Presentation on theme: "Demystifying Domain 9: Performance Management Strategies and Resources"— Presentation transcript:
1 Demystifying Domain 9: Performance Management Strategies and Resources Micaela Kirshy, MPH, LICSWProject Manager, Performance Management and Quality Improvement
2 Roundtable Session Overview Explanation of Performance Management and Public Health Accreditation Board (PHAB) Domain 9Public Health Performance Management FrameworkThe Public Health Performance Management Self-Assessment ToolPerformance Management Tools and ResourcesClosing the loop: Meeting Domain 9 Standards
3 What is Performance Management? “Performance management is the practice of actively using performance data to improve the public's health.This practice involves the strategic use of performance measures and standards to establish performance targets and goals.”Source: From Silos to Systems: Using Performance Management to Improve Public Health Systems – prepared by the Public Health Foundation for the Performance Management National Excellence Collaborative, 2003Performance management uses a set of management and analytic processes supported by technology that enables an organization to define strategic goals and then measure and manage performance against those goals.
4 PHAB Accreditation: Domain 9 Standards Standard 9.1 Use a Performance Management System to Monitor Achievement of Organizational ObjectivesStandard 9.2 Develop and Implement Quality Improvement Processes Integrated Into Organizational Practice, Programs, Processes, and Interventions
5 PHAB Accreditation: Domain 9 For the health department to most effectively and efficiently improve the health of the population, it is important to monitor the quality of performance of public health processes, programs, interventions and other activities. A fully functioning performance management system that is completely integrated into health department daily practice at all levels includes:1) setting organizational objectives across all levels of the department,2) identifying indicators to measure progress toward achieving objectives on a regular basis3) identifying responsibility for monitoring progress and reporting,4) identifying areas where achieving objectives requires focused quality improvement processes.
6 Developed in 2013, adapted from the 2003 Turning Point Most have seen this Turning Point Model – the 30,000 foot view of what we’re talking about today.Turning Point Performance Management National Excellence Collaborative convened about a decade ago. Four year collaborative funded by RWJF established in 2000.Turning Point Performance Management Collaborative (PMC) – seven states (AK, IL, MO, MT, NH, NY, WV) and five national partners (ASTHO, NACCHO, CDC, HRSA, PHF) working to study and promote systems to manage public health performance20+ years ago where we started seeing literature and observation about performance management working in other industries. We began asking questions, what does performance management look like in public health?Managing performance is what you do at the program, organization (local/state), or system level to ensure you get results. It’s the opposite of leaving things to chance.Developed in 2013, adapted from the 2003 Turning PointPerformance Management System Framework
7 Performance Standards Identify relevant standardsSelect indicatorsSet goals and targetsCommunicate expectationsThink about:Do you set or use standards, targets or goals for your organization or program?How do you communicate the expectations and strategic direction for your organization or program?
8 Performance Management Successes/Barriers: Performance Standards Success FactorsRisk FactorsChoose standards by themes to be cross-cuttingTrainingScrutinize regularlyUse QI tools/methods to align and prioritizeAlign standards with policiesStrategic plan alignmentDifficult to develop standardsLack of meaningful visionLack of program goalsTension between goals vs. program focusFunder driven standards vs. department driven standardsPoor decision makingMeasurement becomes the standard
9 Performance Measurement Refine indicators and define measuresDevelop data systemsCollect dataThink about:How do you measure capacity, process or outcomes?What tools exist to support the efforts?
10 Performance Management Successes/Barriers: Performance Measurement Success FactorsRisk FactorsResults focusMission DataRoutine part of workLeadership interestExperience teachesTraining internallySMART measures developed through collaborating and listeningLack of clarity about what and how to measureMeasures not connected to objectivesDifficult to capture in one placeData overload – too much data gathering without prioritization
11 Reporting of Progress Analyze and interpret data Report results broadlyDevelop a regular reporting cycleThink about:Do you document or report your unit / program’s progress?Is this information regularly available? To whom?What is the frequency of analysis and reporting?
12 Performance Management Successes/Barriers: Reporting Progress Success FactorsRisk FactorsIT InfrastructureStandardized reportingTraining on data interpretationLeadership investment in ITUniversity partnershipsTransparency and access to dataVisible and useable dataTied to business planSystems are siloedCommunity-level not integratedData outdatedBias in favor of financial needsInternal reports too longExternal reports too briefLimited investment in time/peopleNo follow-up actionNo sense of “why”No analysisLack of infrastructure
13 Quality ImprovementUse data for decisions to improve policies, programs and outcomesManage changesCreate a learning organizationThink about:Do you have a quality improvement process?What do you do with information gathered through reports?Do you have the capacity to take action for improvement when needed?
