Using Health Status Reports to Effect Systems Change in RHAs Dr. Cordell Neudorf Chief Medical Health Officer Saskatoon Health Region June 2, 2008
Health Status Report Evolution in Saskatoon Demographic and Morbidity/Mortality reports Increasing breadth of data sources (puzzle analogy) Increasing complexity of analysis Inclusion of local research results Adding recommendations for change Increased use of stakeholders in the production, interpretation, and use of the report 1980s1990s2000present
How the process works in SHR Leadership – Chief MOH office via the Public Health Observatory Workplan developed (indicators / data to be included, analysis plan, general layout) Preliminary results presented to PHO staff, MOHs and Public Health Management for initial interpretation and write up Draft report taken to internal and external stakeholders for comment and further recommendation suggestions Final report produced
How the process works in SHR Board and SLT and key stakeholders given heads up re proposed recommendations to allow time for response Public release of report and recommendations and initial response from those affected Chapter by chapter detailed presentation of report to SLT and then Board for adoption of recommendations and to get feedback on the action plan proposed by stakeholders Annual report on progress and updates on new information or key trends
Critical Success Factors Ensure MOH has mandate for production of an independent, regular Health Status report to the local authority/board Create expectation that the Health Status report will be one of the key planning documents for the RHA Gradually add robust analysis and interpretation of data, forecasting of trends and recommendations for change in any sector that can improve health status (public health, health system, other sectors) Public release of report
Critical Success Factors Present report details through both administrative and governance channels in health, getting both streams to adopt those recommendations with which they agree Ensure stakeholders do likewise Build in accountabilities and measure progress (use accreditation, accountability indicators, quality reporting, etc) Repeat process every 5 years, with updates on progress and focused data updates annually
Key messages Properly positioned, health status reports can become key documents to drive systems change and re-orient the health system Recommendations can set the tone for the 5 year strategic plan for public health, the health system, and intersectoral changes necessary to improve health, health determinants, and reduce health disparity
Conclusion All Public Health Units should use health status reports as an opportunity to effect systems change Capacity, data availability, and structure of reports varies greatly across Canada’s 130+ health units Need common core data and report templates in order for more regions to be able to do this Potential solutions include: development of a Network of PHOs and/or analysts in Canada, development of a Network of PHOs and/or analysts in Canada, working with National and Provincial data providers on a core indicator set available free of charge by standardized small area geographies working with National and Provincial data providers on a core indicator set available free of charge by standardized small area geographies Working together on a shared agenda when it is necessary to effect change beyond the local level Working together on a shared agenda when it is necessary to effect change beyond the local level
The Challenge! By collectively adopting the above methods and process, Public and Population Health can have the intended influence on system change necessary to change policies and programs to: Increase public health capacity Increase public health capacity Re-orient the health system Re-orient the health system Reduce health inequalities Reduce health inequalities Improve determinants of health Improve determinants of health Requirements include coordination, a common vision, and a willingness to work together