1. Using Health Status Reports to Effect Systems Change in RHAs Dr. Cordell Neudorf Chief Medical Health Officer Saskatoon Health Region June 2, 2008

2. Health Status Report Evolution in Saskatoon  Demographic and Morbidity/Mortality reports  Increasing breadth of data sources (puzzle analogy)  Increasing complexity of analysis  Inclusion of local research results  Adding recommendations for change  Increased use of stakeholders in the production, interpretation, and use of the report 1980s1990s2000present

3. How the process works in SHR  Leadership – Chief MOH office via the Public Health Observatory  Workplan developed (indicators / data to be included, analysis plan, general layout)  Preliminary results presented to PHO staff, MOHs and Public Health Management for initial interpretation and write up  Draft report taken to internal and external stakeholders for comment and further recommendation suggestions  Final report produced

4. How the process works in SHR  Board and SLT and key stakeholders given heads up re proposed recommendations to allow time for response  Public release of report and recommendations and initial response from those affected  Chapter by chapter detailed presentation of report to SLT and then Board for adoption of recommendations and to get feedback on the action plan proposed by stakeholders  Annual report on progress and updates on new information or key trends

5. Critical Success Factors  Ensure MOH has mandate for production of an independent, regular Health Status report to the local authority/board  Create expectation that the Health Status report will be one of the key planning documents for the RHA  Gradually add robust analysis and interpretation of data, forecasting of trends and recommendations for change in any sector that can improve health status (public health, health system, other sectors)  Public release of report

6. Critical Success Factors  Present report details through both administrative and governance channels in health, getting both streams to adopt those recommendations with which they agree  Ensure stakeholders do likewise  Build in accountabilities and measure progress (use accreditation, accountability indicators, quality reporting, etc)  Repeat process every 5 years, with updates on progress and focused data updates annually

7. Key messages  Properly positioned, health status reports can become key documents to drive systems change and re-orient the health system  Recommendations can set the tone for the 5 year strategic plan for public health, the health system, and intersectoral changes necessary to improve health, health determinants, and reduce health disparity

8. Conclusion  All Public Health Units should use health status reports as an opportunity to effect systems change  Capacity, data availability, and structure of reports varies greatly across Canada’s 130+ health units  Need common core data and report templates in order for more regions to be able to do this  Potential solutions include: development of a Network of PHOs and/or analysts in Canada, development of a Network of PHOs and/or analysts in Canada, working with National and Provincial data providers on a core indicator set available free of charge by standardized small area geographies working with National and Provincial data providers on a core indicator set available free of charge by standardized small area geographies Working together on a shared agenda when it is necessary to effect change beyond the local level Working together on a shared agenda when it is necessary to effect change beyond the local level

9. The Challenge!  By collectively adopting the above methods and process, Public and Population Health can have the intended influence on system change necessary to change policies and programs to: Increase public health capacity Increase public health capacity Re-orient the health system Re-orient the health system Reduce health inequalities Reduce health inequalities Improve determinants of health Improve determinants of health  Requirements include coordination, a common vision, and a willingness to work together