What’s on the Horizon?Exploring Tribal Health Department Strategic Planning for Public Health

AccreditationKeisha Robinson, MPH

Tribal Public Health Analyst / Program ManagerNovember 20, 2013

Overview• Public health accreditation and tribal public

health systems• Strategic planning and accreditation• Tribal Health Departments (THDs) strategic

planning process• Group activities• Questions and answers

Tribal Public Health Systems

Community

Health

Tribal Government

Tribal Health Dept.

Federal agencies

Private Industry

Local/ State Health Dept.

Tribal Colleges

Community

ITCs/Tribal EpiCenters

Multiple stakeholders who work in partnership to assure conditions in which people can be healthy.

Tribal Public Health Infrastructure

Communi

ty Heal

th

Tribal Gov Tribal

Health Dept/C

linic

Federal agenci

es

Private

Industry

Local/ State

Health Depart

Tribal College

s

Community

ITC’s/Epi

Centers

What is Public Health Accreditation

• Measurement of Tribal, state and local health department performance against a set of national standards

• Issuance of recognition of achievement within a specified period of time by a nationally recognized entity

• Supports continuous quality improvement in public health performance

PHAB Standards and Measures v1.0

• Based on the public health functions set forth in the 10 Essential Public Health Services and Core Functions (www.cdc.gov)

• 12 Domains– Each domain has a set of standards and

measures–Required documentation for each measure

Benefits and Opportunities

• Strengthen self-determination• High performance and quality improvement• Strengthen leadership and employee

performance• Build stronger partnerships and increase

communication and collaboration• Recognition, validation and accountability• Potential increased access to resources• It’s about communities

Accreditation Prerequisites

1. Community Health Assessment2. Community Health Improvement Plan3. Department Strategic Plan

What is a Department Strategic Plan?

• Process for defining and determining an organization's roles, priorities, and direction over three to five years

• Sets forth what an organization plans to achieve, how it will achieve it, and how it will know

• Guide for allocating resources and pursuing priorities

Department Strategic Plan for THDs Pursuing Accreditation

• Focus on the entire health department

• Program-specific strategic plans may complement and support the department strategic plan

• Links to the Community Health Improvement Plan (CHIP)

• Domain 5, Standard 5.3

Strategic Planning Resource• Developing a Tribal Health Department

Strategic Plan: A How-To Guide– Adapted from National Association of County and

City Health Officials (NACCHO) resources for local health departments

– Capacity-building resource for THD interested in conducting a strategic planning process and creating a strategic plan that meets PHAB requirements

Strategic Planning Guide Organization

Module I: Introduction to

Strategic Planning for Tribal Health Departments

Module II: Prepare for the

Strategic Planning Process

Module III: Conduct Strategic

Planning

Module IV: Implement, Monitor and Evaluate the

Strategic Plan

Strategic Planning Process• Strategic planning frameworks typically

consists the following: – Prepare for Strategic Planning– Conduct Strategic Planning– Implement, Monitor and Evaluate Progress

• Each phase involves multiple steps

Prepare for

Strategic

Planning

Prepare for Strategic Planning

• Lay the Groundwork– Is the THD ready to move forward?– Who will be on the planning committee?– Who are the stakeholders and how to engage?– What information is available to inform the plan?– What will be the overall approach and timeline?

Prepare for Strategic Planning

• Compile Relevant Information– THD staff identifies and collects the information

available to inform the strategic planning process

• Recommendations and Considerations– Must have a commitment from the leadership– You can’t “go it alone” – Get past the past and rebuild old bridges– Try not to recreate the wheel

Environmental Scan• The collection, analysis and evaluation of

information and data about the internal and external factors that affect an organization– Identify and compile relevant and available data

and information – Determine the value of available data– Collect additional data and information as needed– Summarize data and information for future

analysis

Using CHA and Self-Study Results for Strategic Planning

• The CHA provides information about health status and community priorities

• Use self-study results to understand – How the THD operates– The issues facing the community the THD serves– Provides illustration of strengths and areas for

improvement

Recommendations and Considerations

• Must have a commitment from the leadership

• You can’t “go it alone”• Get past the past;

rebuild old bridges• Try not to recreate the

wheel

Conduct Strategic Planning

Conduct Strategic Planning

• Facilitate the development of Vision, Mission, and Values with stakeholder engagement

