1. Kansas City Health Commission Mapping The Way To A High Performing Public Health System Presented by: Cynthia Davis Kansas City Health Department May 9, 2006

2. Presentation Overview 1. Why conduct assessment? 2. Benefits of conducting assessment 3. The starting point 4. Assessment sessions process 5. Assessment completed

3. Continued 6. Data Driven: Improving the local public health systems performance 7. Reporting back to the community 8. Closing comments

4. Local Public Health System Assessment Route 4

5. Why Route 4 To get a glimpse of what the local public health system might look like Monitor the local public health system and identify weaknesses to make improvements Gather baseline data to measure improvements

6. Continued To raise provider and community awareness about the local public health system vs. individual agency To begin dialoguing about the local public health system and its performance

7. Benefits of Taking Route 4 Learn what essential services of public health other agencies are providing, including how and to whom Opportunity to partner/collaborate on efforts to solve public health problem/issues (systemic approach)

8. Continued Sense of community health approach vs. public health agency Change in mental model: traditional public health system vs. broaden inclusion of all stakeholders ETC. Specific to individual communities

9. Starting Point Convened a meeting inviting all Health Commissioners, members of its 3 committees, and selected health department staff - approximately 70 invites.

10. Continued Meeting Results Grouped essential service numbers: 1 and 2 3, 4, and 5 8, 9, and 10 Identified essential service area co- leaders (5 sets of co-leaders)

11. Continued Second Series of Meetings (5) Co-leaders, health commission committee co-chairs, and selected health department staff identified appropriate agencies to invite to their respective essential service assessment session

12. Continued Meeting Results: Ninety five agencies were identified across the collective 10 public health essential services Invite letters were mailed, with corresponding LPHSA essential service section instrument

13. Continued Follow-up phone calls to every single agency, which resulted in forty-eight agencies across sectors participated. A total of 53 individuals.

14. Assessment Sessions Process Co-leaders facilitated their respective sessions Explained the big picture – MAPP and the end product: Community Health Improvement Plan

15. Continued Clarified definition of local public health system (NACCHO) Explained Assessment instruments structure and concepts Explained group dialogue and decision making (voting) process 1.Each participant quietly read the essential service indicator and model standard

16. Continued 2.The facilitator read the question to the group of participants and they dialogued for the answer: yes/ high partially/low partially/no 3.When the group felt ready, they voted; Tie/close votes led to another dialogue, than another vote. A recorder darkened the answer box from the assessment tool 4.The facilitator moved to the next question and repeated the process

17. Assessment Completed Data Entry and Results Recorder spent approximately 5 hours entering data (answers) into CDCs program CDC generated a report within two weeks

18. Data Driven: Improving the LPHS Performance MAPP leaders sensed what essential service areas were the lowest – CDC results confirmed. Integrated strategies for improving the two lowest scores, into the Community Health Improvement Plan. And to a lesser extent the third lowest score.

19. Reporting Back to the Community Conference to report LPHSA results, May 12. Conference Breakout Sessions (4) One for each of the essential services that were the lowest 3. One for essential service # 2: diagnose and investigate health problems and health hazards in the community – however, not the fourth lowest.

20. Continued Breakout Sessions Purpose Develop interventions for the 3 lowest scoring essential services, plus essential service number # 2.

21. Continued Breakout Sessions Methodology Essential Service 7 CDCs healthy people in healthy places (environment) health protection goals Select 3 of the 7 and determine how to improve the essential service in the selected environments

22. Closing Comments Participant recruitment occurred during the summer months and assessment conducted in August – presented availability challenges Mail invite letters at least five weeks before date assessment is to be conducted

23. Continued Off and on mental model block between individual agency performance and system performance Two separate sessions for essential service # 3: one for providers the other for the community

24. Continued The creation of colored flags for participants to raise when voting made a tedious and long process bearable and even from time to time fun The collective 5 essential services assessment session took approximately 30 hours

25. The End