How Two Island Health Departments Are Preparing for Successful Public Health Planning

April 23, 2024 | Megan Drake-Pereyra, Joanne Pearsol

With the recent Public Health Infrastructure Grant (PHIG) investment in public health across the nation, U.S. territories, and freely associated states, health departments are strengthening their workforce, data modernization (DMI), and foundational capabilities. Health departments can apply similar processes and tools to their work in each of these areas, but knowing where to start can be difficult, especially when doing this work for the first time or with newer staff. Taking time to organize and sequence efforts can seem like a luxury when there is so much work to do, but it pays big dividends, especially with an undertaking as large as PHIG.

The Commonwealth of the Northern Mariana Islands (CNMI) and the Republic of Palau (Palau) are both either updating or developing new public health plans, such as organizational strategic plans, workforce plans, and DMI plans. In January 2024, they took time during a PHIG convening of the U.S. Affiliated Pacific Islands and in follow-up on-site technical assistance sessions with ASTHO to assess their readiness, sequence their plans, and start organizing their planning efforts. “Planning to plan” is easy to skip in the rush to move things forward and CNMI and Palau’s efforts to take this time upfront is already bearing fruit.

Assessing Readiness for Planning

With any initiative, the set up and preparation impacts the outcome. CNMI and Palau piloted a draft of ASTHO’s new planning readiness assessment tool. CNMI assessed their readiness to start their workforce plan, and Palau their data modernization plan. The tool helped them identify some areas they would like to give further consideration before taking their next steps in planning.

Palau noted how helpful they found the exercise. In fact, they completed the assessment again, this time focusing on their readiness to begin workforce development planning.

“Initially, we approached the readiness assessment tool with some doubt. But, when we started going through each feature, we discovered gaps in our process that we hadn't previously considered. We had overlooked crucial aspects such as establishing communication protocols among team members and setting milestones for project evaluation.”

Sequencing to Optimize Capacity and Timelines

For many PHIG recipients, staff are working across workforce, DMI, and foundational capabilities areas; this is no different in CNMI and Palau where staff wear multiple hats. Health agency leadership and planning teams must understand staff and stakeholder capacity and project timelines to effectively navigate competing priorities and the planning process.

After assessing their readiness to dive into workforce and data modernization planning, the teams used a sequencing tool to map out a timeline of their activities. For CNMI, this process helped to create realistic timelines in which to complete their plans. Because of this process, they adjusted previously identified deadlines resulting in more realistic and feasible time frames for completing their community health assessment, community health improvement plan, data modernization plan, workforce plan, and public health services division strategic plan.

For Palau, the sequencing plan helped to visually depict when other major events and projects were occurring. This sparked discussion and problem-solving about the potential impact on their planning momentum and success. For instance, knowing that there would be some overlap among DMI planning, non-communicable disease strategic planning, and workforce planning will help them better anticipate staffing needs and make necessary accommodations.

Taking the time to map milestones, events, and cross-cutting activities helped CNMI and Palau understand how best to manage their planning efforts and maximize their capacity. This also helps them set realistic expectations and prevent burnout.

“The sequencing plan really showed us that there are simultaneous initiatives happening and external events that will impact our overall timeline. Knowing this will help us be realistic about our planning.”

Building Collaboration Through Team Charters

Along with assessing readiness and defining timelines, CNMI and Palau began organizing their planning teams, the staff and stakeholders who will collaborate throughout the planning process. Collaboration is critically important for all parts of planning, including assessing readiness and sequencing. CNMI and Palau both developed team charters to provide structure to their collaborative planning efforts and ensure team readiness to work together.

CNMI’s DMI advisory committee and strategic planning steering committees collaboratively created their respective committee charters, which include the focus and scope of the committee, member roles and responsibilities, and the decision-making process. They will serve as a source of truth the committees can refer to each time they meet—a reminder of what they decided and how they want to work together. In addition, creating and agreeing on a team charter together supports buy-in, ownership, and engagement, all of which are key elements of readiness.

CNMI noted that team charters are not a commonly used tool in their organization. After going through the process of developing charters for their DMI advisory and strategic planning steering committees, several participants shared that they plan to use the tool with other groups too. The same was true in Palau.

“We drafted elements of our team charter for our DMI work during the in-person TA and will finalize it with our partners at our next meeting. It will serve as a touchstone for what we do and how we work together. We will use a similar tool for our workforce planning team.”

Benefit of Taking Time Upfront Preparing to Plan

Palau and CNMI benefitted from extra preparation to really think about how to accomplish everything they want to do, not only with PHIG work, but all the other public health and organizational projects, programs, and grants. Taking the time upfront to assess readiness, create a sequencing plan, and develop team charters led to adjustments in their steps and timelines, and to collaborative team structures. This helped them organize, build good will and buy-in, set realistic expectations, and create a manageable process from what can sometimes feel overwhelming.

“This process has been valuable to my team in CNMI. Collaboration amongst the CHCC teams allowed vital stakeholders to help create a supportive, productive, and constructive atmosphere where effective decisions can be reached. This model can serve as an example in other areas within CHCC.”

Takeaways

PHIG recipients can learn from CNMI's and Palau's experiences:

• Step back. Make and take the time upfront to "plan to plan." It may lead to greater success later.
• Use existing tools to support increased, smoother collaboration and to facilitate steady progress.