14 Performance Management Successes/Barriers Quality Improvement Success FactorsRisk FactorsMandated use of QIFormal QI office or staff providing TAVisibility of successesHC partnersLeadership devoting time for sharingOpen team for PMStanding discussion/agenda itemNo experience in QIQI vs. QALack of time and resourcesLack of collaboration between and among departmentsFear of consequencesDisconnect with reportingNo expectation of need for QI“Little QI” vs. “Big QI”
15 Visible Leadership Engage leadership in performance management Align performance management with organizational prioritiesTrack and incentivize progressThink about:Does senior management take a visible role in performance management?Is performance management emphasized as a priority and goal for your work?
16 Performance Management Successes/Barriers: Visible Leadership Success FactorsRisk FactorsLearn from successesOutspoken proponentsReward successLooking for small winsEducate leaders“Silo busting”Building a cultureLack of clarity about what QI culture is and requiresLack of common prioritiesUse of data to penalizeRisk averse and resistant to changeFailing to ask tough questionsStatus quo/culture takes time to changePolitical ConsiderationsTurnover
17 Public Health Performance Management Self-Assessment Tool “How well does your public health team, organization, or system manage performance? Use this assessment to find out if you have the necessary components in place to achieve results and continually improve performance. This self-assessment tool is a guide that was designed to be completed as a group, and can be adapted to fit an organization or system’s specific needs.”
18 Using the Performance Management Self-Assessment Tool Teams or programs can use this tool to assess relative performance management strengths and weaknesses in their areas of workOrganizations can use this tool to assess relative performance management strengths and weaknesses across divisions and programsSystems composed more than one organization can use this tool to assess how well they are managing across the different parts of the system
19 Tips for Using the Performance Management Self-Assessment Preview the entire tool and definitions before you begin. The detailed questions in Sections II - V may help you better understand performance management and more accurately complete Section I, Visible Leadership.Be honest about what you are currently doing or not doing to manage performance. If you are doing very little in an area, it is better to say "Never" or “Sometimes” than to overstate the attention and resources allocated to it. For questions marked "Never," decision makers can determine the activity’s relevance, and if appropriate, choose to shift priorities or invest resources. Using information for such decision making is a basic tenet of performance management.If you are unsure how to answer a question, the leave it blank until you can find the answer.Use the Notes section at the bottom of each page. Write down improvement ideas, insights, or any qualifications to self- assessment answers. Your individual or group responses will help you interpret the results and choose follow-up actions to the assessment.
20 Snapshot of the Performance Management Self-Assessment
21 Public Health Performance Management Self-Assessment As you complete this assessment, or as a next step, your team should also discuss other important questions:What are examples of work that fall within a performance management system? Do we call them performance management?For those components of performance management we are doing, how well are we doing them?In which areas do we need to invest more time and resources to manage performance more successfully?What can leadership and staff do to make the performance management system work?What steps could we try out this month (or this week) to improve our performance management system?
22 Closing the Loop: Tackling Domain 9 Standard 9.1 Use a Performance Management System to Monitor Achievement of Organizational ObjectivesPublic Health Performance Management Self- Assessment ToolStandard 9.2 Develop and Implement Quality Improvement Processes Integrated Into Organizational Practice, Programs, Processes, and InterventionsQI activities based on identified needs of the program or organization
23 Resources and ToolsStories: Performance Management Examples From the FieldTool: Performance Management PDCA (Plan-Do-Check-Act) Self-Assessment ToolWhitepaper: Performance Management and Cultural Transformation Using PDCA ApproachTechnical Assistance: PHF’s Performance Management Workshop
24 Performance Standards Resources Healthy People 2020 ResourcesProvides performance standards for health departments and other organizationsNational Public Health Performance Standards Program (NPHPS)Which has developed a set of standardized goals for state and local public health systems and boards of health. The Program defines performance in each of the 10 Essential Public Health Services
25 Performance Standards Resources Healthy People 2020 ResourcesProvides performance standards for health departments and other organizationsNational Public Health Performance Standards Program (NPHPS)Which has developed a set of standardized goals for state and local public health systems and boards of health. The Program defines performance in each of the 10 Essential Public Health Services
26 COMING SOON: PHF Performance Management Toolkit One stop shop for all of your Performance Management needsSearch for resources by Framework componentPerformance Management stories from others in the fieldLink to the Performance Management Self- AssessmentAdditional tools and resources