Health Administration
Section Newsletter
Fall 2008

100 Years of Excellence – Two Historical Documents Reflect on Health Administration’s History

During this last year a number of people have been working to uncover our section’s history.  This is being done both by digging through the archives at APHA, a project being managed by Vonna Henry; and uncovering our living history – a coordinated effort to interview past leaders of the Health Administration Section.  The Living History project is being managed by Linda Landesman.  Following are brief descriptions of both.  Out of the efforts of many volunteers will come two documents – both will be available at APHA, and later on the Health Administration Web site.

 

Looking Back – A History of the Health Administration Section

Health Administration members Vonna Henry, Paiker Sayed and Tricia Todd as well as APHA staff members Fran Atkinson and Karla Pearce have all spent time in the APHA Archives digging through old files, pictures, journals and conference programs.  From all the digging, we have attempted to piece together something that describes at least a part of our history.  Digging about in history uncovers a number of things that are quite fascinating.  Perhaps the most noticeable thing is that the more things change the more they stay the same.  There were an amazing number of conference sessions from the early 1900s  with titles that could easily be transferred to 2008.  Titles such as:

  • Public health – past, present and future, by Dr. H. W. Hill (1912).
  • Modern health administration: An analysis, by Oscar Dowly, MD, president of the Colorado State Board of Health (1913) .
  • What should be done in control of Degenerative Diseases?  FS Crum, PhD, assistant statistician, Prudential Life Insurance Company Newark, N.J. (1919).
  • Report of Committee on Standardization of Public Health Training,  (Chairman) Dr. C.E.A. Winslow, New Haven, Conn. (1920).
  • The Place of the APHA in PH and the part the Health officer can play, George W. Fuller, Consulting Engineer, N.Y., N.Y. (1928).

This is just a sampling of some of the sessions and reports that were presented at APHA meetings by those who were members of what is now the Health Administration Section.  And while our digging never found a compiled list of all the names the Section has held in 100 years, we have pieced together, as best we can, a list of what we found in Annual Meeting programs, proceedings, journals and newspapers. 


A Living History – a compilation of thoughts, ideas, reflections from past leaders of Health Administration

The Living History project was a phenomenal undertaking of Linda Landesman as project coordinator, and Gita Uppal, a very new member.  The project involved organizing nine students from the Student Assembly to interview leaders from Health Administration.  Those students also deserve special recognition:

 


Anna K. Bryant

Nicole Dickelson

Jennifer Jordan

Julie Nguyen

Yaw Amoah-Poku

Edna Primas

Paiker Sayed

Michelle Silas

Reigh Simuzoshya


 

The students interviewed a total of 44 leaders.  The results of those interviews were sent to Linda, and she painstakingly reviewed the responses and wove them together into a document that reflects the thoughts, ideas and reflections of those leaders.

 

Leaders were asked to reflect on a number of topics such as what do health administrators do?

 

For Dillep Bal , health administratorskeep the wheels of public health moving. Everybody is attracted to the operational end of public health. Public health administration is not the sexiest discipline, but it is absolutely necessary. Health administration ensures that we get resources for what has to be done and that the bureaucratic barriers to smooth operation are minimized.”

 

Elizabeth Trevino stated that “the important functions that health administrators contribute to the field is a quick assessment of problems, finding effective solutions and carrying out implementation of the same. As health administrators we are in a position that we can make things happen.”

 

Georges Benjamin sees health administrators “helping public health practitioners become better decision-makers in managing a crisis. Also figuring out what a 'win' is.” Georges encourages health administrators to “celebrate your wins no matter how big or small. Some people get over obsessed with what is the right thing to do. Historically, we are a group of competitive people in which we feel as though we need to win.”

 

Leaders were asked to reflect on the contribution the Health Administration Section makes to the field and to public health.  Some of the identified contributions included preparing guidelines for practice, promoting credentialing, serving as leaders by example, and mentoring the future workf orce.

 

Leaders were also asked to reflect on what you need to be successful.

 

Jacquie Duerr believes in being a continuous learner. “Fill your kit bag as full with as many skills and knowledge sets as you can. Take huge responsibility for the work you do, but understand success has many mothers. I have learned that it is my obligation to set the stage for teamwork, to find the incentive to get the best of each individual. Public health belongs to the public; everyone has a role in improving public health.”

 

Bernie Turnock explained his perspective. “I think the most important accomplishments are what you leave behind - a vision, plan and capable people to carry it on.”

