Health Planning, Program management and evaluation Flashcards

1
Q

PSAs for public health

A

Vital statistics
environmental sanitation
health department laboratory services
maternal /child healthcare and surveillance
public health education

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2
Q

levels of intervention

A

individual
community
systems

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3
Q

example of individual intervention

A

counseling a pregnant woman in tobacco cessation methods

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4
Q

example of community level intervention

A

group education in tobacco cessation for teens

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5
Q

example of systems level interventions

A

advocating for tobacco tax increases to decrease motivation to use it

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6
Q

public health nurse roles and responsibilities

A

Vaccinations
Prenatal care
Medication administration for STIs and TB
Home visits for high-risk community members
Establish relationships with individuals and community groups
Recognize social determinants that affect health
Disease control such as Tuberculosis management, Hepatitis A

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7
Q

symptoms of TB

A

night sweats, weight loss, poor appetite, persistent cough.

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8
Q

has complicated and prolonged the fight to eradicate this disease (due to non-adherence). Highly contagious, associated with social determinants such as poverty, crowded living situations (dorms, prisons), alcohol/substance abuse, arrival from another country with high rates of TB infection.

A

drug resistant TB

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9
Q

tx of TB

A

directly observed therapy for several months to ensure adherence or medication electronic monitoring system that tracks the openings of the pill bottle, phone, email or text reminders

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10
Q

public health nurses in investigations of TB

A

investigations that locate where the TB cases are concentrated, and organize outreach services to those community members (testing, information, arrangement of prophylactic treatment as needed)

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11
Q

If there is an outbreak of Hepatitis A in a community what is the most important information that the public needs to know from you to prevent transmission?

A

Washing hands – HepA is transmitted fecal-oral route. Contaminated surfaces, food, and water are touched. Handwashing is the most effective way to prevent transmission.

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12
Q

Drug resistant variants, diseases that have started to infect humans, climate change, globalization/international travel

A

Emerging or re-emerging infections/diseases concerns

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13
Q

case management plans

A

Standards of client care, standards of nursing practice, clinical guidelines using evidence-based practice. Adaptation to each client’s unique situation is key

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14
Q

steps in case management

A

Coordination of services across healthcare specialties and community health services
Improve quality of care, efficiency of services
Cost containment
Must know community resources, be a good communicator
Case management plans
Evaluation: If goals were not met, change the plan

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15
Q

Prevention: exchange information, increase health literacy, instruct on accessing healthcare system, engage in health education

A

primary

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16
Q

Prevention: case finding, using healthcare data to identify health problems, assessments and interventions that promote health

A

secondary

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17
Q

Prevention: monitor and adjust the use of prescription medications and adherence to treatment to reduce the risk of complications

A

tertiary

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18
Q

immunizations programs

A

Essential service
Protects the population from communicable disease
International travel vaccine administration
Post-rabies exposure prophylaxis
Mandated by schools to varying degrees across the country
Immunizations integrated in public health clinical services
If an outbreak occurs, the local health department is responsible for mass immunizations
Coordination of vaccine supplies, rates of immunizations given regionally, statewide immunization registries to document, and free immunization clinics.
Goal: Equitable access

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19
Q

Principles of the ethical practice of public health highlights:

A

-protect the confidentiality of information gathered
-respects the rights of individuals in the community
-advocate & work for the empowerment - resources are accessible to all
-anticipate and respect diverse values, beliefs, and cultures in the community
-engage in collaborations that build the public’s trust

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20
Q

Key components of health program planning

A

Active involvement of the community as a partner
Skill & time to do a competent assessment
Shared conclusions with the partners of the needed interventions
Actual program planning, interventions, & evaluation
Social justice: human rights & equity

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21
Q

Mobilizing for action through planning and partnerships (MAPP)

A

A framework for conducting community assessment
Aims to help communities apply strategic thinking to prioritize PH issues & identify resources to address them

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22
Q

4 different assessments for MAPP

A
  1. Community themes & strengths assessment
  2. Local public health system assessment
  3. Community health status assessment
  4. Forces of change assessment
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23
Q

Assess community themes & strengths

A

Key informant interviews, surveys, focus groups that assess the strengths & problems within the community – from community members’ perspective.

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24
Q

Assess Community health status

A

Identify priority community health & quality of life issues – involves gathering primary and secondary data related to the problem(s)

