Quality Connection
E-Blast
January 2016 - Issue 26
Welcome Public Health Colleagues!
Welcome to ASTHO's Quality Connection E-Blast! In this newsletter you will find news and information on ASTHO resources and tools, upcoming funding and learning opportunities, current publications, and updates on cross-cutting ASTHO programs in the areas of performance management and accreditation readiness. This e-blast is brought to you thanks to funding from CDC.
In This E-Blast
ASTHO News
State and Territory News
Member Spotlight
Public Health Accreditation Board Updates
Dashboard Pilot Test
2015 Accreditation Coordinator Learning Community Calls
2015 Quality Improvement Forum
State Health Improvement Plan Learning Series
PHAB Accreditation
ASTHO encourages all state health agencies to seek voluntary national accreditation from the Public Health Accreditation Board. Visit PHAB's Website for the most up-to-date accreditation materials.
We want to hear from you!
Has your department utilized performance management or quality improvement activities? Do you have an accreditation readiness success that you want to share? We want to feature your story in future issues of Quality Connection! Send us an update of 150 words or less, and we will feature it here. For submissions or questions, please contact ASTHO Performance and Quality Analyst Alex Barton.
If you do not already receive Quality Connection, click the link below to join our monthly mailing list!
2015 Performance, Quality, and Accreditation Resources
NEW! Cross-Jurisdictional Quality Improvement Factsheet
ASTHO partnered with CDC, HRSA, NACCHO, the Vermont Department of Health, and the Tacoma-Pierce County Health Department to create a Cross-Jurisdictional Quality Improvement Factsheet. Cross-jurisdictional quality improvement (QI) can allow health agencies to share resources and lessons learned and solve problems that extend beyond jurisdictional boundaries, and this document provides tips and resources for successfully creating these initiatives. Please contact Denise Pavletic, ASTHO's director of systems improvement, with any questions about this resource.

Developing a State Health Improvement Plan: Guidance and Resources
ASTHO released the report Developing a State Health Improvement Plan: Guidance and Resources in June 2015. This document describes the process for developing a state health improvement plan (SHIP) by using Public Health Accreditation Board (PHAB) requirements. The report includes seven modules that provide tips for the planning and implementation phases, specific examples and lessons learned from states, and sample tools and links to additional resources. ASTHO will be hosting a four-part learning series explaining the SHIP resource and process in February: please see the webinar description at the bottom of this e-blast. For information on this resource or the upcoming learning series, please contact Denise Pavletic.

Workforce Development Plan Toolkit
ASTHO's Workforce Development Plan Toolkit is designed for agencies at all stages of workforce development plan preparation. Agencies that are just starting the process may find it useful to review all toolkit sections in depth, while agencies that are further along might use the toolkit sections as a checklist. For agencies interested in applying for PHAB accreditation, this toolkit addresses the documentation requirement for Measure 8.2.1A, "workforce development strategies," and supports the accomplishment of Measure 8.2.3A, "professional and career development for all staff." For further information, please contact Denise Pavletic.

Accreditation Readiness Resource Kit
ASTHO's Accreditation Readiness Resource Kit is designed to help state and territorial health departments achieve accreditation through resource sharing. The resource kit begins with an introduction to accreditation, and is structured based on PHAB's seven steps to accreditation. Each of the seven steps is explained in detail, and resources and tools are provided. If you have resources you would like us to consider for inclusion in this resource kit, please contact Lia Katz, ASTHO's senior analyst for performance improvement.

ASTHO and NACCHO Performance Improvement Resources for State and Local Health Department Professionals
ASTHO and NACCHO have partnered to create a joint Performance Improvement Resource List. This document contains resources available from ASTHO and NACCHO that are similar in nature in order to help state and local health department practitioners engage in performance management and quality improvement activities. Please direct any questions about these resources to Lia Katz.
Upcoming 2016 Resources
Performance Management, Quality Improvement, and Accreditation Resources for State and Territorial Public Health Leaders
ASTHO is currently developing two resources that aim to engage state health agency leaders in performance management (PM), QI, and accreditation. Both resources focus on issues and concerns pertinent to health department leaders. The accreditation leadership guide will provide guidance and strategies on how leaders can approach various accreditation related issues. The performance management and quality improvement guide focuses on PM, QI, and how a leader is critical to directing agency commitment and momentum. Both resources are being developed based on input from ASTHO members and will include stories from the field and examples of practical application from current health agency leaders. Both resources will be available in May 2016. For more information on these resources, please contact Joya Coffman, ASTHO's director of performance improvement.

