Publications and Presentations from the Minnesota Research to Action Network
Do investments in local public health activities and services contribute to changes in population health and/or health care cost savings? Are returns greater in some communities? Could Medicaid expansion have unintended consequences for public health? In this webinar, participants learned about emerging national research, explored implications for Minnesota, and identified next steps in using this information in Minnesota.
Local health department factors associated with performance in the successful implementation of community-based strategies (PDF)
This study assessed local public health performance during the initial two years of Minnesota's Statewide Health Improvement Program (SHIP), which funds policy, systems and environmental change strategies at the local level, to examine what factors at the local health department-level contribute to success in implementing these community-based interventions.
SHIP 1.0 represented a major learning curve for most grantees, however those that were able to be flexible and embrace the approach were better able to implement the program.
This brief highlights Minnesota-specific findings for the Multi-network Practice and Outcome Variation Examination (MPROVE) Study, a multi-state study led by the National PBRN Coordinating Center and engaging public health practice-based research networks in Colorado, Florida, Minnesota, New Jersey, North Carolina, Tennessee, and Washington.
Minnesota capitalized on existing data and data collection systems (PPMRS) to advance the national agenda for public health systems and services research through the Multi-network Practice and Outcome Examination (MPROVE) Study.
Program evaluation of policy, system and environmental change strategies is crucial to help understand the impact and implementation of this work. The guidelines below outline the components that should be in any evaluation report.
Qualitative interview tool: Discussing public health organizational capacity, process, and performance in the context of Meyer, Davis, Mays PHSSR Conceptual Model (PDF)
Meyer, Davis and Mays (2012) incorporated organizational capacity constructs into a long-standing conceptual model for Public Health Systems and Services Research . The model places organizational capacity at the local, state and federal levels within the context of macro-content, decision-support and strategic decisions (e.g. policy or program implementation). The model suggests that Organizational Capacity influences Process & Performance, which in turn influences Population Health Outcomes. Their model, which was intended to guide future research, provides the framework for this qualitative interview tool, with a focus on the sub-headings within the Organizational Capacity and Process & Performance portions of the model. In addition, some questions focus on quality improvement activities, which reflect the decision-support needed to improve the Quality domain of Process & Performance.
Analysis of local health department factors that accelerate population-based intervention implementation and support success
SHIP 1.0 represented a major learning curve for most grantees; however those local health departments that were able to be flexible and embrace the approach were better able to implement the program. Having a mix of new and established staff, with a fair amount of freedom to act, seemed the most effective approach.
The Research to Action Network looked closely at local factors that helped or hindered performance on SHIP 1.0, so that we can use that information to improve our system. The study addresses important questions facing public health in Minnesota.
The Multi-network Practice and Outcome Variation Examination (MPROVE) Study is a national study with participation from seven public health practice-based research networks (PBRNs), with leadership from the PBRN National Coordinating Center. Minnesota is collaborating to develop and test a package of local public health service measures.
State and local leaders in public health and health care have long called for adequate, stable and flexible funding for local public health services in Minnesota. A recent report by the Institute of Medicine underscores urgency around public health financing nationwide. Emerging research increasingly supports the central role of funding in the performance of public health departments as well as population health outcomes.
Local public health quality improvement organizational survey
- Executive summary (PDF)
- Organizational quality improvement culture in Minnesota local health departments (PDF)
- Quality Improvement capacity in Minnesota local health departments (PDF)
- Quality improvement practice in Minnesota local health departments (PDF)
From 2009-2011, Robert Wood Johnson Foundation monitored the organizational QI culture in the 16 states that participated in the Multi-States Learning Collaborative. This brief highlights findings related to organizational culture, quality improvement and readiness for accreditation.
Organizational culture at the Minnesota Department of Health
- Executive summary (PDF)
- Alignment and spread of quality improvement culture in the Minnesota Department of Health: Results from 2011 survey (PDF)
- Quality improvement capacity in the Minnesota Department of Health: Results from 2011 survey (PDF)
- Quality improvement culture in the Minnesota Department of Health: Results from 2011 survey (PDF)
A department-wide survey relating to quality improvement (QI) capacity and organizational culture was fielded to all employees at the Minnesota Department of Health (MDH) in June 2011. This survey asked questions related to: QI culture and capacity; employee empowerment; cultural competency; and readiness for national, voluntary accreditation. The survey was designed to serve as a baseline for maturity of QI within the department, as well as identify specific areas in which MDH could strengthen its activities around QI. In addition, questions related to organizational culture and employee empowerment provide opportunities to examine the work culture at MDH and how employees might be supported in their work.
Factors associated with local public health department performance
Until recently, most of the public health systems and services research related to local health department performance relied on cross-sectional data sources that made it difficult to determine cause and effect of various factors associated with performance. Two recent studies used longitudinal approaches to study factors related to local health department structure, financing and capacity. These studies were also unique in that they examined those factors with respect to population health outcomes. They found strong associations between local health department spending and staffing with respect to measures of morbidity and mortality.
Little is known about the extent to which community health service (CHS) administrators and local health directors have key authorities related to budgeting and access to elected officials. Information on authority and organizational positioning is needed to help articulate roles of public health leadership. Issues related to authority and positioning are crucial considerations during succession planning, and when discussing changes to local public health governance and organization. This brief will examine the authorities of CHS administrators in relation to their community health boards , and the authorities of local health directors in relation to their county boards or city councils.
Over the past decade, several counties and community health boards have made changes to their public health organizational and governance structures, and more changes are being considered as local elected officials look for ways to address significant budget concerns, create efficiencies, and anticipate the retirements of public health leaders. In 2009, the State Community Health Services Advisory Committee (SCHSAC) convened a workgroup to investigate an apparent increase in changes to the governance and organizational structures at the local level, revisit the foundations underpinning the local public health system, and update the blueprint for strong and successful local health departments.