Public Health Performance Management

What Is Public Health Performance Management?

DPH and its local and community partners carry out a great variety of programs and activities to promote, protect, and improve the health of Connecticut residents. To assure our population that the state's public health system is operating efficiently and effectively, a formal process is needed to track the work performed and the outcomes achieved, and to compare results with established standards.

Performance measurement is the process of developing suitable indicators and using them to track and assess the progress of programs and activities. Performance management is the overall process of using performance data to improve public health activities and achieve desired health outcomes. As shown in the illustration below, a performance management system has four key components.

Source: Turning Point Performance Management Collaborative

What Are the Benefits of Public Health Performance Management

A public health performance management system will benefit Connecticut in many ways.

• It allows health departments and their constituent programs to reassess their goals and objectives-- where they want to go, and the best ways to get there.
• It allows progress toward objectives to be tracked, and activities and practices to be evaluated and improved.
• It helps health departments and programs to identify problem areas and gaps and to target solutions, ultimately to improve the quality, effectiveness, and efficiency of programs and services. Performance and outcome data can be used to reallocate resources and redesign programs and activities to address any identified gaps.
• It helps to ensure accountability to the people served by public health agencies and to the State, federal, and private entities that provide funds and other resources for public health programs and services. It also promotes examination of roles and responsibilities, and levels of authority.
• It creates new opportunities for partnering with other health agencies, programs, organizations, and other stakeholders in the public and private sectors. Collaboration helps to fill gaps, eliminate duplication of effort, and get things done more efficiently.
• It can serve as the basis for performance-based contracting and payment systems that create incentives for improved service delivery.
• It provides information that can be communicated to the larger public health community and to the legislature and other government branches. In this way, it promotes rational policy development and allocation of resources, including funding, personnel, equipment, programs, services, information, and technical assistance.
• It enables consumers and their families to make better choices about their health practices and health care options.

Public Health Accreditation

The supplemental NPHII grant will be used chiefly to prepare DPH for national accreditation by fulfilling three prerequisites:

• Conducting a state health assessment 
• Developing a state health improvement plan
• Creating a strategic plan for the Department of Public Health

What is National Public Health Accreditation?

The Public Health Accreditation Board  (PHAB), a non-profit organization funded by the CDC and Robert Wood Johnson Foundation, was created in 2007 to develop and implement a voluntary national public health accreditation program. The program's purpose is to help public health departments assess their current capacity to carry out their 3 core functions and 10 essential services (see illustration), and guide them to become better by improving service, value, and public accountability. These enhancements lay the groundwork for improved health outcomes.

Source: Adapted from Centers for Disease Control & Prevention, Public Health in America

Accreditation involves three steps:

• Developing a set of standards;
• Measuring the health department's performance against those standards;
• Recognizing or rewarding the agency for meeting the standards.

The PHAB Board of Directors has proposed Standards, Measures, and Documentation Guidance for State Health Agencies.  The benefits and rewards of national accreditation are listed below.

What Are the Benefits of National Accreditation?

• Allows public health agencies to engage in continuous quality improvement
• Furnishes measurable feedback on the agency's strengths and challenges 
• Provides a "seal of approval" validating the agency's services to the public
• Raises the visibility of public health in the state
• Demonstrates accountability to taxpayers, funding sources, and elected officials
• Increases the agency's credibility to its constituents
• Within the agency
  • Improves staff morale
  • Increases understanding of roles and duties of staff in relation to the agency's mission and the delivery of essential public health services
• Has the potential to increase access to resources that support quality and performance improvement, address infrastructure gaps, and support new programs and processes
• Could streamline the application process for federal grants
• Could be a requisite for grant eligibility

- Friskila Damaris Silitonga, SKEP, NS, MPH