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Learn about the Vermont Department of Health's efforts to prioritize data modernization initiatives through its Data Modernization Advisory Committee.

Learn step by step how to modernize data infrastructure at your health agency to improve public health outcomes, with helpful examples and resources.

Operationalizing Goals to Maximize Public Health Planning Operationalizing Goals for Public Health Planning Sara Bell, Marta McMillion Unlock four simple, adaptable tools that will help with operationalizing goals and detailing concrete steps for effective public health planning. Public health plans often include bold goals but can stop short of outlining how those goals will be achieved. Without defined actions, timelines, and responsibilities, plans risk becoming “shelfware,” leaving teams inspired by strategy but unclear on how to move it forward. This resource provides practical, adaptable tools to help public health agencies move from planning to action with clarity and momentum. Organized into the following sections, it is designed to support teams in translating high-level goals into concrete steps, prioritizing activities, and navigating real-world implementation challenges: Translating Strategy into Action: Introduces tools like the Strategic Priority Planning Worksheet and Implementation Plan Template to help teams define goals, identify key players, outline activities, and establish timelines, resources, and measures of success. Prioritizing What Matters Most: Uses the Impact and Effort Matrix to help teams assess which actions will generate the greatest impact relative to effort, enabling them to focus on quick wins and high-value projects to build momentum. Navigating Barriers and Enablers: Applies Force Field Analysis to identify and assess the driving and restraining forces that influence implementation, helping teams focus their energy on what will move work forward. Sustaining Implementation in Practice: Offers facilitation strategies such as 90-day sprint cycles, action ladders, co-creation with implementers, and the use of action libraries to support iterative progress, adaptability, and team engagement over time. By combining structured tools with practical facilitation strategies, this resource helps teams operationalize their goals, maintain momentum, and build more responsive and effective implementation processes. Get the Resource (PDF) Reviewed by - DeNubila, Myers, Rakotoniaina, Westermann OE22-2203 PHIG article yes

Web Accessibility Content Review Guide for Meeting WCAG Web Accessibility Standards Emily Lapayowker This actionable guide helps you prepare accessible web and digital content. Digital accessibility is an important process that makes websites, files like Word documents or PDFs, and other digital products accessible to people with disabilities, as well as making these products more user-friendly overall. There are several different standards to meet when making your web content accessible. This guide provides a comprehensive checklist for ensuring that web content and digital products are accessible, as laid out in the 2024 ADA Title II Web Rule, and hit the current standard of WCAG 2.1. Get the Checklist (automatic Word download) Padding Block - Medium Special Thanks - Resource - Guide for Meeting WCAG Web Accessibility Standards article yes

