Health Districts as Quality Improvement Collaboratives and Multijurisdictional Entities

Livingood, William C.; Marshall, Nandi A.; Peden, Angela; Gonzalez, Ketty; Shah, Gulzar H.; Alexander, Dayna S.; Penix, Kellie O.; Lawrence, Raymona H.; Toal, Russell B.; Woodhouse, Lynn D.

doi:10.1097/phh.0b013e31825b89fd

Cited by 20 publications

(8 citation statements)

References 43 publications

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“…91, 92 While it is not intuitively obvious how smaller LHDs could modify the predictor status of their small jurisdictions, there is increasing evidence that cross-jurisdictional sharing and regionalization of multiple LHDs may provide opportunities to enhance A-EBPs in such settings. 28, 93 …”

Section: Discussionmentioning

confidence: 99%

Understanding Administrative Evidence-Based Practices

Brownson

Reis

Allen³

et al. 2014

American Journal of Preventive Medicine

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Background There are sparse data showing the extent to which evidence-based public health is occurring among local health departments. Purpose The purpose of the study was to describe the patterns and predictors of administrative evidence-based practices (structures and activities that are associated with performance measures) in a representative sample of local health departments in the United States. Methods A cross-sectional study of 517 local health department directors was conducted from October through December 2012 (analysis in January through March 2013). The questions on administrative evidence-based practices included 19 items based on a recent literature review (five broad domains: workforce development, leadership, organizational climate and culture, relationships and partnerships, financial processes). Results There was a wide range in performance among the 19 individual administrative evidence-based practices, ranging from 35% for access to current information on evidence-based practices to 96% for funding via a variety of sources Among the five domains, values were generally lowest for organizational climate and culture (mean for the domain = 49.9%) and highest for relationships and partnerships (mean for the domain = 77.1%). Variables associated with attaining the highest tertile of administrative evidence-based practices included having a population jurisdiction of 25,000 or larger (adjusted odds ratios (aORs) ranging from 4.4 to 7.5) and state governance structure (aOR=3.1). Conclusions This report on the patterns and predictors of administrative evidence-based practices in health departments begins to provide information on gaps and areas for improvement that can be linked with ongoing quality improvement processes.

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Section: Discussionmentioning

confidence: 99%

Understanding Administrative Evidence-Based Practices

Brownson

Reis

Allen³

et al. 2014

American Journal of Preventive Medicine

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“…Through collaborations with other LHDs, regional or multicounty positions can be created. 37,38 Also, collaborations with universities, specifically colleges or schools of public health, and local hospitals can provide important assistance with accreditation activities. 39 …”

Section: Discussionmentioning

confidence: 99%

Patterns and Predictors of Local Health Department Accreditation in Missouri

Beatty

Mayer

Elliott

et al. 2015

Journal of Public Health Management and Practice

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Context Accreditation of local health departments has been identified as a crucial strategy for strengthening the public health infrastructure. Rural local health departments face many challenges including lower levels of staffing and funding than LHDs serving metropolitan or urban areas; simultaneously their populations experience health disparities related to risky health behaviors, health outcomes, and access to medical care. Through accreditation, rural local health departments can become better equipped to meet the needs of their communities. Objective To better understand the needs of communities by assessing barriers and incentives to state-level accreditation in Missouri from the rural local health department (RHLD) perspective. Design Qualitative analysis of semi-structured key informant interviews with Missouri LHDs serving rural communities. Participants Eleven administrators of RLHDs, seven from accredited and four from unaccredited departments were interviewed. Population size served ranged from 6,400 to 52,000 for accredited RLHDs and 7,200 to 73,000 for unaccredited RLHDs. Results Unaccredited RLHDs identified more barriers to accreditation than accredited RLHDs. Time was a major barrier to seeking accreditation. Unaccredited RLHDs overall did not see accreditation as a priority for their agency and failed to the see value of accreditation. Accredited RLHDs listed significantly more incentives then their unaccredited counterparts. Unaccredited RLHDs identified accountability, becoming more effective and efficient, staff development, and eventual funding as incentives to accreditation. Conclusions There is a need for better documentation of measurable benefits in order for a RLHD to pursue voluntary accreditation. Those who pursue are likely to see benefits after the fact, but those who do not, do not see the immediate and direct benefits of voluntary accreditation. The findings from this study of state-level accreditation in Missouri provides insight that can be translated to national accreditation.

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“…Through collaborations with other LHDs, regional or multicounty positions can be created. 39,40 Also, collaborations with universities, specifically colleges or schools of public health, and local hospitals can provide important assistance with accreditation activities. 41 • CONCLUSION Accreditation in rural areas may be a critical tool for improvement and change.…”

Section: Implications For Practicementioning

confidence: 99%

Barriers and Incentives to Rural Health Department Accreditation

Beatty

Mayer

Elliott

et al. 2016

Journal of Public Health Management and Practice

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There is a need for better documentation of measurable benefits in order for an RLHD to pursue voluntary accreditation. Those who pursue accreditation are likely to see benefits after the fact, but those who do not pursue do not see the immediate and direct benefits of voluntary accreditation. The finding from this study of state-level accreditation in Missouri provides insight that can be translated to national accreditation.

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Health Districts as Quality Improvement Collaboratives and Multijurisdictional Entities

Abstract: Regionalization of local public health capacity is a critical emerging issue for public health accreditation and quality improvement. This study demonstrated the utility of regionalization across traditional local geopolitical boundaries.

Cited by 20 publications

References 43 publications

Understanding Administrative Evidence-Based Practices

Understanding Administrative Evidence-Based Practices

Patterns and Predictors of Local Health Department Accreditation in Missouri

Barriers and Incentives to Rural Health Department Accreditation

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