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Performance standards a success in New Hampshire: New England state uses standards to fuel progress, training.

HEALTH and community leaders in New Hampshire have found that performance standards can do more than just measure health services and generate data. Through their use of the National Public Health Performance Standards Program, New Hampshire state and community leaders are building partnerships, creating action plans to address health issues and developing programs they hope will ultimately help improve the health of residents.

Led by the Centers for Disease Control and Prevention, the National Public Health Performance Standards Program is a collaborative effort of seven national public health organizations, including APHA. The program allows health and community leaders to compile and evaluate information on their public health systems and provides a framework for quality improvement. Since its launch in 2002, about two dozen states, 800 local health systems and hundreds of local boards of health have conducted assessments using the standards program.


Among the states that have used the program is New Hampshire, which conducted its first statewide performance standard assessment in October 2005. The New Hampshire Department of Health and Human Services' Division of Public Health Services gathered more than 110 representatives from the private and public sectors to assess the state's health services using the National Public Health Performance Standards Program.

Once data from the assessment was analyzed, the results showed that participants felt New Hampshire was doing well at delivering many essential public health services, such as diagnosing disease, enforcing health regulations and monitoring for health problems. However, the state was lagging on issues such as the public health work force, partnerships, education and research, the evaluation found.


Armed with the results, New Hampshire began charting a course for change. State health officials convened an improvement advisory committee just four months after the assessment with a goal of improving the capacity of the state health system as well as the public's health. The advisory committee led to a 2007 improvement summit, which in turn produced work groups focused on six strategic priorities.

Nearly three years after the initial statewide performance assessment, the work that has been conducted is significant, according to Joan Ascheim, MSN, chief of the Bureau of Policy and Performance Management within the Division of Public Health Services at New Hampshire's Department of Health and Human Services. Funding has been secured to market and communicate the value of public health in New Hampshire, a survey is being drafted on partnerships in the state, a Web-based to coordinate training for health workers and work is under way to improve health data at the community level.

One of the main areas of momentum has been development of partnerships. At the same time the six work groups were carrying out their missions, the New Hampshire Citizen's Initiative was conducting research on health in the state, finding that tobacco, alcohol, poor diet and physical inactivity were the leading preventable causes of illness and death. Because of the findings, several of the performance advisory committee work groups decided to focus their efforts on those health issues, and the organizations are now working more closely together.

Engaging partners has become such a priority that the Division of Public Health Services created a Web site, Improving the Public's Health in New Hampshire, and a newsletter to keep people informed of the process.

New Hampshire plans to conduct its second assessment using the National Public Health Performance Standards Program in 2009 to see how far it has come, and Ascheim says she expects to see many improvements.

For more information on New Hampshire's work, visit www.dhhs.state. htm. For more on the National Public Health Performance Standards Program, visit od/ocphp/nphpsp.
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Title Annotation:ON THE JOB: News for the public health profession
Author:Late, Michele
Publication:The Nation's Health
Date:Jun 1, 2008
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