1. NHSPI™ Briefing for ASTHO/NEMA Workgroup - August 12, 2014

2. 2014 Index Goals Produce Annual Index Improve the Index
Expand the Index
Engage and Communicate with Stakeholders
Use the Index to Support the Science of Preparedness
Transition of Index Ownership to Robert Wood Johnson Foundation
2014 NHSPI™ Activities:
Produce Annual Index
-Deliver a full product by the end of 2015 – from measure research, vetting, data updating to full model review to intensive stakeholder engagement. Anticipating a public release event in Washington DC in early December.
Improve the Index
-Through measure research and vetting, add new measures, replace weaker measures where possible, and update data as sources release new sets
-Create new and improved materials based on stakeholder feedback
Expand the Index
-Enhance the Index through incorporating healthcare and environmental health more fully, resulting in the creation of a new domain and the addition of over 175 measures (final number still in process)
Engage and Communicate with Stakeholders
-Conduct outreach and seek collaboration with new and existing stakeholders, now expanded to include more environmental health partners and healthcare partners
-Activities range from formal feedback gathering to presentation at key meetings to articles in industry newsletters, as well as an extensive search process to bring representatives from partner organizations to participate in the project on Workgroups and Task Forces
-Beginning to Track, Understand, and Strengthen Index Use and Usefulness
Use the Index to Support the Science of Preparedness
-Form the Research Agenda Advancement Team, led by CDC’s Eric Carbone (DSLR)
-Involve key players from RWJF and CDC in forward-thinking planning on research
-Use funding opportunities to encourage schools of public health to embark on NHSPI™-related research, including validation of the Index
Transition of Index Ownership to Robert Wood Johnson Foundation
-From the NHSPI™’s inception, a transition to a permanent entity was planned
-In-depth process undertaken to research and vet potential organizations to take ownership
-RWJF is an excellent fit: credibility, experience with analogous work, fiscal capacity, philosophical alignment, commitment to preparedness and community resilience
Activities for future years:
1. Integrate weighting of measures into the Index Validation 3. Measures optimization (colinearity analysis) 4. Trend analysis Systems dynamic model

3. 2014 NHSPI™ Activities Maintain and Update Current Index1.
Maintain and Update Current Index 2.
Measure Hunt to Expand the Index 3.
Measure Details 4.
Finalize and Perform Quality Control of Model for Transition 5.
Communicate with Current Stakeholders 6.
Engage with Current Stakeholders to Improve the Index 7.
Engage New Stakeholders in Development of the NHSPI™ through SME Task Forces 8.
Engage Current Stakeholders in Use and Usefulness 9.
Advance Efforts with Key Organizations and Federal Partners
10.
Use the Index to Support an Expanded Preparedness Research Agenda
11.
Prepare for Transition to RWJF
12.
Launch Preparation and Release of 2014 Index
Activities for future years:
Integrate weighting of measures into the Index
Validation
Measures optimization (colinearity analysis)
Trend analysis
Systems dynamic model
Database solution

4. Timeline for 2014 Deliverables
Launch Date: December 9 (tentative)
State Preview Period and RWJF NPO Onboarding: November
Model QC and Web Updates: October
Model Finalization: September
Measure Details and Continued Data Collection/Integration: August
Stakeholder Feedback Review: July – August
Stakeholder Feedback Review: July – August
Measure Details and Continued Data Collection and Integration: August
Model Finalization: September
Model QC and Web Updates: October
State Preview Period: November
RWJF NPO Onboarding: November
Launch Date: December 9

5. Model and Measure Activities
Measure Hunt
New Measures for 2014:
Over 400 new measures identified and vetted
189 selected by Task Forces and Workgroup SMEs
Final number of new measures may fluctuate slightly through data gathering and Measure Details process
Existing Measures from 2013:
128 active measures
90 will be updated with new data
38 will remain without update
These numbers are still tentative as we continue to work with chairs to reduce redundancies and identify measures that do not meet the sustainability criteria.
38 measures will not be updated this year. They come from the following sources: American Trauma Society, APHL, NASEMSO 2011 National Emergency Medical Services Assessment Report, HHS ESAR-VHP, WaterISAC, Epi-X and CDC School Health Policies and Practices Study.
Measures not being updated will be reviewed to determine if they are becoming too outdated or the update frequency is not sufficient. Determinations will be made during the finalization of the model in September

