The Florida Department of Health in Duval County (DOH-Duval) is the local county health department in Jacksonville, FL. Duval County comprises close to 928 square miles located on the northeastern coast of Florida. It has a population of approximately 913,010 residents (49% male and 51% female). The median household income is $49,554.00. In addition, Duval County's population is 62% White, 30% Black, and 8% other races, with approximately 9% having Hispanic ethnicity. An estimated 16% or 55,579 residents received federal food assistance (SNAP) benefits in the last 12 months.
The development and implementation of a formal public health workforce development plan is a critical component of the Public Health Accreditation Board (PHAB) process. One key objective of the workforce development plan at DOH-Duval is to increase the leadership skills and abilities of staff throughout the agency. By increasing the skills and effectiveness of public health professionals, leadership development opportunities address Essential Public Health Service #8: Assure a competent public health care workforce.
Currently, DOH-Duval employs 494 people. Approximately 84% of the workforce at DOH-Duval is female. About 36% of staff are White, 56% are African American, and less than 1% are of Hispanic ethnicity. Nearly 60% of staff have been employed by DOH-Duval for 10 or more years, and 39 staff have five or fewer years until they are eligible to retire. Many of the employees preparing to retire work in key positions throughout DOH-Duval.
DOH-Duval developed the Grow! Leadership Academy in 2017 to increase the leadership abilities, critical thinking skills, and effectiveness of staff. Additional goals of The Academy included retention, effective succession planning, and implementation of high-quality service throughout DOH-Duval. Grow! is an eight month intense study of the concepts and issues surrounding the department's leadership competencies. The Academy's curriculum was designed based on a set of leadership competencies developed by the Florida Department of Health to help ensure an engaged and high performing workforce. These competencies include: exemplifies personal integrity and self-awareness, communicates and influences effectively, builds productive relationships, shapes and manages strategy, and achieves results.
Any staff member, regardless of role or position in the agency, was encouraged to apply. Preference was given to front line staff and those not currently in a leadership role. The application process included the requirement of potential candidates to provide:
A current resume.
Two letters of recommendation.
Two written statements of 500 words or less about their leadership capacity to improve the health of the public and a personal statement outlining what they hoped to gain through participating in the Academy.
Signatures to acknowledge professionalism standards and participant responsibilities and expectations.
The cohort met monthly for workshops, guest speakers, and preparation and planning for team projects. Examples of the curriculum content included: Leadership 101, Public Health 101, Cultivating Emotional Intelligence, Managing Up, Fiscal Responsibilities of Leaders, The Elements of Effective Strategic Planning, and the Impact of Health on City Economics. In addition, Grow! participants were divided into five groups. Each group was responsible for developing a project to address an objective on DOH-Duval's Strategic Plan, Duval County's Community Health Improvement Plan, or an identified community health issue. The culminating event for the class included a presentation from each group detailing their goal(s), strategies and activities, associated data, and cost for implementation.
Twenty seven DOH-Duval staff were selected for the Academy and 20 staff completed the program. Academy participants completed a pre- and post-assessment based on DOH leadership competencies. Preliminary results indicated high participant satisfaction and growth in knowledge, skills, and abilities across all competencies.
100% of participants rated the Grow! Leadership Academy as excellent (58%) or very good (42%).
95% reported that they were authentically engaged in the Grow! Leadership Academy.
95% strongly agreed that Grow! Leadership Academy provided useful knowledge and skills and 84% strongly agreed that Grow! Leadership Academy was valuable for their professional growth.
DOH leadership competencies were rated on a scale ranging from 1 (Do not do well) to 4 (Proficient). Improvements were observed in all five DOH leadership competencies, with the competency Shapes and Manages Strategy demonstrating the largest increase from pre- (2.5) to post-test (3.3).
Factors that led to the success of the program included:
The support of agency leaders, managers, and supervisors.
A small team (4) of facilitators and organizers.
Facilitator planning meetings prior to each session and post meeting sessions immediately following each class.
The willingness of community partners to participate.
The website for the organization is www.duval.floridahealth.gov
Public health organizations are facing challenges due to budget reductions, global public health issues, changes in public health policy and healthcare that impact prevention and health promotion, and workforce demographics.
48% of the public health workforce is age 50 and over. The average age is 48 years old.
38% plan to leave governmental public health before 2020. This is an expected turnover of 24% in the southeast region of the United States.
Opportunities for professional development and to demonstrate leadership skills are reported actions that can influence public health workforce job satisfaction.
DOH-Duval developed the Grow! Leadership Academy in 2017 to increase the leadership abilities, critical thinking skills, and effectiveness of staff. The proposed practice of local leadership development is relevant as a strategy to close the gap in employee retention and satisfaction, succession planning, and organizational and community impact.
The Academy's curriculum was designed based on a set of leadership competencies developed by the Florida Department of Health (DOH) to help ensure an engaged and high performing workforce.
The competencies are structured into four levels:
Level 1: Supervisors
Level 2: Managers
Level 3: Directors
Level 4: DOH Executive Management Team
The competencies are consistent, but get increasingly complex in behavioral demonstration with upward movement through the four levels.
The competencies include:
Exemplifies personal integrity and self-awareness
Communicates and influences effectively
Builds productive relationships
Shapes and manages strategy
The use of the leadership competency tool was utilized to design an effective program to support future leaders in the field of public health. In addition, the leadership competencies provide participants with a descriptive ladder of behavioral expectations as they move through and/or aspire to higher leadership levels at the department.
