Community Health Assessment Conference
description
Transcript of Community Health Assessment Conference
Community Health Assessment ConferenceNew Paradigm for Planning and the Data That Supports Planning Efforts
February 11th and 18th
Kevin “Doc” KleinUncharted Territories Inc.
1:15 Introduction (who am I, what is my work)1:20 Telling a story about your work with communities1:35 Exploring an alternative story2:00 Paired conversations (thinking through stakeholders strategic questions)2:20 Sampling of questions2:40 Creating a framework for grounding data conversations using system
thinking tools3:15 Summary
Keynote Outcomes and Agenda
√ Understanding for how CHA can be integrated into an action planning process√ Whet your whistles about the discipline of systems thinking√ Transfer the learning to some concrete next steps (what will we do on Monday?)
3:45 Problem in a hat (what problems might arise under this new approach)turning problems into outcomes that lead to success
4:30 Summary of insights and next steps4:45 Depart
Breakout Session Agenda
√ Discussion about how to turn your problems into outcomes√ Acknowledge the “yes buts” and develop a curiosity for the possibilities√ Understanding for some of the common themes or challenges everyone shares
Action Planning and Data
Systems Thinking Tools
Concrete Next Steps
is our work making a difference?
Action Planning and Data
helping stakeholders make the best decisions possible
Why do we gather data?
Framing our mental models about the planning process
What data is most helpful for making decisions and taking action?
Understanding our Mental Models About Planning
Question: Why do we gather data?
Answer: To help community partners improveperformance with health outcomes
Data Priorities PartnerPlanning Actions
What data is most
important?
How do we determine priorities?
Who is at the table? What’s in it for them?
What strategies are best and how
do we mobilize partners?
Strategic Planning Implementation
Mental Model or Mental Picture of Our Work
Mental Model
QuestionsTo be Answered
Data Evidence/Insights
CatalyzingPartners
Priorities/Commitments/
ActionsEvaluation
What questions do stakeholders need answers
to?
What data do we have? What data
to we need?
Who are the right people to work
together on what?Organizing for Action
What leadership is needed to turn
theories into actions?
What do we know about what works? Where do we need
innovation?
Exploring a Different Mental Model for How Data Can Support Planning
What Questions Need to Be Answered?
What are the most important questions for improving health?
Figuring out what stakeholders care about?
The right question is better than a thousand wrong answers
Chinese Proverb
Population Level Questions
Stakeholder Level Questions
Where are the opportunities for improving health from a systems level?
What are we doing well? What could we do better? Who do we need to help?
Where are the opportunities for improving health from an organizational level?
Important Questions That Define our Data Needs
Population Health ImpactsRace/Ethnicity, Gender, Economic, Age
related to Place and Time
Organizational ResultsContributions, ROI, and Sustainability
types of questions
types of questionsWhat population has the lowest life expectancy in our county and why?
Why are my employees or students absent and what combination of health improvements would lead to more productivity? What do we know about their risk factors?
Strategic Questions That Drive Performance Improvement
ACTION ZONE
What Data Do We Need?
Obtaining data that helps stakeholders make decisionsand move forward
Data: What is working well and why? What are areas we would like to improve? Where are the assets?
What is working well?
Where would we like to improve and who is best suited to help?
Where are the assets that exist in the community/state?
This is more than just an best practices question, but taps into experience as well
It is also a question of where people who are struggling with challenges are overcoming those challenges (i.e. why are some people living longer lives than others)
Scanning or assessing the whole system is impossible, although overtime there are patterns that begin to develop in the system as you capture their stories and ground them in the system maps?
Who are the shakers/movers, the connectors, and decision-makers in the community, state, or region?
Creating maps of where gifts and assets exist to address the opportunities for creating more healthcan be time consuming, but highly rewarding
Some of this work has already been done or exists…Scanning for what we know is the critical first step; having conversations with the connectors is the next.
What do we know about the health status in populations?How do people move through the system? What areas should be disaggregated?
What Works? What Innovations Do We Need?
