Creating an Action PlanCreating an Action Plan

Jennifer Woodward, MD, MPH

Kansas Health Institute

"People don't plan to fail. Instead they fail to plan." "People don't plan to fail. Instead they fail to plan." 

Objectives

Review CHIP framework

Describe action plans

Outline components of an action plan

Review sample action plans

OVERVIEW

OVERVIEW

CHA

Strategic Plans

CHIP

Describe health status of community

• Priority setting exercise priority areas

• Investigate root causes of the problem

• Set goals for each priority area

• Write SMART objectives for each goal

• Choose evidence-based intervention strategies that address the root cause of priority area

• Develop action plan to assign tasks to members and ensure timely completion

• Implementation, evaluation, adjustments

What is an action plan?What is an action plan?

Detailed work plan that guides the implementation of the CHIP

Gets people organized and adds structure to the details needed to get things done

Early organization and structure can save time, energy, and resources

Functions of an action planFunctions of an action plan

Helps us think through why we are doing things instead of just jumping in

Provides framework to a complex project with multiple moving parts

Clarifies responsibilities

Action Plan BenefitsAction Plan Benefits

A comprehensive action plan can have positive side effects

Maximizes probability of a successful CHIP

Can help justify funding requests

Adds credibility to your CHIP process

Contributes to transparency

Components of an action planComponents of an action plan Associated goal, objective, and intervention

strategy

Planned activities

Individual/organization responsible for each activity

Timeline for each activity

Resource needs

Status report and results of actions taken, monitoring system

Three Cs of action plansThree Cs of action plans

Complete List all action steps or changes to be sought

in all relevant parts of the community (health department, schools, government)

Clear Make sure everyone knows who will do

what by when

Current Update and re-update

PHAB RequirementsPHAB Requirements

“The tracking process must specify the strategies being used, the responsible partners involved, and the status of the effort or results of the actions taken.

Documentation could be, for example, a narrative, table, spread sheet, or a combination. This may look like a work plan that includes the status of the implementation of the work plan.”

Process measuresProcess measures

Answers the question: are we doing what we said we were going to do in our action plan?

Evidence of whether or not the activities in the action plan were carried out

Completed action steps can be listed as process measures

Example Action step: Plan meeting with school board Process measure: Meeting planned for 7/28/14

Pre-plan considerationsPre-plan considerations

What are the existing resources, assets, and strengths for this work?

Who is already engaged in this work? What are they doing? Can we partner?

Who else needs to be engaged in this work?

What are the barriers and how can they be overcome?

Pre-plan considerationsPre-plan considerations

More work on understanding the problem may be necessary

Good time to think about why you have chosen this particular strategy

What is it about your CHA, root cause analysis, additional investigation that makes you sure completion of these action steps will lead to change?

Immunization exampleImmunization example Due to low immunization rates in your county which is reflected in

your CHA data, you have chosen immunizations as a priority area

Goal: Increase immunization rates in your community

Objective #1: Increase the percentage of kindergarten age children immunized to the HP2020 goal of 95% by 2017

Outcome measure: 95% of kindergarten age children will be appropriately immunized by 2017 [school immunization survey data]

Intervention strategy: Develop/promote an educational campaign to increase awareness about immunizations in the community

Before developing action steps and getting started on the work, cycle back to think about why you know an educational campaign is going to increase immunization rates in your community

Example #1Example #1 Priority area: Decrease obesity

Goal: Increase consumption of healthy foods by County residents

Objective: Increase the percent of children and teens (ages 2-17) who consume five or more servings of fruits and vegetables daily to 22% by 2017

Outcome measures: measures of F/V intake, # of schools with healthy vending policy, healthy vending sales, decrease % of children consuming sugary beverages

Intervention strategy #1: Healthy vending machines - work with school board to create and implement healthy vending policy

Worksheet #9Worksheet #9

Goal: Increase consumption of healthy foods by County residents

Objective: Increase the percent of children and teens who consume 5+ servings of fruits and vegetables daily to 22% by 2017

Intervention strategy: Healthy vending machines - work with school board to create and implement healthy vending policy

Action stepsTarget date

Lead person/organization

Resources needed

Potential partners

Process measure /progress

notes

Goal: Increase consumption of healthy foods by County residents

Objective: Increase the percent of children and teens who consume 5+ servings of fruits and vegetables daily to 22% by 2017

Intervention strategy: Healthy vending machines - work with school board to create and implement healthy vending policy

