MPH 560 Week 6 Public Health Agency Management Plan Example

The New Director's First Year: A Management Plan for Strategy, Performance, Quality Improvement and Accreditation in a County Health Department

[Student Name]

University of Phoenix

MPH/560: Public Health Systems and Services Administration

Week 6 Assignment

[Instructor Name]

[Date]

The county health department, its director, clinic data, plans, budget figures and timeline are composites written for a model paper; research findings come from the sources cited.

The county's new health director met the board of health in her first week. The board chair was direct: the department had lost a third of its staff in two years, a key grant was ending, clinic waits were long and residents did not know what the department did. The board wanted a plan within 90 days. This paper presents that plan, drawing on the analyses of structure, financing, access, policy and workforce completed earlier in the course.

Organizational Assessment

The director began with an assessment. Strengths included committed long-tenured staff, strong partnerships with schools and the community health center and a board willing to act. Weaknesses included dependence on restricted federal grants, 29 vacancies, loss of epidemiology capacity, long clinic waits, outdated information systems and no strategic plan since 2016. Opportunities included regional partnerships and a community eager for help with access to care. Threats included funding cuts and public hostility toward health measures.

How Priorities Were Chosen

The director applied the principles of evidence-based public health: decisions based on the best available evidence, systematic use of data, planning frameworks, community engagement in decisions, sound evaluation and sharing what is learned (Brownson et al., 2009). Staff reviewed community health data, program data and evidence on effective interventions, and residents weighed in at four listening sessions.

What Residents Said

Listening sessions shaped the priorities. Residents on the east side described long waits for immunizations and trouble renewing Medicaid. Parents asked for help finding child care that met health standards. Several participants said they had never heard of the department until the pandemic. Those comments moved access and communication higher on the list than staff had expected.

Four Strategic Priorities

The resulting three-year strategic plan set four priorities: first, stabilize the workforce; second, rebuild data and epidemiology capacity; third, improve access to the department's clinical and enrollment services; and fourth, reduce the burden of chronic disease and overdose in the neighborhoods with the greatest need.

Goals and Measures

Each priority carries measures with baselines and targets. For workforce, turnover would fall from 22% to 12% within two years. For data, a community health assessment would be completed and the overdose dashboard updated monthly. For access, days to the next available immunization appointment would fall from 18 to 5. For chronic disease and overdose, program measures would track reach in priority neighborhoods.

Performance Management

Measures need a routine. Each program will report its measures monthly on a shared dashboard. Managers will review results monthly with the director, and the board will receive a quarterly report. When a measure lags for two consecutive months, the program will analyze the cause and, where the problem lies in a process, launch a quality improvement project.

Quality Improvement Defined

One widely cited definition describes quality improvement in public health as a distinct management process and set of tools and techniques coordinated so that departments consistently meet the health needs of their communities (Riley et al., 2010). It differs from quality assurance, which checks compliance, by focusing on improving processes.

A Worked Quality Improvement Project

The first project targeted immunization clinic access. The team mapped the process from phone call to vaccination and found that appointments were booked through one phone line staffed part-time, that 22% of booked appointments were no-shows and that walk-ins were turned away even when slots sat empty.

Plan-Do-Study-Act Cycles

In the first cycle, the team opened online scheduling and text reminders; no-shows fell from 22% to 13% in six weeks. In the second, they reserved four walk-in slots each clinic day. In the third, they added one evening clinic a week. Over four months, days to the next available appointment fell from 18 to 6. Most of the wait was in the process, not in a shortage of nurses.

Spreading the Method

After the first project, the department trained 12 staff in basic quality improvement tools, including process mapping and run charts. Each program will attempt at least one project a year, chosen from measures that lag on the dashboard. Small, visible successes build a culture in which staff expect to fix problems rather than work around them.

Why Pursue Accreditation

National accreditation provides a framework for the whole plan. The Public Health Accreditation Board launched its voluntary program in 2011, and by May 2016, 134 health departments had been accredited and 176 more had begun the process, covering nearly 167 million people. In a survey of health departments one year after accreditation, upward of nine in ten said the process had spurred improvement work, made them more accountable and open and strengthened how they were managed (Kronstadt et al., 2016).

Accreditation Readiness

The department will begin with a readiness review against the standards, then finish the three required documents: an assessment of community health, a plan to improve it and the department's strategic plan. The formal application would follow in year two.

Budget

The plan draws on earlier financing analysis: county funds for foundational epidemiology, billing improvements and a regional partnership. Accreditation fees and staff time for documentation are budgeted over three years.

Workforce

The retention plan developed earlier, including pay adjustments, flexibility, career ladders, supervisor training and pipelines, is the first priority because every other goal depends on staff.

Data Systems

The performance system depends on data. The department will replace its spreadsheet tracking with a shared dashboard drawing from clinic scheduling, environmental health inspections and program records, built by the rebuilt epidemiology team. Until it is ready, programs will report a short set of measures by hand.

Governance

The board of health will approve the strategic plan, review quarterly performance reports and use the measures in budget discussions with county commissioners. The director will meet monthly with the board chair.

Communication

The department will publish an annual report in plain language, share dashboard results publicly and tell residents what it does through local media and community partners, addressing the board's concern that residents did not know the department's work.

Risks

Funding may fall short, recruitment may lag and performance measures may be gamed if tied to punishment. The director will present measures as tools for learning, not blame. She will also keep a short list of measures rather than dozens, since a dashboard nobody reads manages nothing.

First-Year Timeline

Months one to three: assessment, listening sessions and draft strategic plan. Months four to six: board approval, dashboard launch and first quality improvement project. Months seven to nine: community health assessment and retention measures. Months ten to twelve: accreditation readiness review and first annual report.

Conclusion

The director's first-year plan turns earlier analyses into management action. Evidence-based public health guides priorities, a performance management routine links priorities to measures, quality improvement fixes processes such as clinic scheduling and accreditation provides a framework that accredited departments report improves management and accountability. With stable staff and clear measures, the board can see whether the department is improving.

References

Brownson, R. C., Fielding, J. E., & Maylahn, C. M. (2009). Evidence-based public health: A fundamental concept for public health practice. Annual Review of Public Health, 30, 175-201. https://doi.org/10.1146/annurev.publhealth.031308.100134

Kronstadt, J., Meit, M., Siegfried, A., Nicolaus, T., Bender, K., & Corso, L. (2016). Evaluating the impact of national public health department accreditation: United States, 2016. MMWR. Morbidity and Mortality Weekly Report, 65(31), 803-806. https://doi.org/10.15585/mmwr.mm6531a3

Riley, W. J., Moran, J. W., Corso, L. C., Beitsch, L. M., Bialek, R., & Cofsky, A. (2010). Defining quality improvement in public health. Journal of Public Health Management and Practice, 16(1), 5-7. https://doi.org/10.1097/PHH.0b013e3181bedb49