Dr. Nafissa Cisse Egbuonye, Public Health Director, Black Hawk County Health Department and
Sonja Armbruster, Performance Management & Quality Improvement Expert, PHF, and Director of Wichita State University’s Center for Public Health Initiatives
Valentine’s Day conjures memories of elementary school parties and grocery stores packed with roses. The performance management (PM) team at
Black Hawk County Health Department (BHCHD) in Waterloo, Iowa celebrated Valentine’s Day 2017 with some pink treats and a deep dive into PM training. To gain an understanding of where we were as an organization and establish a foundation of knowledge for all participants, the team completed the
Performance Management Self-Assessment and learned about the
basics of PM. The team then spent more quality time together structuring the goals, objectives, and measures for each division that best aligned with the health department's strategic plan and programmatic priorities.
All too often, that is where the training ends. The work is often discarded like paper valentines and candy wrappers on February 15th. At BHCHD, we were determined to design a plan and ensure follow through. Our transformational PM system has three goals:
- Strengthen agency capacity
- Assure a prepared and protected community
- Promote a healthy community
Each goal had a small team working on objectives and measures. After the training, each team met with Public Health Foundation (PHF) expert
Sonja Armbruster for coaching on how to improve the measures. The teams reconvened a month later for a second PHF-led workshop to:
- Refine objectives and measures to support agency strategic goals
- Develop the plan for deploying and monitoring the PM system
- Develop a plan for the PM team
- Develop a PM communications plan
After a successful first day, a dedicated plan for coaching, and a second day of PM implementation training, BHCHD has made significant progress in three areas. First, teams went beyond practicing with new PM ideas to refined, clear, relevant, and meaningful measures with baselines and targets linked to the strategic plan. Second, we developed a PM Team Charter that established staff roles and responsibilities and set the timeline and schedule for frequency of data collection, analysis, and action. The charter also outlined the process for ongoing discussion of performance measures, including these guiding questions:
- Why do these data matter?
- Is this the result that the public or stakeholders are seeking?
- Are additional partners needed for success?
- How has this effort contributed to the public health evidence base?
- What quality improvement work is happening related to this measure?
Third, using a guide from the National Association of County and City Health Officials, the team formulated a plan for communicating about performance improvement to strengthen staff understanding and increase engagement with the new PM plan. Additionally, strategies were developed for regularly updating BHCHD’s board of health about PM efforts.
This agency-focused, practical, and applied approach to training allowed us to move quickly, from no shared understanding about PM, to a completed system and process for managing it. Through team unity, the agency now has an authentically, locally-designed PM plan and process that aligns with the strategic plan and staff-developed measures of success. For example, the measures include tracking food safety risk assessments on a consistent scale. When all was said and done, it was a lovely Valentine’s Day for our organization, and the gifts just keep on giving.
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