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Performance Improvement


Performance improvement is a critical piece of the NPHPSP activities and is highlighted in the stated mission and goals of the program. If the results of the assessments are not used for action planning and performance improvement, then the hard work of the assessments will not have its intended impact.

Performance improvement is shown through positive change in capacity, process and outcomes of public health as practiced in government, private, and voluntary sector organizations. Performance improvement can occur system-wide as well as within individual organizations that are part of the public health system. It involves strategic changes to address public health system (or organizational) weaknesses and the use of evidence to inform decision-making.

Performance improvement can be achieved through the practice of "performance management." As defined by the Turning Point Performance Management Collaborative, 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, to prioritize and allocate resources, to inform managers about needed adjustments or changes in policy or program directions to meet goals, to frame reports on the success in meeting performance goals, and to improve the quality of public health practice.

Therefore, performance improvement is what systems and organizations should strive to achieve; performance management is how it can be done.

This information and the following links provide sites that are using the NPHPSP assessments with guidance and resources for this important activity.


Moving Toward System Performance Improvement After the NPHPSP Assessments

The NPHPSP performance assessments should provide system participants with an understanding of the gaps between their current performance and the optimal level of performance described by the standards. System partners can then determine where the largest or most crucial gaps in performance are; these are the areas on which the action plan should focus.

The results should be incorporated into a broader planning process, such as a community health improvement process such as Mobilizing for Action Through Planning and Partnerships (MAPP), a state health improvement process, or a local board of health strategic planning process.

If this type of planning process is not underway, go to the "What Next?" section of the NPHPSP User Guide for strategies and ideas for moving forward with performance improvement efforts. The Resources link also provides useful information.

Depending on which assessments are used, different levels of improvement planning may be needed:

  • State / local system performance improvement planning - every responding state or local public health system should conduct improvement planning. These plans should be based both on the CDC quantitative reports, as well as on qualitative ideas and comments that emerged during the assessment discussions. Improvement strategies and areas for accountability should be identified for the public health agency and system partners.
  • Governance body improvement planning - governing entities that undertake the governance assessment often use their results to develop a strategic plan for the board of health. To the extent possible, boards should work with their local health official and other agency staff to identify key areas and strategies for improvement. If the local public health system assessment was done, the two sets of information can be quite insightful. In these cases, the governance action plan should be coordinated with the system performance improvement plan.
  • Statewide performance improvement planning - in states where a coordinated statewide approach is used to implement multiple NPHPSP assessments, the statewide action plans should be developed. CDC provides statewide aggregate reports to states that use the local instrument in all or most local jurisdictions. Another report is also available that summarizes both the state and local data, if both instruments have been used.

Once improvement planning is underway, the action plans should be institutionalized to assure that the performance continues at the higher levels.

Reassessments every three to four years can aid in monitoring progress and identifying new gaps that need to be addressed.


Performance Improvement Activities in the Field

The NPHPSP partnership has recently established a monthly teleconference series for individuals who are coordinating statewide efforts to implement the National Public Health Performance Standards (NPHPS).

The purpose of the calls is for participants to share lessons learned in using the NPHPSP assessment instruments as well as to discuss ideas for moving forward in implementing performance improvement activities.


Post-Assessment / Performance Improvement RESOURCES

This section includes sample tools and links to resources for groups that have completed the NPHPSP assessment and have entered the post assessment / performance improvement phase. Many of these resources are available for download and customization.

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