• Mission: – Tells what the organization’s purpose is now– Explains what the organization does and why– Should guide overall organizational direction

Conduct Strategic Planning

• Vision: – Futuristic view regarding the ideal state or

conditions that the organization aspires to change or create

• Values: – Principles, beliefs, and underlying assumptions

that guide the organization

Values• Accountability• Collaboration• Community• Dependability• Effectiveness• Efficiency• Excellence• Innovativeness• Integrity

• Quality• Respect• Responsibility• Self-determination• Sovereignty• Timeliness• Traditions• Wellness• Wisdom

Conduct Strategic Planning

• Analyze the data and information– Complete a strengths,

weaknesses, opportunity and threats (SWOT) Analysis

– Identify crosscutting themes, emerging issues, and assets

Internal Considerations (Strengths and Weaknesses)

• Resources to do the job • Adequate knowledge and skill• Organizational culture• Communication, processes, and organizational

structure • Training, staff qualifications and skills• Timeline to complete the project, • Authority around decision-making

External Considerations(Opportunities and Threats)

• Economic trends • Competition• Technology• Resources• Governmental regulations • Stakeholders• Funding sources

Conduct Strategic Planning

• Engaging stakeholders in defining and framing strategic issues that emerge from the environmental scan and SWOT analysis

• Prioritize a select a manageable number of strategic issues to be included in the plan

• Create a Strategic Planning Document with goals, objectives and targets

Recommendations and Considerations

• The list of strategic issues may be unrealistic for a THD to address in a three to five year period

• Common prioritization techniques include:– Multi-voting Technique– Strategy Grids– Nominal Group Technique– The Hanlon Method– Prioritization Matrix

Recommendations and Considerations

• Reach consensus on strategic priorities– Many Tribes use consensus to make decisions that

impact the community– Demonstrates unity in decision making and

reinforces the principles of engagement– Does not mean that everyone is in complete

agreement, but that most can give their support for the greater good of the community

Implement, Monitor, and Evaluate

Implement, Monitor, and Evaluate Progress

• After adopting the plan, put it into action– Some organizations develop an implementation

plan that outlines how staff will implement the strategic plan in day-to-day work

• Establish a process to monitor and evaluate the plan– How is the strategic plan integrated into the

health department’s daily practice?

Implement, Monitor, and Evaluate Progress

• When monitoring the plan, look for quality improvement opportunities– Remember: The Strategic Plan is intended to

create change in an organization• Regularly communicate the results of strategic

plan progress• Revise and update the plan as needed

Recommendations and Considerations

• The strategic planning process does not end with developing a plan – it must be implemented

• Are we doing what we set out to do?• Share the findings– Internally with staff, leadership and advisory

committees– Key external stakeholders part of the public health

system

Activity 1• Articulating Values and

Reaching Consensus– Different than majority

voting– End result is that the

group finds the decision acceptable, even if they have other individual preferences

Activity 1 – Report Out• Did the group reach consensus through only

discussion?• How did the group finalize the decision?• Did everyone participate?• Was there cooperation throughout the

process?• How did you feel at the end of the discussion?

Did you feel your input was heard?

Activity 2Selecting Strategic Priorities using Three-Round

Multi-Voting*• Scenario: A group of program managers convent to

select top strategic priorities for the THD Strategic Plan– Round 1 – Vote as many times as you like and update– Round 2 – Vote up to 3 times and update– Round 3 – Vote up to 2 times and determine results

*NAACHO – Guide to Prioritization Techniques

Activity 2 – Report Out• Overall, how did your group do?

• How many priorities made it to Round 3?

• Was everyone happy with the selections?

• How did you feel if your main strategic priorities did not make the final cut?

Resource• Developing a Tribal Health Department

Strategic Plan: A How-To Guide

• Available at:– Red Star Innovations

http://redstar1.org/resources– NACCHOhttp

://www.naccho.org/topics/infrastructure/accreditation/preparing.cfm

Questions and Answers

Contact Information

Keisha Robinson, MPHTribal Health Program Manager/Data Analyst

Red Star InnovationsEmail: keishar1@redstar1.orgWebsite: http://redstar1.org/