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Consultation Services To Assist The Aberdeen Area Office Of The Indian Health Service To Develop A Strategic Plan, 2012-2017
Sundance Research Institute, in partnership with Econometrica, Inc., is developing a Strategic Plan for the Aberdeen Area Indian Health
Service for the years 2012–2017. Strategic planning for Indian Health Service is particularly complex due to:
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The number of organizations and entities that comprise the complete Indian health care
system—IHS Service Units, Tribal health programs, Urban Indian Health Programs—each of
which may have unique priorities, goals, and objectives determined by its local stakeholders
and circumstances.
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The importance of developing the Plan in partnership with Tribes to ensure that the
priorities and issues of Tribal leaders and Tribal members are reflected and addressed
in the Plan.
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The need to ensure that the AAIHS Strategic Plan is coordinated and consistent
with the goals and objectives of the national IHS Strategic Plan and with the U.S. DHHS
Strategic Plan.
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Limitations and uncertainties about the funding levels that will be available
to AAIHS over the years 2012–2017 that would support initiatives to implement Strategic
Plan goals and objectives.
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Anticipated significant changes in the national health care system that will affect
AAIHS, stakeholders, Tribal members, and all components of the local health care
system, through expanded insurance coverage, increased revenue opportunities, changing
reimbursement levels, expanded use of health information technologies, and
a wide range of regulatory changes and reporting requirements.
The key activities being conducted during this one year project include:
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Conduct Internal I/T/U Environmental Scan: The internal I/T/U environmental
scan will document current resources, types and quantities of services
provided, characteristics of patients, performance measures and monitoring,
existing initiatives (e.g., IPC activities, EHR, and other health information technology
plans), identified needs for improvement, and challenges faced by the I/T/U
system. The internal environmental scan will be conducted through interviews with
managers and key staff of the I/T/U system; focus groups with I/T/U patients,
interviews with Contract Health Service providers; interviews with other individuals
who coordinate and partner with AAIHS; and review of program statistics, internal
documents, and other materials that will provide insight into the strengths,
weaknesses, and issues that will guide development of the Strategic Plan.
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Conduct External Environmental Scan:
The external environmental scan will document the health care system within
which AAIHS and the I/T/U system operates, including:
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Documentation of available non-I/T/U health resources that provide
services to AI/AN people in the four-State AAIHS region.
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Key informant interviews with a small number of managers of non-I/T/U health facilities to obtain information and perceptions of their role and contribution to Indian health.
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Documentation of Medicaid/SCHIP programs in each AAIHS State and any special AI/AN health-related programs and initiatives in each State.
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Review the Indian-specific provisions in the Affordable Health Care Act and identify those that will require AAIHS and the I/T/U system to make changes and/or present opportunities or threats.
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Review IHCIA provisions and identify specific issues that may affect AAIHS and the I/T/U system.
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Review U.S. DHHS Strategic Plans and national IHS Strategic Plans.
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Prepare Environmental Scan Report: The Internal and External Environmental Scan Report will summarize and document strengths, weaknesses, opportunities, and threats that will provide background for AAIHS, GPTCHB, and other stakeholders to assist them in identifying priorities and specific objectives that might be necessary and feasible. In addition, the Environmental Scan may identify potential new partnerships and resources that can be useful in advancing and achieving elements of the Strategic Plan.
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Gather Partner and Stakeholder Input: AAIHS partners with the Tribes it serves to establish priorities, address issues, and resolve problems that occur within the IHS system. AAIHS Area Office division leaders, individual Service Units, Tribally-operated health programs, and UIHPs are also stakeholders in the I/T/U system and collaborate and coordinate with the Area Office to ensure that services are available, accessible, of high quality, and are user friendly. Other possible stakeholders include Contract Health Service providers, State and local public health agencies, State Medicaid/SCHIP programs, and other non-governmental health-related organizations and programs that provide services and resources to AI/AN people in the Aberdeen Area. Input from all partners and stakeholders is an essential and critical component of the strategic planning process and will be gathered throughout the project through multiple approaches, including:
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Involvement of Great Plains Tribal Chairmen’s Health Board in all stages of the Work Plan and strategic planning process, through a joint process with AAIHS.
