Blueprint for Public Health System Transformation

For decades, there have been significant efforts to revitalize the United States’ public health system. Transformation requires reimagining the system and creating a shared vision that supports the mindsets, workforce, capacity, and resources to deliver the Foundational Public Health Services and Essential Public Health Services — and to promote health and well-being.

The new Blueprint for Public Health System Transformation guides health departments interested in system transformation. It describes four phases of system transformation and provides questions, steps, and resources for each. The Blueprint also incorporates “cross-cutting concepts” that apply to all phases of the system transformation process.

Acknowledgement: PHAB partnered with the Center for Public Health Systems at the University of Minnesota School of Public Health (CPHS) to develop the Blueprint for Public Health System Transformation. This microsite builds from this initial document.

Download the full Blueprint or explore our interactive microsite.

Are you a leader at a hospital or health care system? Download our free supplemental resource, Hospitals as Partners in Public Health System Transformation, to learn how the Blueprint can help you strengthen partnerships, align and maximize limited resources, and co-design shared strategies that improve community conditions and population health outcomes.

Phases of Transformation

Cross-Cutting Concepts

Public Health Services Frameworks

Specific articulations of public health capabilities or service areas (e.g. 10 Essential Public Health Services, FPHS, Core Public Health Services), which varies by system.

Governance

The process for state and nonstate actors to interact, design, and implement policies within a set of formal and informal rules. This includes policy development, resource stewardship, legal authority, and oversight.

Service Delivery

How services are delivered within or across jurisdictions. This may be done by a single agency (public or private) or multiple partners.

Human & Financial Resources

The people (employees, contractors, volunteers) and funding that support the delivery of public health services.

Policy & Legislation

Laws, regulations, and policies that can enable or impede public health activities. Revitalizing rules is important for system transformation.

Standards & Performance Measures

Metrics that establish accountability and evaluate success of system transformation activities.

Responsibility & Accountability

Separate from governance, this refers to who is responsible/accountable for system transformation and service delivery. It is important to consider this throughout the transformation process.

Key Considerations & Best Practices

Consider Uniformity and Uniqueness

System transformation is a complex process involving many partners and activities over time. Partners should establish a shared vision and goals while recognizing the need to tailor activities, plans, and communications to different roles and audiences.

Enhance Quality Through Engagement

The goal of system transformation should be to improve the equitable distribution and access to services, i.e. to offer every individual a “fair and just opportunity to attain their highest level of health.” Ensuring input from a variety of perspectives can lead to more effective improvement.

Communicate Throughout Transformation

Plan how to communicate with partners throughout the process. Tailor materials for different audience roles, levels of engagement, and need for information. Create a communications timeline with important milestones and regular reporting on findings, successes, and challenges.

Consider Feedback and Adjust Approach

You may have a set structure and timeline, but plan for repetition or revision. While Phase 4 is focused on performance management and quality improvement, performance and evaluation should be considered throughout the process.