NHSPI v.1.0 Project Briefing & Launch Plan 2013 ASTHO Annual Meeting 1
OVERVIEW OF NHSPI DEVELOPMENT 2
What Is the NHSPI? The National Health Security Preparedness Index (NHSPI) will be an annual measure of health security and preparedness at the national and state levels The Index is being designed to give objective information about how well communities, states, and the nation are prepared for public health and other emergency situations The Index will assess where we are and helps guide efforts to achieve a higher level of health security preparedness Much broader than PHEP / HPP and not tied to funding 3
What is the NHSPI (Cont.)? ASTHO leading development of the Index through a CDC cooperative agreement Assembled over 75 experts from across stakeholder community Including public health, emergency management, private sector, non-profits, government, and academia A composite Index which includes a range of elements impacting national health security preparedness: Initial focus on public health and health care systems Over time, the NHSPI will include additional elements of national health security
What is the Purpose of the NHSPI? Provide objective, evidence-based measures to help: Policy-Makers Assess the progress made in preparedness/track changes over time Guide inquiry needed to inform decisions about investments Practitioners Understand the interdependencies of the health security preparedness system Benchmark and facilitate quality improvement at the state and national level 5
Uses of the Index 1. Support quality improvement Strengths, gaps, planning, identify strong practices, trends 2. Enhance collaboration/increase shared responsibility Generate discussion among stakeholders on needs and solutions 3. Inform policy and resource decisions 4. Advance preparedness science Evidence base for practices, advance measurement, CQI of Index 6
NHSPI Guiding Development Principles Create no new administrative burden Should be owned and embraced by practice community Must be better than what we currently have Cannot be a one-time effort, must continuously improve As much as possible, avoid unintended consequences 7
How Was the NHSPI Built? Chair: Dr. John Lumpkin 18 members Chair: Dr. Tom Inglesby 16 members Chair: Dr. Jonathan Links 19 members Steering Committee Representative of community Voting seat Provide direction & guidance Governance Advise SC on major decisions Issues management Future ownership plan Project Support ASTHO Booz Allen CDC ORISE Chair: Dr. Cathy Slemp 21 members Model Design Develop Index framework Select indicators Design prototype Index model Stakeholder Communications Support sharing of information with stakeholders Gather stakeholder feedback Share feedback w/ WGs 8
Five-Step Process for Each Measure Selected Identification Selection NQF Criteria Calculation Vetting The path taken in identifying the data source and then the measure Representational Immediate data availability State-level (or normalized) data availability Sustainability Philosophy Important to measure and report Scientifically acceptable Useable and relevant Feasible to collect How data integrated into model How data normalized into model How a performance target was determined The path taken in vetting the measure with the Model Design Workgroup and arriving to consensus 9 9
Selected Measures Wide Range of Data Sources 2010 Save the Children Report 2010 NACCHO profile America s Health Rankings American Burn Association American College of Surgeons American Hospital Directory American Trauma Society APHL All Hazards Preparedness Survey (2012) ASTHO 2010 Profile Survey ASTHO Workplace Survey 2007 Behavioral Risk Factor Surveillance System Bureau of Labor Statistics Occupational Employment Statistics Bureau of Labor Statistics/Census Data CDC - Snapshots of Public Health Preparedness in States and Directly Funded Localities CDC/OPHPR Cities Readiness Initiative CDC/Public Health Emergency Preparedness (PHEP) Cooperative Agreement CMS.GOV/Hospital Compare DASH School Health Policies and Programs Study 2012 (State) EM Report Card, Emergency Management Foundation Emergency Management Accreditation Program Epi-X ESAR-VHP FOOD - Foodborne Online Outbreak Database George Washington University and UNC HAvBED Medical Reserve Corps National Council of State Boards of Nursing National Electronic Disease Surveillance System National Health Immunization Survey NHTSA / 2011 National EMS Assessment (ems.gov) Public Health Accreditation Board (PHAB) 10
DEVELOPMENTAL DRAFT REVIEW 11
Developmental Draft Review: April May 2013 A broad range of stakeholders were invited to review the draft NHSPI containing 120 candidate measures in six domains and 15 subdomains: State Preparedness Directors & Colleagues NHSPI Project workgroup members Representatives from 48 national associations, including: National Association of County and City Health Officials Association of Public Health Laboratories National Association of State EMS Officials American Academy of Pediatrics National Emergency Managers Association National Funeral Directors Association American College of Surgeons National Volunteer Fire Council 12
Reviewers Provided Feedback in Three Areas: Index Content Review of Each Domain, Subdomain & Measure Relevance and Fit Improvements/Additional Data Sources Conceptual Framework and Structure How well materials available at www.nhspi.org communicate the Index structure and intent to further develop in certain ways Thinking Forward Potential Uses Index Visualization Messages, Issues and Support Tools Next Steps/Future Index Development
Strong Response to Request for Index Feedback Responses from 39 States and 22 partner organizations Over 125 individual respondents Most respondents were preparedness directors, followed by epidemiologists and other roles such as: Preparedness and response assistant director/executive assistant/manager/evaluator Emergency responder/manager/director/lead Business operations including finance director and grants manager Research scientist or chief science officer Total of 14,430 structured + 3,344 free-form comments from 125 overall respondents 14
15 REVISED MISSION STATEMENT & CORE CONCEPTS
