Public Health Accreditation: Road MAPP to Quality Improvement, Performance, and Impact

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Public Health Accreditation: Road MAPP to Quality Improvement, Performance, and Impact Tomás Aragón, MD, DrPH and The San Francisco DPH PHABulous Team April 13, 2012 1 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

The San Francisco DPH PHABulous Core Team! Tomás Aragón, MD, DrPH, Health Officer; Director, Population Health and Prevention Colleen Chawla, MPA, Director, Policy & Planning Lori Cook, MPP, Senior Planner, Policy & Planning Patricia Erwin, MPH, Director, Community Health Promotion and Prevention, Population Health and Prevention Karen Pierce, Public Health Accreditation Coordinator (NEW!), Office of the County Health Officer Randy Reiter, PhD, MPH, Epidemiologist, CASPER Unit, Office of the County Health Officer 2 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Outline Background and Review 1 Background and Review 2 3 3 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

What is public health? Background and Review Ensuring the conditions in which people can be healthy. 4 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Population Health transformations Nationally Patient Protection and Affordable Care Act National Prevention Strategy National Quality Strategy (for Health Care Improvement) Healthy People 2020; Locally San Francisco DPH Population Health and Prevention Systems Integration San Francisco Health Care Services Master Plan DPH Integrated Delivery System planning DPH 5-Year Budget Strategic Planning SF Community Transformation Grant DPH Public Health Accreditation 5 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Vision and Mission Background and Review Vison of the SF Department of Public Health Vision To protect and promote the health of all San Franciscans Mission of SFDPH Public Health Accreditation (proposed) To transform SFDPH into a learning, high-performance organization. 6 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

DPH Public Health Accreditation Guiding Principles (proposed) 1 We are one health department with a shared vision/mission; 2 Use holistic, integrated approaches Socio-ecological health models (address social determinants) Population health approach (optimize summary measures) Life-course approach (improve health at every stage of life ) Systems approach (understand/transform complex systems); 3 Address health inequities, not just disparities 4 Use and promote science-based priority setting 5 Build stakeholder trust through value-based partnerships 6 Promote and support innovation, discovery, and translation 7 Use evidence-based practices and develop practice-based evidence 7 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Purpose of Accreditation Background and Review National public health department accreditation consists of Adopt a set of quality standards; Measure performance against those standards Recognize those health departments that meet the standards. Public health department accreditation aims to Improve performance and quality of practice Improve accountability to our stakeholders Improve management and develop leadership 8 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Purpose of Accreditation (continued) Public health department accreditation standards address a range of core public health programs and activities including, for example, Disease and injury prevention and control Health protection and health promotion Environmental and occupational health Maternal, child, and adolescent health Public health emergency preparedness Public health laboratory services Management / administration Leadership and governance Linking to clinical services 9 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

SFDPH Public Health Accreditation Triple Aim Efficiencies 10 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

The Public Health Core Functions and Essential Services Accreditation will demonstrate DPH s capacity to deliver the three core functions and the ten essential services of public health. The PHA Domains also includes management and administration, and governance. 11 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Public Health Accreditation and the National Prevention Strategy 12 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Accreditation Process Background and Review PHAB accreditation process consists of seven steps: 1 Pre-application, 2 Application, 3 Documentation Selection and Submission, 4 Site Visit, 5 Accreditation Decision, 6 Reports, and 7 Reaccreditation. 13 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

2. Application Background and Review a. Submission of following documents The application process begins once a health department submits a completed application form and required supporting material. This material includes, but is not limited to, a letter of support by the health department s appointing authority and three prerequisite documents, updated in the last 5 years: 1 Community Health Assessment (CHA) and profile; 2 Community Health Improvement Plan (CHIP), a and 3 Departmental Strategic Plan. b a The CHA/CHIP must be conducted using a community engagement process, be a resource for the entire city, and incorporate social determinants of health. b The Strategic Plan respresents DPH s plan to address CHIP components for which DPH is accountable. 14 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

How? MAPP: Mobilizing for Action through Planning and Partnerships Projects HCSMP PHP-SI, CTG-SF DOE Healthy Homes Community Vital Signs Partners Community Benefits Partnership UCSF SF-HIP SFSU MPH Program 15 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Public Health Accreditation aligns with selected projects 16 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Public Health Accreditation Domains 1 Assess 2 Investigate 3 Inform and educate 4 Community Engagement 5 Policies and Plans 6 Public Health Laws 7 Access to care 8 Workforce 9 Quality Improvement 10 Evidence-based Practices 11 Administration and Management 12 Governance 17 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Standards for Domain 1: Assess Conduct and disseminate assessments focused on population health status and public health issues facing the community 1.1: Participate in or Conduct a Collaborative Process Resulting in a Comprehensive Community Health Assessment 1.2: Collect and Maintain Reliable, Comparable, and Valid Data That Provide Information on Conditions of Public Health Importance and On the Health Status of the Population 1.3: Analyze Public Health Data to Identify Trends in Health Problems, Environmental Public Health Hazards, and Social and Economic Factors That Affect the Publics Health 1.4: Provide and Use the Results of Health Data Analysis to Develop Recommendations Regarding Public Health Policy, Processes, Programs, or Interventions 18 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Standards for Domain 2: Investigate Investigate health problems and environmental public health hazards to protect the community 2.1: Conduct Timely Investigations of Health Problems and Environmental Public Health Hazards 2.2: Contain/Mitigate Health Problems and Environmental Public Health Hazards 2.3: Ensure Access to Laboratory and Epidemiologic/Environmental Public Health Expertise and Capacity to Investigate and Contain/Mitigate Public Health Problems and Environmental Public Health Hazards 2.4: Maintain a Plan with Policies and Procedures for Urgent and Non-Urgent Communications 19 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Standards for Domain 12: Governance Maintain capacity to engage the public health governing entity 12.1: Maintain Current Operational Definitions and Statements of the Public Health Roles, Responsibilities, and Authorities 12.2: Provide Information to the Governing Entity Regarding Public Health and the Official Responsibilities of the Health Department and of the Governing Entity 12.3: Encourage the Governing Entitys Engagement In the Public Health Departments Overall Obligations and Responsibilities 20 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Standards for Domain 8 (Workforce) and 9 (Quality Improvement) Maintain a competent public health workforce 8.1: Encourage the Development of a Sufficient Number of Qualified Public Health Workers 8.2: Assess Staff Competencies and Address Gaps by Enabling Organizational and Individual Training and Development Evaluate and continuously improve processes, programs, and interventions 9.1: Use a Performance Management System to Monitor Achievement of Organizational Objectives 9.2: Develop and Implement Quality Improvement Processes Integrated Into Organizational Practice, Programs, Processes, and Interventions 21 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Road MAPP to Public Health Accreditation 22 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Summary Background and Review 1 Background and Review 2 3 23 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future

Resoures Background and Review Public Health Accreditation: www.phaboard.org National Association of County and City Health Officials: http://www.naccho.org/topics/infrastructure/ The National Prevention Strategy: http://www.healthcare.gov/center/councils/ nphpphc/strategy/report.pdf The National Quality Strategy: http://www.healthcare. gov/center/reports/quality03212011a.html 24 Tomás Aragón, MD, DrPH Public Health Accreditation: Road MAPP to the Future