American Public Health Association
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Health Administration
Section Newsletter
Fall 2006

Letter from the Chair

It is hard to believe that it is almost time for our Annual Meeting! Before we know it, we will all be hustling to get to scientific sessions, business meetings, and renewing old acquaintances and making new connections. As the chair for the Health Administration Section this year, I am pleased to report progress in a couple of key areas.

First, as one of APHA’s oldest and largest sections, we are attempting to reconnect with one of the original segments of health administration: governmental public health officials from local, state, and federal agencies. While our section began as the assembly of municipal health officers, we have successfully diversified our membership to include a wide variety of individuals from many different aspects of administration, including program administrators, academics, students and others. In this year, we have attempted to make a special effort to reconnect with health officers who have, over time, diminished from the active ranks of our Section.


In an attempt to become more relevant to health officials and other members of the Section, we endeavored to become more focused in our call for abstracts and subsequent decisions around scientific sessions. Under the skilled leadership of our program chair, Dr. Glen Mays, we focused primarily on soliciting sessions that contribute to topics focused on leadership and management. Second, we wanted to explicitly provide an opportunity to highlight scientific presentations that described work generally referred to as public health systems research. I am pleased to say, that thanks to the work of Dr. Mays and his program committee, we have a great variety of scientific sessions which should be of significant interest to our section and especially to our public health officials.


Of particular note this year is a session that will highlight some of our greatest leaders in public health. On Sunday afternoon, we will host a session featuring two former surgeon generals, Dr. Joceyln Elders and Dr. David Satcher, in addition to former APHA president and state and local health officer Dr. Hugh Tilson, and the current health officer from Los Angeles and UCLA professor Dr. Jonathon Fielding. It will be my pleasure to act as moderator of what I am confident will be an inspiring and provocative session on leadership exercised at the front lines of public health. This is a session you will not want to miss!


This year, as in past years, we will be meeting in the early morning hours on Sunday through Wednesday as a Section. On Sunday and Monday we will devote our attention primarily on discussing proposed APHA policy statements as well as providing an opportunity to candidates for APHA elected positions to speak to the Section. On Wednesday we will transition to our new chair, Ms. Gloria McNeil, who will officially begin her term. We will also be hosting a welcome reception and section awards on Monday evening -- a great opportunity to connect with members of the Section and open to all Section members and interested guests.


It has truly been an honor to serve this year as your chair. Thanks to all of our committee chairs and members of our various committees for their hard work and effort. We look forward to the leadership of Chairman McNeel and in congratulating Ms. Tricia Todd as our chair elect for next year.  See you in Boston!


Best Regards,

Paul Halverson

APHA Annual Meeting – How You Can Get Connected

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Attending APHA?  Feeling a little lost because you only know one or two other people?  Don’t even know anyone in the Health Administration Section by name?  Come meet people, have fun and learn at the same time.  We are looking for volunteers to sit at the Health Administration Booth in the APHA Exhibit Hall.  You’d be surprised how many old friends and new colleagues you will meet.  It’s easy – e-mail  or call Audrey Smith at asmith48219@aol.com or (313) 570-3756 and let her know you are available.  We are still looking for coverage during the following days/hours [A minimum of two hours blocks is requested]. 


Sunday, Nov. 5- 4 p.m.-7 p.m.
Monday, Nov. 6- 9:30 a.m. - 5:30 p.m.
Tuesday, Nov. 7- 9:30 a.m. - 5:30 p.m.
Wednesday, Nov. 8- 8:30 a.m. - 12:30 p.m.


For a full schedule of HA sessions at APHA, see the end of the newsletter.

Strategic Planning: Does it Need to be Painful?

The words strategic planning tend to send people scurrying for cover.  The groans can be heard for miles as staff cry, “Why me? Why now? Why plan?”  But strategic planning doesn’t have to be painful, and it doesn’t even have to be long.  Think of it more as tactical thinking and doing.  We do this all the time, whether it’s at home planning a trip, or just getting through our busy weeks and months. 


 


Probably the most important part of strategic planning is the part of making something happen that moves your organization in the right direction.  Without conducting laborious assessments you as the leader often have a sense of the right direction.  Cultivate the personal skills of observation, listening and awareness and apply them daily.  A second personal skill that will help is the ability to set priorities and stick with them.  Often leaders in organizations wait until months of assessment work and input from stakeholders to set a priority list.  With a little digging you can probably find that level of work has been done in your organization more than once to date (unless you are a very new/young organization).  Use that information and your own knowledge as the leader, and set some organizational priorities that you can justify. Once those priorities are set, it makes it so much easier to make concrete decisions. Remember that to be successful you can’t be everything to everyone, so when a new issue or problem arises, if it is not essential to your mission, or moving you toward a vision of excellence in your work, it needs to be owned by someone other than your organization.  You can always support others in their work, just don’t take it on yourself.