Revision of the NHSPI Mission Mission Statement The mission of the NHSPI is to provide an accurate portrayal of our nation's health security using relevant, actionable information. The intended uses include strengthening preparedness, informing decision making, guiding quality improvement, and advancing the science behind community resilience. Objectives Year 1: Deliver a structure for portraying public health and health system national preparedness components and establish a framework for further development. Longer Term: Establish a standardized, universally-accepted assessment and reporting tool that encompasses all components impacting national health preparedness and to inform development of additional measures that more fully reflect the state of our health security. 16
NHSPI Definitions Need to Follow Established National Framework Definitions Success of the National Preparedness Goal is... (PPD-8) A secure and resilient nation with the capabilities required across the whole community to prevent, protect against, mitigate, respond to, and recover from the threats and hazards that pose the greatest risk. PPD-8 Definition of National Preparedness The actions taken to plan, organize, equip, train, and exercise to build and sustain the capabilities necessary to prevent, protect against, mitigate the effects of, respond to, and recover from those threats that pose the greatest risk to the security of the Nation. NHSS Definition of National Health Security National health security is a state in which the Nation and its people are prepared for, protected from, and resilient in the face of health threats or incidents with potentially negative health consequences. 17
18 REVISION OF THE NHSPI MODEL
Recap: Original NHSPI Structure 6 Domains and 15 Sub-Domains 6 Domains 1 BIOSURVEILLANCE 2 COMMUNITY 3 COUNTER- 4 INCIDENT PLANNING AND ENGAGEMENT MEASURE MANAGEMENT AND INFO MANAGEMENT 5 SURGE MANAGEMENT 6 15 Sub-Domains Public Health Surveillance & Epidemiologic Investigation Public Health Laboratory Testing Community-Wide At-Risk Populations Medical Materiel Management and Dispensing Non- Pharmaceutical Interventions Incident Management Emergency Public Information and Warning Mass Care (Congregate Locations) Fatality Management Cross Cutting Volunteer Management Responder Safety and Health Medical Surge (Rapid Expansion) Legal Infrastructure 19
2013 National Health Security Preparedness Index Structure 1 HEALTH SURVEILLANCE 2 3 4 5 COMMUNITY PLANNING & ENGAGEMENT INCIDENT & INFO MANAGEMENT SURGE MANAGEMENT COUNTER- MEASURE MANAGEMENT 14 Sub-Domains Public Health Surv eillance & Epidemiologic Investigation Cross-Sector/ Community Collaboration Incident Management and Multi- Agency Coordination Emergency Medical Serv ices Medical Materiel Management, Distribution & Dispensing Env ironmental and Biological Monitoring At-Risk Populations Emergency Public Information and Warning Acute and Primary Care Countermeas ure Utilization and Effectiv eness Laboratory Testing Management of Volunteers During Emergencies Mental and Behavioral Health Care Social Capital and Cohesion 128 Active Indicators As of 9/3/2013 20
Where is the NHSPI Heading Next (v.2.0)? Pre-Ev ent Community Status (19) Federal Contributions to State Preparedness (0) 1 HEALTH SURVEILLANCE 2 3 4 5 COMMUNITY PLANNING & ENGAGEMENT INCIDENT AND INFO MANAGEMENT SURGE MANAGEMENT COUNTER- MEASURE MANAGEMENT 6 ENVIRONMENTAL AND OCCUPATIONAL HEALTH 22 Sub-Domains Public Health Surveillance & Epidemiologic Investigation Cross-Sector/ Community Collaboration Incident Management and Multi- Agency Coordination Emergency Medical Services Medical Materiel Management, Distribution and Dispensing Responder Safety and Health Environmental and Biological Monitoring At-Risk Populations Emergency Public Information and Warning Acute and Primary Care Non- Pharmaceutical Interventions Air, Food, and Water Security Laboratory Testing Management of Volunteers During Emergencies Legal and Administrative Chronic and Long-Term Care Countermeasure Utilization and Effectiveness Human, Animal & Environmental Decontamination Social Capital and Cohesion 2013 NHSPI 5 Domains, 14 Subdomains, and 128 Active Indicators in NHSPI v1 As of 9/3/2013 Congregate Care Mental and Behavioral Health Care Fatality Management 2014 NHSPI = To Be Added 1 additional Domain, 8 Subdomains, and 2 Overarching Areas 165 + Indicators in NHSPI v2 21
LAUNCH OF VERSION 1.0 22
23 Launch Process Four week period prior to public release to allow States to: Get familiar with v.1.0 of Index and materials Proof data for any obvious errors/typos Brief leadership Prepare to respond to interest / inquiries Support Tools available: Briefing kit Talking points and draft press releases Executive summary Data Visualization on the NHSPI Website: Will support uses of the Index Will not encourage State by State rankings
NHSPI v1.0 Launch Plan October 1-8 Sneak- Peek Oct 9-Nov 10 Pre-Launch Release Week of Nov 11 Public Launch Mid Nov Forward Targeted Outreach Audience Preparedness Directors, State Health Officials and Select Associations Audience Preparedness Directors, State Health Officials and Select Associations Audience Practice and Policy Community, Academic and Next Step Partners Audience Practice and Policy Community, Academic and Next Step Partners Channel Webinars Channels DPHP Conference Presentation 10/9, Follow-up Calls and Emails Channels Launch v.1.0 on Website, Partner Calls / Emails and Media Outreach Channels Briefings, Calls, Conferences, Meetings, Listservs and Newsletters Goals Review Feedback Results, Index Changes and Launch Plans Goals Recap of Feedback and Index Changes, Review Data, Website and Resources Goals Introduce NHSPI v.1.0 and Generate Interest Goals Promote use of NHSPI and Engage in Further Development 24
Post Launch / Next Steps Targeted Outreach Engage additional sectors of health security preparedness (e.g. Emergency Management) Address Issue of Long-term NHSPI Ownership CDC currently in discussions with the Robert Wood Johnson Foundation to manage and evolve the Index in the future Address Model Design Considerations for Version 2.0 Hazard Weighting Setting Targets or Benchmarks Index Validation Research Agenda 25
QUESTIONS AND COMMENTS 26