Health System OrganizationSession 4:Health Care WorkforcePublic Health CompetenciesRace Against Time: Group 2 Presentation

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Health Care Workforce

•Who are they?•How are they trained/educated?•Where do they come from?•Where do they go?

•WHY?

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Functions of Health Education •Governance•Educational services•Selection of staff•Financing•Infrastructure and Technology•Information and Knowledge

Access and quality depend on the number and training of health professionals

Source: The looming crisis of the health workforce: How can OECD countries respond? (OECD, 2008).

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Medicine•MD – allopathic•DO – osteopathic•Others

▫Naturopathic▫Chiropractic▫Psychologist▫Podiatrist▫Optometrist

•Traditional Healer•Physician Assistant

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Nursing•Advanced Practice (Registered) Nurse

(APN/APRN)▫NP▫CNM▫CRNA▫CNS

•Registered Nurse (RN)▫BSN▫ADN▫Diploma

•Licensed Practical Nurse (LPN) •Nursing Aide/Assistant (CNA)

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Allied Health Professionals•Dentist/Dental Hygienist•MPH•Pharmacist•Physical/Occupational/Speech Therapist•MSW•Technologist (laboratory, biomedical,

radiology)•Dietician•Audiologist•Optician•Etc., etc.

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The Markets for Health Professions

Education

LaborHealth Services

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Public Health Workforce Challenges

•Increased federal workforce -- bioterrorism dollars

•Decreased state and local positions•Change in worker productivity due to

technologies•Administrative and bureaucratic obstacles

to growth and recruitment

Gebbie & Turnock, 2006

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Workforce Development•Development of core competencies for

public health workers•Competency-based training•Competency-oriented job descriptions•Credentialing individuals•Accreditation of public health agencies

Gebbie & Turnock, 2006

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Public Health Functions•Assess & Monitor

1. Monitor health status to identify community health problems.

2. Diagnose and investigate health problems and health hazards in the community.

3. Inform, educate and empower people about health issues.

•Formulate Public Policies4. Mobilize community partnerships to identify

and solve health problems. 5. Develop policies and plans that support

individual and community health efforts. Institute of Medicine, The Future of Public Health, National Academy of Sciences, 1988. Public Health Functions Steering Committee, 1994 (multiple organizations).

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Public Health Functions• Assure Access to Care

6. Enforce laws and regulations that protect health and ensure safety.

7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.

8. Assure a competent public health and personal health care workforce.

9. Evaluate effectiveness, accessibility and quality of personal and population-based health services.

10.Research for new insights and innovative solutions to health problems.

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What Is a Competency?•Reflects knowledge•Reflects skills•Continuum of expertise•Develops with application and experience•Can be measured or observed•Basis for performance assessment

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Multiple Sets of Competencies•Association of Schools of Public Health,

Core Competency Project•Council on Linkages -- public health•National Center for Healthcare

Leadership -- health administration•Veterans Health Administration High

Performance Development Model -- health administration

•ACGME -- postgraduate medicine

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Core Competency Project, ASPH•Five discipline-specific sets of

competencies▫Biostatistics▫Environmental health sciences▫Epidemiology▫Health policy and management▫Social and behavioral sciences

•Upon graduation, a student with an MPH should be able to … [list of abilities related to each of five areas]

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Interdisciplinary Competencies•Communication and informatics•Diversity and culture•Leadership•Public health biology•Professionalism•Program planning•Systems thinking

Relevant to ALL graduates with an MPH!

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Council on Linkages:Public Health Competencies/Skills (2001)

•Analytic assessment skills•Policy development/program planning•Communication•Cultural competency•Community dimensions of practice•Public health sciences•Financial planning and management•Leadership and systems thinking

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National Center for Healthcare Leadership:Competencies for Health Management (2002)

•Learning and performance improvement

•Professionalism•Personal and community health

systems•Leadership•Collaboration and communication•Management practice

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VA High Performance Development Model Competencies (HPDM)

•Interpersonal effectiveness•Customer service•Systems thinking•Flexibility/adaptability•Creative thinking•Organizational stewardship•Personal mastery•Technical competency

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Postgraduate Medicine (ACGME, 2001)

•Patient care•Medical knowledge•Practice-based learning and

improvement•Interpersonal and communication skills•Professionalism•Systems-based practice

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National Board of Public Health Examiners: Public Health Credentialing•New effort by National Board of Public

Health Examiners•Ensure MPH graduates have mastered

prescribed set of skills/competencies•Voluntary exam started summer 2008

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Competencies and Credentialing•Competencies

▫Are these useful?▫Which ones appeal/are not useful?▫Do they transcend borders?▫How would you use these?

•Credentialing▫Is it necessary?▫Since voluntary, will people take it?▫How much effect will it have?

•OMPH position statement on exam