Ninth Annual DPHP Meeting October 9, 2013 1
NHSPI Speaker Introductions James Blumenstock Chief Program Officer Association of State and Territorial Health Officials (ASTHO) Ali Khan, MD, MPH Director, Office of Public Health Preparedness and Response Centers for Disease Control and Prevention (CDC) Robert L. Burhans New York State Department of Health Director of Health Emergency Preparedness (retired) Health Emergency Management Consultant Cathy Slemp, MD, MPH West Virginia State Health Officer (retired) Public Health Consultant Jim Craig Director, Health Protection Mississippi State Department of Health Jacqueline Scott, DVM, PhD Director, Office of Public Health Preparedness Michigan Department of Community Health 2
James Blumenstock Chief Program Officer Association of State and Territorial Health Officials (ASTHO) 3
Agenda Welcome and agenda walk through Opening remarks Introduction and process overview Model design NHSPI website demonstration Communications: tools and resources Launch plans and next steps Panel discussion Q&A 4
Video Message Ali Khan, MD, MPH Director, Office of Public Health Preparedness and Response Centers for Disease Control and Prevention (CDC) 5
INTRODUCTION AND PROCESS OVERVIEW 6
NHSPI Mission Statement The mission of the NHSPI is to provide an accurate portrayal of our nation's health security using relevant, actionable information. The intended uses include strengthening preparedness, informing decision making, guiding quality improvement, and advancing the science behind community resilience. 7
Short-Term and Long-Term Objectives Year 1 Deliver a structure for portraying public health and health system national preparedness components and establish a framework for further development. Longer Term Establish a standardized, universally accepted assessment and reporting tool that encompasses all components impacting national health preparedness and inform development of additional measures that more fully reflect the state of our health security. 8
Uses of the Index 1. Support quality improvement Identify strengths, gaps, trends (future), strong practices; support QI planning with partners 2. Enhance collaboration / increase shared responsibility Generate discussion among stakeholders on successes, needs and solutions 3. Inform policy and resource decisions Provide information; stimulate dialogue leading to fuller understanding of issues 4. Advance preparedness science Stimulate evidence based target development, improved measures / measures for gap areas, CQI of Index 9
Index Ownership Plans Robert Wood Johnson Foundation (RWJF) In active discussions MOU in development Transition plans for 2014 to be developed 10
Why an Index? Familiar tools for evaluating relative levels of things economy (i.e., CPI, Dow Jones), health (i.e., Well Being Index), etc. Can incorporate multiple aspects of complex issues Meaningful groupings of information paint a more complete picture than the sum of the parts Preparedness and response systems are dynamic and complex; need to simplify many measures into visualizations people can understand 11
What is the NHSPI? The National Health Security Preparedness Index (NHSPI) is an annual measure of health security and preparedness at the national and state levels. The Index is designed to give objective information about how well states and the nation are prepared for public health and other emergency situations. Not tied to funding Much broader than PHEP / HPP Much broader than PHEP / HPP 12
What is the NHSPI? The Index will assess where we are and help guide efforts to achieve a higher level of health security preparedness. As a composite, it includes many elements and sectors impacting national health security preparedness: Initial focus on public health and health care systems Future direction to include additional influencers (environmental health, emergency management, federal contributions, etc.) NHSPI: A New Way to Measure and Advance Our Nation's Preparedness. 13
Original Guiding Principles for Developing the NHSPI Do not add data collection burden to practitioners Create transparent process that engages stakeholders Be practical and of greater use than what we currently have Make it a continuous improvement process Avoid unintended consequences as much as possible 14
Feedback Response Process What did we hear from stakeholders? How did we respond to the feedback? How will the 2013 Index be launched? Feedback Analysis Technical Review Model Revisions Resource Development Launch 15
Strong Response to Request for Index Feedback Distributed Index draft to all 50 states and 48 organizations on April 2, 2013 States could only see their own data 39 states responded with more than 125 individual respondents; average of 115 structured + 27 free form comments from each respondent States encouraged to further distribute for broader audience feedback Majority of responses were received from state public health agencies, with a small number received from local health agencies and external partner associations Total of 14,430 structured + 3,344 free form comments from 125 overall respondents 16
Response to Feedback Recommendations for Improvement Based on Feedback Results 1. Revise the NHSPI Mission Statement 2. Develop Short Term and Long Term Objectives 3. Define Uses of the Index 4. Revise Index Structure 5. Identify New Measures and Revise Model 6. Develop and Improve Communications Tools and Resources 7. Provide Data Visualization Options 8. Establish a Phased Approach Launch Plan 17
Robert L. Burhans New York Department of Health Director of Health Emergency Preparedness (retired) Health Emergency Management Consultant 18
MODEL DESIGN 19