 

Those interviewed were also asked to give advice to future leaders.  Lester Breslow said thatthere are two greatest lessons that I would want to pass on to future health administrators. One is to listen and the second is to challenge all assumptions and establishments. I advise the future health administrators to listen to constituents and expert advisors and learn from their experience. My second advice is to challenge all assumptions and establishments.”

 

The full document is pages of reflections on why and how to become involved in the Section, important issues faced by Section leaders and experiences learned through holding leadership positions in HA and APHA.  But the focus isn’t only on leaders of the Section.  Many other members of Health Administration were asked to reflect on how the field of health administration contributes to public health, and what the greatest accomplishments were these leaders achieved in their professional careers.  The final section of the document focused on thinking about the future, and what are the greatest challenges public health professionals anticipate for the future, and perhaps most important, what advice they would give to the future leaders.

 

Both documents will be available at the APHA Annual Meeting at the event on Tuesday evening.  If you have not yet registered to attend our celebration, please do.  In the words of Georges Benjamin, we plan to “celebrate your wins no matter how big or small.” Turning 100 as a Section is an important milestone; please register to join us at the celebration on Oct. 28, 2008, 6:00-8:00 p.m.  - complimentary appetizers in a fun atmosphere. Register at:  http://www.apha.org/membergroups/sections/aphasections/healthadmin/HASAnniversary.htm

 

If you are unable to attend tbe APHA Annual Meeting, the documents will be made available on the Health Administration Web site after the conference.

 

Health Administration Newsletter – September 2008

 

The Health Administration Newsletter welcomes articles on best practices and other information pertinent to health administrators.  If you would like to submit to this newsletter, please contact Tricia Todd, todd0002@umn.edu .   Feel free to send editorial comments for publication on articles you read in the newsletter.

 

Health Administration- Best Practices

Using multi-disciplinary teams to conduct Root Cause Analysis leads to innovative solutions while simultaneously transforming group dynamics  By: Denise G. Osborn, JD, MPH(2008)

 

What is Root Cause Analysis? Root Cause Analysis (RCA) is an effective tool that can be used to study why something that is undesirable has happened.  A multi-disciplinary team works collaboratively to conduct a retroactive analysis by uncovering several contributory factors that led to the undesired event, as well as multiple root causes that actually caused the event.  Each team member brings their unique perspective as to why the event occurred and what should be done to avoid a future reoccurrence.  Structured brainstorming and robust interaction is encouraged by a team facilitator with the desired goal of helping the team to discover new and innovative solutions.  The beauty of a well conducted RCA is revealed when everyone has contributed to the process and is able to see measurable results that led to positive change.  

 

What do I need to conduct a thorough and credible Root Cause Analysis?  A person to serve as a facilitator who is familiar with the RCA process; a multi-disciplinary team of eight or less persons;  eight to 10 hours of scheduled time for four team meetings (time may vary depending upon complexity of the analysis); and ccess to and competency with word processing and flow charting software.

 

What are the components of a Root Cause Analysis?

 

  • A flow chart of the actual sequence of events that led up to the event .
  • A thorough literature review pertinent to the event being studied.
  • A flow chart of the optimal sequence of events that should have occurred.
  • A list of corrective actions that took place right after the event occurred.
  • A list of contributory factors (from brainstorming) that may have contributed to the event.
  • A drill down on each contributory factor by asking Why at least five times to find the root causes.
  • A prioritization of the root causes using a matrix, variables and scoring.
  • A list of proposed improvement actions with timelines for each root cause.
  • Mechanisms developed by the team to measure and report results such as bar graphs, scatter diagrams or run charts.

 

How does RCA transform group dynamics?  A well-facilitated RCA not only provides an environment for learning but can also inspire positive cultural changes within an organization.  Every RCA requires a thorough literature review before the first team meeting.  This review contains important research including findings around what other organizations have done to address similar problems.  This information takes the team above and beyond their own frame of reference and equips them to consider new approaches, best practices and methodologies.  In essence, the RCA provides continuing education that may not have otherwise been introduced to the team members in their every day work.  Similarly, team members are given an opportunity to learn more about what their colleagues do and how they approach problems.  Exposure to other disciplines allows for a better understanding of the proverbial big picture and sensitizes people to the challenges that others face in performing their duties.  The level of collaboration necessary to perform a RCA has the potential to solidify working relationships, build strong teams and transform culture within an organization.

