National Public Health Performance Standards


NPHPS Background

  • There are four concepts that have helped to frame the NPHPS:

    • 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 NPHPS 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. NPHPS 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 NPHPS assessments

    The NPHPS 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 NPHPS 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 NPHPS 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.