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Central California Center for Health and Human Services California State University, Fresno Donna DeRoo, MPA, ABD, Fresno State Allison Hensleit, MBA,

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Presentation on theme: "Central California Center for Health and Human Services California State University, Fresno Donna DeRoo, MPA, ABD, Fresno State Allison Hensleit, MBA,"— Presentation transcript:

1 Central California Center for Health and Human Services California State University, Fresno Donna DeRoo, MPA, ABD, Fresno State Allison Hensleit, MBA, Fresno State Sara Bosse, Fresno County Department of Public Health Ashley Hart, Fresno State

2  San Joaquin Valley Public Health Consortium  San Joaquin Valley Public Health Departments Participating Counties: ◦ Fresno, Madera, Merced, San Joaquin, Tulare  California Department of Public Health  Center for Disease Control and Prevention  National Network of Public Health Institutes (NNPHI)  Open Forum December

3  Participants will increase their understanding and knowledge of the process and lessons learned in implementing a performance management system.  Participants will increase their understanding and knowledge of a performance management system’s utilization as it relates to: ◦ Departments Strategic Plan ◦ Community Health Improvement Plan ◦ Quality Improvement Plan ◦ Public Health Accreditation 3

4 PMPM PMPM QI Attended First Open Forum Charlotte, NC Fresno County [2 Divisions] & Madera County Merced County [Training] Fresno County Madera County Merced County [All Divisions] & Tulare County San Joaquin County [2 Divisions] Fresno County San Joaquin County [2 Divisions] San Joaquin County Tulare County [All Division]

5 5

6 6 Approach Process Performance Management Tool

7 We chose this one … 1-on-1 Training Webinars Conference Calls 7 Robust discussion Team building Highly collaborative Pulse read of activities Accommodates flexible schedules Easily accessible Accommodates flexible schedules Remote accessibility

8 Met with Senior Leadership Met with ALL managers & supervisors Met with Divisions/Sectors/ Programs Performance Management System Tool Delivered! 8 Background & general PMQI overview M1: Brainstorm Aims, & Goals M2: Prioritize Aims, Brainstorm Goals & Performance Measures M3: Prioritize Goals & Performance Measures, Draft Targets, Timing, Responsibility, Data sources M4: Presentation of Performance Management System Tool Draft User Guide M1: 1 st Meeting M2: 2 nd Meeting M3: 3 rd Meeting M4: 4 th Meeting

9 Dept. Mission, Vision, Values Dept. Strategic Aims Division Strategic Aims Division Standards/Goals Division Performance Measures 9

10  Review overall department aims and how they relate to the division or unit.  Articulate how the division or unit contributes to accomplishing department aims.  Develop specific aims for the division.  Review and adjust aims to reflect accurate assessment of division resources and scope of authority. 10 Dept. Mission, Vision, Values Dept. Strategic Aims Division Strategic Aims Division Standards/Goals Division Performance Measures

11 S.M.A.R.T  Specific ◦ Action oriented; providing clear direction; easily understood  Measureable ◦ Quantifiable and/or verifiable  Aggressive, but Attainable ◦ Challenging and realistic  Results-Oriented ◦ Focused on outcomes; not methods  Time Bound ◦ Having a reasonable, yet aggressive, time frame 11

12  Performance measures are the quantitative data elements that let us know:  How well we are doing  If our processes are functioning efficiently  If we are meeting our goals  If and where improvements are necessary  If our customers are satisfied 12 Capacity Measure Process Measure Outcome Measure

13  A target is the desired end of the year performance outcome which is typically determined by past performance.  What needs to be in place before setting targets? ◦ Aim Statements ◦ Goal statements ◦ Performance Measures/Indicators 13

14 How do I determine what should be the target? 14 Performance Indicator Funding Source Sets Target Is this doable? Yes Apply target or set one higher No Set interim targets that bridge the gap Organization Sets Target Do we have the data? Yes Evaluate your history and set benchmark year No Extrapolate to build initial target Leverage other program targets as starting point Leverage expert input

