Measuring public health program outcomes: Essential strategies for practice and financial stability

Background and Issues: Generating valid and reliable data in local health departments is essential to quantify practice, produce reports for diverse audiences, meet the federal mandate for electronic health records (EHRs), and provide the highest quality care possible. Description: In 2003, Washington's public health nursing directors identified the need to select similar outcome measures to quantify the impact of their programs. Representatives from the state's 35 local jurisdictions developed an evidence-based action plan, selected the Omaha System as the standardized terminology for their multidisciplinary staff, and agreed that automated clinical information systems were essential. Kitsap County's leaders initiated the steps to actualize the plan locally. In 2005, they selected EHR software, and identified needed resources. Currently, public health nurses and other staff are proficient software users. They generate consistent, accurate, and meaningful data that describe their clients, the interventions they provide, and positive outcomes of care. Reports are shared within the health department and with the local community and colleagues in Washington confirming the quality of practice and value of the programs. Lessons Learned: The transition from an unstructured documentation system to an automated clinical information system in Kitsap County was a large paradigm shift. Multidisciplinary employees needed to embrace a shared vision and collaborate as partners with each other and their software vendor. Recommendations: The time is now for public health nurses to become involved with evidence-based action plans to generate measurable outcome data that are essential for improving practice, accountability, and financial stability.