Defining Clear Roles and Responsibilities for Effective Public Health Plans Defining Clear Roles and Responsibilities in Public Health Sara Bell, Marta McMillion Executive Summary Public health plans often stall not because of weak strategy but because roles, decision-making authority, and accountability are unclear. Without clear ownership, teams may hesitate, duplicate efforts, or lose momentum. This resource provides practical tools to help teams move from planning to action with clarity and consistency. It is designed to help public health agencies define roles, clarify decision-making authority, and strengthen accountability to support effective implementation of organizational plans: Ownership and Role Clarity: Introduces the RACI model to define who is responsible for tasks, accountable for outcomes, and engaged in the work. This helps reduce confusion and improve coordination across teams. Decision-Making Authority: Focuses on identifying who has authority to make decisions and how decisions are communicated. Tools like decision-making charts and the DACI model help clarity ownership and prevent delays. Accountability Mechanisms: Outlines formal approaches (e.g., project tracking, performance management) and informal approaches (e.g., peer accountability, leadership modeling, team norms) to reinforce follow-through and transparency. Putting It Into Practice: Provides actionable strategies such as assigning implementation champions, using short-cycle check-ins, embedding progress reporting, and strengthening team culture. It also emphasizes adapting over time and celebrating progress to sustain momentum. By clarifying ownership, decision-making, and accountability, teams can create more coordinated and effective implementation processes that turn plans into action. Introduction It’s not uncommon for public health plans to stall during implementation due to unclear roles and responsibilities. Without defined ownership, decision-making authority, and mechanisms for accountability, teams may hesitate, duplicate effort, or disengage. This resource provides tools and strategies to support health departments and their partners in clarifying ownership, navigating decision-making, and reinforcing follow-through. Ownership and Role Clarity Use the RACI model to define who is responsible for each aspect of your implementation plan, as illustrated in Table 1: R = Responsible — Who is doing the work? A = Accountable — Who owns the outcome? C = Consulted — Who should be asked for input? I = Informed — Who needs to be kept in the loop? Table 1 - Resource - Defining Clear Roles and Responsibilities for Effective Public Health Plans Decision-Making Authority Understanding who has formal and informal decision-making power is essential in cross-functional and collaborative environments. To support this process, consider reviewing ASTHO’s Charter Template and Guide, which includes a structured approach to documenting governance, decision-making norms, and communication practices across implementation teams. Additionally, when collaborating with internal teams, across departments, or even external organizations, a Memorandum of Understanding (MOU) can be a helpful tool to formalize shared expectations. MOUs clarify roles and responsibilities, outline how communication and decision-making will occur, and document commitments in a way that supports transparency and accountability. A well-structured MOU typically includes the purpose of the partnership, the scope of work, responsibilities of each party, communication channels, and points of contact, helping key partners stay aligned as work progresses. Decision-making authority is often overlooked during implementation planning, yet unclear or misaligned authority can create barriers that impede progress. Teams can create a Decision-Making Agreement Chart (illustrated in Table 2) to help proactively identify key decisions, clarify ownership, and support smoother implementation. Table 2 - Resource - Defining Clear Roles and Responsibilities for Effective Public Health Plans(2) Finally, the DACI Model (Driver, Approver, Contributor, Informed) offers another helpful framework for clarifying decision-making roles. Similar to RACI, DACI emphasizes who is driving the decision process, who is the final approver, who contributes input, and who should be informed. Accountability Mechanisms Reinforce follow-through on implementation work with a mix of formal and informal approaches. Formal Approaches Project tracking systems: Use project management platforms to assign tasks and deadlines. You don’t need a fancy paid option; often, tools made available through your organization or free options are just what you need. Regular status reports: Include updates in recurring meeting agendas or distribute monthly progress reports. Performance management: Use your organization’s performance management system to monitor progress. Review data regularly to inform course corrections. Routine working meetings: Come together as a team to work on the item at hand in a shared environment to help with focus. Visual management: Use dashboards, charts, or simple visual trackers to display progress and milestones. These tools make dense information easy to interpret at a glance, promote transparency, and help communicate progress to a broad range of audiences, including those less involved in day-to-day implementation. Informal Approaches Peer accountability: Set up buddy systems or peer-review structures to create shared ownership. Leadership modeling: Encourage leaders to publicly share their own progress or reflect on implementation challenges to foster openness. Norms and expectations: Co-develop shared group norms (e.g., communicating back to teams as a liaison, circling back with homework done/reaching out to the lead in advance with delays, sharing responsibility for facilitating or notetaking), and revisit them during team check-ins. Putting It Into Practice Clarifying ownership and ensuring accountability aren't one-time activities — they require ongoing practices that reinforce role clarity, build mutual trust, and promote follow-through over time. The following strategies can help implementation teams embed accountability into their daily work and cross-functional collaboration Assign Implementation Champions Designate a person or small team to lead implementation for each major goal or strategic area. Assign champions thoughtfully, with attention to role clarity, capacity, and opportunities to rotate responsibilities over time. This champion doesn’t do all the work but ensures tracking of progress, elevation of barriers, celebration/acknowledgement of milestones, and adjustments when needed. Rotating champions can help distribute ownership, reduce fatigue among highly engaged team members, and infuse fresh energy and perspective into the work. Use Short-Cycle Check-Ins Break down implementation into manageable intervals. Check in every 30, 60, or 90 days to revisit responsibilities, track progress, and realign if roles or context shift. Consider identifying a secondary point of contact or back-up lead during these check-ins to support continuity if the primary lead is unavailable. This builds agility and accountability without being overwhelming. <!-- ASTHO’s “Operationalizing Goals to Maximize Public Health Planning” offers additional guidance and strategies for keeping plans actionable. --> Embed Progress Reports Into Team Culture Make accountability visible. Use shared reporting templates, dashboards, or standing agenda items to make progress transparent. Consider spotlighting wins or learning moments during regular meetings to reinforce shared responsibility. You might also establish time for site visits or rounding practices, creating opportunities for teams to share their successes visually and in person. These face-to-face exchanges help celebrate progress, surface challenges, and strengthen connections across teams. Strengthen Team Culture Through Shared Roles Team norms around shared facilitation, rotating notetaking, and collective problem-solving can reinforce a culture of inclusion, empathy, and ownership. Rotating responsibilities builds appreciation for the complexity of project management, ensures everyone has a voice, and reduces reliance on a single point person to carry the process forward. Visualize Roles in Real-Time Use visual tools like RACI charts or decision maps during meetings to remind everyone who owns what. When teams use these actively, there is a shift from documentation to facilitation. Normalize Course Correction Implementation rarely goes as planned. Normalize the practice of revisiting roles, responsibilities, and accountability practices. Discuss openly: Is this still working? Do we need to redistribute roles? Are our accountability methods inclusive and effective? Celebrate Successes and Small Wins Build in time to recognize progress along the way. Celebrating achievements — whether completing a key deliverable, reaching a milestone, or modeling collaborative problem-solving — helps sustain momentum and morale. These moments reinforce accountability by reminding teams that their efforts matter and that consistent progress, even in small steps, leads to long-term success. Reviewed by - DeNubila, Myers, Rakotoniaina, Westermann <!-- OE22-2203 PHIG --> article yes

