State of the State’s Health Report: A Community Health Profile Presented by Joyce Marshall, MPH Director, Office of Performance Management Oklahoma State Department of Health September 16, 2009

Oklahoma Health Department Structure  Population Served: 3,617,316 Oklahomans  Centralized health department system (OSDH) for state central office and 68 county health departments 2350 employees at 89 sites $356 million budget (over 50% federal) Governed by appointed Board of Health Led by Board appointed Commissioner of Health Autonomous city-county health departments in Tulsa and Oklahoma City metropolitan areas Medicaid, Mental Health & DEQ separate agencies

Oklahoma MLC-3 Mini-Collaborative Structure PERFORMANCE MANAGEMENT ACTION TEAM Step UP SOS Health Report Accreditation Readiness CVH/OBESITY STRATEGIC PRIORITY WORK TEAM Childhood Obesity STRATEGIC PLANNING TEAM

Performance Management Action Team [Mini-Collaborative]  Performance Management Action Team County Performance Management Committee SOSH Report Core Implementation Group  Team Membership Deputy Commissioners Chief Financial Officer County Administrators CHS Service Chiefs Epidemiologists IT Director Director, Office of Scientific Affairs Director, Center for Health Statistics Director, Office of Performance Management

Focus on Priorities for Improving Health Outcomes Achieve Targeted Improvements in the Health Status of Oklahomans Strengthen Public Health System Infrastructure Increase Departmental Effectiveness and Accountability Lead Public Health Policy & Advocacy Development Oklahoma State Department of Health Strategic Map: SFY 2008 – SFY 2010 Performance Management Action Team Goals Target Specific Improvements in Cardiovascular Health Define Competency Sets for the Public Health Workforce and Other Providers Conduct System-wide Workforce Planning and Development Promote Compatible Information/Health Data Systems Across Delivery Entities Optimize Leadership Effectiveness Develop Accreditation Process for Health Departments Implement Systematic Agency-wide Performance Mgmt & Other Key QI Processes Assure Policies Are Evidence-Based and Data-Driven Engage and Inform Policy Makers and Opinion Leaders at All Levels Foster Appropriate Service Delivery Modalities Across Diverse Populations Build Understanding of the Value of Public Health Using Social Marketing Target Specific Reductions in Obesity Target Specific Improvements in Health Disparities Increase Emphasis on Health Status Improvements in All Programs Strengthen Policy Development and Analysis Promote the Value of Employees to Departmental Performance Engage Public and Private Sector Partners to Leverage Effectiveness Optimize Internal And External Communication Optimize Resources and Align to Meet Key Priorities Optimize Current Funding and Pursue New Opportunities Align Resources to Maximize Health Outcomes Assess & Address Department’s Physical Plant/ Infrastructure Needs Develop and Implement Enterprise-wide IT Architecture Implement Continuity of Operations Planning

Community Health Profile Target Area Priority Objectives for SFY Agency-wide health status indicators determined and State of the State’s Health Report format designed by end of SFY Develop and publish new State of the State’s Health Report with overall health status indicators and county specific information by May Update and publish State of the State’s Health Interim Report with overall health status indicators by February 2010.

State of the State’s Health Report/Profile P-D-C-A Process  Plan Locally driven request by CHS and county administrators Assure county buy-in from beginning New Report Format Determine Overall Health Status Indicators Include Demographic/Socioeconomic Information in Report Indicator Report Cards County Rankings and Report Cards

State of the State’s Health Report/Profile P-D-C-A Process  Do Vetting and Adoption of Health Status Indicators Designed New Format for Report Adoption of New Format by PMAT, SPT, SLT & BOH Designed reporting system to integrate into publication design Recruited program expertise for indicator narratives Recruited turning point coalitions expertise for county narratives

State of the State’s Health Report/Profile P-D-C-A Process  Check Methodology for Validity/Reliability Flow of Report Accuracy of Report Design Does it Relay Information as Needed/Desired? Does it Promote Advocacy Usage? Does it Assist Counties/State in Assessment & Improvement Processes?

State of the State’s Health Report/Profile P-D-C-A Process  Act Publish Report Distribute Report Begin Cycle Again Was Report Used as Desired? –Advocacy Purposes –Health Quality Improvement Purposes Web Site Hits Report Requests Lessons Learned

QI Tools Used  SWOT Analysis (Level 1)  Brainstorming (Levels 1-3)  Prioritization (Levels 1-3)  Surveys (Levels 1-3)  Multi-voting (Levels 1-2)  PDCA (Levels 1-3)  Action Plans (Levels 1-3)  Sorting Tool (Levels 2-3)

Sorting Tool Indicator Criteria  Data availability (N,S,C)  Impact on health  Perceived ability to affect change  Perceived public importance/emerging issue of importance  Meaningfully measured  Links to other measures  Demographic availability  Trend data availability  Accepted as a measure of underlying/foundational characteristic

Appendices

Overall Health Status Indicators  Leading Causes of Death  Common Diseases  Risk Factors & Behaviors  Socioeconomic Factors

State Report Card

Indicator Report Cards & County Rankings

County Report Cards

Lessons Learned  Working Design Format  Resource Limitations  Extensive Style Guide Needed  Role Definition  Publication Limitations  Timing of Release  Information/Process Gained Will Assist Future Efforts  Still Learning!