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Choose criteriaThe following criteria should be used to discuss, evaluate and score each potential priority area:
Questions to consider for the facilitated discussion are detailed in Step 4.
Determine who to involve
The prioritization process is an important way to gain buy-in from those in the best position to influence outcomes of the public health improvement plan and ensure that underrepresented communities and participants have a voice. Being strategic in your selection of participants means you have identified a role for everyone involved in the process, for examples:
Be sure to clearly communicate the participants' roles and level of decision-making authority to the group ahead of time. Determine whether it's the role of the participants in the prioritization meeting to make the final decision on priorities for public health improvement or whether they're to make a recommendation to the Board of Health or other entity. Note that the public health agency need not be the lead organization on every community health priority. The more engaged stakeholders are in terms of being able to make decisions, the more likely that advocates and lead organizations will step forward.
There are probably many groups already focusing locally on priority health issues. Some may be addressing an issue with great success while other may be struggling because they lack funding, staff or other resources, or they may be using an ineffective strategy. A prioritization process can help stakeholders align by focusing energy, funding and other resources on the same areas and respective strategies that result from this process.
Determine who'll facilitate the meeting or meetings. The prioritization process will involve a considerable amount of discussion, both before issues are scored and ranked and afterward, to validate or change the rankings and to determine the number of priorities given levels of capacity. If you feel like you don't have the capacity to provide skilled, neutral facilitation of the prioritization process within your agency or community, contact OPPI to assist with identifying a facilitator who can help guide the group toward consensus and moving forward.
DocumentationDocumenting the process, method(s), who is involved and how demonstrates the integrity of your process. It is a PHAB requirement as well as a best practice in being transparent about a critical part of the CHAPS process.
Design a process
Combine previous decisions about method, who to involve and how to create your prioritization process. This will provide direction for a facilitated discussion with key stakeholders to systematically determine which issues should have a more targeted and planned focus over the next five years. The five-year goals is to "move the needle" on the issue, by either improving capacity or positively impacting a health outcome in a measureable way.
Determine the best format(s) to present this information to stakeholders participating in the prioritization process to ensure they have a common understanding of the issues and all of the information needed to select priorities. Methods of delivery include:
Depending on your group, provide adequate information either before the prioritization process or during to ensure everyone has had an adequate amount of time to take in the information and to be prepared to make a decision.
The initial part of the meeting should provide background in terms of purpose, the role of the group, the decision-making process and method of scoring. Consider setting ground rules or meetings norms as well. Choosing priorities can be challenging, as decisions will be difficult and not everyone's preferred issue will be selected. Ask the group to brainstorm norms for working together (e.g., confidentiality, respecting one another's opinions, etc.) and record them on a flip chart that all participants can see during the meeting. Ask participants if they can agree to all the norms. When a norm is broken, the facilitator can remind the group by referencing the flip chart.
The next part of the meeting will be the issue presentation. These are the five to ten issues up for consideration to be focus areas for the public health improvement plan. The objective of this activity is to educate the participants about the issues, provide enough background so they can score them, and have a discussion so that participants can exchange thoughts and ask questions. This part of the meeting will take the longest; you may want to allow a half-hour to present and discuss each issue.
Following the presentation and discussion of the issues comes the prioritization method that you have designed. Depending on the size of the group that you are working with and the method that you have chosen, this may occur in-person or through the use of technology.
The final part of the meeting is selecting priorities based on the discussion of the rankings. Scoring and ranking is not a perfect process. As such, the group should discuss how the rankings come out. The facilitator can use questions such as the following to prompt discussion:
At this point in the process, the group should be close to consensus on all or most of the issues. A show of thumbs or use of the clicker can indicate consensus or disagreement. If there is disagreement among several members, either a discussion should continue or the group may decide they need more information before coming to a consensus or compromise. As decisions are made on focus are priorities, record them. Reflect any notes having to do with voting, dissenting opinion or any further actions needed before a consensus or compromise can occur.
End your meeting by discussing the next steps of the process. The priorities will need to be developed into action plans by workgroups (explained in Phase 6 - Develop the plan). Consider what communication might need to occur with stakeholders who weren't able to attend. Help the participants understand and/or determine their potential roles in future steps. Lastly, celebrate the completion of this pivotal milestone in the public health improvement process.