template implementation plan v1 0 chachip sites 081412

7/24/2019 Template Implementation Plan v1 0 CHACHIP Sites 081412

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TEMPLATE

IMPLEMENTATION PLAN*

A tool to help your communitys eforts to be

ocused and efective

Introduction

When it comes time to take action on a communitys chosen health priorities, sometimes it

is a challenge to move rom a broad goal to efective and strategic action. In the Action

Plan checklist o the Wisconsin !uidebookthere are several steps outlined to help ensure

efective implementation "" be sure to revie# those steps #hen using this tool.

$his document addresses one speci%c part o action planning or impact& a #ell thought"out

implementation plan. 'ou may have already created some o the critical parts o this plan&

priority areas and broad goals. $his template moves into more speci%city including&

(peci%c and measurable ob)ectives

(trategies that have a strong oundation in the evidence base

(peci%c action steps #ith accountabilities, deadlines and resources needed

*inks to national goals and strategies

$his template #ill help your community to create a plan that is ocused and evidence based

and that #ill help you stay on track. In addition, the tool #ill help hospitals and health

department to achieve some o their speci%c re+uirements related to community health

improvement. (ome o the sections o the template are there to assure those key

re+uirements are included. (See theAttachment 1below for a more detailed description of

the specic requirements.)

$o enhance the efectiveness o your eforts, be sure you are ully engaging the community

leaders and community members concerned #ith each issue at every stage, including this

planning phase. $heir involvement at this stage #ill help to assure chosen strategies %t the

target population and #ill leverage ongoing support o this #ork during implementation.

(ee the -ollaborate checklist in the Wisconsin !uidebookor more guidance on engaging

partners.

How to Use this Tool

'our community #ill have already selected top priority areas to address and may have

selected broad goals and some strategies or addressing those priority areas. /any times

$emplate Implementation Plan v 0.12 345105 67inal 8ersion 9ue (pring 510:;

Wisconsin -evised ?45105 or @A--


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those elements are included in a %nal report to the community on the results o the

community health assessment process. @o# it is time to get more speci%c.

A e# things to keep in mind&

-onsider orming small, ocused teams to do this #ork. /any communities use

implementation teams #ith eBpertise and interest in the particular priority topics.

Cngaging those key partners in this planning process #ill help in maintaining

commitment and involvement over the long haul.

An implementation plan should describe the logical se+uence o events that #ill

result in the change you desire. It #orks like a logic model or strategy map, helping

you to drill do#n rom a broad goal to intermediate accomplishments or outcomes

and then to very concrete strategies and action steps. (SeeAttachment 2for a

description of the link between the template implementation plan and a logic model.)

67or more inormation on logic models, see the Dniversity o Wisconsin CBtension

resources;

$he most detailed level o your Implementation Plan E the Action Plan "" oten

becomes your implementations teams annual #ork plan. 'ou may #ish to cut and

paste it into an annual #ork plan document and have your teams use that to guide

their #ork.o When put into use, a #ork plan should be a dynamic tool. $arget dates may

need to be adapted. Actual results may be diferent than anticipated.o Dse this tool to document your progress.

@ote& (ome organiFations are re+uired to track and report on their progress in

their community health improvement plan. Dsing this tool can achieve that

end. (ee the Attachment 0belo# or more inormation on those

re+uirements.

Partner organiFations can eBtract the appropriate sections o this Implementation

Plan to insert into their organiFations strategic plan and4or perormance

management plan. 9oing that #ill help to document their commitment to the

collaboration and to track their eforts internally.

While this tool is primarily designed or #riting an entire implementation plan or a

community health improvement initiative, it can also be used on a smaller, more

speci%c scale. 7or eBample, a team or volunteer #orking on strategies to improve

healthy nutrition #ithin one particular school might use )ust the Action Plan portion

to organiFe and guide their #ork.

nce your plan is complete, your community #ill move into actual implementation #here

you #ill use this document as a oundation or monitoring, evaluation, and communicating

progress to community leaders and community members. 7or more inormation on these

steps, revie# the Implementation and Cvaluation checklists in the Wisconsin !uidebook on

Improving the


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Helpful ResourcesAs you complete this tool or your community, there are several resources that #ill be very

helpul.

(tate and @ational


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also choose to provide a link to any program sites as applicable.

Acti%ity utline the steps you #ill take to achieve each ob)ective. $he

activities are the ho# portion o the action plan. It is best to arrange

activities chronologically by start dates. Place each activity in a

separate ro# and add as many ro#s as you need to the template.

Ti"eline (tate the pro)ected start and end date or each activity.

Resources

Re)uired

Include all resources needed or this action step. CBamples& unding,staf time, space needs, supplies, technology, e+uipment, and key

partners.

Lead

Person

Or(ani+at

ion

Identiy by name the key person #ho #ill initiate the activity, provide

direction or the #ork, and monitor progress.