15 In addition to annual targets, Red Line targets are just as important because they help determine the minimum level of acceptability.  Red line targets are unacceptable outcomes at any point and time that require immediate program or organizational attention and intervention.  Setting redline targets is essential, and often left out, to help your organization gauge and prioritize your program improvement efforts. 15 Achieved or Exceeded Target Fell on or Short of Red Line Target Performed Above Red Line & Short of Annual Target Red Line TargetAnnual Target

16 “Kick the tires and light the fires”  Implement it – IMMEDIATELY.  Allow your teams to become comfortable navigating through the system.  Embed the process such that it involves all employees within an organization.  Set a date from which all designated performance measure data will be inserted into the performance management system. 16

17 17 Division Performance Measures Division Standards/Goals Division Strategic Aims Dept. Strategic Aim CHIP, CHA Mission Vision Values Quality Improvement Performance Management System

18 18

19 Performance Management System Implementation 19

20  Cohesive system  Increased communication  Increased cross-division projects  Integration aims, goals, and measures into Department strategic planning  Increased accountability  More information available for reports and presentations to the Board of Supervisors 20

21 Leadership & Staff Engagement 21

22  Complex scheduling coordination  Requires more time than LDHs anticipated  Right leaders in the room  Fear of change  Fear of accountability given reduced resources  Marathon not a sprint  Don’t bite off more than you can chew  Strategic plans may need to be refreshed  Not for the faint of heart – requires commitment 22

23  Built community of practice  New collaborations  Improved internal awareness  Potential for maximization of resources  Asking the right questions to propel their community impact forward  Ownership in the performance management system 23

24  We would have expanded the implementation timeline to allow the LHDs a month of piloting the performance management tool  Basic level of Microsoft Excel experience was much lower than anticipated  Underestimated the amount of time required to facilitate the journey from strategic Aims to Performance Measures and Targets  Essential to have the groups working together in a room to discuss and collaborate with one another  Requires a cultural change from the top down 24

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26  Donna DeRoo, MPA, ABD ◦ (559)  Allison Hensleit, MBA ◦ (415)  Sara Bosse ◦ (559)  Ashley Hart ◦ (559)

27 Appendix 27

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29 29 TermDefinitionExample AIM Statement A clearly articulated aim statement provides both the foundation and the focus of the problem-solving effort. AIM statements answer the question: “What are we trying to achieve?” Increase the means of communication between management and staff Increase opportunities for staff to work cohesively together as a team. Performance Standard/Goal Objective standards or guidelines that are used to assess an organization’s performance. “What approaches will we utilize to achieve our Aim?” One epidemiologist on staff per 100,000 population served. 80 percent of all clients who rate health department services as “good” or “excellent.” Performance Measure Quantitative measures of capacities, processes, or outcomes relevant to the assessment of a performance standard/goal. “What quantitative data do we have available to measure our progress against our goals?” Number of trained epidemiologists available to investigate Percentage of clients who rate health department services as “good” or “excellent.” Performance Targets Specific and measureable goals related to agency or system performance. “What is he end of year performance we are trying to achieve? Targets may be the same as, exceed, or be an intermediate step toward the measure.

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31 It’s the New Year and for 2014 you want to live a healthier lifestyle.  During your annual physical, your doctor recommends that you lose weight.  To determine a reliable indicator of healthy weight, you look at Body Mass Index (BMI) tables and identify the normal weight range for your height.  With that standard in mind, you decide to measure weekly weight loss, with a target of losing 2 pounds per week. You also decide to measure caloric intake and physical activity, with a daily target of limiting your calories to 1800 and walking a mile.  You monitor your weight weekly using your bathroom scale and report (to yourself!) your weight on a spreadsheet.  After tracking weight loss for four weeks, you find that you have only lost an average of one pound per week, so you decide to test an improvement, which involves adding an additional mile of walking per day.  Four weeks later, you find that you are meeting your goal of losing an average of two pounds per week. 31 Source: MPHI Office of Accreditation and Quality Improvement

32 Performance Standard/Goal Reduce BMI to 27 Performance Measure WeightCaloric Intake Physical Activity Performance Target Two lbs per week <1800 calories per day 1 mile walk Reporting Recording weight Recording calories Recording Physical Activity Quality Improvement Test add’l physical activity 32 When target weight loss was not being met AIM: Live a more healthy lifestyle in 2014.


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