The cohort met monthly for workshops, guest speakers, and preparation and planning for team projects. Examples of the curriculum content included: Leadership 101, Public Health 101, Cultivating Emotional Intelligence, Managing Up, Fiscal Responsibilities of Leaders, The Elements of Effective Strategic Planning and the Impact of Health on City Economics. Academy participants were also required to work in teams to develop a project to address an objective on DOH-Duval's Strategic Plan, Duval County's Community Health Improvement Plan, or an identified community health issue. The culminating event for the class included a presentation from each group detailing their goal(s), strategies and activities, associated data, and cost for implementation.
Participants completed a pre- and post-assessment based on the competencies. The results were used to demonstrate the effectiveness and impact of the curriculum, as well as to ascertain the need for adjustments in the curriculum. Preliminary results demonstrated a positive impact on participants' knowledge, skills, and abilities to demonstrate each leadership competency.
The Grow! Leadership Academy met monthly for eight months in 2017 for a variety of workshops, group discussions, guest presenters, and project planning. DOH-Duval's Executive Leadership Team provided input and recommendations for scoring applications and final applicant selection.
Examples of content included:
Public Health 101
Cultivating Emotional Intelligence
Fiscal Responsibilities of Leaders
The Elements of Effective Strategic Planning
The Impact of Health on City Economics
The Academy was led by the Director of Organizational Development for DOH-Duval. The internal facilitator team included:
The Operations Review Specialist
The Education and Training Specialist
The Volunteer and Intern Services Specialist
Additional DOH-Duval presenters included:
The Assistant County Health Department Directors
The Medical Director
The General Services Director
One of the Clinical Operations Manager
External stakeholders that assisted with curriculum implementation included:
A representative from the City Council and Chamber of Commerce
A Public School partner
Nonprofit sector representatives
External stakeholders provided presentations to Academy participants on leadership, personal perspectives on leadership, and resources for leadership development. DOH-Duval strives to consistently and successfully work with a variety of stakeholders throughout our community to reach our strategic and community health goals. As our agency works toward impact and effectiveness of our strategic plans, in tandem with external partners, their inclusion was a pivotal component of Grow!
Evaluation of the Grow! Leadership Academy focused on demonstrating the impact of the Academy on growth in DOH leadership competencies. A 100-item assessment was created to assess proficiency with DOH leadership competencies in the domains of: Exemplifies personal integrity and self-awareness, Communicates and influences effectively, Builds productive relationships, Shapes and manages strategy, and Achieves results. All items were measured on a scale ranging from 1 (Do not do well) to 4 (Proficient). Participants completed a pre- and post-assessment survey that was distributed via SurveyMonkey.com. Responses were averaged for each leadership dimension and pre- and post-assessment results were compared to demonstrate the impact of the Grow! Leadership Academy on DOH leadership competencies. Preliminary evaluation indicates that participation in the Grow! Leadership Academy was associated with improvements in proficiency for each DOH leadership competency.
Exemplifies personal integrity and self-awareness increased from 2.9 at pre-assessment to 3.4 at post-assessment.
Communicates and influences effectively increased from 2.6 at pre-assessment to 3.2 at post-assessment.
Builds productive relationships increased from 2.7 at pre-assessment to 3.3 at post-assessment.
Shapes and manages strategy increased from 2.5 at pre-assessment to 3.3 at post-assessment.
Achieves results increased from 2.8 at pre-assessment to 3.3 at post-assessment.
A second component of the evaluation of the Grow! Leadership Academy was to assess satisfaction with participation in the Academy. A satisfaction survey was distributed following completion of the Grow! Leadership Academy. Results indicated a high level of satisfaction with this leadership development opportunity.
100% of participants rated the Grow! Leadership as excellent (58%) or very good (42%).
95% reported that they were authentically engaged in the Grow! Leadership Academy.
95% strongly agreed that Grow! Leadership Academy provided useful knowledge and skills.
84% strongly agreed that Grow! Leadership Academy was valuable for their professional growth.
Grow! Leadership Academy participants reported that they would implement a number of key skills learned in the academy, including:
Team work and collaboration
The evaluation and satisfaction survey results and comments support the plan to lengthen the time of the Academy from eight months to twelve months to allow for adequate time to cover curriculum content thoroughly.
DOH-Duval plans to continue the Academy in 2018 with a new cohort of students. The sustainability of the program is extremely likely since the costs associated with implementation of Grow! Leadership Academy are minimal. Because of the positive feedback and the survey results that showed improvements in DOH leadership competencies, the Grow! Leadership Academy will become a permanent part of DOH-Duval's workforce development plan.
Lessons learned include:
Community partners are eager and willing to support professional growth and development in leadership skills.
Lengthen the time of the Academy to 12 months to allow for adequate time to cover and include curriculum content thoroughly.
Add to the curriculum public speaking, writing and interviewing skills, and a community service project in collaboration with a community partner.
Host more external partners as guest presenters.
The sustainability plan includes:
Ensuring there are multiple DOH-Duval staff that can take the lead in coordination, planning and implementation of the Academy.
Building and maintaining community partnerships that can benefit the Academy and current and past participants.
Maintaining electronic files of the processes and content for the Academy.
Rewarding and recognizing staff that complete the program.
Using program graduates as spokespersons for recruitment for future cohorts as well as Academy facilitator team members and/or guest presenters.
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