1. Tribal Public Health Analyst / Program Manager
What’s on the Horizon? Exploring Tribal Health Department Strategic Planning for Public Health Accreditation
Keisha Robinson, MPH
Tribal Public Health Analyst / Program Manager
November 20, 2013

2. Overview Public health accreditation and tribal public health systems
Strategic planning and accreditation
Tribal Health Departments (THDs) strategic planning process
Group activities
Questions and answers

3. Tribal Public Health Systems
Community Health
Tribal Government
Tribal Health Dept.
Federal agencies
Private Industry
Local/ State Health Dept.
Tribal Colleges
Community
ITCs/Tribal EpiCenters
Multiple stakeholders who work in partnership to assure conditions in which people can be healthy.

4. Tribal Public Health Infrastructure
Community Health
Tribal Gov
Tribal Health Dept/Clinic
Federal agencies
Private Industry
Local/ State Health Depart
Tribal Colleges
Community
ITC’s/Epi Centers

5. What is Public Health Accreditation
Measurement of Tribal, state and local health department performance against a set of national standards
Issuance of recognition of achievement within a specified period of time by a nationally recognized entity
Supports continuous quality improvement in public health performance

6. PHAB Standards and Measures v1.0
Based on the public health functions set forth in the 10 Essential Public Health Services and Core Functions (
12 Domains
Each domain has a set of standards and measures
Required documentation for each measure

7. Benefits and Opportunities
Strengthen self-determination
High performance and quality improvement
Strengthen leadership and employee performance
Build stronger partnerships and increase communication and collaboration
Recognition, validation and accountability
Potential increased access to resources
It’s about communities

8. Accreditation Prerequisites
Community Health Assessment
Community Health Improvement Plan
Department Strategic Plan

9. What is a Department Strategic Plan?
Process for defining and determining an organization's roles, priorities, and direction over three to five years
Sets forth what an organization plans to achieve, how it will achieve it, and how it will know
Guide for allocating resources and pursuing priorities

10. Department Strategic Plan for THDs Pursuing Accreditation
Focus on the entire health department
Program-specific strategic plans may complement and support the department strategic plan
Links to the Community Health Improvement Plan (CHIP)
Domain 5, Standard 5.3

11. Strategic Planning Resource
Developing a Tribal Health Department Strategic Plan: A How-To Guide
Adapted from National Association of County and City Health Officials (NACCHO) resources for local health departments
Capacity-building resource for THD interested in conducting a strategic planning process and creating a strategic plan that meets PHAB requirements

12. Strategic Planning Guide Organization
Module I: Introduction to Strategic Planning for Tribal Health Departments
Module II: Prepare for the Strategic Planning Process
Module III: Conduct Strategic Planning
Module IV: Implement, Monitor and Evaluate the Strategic Plan

13. Strategic Planning Process
Strategic planning frameworks typically consists the following:
Prepare for Strategic Planning
Conduct Strategic Planning
Implement, Monitor and Evaluate Progress
Each phase involves multiple steps

14. Prepare for Strategic Planning

15. Prepare for Strategic Planning
Lay the Groundwork
Is the THD ready to move forward?
Who will be on the planning committee?
Who are the stakeholders and how to engage?
What information is available to inform the plan?
What will be the overall approach and timeline?

16. Prepare for Strategic Planning
Compile Relevant Information
THD staff identifies and collects the information available to inform the strategic planning process
Recommendations and Considerations
Must have a commitment from the leadership
You can’t “go it alone”
Get past the past and rebuild old bridges
Try not to recreate the wheel

17. Environmental Scan
The collection, analysis and evaluation of information and data about the internal and external factors that affect an organization
Identify and compile relevant and available data and information
Determine the value of available data
Collect additional data and information as needed
Summarize data and information for future analysis

18. Using CHA and Self-Study Results for Strategic Planning
The CHA provides information about health status and community priorities
Use self-study results to understand
How the THD operates
The issues facing the community the THD serves
Provides illustration of strengths and areas for improvement

19. Recommendations and Considerations
Must have a commitment from the leadership
You can’t “go it alone”
Get past the past; rebuild old bridges
Try not to recreate the wheel

20. Conduct Strategic Planning

21. Conduct Strategic Planning
Facilitate the development of Vision, Mission, and Values with stakeholder engagement
Mission:
Tells what the organization’s purpose is now
Explains what the organization does and why
Should guide overall organizational direction

