7

Medical Materiel Management, Distribution, & Dispensing 9.4 7.2 – 10Countermeasure Utilization & Effectiveness 8.8 7.8– 9.7

Environmental & Occupational Health 5.9 3.3 – 8.3Food & Water Security 6.7 4.1 – 9.7Environmental Monitoring 5.2 1.5 – 7.1

Overall Index Results: 7.4 Overall State Range: 6.5 - 8.2

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2014 NHSPI™ Results at NHSPI.org

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2014 NHSPI™:Results for the Nation

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2014 NHSPI™:Results for the States

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2014 NHSPI™ National ResultsStrengthsThree areas (i.e., domains) of health security preparedness strength:

Incident &Information

Management

Result: 9.1

CountermeasureManagement

Result: 8.1 Result: 7.8

Health SecuritySurveillance

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2014 NHSPI™ National ResultsStrengthsSix relative areas (i.e., sub-domains) of health security preparedness strength:

CountermeasureManagement

Medical Materiel

Management, Distribution,& Dispensing

Result: 9.4

CountermeasureUtilization &Effectiveness

Result: 8.8

Incident & InformationManagement

Incident Management &

Multi-AgencyCoordination

Result: 8.2 Result: 8.1

Legal &Administrative

Health SecuritySurveillance

HealthSurveillance &

EpidemiologicalInvestigation

Biological Monitoring &

LaboratoryTesting

Result: 7.9 Result: 7.6

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2014 NHSPI™ National ResultsAreas in Greater Need of DevelopmentThree key areas (i.e., domains) in greater need of development:

Environmental &Occupational

Health

HealthcareDelivery

Community Planning &

Engagement

Result: 5.9Result: 6.5 Result: 6.7

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2014 NHSPI™ National ResultsAreas in Greater Need of DevelopmentThree relative areas (i.e., sub-domains) reflecting need for work:

Environmental &Occupational

HealthHealthcare

Delivery

Community Planning &

Engagement

Result: 5.2

Environmental Monitoring

Inpatient Care

Result: 5.8 Result: 5.8

Children & OtherAt-Risk

Populations

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2014 NHSPI™ State ResultsRelative to National Averages Structure View for State A

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2014 NHSPI™ State ResultsRelative to National Averages Structure View for State A

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2014 NHSPI™ State ResultsMeasure ResultsReport View for State A

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Example Measure Detail

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Contents

• NHSPI™ Overview and Background

• The 2014 NHSPI™

• 2014 NHSPI™ Results

• Using the NHSPI™ Results

• Future Direction and Next Steps

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Who is the NHSPI™ for?Emergency

Management Personnel

City and Regional Planners

Healthcare Preparedness Staff

Community Coalitions and

Advocacy Groups

Federal and State Legislative Staff

Public Health, and more…

The Index is intended to be used to:• Support quality improvement,• Inform resource and policy decisions,• Enhance collaboration and strengthen shared responsibility, and• Advance the science of measuring preparedness.

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NHSPI™: Driving Dialogue Around Results

Examine results at the national

or state level

Examine results in relation to national averages and broad groupings of state results

Areas of relative strength and areas for further development

Stakeholder dialogue offers greater context and can galvanize improvement efforts

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Beyond the Numbers

Usefulness also lies in NHSPI™ content and structure

Understanding the types of efforts required to advance health security preparedness

Emphasizing relationship between the strength of everyday systems and disaster response capability

Guiding inquiry needed for informed resource and policy decisions

Fostering new partnerships and collaborations

Serving as a call for addressing gaps in measurement and advancing preparedness science

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Too soon for formal evaluation, though comments and early experience suggest:

Sharper understanding of what is involved in health security

Renewed interest in system assessment

Opportunities for new collaborations around preparedness

What Effect is It Having?

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Contents

• NHSPI™ Overview and Background

• The 2014 NHSPI™

• 2014 NHSPI™ Results

• Using the NHSPI™ Results

• Future Direction and Next Steps

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New Leadership from RWJF The Robert Wood Johnson Foundation (RWJF)

will take over as owner and manager of the NHSPI™ in late 2014 University of Kentucky selected as the new Program

Management Office

National Advisory Committee appointments in process (replaces current Steering Committee)

RWJF and UK are committed to remaining engaged with current stakeholders and expanding engagement with new sectors

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The NHSPI™ will continue to evolve with input from stakeholders, experience from use, and model refinements.

Future Directions

The Future of the NHSPI™

Incorporate additional sectors

Model refinement and validation

Expand tools to support use

Build capability for trending

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Stakeholders will continue to shape the Index!Receive updates and share ideas at www.nhspi.org.

Send input on the Index

structure and uses

Join the NHSPI™ mailing list

View the NHSPI™

calendar of events

Built by the Community, for the Community

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For More InformationWebsitewww.nhspi.org

General Inquiriesnhspi-info@astho.org

Media InquiriesScott Briscoe ASTHOSenior Director, Communications and Marketingsbriscoe@astho.org571-527-3173

For inquiries relating to the transition in leadership:Alexis LevyCommunications Officer, Robert Wood Johnson Foundationalevy@rwjf.org609-627-5702