+ Goal Setting & Establishing Performance Measures Small Counties Learning Community Tamara Maciel Bannan, MPH Public Health Institute California Gaining Ground Coalition

+ Objectives Define a goal Learn about the relationship between goals and performance measures Define performance measures See it all put together

+ Who would like to share with us the definition of a goal?

+ Goal Definition in PHAB’s Glossary of Terms Goals are general statements expressing a program's aspirations or intended effect on one or more health problems, often stated without time limits. (Turnock, B.J. Public Health: What It Is and How It Works. 4th ed. Sudbury, MA: Jones and Bartlett; 2009.)

+ Goals State what is desired Many times are directional and tend to start with: Increase Decrease Reduce Improve Should be able to measure progress with supporting measurable objectives – this is where the link with performance metrics comes in

+ Some Examples of Goals for Health Priorities in a CHIP Health PriorityGoal Healthy EatingIncrease fruit and vegetable consumption in Our County Tobacco UseReduce the number of smokers in Our County STDsDecrease the rate of new STD infections in Our County

Health Improvement & Strategic Planning Determine Priorities & Goals What are the priority health issues in Our County? What are the behaviors and outcomes related to these issues that we want for people who live in Our County? How can we measure these conditions? Program Objectives Public Health Strategic Plan Community Health Improvement Plan

+ Who knows what the acronym SMART stands for?

+ Measurable Objectives Specific Measurable Achievable (Attainable) Realistic (Relevant) Time-bound M S A R T

+ Performance Based Measurement  Integrated department-wide system  Emphasis on measurement at program, organization, and community levels Data integration IT solutions (e.g., dashboards)  Routine review of results to drive decision- making

+ Definition of Performance Management As defined by Turning Point. From Silos to Systems: Using Performance Management to Improve the Public’s Health, 2003 Performance Management is a systematic process which helps an organization achieve its mission and strategic goals by improving effectiveness, empowering employees, and streamlining decision making. In public health, performance management means actively using performance data to improve the public’s health, including the strategic use of performance standards, measures, progress reports, and ongoing quality improvement efforts to ensure an agency achieves desired results.

+ Poll: Does your department have a standardized way to collect, track, and report performance data 1. Yes 2. No

+ Two types of measures TOTAL POPULATION INDICATORS (measures of population-level health outcomes, behaviors, and environments) PERFORMANCE MEASURES (measures of program effort and output) AND

How Do We Measure Our Goals? Community level indicators Health outcomes Behaviors Environment Program level measures Effort & Output Outcomes Program Objectives Public Health Strategic Plan Community Health Improvement Plan

Total Population Indicators Life expectancy Quality of life Health equity Disease rates Premature death Tobacco use Affordable housing TOTAL POPULATION HEALTH OUTCOMES, BEHAVIORS, AND ENVIRONMENTS

+ Examples of Population Indicators Percent of students who had at least one drink of alcohol in the past 30 days Rate of foodborne illness hospitalizations each year (per 100,000) Percent of children with up-to-date immunizations Rate of colorectal cancer deaths (per 100,000 population)

+ Common Data Sources Population Indicators Examples: Disease specific surveillance systems Vital Records CA Health Interview Survey OSHPD (Healthcare Utilization data) BRFSS YRBS National Immunization Survey

+ Example from San Diego

+ Example from Sonoma

+ Final Discuss & Questions