Important Elements of the Model's Design Process A quality improvement based development/feedback/revision/refinement approach Quality criteria based measure selection and evaluation Design Two important elements the structure of the Index and the measures that populate it The structure is not simply conceptual/theoretical, but determines the actual Index computation (how the measures are used) The number and quality of the measures determine which components of the structure can be implemented in a given version Quality Improvement Continuing development and validation over time A series of annual versions, with backwards compatibility to enable assessment of improvement over time 20
Original NHSPI Structure: 6 Domains,15 Sub-domains 6 Domains 1 BIOSURVEILLANCE 2 COMMUNITY 3 COUNTER- 4 INCIDENT PLANNING AND MEASURE AND INFO ENGAGEMENT MANAGEMENT MANAGEMENT 5 SURGE MANAGEMENT 6 15 Sub Domains Public Health Surveillance & Epidemiologic Investigation Public Health Laboratory Testing Community-Wide At-Risk Populations Medical Materiel Management and Dispensing Non- Pharmaceutical Interventions Incident Management Emergency Public Information and Warning Mass Care (Congregate Locations) Fatality Management Cross Cutting Volunteer Management Responder Safety and Health Medical Surge (Rapid Expansion) Legal Infrastructure 21
Index Structure Summary of Changes Eliminated Cross Cutting domain Created new Environmental Health domain Renamed a domain and several sub domains Re aligned and added several sub domains and measures Developed a definition for each domain / sub domain Added two future topic areas to the Index Structure 1. Pre Event Community Status 2. Federal Contributions to State Preparedness 22
Index Structure The 2013 Index 5 Domains 14 Sub domains 128 Active Indicators 23
Where is the NHSPI Heading Next? The 2013 Index 5 Domains 14 Sub domains 128 Active Indicators Future Index 1 Additional Domain 8 Additional Sub domains 2 Overarching Areas 165 + Total Indicators 24
Cathy Slemp, MD, MPH West Virginia State Health Officer (retired) Public Health Consultant 25
NHSPI WEBSITE DEMONSTRATION 26
Website: Data Visualization, Design, and Structure Data visualization is designed to Support intended uses of the Index Remain consistent over time Shift paradigm away from state by state rankings Website demonstration Home page / navigation Results» Instructions» The 2013 Index (national and state views) Resources 27
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COMMUNICATIONS: TOOLS AND RESOURCES 33
Feedback for Improving Communications Adapt materials for a broader audience Develop key messages around data visualization Acknowledge limitations of 2013 Index; note greater future potential Methods for improving communications about the Index Improve navigation of domains, sub domains, measures More clearly articulate Index purpose and value Be clearer about future direction 34
Communications Tools and Resources NHSPI tools available for use Overview fact sheet Frequently asked questions Briefing slides Key messages and talking points Using the NHSPI results 35
Communications Tools and Resources NHSPI resources available for use NHSPI.org website overhaul 2013 result views Design and structure Glossary of terms Methodology Guiding principles for development Index framework Measure details Measure sources Domain and sub domain definitions 36
Communications Tools and Resources Additional tools and resources in development Available prior to public launch National press release State press release template State specific key messages based on Index results Feedback response summary Development after public launch Facilitator s guide Videos Validation plan Research agenda 37
LAUNCH PLANS AND NEXT STEPS 38
10/1 DPHP call and 10/4 SHO call Sneak Peek NHSPI v1.0 Launch Plan ASTHO DPHP meeting San Antonio, Texas October 1 8 October 9 Mid November Mid November + Pre Launch Release Public Launch Targeted Outreach Audience Preparedness Directors, State Health Officials and Select Associations Audience Preparedness Directors, State Health Officials, Select Associations, and Partners Audience Practice and Policy Community, Academic and Next Step Partners Audience Practice and Policy Community, Academic and Next Step Partners Channel Webinars Channels DPHP Conference Presentation 10/9, Follow up Calls, E mails, and Briefings Channels Launch v.1.0 on Website, Partner Calls / E mails, and Press Release Channels Conferences, Calls, E mails, Meetings, Listservs and Newsletters Goals Review Feedback Results, Index Changes, and Launch Plans Goals Recap Feedback and Index Changes, Review Website Data, Launch Plan and Resources Goals Introduce NHSPI v.1.0 and Generate Interest Goals Promote Use of NHSPI and Engage in Further Development 39
Preparing for Public Launch Suggested Activities Week of October 7 Attend DPHP meeting Learn more about the NHSPI and available resources Week of October 21 Obtain NHSPI website password/ review NHSPI results and resources Pre brief staff and state officials Anticipate response and develop state based messages about the NHSPI Week of Oct 28 Seek any additional technical assistance needed regarding results and resources through info nhspi@astho.org 40
Targeted Outreach Goals by Stakeholder Category Promote Use of Index Practitioners Policymakers Quality improvement Enhance collaboration / shared responsibility Ensure understanding of Index uses Inform policy and resource decisions Engage Academic Partners Next Step Partners Support research in identified gap areas Develop better measures Define measure specific targets Further develop research agenda Expand sectors incorporated into the Index Engage each in further Index development as applicable 41
PANEL DISCUSSION 42
The Panel Facilitator James Blumenstock Participants Jim Craig Director, Health Protection Mississippi State Department of Health Jacqueline Scott Director, Office of Public Health Preparedness Michigan Department of Community Health 43
QUESTIONS 44
The password to access the NHSPI website will be distributed via e mail the week of October 21. Please direct additional questions to nhspi info@astho.org. 45