Domain 3: Population Health

Descriptor: Population health spans the healthcare delivery continuum from public health prevention to disease management of populations and describes collaborative activities with both traditional and non-traditional partnerships from affected communities, public health, industry, academia, health care, local government entities, and others for the improvement of equitable population health outcomes. (Kindig & Stoddart, 2003; Kindig, 2007; Swartout & Bishop, 2017; CDC, 2020).

Contextual Statement: A population is a discrete group that the nurse and others care for across settings at local, regional, national, and global levels. Population health spans the healthcare delivery continuum, including public health, acute care, ambulatory care, and longterm care. Population health also encompasses collaborative activities among stakeholders – all relevant individuals and organizations involved in care, including patients and communities themselves - for the improvement of a population’s health status. The purpose of these collaborative activities, including development of interventions and policies, is to strive towards health equity and improved health for all. Diversity, equity, inclusion, and ethics must be emphasized and valued. Accountability for outcomes is shared by all, since outcomes arise from multiple factors that influence the health of a defined group. Population health includes population management through systems thinking, including health promotion and illness prevention, to achieve population health goals (Storfjell, Wehtle, Winslow, & Saunders, 2017). Nurses play a critical role in advocating for, developing, and implementing policies that impact population health globally and locally. In addition, nurses respond to crises and provide care during emergencies, disasters, epidemics, or pandemics. They play an essential role in system preparedness and ethical response initiatives. Although each type of public health emergency will likely require a unique set of competencies, preparedness for responding begins with a population health perspective and a particular focus on surveillance, prevention, and containment of factors contributing to the emergency.

Entry-Level Domain 3 Competencies

3.1 Manage population health.

  • 3.1a Define a target population including its functional and problem-solving capabilities (anywhere in the continuum of care).
     
  • 3.1b Assess population health data.
     
  • 3.1c Assess the priorities of the community and/or the affected clinical population.
     
  • 3.1d Compare and contrast local, regional, national, and global benchmarks to identify health patterns across populations.
     
  • 3.1e Apply an understanding of the public health system and its interfaces with clinical health care in addressing population health needs.
     
  • 3.1f Develop an action plan to meet an identified need(s), including evaluation methods.
     
  • 3.1g Participate in the implementation of sociocultural and linguistically responsive interventions.
     
  • 3.1h Describe general principles and practices for the clinical management of populations across the age continuum.
     
  • 3.1i Identify ethical principles to protect the health and safety of diverse populations.

3.2 Engage in effective partnerships.

  • 3.2a Engage with other health professionals to address population health issues.
     
  • 3.2b Demonstrate effective collaboration and mutual accountability with relevant stakeholders.
     
  • 3.2c Use culturally and linguistically responsive communication strategies.

3.3 Consider the socioeconomic impact of the delivery of health care.

  • 3.3a Describe access and equity implications of proposed intervention(s).
     
  • 3.3b Prioritize patient-focused and/or community action plans that are safe, effective, and efficient in the context of available resources.

3.4 Advance equitable population health policy.

  • 3.4a Describe policy development processes.
     
  • 3.4b Describe the impact of policies on population outcomes, including social justice and health equity.
     
  • 3.4c Identify best evidence to support policy development.
     
  • 3.4d Propose modifications to or development of policy based on population findings.
     
  • 3.4e Develop an awareness of the interconnectedness of population health across borders.

3.5 Demonstrate advocacy strategies.

  • 3.5a Articulate a need for change.
     
  • 3.5b Describe the intent of the proposed change.
     
  • 3.5c Define stakeholders, including members of the community and/or clinical populations, and their level of influence.
     
  • 3.5d Implement messaging strategies appropriate to audience and stakeholders.
     
  • 3.5e Evaluate the effectiveness of advocacy actions.

3.6 Advance preparedness to protect population health during disasters and public health emergencies.

  • 3.6a Identify changes in conditions that might indicate a disaster or public health emergency.
     
  • 3.6b Understand the impact of climate change on environmental and population health.
     
  • 3.6c Describe the health and safety hazards of disasters and public health emergencies.
     
  • 3.6d Describe the overarching principles and methods regarding personal safety measures, including personal protective equipment (PPE).
     
  • 3.6e Implement infection control measures and proper use of personal protective equipment.

Advanced-Level Domain 3 Competencies

3.1 Manage population health.

  • 3.1j Assess the efficacy of a system’s capability to serve a target sub-population’s healthcare needs.
     
  • 3.1k Analyze primary and secondary population health data for multiple populations against relevant benchmarks.
     
  • 3.1l Use established or evolving methods to determine population-focused priorities for care.
     
  • 3.1m Develop a collaborative approach with relevant stakeholders to address population healthcare needs, including evaluation methods.
     
  • 3.1n Collaborate with appropriate stakeholders to implement a sociocultural and linguistically responsive intervention plan.

3.2 Engage in effective partnerships.

  • 3.2d Ascertain collaborative opportunities for individuals and organizations to improve population health.
     
  • 3.2e Challenge biases and barriers that impact population health outcomes.
     
  • 3.2f Evaluate the effectiveness of partnerships for achieving health equity.
     
  • 3.2g Lead partnerships to improve population health outcomes.
     
  • 3.2h Assess preparation and readiness of partners to organize during natural and manmade disasters.

3.3 Consider the socioeconomic impact of the delivery of health care.

  • 3.3c Analyze cost-benefits of selected population-based interventions.
     
  • 3.3d Collaborate with partners to secure and leverage resources necessary for effective, sustainable interventions.
     
  • 3.3e Advocate for interventions that maximize cost effective, accessible, and equitable resources for populations.
     
  • 3.3f Incorporate ethical principles in resource allocation in achieving equitable health.

3.4 Advance equitable population health policy.

  • 3.4f Identify opportunities to influence the policy process.
     
  • 3.4g Design comprehensive advocacy strategies to support the policy process.
     
  • 3.4h Engage in strategies to influence policy change.
     
  • 3.4i Contribute to policy development at the system, local, regional, or national levels.
     
  • 3.4j Assess the impact of policy changes.
     
  • 3.4k Evaluate the ability of policy to address disparities and inequities within segments of the population.
     
  • 3.4l Evaluate the risks to population health associated with globalization.

3.5 Demonstrate advocacy strategies.

  • 3.5f Appraise advocacy priorities for a population.
     
  • 3.5g Strategize with an interdisciplinary group and others to develop effective advocacy approaches.
     
  • 3.5h Engage in relationship-building activities with stakeholders at any level of influence, including system, local, state, national, and/or global.
     
  • 3.5i Demonstrate leadership skills to promote advocacy efforts that include principles of social justice, diversity, equity, and inclusion

3.6 Advance preparedness to protect population health during disasters and public health emergencies.

  • 3.6f Collaboratively initiate rapid response activities to protect population health.
     
  • 3.6g Participate in ethical decision making that includes diversity, equity, and inclusion in advanced preparedness to protect populations. 
     
  • 3.6h Collaborate with interdisciplinary teams to lead preparedness and mitigation efforts to protect population health with attention to the most vulnerable populations.
     
  • 3.6i Coordinate the implementation of evidencebased infection control measures and proper use of personal protective equipment.
     
  • 3.6j Contribute to system-level planning, decision making, and evaluation for disasters and public health emergencies.