Completing community health assessments and community health improvement plans for accreditation preparation: Findings from a national demonstration project

Completing community health assessments and community health improvement plans for accreditation preparation: Findings from a national demonstration project

Reena Chudgar

Program Analyst, Assessment and Planning for

Accreditation Preparation

NACCHO

10/29/12

Presenter Disclosures

(1)The following personal financial relationships with commercial

interests relevant to this presentation existed during the past 12

months:

Reena Chudgar

“No relationships to disclose”

By the end of this session, participants will be able to:

1. Define community health assessments (CHAs) and community health

improvement plans (CHIPs) in the context of accreditation.

2. Discuss the lessons learned from a national demonstration project of local health

departments who used MAPP and other community health improvement process

frameworks/models to complete CHAs and CHIPs for accreditation preparation.

3. Assess the use of MAPP or other community health improvement process

frameworks/models for their own community's efforts to prepare for public health

accreditation.

4. Name the resources available to local health departments and their partners to

conduct CHAs and CHIPs for accreditation preparation.

Session Learning Objectives

Definition: Community Health Improvement Process

An ongoing, collaborative, community-wide effort to identify and address health problems through coordinated activities. It may include environmental, business, economic, housing, land use, and other community issues indirectly affecting the public’s health.

(Adapted from National Public Health Performance Standards Program, Acronyms, Glossary, and Reference Terms, CDC, 2007. www.cdc.gov/nphpsp/PDF/Glossary.pdf).

Definition: Community Health Assessment

A community health assessment is a process that uses quantitative and qualitative methods to systematically collect and analyze health status data within a specific community. The process should involve active community engagement.

Health status data include information on risk factors, quality of life, mortality, morbidity, community assets, and other information that illustrates why health issues exist in a community.

Community health assessment data inform community decision-making, the prioritization of health problems, and the development and implementation of community health improvement plans.

(Issel 2004, Cibula et al 2003, Dever 1997)

Definition: Community Health Improvement Plan

An action-oriented plan outlining the priority community health issues (based on the community health assessment findings and community member and LPHS partner input) and how these issues will be addressed, including strategies and performance measures, to improve the health of a community. The CHIP is developed through the community health improvement process.

7

National Context

• Public Health Accreditation Board

• Patient Protection and Affordable Care Act of 2010: IRS

Community Benefit Requirement

• Program-specific assessments

• Economic Downturn

• Other organizations conducting similar work or CHAs

(e.g., FQHCs, United Way)

8

Momentum and Opportunity

• Collaborate

• Leverage and share resources

• Meet multiple organizations’ requirements

• Increase efficiency

• Quality Improvement

National Accreditation of Health Departments

• Goal: To improve and protect the health of every community by advancing the quality and performance of public health departments (state, local, tribal, territorial)

• Accreditation is a status that provides public notification that an agency meets standards of quality set forth by an accrediting agency

• Public Health Accreditation Board’s program launched in September 2011

Accreditation Prerequisites

1. Community Health Assessment (CHA)

2. Community Health Improvement Plan (CHIP)

3. Agency Strategic Plan

Community Health Improvement Process Steps

Prepare and Plan Engage the Community Develop a Vision* Conduct Health Assessment(s) Prioritize Health Issues Develop a Health Improvement Plan Implement Health Improvement Plan Evaluate and Monitor

*Not required by PHAB

Association for Community Health Improvement Framework

13

• Mobilizing: Engaging the community• Action: Implementing a health

improvement plan• Planning: Applying strategic planning

concepts• Partnerships: Involving local public

health system and community partners

Mobilizing for Action Though Planning and Partnerships

14

MAPP Overview

CHAs and CHIPs for Accreditation Preparation Demonstration Project

Goal: To increase the readiness of local health departments (LHDs) to apply for PHAB accreditation by building the capacity of LHDs to engage in a community health improvement process that yields a CHA and a CHIP, two of the three prerequisites for PHAB accreditation application.

Funded by the Robert Wood Johnson Foundation

16


Demonstration sites will produce CHAs and CHIPs that will:

(1) Engage community members and local public health partners in a

meaningful way;

(2) Address the social determinants of health; and

(3) Use quality improvement and quality planning techniques.

These CHAs and CHIPs are intended to serve as exemplary CHAs and

CHIPs for accreditation preparation.

17


The project also aims to:

Model meaningful LHD collaboration with select

local public health system (LPHS) partners in

the community health improvement process.

