254334 New Conceptual Framework for Quality Improvement of Public Health Programs, National Guard Health Affairs, Kingdom of Saudi Arabia, 2011

Wednesday, October 31, 2012 : 10:30 AM - 10:45 AM

Scott J.N. McNabb, PhD, MS , Hubert Department of Global Health, Emory University, Rollins School of Public Health, Atlanta, GA
Victoria L. Phillips, DPhil , Rollins School of Public Health, Emory University, Atlanta, GA
Thaddeus Miller, DrPH, MPH , Department of Health Management and Policy School of Public Health, Texas College of Osteopathic Medicine University of North Texas Health Science Center at Fort Worth, Ft. Worth, TX
Hanan Balkhy, MD , Infection and Prevention Control, Kingdom of Saudi Arabia, National Guard Health Affairs, Riyadh, Saudi Arabia
     
Introduction Effective and efficient use of healthcare resources means activities be directed by evidence. Moving from a current state of performance and expenditure to an improved one requires a baseline assessment and on-going monitoring. To strengthen public health programs in the National Guard Health Affairs (NGHA), Kingdom of Saudi Arabia, we conducted an assessment conceived to develop a Public Health Management Tool (PHMT) that would track performance and cost in real time. Methods We gathered data about the hepatitis and tuberculosis programs in the NGHA for 2009 by interviewing stakeholders and reviewing records. Using a Public Health Action Model (PHAM) and new Program Assessment Model (PAM) – both with epidemiologic, economic, and policy perspectives – we characterized the programs from both macro and micro perspectives. Results We found opportunities for improved performance, cost savings, and health benefit. A large (>127,000 blood donors/yr) investment in hepatitis screening produced no health benefit for 158 of 462 (34%) HBsAg+ patients lost to follow-up. This represented a lost investment of > $3,500/patient. Sixteen TB exposure-events occurring 2008 – 2010 involved 287 HCWs. Among these, baseline TST status was documented for only 115 (40%). Discussion Information from these assessments will guide improved program policy and performance. The PAM aggregated into the PHAM presented expenditure and performance data in a useful baseline report. We recommend continued efforts to develop a Phase-2 roadmap with program goals, objectives, milestones, and indicators and then to encode this (Phase-3) into a software tool for managers and executives.

Learning Areas:
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Define new conceptual program assessment approaches 2. Describe benefits of automating program performance and expenditure goals, objectives, milestones

Keywords: Health Information Systems, Quality Improvement

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am uniquely qualified to serve as abstract author. Having directed public health surveillance activities and communicable disease control programs (including all outbreak investigations) at the Oklahoma State Health Department plus directing the U.S. national public health surveillance activities at the Centers for Disease Control and Prevention (CDC), I have a thorough knowledge of public health policy, practices, and performance. Additionally, I have conducted acute, active surveillance research during emergencies, and I conceived and established the Integrated Disease Surveillance and Response (IDSR) program in WHO/Afro 13 years ago. The IDSR is ongoing and was just recently renewed as the overarching surveillance approach in WHO/Afro. I served as Chair, International Health Regulations (IHR) committee at CDC to stand up compliance in the United States. I also directed the Defense Threat Reduction Agency (DTRA) Electronic Integrated Disease Surveillance System (EIDSS) for two years while at CDC and have interfaced with professionals in the intelligence community since 2004. I was PI of a U.S. State Department-sponsored science project in Armenia and held a top secret clearance. Having worked with both communities and seen the tensions and miscommunication, yet recognizing the common workspace, I have a passion for describing the common values, mission, and workspace between these communities.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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