Title V Transformation Tools

Title V Transformation Tools

Transformation Foundational Skills To Support the
Title V National Performance Measures (NPMs)

DRAFT

Background. The Maternal and Child Health Bureau (MCHB) Title V Maternal and Child Health Services Block Grants to States Program has established 15 National Performance Measures (NPMs) for the 2015-2017 grant cycle. In order to effectively address the NPMs, MCH professionals need to think about not only the evidence and strategies to make change, but also the capacity of the workforce to carry out these activities. These lists identify online learning materials, resources, and evidence-based strategies and programs to support the knowledge sets and skills needed to advance each NPM.

Introduction. Six skill sets have been identified by the National MCH Workforce Development Center to support overall implementation of the Title V NPMs: (1) advancing equity; (2) analytical and assessment skills; (3) building and sustaining partnerships; (4) financial and management skills; (5) implementation; and (6) leadership and systems thinking skills.

The MCH Navigator in collaboration with the Center has developed this crosswalk to guide MCH professionals to online learning opportunities and implementation resources to support these skill sets.

Please click on the Read More buttons below for additional information, learning materials, and implementation resources. You can also email us with suggestions for additions.

1. Advancing Equity

Advancing equity is key to making change happen in the social determinants of health. With the release of the MCHB Health Equity Blueprint, Title V professionals have the opportunity to assess current programs and practices and plan future initiatives through an equity lens.

Skills:

  1. Ability to identify and address structural inequities and their consequences within communities and the institutions that serve them that limit opportunities for optimal maternal and child health (MCH) outcomes
  2. Ability to develop a shared vision for equity with partners
  3. Ability to use data analysis findings to:
      1. Assess the equity of current and proposed interventions
      2. Influence and inform policy, program, and funding choices
  4. Ability to apply cultural and linguistic competency skills, including:
      1. The ability to understand the role that social norms play in diverse communities
      2. The ability to include stakeholders and communities in assessment of the cultural competence of current and proposed programs and policies
  5. Ability to examine the historical and cultural practices related to a given national performance measure

Learning Materials:

MCH Workforce Development Center Materials:

  • Health Impact Assessment. This video provides an overview of Health Impact Assessment (HIA). HIA is one approach to build working relationships with partners outside of public health in pursuit of health equity.
  • Basic Cluster Analysis Techniques for Maternal and Child Health Data. This presentation describes three types of spatial analysis and their potential applications for MCH populations: mapping of health data, cluster analysis and exposure/accessibility assessment.

The MCH Navigator Materials on Health Equity:

Resources:

2. Analytical and Assessment Skills

These skills include competencies from the traditional MCH toolbox of needs assessment and data collection and analysis. These skills also include more advanced technical skills from implementation science, quality improvement and systems science to allow MCH programs to understand and use data for effective program selection and implementation. To advance outcomes in the current areas of focus, skills that focus on assessment of current systems vs. a future desired state are a critical first step before beginning the implementation of selected strategies for change.

Skills:

  1. Skills to conduct effective needs assessment with consumers
  2. Ability to effectively and efficiently test and implement changes to systems and processes using improvement and implementation science
  3. Ability to use systems tools to:
    1. Map current systems vs. desired systems
    2. Engage consumers in analysis of current and desired future systems
    3. Engage system stakeholders in problem solving
    4. Identify service gaps, duplications, barriers, and unintended consequences of interventions
  4. Ability to develop data systems, data sharing structures, and data gathering tools to simplify reporting and improve data quality and consistency across sectors
  5. Ability to utilize appropriate quality improvement tools and methods to assess and improve current systems
  6. Ability to develop, utilize, display, interpret, and translate data from performance measures
  7. Skills to monitor and evaluate outcomes/impact of policies and programs selected to address a given national performance measure
  8. Ability to access peer-reviewed literature, analyze findings, and apply findings to practice
  9. Skills to analyze the ‘Strengthen the Evidence for MCH Programs’ initiative from Georgetown University's National Center for Education in Maternal and Child Health (NCEMCH), and other MCHB resources to examine and select appropriate evidence-based interventions
  10. Skills to effectively select client-based vs. population level interventions