6. 2013 NHSPI™ Structure Figure illustrates the 2013 NHSPI™
The 2013 Index
5 Domains Sub-domains 128 Active Measures

7. Draft 2014 NHSPI™ Structure Changes
The 2014 NHSPI™ will include both updated and new domains, sub-domains, and measures aimed at better reflecting the current cycle of preparedness, response, recovery, and mitigation.
Structural Changes Include:
Refinement of existing domains and sub-domains
A new Environmental & Occupational Health domain
Major revisions to the Healthcare Delivery domain (previously “Surge Management”)
The 2014 NHSPI™ will include both model refinements and new measures.
- Added one new domain with three sub‐domains
Environmental & Occupational Health
Responder Safety & Health
Air, Food, & Water Security
Human, Animal, and Environmental Monitoring & Decontamination
- Revised the Surge Management domain and sub‐domains:
Renamed Surge Management to Healthcare Delivery
Renamed Emergency Medical Service to Prehospital Care
Split Acute & Primary Care into two new sub‐domains; Inpatient Care, Outpatient Care
Added Long‐Term Care and Home Care
Removed Chronic & Long‐Term Care; measures for this sub‐domain have been moved to the Inpatient Care, Outpatient Care, Long‐Term Care, and Home Care sub‐domains
- Moved Congregate Care sub‐domain to the Community Planning & Engagement domain
- Added a Legal & Administrative sub‐domain to the Incident & Information Management domain
- Moved Fatality Management from the Healthcare Delivery domain (previously “Surge Management”) to the Incident and Information Management domain.
- Added a Non‐Pharmaceutical Interventions sub‐domain to the Countermeasure Management domain
- Revised and / or developed definitions for Healthcare Delivery and Environmental & Occupational
Health domains and sub‐domains

8. Draft 2014 NHSPI™ Structure Changes
Figure illustrates the DRAFT 2014 NHSPI™ Structure Changes. The 2014 NHSPI™ will include both model refinements and new measures. The Draft 2014 NHSPI™ Structure as depicted above includes the following changes:
- Added one new domain with three sub‐domains
Environmental & Occupational Health
Responder Safety & Health
Air, Food, & Water Security
Human, Animal, and Environmental Monitoring & Decontamination
- Revised the Surge Management domain and sub‐domains:
Renamed Surge Management to Healthcare Delivery
Renamed Emergency Medical Service to Prehospital Care
Split Acute & Primary Care into two new sub‐domains; Inpatient Care, Outpatient Care
Added Long‐Term Care and Home Care
Removed Chronic & Long‐Term Care; measures for this sub‐domain have been moved to the Inpatient Care, Outpatient Care, Long‐Term Care, and Home Care sub‐domains
- Moved Congregate Care sub‐domain to the Community Planning & Engagement domain
- Added a Legal & Administrative sub‐domain to the Incident & Information Management domain
- Moved Fatality Management from the Healthcare Delivery domain (previously Surge Management) to the Incident and Information Management domain.
- Added a Non‐Pharmaceutical Interventions sub‐domain to the Countermeasure Management domain
- Revised and / or developed definitions for Healthcare Delivery and Environmental & Occupational
Health domains and sub‐domains

9. Draft 2014 NHSPI™ Complete Structure
Figure illustrates the DRAFT 2014 NHSPI™ Complete Structure – note that this is not the final structure – will continue to evolve in 2015 and beyond.
Important to note in discussing this that like last year, not all subdomains will "light up" in 2014.

10. Built by the Community, for the Community
Stakeholders will continue to shape the Index! Receive updates and share ideas at
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