22. Conduct Strategic Planning
Vision:
Futuristic view regarding the ideal state or conditions that the organization aspires to change or create
Values:
Principles, beliefs, and underlying assumptions that guide the organization

23. Values Accountability Quality Collaboration Respect Community
Responsibility
Dependability
Self-determination
Effectiveness
Sovereignty
Efficiency
Timeliness
Excellence
Traditions
Innovativeness
Wellness
Integrity
Wisdom

24. Conduct Strategic Planning
Analyze the data and information
Complete a strengths, weaknesses, opportunity and threats (SWOT) Analysis
Identify crosscutting themes, emerging issues, and assets
Internal s/o
Resources to do the job
Adequate knowledge and skill
Organizational culture
Communication, processes, and organizational structure
Training, staff qualifications and skills
Timeline to complete the project,
Authority around decision-making
External
Economic trends
Competition
Technology
Resources
Governmental regulations
Stakeholders
Funding sources

25. Internal Considerations (Strengths and Weaknesses)
Resources to do the job
Adequate knowledge and skill
Organizational culture
Communication, processes, and organizational structure
Training, staff qualifications and skills
Timeline to complete the project,
Authority around decision-making

26. External Considerations (Opportunities and Threats)
Economic trends
Competition
Technology
Resources
Governmental regulations
Stakeholders
Funding sources

27. Conduct Strategic Planning
Engaging stakeholders in defining and framing strategic issues that emerge from the environmental scan and SWOT analysis
Prioritize a select a manageable number of strategic issues to be included in the plan
Create a Strategic Planning Document with goals, objectives and targets

28. Recommendations and Considerations
The list of strategic issues may be unrealistic for a THD to address in a three to five year period
Common prioritization techniques include:
Multi-voting Technique
Strategy Grids
Nominal Group Technique
The Hanlon Method
Prioritization Matrix

29. Recommendations and Considerations
Reach consensus on strategic priorities
Many Tribes use consensus to make decisions that impact the community
Demonstrates unity in decision making and reinforces the principles of engagement
Does not mean that everyone is in complete agreement, but that most can give their support for the greater good of the community

30. Implement, Monitor, and Evaluate

31. Implement, Monitor, and Evaluate Progress
After adopting the plan, put it into action
Some organizations develop an implementation plan that outlines how staff will implement the strategic plan in day-to-day work
Establish a process to monitor and evaluate the plan
How is the strategic plan integrated into the health department’s daily practice?

32. Implement, Monitor, and Evaluate Progress
When monitoring the plan, look for quality improvement opportunities
Remember: The Strategic Plan is intended to create change in an organization
Regularly communicate the results of strategic plan progress
Revise and update the plan as needed

33. Recommendations and Considerations
The strategic planning process does not end with developing a plan – it must be implemented
Are we doing what we set out to do?
Share the findings
Internally with staff, leadership and advisory committees
Key external stakeholders part of the public health system

34. Activity 1 Articulating Values and Reaching Consensus
Different than majority voting
End result is that the group finds the decision acceptable, even if they have other individual preferences

35. Activity 1 – Report Out
Did the group reach consensus through only discussion?
How did the group finalize the decision?
Did everyone participate?
Was there cooperation throughout the process?
How did you feel at the end of the discussion? Did you feel your input was heard?

36. Selecting Strategic Priorities using Three-Round Multi-Voting*
Activity 2
Selecting Strategic Priorities using Three-Round Multi-Voting*
Scenario: A group of program managers convent to select top strategic priorities for the THD Strategic Plan
Round 1 – Vote as many times as you like and update
Round 2 – Vote up to 3 times and update
Round 3 – Vote up to 2 times and determine results
*NAACHO – Guide to Prioritization Techniques

37. Activity 2 – Report Out Overall, how did your group do?
How many priorities made it to Round 3?
Was everyone happy with the selections?
How did you feel if your main strategic priorities did not make the final cut?

38. Resource
Developing a Tribal Health Department Strategic Plan: A How-To Guide
Available at:
Red Star Innovations
NACCHOhttp://

39. Questions and Answers

40. Contact Information
Keisha Robinson, MPH
Tribal Health Program Manager/Data Analyst
Red Star Innovations
Website: