Book review: J. S. Durch, L. A. Bailey and M. A. Stoto (Eds), Improving Health in the Community. A Role for Performance Monitoring. Washington DC: A report from the Institute of Medicine, National Academy Press, 1997. ISBN: 0 309 05534 2, 478 pages. Price: unknown.
✍ Scribed by Teri Knight
- Publisher
- John Wiley and Sons
- Year
- 1998
- Tongue
- English
- Weight
- 66 KB
- Volume
- 13
- Category
- Article
- ISSN
- 0749-6753
No coin nor oath required. For personal study only.
✦ Synopsis
This book is timely for those in the UK in that it oers one approach to the development of the Health Improvement Programmes which will be required as part of The New NHS' and Our Healthier Nation (Department of Health, 1997Health, , 1998)). It will no doubt be of relevance to similar programmes in other countries. The Community Health Improvement Programme' (CHIP) proposed and described in the book has its origins in two workshops held in the US during 1995, which considered the use of performance monitoring to improve community health. Following these, a study was undertaken by the US Institute of Medicine Committee on Using Performance Monitoring To Improve Community Health. The book contains a report on the ®ndings form this study as well as summaries of the original workshops.
The book opens with an executive summary followed by an introductory chapter. Health and its determinants are the subject of chapter two, followed by a chapter discussing management issues related to community health improvement. The CHIP approach is covered in detail in chapter four, followed by a discussion of measurement and data collection issues in chapter ®ve. The main text of the book concludes at chapter six (page 179) with conclusions and recommendations. The remainder of the book's 478 pages are taken up with appendices.
The fundamental concept proposed is of performance monitoring as . . . an eective tool for developing a shared vision and supporting a planned and integrated approach to improve community health.' The CHIP model includes two principal interacting cycles; the problem identi®cation and prioritizing cycle involves forming a community health coalition', preparing and analysing community health pro®les' and from these, identifying critical health issues. This cycle of activity links with the analysis and implementation cycle, which is applied to each separate health issue identi®ed, moving through resources inventory, development of a health improvement strategy, establishment of accountability for health improvement activities, development of a set of performance indicators, implementation of the strategy and the monitoring of process and outcomes. although presented sequentially, the point is made that the dierent steps are likely to interact and be repeated.
The processes contained within the model will be recognized by those involved in health needs assessment and the public health function. Similar processes of health strategy formulation have been undertaken in UK localities, often on a multi-agency basis through Health Alliances'. What is useful about the CHIP model, however, is the explicit linkage with performance monitoring and accountability. For each strategy formulated to address speci®c health issues, sets of performance indicators are developed. Accountable entities' within the community coalition are then identi®ed in relation to each indicator and the establishment of `social contracts' cement the performance± accountability relationship. Useful prototype sets of performance indicators for speci®c