 


Past chair of the HA Section, Giorgio Piccagli explains that “For me, a strategic plan points to a target and tells us the emphasis we will put in that direction. It allows us to say what is important and what we will do. Even more important, it allows us to say what we will not do. I think a clear statement of vision, mission, and direction allows people to save their energies proposing things you will not do, and also acts as a recruiting mechanism for human and other resources to implement that plan.”


 


Often when leadership changes, new leaders believe they need to go through strategic planning.  It’s essential that those leaders spend some time looking at the organization and determining how many times those employees have already been asked to strategically plan already.  Too much strategic planning can lead to a lack of strategic doing.   While a full-blown strategic planning process is sometimes necessary to shift the direction of an organization, it isn’t always essential, and particularly in organizations where leadership changes frequently.


 


So think carefully before investing in a full-blown strategic planning process and find out if you can’t instead do a little strategic investigation and build on the good historical work that might be in your organization already.  Your employees will be happy to tell you if they think a strategic planning process is needed or warranted.



To comment or share your thoughts on this article to be included in the next HA edition, please e-mail tricia.todd0002@umn.edu.

Public Health Business Processes

The public health nurse enters her work station, checks her e-mail, goes out to the Web for information about the most recent vaccine that has been licensed, enters her home visit for the new mother into the public health management system, and then checks the immunizations of the other children in the home on an immunization registry. The modern public health department has computers, Internet access, networks, and multiple computer programs. How do the managers of this public health department assure that their computer systems support all of the needs of the public health programs served while also being as efficient as possible? What should managers be doing to assure that systems are integrated and interoperable?  How should public health managers plan for client information to move between their electronic health record system and those of other providers? What information will the public health department get from e-health records?


The growing demands in public health are forcing local health departments to look at existing information systems and seek new solutions to move forward. Despite having spent significant amounts in technology, systems and planning, most public health departments lack the ability to gather, analyze and use information needed to respond to public health problems. Traditionally public health departments have used silo systems that don’t talk to each other, have made decisions based on specific program needs, and all systems have been independent. Public health departments can no longer afford to have systems that are not interoperable and work independently. Health departments need processes to collaborate on system application decisions. There needs to be a strategy of achieving the vision of interoperable systems.


Recently the National Association of County and City Health Officials (NACCHO) and the Public Health Informatics Institute (PHII) undertook a process to define the business processes of public health.  A business process is the sets of related tasks defined to produce a specific programmatic (business) result.   Much of the work at a health department cuts across departmental lines.  Thus, understanding how the work actually gets done is key to designing better information systems.  ‘Business process’ is not a phrase often heard in the halls of a public health department but thanks to the NACCHO-PHII project is becoming a phrase of importance to more and more health department leaders.  Once defined, the business processes can serve as the foundation for developing a base set of detailed information system requirements.  By sharing information system requirements, we encourage development of a new generation of systems that integrate data, support more effective population health assessment, and streamline workflow.  Through shared definition of our work processes and information needs every  local health departments benefits.


What distinguished this information system project from others was its collaborative nature; eight health department leaders from medium to large cities and counties joined forces with PHII to convince themselves that they have more in common. Collaboratively defining the business processes of local health departments created common understanding of how we do our work, helped  health department better understand how their work contributes to accomplishing our health protection and health improvement goals, and how our work processes are intimately linked to a host of external partners. In addition, the business process project helped encouraged best practices and has stimulated more concrete thinking about practice improvement and performance measurement. 

It is essential that informatics principles and the collaborative approach to requirements development be widely understood if public health departments are to develop the capacity to support the functions of public health. The full report is available “Taking Care of Business: A Collaboration to Define the Local Health Department Business Processes” is available at http://www.phii.org.  It is suggested reading for all public health administrators.


To comment or share your thoughts on this article to be included in the next HA edition, please e-mail tricia.todd0002@umn.edu.

