Advances in Public Health Accreditation Readiness and Quality Improvement

Abstract

Introduction Continuous quality improvement is a central tenet of the Public Health Accreditation Board’s (PHAB) national voluntary public health accreditation program. Similarly, the Centers for Disease Control and Prevention launched the National Public Health Improvement Initiative (NPHII) in 2010 with the goal of advancing accreditation readiness, performance management, and quality improvement (QI). Objective Evaluate the extent to which NPHII awardees have achieved program goals. Design NPHII awardees responded to an annual assessment and program monitoring data requests. Analysis included simple descriptive statistics. Setting Seventy-four state, tribal, local, and territorial public health agencies receiving NPHII funds. Participants NPHII performance improvement managers or principal investigators. Main Outcome Measure(s) Development of accreditation prerequisites, completion of an organizational self-assessment against the PHAB Standards and Measures, Version 1.0, establishment of a performance management system, and implementation of QI initiatives to increase efficiency and effectiveness. Results Of the 73 responding NPHII awardees, 42.5% had a current health assessment, 26% had a current health improvement plan, and 48% had a current strategic plan in place at the end of the second program year. Approximately 26% of awardees had completed an organizational PHAB self-assessment, 72% had established at least 1 of the 4 components of a performance management system, and 90% had conducted QI activities focused on increasing efficiencies and/or effectiveness. Conclusions NPHII appears to be supporting awardees’ initial achievement of program outcomes. As NPHII enters its third year, there will be additional opportunities to advance the work of NPHII, compile and disseminate results, and inform a vision of high-quality public health necessary to improve the health of the population.

Barriers and Incentives to Rural Health Department Accreditation

“…Two sources of support that have been successful in improving LHD PHAB accreditation readiness are the CDC/NACCHO Accreditation Support Initiative and CDC's National Public Health Improvement Initiative. [31][32][33] The provision of technical support to RLHDs is another area needed to support for both MOVAP and PHAB accreditation. Using a train-the-trainer model (shown successful for LHDs in related content areas), 34 staff from accredited LHDs could be used as change agents to move the accreditation process forward by providing technical expertise to those rural health departments where accreditation is not seen as a priority.…”

Assessing Continuous Quality Improvement in Public Health: Adapting Lessons from Healthcare

“…For instance, in their qualitative study of 51 quality improvement initiatives in various public health departments in the US, Riley et al emphasized leadership and appropriate performance measures, which are also highlighted in the strategic and technical dimensions of CQI (Riley et al 2012). Resource inadequacy was a key barrier in McLees et al's (2014) study of 74 public health agencies involved with the National Public Health Improvement Initiative in the US, as it is in the strategic dimension of Shortell et al's framework. The importance of training and education in quality-improvement concepts and techniques is also stressed in both the public health literature and the technical dimension (Corso et al 2010).…”

“…Despite this phenomenon, there exists a limited body of empirical evidence on the impact of quality improvement approaches in public health settings (Corso et al 2010; Dilley et al 2012; McLees et al 2014; Riley et al 2012). Moreover, valid and reliable frameworks for assessing the integrity and impact of such systems in public health are still emerging.…”

Defining and Assessing Quality Improvement Outcomes: A Framework for Public Health

“…5,22,23 Only recently have researchers and practitioners begun to describe or assess outcomes of public health QI in a way that has the potential to demonstrate the impact of this work on public health organizations and the public health system more broadly. 5,22,24,25 Recent studies have described the role of public health QI in addressing service and program processes as well as operational processes. 5,22 Another study highlighted that certain characteristics of QI initiatives correlate with an increased likelihood of attaining stated objectives, including clarity around select measurement parameters such as time frames, baselines, and targets.…”

“…To improve performance, public health practitioners and researchers need to clarify what we hope to achieve and continue to build the evidence base for what works. 5,22,25 …”