Anticipat

ed

Result

9escribe the direct, tangible and measurable results o the activity

eB& a product or document, an agreement or policy, number o

participantsPro(ress

Notes

$rack progress o completion o activities. Also note any uneBpected

outcomes, both positive and negative.Ali(n"en

t

(ho# the alignment bet#een your communitys priority area and both

state and national priorities. Also sho# the alignment to tribal

priorities #hen applicable. 'ou can cite the speci%c ob)ectives listed

at these sites above under esources.




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E,a"ple

ABC County Health Improvement Process

Implementation Plan

-ate .reated -ate Re%iewedUpdated

PRIORIT/ AREA utrition ! "h#sical Acti$it#

!OAL

A%& &ount# will implement policies that support residents in achie$ing a health# diet and

increased ph#sical acti$it#.

PER0ORMAN.E MEA1URE1

How 2e 2ill 3now 2e are Ma'in( a -i4erence

1hort Ter" Indicators 1ource 0re)uen

cy

%# 'A* decrease the percentage of adults engaging in no ph#sical

acti$it# from +, to #,

-/%S Annual

%# 'A* decrease the percentage of adults eating less than $e

ser$ings of fruits and $egetables dail# from +, to #,

-/%S Annual

%# 'A* increase the percentage of -& infants e$er breastfed

from +, to #,

-/'S

("edSS)

Annual

Lon( Ter" Indicators 1ource 0re)uen

cy%# 'A* decrease the percentage of o$erweight adult from +, to #

,

-/%S Annual

%# 'A* decrease the percentage of obese adults from +, to #, & Annual

O&5E.TI6E 78

Gy 9A$C, increase the number o AG- -ounty municipalities that are #orking to#ards adopting

local complete street policies rom J to J

&A.3!ROUN- ON 1TRATE!/

1ource &omplete Streets "rogram http344www.completestreets.org4

E%idence &ase: 56rban design and land use policies7 recommended b# he 8uide to &ommunit#

"re$enti$e Ser$ices

Policy .han(e 9/N: 9esA.TION PLAN

Acti%ity Tar(e

t

Resources

Re)uired

Lead Person

Or(ani+ation

Anticipated

Product or

Pro(ress

Notes




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-ate ResultAttend training on WIs

complete street legislation

and assess eBpected impact

on AG- -ounty by

discussing #ith


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-ate Result

O&5E.TI6E 7


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Te"plate

_______ Health Improvement Process

Implementation Plan

-ate .reated -ate Re%iewedUpdated

PRIORIT/ AREA

!OAL

PER0ORMAN.E MEA1URE1

How 2e 2ill 3now 2e are Ma'in( a -i4erence

1hort Ter" Indicators 1ource 0re)uency

Lon( Ter" Indicators 1ource 0re)uen

cy

O&5E.TI6E 78


1ource

E%idence &ase:

Policy .han(e 9/N:

A.TION PLAN

Acti%ity Tar(e

t

-ate

Resources

Re)uired

Lead Person

Or(ani+ation

Anticipated

Product or

Result

Pro(ress

Notes

O&5E.TI6E 7;




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1ource

E%idence &ase

Policy .han(e 9/N:

A.TION PLAN

Acti%ity Tar(et

-ate

ResourcesRe)uired

Lead PersonOr(ani+ation

AnticipatedProduct or

Result

Pro(ressNotes

O&5E.TI6E 7


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Attach"ent 8

Hospital > Pu#lic Health Re)uire"ents related to

I"ple"entation Plannin(

Not?for?pro@t hospitalshave particular re+uirements related to community health

improvement. In terms o an Implementation (trategy, those re+uirements include&

Adopt a #ritten Implementation (trategy to address the community health needs

identi%ed during the assessment 9escribe ho# the hospital #ill address the needs

Adopt a budget or the provision o services that address the identi%ed needs

9escribe any planned collaboration to address the needs

CBecute the implementation strategy

Pu#lic health depart"entsseeking national accreditation need to meet the speci%c

re+uirements or an implementation plan outlined in Public


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S otice 2011/>2 (D42>411) http&44###.irs.gov4pub4irs"drop4n"00"5.pd"ublic ealth Accreditation %oard ("A%)http&44###.phaboard.org4

-isconsin State Statutes ! Administrati$e ules http344legis.wisconsin.go$4rsb4Statutes.html

http&44legis.#isconsin.gov4rsb4code.htm

Attach"ent ;

Lin' &etween Te"plate I"ple"entation Plan and Lo(ic

Model

$he template implementation plan provided here is intended to ollo# a typical logic model

by providing a structure to move rom a broad goal to intermediate accomplishments or

outcomes and then to very concrete strategies and action steps. Gecause diferent

models4tools use diferent language, this cross#alk is provided to illustrate the link bet#een

the language used in this template implementation plan and that used in a logic model.

$emplate Implementation Plan -ategory

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utputs

Inputs

Ac'nowled(e"ents

$his template dra#s heavily on the #ork o the


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-onsultation on this tool #as provided by members o the -

template implementation plan v1 0 chachip sites 081412

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