Learning Materials:

MCH Workforce Development Center Materials:

The MCH Navigator Materials:

Resources:

3. Building and Sustaining Partnerships

These skills focus on the role of partnerships and collaboration to align initiatives among many sectors. The Title V workforce has historically strong workforce capacity in this area, and strategic alliances and effective partnerships continue to surface as a particularly important competency for Title V professionals in rapidly changing environments.

Skills:

  1. Ability to effectively collaborate with community partners and manage shared challenges
  2. Ability to leverage mutually reinforcing activities and integrate performance measures with other public health, privately funded, and cross-sector initiatives
  3. Ability to identify non-traditional partners, their perspectives around given performance measures, and which should be asked to participate in Title V efforts
  4. Skills to effectively facilitate diverse stakeholder groups and ongoing collaborative learning efforts and partnerships processes
  5. Ability to convene and/or participate in multi-sector initiatives such as collective impact
  6. Ability to partner effectively in advocacy efforts, including aligning messaging for communications related to each measure
  7. Ability to be sensitive to all stakeholders’ interests in multi-sector initiatives

Learning Materials:

MCH Workforce Development Center Materials:

  • Network Analysis in MCH Practice. This 27-minute tutorial explains and demonstrates a systems tool that can help users understand connections between agencies, partners and their roles.
  • Community Benefit & Title V. This fact sheet highlights the CHNA needs assessment process, potential opportunities for collaboration with the Title V, and a few state examples

The MCH Navigator Materials:

Resources:

4. Financial and Management Skills

Complementary to leadership and systems thinking skills are the essential financial planning and management skills required to move complex endeavors forward. The specific skills listed below have been identified as particularly relevant to the management of Title V programs in a transformative environment.

Financial Skills:

  1. Ability to effectively align and distribute block grant funds with specific national performance measures
  2. Ability to effectively monitor use of funds to maintain alignment with national performance measures
  3. Ability to obtain and manage diverse funding streams relevant to national performance measures
  4. Skills to effectively align Title V funding with other public and private funding streams already supporting selected national performance measures
  5. Ability to understand and leverage Medicaid administrative match funds

Management Skills:

  1. Ability to calculate return on investment of policies and programs supported by Title V
  2. Ability to develop data-sharing agreements
  3. Ability to clearly align work plans with specific performance measures by connecting program planning, implementation and evaluation skills to staff performance measures, activities, and timelines
  4. Ability to provide effective staff training specific to a given national performance measure
  5. Ability to train local MCH staff to effectively convene, collaborate, and facilitate partnerships
  6. Project management skills, including:
    1. Meeting facilitation and management
    2. Planning and timeline management
    3. Project scoping
    4. Effective communication
    5. Eliminating waste by designing effective processes and systems
  7. Ability to effectively terminate partnerships/subcontracts that do not support national performance measures
  8. Ability to effectively leverage project timelines and understand the relationship between short-, medium- and long-term goals
  9. Ability to develop, use and communicate “SMART” goals (specific, measurable, achievable, relevant, and time-bound) for teams and coalitions to guide health transformation efforts
  10. Ability to effectively develop subcontracts that ensure adherence to evidence-based interventions

Learning Materials:

MCH Workforce Development Center Materials:

The MCH Navigator Materials:

Resources:

5. Implementation

Implementation is defined as a set of activities that put evidence-based interventions into practice, in a way that produces results. Implementation processes must be purposeful and well-defined so that collaborators can learn, utilize, assess and improve. Implementation science integrates the expertise of many disciplines, including change management, systems thinking and quality improvement. Many of the workforce capacities listed below are also incorporated in categories listed throughout this document. They are included separately here to illustrate the scope of the necessary skill set for Title V staff involved in translating evidence based interventions into practice.

