San Bernardino County Sets Big Data-Driven Goals

Think of these as lofty, aspirational peaks: a healthy, empowered community or the elimination of a chronic condition like obesity. Knowing what your government seeks to accomplish can be easy, particularly compared to the more challenging process of determining the steps required to enact a top-level vision.

Starting in 2015, with the launch of their strategic plan for 2015 through 2020, the San Bernardino County Department of Public Health has been engaged in this process. In her presentation at Socrata Connect, Public Health Director Trudy Raymundo detailed the process her department undertook to bring the county’s strategic plan to live.

Empowering Staff to Create Their Own SMART Goals

The San Bernardino County Department of Health has a $1 million annual budget and 900 staff members working on everything health-related in the county, from maternal health to animal control to food safety. In 2015, the county kicked off a strategic planning process to determine top-level goals, such as increasing physical activity, maternal mental screening, and food safety practices.

Rather than enacting a top-down process to get to individual-level goals, however, Raymundo opted to give staffers ownership over the process. This was an acknowledgment of their on-the-ground insights into the issues. Staffers created their own unique SMART (specific, measurable, achievable, relevant, time frame) goals, as well as determining how goals would be measured.

The next step was to track results, which San Bernardino did on a public-facing performance portal.

We really wanted staff involvement so that they would own the plan itself.

Trudy Raymundo

San Bernardino County Public Health Director

To encourage engagement, Raymundo launched the open performance site with a mini-roadshow, rather than just another easily ignored announcement email. She joined team meetings and did a 15-minute demo of the new site, then followed up with a survey and requests for feedback.

Data Is Not a Hammer

With the Socrata-powered performance site, colleagues, managers, and the public can track progress toward goals, along with priorities that need improvement. That can be intimidating for staff, particularly if they’re responsible for goals that need improvement. Raymundo managed that challenge by broadcasting her belief in the power of failing forward.

“You never learn until you fail; you don’t look at how you can improve unless something goes wrong,” says Raymundo, noting that it’s not about the “needs improvement” alert, but how you respond to it.

“A number is just a number is just a number. The open performance site is not a hammer; it’s a way for you to be engaged with your own data,” says Raymundo.

How Tracking Goals Improves Results

Tracking progress on goals — and doing so publicly — can lead to potentially significant and incremental improvements.

One of the Public Health Department’s goals is to work with restaurants identified as having issues with food safety to improve their outcomes. Inspectors were visiting restaurants with repeat violations and explaining necessary changes, yet during repeat visits, violations would still be occurring, which left the goal to improve unsafe food handling hovering below the marker for success.

In a strategic twist, the team developed brief videos known as Preliminary Education Presentations or PEP Talks, which they shared with restaurant owners. As it turns out, less can be more — the five-minute videos had more of an impact than the previous lengthy feedback. For supervisors, examining the data, and seeing the improved results, offered a view into the value of tiny tweaks and initiatives.

Tracking goals that are in the “needs improvement” zone is also helpful (so long as you convey that message that failure is part of the process and not an indictment on staffers’ abilities or work). As Raymundo puts it: When something doesn’t work, we need to evaluate and make changes to improve the results.

San Bernardino County has a goal of increasing the percentage of WIC infants who are exclusively breastfed for six months to 20 percent by the year 2020. The current status of this goal is "needs improvement", and the team has responded by instituting three-month long PDSA (plan-do-study-act) cycles to help identify small new approaches that can affect this goal. To keep morale high for staffers working on this goal, Raymundo notes the importance of focusing on incremental improvements — even a 1 percent uptick is significant given the county’s large population. Tracking performance can focus on month-over-month and year-over-year improvements along with the trajectory toward hitting the overall performance indicator.

The Power of Public Goals

Along with prioritizing an engaged staff with a feeling of ownership over both high-level goals and their own SMART goals, Raymundo believes having the performance available on a public platform is essential. Not only does it encourage collaborations across the many teams within the sprawling department, but it informs the whole community of what the department is working on.

I wanted to make sure the world knew what we were doing on a daily basis.

Trudy Raymundo

San Bernardino County Public Health Director

Every page on goals provides a plain-English summary of why the goal is in place and what steps are being taken to achieve it, along with how community members can get involved.

For staff, seeing their work on display is empowering. The decision-making process is inclusive, and all 900 employees of the Public Health Department can view and act upon the data.

Case Study Highlights

  • All 900 public health department staff contributed input on goals, priorities, and related data
  • New public access to SMART goals and simple tracking, such as “on track” or “needs improvement”
  • Automated charts share progress on goals and provide quick access to raw data

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