Learning from past experience, experimenting withnew ideas
Drawing on Both Knowledge and Imagination
Political Will Leadership/ Passion
Innovations Needed What’s Working Interventions/Strategies
Best Practices
Learning HistoriesCollective Wisdom From Community
Theories/Insights
Catalyzing Partners
Once the data and insights are readily available, whatprocesses, tools, and support are necessary to help stakeholders make informed decisions and turn those decisions into action?
The Work of Design Teams/Steering Committees
X
X
X
X
Learn to better see the whole system
Help define the desired future
Determine focus areas (combination of system-wide strategy areas)
Help to form action teams (collaboratives)
Priorities, Commitments, Actions
How do stakeholders choose priorities and make commitments to action?
Choosing Priorities
Data: What do we know about health status of populations? What is working well and why? What areas in the systems would we like to improve? Where are the assets?
High Impact Leverage: What interventions do we know have the greatest impact
Evidence (Best Practices): What has worked in the past and why?
Experience: What does our past experience point to as successful and why?
Determining what combination of interventions will have the most impact involves five key elements:
Decision Filters (Criteria): Guiding principles that provide direction and focus
High Impact Leverage: What interventions do we know have the greatest impact
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Paradigms=the deep underlying story or beliefs that drive our actions
Vision/Goals=the story of the future we aspire to create and the measurable outcomes that define whether we have arrived
Wisdom (education)=the knowledge, experience, skills, and dispositions to bring about a desired future
Leadership=those who inspire, sets examples through their actions, and organize for action
Polices=the rules, rewards, and punishments that are enforced by asociety or community
Framing/Language=the ways we organize our thoughts to speak toour values and how we choose to describe the system
Data/Information Flows=the relevant information and relationships of that information that influence decision-making
Examples of Leverage in Order of Importance
Decision Filters (Criteria): Guiding principles that provide direction and focus
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We will choose to invest in places that impact quality of life as defined bylife expectancy, educational attainment, and livable wage for all populations, including the most vulnerable.
We will seek a balanced approach between primary prevention and disease management
We will seek maximum impact for each dollar invested
We will build on the assets and strengths of communities, not just develop programs
5We will develop and support networks of action collaboratives/teams wherecooperation and coordination show the most promise of results
Listed below are five sample criteria designed to help decision-makers make informed thoughtful choices about their investments of time and resources
Systems thinking tools
helping stakeholders make the best decisions possible
Learning to Better See the Whole System
Clarifying the Desired Future
Determining What Combination of Strategies Will Lead to Results
Who Needs to Do What By When?
WARNING!!!
The discipline of systems thinking, like anything new takes some time to learn. It requires us to think differently about how we approach complex systems, moving beyond reductionism to understanding how complex relationships interact.
“I wouldn’t give a fig for the simplicity on this side of complexity, but for the simplicity on the other side of complexity, I would give my life.”
Oliver Wendell Holmes
Time toParticipate
Access toFacilities/
Healthy Food
Support
Incentives
Worksite WellnessPrograms
ActionsLong-TermOutcomes
Short-TermOutcomes
Profitable,SustainableCompany
ProgramObjectives
ProgramComponents
Mental Model Regarding Worksite Wellness and ROI
Level of Employee
ParticipationOver Time
Level of EmployerInvestment in
Worksite Wellness
Worksite Wellness
ActionsLong-TermOutcomes
What is our story about health impact?
Actions Long-TermOutcomes
Short-TermOutcomes
Worksite Wellness
Level of Employee
ParticipationOver Time
Time toParticipate
Access toFacilities/
Healthy Food
Support
Incentives
Equal Opportunity For All Employees
No. of EmployersSeeing Results
Level of EmployerInvestment in
Worksite Wellness
Telling a More Explicit Story About Health Impact
Diabetes Systems Thinking Framework(Learning to Better See the Whole System)
Visi
onB
ig P
ictu
re
Out
com
esPo
pula
tion
Flow
Stru
ctur
eSy
stem
C
ateg
orie
sPo
tent
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yste
m L
evel
Inte
rven
tion
Poin
ts
Diabetes Systems Thinking Framework(Learning to Better See the Whole System)
Visi
onB
ig P
ictu
re
Out
com
esPo
pula
tion
Flow
Stru
ctur
eSy
stem
C
ateg
orie
sPo
tent
ial S
yste
m L
evel
Inte
rven
tion
Poin
ts
Diabetes Systems Thinking Framework(Learning to Better See the Whole System)
Visi
onB
ig P
ictu
re
Out
com
esPo
pula
tion
Flow
Stru
ctur
eSy
stem
C
ateg
orie
sPo
tent
ial S
yste
m L
evel
Inte
rven
tion
Poin
ts
Overall Cost of Care w/oDiabetes
Quality of Life w/o
Diabetes
Level of Health Equity
Overall Cost of Care with Diabetes
Prevalence of Diabetes Longevity
Quality of Life with Diabetes
Maintain or Lower Costs For Being
Healthy
Maintain or Improve Number of Healthy
Days
Income Stability/Levels,
Educational Attainment/ Access To Care, Other???
