Public Health Accreditation and Quality Improvement Ron Chapman, MD, MPH Director and State Health Officer California Department of Public Health
California 37. 6 Million Californians 61 Local Health Departments California Department of Public Health (CDPH) • 3800 employees • $3. 5 billion • 40 field offices • 200 programs
www. phaboard. org
National Accreditation Program The goal of the national public health accreditation program is to improve and protect the health of the public by advancing the quality and performance of state, local, territorial and tribal health departments. Accreditation will drive public health departments to continuously improve the quality of the services they deliver to the community.
The Value of Accreditation • Drive organizational change. • Create a quality improvement infrastructure. • Improve business operations. • Improve accountability and monitoring. • Increase credibility.
Overview • • • CDC and RWJ funded since 2007 Beta-Test site visits 2009 -2010 Standards published July 2011 Launch Event September 2011 Voluntary Accreditation-two categories • • Accredited (5 years) Not Accredited
Accreditation Structure Domains (12) Standards (30) Measures (106)
Domains 1. Conduct and disseminate assessments focused on population health status and public health issues facing the community. 2. Investigate health problems and environmental public health hazards to protect the community. 3. Inform and educate about public health issues and functions. 4. Engage with the community to identify and address health problems. 5. Develop public health policies and plans. 6. Enforce public health laws.
Domains 7. Promote strategies to improve access to health care services. 8. Maintain a competent public health workforce. 9. Evaluate and continuously improve health department processes, programs, and interventions. 10. Contribute to and apply the evidence base of public health. 11. Maintain administrative and management capacity. 12. Maintain capacity to engage the public health governing entity.
Public Health Accreditation Critical Elements Strategic Plan Quality Improvement State Health Assessment • Let’s Get Healthy California www. chss. ca. gov State Health Improvement Plan
Standard 9. 2: Develop and implement quality improvement processes integrated into organizational practice, programs, processes, and interventions. Written quality improvement plan. Describe a culture of quality and the desired future state of quality in the department. QI communication plan. QI training plan.
The World Is Flat We see the world from one place - OURS. What if we could see the world through a thousand eyes? Easy to blame the people when the system has no name and is hard to identify.
The World Is Round: Systems Run Our lives People create systems: “Each system is perfectly designed to serve the purpose for what is was intended. ” People are not the system. Need to analyze and change the system, not the people.
What is the System? Pipes where demand for services goes in one end a service/product comes out the other end. History and a series of decisions makes the pipes long and tortuous. The pipes need to be straightened and shortened.
Expectations People will learn and use the tools to analyze and transform systems. People will be empowered to use these tools and to make the systems changes. The system will be changed to provide better and faster services for our customers. Process will not be sacrificed for product.
What Performance Management and QI Are Not a replacement for: • Leadership skills • Functional teams (team building) • Governance
The Tools QI is a set of tools to help people understand, analyze, and transform systems. Need to tear apart the house to see the pipes. QI principles • Systems and customer focus • Evidence-based and data driven • Shared decision making • Multidisciplinary process (many eyes!) • Continuous Quality Improvement (CQI) • Plan, Do, Study, Act (PDSA)
Contracts Problem: Contracts are not being executed timely (3, 000 contracts in CDPH) • Severely harmed credibility • Risk of losing Federal funding Baseline Data: • Department of General Services (DGS) routinely rejected 60 – 70 % of contracts • Review all of the DGS Rejections for past year Unclear and/or Poor Scope of Work and Budget 75% Conflicting Exhibits – 25%
Results Of last 900 contracts only 4 were returned from DGS = 0. 4% rejection rate. Some programs given streamlined contract authority from DGS. Customers have noted improved contracting process.
Office of Quality Performance and Accreditation (OQPA) Established July 2012. Deputy Director reporting to CDPH Director. Staff integrated from across CDPH. CQI training for executives & teams July. Sept. CQI Academy to train all 3, 800 employees. • Disseminate to local public health.
Hire Experts External expertise for training/coaching • Public Health Foundation: Dr. Jack Moran July 2012: Executive Management training August 2012: Two-day QI team training (4) • Patricia Porter: QI Consultant September 2012 – Current: Coaching of QI teams (4)
Pioneer QI Teams Four QI teams • Human Resources, Communicable Disease, Employee Satisfaction and Vital Records
Next Steps Performance Management System Build department knowledge on accreditation requirements Deploy web based Quality Improvement training (mandatory) for all current/future employees State Health Assessment and Plan Hire dedicated accreditation staff
Скачать презентацию Public Health Accreditation and Quality Improvement Ron Chapman
2bdc61134e107676ac21dea026418e5f.ppt