|Promoting Accountability by Establishing More Effective Evaluation Mechanisms
Throughout the course of the review process, the project team and its subcommittees grappled with determining what constituted success when addressing public health needs in an urban environment. The overwhelming conclusion was that, while the public health challenges of American cities may vary, there exists a universal need for urban health professionals to establish a clear vision for improving public health in their communities. This vision must move beyond the typically reactionary focus of public health and include quantifiable metrics and goals with specified criteria against which to measure progress and success.,
In Baltimore, the Department needs to implement a comprehensive performance measurement program that sets quantifiable performance goals for each of the Department’s major initiatives and operational areas. In addition to establishing goals, specific Departmental managers must be identified as being responsible for each performance goal, and an annual ‘report card’ detailing the Department’s progress toward meeting the established measurable goals should be issued.
In recognition of the fact that the vast majority of public health services are delivered by contract providers, the Department must expand the use of outcome-based contracts with performance criteria, service goals, and outcome objectives. Through improved performance monitoring of contract providers, the Department can make informed funding decisions. In sum, the Department can reward the best providers with future financial support and reduce or eliminate support to under-performing providers. Additionally, better outcome-data could strengthen the Department’s case in appealing to the State and other funders for resources needed to address priority health issues, such as substance abuse.
Ultimately, the benefits of promoting accountability and developing more effective evaluation mechanisms reach far beyond improving the Department’s efficiency. Given the likelihood that Baltimore will always have a public health agenda that extends past its limited financial resources, the significance of educating the public about the city’s most pressing health needs takes on greater importance. A knowledgeable citizenry represents the Department’s best partner in its ongoing efforts to protect and promote public health in Baltimore. In the final analysis, the availability of information’regarding both the threats to the city’s collective public health and the Department’s responsiveness to those threats’is critical to making more informed and better decisions about the use and necessity of public health resources.
Introduction: Health Department