Guam, Palau, and CNMI PHIG teams leverage diverse expertise to advance data modernization assessment, planning, and implementation strategies.

Use Partner Mapping to Power Data Modernization Projects Allen Rakotoniaina, Heidi Westermann, Elyssa Stoops, Charlie Ishikawa Learn how to use partner mapping to clarify and understand your data modernization partners, and tailor engagement strategies for shared projects ownership. Partner mapping is a practical way for state, territorial, local, and tribal public health agencies to identify, organize, and engage the wide range of stakeholders involved in data modernization (DM). This resource helps agencies clarify who their DM partners are, understand their perspectives, and tailor engagement strategies to build shared ownership of DM projects. article yes

Learn how to build a business case for data modernization efforts to translate technical needs into impact-driven narratives.

Measuring Health Equity for Planning and Performance Improvement astho, association of state and territorial health officials, environmental scan, health equity, health equity metrics, health equity strategies, social determinants of health, improve health, gender identity, sexual orientation, united states, race ethnicity, health outcomes, public health practice, health disparities, external factors, conducting an environmental scan, highest level of health, health and health, local health, measuring health equity, reduce health disparities, achieve health equity, public health, advancing health equity, health and health care Heidi Westermann, Melissa Lewis Better defining and measuring health equity in ASTHO jurisdictions. With support from CDC’s Center for State, Tribal, Local, and Territorial Support, in 2021, ASTHO initiated a health equity metric assessment to strengthen the evidence base for measuring health equity by identifying and collecting known and emerging metrics that support health equity strategies and monitor advancements toward health equity. To better understand the state of the field, ASTHO conducted an environmental scan that looked at state and territorial planning documents and national frameworks. As the scan revealed wide variation in how jurisdictions use equity-related terms and limited established metrics, ASTHO convened an advisory group to help identify resources and guide the work’s direction. Participating health agencies told ASTHO about their challenges in developing health equity standards and measures, including obstacles related to the underlying culture and the change management required to evolve toward a more equitable public health system. The agencies described both data limitation challenges and workforce capacity and communication challenges. This report summarizes these challenges, proposes incremental recommendations, and acknowledges the need for states and territories to apply both health equity and performance management strategies to develop health equity standards and measures. ASTHO recommends: Addressing data limitations and being transparent about remaining gaps. Building workforce capacity to recognize and address complex concepts and evolving needs through strategic skills and structural, transitional, and transformational change. Employing inclusive planning and performance management promising practices to engage stakeholders to develop meaningful, community-driven metrics. Committing to human-centered communication and community engagement through data visualization, storytelling, and trusted messengers. While this assessment confirmed that states and territories are interested in a list of nationally vetted common health equity metrics, the findings demonstrate a need for true equity engagement between communities and governmental public health leading to a paradigm shift in how we partner to improve health, prevent disease, and eliminate disparities. In addition, given that this assessment began before the COVID-19 pandemic, it does not fully account for the ongoing change associated with dedicated COVID disparities funding, investments in data and infrastructure, and the pandemic’s complex mental, physical, political, social, and economic impacts. As a result, several jurisdictions may need to adapt strategies already underway that are aligned with ASTHO’s recommendations. Health agencies should also consider their level of influence and authority and which partners they would engage to implement these strategies; this may vary by jurisdiction and governance structure. ASTHO will continue to strategize ways to improve and formalize health equity metrics to help public health agencies better serve their communities. Get the Report (PDF) article yes