Territory Accreditation Performance Toolkit
ASTHO has developed and will soon release the Territorial Health Agency Public Health Performance and Accreditation 101 Resource. This resource will provide territorial health agencies with practical guidance on how to improve their public health systems' overall performance and review first steps to approaching accreditation within the context of a territorial health agency. It includes sections on the public health accreditation process, organizational self-assessments, creating a culture of quality improvement, and how to sustain PM and QI work. This toolkit is intended for performance improvement managers, accreditation coordinators, and other health agency staff involved in performance improvement. The final toolkit will be available for download in March 2016. Please contact Alex Barton for more information.
State and Territorial News
Congratulations to Our Newly Accredited Members!

ASTHO congratulates the following members that achieved accreditation status in 2015: District of Columbia Department of Health, Illinois Department of Public Health, New Mexico Department of Health, Ohio Department of Health, and Rhode Island Department of Health.

These four states and Washington, D.C. join the seven other states that currently have accredited status: California Department of Public Health, Florida Department of Health, Minnesota Department of Health, New York State Department of Health, Oklahoma State Department of Health, Vermont Department of Health, and Washington State Department of Health. In addition to the 12 state health departments with an accredited status, 21 states are currently in the accreditation process.
Member Spotlight
ASTHO has two new case studies on accreditation readiness in territories:

Federated States of Micronesia's Yap State Breaks Down Silos during its Organizational Self-Assessment
Federated States of Micronesia's Yap state initiated an organizational self-assessment (OSA) process in hopes of better understanding its health department's systems and processes and identifying areas in need of improvement. With technical assistance from ASTHO, the territory's performance improvement manager conducted the OSA with Yap staff, allowing them to discuss problems at an agency level, instead of programmatically, identify and share current resources and tools, and focus on priority areas in need of growth. As a result, program areas that once worked disjointedly in Yap state are now collaboratively involved in quality improvement projects. Read the full story on ASTHO's website.

Republic of Palau Ministry of Health Takes Creative Approach to Gathering Community Health Assessment Feedback
The Republic of Palau faced challenges in its efforts to obtain community feedback on its community health assessment (CHA). Although many states and territories are able to post their health assessments on their websites to gain community input, at that time Palau did not have a functional health department website, and had to identify alternative strategies to overcome these technological limitations. After learning about one local health department's approach to marketing its CHA at county fairs, Palau began to solicit feedback during its bimonthly International Night Markets. Despite having no online access to solicit feedback, Palau received input from 180 community members from the International Night Markets alone, in addition to finding other creative ways to obtain feedback. Read the full story on ASTHO's website.
Public Health Accreditation Board's Updated Guidance
In August 2015, PHAB released updated guidance on initial accreditation for public health departments. This guidance was developed out of conversations from PHAB's Accreditation Improvement Committee on how to improve the process of seeking initial accreditation.

Among these revisions are changes to the names of accreditation process steps, shortening the time between registration and application submission, and requiring departments to state that they have implemented or nearly completed a workforce development plan, public health emergency operations plan, and QI plan. Two changes went into effect in September 2015: the first creates a formal policy for extensions during documentation selection and submission, and the second drops the "not accredited" designation in favor of a request for revision and resubmission from the Accreditation Committee. All other revisions will go into effect Feb. 1. PHAB released a summary of the revisions  that outlines the old and new accreditation processes.
ASTHO's Performance Dashboard Pilot Test
In September 2015, ASTHO launched its pilot test of its Performance Dashboard (PD), a member-driven product that is a performance management tool designed for state and territorial health officials and executive leaders. The PD has a core set of measurable and comparable performance indicators that can be utilized to determine the operational and organizational health of state and territorial health agencies' operational and organizational health. The PD aims to both inform a leader about the organizational health of his or her agency and to support decisions and inform QI.

The pilot test aims to evaluate each indicator, determine applicability, determine perceived value and importance to public health leaders, assess ability to track and improve processes and practices that affect health department operations and infrastructure, and inform modifications in preparation for dissemination to all members. Currently, eight states and one territory are providing feedback on their experiences with collecting data for the indicators and using the online dashboard system: California, Commonwealth of the Northern Mariana Islands, Connecticut, Georgia, Minnesota, Pennsylvania, Vermont, Washington, and Wyoming.

NORC at the University of Chicago is conducting an independent evaluation of the performance indicators in the pilot test, and will provide a final evaluation report this spring. This report will inform next steps in rolling out a final version of the dashboard, including revisions made to the indicators and dashboard system. For more information on the PD pilot test, please contact Joya Coffman.
Convening the Accreditation Coordinator Learning Community
ASTHO hosted four Accreditation Coordinator Learning Community (ACLC) calls in 2015. Each quarterly call focused on different accreditation preparation topics, including domain nine and performance management, domain eight and workforce development, aligning the PHAB prerequisites and plans, and a discussion on the future of ACLC and future calls topics of interest.

ACLC serves as a peer network where members exchange accreditation related resources and engage with colleagues in other state health agencies for the purposes of successfully serving as an accreditation coordinator and leading an accreditation application process.