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HA Sponsored Sessions at APHA

Monday, November 6, 2006

8:30 a.m.-10:00 a.m.
3032.0 Advances in Organizational Design and Management (Oral)
3033.0 The Economics of Health and Health Services I (Oral)
3034.0 Innovations in Public Health Workforce Development I (Oral)
3035.0 Community-based Approaches to Public Health Management and Practice (Oral)
3051.0 Rural & Urban Health Issues in Service Provision & Emergency Preparedness (Oral)


10:30 a.m.-12:00 p.m.
3119.0 Managing Health and Leading Improvement: New Directions in Health Administration (Roundtable)
3120.0 Advances in Health Systems Research: Data and Resources (Oral)
3121.0 Systems of Care for Pediatric Trauma: Issues and Experiences (Oral)
3135.0 Alternative Approaches to Universal Access to Health Insurance (Panel Discussion)


12:30 p.m.-1:30 p.m.
3162.0 Managing Health and Leading Improvement: New Directions in Health Administration (Poster)
3163.0 Improving the Health Workforce: Posters (Poster)
3164.0 New Directions in Public Health Leadership Development (Poster)
3165.0 Advances in Health Systems Research: Posters (Poster)
3166.0 Managing Alliances and Partnerships for Health Improvement (Poster)


12:30 p.m.-2:00 p.m.
3215.0 Financing Public Health Services: Research and Practice (Oral)


2:30 p.m.-4:00 p.m.
3316.0 Hospital Quality Reporting: Challenges and Opportunities (Oral)
3317.0 Advances in Health Workforce Research (Oral)
3334.0 Quality Improvement and Outcomes of Care on a National Scale (Oral)


4:30 p.m.-6:00 p.m.
3404.0 Technology Adoption and Health Administration (Roundtable)


Tuesday, Nov. 7, 2006

8:30 a.m.-10:00 a.m.

4033.0 Leading Health Policy Change: America's Health Rankings (Oral)
4034.0 Innovations in Health System Financing, Contracting, Purchasing and Payment (Oral)
4035.0 Ethics, Justice, and Human Rights Issues in Health Administration (Oral)


12:30 p.m.-2:00 p.m.
4119.0 Where Data Meets Practice: Evaluating Community Health Assessments (Oral)
4134.0 Exploring Accreditation for Public Health Agencies (Oral)
4135.0 Workforce Issues in the Health System (Oral)
4136.0 Assessing Consumer Experiences with Hospital Care: The HCAHPS Project (Oral)
4137.0 The Economics of Health and Health Services II (Oral)


2:30 p.m.-4:00 p.m.
4224.0 Advances in Health Systems Research: Methods and Applications (Oral)
4225.0 Innovations in Health Care Quality Improvement (Oral)
4226.0 Policy Innovations to Improve Health System Performance and Outcomes (Oral)
4240.0 Applications of Health Economics to Medicare and Hospital Efficiency (Oral)


4:30 p.m.-6:00 p.m.
4314.0 Leadership Development Strategies in Public Health (Oral)
4315.0 Public Health Systems Research: From Evidence to Improvement (Oral)
4316.0 Performance Measurement, Reporting, and Standards in Hospital Care (Oral)


Wednesday, Nov. 8, 2006

8:30 a.m.-10:00 a.m.

5051.0 Public Health Assessment and Accreditation: Lessons from State Experience(Oral)
5052.0 Advances in Health Disparities Research (Oral)
5053.0 Alliances, Partnerships, and Interorganizational Relationships for Health Improvement (Oral)


12:30 p.m.-2:00 p.m.
5112.0 New Directions in Public Health System Financing (Oral)
5113.0 Information, Technology Adoption and Public Health Practice (Oral)
5114.0 Improving the Health Workforce: Issues and Opportunities (Oral)
5126.0 Health Services Research: Quality of Care and Patient Satisfaction (Oral)


2:30 p.m.-4:00 p.m.
5165.0 Advances in Health Management Research (Oral)
5166.0 Quality Improvement in Public Health: Opportunities and Challenges (Oral)
5167.0 Cost, Efficiency, and Economic Impact of Health Interventions (Oral)

Join Your State Affiliate at the Annual Meeting

While APHA is the national voice on public health, it cannot succeed without the complementary efforts of its state Affiliates. To help build infrastructure and strengthen local efforts, APHA will be implementing an exciting new initiative to promote Affiliate membership at this year's Annual Meeting. This new project includes a booth at the Exposition that gives meeting attendees an opportunity to join their local Affiliate on site electronically. To join your state public health association, please visit the Affiliate membership booth, numbers 942 and 1041 in the exhibit hall, located near “Everything APHA.” If you are interested in volunteering to help staff the booth, contact Katie Sheedy at (202) 777-2432 or kaitlin.sheedy@apha.org.