South Carolina Performance Management System MLC3 work

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South Carolina Performance Management System
MLC-3 work
Joe Kyle .on behalf of the SC team Director,
Office of Performance Management Health
Services Dept of Health and Environmental
Control
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Overview of Presentation

• Description of South Carolina Department of
  Health and Environmental Control, Health Services
  Deputy area
• Description of what implementation of Performance
  Management in DHECs Health Services has been and
  what it is striving towards
• What Health Services plans on implementing
  through the MLC-3 grant efforts

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DHEC andHealth Services

• DHEC is the lead environmental and public health
  agency in the state (combined EPA, CDC, HRSA ,
  DOA (WIC), functions)
• Health Services is the largest organizational
  unit in DHEC, and where most traditional health
  department services are located
• About 3,112 FTEs and 572 hourly/temporary/per
  visit employees statewide
• Health department is vertically integrated. All
  employees from counties to regions to state, are
  state employees, all answer, ultimately, to same
  boss
• 8 Public Health Regions with local health
  departments in 95 sites in all 46 counties in SC

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General Role of Central Office and Regions

• Central Office (State) Level
• State level Health Improvement
• Obtaining Resources
• Development of Policies, Regulations, etc
• Program Guidance Oversight
• Subject Matter Expertise Consultations (public
  private sector)
• State, Federal and National relationships,
  partnerships
• Region (Local) Level (local decision level)
• Community level Health Improvement
• Direct Service Delivery
• Implementation of Policies
• Region and local relationships, partnerships

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DHECs Eight Public Health Regions
Region 2
Cherokee
Greenville
Region 3
York
Spartanburg
Pickens
Oconee
Union
Chester
Lancaster
Marlboro
Region 4
Chesterfield
Anderson
Laurens
Dillon
Kershaw
Fairfield
Darlington
Newberry
Abbeville
Lee
Marion
Greenwood
Florence
Saluda
Richland
McCormick
Lexington
Sumter
Horry
Region 1
Edgefield
Clarendon
Calhoun
Williamsburg
Aiken
Orangeburg
Region 6
Georgetown
Barnwell
Bamberg
Berkeley
Dorchester
Region 5
Allendale
Colleton
Hampton
Charleston
Region 7
Jasper
Region 8
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Health Services is..1

• Many different types of organizations
• Regulatory (Environmental Health)
• Disease Focused (STD, TB, HIV)
• Population Focused (Child Health, Perinatal
  Health, Imm)
• Policy Focused (Community Health Chronic
  Disease)
• Direct Service Delivery-Gap Filler (Family
  Planning)
• Core Public Health Provider (Obesity Program)
• Political

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Health Services is..2

• Many different types of organizations
• Discipline Driven (Nursing, SW. HE, Nut)
• Stovepiped (specialized) in central office
• Organized by funding
• Organized by disease, issue, population
• Priority of relationship to the mother ship
  (feds)
• More horizontally aware in the Regions
• Out of necessitymulti-tasking and multi-function
  staff
• Organized more by function, unlike central office
• Centralized to some, decentralized to others
• Role of accountability
• Highly consultative with internal stakeholders
  prior to major decisions

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Performance Management within Health Services
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Performance Management antecedents

• CHAP
• agency accreditation for its HH program-ongoing
• Baldrige
• region self assessment and annual agency
  accountability report to legislature
• Agency Strategic Plan, 2000-2005 and 2005-2010
• 00-05 first outcome-based plan 05-10 performance
  concepts incorporated
• Health Services Operational Plan
• first attempt at integrated planning based on
  outcomes
• Pilot of Performance Management System
• first attempt at within control accountability,
  span of HS

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Performance Management Framework And Components
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Public Health Agency Model
Turning Point From Silos To Systems
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Performance Management System
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Span of Measures and Prioritization
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Performance Standard 90 of women testing
positive for Chlamydia should be treated within
30 days of test
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Performance Measurement Percent of DHEC family
planning and STD clinic clients with positive
Chlamydia tests that are treated within 30 days
of the specimen collection date
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Report Progress/Analyze Data Quarterly reports
for each region provided to STD/HIV Division and
reported in PM database. Reports shared at
Region level and at quarterly CO/Region meetings
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Quality Improvement Process Region and STD/HIV
Division identify regions that are below
standard, initiate QI process to improve
performance and communicate results
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CQI Action Steps
Performance Measurement Monitoring Problem
Identification Problem Prioritization
Define
Communicate
ACT
PLAN
Action Steps To Improve Performance
Measure
Implement
DO
CHECK
Analyze
Evaluate
Innovate
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Getting the PM work done

• Office of Performance Management
• CQI Team
• Since 1996
• Reps from each region, major program areas
• Each region has point of contact or coordinator
  for PM
• Each measure and program area has owner,
  responsible party
• Data entry, troubleshooting, consultation

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Multistate Learning Collaborative Grant What will
happen in South Carolina?

• Collaborative work will primary focus on two
  regions (4 and 8)
• In these regions, two collaboratives will be
  formed, sequentially, based on the IHI
  Collaborative Model
• 1) reducing exposure to 2nd hand smoke 2)
  improving first trimester access to prenatal
  care.
• Collaboratives will consist of 7 county teams,
  with possible participation of region staff and
  community partners
• TA and support from USC (contract), OPM, and
  other experts
• Lessons learned from doing systematic
  collaborative-based quality improvement, and
  accreditation work, will be shared out
  continuously to DHEC, other partners in SC and
  outside through reports, presentations, site
  visits (to SC, to other states)including
  presentation to SCPHA, and large statewide
  management conference in year 3

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Multistate Learning Collaborative Grant What will
happen in South Carolina?

• Preparing the workforce for accreditation
• Linking up our PMS with accreditation, to create
  one seamless system
• Taking advantage of our many face-to-face
  meetings throughout the state with region and
  central office staff, to educate, inform, solicit
  input regarding accreditation
• Training. All told, 11 staff in HS will receive
  training to become a Lean Six Sigma Greenbelt
  (one from each of the regions, two from OPM, one
  from OQM)2 staff trained on IHI model from HS,
  and 1 staff from our academic partner

What do we hope to gain through MLC3 and
accreditation work includes improve upon and
fully make PM and QI part of our culture, to
learn from other states and organizations about
how best to do this, and to merge our PM efforts
with voluntary accreditation processes