• Performance management overview and relevance to public health
• Turning Point Performance Management System Framework overview
• Turning Point Performance Management System Framework 2012 refresh
• Tools to help your organization assess performance management capacity
• Performance management resources
1. Performance Management: Improving
Systems Systematically
Margie Beaudry and Jack Moran
Public Health Foundation
Public Health Agency & Systems Improvement
Webinar Series
December 20, 2011
2. Overview
Performance management overview and relevance to
public health
Turning Point Performance Management System
Framework overview
Turning Point Performance Management System
Framework 2012 refresh
Tools to help your organization assess performance
management capacity
Performance management resources
3. “Performance management is the practice of actively using
performance data to improve the public's health.
This practice involves the strategic use of performance
measures and standards to establish performance targets
and goals.”
Source: From Silos to Systems: Using Performance Management to Improve Public Health Systems – prepared by the
Public Health Foundation for the Performance Management National Excellence Collaborative, 2003
4. Performance Management
A systematic process by which an organization
involves its employees in improving the effectiveness
of the organization and achieving the organization’s
mission and strategic goals.
By improving performance and quality, public health
systems can save lives, cut costs, and get better
results.
Enables health departments to be more:
Efficient
Effective
Transparent
Accountable
5. Performance Management
Core performance management practices and processes generally
include:
goal setting
financial planning
operational planning
data collection
consolidation of data
data analysis
reporting of data
quality improvement
evaluation of results
monitoring of key performance indicators
others???
The focus of these performance management activities is to
ensure that goals are consistently met in an effective and efficient
manner by an organization, a department, or an employee.
6. The Importance of Performance Management
Some of the ways performance management can
positively influence a public health agency include:
better return on dollars invested in health
greater accountability for funding and increases in the
public’s trust
reduced duplication of efforts
better understanding of public health accomplishments and
priorities among employees, partners, and the public
increased sense of cooperation and teamwork
increased emphasis on quality, rather than quantity
improved problem-solving
7. Performance Management
Federal Government Perspective
The Accountable Government Initiative - an Update on
Our Performance Management Agenda states that
performance management efforts for 2011 are focused
on six strategies that have the highest potential for
achieving meaningful performance improvement within
and across Federal agencies:
1. Driving agency top priorities
2. Cutting waste
3. Reforming contracting
4. Closing the Information Technology gap
5. Promoting accountability and innovation through open government
6. Attracting and motivating top talent
Source: Memorandum for the senior executive service; Jeffrey D. Zients, Federal Chief
Performance Officer and Deputy Director for Management, Office of Management and Budget;
9/14/2010
8. Why Collect Data
Data: A set of discrete facts
Example: NPHPSP Report of Results
Information: What the data tells us
Example: Where are public health systems optimally performing
and where are opportunities for improvement related to the 10
Essential Services (ES)
Knowledge: Synthesis of information
Example: Performing lower in ES 8 may be connected to
insufficient workforce training opportunities
9. How to Use Data
Public Health Departments usually have lots of data on
Health Status. Some limitations of these data are:
Aggregate level
Timeliness
Reliability and Validity
Process data
Customer data
11. Turning Point Framework
Performance management is the strategic use of
performance standards, measures, progress reports, and
ongoing quality improvement efforts to ensure an agency
achieves desired results.
In the case of public health, the ultimate purpose of these
efforts is to improve the public’s health and make the
community better to live in.
12. Source: From Silos to Systems: Using Performance Management to Improve Public Health
Systems – prepared by the Public Health Foundation for the Performance Management
National Excellence Collaborative, 2003
13. Polling Question
Are you familiar with the Turning Point PMS
Framework?
Yes, it’s very useful and I apply it to every
day practice
Yes, I’m familiar with the framework but
don’t apply it regularly
No, it’s difficult to understand and apply
No, I’ve never heard of this framework
14. Terms
Performance Standards are objective standards or guidelines
that are used to assess an organization’s performance (e.g., one
epidemiologist on staff per 100,000 people served, 80 percent of
all clients who rate health department services as “good” or
“excellent”). Standards may be set based on national, state, or
scientific guidelines (e.g., National Public Health Performance
Standards Program standards, Public Health Accreditation
Board standards, etc.); by bench-marking against similar
organizations; based on the public’s or leaders’ expectations (e.g.,
100% access, zero disparities); or other methods.
15. Terms
Performance Measurement consists of quantitative
measures of capacities, processes or outcomes relevant to the
assessment of a performance indicator (e.g., the number of
trained epidemiologists available to investigate; percentage of
clients who rate health department services as “good” or
“excellent”). To select specific performance measures, public
health agencies may consult national tools containing tested
measures, such as Healthy People 2020, as well as developing
their own procedures to help them measure performance.
16. Terms
Reporting of Progress is how a public health agency tracks
and reports progress depending upon the purpose of its
performance management system and the intended users of
performance data. A robust reporting system makes
comparisons to national, state, or local standards or benchmarks
to show where gaps may exist within the system.
17. Using Data for Improvement
Quality improvement
techniques
Policy change
Managerial Action Resource allocation
change
Program change
18. Terms
Quality Improvement is the establishment of a
program or process to manage change and
achieve quality improvement in public health
policies, programs, or infrastructure based
on performance standards, measures, and
reports.