The next ACLC call will take place on Jan. 26 from 3 - 4:30 p.m. EST. PHAB representatives will be joining the call, which will be jointly hosted with NACCHO and the National Indian Health Board (NIHB), to discuss the recent results from PHAB's evaluation undertakings and the updated Guide to National Public Health Department Initial Accreditation that comes into effect on Feb. 1. For more information about ACLC, please contact Lia Katz.
Federal, State, and Local Public Health Participate in QI Projects to Improve the Public Health Enterprise
During 2015, ASTHO worked with federal, state, and local public health agencies to pursue QI initiatives that would focus on improving the public health enterprise. This initiative was sponsored by the Robert Wood Johnson Foundation, and involved four projects, more than 20 agencies, and more than 60 public health professionals. These four projects were identified by participants in a series of three meetings intended to explore opportunities for QI projects that would more efficiently and effectively deliver federal agency public health programs at the state and local system levels. Participants saw value in coordinating related efforts across federal, state, and local systems to reduce waste, improve performance and impact, and maximize the benefits of investments. 

The selected projects were focused on improving death record data transfer and delivery from state to local public health agencies, improving the state process for grant reporting on federal awards, and determining best practices to spread cross-sector QI within public health. Each project focused on achieving measurable improvement results, benefiting impacted stakeholders at all program levels, and increasing the knowledge and enthusiasm for continual quality improvement. For more information on the results of this work, please see the column published in the January edition of the Journal of Public Health Management and Practice, "Working Together to Improve the Public Health Enterprise."
Are You Ready to "Sail" Your SHIP (State Health Improvement Plan)?!
If so, please save the dates for ASTHO's upcoming SHIP learning series: February 4th, 11th, 18th, and 25th from 1:00-2:15 EST.If your agency is interested in learning more about the process of creating a SHIP, please save the dates for ASTHO's upcoming SHIP learning series, which will take place Feb. 4, 11, 18, and 25 from 1-2:15 p.m. EST. This four-part learning series will cover the seven modules detailed in ASTHO's "Developing a State Health Improvement Plan: Guidance and Resources" document. Representatives from Alabama, Alaska, Oklahoma, and New York will present their journey in developing the SHIP process and SHIP plan. Additionally, Oklahoma and New York will share experiences from the PHAB site visit on their SHIP review.

The learning series is designed for those state employees responsible for or involved in the development of the SHIP. If you are interested in joining the learning series, please hold the dates and times below, and contact Alex Barton to be added to the invitation listserv. Please direct any questions about the SHIP learning series to Denise Pavletic. We hope that you can join us!

Webinar
DateTimeModules covered
1
Feb. 4
1 - 2:15 p.m. EST
Module 1: Identifying and Engaging Stakeholder in Planning and Implementation
Module 2: Engaging in Visioning and Systems Thinking
2
Feb. 11
1 - 2 p.m. EST
Module 3: Leveraging Data Inputs
3
Feb. 18
1 - 2:15 p.m. EST
Module 4: Establishing Priorities and Identifying Issues through Priority Setting
Module 5: Communicating SHIP Priorities
4
Feb. 25
1 - 2:15 p.m. EST
Module 6: Developing Objectives, Strategies, and Measures
Module 7: Implementing and Monitoring the SHIP

We enjoy your participation in the new Quality Connection E-Blast. Please note that we are moving from a quarterly newsletter to a monthly e-blast with up-to-date information. Please let us know your thoughts on the new e-blast and if you have a preference regarding our on publication frequency. We welcome contributions, and would like to highlight your agency or a program going on in your state. Please contact Alex Barton to contribute an update for a future issue.

Sincerely,

ASTHO Performance and Quality Staff

ASTHO Board of Directors
 
President: Edward Ehlinger, MD, MSPH (MN)
President-Elect: Jay C. Butler, MD, CPE (AK)
Secretary-Treasurer: Brenda Fitzgerald, MD (GA)
Immediate Past President: Marissa Levine, MD, MPH (VA)
Past President: Terry L. Cline, Ph.D. (OK)
 Regional Representatives
 I: Harry L. Chen, MD (VT)
II: Howard A. Zucker, MD, JD (NY)
III: Marissa Levine, MD, MPH (VA)
IV: Mary Currier, MD, MPH (MS)
V: Karen McKeown, MSN, RN (WI)
VI: J.T. Lane (LA)
VII: Gerd W. Clabaugh, MPA (IA)
VIII: Wendy E. Braund, MD, MPH, MSEd, FACPM (WY) 
IX: James W. Gillan, MS, HSA (GU)
X: John M. Wiesman, DrPH, MPH (WA)
 Ex-Officio
ASTHO Interim Executive Director: Sharon Moffatt, RN
Rep. Senior Deputies Committee: Julie Cox-Kain, MPA (OK)
Rep. Affiliate Council: John W. Robitscher, MPH (National Association of Chronic Disease Directors) 
Alumni Board Member: David N. Sundwall, MD