6. CPH Domain 3: Strategic Planning, PDSA, Prioritization
After this lesson you can
- Compute a Hanlon Basic Priority Rating and apply PEARL as a yes-or-no feasibility gate
- Classify a strategic plan sentence as a mission, vision, goal or objective
- Distinguish quality assurance from quality improvement and walk through a PDSA cycle
- Match common QI tools (flowchart, fishbone, Pareto, run and control charts) to what each shows
- Pick cost-benefit, cost-effectiveness or return on investment for a given comparison
- Describe a performance management system, the balanced scorecard and capacity building at three levels
The second Domain 3 lesson, covering the organizational task statements (tasks 1 and 7 to 13). It moves from criteria-based prioritization with the Hanlon method and PEARL, through the strategic planning cycle, to continuous quality improvement, performance management and capacity building, using a Harbor County case in which six divisions compete for one grant.
Questions and answers
Questions a learner would ask about this lesson. Think through your own answer before you open each one.
- How does the Hanlon method rank health problems?
Show answer
Hanlon, also called the Basic Priority Rating, scores each problem on A, the size of the problem, B, its seriousness, and C, the effectiveness of available interventions. Seriousness is weighted double, and the rating is (A + 2B) x C / 3. Dividing by three only rescales the score. A fourth component, the PEARL screen, then works as a gate rather than a score.
- What does PEARL check, and what happens if a problem fails it?
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PEARL stands for propriety, economics, acceptability, resources and legality. Each factor is answered yes or no, and a single no removes the problem from consideration no matter how high its rating. PEARL does not measure size, seriousness or effectiveness. At Harbor County, lead abatement failed the resources gate because the one-time grant could not cover housing remediation.
- How do I tell a mission, a vision, a goal and an objective apart?
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A mission states the organization's purpose in the present tense. A vision describes the desired future and is aspirational. A goal is a broad statement of direction with no measure and no date. An objective is specific, measurable and time-bound, with a baseline, a target and a date, and SMART applies to objectives, not goals.
- What is the difference between quality assurance and quality improvement?
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Quality assurance checks compliance with a standard after the work is done and asks whether the standard was met. Quality improvement improves the process continuously so the standard rises, and it asks how the work can be done better, using data and small tests. Both are needed, and the exam asks which one a stem describes.
- How is a strategic plan different from a community health improvement plan?
Show answer
A strategic plan is organization-wide and owned by the health department. A CHIP is community-wide, owned by the community and its partners, and its priorities come from the community health assessment. The department's strategic plan should align with the CHIP, and PHAB requires both.
Practice quiz
- Question 1A health department rates a problem with size A = 4, seriousness B = 7 and effectiveness C = 6. Using the Hanlon formula (A + 2B) x C / 3, what is the rating?
- Question 2A problem has the highest Basic Priority Rating on the list, but the agency answers no on the resources factor of PEARL. What happens to it?
- Question 3"A county where every resident can live a long and healthy life" is best classified as a:
- Question 4A supervisor reviews last month's charts to see whether staff met the documentation standard and corrects the deviations found. This is:
- Question 5In the PDSA cycle, what happens in the Study step?
- Question 6Which QI tool organizes the possible causes of a problem by category?
- Question 7Which chart adds statistically derived upper and lower limits so a team can separate common-cause from special-cause variation?
- Question 8A board wants to compare two overdose programs by the cost per death prevented. Which analysis fits?
- Question 9In a SWOT scan, the fact that a foundation grant ends after year two is a:
- Question 10In the balanced scorecard, staff training, retention and capability belong to which perspective?
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