Presentation on theme: "Using Data to Drive Health System Performance"— Presentation transcript:
1Using Data to Drive Health System Performance Commissioned from Ovations by the NationalPrimary and Care Trust Development Programme
2Strategic Planning for PCTs We need a blend of two perspectives MedicineAsklepiosFirst physician according toGreek legend
3Strategic Planning for PCTs We need a blend of two perspectives Public HealthHygeiaDaughter of AsklepiosNote: Asklepios had another daughter,Panaceia (Pharmacy)
4PCT Strategic Planning What to Do Based on Information & Knowledge Notice that “strategy” is embedded in the Progress Pyramid.Unlike “Vision & Mission” which are stable for many years, a typical strategy (especially in health care), is stable for 1-3 years.
5Strategic Planning Where are you with your health care PCT planning? OutwardImagination & InnovationBackwardHistory & ExperienceForwardPlanning & GoalsInwardAssessment & Correction
6Strategic Planning The Strategy Change Cycle - Bryson & Alston Through a carefully aligned strategic plan, PCTs can:1. Examine the health care environment in which they exist and operate.2. Explore health care factors and trends that affect the way PCTs provide care and intervention from a medical and public health perspective.
7The Strategy Change Cycle Through a carefully aligned strategic plan, PCTs can:3. Seek to meet mandates and fulfill their mission consistent with National, regional and locally identified needs.4. Frame strategic issues creatively to drive health care delivery and prevention/health promotion initiatives.
8The Strategy Change Cycle ABCs Who and what you areWhat you do nowWhy you do itAssessBWhat do you want to be in the futureGoalCHow do you get thereStrategy
9The Strategy Change Cycle Ten Steps 7. Review and adopt theStrategic Plan8. Establish “Vision forSuccess”9. Develop implementationprocess10. Reassess1. Agree to a process2. Clarify mandates3. Identify stakeholders -mission & values4. Conduct a SWOT5. Frame strategic issues6. Formulate strategies to manage the issues
11= Places where the process typically starts = Places where the goal formulation may occur= Places where vision formulation may occurForces/TrendsPoliticalEconomicSocialTechnologicalEducationalPhysicalKey ResourceControllersClientsCustomersPayersMembersRegulatorsCompetitorsCompetitiveForcesCollaboratorsCollaborativeGExternal EnvironmentV4AExternalEnvironmentalAssessmentS2NationalMandatesGGGGGG5Strategic IssuesDirect approachGoals approachVision of successapproachIndirect approach1InitialAgreement(Plan forPlanning)SSStakeholdersExternalInternalS6StrategyFormulation7Strategy andPlan reviewand Adoption8Descriptionof Organisationin the Future(Visionof Success)OptionalS9Implementation10Strategy andPlanningProcessReassessmentSVVVVStrengths/WeaknessesVV3Mission/ValuesBy Stakeholders4BInternalEnvironmentalAssessmentInternal EnvironmentResourcesPeopleEconomicInformationCompetenciesCulturePres. StrategyOverallDepartmnentBus. processFunctionalPerformanceIndicatorsResultsHistoryAdopted from BrysonStrategic planningManagement
12Strategic Planning For PCTs DiffusionofInnovations
13Diffusion of Innovations Everett M. Rogers Diffusion: The process by which an innovation is communicated through certain channels over time among members of a social system.Innovation: An idea, practice, or object that is perceived as new by an individual or other unit of adoption.
14Diffusion of Innovations Key Constructs Innovators: VenturesomeEarly Adopters: Get an opinionEarly Majority: DeliberateLate Majority: SkepticalLaggards: Last to adopt, traditionalAdopter Categories
16Diffusion of Innovations Key Constructs Relative Advantage: Is the program betterCompatibility: Is it consistent with existing valuesComplexity: How difficult is it to understand and useTrialability: How does it stand up under experimentationObservability: How are results visible to othersCharacteristics of Change
17Health System Program Planning: Operationalising Your PCT Strategy PRECEDE/PROCEEDFrameworkScenarioPlanning
18Health System Program Planning The PRECEDE/PROCEED Framework Lawrence W. Green & Marshall W. Kreuter P = predisposingR = reinforcingE = enablingC = constructsE = educationalecologicalD = diagnosisE = evaluationPROCEEDP = policyR = regulatoryO = organizationalC = constructsE = educationalE =environmentalD = development
19PRECEDE-PROCEED Framework* HealthEducationPolicyRegulationOrganizationProgram*Phase 5Administrative &policy assessmentPredisposingFactorsReinforcingEnablingPhase 4Educational &ecologicalassessmentBehaviorEnvironmentPhase 3Behavioral &environmentalassessmentHealthPhase 2EpidemiologicalassessmentQuality ofLifePhase 1SocialassessmentFormative evaluation & baselinesfor outcome evaluation*InterventionMapping&Tailoring*Phase 6ImplementationPhase 7Process evaluationPhase 8Impact evaluationPhase 9Outcome evaluation*New in 4th ed., Green & Kreuter, Health Promotion Planning, in press.
20PRECEDE/PROCEED Nine Phases 1. Social Diagnosis: Identify social problems that impact quality of life, health care and priorities of individuals or populations.e.g., unemployment, absenteeism, crime, crowding, overall population health2. Epidemiological Diagnosis: Determine health issues associated with the quality of life.e.g., morbidity, mortality, risk factors, disability,longevity, intensity, incidence, prevalence
21Nine Phases con’t3. Behavioral & Environmental Diagnosis: Identify health practices linked to the health problems.e.g.,compliance, consumption patterns,preventive actions,utilization, self-care, frequency, lifestyle4. Educational Diagnosis:Predisposing factors: e.g.,knowledge, attitudes, values, beliefsReinforcing factors: e.g., attitudes and beliefs of othersEnabling factors: e.g., resources, accessibility, skills
22Nine Phases con’t5. Administrative and Policy Diagnosis: Administrative & organizational concerns prior to implementation.e.g., > The resources needed to launch and sustain your program> The organisational barriers that effect implementation> Policies that support the program or need to be changed6. Implementation of the Programe.g., > Well thought out plan, budget, training, careful monitoring
24PRECEDE/PROCEED Behavioral Matrix More Important Less ImportantHigh priority Low priorityfor a program except for political reasonsMore ChangeablePriority for No programinnovationsassessment iscrucialLess Changeable
25PRECEDE/PROCEEDLets try a population health issue specific to your PCT and run it through the framework