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Meetings and key informant interviews with Area Office division managers and other key staff.
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Design and analysis of a survey of stakeholders to identify issues they would like to have addressed in the Strategic Plan and their suggestions and recommendations.
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Meetings with Aberdeen Area health care facility leadership to identify issues of concern, priorities in their individual strategic plans, and recommendations for integrating facility strategic goals and objectives into the Aberdeen Area Strategic Plan.
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A broad process of sharing interim information and draft deliverables with all stakeholders identified by AAIHS.
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Identify Priorities and Goals: Priorities and goals for the two Strategic Plans—Aberdeen Area Office Strategic Plan and Aberdeen Area Strategic Plan—will be identified through an iterative process with AAIHS leadership, GPTCHB, Area Office division managers, and other stakeholders. Based on meetings and discussions with AAIHS and GPTCHB, the Environmental Scan findings, the Stakeholder Survey analyses and results, and input and feedback from stakeholders, the Econometrica/Sundance Research Institute team will develop a preliminary outline of Mission and Values, Strategic Priorities, and Measurable Goals. This preliminary outline will be circulated to AAIHS, GPTCHB, and appropriate stakeholders identified by AAIHS and GPTCHB. Feedback and input on the preliminary outline will be obtained from all parties, and a second draft of the Mission and Values, Strategic Priorities, and Measurable Goals will be prepared and again disseminated to AAIHS, GPTCHB, and other stakeholders. Feedback and input on this second draft will then be used to prepare the final version of these dimensions of the strategic planning process. These will then be organized into a matrix format that will guide the development of the AAIHS Area Office Strategic Plan and the AAIHS Strategic Plan.
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Identify Feasible Objectives Under Each Priority/Goal: Once a consensus is reached on Strategic Priorities, a similar process will be used to obtain consensus on specific objectives under each Priority. These specific objectives are sub-priorities within the Strategic Priority—i.e., if Prevention is a Strategic Priority, there are many prevention targets that might be considered such as preventing infant mortality, preventing cervical cancer, or preventing long-term consequences of tobacco use. The specific objectives within each Strategic Priority will vary in feasibility, based on costs of training and implementation and on other factors. Each preliminary specific objective identified will be broadly assessed for feasibility and other considerations and ranked in terms of potential resources required and other factors that might affect feasibility The Econometrica, Inc./Sundance Research Institute team proposes to use a similar iterative process with AAIHS, GPTCHB, and other stakeholders to identify the highest sub-priorities within each Strategic Priority, circulating a preliminary list of potential specific objectives within each Strategic Priority for ranking and feedback, refining the list and re-circulating, and then developing the final list of specific objectives with input from AAIHS and GPTCHB.
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Identify Best Practices for Each Strategic Priority and Specific Objectives: Once consensus is reached on Strategic Priorities and Specific Objectives under each Priority, the Econometrica, Inc./Sundance Research Institute team will work with AAIHS to identify evidence on Best Practices for accomplishing each Strategic Priority/Specific Objective. This will include a brief review of the literature on each Specific Objective to identify evidence-based research on interventions or management practices that have been found to be effective in achieving the objective, review of the IPC website to identify strategies for improving patient care and access, review of other Federal agency websites (e.g. SAMHSA’s Evidence-Based and Promising Practices Programs), and discussions with stakeholders. The information on Best Practices will be incorporated into the discussion of Strategic Priorities and Specific Strategies within the AAIHS Strategic Plan, along with references and contact information, if applicable.
Annual reports on the progress and implementation issues and “lessons learned” will
be prepared and provide to the Tribe to assist in program monitoring and reporting.
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