Health Planning, Program management and evaluation Flashcards
PSAs for public health
Vital statistics
environmental sanitation
health department laboratory services
maternal /child healthcare and surveillance
public health education
levels of intervention
individual
community
systems
example of individual intervention
counseling a pregnant woman in tobacco cessation methods
example of community level intervention
group education in tobacco cessation for teens
example of systems level interventions
advocating for tobacco tax increases to decrease motivation to use it
public health nurse roles and responsibilities
Vaccinations
Prenatal care
Medication administration for STIs and TB
Home visits for high-risk community members
Establish relationships with individuals and community groups
Recognize social determinants that affect health
Disease control such as Tuberculosis management, Hepatitis A
symptoms of TB
night sweats, weight loss, poor appetite, persistent cough.
has complicated and prolonged the fight to eradicate this disease (due to non-adherence). Highly contagious, associated with social determinants such as poverty, crowded living situations (dorms, prisons), alcohol/substance abuse, arrival from another country with high rates of TB infection.
drug resistant TB
tx of TB
directly observed therapy for several months to ensure adherence or medication electronic monitoring system that tracks the openings of the pill bottle, phone, email or text reminders
public health nurses in investigations of TB
investigations that locate where the TB cases are concentrated, and organize outreach services to those community members (testing, information, arrangement of prophylactic treatment as needed)
If there is an outbreak of Hepatitis A in a community what is the most important information that the public needs to know from you to prevent transmission?
Washing hands – HepA is transmitted fecal-oral route. Contaminated surfaces, food, and water are touched. Handwashing is the most effective way to prevent transmission.
Drug resistant variants, diseases that have started to infect humans, climate change, globalization/international travel
Emerging or re-emerging infections/diseases concerns
case management plans
Standards of client care, standards of nursing practice, clinical guidelines using evidence-based practice. Adaptation to each client’s unique situation is key
steps in case management
Coordination of services across healthcare specialties and community health services
Improve quality of care, efficiency of services
Cost containment
Must know community resources, be a good communicator
Case management plans
Evaluation: If goals were not met, change the plan
Prevention: exchange information, increase health literacy, instruct on accessing healthcare system, engage in health education
primary
Prevention: case finding, using healthcare data to identify health problems, assessments and interventions that promote health
secondary
Prevention: monitor and adjust the use of prescription medications and adherence to treatment to reduce the risk of complications
tertiary
immunizations programs
Essential service
Protects the population from communicable disease
International travel vaccine administration
Post-rabies exposure prophylaxis
Mandated by schools to varying degrees across the country
Immunizations integrated in public health clinical services
If an outbreak occurs, the local health department is responsible for mass immunizations
Coordination of vaccine supplies, rates of immunizations given regionally, statewide immunization registries to document, and free immunization clinics.
Goal: Equitable access
Principles of the ethical practice of public health highlights:
-protect the confidentiality of information gathered
-respects the rights of individuals in the community
-advocate & work for the empowerment - resources are accessible to all
-anticipate and respect diverse values, beliefs, and cultures in the community
-engage in collaborations that build the public’s trust
Key components of health program planning
Active involvement of the community as a partner
Skill & time to do a competent assessment
Shared conclusions with the partners of the needed interventions
Actual program planning, interventions, & evaluation
Social justice: human rights & equity
Mobilizing for action through planning and partnerships (MAPP)
A framework for conducting community assessment
Aims to help communities apply strategic thinking to prioritize PH issues & identify resources to address them
4 different assessments for MAPP
- Community themes & strengths assessment
- Local public health system assessment
- Community health status assessment
- Forces of change assessment
Assess community themes & strengths
Key informant interviews, surveys, focus groups that assess the strengths & problems within the community – from community members’ perspective.
Assess Community health status
Identify priority community health & quality of life issues – involves gathering primary and secondary data related to the problem(s)
Forces of change
Focuses on identifying forces such as laws, technology, or funding that affect the context in which the community & its public health system operate
Examples of PH interventions at the individual and community levels:
Women, Infants & Children (WIC), school health programming, and immunization campaigns.
MAPP example
Problem: Infant mortality
Mobilize community partnerships: A MAPP committee was formed
Action: Community assessments were done by committees: Data collected and funding sought
Planning/Partnership: High infant mortality found to be higher among African Americans in the community than among others.
Programs built to improve access to prenatal care, birth weight, & reduce teen pregnancy, tobacco use among pregnant women & girls
graphic depiction (road map) that presents the shared relationships among the resources, activities, outputs, outcomes, and impact for your program
logic model
logic model depicts the relationship between:
your program’s activities and its intended effects
logic model helps clarify
what the program is doing (implementation) and the intended results
Some key terms used in logic models, although not all are employed in any given model:
Inputs: The resources needed to implement the activities
Activities: What the program and its staff do with those resources
Outputs: Tangible products, capacities, or deliverables that result from the activities
Outcomes: Changes that occur in other people or conditions because of the activities and outputs
Impacts: long-term outcomes
Moderators: Factors that are out of control of the program but may help or hinder achievement of the outcomes
precautions for measles
airborne
measles rash
A rash appears within a week of infection, symptoms appear average 14 days. Cough, sore throat, conjunctivitis.
