Health System Organization Session 4: Health Care Workforce Public Health Competencies Race Against Time: Group 2 Presentation

Health Care Workforce Who are they? How are they trained/educated? Where do they come from? Where do they go? WHY? 2

Functions of Health Education Governance Educational services Selection of staff Financing Infrastructure and Technology Information and Knowledge 3

Access and quality depend on the number and training of health professionals Source: The looming crisis of the health workforce: How can OECD countries respond? (OECD, 2008). 4

Medicine MD – allopathic DO – osteopathic Others ▫Naturopathic ▫Chiropractic ▫Psychologist ▫Podiatrist ▫Optometrist Traditional Healer Physician Assistant 5

Nursing Advanced Practice (Registered) Nurse (APN/APRN) ▫NP ▫CNM ▫CRNA ▫CNS Registered Nurse (RN) ▫BSN ▫ADN ▫Diploma Licensed Practical Nurse (LPN) Nursing Aide/Assistant (CNA) 6

Allied Health Professionals Dentist/Dental Hygienist MPH Pharmacist Physical/Occupational/Speech Therapist MSW Technologist (laboratory, biomedical, radiology) Dietician Audiologist Optician Etc., etc. 7

The Markets for Health Professions Education LaborHealth Services 8

Public Health Workforce Challenges Increased federal workforce -- bioterrorism dollars Decreased state and local positions Change in worker productivity due to technologies Administrative and bureaucratic obstacles to growth and recruitment Gebbie & Turnock,

Workforce Development Development of core competencies for public health workers Competency-based training Competency-oriented job descriptions Credentialing individuals Accreditation of public health agencies Gebbie & Turnock,

Public Health Functions Assess & Monitor 1.Monitor health status to identify community health problems. 2.Diagnose and investigate health problems and health hazards in the community. 3.Inform, educate and empower people about health issues. Formulate Public Policies 4.Mobilize community partnerships to identify and solve health problems. 5.Develop policies and plans that support individual and community health efforts. Institute of Medicine, The Future of Public Health, National Academy of Sciences, Public Health Functions Steering Committee, 1994 (multiple organizations). 11

Public Health Functions Assure Access to Care 6.Enforce laws and regulations that protect health and ensure safety. 7.Link people to needed personal health services and assure the provision of health care when otherwise unavailable. 8.Assure a competent public health and personal health care workforce. 9.Evaluate effectiveness, accessibility and quality of personal and population-based health services. 10.Research for new insights and innovative solutions to health problems. 12

What Is a Competency? Reflects knowledge Reflects skills Continuum of expertise Develops with application and experience Can be measured or observed Basis for performance assessment 13

Multiple Sets of Competencies Association of Schools of Public Health, Core Competency Project Council on Linkages -- public health National Center for Healthcare Leadership -- health administration Veterans Health Administration High Performance Development Model -- health administration ACGME -- postgraduate medicine 14

Core Competency Project, ASPH Five discipline-specific sets of competencies ▫Biostatistics ▫Environmental health sciences ▫Epidemiology ▫Health policy and management ▫Social and behavioral sciences Upon graduation, a student with an MPH should be able to … [list of abilities related to each of five areas] 15

Interdisciplinary Competencies Communication and informatics Diversity and culture Leadership Public health biology Professionalism Program planning Systems thinking Relevant to ALL graduates with an MPH! 16

Council on Linkages: Public Health Competencies/Skills (2001) Analytic assessment skills Policy development/program planning Communication Cultural competency Community dimensions of practice Public health sciences Financial planning and management Leadership and systems thinking 17

National Center for Healthcare Leadership: Competencies for Health Management (2002) Learning and performance improvement Professionalism Personal and community health systems Leadership Collaboration and communication Management practice 18

VA High Performance Development Model Competencies (HPDM) Interpersonal effectiveness Customer service Systems thinking Flexibility/adaptability Creative thinking Organizational stewardship Personal mastery Technical competency 19

Postgraduate Medicine (ACGME, 2001) Patient care Medical knowledge Practice-based learning and improvement Interpersonal and communication skills Professionalism Systems-based practice 20

National Board of Public Health Examiners: Public Health Credentialing New effort by National Board of Public Health Examiners Ensure MPH graduates have mastered prescribed set of skills/competencies Voluntary exam started summer

Competencies and Credentialing Competencies ▫Are these useful? ▫Which ones appeal/are not useful? ▫Do they transcend borders? ▫How would you use these? Credentialing ▫Is it necessary? ▫Since voluntary, will people take it? ▫How much effect will it have? OMPH position statement on exam 22