19. PDCA: A Quality Improvement Model Often Used In Public Health
Act Plan
Check Do
• Model Often Used In Public Health
• Uses Many Tools
20. Many QI Tools
Most Commonly Used Other QI Tools
Brainstorming Affinity Diagrams
Flow Chart ID Graphs
SIPOC+CM Tree Diagrams
Cause and Effect Diagram Process Decision Charts
Five Whys Radar Charts
Solution and Effect Diagram Control and Influence Plots
Checksheets Gantt Chart
Pareto Charts Value Stream Mapping
Pie Charts Lean Waste
Run Charts Matrix Diagrams
Control Chart
Force Field Analysis
Nominal Group Technique
21. Performance Management in Public Health Today
QI Definition in Public Health
Journal of Public Health Management Practice (JPHMP)
January/February 2010 issue focused exclusively on QI
in public health
New initiatives:
National Public Health Performance Standards Program
(NPHPSP)
Multi-state Learning Collaborative (MLC)
CDC’s Winnable Battles
National Public Health Improvement Initiative (NPHII)
National Prevention Strategy (June 2011 launch)
Public Health Accreditation Board (Sept. 2011 launch)
Accreditation Domain 9 required documentation
22. Turning Point Framework 2012 Refresh
Purpose
Introduce updates that reflect current
challenges and priorities in public
health
Refresh guidance and tools to make
the framework more easily understood
and implemented within public health
Add contemporary examples
Got refresh ideas? Send them to Performance Management
Julia Gray at jgray@phf.org Self-Assessment Tool
23. Polling Questions
Which quadrant of the Turning Point
Performance Management model do you
think your organization shows the most
experience, strengths, or competency?
Performance Standards, Performance
Measurement, Reporting of Progress, Quality
Improvement Process
In which quadrant do you think your
organization could improve its efforts?
Performance Standards, Performance
Measurement, Reporting of Progress, Quality
Improvement Process
25. Radar Chart:
Rate Your Current Performance Management Capability
Performance Standards
SA Performance
Organization A Measurement
Support
D
SD
Organization
Understanding Reporting of
Progress
Quality Improvement
26. What is the health department currently working on?
27. Every System is Perfectly Designed to Achieve
Exactly the Results it Gets
Results are properties of systems.
Results do not occur by new goals or targets, but through systemic
change.
Improvement comes only with change; but change doesn’t always
improve results.
28. Resources:
Conduct a keyword search in the Public Health Improvement
Resource Center - http://www.phf.org/improvement/. Type in
“Turning Point” in the Quick Search menu on the home page and
press search for Turning Point Performance Management System
resources. Type in “performance management” for broader
resources.
Turning Point Performance Management resources -
http://www.phf.org/resourcestools/Pages/Turning_Point_Project_Pu
blications.aspx
Performance Management Self-Assessment Tool -
http://www.phf.org/resourcestools/Documents/PM_Self_Assess_Too
l.pdf
CDC Performance Management and Quality Improvement
resources - http://www.cdc.gov/ostlts/performance/Resources.html
Notas do Editor
Jennifer McKeever to introduce and give orientation to webinar raise hand and chat tool featuresRon will advance presentation slides
Performance managementuses a set of management and analytic processes supported by technology that enables an organization to define strategic goals and then measure and manage performance against those goals.
Ron – I created this slide to replace Jack’s data PIM Network presentation slide about Behavior Attitudes that we discussed you wanting to exclude. I didn’t want to leave out the concept of Data Information Knowledge. I used a NPHPSP example since this webinar since I thought it would resonate well with CDC given that this webinar is part of the NPHPSP User Call series.
Turning data into information – useful for building some knowledge to see how results of the process or performance for the organization is doing as a wholeIdeal to use technology to collect data (quantitative or qualitative both important) on a regular basis, measure and then manage performance against those goalsGathering data on processes and collecting customer data (delivery of services) is as important as health status data
Ron – I came across this comic in my performance management background research and thought it could be something light-hearted to include in your presentation to kick-off the topic – your choice to leave in or out
NNPHI will replace this slide with a polling slide
Stress difference between QI and PM
More information available on PHF’s website: Public Health QI Handbook, Memory Jogger II, White Papers on QI tools, Encyclopedia of QI Tools (coming 2012)
Ten years since TP Framework and materials developed. Changing environment – QI has been defined and more accepted and more QI tools have been developed, translated from industry. New initiatives (e.g., NPHII initiative is encouraging health departments to move in direction of QI)Accreditation: Domain 9 required documentation (PHAB Accreditation Standards and Measures pg. 192-195): 9.1.1 A – Engage staff at all organizational levels in establishing or updating a performance management system9.1.2 A – Implement a performance management system“9.1.2.A - The health department must provide a completed performance management self-assessment that reflects the extent to which performance management practices are being used. The health department may develop its own performance management assessment or use existing models, such as The Performance Management Self-Assessment Tool from the Turning Point Performance Management National Excellence Collaborative (http://www.phf.org/resourcestools/Documents/PM_Self_Assess_Tool.pdf). Self-assessment tools are also available through the Baldrige Performance Excellence Program (http://www.nist.gov/baldrige/enter/self.cfm)”
PHF will be gathering input from a “think tank” group and querying other public health groups (e.g., NPHII PIM Network) to make recommendations based on the refresh/revise objectivesPotential items to be refreshed include the following:Performance Management framework graphicPerformance Management Self-Assessment toolFrom Silos to Systems: Using Performance Management to Improve the Public’s Health
NNPHI will replace this slide with a polling slide
A radar chart is a scale that can be used to generate discussion around where your organization is around performance management? What do people think about performance management? Important to capture the range of responses in groups and consent to a group score and capture reasons why there were disagreements in scores.Reiterate: A performance management systemis the continuous use of all the practices (Performance Standards, Performance Measurement, Reporting of Progress, Quality Improvement)so that they are integrated into an agency’s core operations. A few other items have been added: questions around does your organization understand it and do you have support of your organization.
