This issue of the Journal of Public Health Management and Practice (Vol. 12, Issue 5) focuses on the Management Academy for Public Health. This is a management development program jointly offered by the School of Public Health and the Kenan-Flagler Business School at the University of North Carolina at Chapel Hill since 1999. Initially funded by the Centers for Disease Control and Prevention, the Health Resources Services Administration, the W.K. Kellogg Foundation, and the Robert Wood Johnson Foundation, and originally taking students from four southern states, the Management Academy is now a revenue-supported program that attracts participants from every region of the country. It is an intensive, 9-month, team-based program, using coursework in Chapel Hill, distance learning activities, and a capstone project consisting of a complete business plan that participants are expected to implement after being graduated from the program. A hallmark of the program is that it is thoroughly cross-disciplinary between public health and business, with the goal of applying business methods of management and business planning to public health issues. This orientation affects every aspect of the program and models the type of partnering between public health and business people that program planners believe is essential for successfully meeting the challenges faced by public health managers every day.
A major theme of my tenure as Dean of the UNC School of Public Health was collaboration across departments, disciplines, schools, and sectors. I was fortunate to have colleagues in the school and across campus who shared the ideal of strengthening the whole by cooperative endeavor. We believed--we still believe--that cross-disciplinary, collaborative initiatives can make a real change in important arenas.
When the Request for Proposals for the Management Academy was issued, we at the University of North Carolina were most excited by the idea of combining business and public health expertise to improve the effectiveness of public health systems. Robert Sullivan, then Dean of the UNC Kenan-Flagler Business School, and I had spoken about the need for managers in public health to understand and use state-of-the-art business methods, strategies, and tools in public health decision-making. In a time of mounting public health needs and shrinking resources, increasing the management skills of senior, midlevel, and entry-level staff clearly was a critical strategy for addressing tremendous challenges in local and state health departments throughout the region.
The first section of articles that follow sketches the background of the Management Academy's development, describing first the program design and how it works to develop public health managers (Orton et al), and then stepping back to trace the broad demographic, socioeconomic, and political trends reshaping public health in the 1990s and today that went into the design (Johnson et al), as well as describing how various partners came together to conceive of the program (Baker et al) and to design and develop it (Porter et al). These articles outline the critical success factors that have made the program so popular and successful.
The second section of articles in this special issue examines the outcomes from the Management Academy--what this program has made possible in individual and organizational achievement. Umble et al provide an overview of the external outcomes evaluation of the program's pilot years (1999-2003), defining precisely what the Management Academy is trying to teach and detailing the impact--on the individuals and organizations that have participated in the program--of having addressed these learning goals. This overview of outcomes is followed by six case studies written by public health managers who attended the Management Academy and accomplished with their learning exactly what the planners intended for them to do. They took their learning--usually in the form of the business plan created for the program's capstone assignment--and applied it to the challenges they faced in their home communities. Like public health managers everywhere, these individuals are grappling with being the provider of last resort for the growing number of un- or underinsured citizens in their districts; providing mental health services to the poor and indigent; protecting the population against threats to their health--from rabies, to chronic disease, to bioterrorism, and other disasters-and, finally, facilitating the work of others who work to improve population health by providing the support, information, and technological resources for them to do so.
The difficulty (for the editors) in this section was choosing who among the Management Academy graduates should write--perhaps a team from southern Georgia that developed a home visitation program to provide medical care and support to families with a preterm child; or a Portsmouth, Virginia, team that created a fee-based program to prevent lead poisoning; or a South Carolina program funded by restaurants to create safety training materials for food workers, or another to prevent asthma in that state. The decisions came down, often, to availability to write, for truly scores of graduates from across the target area would have had inspiring stories to tell about their successes.
One of the greatest challenges facing public health today is the increased demand for accountability and effectiveness. Society, in general, is demanding accountability for resource expenditure in a variety of ways and across disciplines and fields. In the case of the provision of public health services and healthcare delivery, this demand creates challenges and opportunities as we strive to strike a balance among efficiency, accessibility, and quality in all areas of the public's health. Public health managers have myriad jobs: they must supervise people who are providing services; analyze data and use it to develop new programs, evaluate existing programs, and make the case for programs to an expanding and increasingly attentive constituency; and administer a budget to pay for these efforts. Clearly, strong skills--gleaned not only from years of experience in public health management but also from a sound education in business methods and modes of thinking--will help the individuals who hold these positions of great responsibility.
But beyond basic business skills, the very act of joining forces with the business community and, by extension, understanding the concept of partnering more generally, is an important element of the Management Academy program. One of our best decisions in creating the program, and one that mirrors our original cross-disciplinary collaboration, was to stipulate that students come in teams, and to suggest that these teams include community partners. Through these elements we teach how to create and maintain partnerships--not only with others involved in protecting and improving the public's health, such as healthcare providers, first responders, law enforcement personnel, etc, but also with politicians and, of course, the business community. Such partnerships not only help individuals but also improve systems and redefine public health, allowing us to broaden our reach by joining forces with an ever-widening circle of colleagues. The case studies included in this issue examine how such partnerships can work in the real world of public health practice.
Finally, the last submissions in the issue are by noted personages in the fields of public health and healthcare, who were solicited, based on their expertise, experience, and thoughtfulness on these issues, to provide commentary on the Management Academy for Public Health, on management education in public health more generally, or on the state of public health. They were asked to think about the implications of applying a business model to social service allocation, what elements of the program seemed most and least relevant to them and their colleagues, or what recommendations they had for an audience of public health leaders, policy makers, managers, potential sponsors of public health initiatives, and others interested in the workings of the public health system. On the whole, the commentary writers endorse the Management Academy model, and each provides valuable advice about how the program should proceed.
The Management Academy for Public Health, with its emphasis on bringing people together to think in new ways about public health, is making a difference in how public health professionals address the daunting set of challenges they face today and will face in the future.