Creating Successful Collaboration Structures in Public Health Initiatives Creating Successful Collaboration Structures in Public Health Sara Bell, Marta McMillion Public health initiatives rely on strong partnerships to sustain momentum and achieve impact, but collaboration can stall when roles, structures, and relationships are unclear. Without intentional design, collaborative efforts risk misalignment, fragmented communication, and missed opportunities to fully engage partners. This resource provides practical tools and guidance to help public health teams design, strengthen, and sustain effective collaboration structures. Highlighting the following, it is designed to support agencies in organizing partnerships, building trust, and aligning communication to advance shared goals: Clarifying Collaboration Structures: Outlines common structures — such as backbone entities, advisory bodies, and community-based implementation teams — and how they function together to support coordinated, inclusive, and effective action. Understanding Group Dynamics: Applies Tuckman’s stages of group development to help teams recognize where they are in the collaboration lifecycle and use stage-appropriate strategies to build trust, navigate tension, and strengthen performance. Organizing and Strengthening Partnerships: Introduces tools like the Partner Inventory, Engagement Pathways, Ecosystem Mapping, and “Who’s Missing?” tool to help teams understand partner roles, identify gaps, and intentionally expand and deepen engagement. Aligning Communication and Influence: Uses tools such as the Power-Interest Matrix, CLIP framework, and communication planning templates to help teams tailor engagement strategies, clarify influence and leadership dynamics, and maintain consistent, meaningful communication across partners. Putting Collaboration Into Practice: Offers actionable strategies — such as co-creating charters, using inclusive facilitation, building from local context, and reflecting on shared power — to help teams operationalize collaboration and sustain engagement over time. By combining structured tools with relationship-centered practices, this resource helps public health teams build stronger, more coordinated partnerships that support effective and sustainable implementation. Get the Resource (PDF) Reviewed by - DeNubila, Myers, Rakotoniaina, Westermann OE22-2203 PHIG article yes

