National Public Health Performance Standards

National Public Health Performance Standards

The National Public Health Performance Standards Program (NPHPSP) is a collaborative effort to enhance the Nation’s public health systems. Seven national public health organizations have partnered to develop national performance standards for State and local public health systems.

NPHPS tools are used to

  • Identify partners and community members in the public health system
  • Engage those partners in health assessment and health improvement planning
  • Promote improvement in agencies, systems, and communities

Funding for this project was provided by the Centers for Disease Control and Prevention, Office for State, Tribal, Local and Territorial Support, under grant #5U38HM000454-05.

ASTHO supports states in their assessment preparation and implementation efforts and contributes to the development, implementation, and evaluation activities of the national program and the partnership. The NPHPSP assessments can help states identify areas for system improvement, strengthen their partnerships with state and local agencies, and ultimately assure that a strong system is in place.

The Assessments

The NPHPSP is based on the ten Essential Public Health Services, and is designed to assist state and local public health systems, and local governance entities in assessing and improving their public health systems or boards of health. The State Public Health System Assessment Instrument focuses on the state public health system, which includes state public health agencies and other partners that contribute to public health services at the state level. The State Public Health System Performance Assessment measures the capacity and infrastructure of state public health systems and helps states to recognize where improvements can be made.

The latest version of the Assessment, Version 3.0, is now available for download. Please see links below.

For further information about the Performance Standards or for technical assistance, please contact Denise Pavletic.

Note: There are a number of limitations to the NPHPS assessment data due to self-report, wide variations in the breadth and knowledge of participants, the variety of assessment methods used, and differences in interpretation of assessment questions. Data and resultant information should not be interpreted to reflect the capacity or performance of any single agency or organization within the public health system or used for comparisons between jurisdictions or organizations. Use of NPHPS generated data and associated recommendations are limited to guiding an overall public health infrastructure and performance improvement process for the public health system as determined by organizations involved in the assessment.

Background

There are four concepts that have helped to frame the NPHPSP:

  • The standards are designed around the ten Essential Public Health Services to assure that the standards fully cover the gamut of public health action needed at state and community levels.
  • The standards focus on the overall public health system (all public, private, and voluntary entities that contribute to public health activities within a given area), rather than a single organization. This assures that the contributions of all entities are recognized in assessing the provision of essential public health services.
  • The standards describe an optimal level of performance rather than provide minimum expectations. This assures that the standards can be used for continuous quality improvement. The standards can stimulate greater accomplishment and provide a level to which all public health systems can aspire to achieve.
  • The standards are intended to support a process of quality improvement. System partners should use the assessment process and the performance standards results as a guide for learning about public health activities throughout the system and determining how to make improvements.

The Benefits of Implementation

The NPHPSP is a valuable tool in identifying areas for system improvement, strengthening state and local partnerships, and assuring that a strong system is in place for effective response to day-to-day public health issues as well as public health emergencies. NPHPSP instrument users at all levels report numerous such benefits, including:

  • Improves organizational and community communication and collaboration, by bringing partners to the same table.
  • Educates participants about public health and the interconnectedness of activities, which can lead to a higher appreciation and awareness of the many activities related to improving the public s health.
  • Strengthens the diverse network of partners within state and local public health systems, which can lead to more cohesion among partners, better coordination of activities and resources, and less duplication of services.
  • Identifies strengths and weaknesses to address in quality improvement efforts. Responses to the assessment can be tracked over time to identify system improvements or changes.
  • Provides a benchmark for public health practice improvements, by providing a gold standard to which public health systems can aspire.

Moving towards system performance improvement after the NPHPSP assessments

The NPHPSP performance assessments should provide system participants with an understanding of the gaps between their current performance and the optimal level of performance described by the standards. System partners can then determine where the largest or most crucial gaps in performance are; these are the areas on which the action plan should focus.

The results should be incorporated into a broader planning process, such as a community health improvement process such as MAPP, a state health improvement process, or a local board of health strategic planning process.

If this type of planning process is not underway, go to the "What Next?" section of the NPHPSP User Guide for strategies and ideas for moving forward with performance improvement efforts. The Resources link also provides useful information.

In states where a coordinated statewide approach is used to implement multiple NPHPSP assessments, the statewide action plans should be developed. CDC provides statewide aggregate reports to states that use the local instrument in all or most local jurisdictions. Another report is also available that summarizes both the state and local data, if both instruments have been used.

Once improvement planning is underway, the action plans should be institutionalized to assure that the performance continues at the higher levels.

Reassessments every three to four years can aid in monitoring progress and identifying new gaps that need to be addressed.

Case Study

The Perfect Storm: Case Study from the Kansas Department of Health and Environment

Has your state used the NPHPS? If so, we’d love to hear about your experiences! Please share with us by emailing Denise Pavletic. We look forward to featuring your stories!

NPHPSP Partners

In addition to ASTHO, the NPHPSP Partners consist of CDC, NACCHO, NALBOH, NNPHI, and the PHF. Collectively, they contribute to the advancement of the program by providing technical assistance and support, and ensuring that the program and resources meet the needs of users.