 

Is Root Cause Analysis utilized by health care professionals?  Absolutely. Root Cause Analysis is recommended by JCAHO to be used by hospitals as a methodology to study and report sentinel events.  RCA is used routinely by medical device companies and the pharmaceutical industry as a quality assurance tool to uncover reasons behind adverse events.  In academia, students at The University of Minnesota, School of Public Health host nationwide competitions where teams are given a case study and charged with creating a root cause analysis. 

 

Where can I learn more about Root Cause Analysis?

www.jointcommission.org  The Joint Commission

http://www.patientsafety.gov  The National Center for Patient Safety

www.rca-fmea.com  RCA Solutions

 

Denise Osborn is a member of the Health Administration Section.  She is a licensed attorney who works in the area of patient safety and health policy.  She has a certificate in Healthcare Corporate Compliance and is a candidate for her Masters Degree in Public Health from George Washington University.  Denise is the owner of RCA Solutions a consulting firm in Great Falls, Va., that provides consulting services to health care professionals.  She is a senior consultant and has taught RCA to health care professionals for over 10 years.  You can contact Denise directly at denise@rca-fmea.com or visit her Web site at www.rca-fmea.com

APHA Policy Resolution Review – Add Your Voice

Do you have an opinion on the policy resolutions being presented to the APHA Governing Council at this year’s APHA Annual Meeting?  Even if you are not attending the meeting, you can submit an opinion to Marcia Rosenstein at Marcia.Rosenstein@cdph.ca.gov

 

 

If you are attending APHA and would like to represent the Section at the Public Hearings on Sunday from 3:00 p.m. – 6:00 p.m.,  please contact Marcia Rosenstein Marcia.Rosenstein@cdph.ca.gov

 

Information about the 2008 Policies are also available on the APHA Web site at

http://www.apha.org/advocacy/policy/proposedpolicies.htm   

 

So how do you review? When you contact Marcia, she will provide you with a policy review form.  Then you will choose one of the policy groups  (Group A, B, C, or D).  After reviewing, you will attend the first Section Meeting on Policy Review on Sunday, Oct. 25, 7:00 a.m. – 8:30 a.m. in the Convention Center Room 16 B, OR you will send your comments to Marcia prior to the Annual Meeting so she can include them in the discussion.

 

How does this policy process work?  Marcia has outlined the steps below and indicated our point in the process right now: 

  • Any member is permitted to propose a policy based on APHA’s criteria. 
  • The policies are submitted to the Joint Policy Committee (JPC) for review (made up of members of the Action Board, the Education Board and the Science Board). 
  • The JPC reviews them, edits them, makes suggestions, and the authors then revise them.
  • The JPC then sends them for PRELIMINARY review. 
  • We submit our comments to the JPC (see the e-mail address below).
  • The JPC then integrates the suggestions.
  • Then right before the APHA Annual Meeting, the revised policies are submitted for general review by the membership, and we will re-review in preparation for the Health Administration Section Policy Committee and Section meeting. WE ARE AT THIS POINT RIGHT NOW.
  • At the APHA Annual Meeting, the Health Administration Section Policy Committee will convene and re-review the policies as they stand at this point. 
  • I will then ask each of you to attend a public hearing on the policies, and provide the input we have received on the policies.
  • At the Public Hearing, all the Sections/individuals/Caucuses/SPIGs provide input.
  • The JPC integrates the suggestions.
  • The JPC then recommends policies for placement on the Consent Calendar.  At this point, if the policy is on the Consent Calendar, if the Governing Council votes to accept the Consent Calendar, the policies on the Consent Calendar list then become APHA Policy.
  • Those that are taken off the Consent Calendar are then reviewed and voted yes or no at the Governing Council meeting.
  • Once the Governing Council votes yea, a Policy is then APHA Policy.  If it is voted no, it does not become APHA policy.

 

  • There is a process for introducing Latebreakers.  If there is a hot topic that has arisen after the initial process has been completed, it is possible for a member to introduce a Latebreaker.  The Latebreakers are reviewed in the Public Hearings.  If they are placed on the Consent Calendar, they become APHA policy FOR ONE YEAR, during which they must undergo the rigorous review I just outlined.

 

2008 Proposed Policies

A: Health Disparities

B: Environmental Health

C: Access to Care

D: Public Health Science and Infrastructure

Job Postings and Other News

The Department of Health & Nutrition Sciences at Montclair State University will be hiring a full-time tenure track faculty member in health policy and management/administration to begin in fall 2009. Join a dynamic department with a new MPH program. Please e-mail Dr. Amanda Birnbaum at birnbauma@mail.montclair.edu for a position announcement and more information.