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Forces of change
Focuses on identifying forces such as laws, technology, or funding that affect the context in which the community & its public health system operate
26
Examples of PH interventions at the individual and community levels:
Women, Infants & Children (WIC), school health programming, and immunization campaigns.
27
MAPP example
Problem: Infant mortality Mobilize community partnerships: A MAPP committee was formed Action: Community assessments were done by committees: Data collected and funding sought Planning/Partnership: High infant mortality found to be higher among African Americans in the community than among others. Programs built to improve access to prenatal care, birth weight, & reduce teen pregnancy, tobacco use among pregnant women & girls
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graphic depiction (road map) that presents the shared relationships among the resources, activities, outputs, outcomes, and impact for your program
logic model
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logic model depicts the relationship between:
your program’s activities and its intended effects
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logic model helps clarify
what the program is doing (implementation) and the intended results
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Some key terms used in logic models, although not all are employed in any given model:
Inputs: The resources needed to implement the activities Activities: What the program and its staff do with those resources Outputs: Tangible products, capacities, or deliverables that result from the activities Outcomes: Changes that occur in other people or conditions because of the activities and outputs Impacts: long-term outcomes Moderators: Factors that are out of control of the program but may help or hinder achievement of the outcomes
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precautions for measles
airborne
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measles rash
A rash appears within a week of infection, symptoms appear average 14 days. Cough, sore throat, conjunctivitis. The sick are contagious from four days before, to four days after the rash starts. Rash with high fevers that can cause infertility, pneumonia, immune problems in later years, hearing problems, death.
34
heard immunity for measles
requires 96% of people in a community to be immunized in order to protect the unimmune from infection.
35
A clear statement of the health problem and the causal reasons or theories for the health problem
community diagnosis guides community teams thinking in how to design program and decide what components are necessary
36
community program management
Community health program planning is population focused, promotes health equity, empowers communities and advocates for social justice Planned to meet the needs of specific individuals, groups, communities
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examples of community program management
Home health, immunization programs, family planning programs, school health programs, occupational health & safety, environmental health, community programs directed at preventing specific health condition
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program planning
describe the problem formulate the plan conceptualize the problem detail the plan evaluate the plan
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ultimate goal of program planning
ensure that health care services are acceptable, equal, effective, and efficient
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program evaluation
Systematic collection of information about activities, outputs, and outcomes to enhance a program and it effectiveness Provides feedback about how the activity design worked, cost effectiveness, and if the interventions worked, if the timeline was appropriate, if the program should be expanded or used in another location
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For the purpose of assessing whether objectives are being met or planned activities are completed. Begins with an assessment of the need for a program and is ongoing as the program is happening. Allows for changes to be made.
formative evaluation
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To assess program outcomes or as a follow-up of the results of the program activities and usually occurs when a program is completed. Includes evaluation of objectives and goals.
summative evaluation
43
program goals
Overall aim A broad statement of the impact expected by implementing a program A statement of outcome rather than activity Usually only a few goals for a program Should be realistic, achievable, and sustainable Must be a sustainable program
44
creating objective
Clarify the goal Design an outcome measurement Keep the program focused on the intended intervention Measurable, time-limited, action-oriented Include who will achieve what, by how much, by when HP 2030: Goal: Increase local PH departments that have developed a community health improvement plan Objective: By 2030, increase the percent of PH agencies who have CHIP (measure: % of increased enrollment in CHIP)
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SMART
specific measurable achievable realistic timeline
46
healthcare improvement in the community
Quality of healthcare has been difficult to evaluate in the US because there are different definitions of quality of care and it is hard to get same kinds of data to compare from different healthcare sites Improving quality can help provide better care, effective interventions, save lives, reduce costs, improve client confidence in health care delivery Focus is on finding problems in the system, not blaming individuals
47
milestones in quality
Managed care organization Core Competencies of Public Health Nursing (2010) Several nursing organizations, which comprise the Quad Council for Public Health Nursing, have taken the charge to strengthen nursing practice in the community Quad Council renamed to Council of Public Health Nursing Organizations The Council on Linkages between Academia and Public Health Practice has worked to advance academic and practice collaboration to ensure a well-trained, competent workforce and a strong, evidence-based public health infrastructure
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: Defined by the client as the improvement in health status, by the organizations and providers as accurate interventions and the skill of the provider
quality
49
The degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge
quality health care
50
The degree to which policies, programs, services, and research for the population increase desired health outcomes and conditions in which the population can be healthy
quality in public health
51
approaches to quality improvement: voluntary approaches
Credentialing – competence recognition Accreditation – organization regulation compliance Certification – skills recognition Charter – institutional status to give degrees Recognition – cross-institutional credentialing Academic degrees
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approaches to quality improvement: required approaches
Licensure - individual Accreditation – regulation compliance for agency reimbursement Certification – achievement qualifying for professional practice Academic degrees – required to enter professions
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To monitor the outcomes of health agency services over a 3–5-year plan. Long-term approach to address public health problems. Results in improved agency care delivery, coordination, performance. Helps to achieve accreditation
Community Assessment-Community Health Improvement Plans (CHA/CHIP)
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A model of care that addresses individuals’ health needs at all points along the continuum of care, including in the community setting, through participation, engagement and targeted interventions for a defined population. Goal is to address health disparities with cost-effective, customized interventions.
Population Health Management (PHM)
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A process of selecting community indicators that measure the process and outcomes of a health improvement intervention strategy. Indicators can be assessed to determine intervention effectiveness or agency performance.
performance monitoring
56
Protocols of recommended practice developed by governmental and health care agencies and professional organizations.
guidelines
57
evaluation, interpretation, action
Regular intervals for evaluation should be established within the agency and periodic reports written so performance improvement efforts can be analyzed, and problems identified Course of action should be based on their performance, cost, timeliness Take action Follow up and evaluation of actions taken must occur for performance improvement
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documentation in public health
Documentation is essential to the evaluation of quality care in any organization Healthcare organization records determined by state departments of health Public health agency records predict population trends, identify community health needs, determine program budgets (infant mortality, chronic disease prevalence, life expectancy) Public health agency records can provide a picture of the overall health and healthcare status of a community, population, country.
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