Presentation on theme: "Using Data to Drive Health System Performance"— Presentation transcript:
1 Using Data to Drive Health System Performance Commissioned from Ovations by the NationalPrimary and Care Trust Development Programme
2 Strategic Planning for PCTs We need a blend of two perspectives MedicineAsklepiosFirst physician according toGreek legend
3 Strategic Planning for PCTs We need a blend of two perspectives Public HealthHygeiaDaughter of AsklepiosNote: Asklepios had another daughter,Panaceia (Pharmacy)
4 PCT 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.
5 Strategic Planning Where are you with your health care PCT planning? OutwardImagination & InnovationBackwardHistory & ExperienceForwardPlanning & GoalsInwardAssessment & Correction
6 Strategic 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.
7 The 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.
8 The 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
9 The 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
12 Strategic Planning For PCTs DiffusionofInnovations
13 Diffusion 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.
14 Diffusion of Innovations Key Constructs Innovators: VenturesomeEarly Adopters: Get an opinionEarly Majority: DeliberateLate Majority: SkepticalLaggards: Last to adopt, traditionalAdopter Categories
16 Diffusion 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
17 Health System Program Planning: Operationalising Your PCT Strategy PRECEDE/PROCEEDFrameworkScenarioPlanning
18 Health 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
19 PRECEDE-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.
20 PRECEDE/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
21 Nine 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
22 Nine 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
23 Nine Phases con’t 7. Process Evaluation: tomorrow! 8. Impact Evaluation: tomorrow!9. Outcome Evaluation: tomorrow!
24 PRECEDE/PROCEED Behavioral Matrix More Important Less ImportantHigh priority Low priorityfor a program except for political reasonsMore ChangeablePriority for No programinnovationsassessment iscrucialLess Changeable
25 PRECEDE/PROCEEDLets try a population health issue specific to your PCT and run it through the framework