18


The demonstration sites received:

• A $35,000 grant

• Comprehensive in-person and Web-based

training and technical assistance

19

CHAs and CHIPs for Accreditation Preparation Demonstration Sites

20

Demonstration Site Specifics

• 10 of the 12 sites are using MAPP

• 2 of the 12 sites are using the Association for Community Health

Improvement (ACHI) Framework

• Vary in levels of experience in completing a community health

improvement process

• Vary in size, location and type of populations served

21

Project-specific Approaches

#1: LHDs that co-lead the community health improvement process with non-profit hospital(s) to conduct a CHA and develop a CHIP that meet the requirements for this project and substantially helps the hospital(s) fulfill their community health needs assessment requirement, such as the IRS community benefit requirement. 5 Sites

#2: Regional or district LHDs (i.e., single-governance entities that serve two or more counties, townships, cities, etc.) in which the CHA and CHIP reflect the needs of all governmental jurisdictions. 2 Sites

#3: Two or more LHDs, with a formal agreement to share services, that jointly conduct a CHA and develop a CHIP(s) that reflect the needs of all participating jurisdictions. 2 Sites

#4: LHDs that collaborate with a tribe(s) in their jurisdiction, in which the CHA and CHIP reflect the needs of the tribe as well as the broader community. 1 Site

#5: LHDs that receive assistance in undertaking the community health improvement process from academic institutions. 5 Sites

#6: LHDs that partner with a public health institute in the community health improvement process. 1 Site


Prepare and Plan

Engage the Community

Develop a Vision

Conduct Health Assessment(s)

Prioritize Health Issues

Develop a Health Improvement Plan

Implement Health Improvement Plan

Evaluate and Monitor

22

23

Demonstration Site Strategies for Success During the Preparing and Planning Phase

• Review PHAB Standards and Measures upfront to know what is expected

• Choose a model/framework that works for your community

• Plan Plan Plan!

• Ensure enough time for planning and implementation

• Create a timeline


Prepare and Plan

Engage Partners and Community

Develop a Vision






24

25

Demonstration Site Strategies for Success During the Engagement Phase

• Engage partners throughout the process, not just the start

• Spend ample time engaging partners upfront and explaining the value and mutual benefit

• Identify champions

• Use the process as an opportunity to increase knowledge of health department’s role in

community

• Provide and share information in a language that everyone can understand

• Communicate with governing entities early and often

• Institutionalize partnerships by formal agreement

• Establish roles, responsibilities and expectations for all involved

• Communicate openly

• Balance time commitment with understanding that all are busy


Prepare and Plan


Develop a Vision






26

27

Demonstration Site Strategies for Success During Developing a Vision

• Ensure a broad spectrum of partners are involved in visioning

• Consider using a neutral facilitator for the session

• Do not get hung up on language/wording if it is holding back progress

• Use the vision statement throughout the process moving forward to keep

focused


Prepare and Plan


Develop a Vision






28

29

Demonstration Site Strategies for Success During Conducting the CHA

• Do not reinvent the wheel – use data, resources, etc. that already exist

• Do not get caught up in collecting too much information - Ensure there’s

enough time for planning and implementation

• Use social media to communicate out information

• Use qualitative, quantitative, primary, and secondary data


Prepare and Plan


Develop a Vision






30

31

Demonstration Site Strategies for Success During Prioritization of Issues

• Involve key stakeholders to ensure buy-in

• Determine goals, criteria and methods in advance of the meeting

• Ensure all participants have access to data and other information that will

be used


Prepare and Plan


Develop a Vision






32

33

Demonstration Site Strategies for Success During Developing the CHIP

• Consider incorporating early wins

• Acknowledge that not everything can be accomplished so focus on the vital

few among the important many

• Create an action plan that provides clear roles and responsibilities

• Plan for future meetings to check on progress


Prepare and Plan


Develop a Vision






34

35

Demonstration Site Successes

• Use of a framework/model provided structure and access to many resources

• Resulted in new or strengthened partnerships

• Leveraging of resources

• Alignment of similar initiatives in community

• Opportunity to increase knowledge of the local health department’s role in

community

• Received press coverage

• Setting the foundation

• Dividing and conquering for great impact

• Use of Quality Improvement and Quality Planning techniques

• Received great community response

36

Demonstration Site Challenges

• Time

• Staff/Manpower

• Transition in key players and partners

• Sustaining momentum - through process and partner

engagement

• Diverse understanding of Social Determinants of Health

37

CHA/CHIP Resource Center

• Online, public resource center

• Provides practical, customizable tools and resources such as: •Community vision statements.•Advisory committee invitations.•Tip sheet on prioritization methods.

• Contains free, archived CHA and CHIP training webinars and materials

• By early 2013 it will contain the example CHAs and CHIPs from the

demonstration sites

www.naccho.org/chachipresources

38

Other NACCHO Resources

• MAPP Clearinghouse of Resources:

http://www.naccho.org/mapp

• Accreditation Preparation and Quality Improvement Website:

http://www.naccho.org/accreditation

39

Reena Chudgar

Program Analyst, Assessment and Planning for Accreditation Preparation

NACCHO

[email protected]

202-507-4220

Documents

Completing community health assessments and community health improvement plans for accreditation preparation: Findings from a national demonstration project