Action stepsTarget date

Lead person/organization

Resources needed

Potential partners

Process measure /

progress notes

1. Research model policies

2. Adapt policy for our community

3. Peer review and corrections

Goal: Increase consumption of healthy foods by County residents

Objective: Increase the percent of children and teens who consume 5+ servings of fruits and vegetables daily to 22% by 2017

Intervention strategy: Healthy vending machines - work with school board to create and implement healthy vending policy

Action stepsTarget date

Lead person/organization

Resources needed

Potential partners

Process measure /

progress notes

1. Research model policies

April-14County

Commission20 hours staff time

KHIWritten summary

completed

2. Write policy adapted to our community

Jun-14

LHD Communications

staff

10 hours of staff time

County Commission, KHI, KDHE

Draft policy created

3. Peer review and corrections

Jul-14 LHD staff5 hours

staff timeKHI Policy finalized

Example #2Example #2 Priority area: Address needs of elderly in county

Goal #1: Reduce preventable injuries to elderly adults

Objective #1: Reduce the number of fall-related injuries to elderly residents of county by 20% by 2016

Outcome measure: Number of ED visits due to preventable fall-related injury to elderly residents decreases from approx. 425/year to 340/year (20% decrease) by 2016 [ED data]

Intervention strategy #1: Develop educational campaign to bring awareness to issue of elderly falls in the community

Intervention strategy #2: Provide CDC’s STEADI (Stopping Elderly Accidents and Injuries) toolkit to health care providers in county and offer education for its use

Worksheet #9Worksheet #9

Goal: Reduce preventable injuries to elderly adults in county

Reduce the number of fall-related injuries to elderly residents of county by 20% by 2016

Intervention strategy: Provide CDC’s STEADI (Stopping Elderly Accidents and Injuries) toolkit to health care providers in county and offer education for its use

Action stepsTarget date

Lead person/organization

Resources needed

Potential partners

Process measure /progress

notes

Goal: Reduce preventable injuries to elderly adults in county

Objective: Reduce the number of fall-related injuries to elderly residents of county by 20% by 2016

Intervention strategy: Provide CDC’s STEADI (Stopping Elderly Accidents and Injuries) toolkit to health care providers in county and offer education for its use

Action stepsTarget date

Lead person/organization

Resources needed

Potential partners

Process measure /

progress notes

1. Obtain list of all clinical providers serving elderly adults in county

2. Order CDC STEADI materials

3. Contact providers to announce materials and offer training

4. Complete provider training sessions

Goal: Reduce preventable injuries to elderly adults in county

Objective: Reduce the number of fall-related injuries to elderly residents of county by 20% by 2016

Intervention strategy: Provide CDC’s STEADI (Stopping Elderly Accidents and Injuries) toolkit to health care providers in county and offer education for its use

Action stepsTarget date

Lead person/organization

Resources needed

Potential partners

Process measure /

progress notes

1. Obtain list of all clinical providers serving elderly adults in county

7/1/14Senior Citizen Center

In kind staff time

KAFP, KUMC geriatric society

List created

2. Order CDC STEADI materials

8/1/14Health

departmentFree N/A Materials arrived

3. Contact providers to announce materials and offer training

9/1/14 KAFPIn kind staff

timeSenior Citizen

CenterProviders contacted

4. Complete provider training sessions

3/1/15KUMC

geriatric society

$50/class for materials/

snacksKAFP

Trainings completed

Tips to ensure actionTips to ensure action

Make sure individuals responsible for action items in the plan are involved in its creation

Identify a responsible organization for each action item

Everyone with an assigned task receives a copy of the action plan with his/her role is clearly defined

Tips to ensure actionTips to ensure action

CHIP leaders regularly make friendly, supportive contact to check in

Add reports on accomplishments to meeting agendas

Acknowledge and commend those who complete activities

Think about adding things that have the potential for quick, highly visible results

Ongoing monitoring, evaluation, and adjustments

ConclusionConclusion Action plans are detailed work plans that guide the

most important part of the CHIP process – implementation

Organization early can save resources and maximize the possibility of success

Be specific

Communicate with members, celebrate accomplishments

Adapt action plan as needed

ReferencesReferences Information adapted from several sources:

Connecticut Department of Public Health: Guide and Template for Comprehensive Health Improvement Planning

KU Community Toolbox: Developing an Action Plan

Beginning with the End in Mind: Supporting the Development of Health Improvement Plans Designed for Action. IPHI, MPHI – available on NACCHO website