The sick are contagious from four days before, to four days after the rash starts.
Rash with high fevers that can cause infertility, pneumonia, immune problems in later years, hearing problems, death.
heard immunity for measles
requires 96% of people in a community to be immunized in order to protect the unimmune from infection.
A clear statement of the health problem and the causal reasons or theories for the health problem
community diagnosis
guides community teams thinking in how to design program and decide what components are necessary
community program management
Community health program planning is population focused, promotes health equity, empowers communities and advocates for social justice
Planned to meet the needs of specific individuals, groups, communities
examples of community program management
Home health, immunization programs, family planning programs, school health programs, occupational health & safety, environmental health, community programs directed at preventing specific health condition
program planning
describe the problem
formulate the plan
conceptualize the problem
detail the plan
evaluate the plan
ultimate goal of program planning
ensure that health care services are acceptable, equal, effective, and efficient
program evaluation
Systematic collection of information about activities, outputs, and outcomes to enhance a program and it effectiveness
Provides feedback about how the activity design worked, cost effectiveness, and if the interventions worked, if the timeline was appropriate, if the program should be expanded or used in another location
For the purpose of assessing whether objectives are being met or planned activities are completed. Begins with an assessment of the need for a program and is ongoing as the program is happening. Allows for changes to be made.
formative evaluation
To assess program outcomes or as a follow-up of the results of the program activities and usually occurs when a program is completed. Includes evaluation of objectives and goals.
summative evaluation
program goals
Overall aim
A broad statement of the impact expected by implementing a program
A statement of outcome rather than activity
Usually only a few goals for a program
Should be realistic, achievable, and sustainable
Must be a sustainable program
creating objective
Clarify the goal
Design an outcome measurement
Keep the program focused on the intended intervention
Measurable, time-limited, action-oriented
Include who will achieve what, by how much, by when
HP 2030: Goal: Increase local PH departments that have developed a community health improvement plan
Objective: By 2030, increase the percent of PH agencies who have CHIP (measure: % of increased enrollment in CHIP)
SMART
specific
measurable
achievable
realistic
timeline
healthcare improvement in the community
Quality of healthcare has been difficult to evaluate in the US because there are different definitions of quality of care and it is hard to get same kinds of data to compare from different healthcare sites
Improving quality can help provide better care, effective interventions, save lives, reduce costs, improve client confidence in health care delivery
Focus is on finding problems in the system, not blaming individuals
milestones in quality
Managed care organization
Core Competencies of Public Health Nursing (2010)
Several nursing organizations, which comprise the Quad Council for Public Health Nursing, have taken the charge to strengthen nursing practice in the community
Quad Council renamed to Council of Public Health Nursing Organizations
The Council on Linkages between Academia and Public Health Practice has worked to advance academic and practice collaboration to ensure a well-trained, competent workforce and a strong, evidence-based public health infrastructure
: Defined by the client as the improvement in health status, by the organizations and providers as accurate interventions and the skill of the provider
quality
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
quality health care
The degree to which policies, programs, services, and research for the population increase desired health outcomes and conditions in which the population can be healthy
quality in public health
approaches to quality improvement: voluntary approaches
Credentialing – competence recognition
Accreditation – organization regulation compliance
Certification – skills recognition
Charter – institutional status to give degrees
Recognition – cross-institutional credentialing
Academic degrees
approaches to quality improvement: required approaches
Licensure - individual
Accreditation – regulation compliance for agency reimbursement
Certification – achievement qualifying for professional practice
Academic degrees – required to enter professions
To monitor the outcomes of health agency services over a 3–5-year plan. Long-term approach to address public health problems. Results in improved agency care delivery, coordination, performance. Helps to achieve accreditation
Community Assessment-Community Health Improvement Plans (CHA/CHIP)
A model of care that addresses individuals’ health needs at all points along the continuum of care, including in the community setting, through participation, engagement and targeted interventions for a defined population. Goal is to address health disparities with cost-effective, customized interventions.
Population Health Management (PHM)
A process of selecting community indicators that measure the process and outcomes of a health improvement intervention strategy. Indicators can be assessed to determine intervention effectiveness or agency performance.
performance monitoring
Protocols of recommended practice developed by governmental and health care agencies and professional organizations.
guidelines
evaluation, interpretation, action
Regular intervals for evaluation should be established within the agency and periodic reports written so performance improvement efforts can be analyzed, and problems identified
Course of action should be based on their performance, cost, timeliness
Take action
Follow up and evaluation of actions taken must occur for performance improvement
documentation in public health
Documentation is essential to the evaluation of quality care in any organization
Healthcare organization records determined by state departments of health
Public health agency records predict population trends, identify community health needs, determine program budgets (infant mortality, chronic disease prevalence, life expectancy)
Public health agency records can provide a picture of the overall health and healthcare status of a community, population, country.