Skills:

  1. Ability to guide implementation and systems change efforts by developing effective relationships and build strategic connections with established and emergent leaders and stakeholders
  2. Ability to build and support teams to actively guide program design, delivery, and improvement
  3. Ability to support Title V and local MCH agencies to identify, assess, and select appropriate evidence-based interventions
  4. Ability to develop and use data systems to measure progress and guide improvement efforts
  5. Ability to assess the degree to which evidence-based interventions are implemented with fidelity in the state and local agencies
  6. Ability to assess context for implementation in order to develop tailored implementation support strategies
  7. Ability to use implementation tools to assess readiness of state and local agencies to implement selected evidence-based interventions
  8. Ability to provide appropriate technical guidance regarding the co-creation and effective implementation of evidence-based interventions
  9. Ability to engage in competent systems coaching to build the capacity of others to use practices of implementation science and transform their systems

Learning Materials:

MCH Workforce Development Center Materials:

The MCH Navigator Materials:

Resources:

6. Leadership and Systems Thinking Skills

Leadership and systems thinking skills are key to unlocking workforce capacity in any organization. Even individuals with highly developed technical skills that serve to advance a specific strategy may fail to have impact in an organization or system that lacks high functioning leadership and systems thinking skills. Furthermore, organizations with high functioning leadership and systems thinking skills can operate even more effectively in supportive political, financial, and social climates.

Human Resources Skills:

  1. Skills to recruit and manage a diverse and inter-professional workforce
  2. Ability to provide effective oversight for staff in execution of work plans
  3. Succession planning skills to effectively plan for turnover and retirements
  4. Ability to recruit and manage a workforce capable of leading population-level initiatives
  5. Ability to determine best fits for work assignments based on analysis of current workforce educational background and experience
  6. Ability to find and engage with peer mentors involved in similar transformation challenges
  7. Ability to train early-career staff to ensure the maintenance of critical knowledge and skills

Leadership Skills:

  1. Ability to identify, communicate, and leverage Title V’s role in cross-sector efforts to address selected outcomes
  2. Ability to lead both MCH and external coalitions, including intergovernmental initiatives, partnerships outside government, and state initiatives
  3. Ability to translate leadership and change management theory and practice into daily activities
  4. Adaptive leadership skills to form, manage, and lead teams in adaptive and evolving environments
  5. Ability to convene public health and primary care professionals to align strategies and communication related to national performance measures
  6. Ability to lead and influence without authority, including willingness to challenge cultural norms
  7. Skills associated with emotional intelligence: self-awareness; self-regulation; motivation; empathy; and social skills
  8. Ability to lead change efforts with an eye toward sustainability of human resources and funding

Systems Thinking Skills:

  1. Ability to identify systems causes of persistent challenges
  2. Ability to identify adaptive and technical challenges and respond appropriately to each using a systems thinking skill set

Learning Materials:

MCH Workforce Development Center Materials:

  • Action Learning Set Guide. The MCH Workforce Development Center is using an approach called Action Learning to help leaders build “learning organizations” that can adapt to change.
  • Adaptive Leadership. Adaptive Leadership is an essential concept for MCH leaders to understand. We also recommend the use of strengths-based leadership approaches including Collaborative Leadership, Servant Leadership, and Appreciative Inquiry.
  • Leading through Health Systems Change. A planning tool ​to assist public health leaders in ​thinking about the future in the era of health transformation.
  • Using Process Flow Diagramming to Understand and Improve MCH Systems. This presentation from the 2015 AMCHP conference focuses on mapping out processes through flow diagramming in order to better understand and make improvements to Maternal and Child Health Systems.

The MCH Navigator Materials:

Resources:


See other online learning resources related to health transformation, collected in the Health Transformation Learning Laboratory.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UE8MC25742; MCH Navigator for $180,000/year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.