Lower Costs of Care Through Improved
Clinical/Self Management
Slow Down Rise of Prevalence and
Eventually Level Off
Increase Life Expectancy and Quality of Life
Increase Number of Healthy Days,
Improve Health Indicators (BP, A1C, etc)
Desired Future of Diabetes
Question 1: Where are we starting? What is our history?
Question 2: Where would we like to be (scope and scale)
Setting Goals by Understanding Bathtub Dynamics
Getting the Best Results for Your Investment of Time and Resources
Data: What do we know about health status of populations? What is working well and why? What areas in the systems would we like to improve? Where are the assets?
High Impact Leverage: What interventions do we know have the greatest impact
Evidence: What has worked in the past and why?
Experience: What does our past experience point to as successful and why?
Determining what combination of interventions will have the most impact involves five key elements:
Decision Filters (Criteria): Guiding principles that provide direction and focus
Concrete Next Steps
what will you do on Monday in the office?
Step by step approach to action planning
Little things you can do
Step by Step Process for Action Planning
List out your key funders and community leaders and do key informant interviews with them:
Ask these three questions (1) what is our community doing well? (2) What would you like to see improved and why? (3) Who needs to be involved to make it happen?
Imagine what each key stakeholder cares about most and assess whether you have data to answer their questions about these outcomes
Make of map of the key assets of the county and overlay that with your health status/population data (i.e. diabetes, income, race/ethnicity etc)
Look at your obesity or other disease data over time and make a listOf the key drivers (root causes) that make that graph go up or down. Sketch out the relationships between the drivers on your list. Lastly figure out who needs to be involved to influence each driver.
concrete next steps across and action planning process
Materials and Extras
Prin
cipa
l of a
Hig
h Sc
hool
Out
com
es th
at m
atter
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Chal
leng
es th
ey fa
ce:
Impo
rtan
t que
stion
s tha
t wan
t ans
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s to:
Data
nee
ded
to m
ake
bette
r dec
ision
s:
Hosp
ital A
dmin
istr
ator
Out
com
es th
at m
atter
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Chal
leng
es th
ey fa
ce:
Impo
rtan
t que
stion
s tha
t wan
t ans
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s to:
Data
nee
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to m
ake
bette
r dec
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s:
Prim
ary
Care
Phy
sici
anO
utco
mes
that
matt
er:
Chal
leng
es th
ey fa
ce:
Impo
rtan
t que
stion
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s to:
Data
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to m
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bette
r dec
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Min
iste
r of a
Chu
rch
Out
com
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at m
atter
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Chal
leng
es th
ey fa
ce:
Impo
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t que
stion
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t wan
t ans
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s to:
Data
nee
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to m
ake
bette
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Fire
and
Res
cue
Serv
ices
Dire
ctor
Out
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es th
at m
atter
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Chal
leng
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ce:
Impo
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t que
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t wan
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s to:
Data
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to m
ake
bette
r dec
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s:
Child
and
Fam
ily S
ervi
ces A
dmin
istr
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Out
com
es th
at m
atter
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Chal
leng
es th
ey fa
ce:
Impo
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Data
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to m
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bette
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Coun
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omm
issi
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Out
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Chal
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Impo
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to m
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Smal
l Bus
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s Ow
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Out
com
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at m
atter
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Chal
leng
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ce:
Impo
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Data
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ake
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Lega
l Ser
vice
s Dire
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O
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matt
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Chal
leng
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Impo
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Data
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