How Public Health Can Support Modern Administrative Readiness in a Dynamic World How Public Health Can Support Modern Administrative Readiness in a Dynamic World Kristin Sullivan, Heidi Westermann Learn how creating resilient administrative infrastructure is critical to public health work. Public health agencies must be administratively ready to fulfill core functions, respond capably to public health emergencies, and utilize funds efficiently and effectively to improve health outcomes. Administrative readiness also depends on an organization’s ability to navigate challenges and ensure operational continuity in a complex and uncertain environment. Key strategies used in health departments emphasize proactive planning, risk assessment, leveraging information technology, building resilience, and continuous improvement. When in place, these foundations support readiness to respond to any public health issue. What is Administrative Readiness and Why Does It Matter? Administrative readiness is the capacity of an organization to rapidly adapt administrative and operational systems to support daily operations and emergency response. It ensures that administrative barriers do not delay critical actions during a public health emergency. Readiness is marked by: Flexibility in processes. Having the tools, data, and trained workforce for fiscal management, procurement, contracting, human resources, or staffing. Legal authorities. Public health agencies must be able to perform daily operations and respond to unexpected events or crises while maintaining compliance with laws and regulations. Administrative readiness matters because it provides the infrastructure for public health agencies to continue normal operations efficiently and effectively. At a 2025 convening of executive leaders from state and territorial health agencies, ASTHO asked how administrative readiness helps public health work. Responses included: Facilitates rapid assessment. Helps to ask the right questions. Promotes intentional data requests. Improves employee satisfaction. Standardized approach to data sharing. Builds better relationships and trust. Reduces grey areas. Promotes anticipatory decision making. Increases compliance. Creates projections. Creates strong processes. Matches expectations with reality. Critical Strategies in a Dynamic World Understanding Context and Environment Our current environment is fast-paced, rapidly changing, and unpredictable. The challenge for leaders is to shift away from reacting to change and move toward a proactive stance built through available frameworks and tools that help understand context and environment, make better decisions, and manage change more effectively. For example, Volatility, Uncertainty, Complexity, or Ambiguity (VUCA) is a framework that describes the environment or how people view the conditions under which they make decisions, mitigate risks, solve problems, and manage change. VUCA compares how much you know about a situation and how well you can predict the results of your actions. In this way, the framework helps leaders respond more effectively. Other frameworks include Kotter’s Change Management Theory, Kriegel and Brandt’s Seven Traits of Change Readiness, and Rogers’ Law of Diffusion of Innovations. Applying these together can help organizations understand how to adopt new ideas and manage the process of change: Adopting new ideas in an organization follows a bell curve from quick (innovators) to slow (laggards) with the majority in the middle needing proof and commitment to advance. Find innovators and early adopters that look for a challenge and the “why” to adopt. Traits of change readiness include resourcefulness, adaptability, optimism, confidence, adventurousness, and tolerance for ambiguity. These contribute to the ability to thrive during significant change. Create true urgency for change with fast moving action, clear purpose, and alignment. Move away from complacency and status quo, and an environment of false urgency where everything is a priority. Replace the sole focus on a traditional organizational hierarchy with a “dual operating system” that includes a broad network of volunteers across the agency for agility, speed, and innovation. Improving Internal Communication and Clarifying Roles and Responsibilities Often challenges to readiness start with communication and clarity of roles and responsibilities. It is critical to build strong working relationships and communication internally and across different teams. When agencies invest in standardized and accessible process documents, they support efficiency and accountability while reducing friction caused by ambiguity. Clearly defined roles eliminate confusion over who should do what, reducing bottlenecks and preventing duplicate work. Challenges stem from constant organizational restructuring or change and poor communication. Use a Responsibility Assignment Matrix, also called a RACI chart, by assigning each task or decision to one of four categories: Responsible (does the work), Accountable (owns the outcome, final sign-off), Consulted (provides input), and Informed (kept updated). Data Sharing and Information Management Data and information are critical to decision-making, timely and effective response, and continuity of operations. Health agencies need modern information systems, tools, and resources to move from data collection to managing and harnessing information for decision-making and action: A thoughtful data sharing strategy that includes current and adaptable data use or data sharing agreements with key partners should consider the risks of disclosing the data by considering current laws (permissible or requirement), the benefits of disclosing data, and the risks of not disclosing data. Informatics workforce capacity that can obtain, effectively use, and securely exchange information electronically to ensure data-driven decision-making to improve health outcomes. Interoperable systems for efficient data sharing that reduce the labor-intensive data manipulation critical for assessment and forecasting. Many agencies are improving interoperability as well as building tools and trackers that support improved response times to data and information requests. Leveraging AI for real time access to and production of information. This can include integrating AI-enabled or automated tools into existing information systems or workflows to support operations. Knowledge Management Knowledge management is an important yet often overlooked aspect of public health operations and helps sustain many of these foundations during disruptions to staffing and organizational changes, for example. It encompasses a broad range of activities, from documenting best practices and lessons learned to facilitating mentorship and peer-to-peer learning or leveraging technology for knowledge sharing to capture both explicit and tacit knowledge. Role-based knowledge management is often captured through standard operating procedures, training, and succession planning. Capturing institutional knowledge is more complex but just as important. It ensures valuable insights and experiences are not lost but instead become part of the agency’s long-term memory and used to inform decision-making, ensure continuity, improve performance, and drive innovation. Continuous Improvement Continuous improvement involves testing, exercising, and streamlining processes and procedures to improve response times. Rather than a one-time achievement, it is an ongoing process of developing the capacity to adapt to changing environments, optimize workflows, and maintain high performance. Incorporating Plan-Do-Check-Act cycles and basic lean principles to eliminate waste helps ensure that processes are simple, user centric and support operations as intended. Build Resilience Resilience is the capacity to withstand or recover quickly from difficulties or challenges. Strength or relationship-based leadership skills such as competent humility (the balance of having expertise to make sound decisions while remaining grounded, self-aware, and open to others’ input), appreciative approaches (strengths-based and positive change approach that focuses on what works well rather than just fixing problems), and well-being (nurturing employees’ physical, emotional, and mental health to foster a thriving environment) foster resilience by building psychological safety, trust, and long-term sustainability. Encourage and provide leadership development opportunities. Shift from knowledge and technical skills to building team cohesion and psychological readiness. Conclusion Employing these critical strategies can support your administrative readiness; however, this work is rarely linear or simple. Your operational systems must address the complex and intersecting nature of people, processes, technology, and governance, performance, and accountability. As public health leaders, it can be helpful to embrace humility to foster resilience. With this, and a value on transparency and continuous improvement, you and your teams can thoughtfully ready your administrative and operational systems and feel empowered in the face of our continuously evolving field. Reviewed by - Lindsey Myers OE22-2203 PHIG article yes

This blog describes how Palau's health ministry collaborated with its community to design indicators to better measure health equity in its jurisdiction.