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Priority Settings for CHA (because we can’t always do what we want…). Gianfranco Pezzino Senior Fellow and Strategy Team Leader Kansas Health Institute. Prioritization.

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Priority settings for cha because we can t always do what we want

Priority Settings for CHA(because we can’t always do what we want…)

Gianfranco Pezzino

Senior Fellow and Strategy Team Leader

Kansas Health Institute


Prioritization
Prioritization

A process whereby an individual or group places a number of items in rank order based on their perceived or measured importance or significance

Source: APEXPH in practice


Exercise
Exercise

  • Look at the list of health issues on the next slide

  • Take no more than 1 minute to rank on a piece of paper the health issues (most important first)

  • Be ready to present and justify your ranking


Obesity

Alzheimer disease

IMR

Cancer

Vaccine-preventable

disease

Unintentional injuries

Cardio-vascular disease

Foodborne disease

Mental illness

HIV infection

Oral health


Report
Report

  • What are “your” priorities?

  • How did you come to this conclusion?

  • Could there be something missing?


Do we have a consensus
Do we have a consensus?

  • If not, what would it take to get to a consensus?


Key issues
Key Issues

  • “…an individual or group places a number of items …”

    • Each of us has values through which we judge the world

    • For group prioritization, we need to “combine” values from multiple people

  • “…based on their perceived or measured importance…”

    • Some issues have significance beyond statistics


Priority settings tools
Priority Settings Tools

  • Many tools available:

    • “Qualitative”: build consensus, based primarily on perceptions and values (e.g., brainstorming, affinity diagrams, Pareto charts, etc.)

    • “Quantitative”: use data (e.g., statistics, scores, indexes, evidence of effectiveness)

  • Mixing tools is often recommended


Resources all provided
Resources (all provided)

  • Handbook, page 6

  • Memory Jogger

  • NACCHO: “Tip Sheet”

  • Additional resources available upon request


Model for ranking process
Model for Ranking Process

  • Decide and refine criteria to use for ranking

    • Decide relative significance of each criterion (weights)

  • Define list of potential issues

  • Use a ranking method of choice, identify 2-6 priority issues

  • Develop an improvement plan / action plan to address the priority issues


Model for ranking process1
Model for Ranking Process

  • Decide and refine criteria to use for ranking


How to reach consensus on criteria
How to Reach Consensus on Criteria

  • Involve the stakeholders in the process

    • Can start from a provided list of criteria or leave options open

  • This is a very important step:

    • If there is no agreement on how to judge each health issue, there can be no real consensus

    • Vision and mission statements may be helpful


Commonly used criteria
Commonly Used Criteria

  • MAGNITUDE: How many people are affected?

  • SERIOUSNESS: How severe is the issue?

  • STRATEGIES: Is the problem responsive to interventions

  • FEASIBILITY: How feasible is an intervention to attack this problem?

  • CONCERN: What is the level of concern in the community?


Model for ranking process2
Model for Ranking Process

  • Decide and refine criteria to use for ranking

  • Define list of potential issues


Why compiling a list of potential issues
Why Compiling a List of Potential Issues?

  • People need to know WHAT to rank and prioritize

  • Start from your data profile:

    • If relatively few measures, that can be your list

    • If lots of measures, you need to develop shorter list

  • Several techniques can be helpful (e.g., nominal group, “dotmocracy”)


Hands on activity 5 minutes
Hands-on Activity (5 minutes)

  • Refer to the handout with KHM priority indicators

  • Imagine that you have included in your CHA the 20 KHM priority health indicators

  • Spend a few minutes thinking which 10 indicators should be ranked for priority setting

  • Put a colored sticker next to the 10 selected indicators on the flip chart (in no particular order)

  • The 10 indicators with more stickers will be then prioritized


Discussion
Discussion

  • What do you think of this method?


Model for ranking process3
Model for Ranking Process

  • Decide and refine criteria to use for ranking

  • Define list of potential issues

  • Use a ranking method of choice, identify 2-6 priority issues


Recap
Recap

  • Now you have:

    • A list of issues to rank

    • Criteria for ranking them

  • Useful techniques:

    • Nominal Group

    • Dotmocracy

    • Multi-voting technique

    • Others (see handout from North Carolina)


Priority setting individual scores
Priority Setting –Individual Scores


Priority setting aggregate scores
Priority Setting – Aggregate Scores


Are we done yet
Are We Done Yet…?

  • Review the results of the ranking process

  • Does the group members recognize themselves in that list?

  • Can everyone live with that?

  • Make adjustments as necessary

  • Process is only a tool

    • Process serves the team, not vice versa

    • Adapt process based on the group’s needs


Model for ranking process4
Model for Ranking Process

  • Decide and refine criteria to use for ranking

  • Define list of potential issues

  • Use a ranking method of choice, identify 2-6 priority issues

  • Develop an improvement plan / action plan to address the priority issues


Model for ranking process5
Model for Ranking Process

  • Decide and refine criteria to use for ranking

  • Define list of potential issues

  • Use a ranking method of choice, identify 2-6 priority issues

  • Develop an improvement plan / action plan to address the priority issues

    Community Health Improvement Plan – Strategic Plan


Kansas health institute
Kansas Health Institute

Information for policy makers. Health for Kansans.


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