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Public Health Department
Accreditation
Stephen W. Ronck, M.P.H.
Deputy Commissioner Community & Family Health Services Oklahoma State Department of Health March 27, 2012
Development of Accreditation
• NPHPS
• MAPP
• MLC
• IOM, 2003
• CDC Strategic Planning 2004
• RWJF Meeting 2004
• Exploring Accreditation Project, 2005
• Public Health Accreditation Board, 2007
Public Health Accreditation Board (PHAB)
• PHAB is the non-profit, voluntary accreditation organization founded in 2007
• PHAB is the national organization charged with administering the public health accreditation program.
• Goal is to advance public health performance by providing a national framework of accreditation standards for Tribal, local, state, and territorial health departments.
The Public Health Accreditation Board (PHAB)
• PHAB is funded by the Robert Wood Johnson Foundation (RWJF) and by the Centers for Disease Control and Prevention (CDC) but will also have accreditation fees associated with the application.
• PHAB’s governance structure is a board of directors composed of public health leaders
PHAB Accreditation Themes
• Quality Improvement
• Partnerships
• Workforce development
• Leadership and governance
• Customer focus
• Community engagement
• Planning
The PHAB Accreditation Process
What is Public Health Accreditation?
• The measurement of health department performance against a set of nationally recognized, practice-focused and evidenced-based standards.
• The issuance of recognition of achievement of accreditation within a specified time frame by a nationally recognized entity.
• The continual development, revision, and distribution of public health standards.
Importance of Accreditation
• Accreditation can help your health department:
– identify successes and opportunities for improvement
– promote quality initiatives
– energize the workforce and develop a strong team
– focus the health department on common goals
– evaluate your health department’s performance
– align your resources with your strategic objectives
– deliver results
Voluntary Accreditation Goal
The goal of the voluntary national accreditation program is to improve and protect the health of the public by advancing the quality and performance of state ,local, tribal and territorial public health departments.
Why Accreditation?
Why Seek Accreditation?
• Responsive to Change
• Shared Decision-Making
• Workforce Development
• Services and Programs
• Performance Improvement
• Strong Partnerships
Benefits of Accreditation to the Public Health System
• Planning – standard, routine
• Management - framework
• Quality Improvement –culture of QI
• Leadership – strengthened
• Partnerships – shared responsibility
• Community Engagement – link
• Customer Focus – meet needs
• Workforce Development – capacity
Benefits of Accreditation to the Health Departments
• Staff team building
• Access to knowledgeable peers for review and comment on performance
• Increased visibility and recognition
• Increased credibility and accountability
• Clear expectations
• Potential access to new funds
• Potential streamlined reporting
Incentives
• National recognition for public health practice
• Opportunity to engage the public health workforce
• Access to network of public health experts • Focus on improving the health department • Potential access to new funding streams • Potential streamlining of grant reporting • Participation in developing a strong data
base for exploring best practices
Accreditation looks at:
• Leadership
• Strategic planning
• Community engagement
• Customer focus
• Workforce development
• Evaluation and quality improvement
PHAB 12 Domains Based on Core Functions of Public Health &
Ten Essential Public Health Services
Twelve Domains 1. Conduct assessments focused on population health status and
health issues facing the community 2. Investigate health problems and environmental public health
hazards to protect the community 3. Inform and educate about public health issues and functions 4. Engage with the community to identify and solve health problems 5. Develop public health policies and plans 6. Enforce public health laws and regulations 7. Promote strategies to improve access to healthcare services 8. Maintain a competent public health workforce 9. Evaluate and continuously improve processes, programs, and
interventions 10. Contribute to and apply the evidence base of public health 11. Maintain administrative and management capacity 12. Build a strong and effective relationship with governing entity
Principles of Standards and Measures
• Advance the collective public health practice
• Moderate level: not minimum, not maximum
• Be simple, reduce redundancy, minimize burden
• Apply to all sizes of HDs and all forms of governance structure
• Establish same standards for Tribal, state, and local health departments
• Build quality improvement into standards
Structural Framework
Domain
Standard
Measure
Documentation
Guidance
Preliminary Review Manufactured Food Regulatory Program Standards and
PHAB Public Health Accreditation Standards and Measures Linkages
Manufactured Food Regulatory Program Standards Public Health Accreditation Standards & Measures
Standard 1: Regulatory Foundation
“sound science based regulation foundation”
Domain 10: Contribute to and apply the evidence base of public health
Measure 12.1.1: Provide mandated public health operations, programs, and services
Standard 2: Trained Regulatory Staff
“trained regulatory staff with skills and knowledge necessary to conduct quality inspections”
Domain 8: Maintain a competent public health workforce
Standard 3:InspectionProgram Based on HACCP Principles
“identify risk factors and obtain immediate and long-term corrective action for recurring risk factors
Domain 2: Investigate health problems and environmental public health hazards to protect the community.
Measure 2.1.3: Demonstrate capacity to conduct investigations of non-infectious health problems,
environmental, and/or occupational public health hazards
Measure 2.1.5: Monitor timely reporting of notifiable/reportable diseases, lab test results, and investigation
results
Standard 4: Uniform Inspection Program
“uniform high quality inspections”
Measure 2.1.1: Maintain protocols for investigation process
Domain 9: Evaluate and continuously improve process, programs, and interventions
Standard 5: Preparedness and Response
“systematic approach for the detection, investigation, response, documentation, and analysis of alleged
food-related incidents”
Measure 2.1.1: Maintain protocols for investigation process
Standard 2.2: Contain/mitigate health problems and environmental health hazards
Standard 6: Compliance and Enforcement
Program implemented consistently to achieve compliance with regulatory requirements
Domain 6: Enforce public laws
Standard 7:Industry and Community Relations
“enhanced communications with industry and consumers through forums designed to solicit input”
Domain 4: Engage with community to identify and addressing health problems
Standard 8:Program Support and Resources
“resources available to support risk-based retail food safety program”
Measure 11.2.4: Seek resources to support agency infrastructure and processes, programs, and
interventions
Standard 9:Program Assessment
“enable managers to measure their program against national criteria”
Domain 9: Evaluate and continuously improve process, programs, and interventions
Standard 10: Lab
Road to Accreditation
• Oklahoma chosen as one of 8 states in the nation to participate as state health department beta test site
• Comanche CHD chosen as one of 19 county health department sites in the nation to participate as local health department beta test site
• Oklahoma is the only state in the nation to be selected in all three venues of national accredi- tation health department beta test sites!
State Beta Test Sites
– Florida
– Iowa
– Michigan
– Mississippi
– Ohio
– Oklahoma
– Washington
– Wyoming
Local Beta Test Sites
– Coconino (AZ) - Portland (ME)
– Miami-Dade (FL) - Hennepin (MN)
– Franklin (KY) - Carson City (NV)
– Amherst (MA) - Tioga (NY)
– Solutions District (NE) - Central Valley (ND)
– Bloomfield Township (NJ) - Comanche (OK)
– Cabarrus (NC) - Austin/Travis (TX)
– Mahoning (OH)
– Deschutes (OR)
– Tooele (UT)
– San Diego (CA)
– Norton (KS)
Tribal Beta Test Sites
- Navajo Nation (AZ)
- Cherokee Nation (OK)
- Keweenaw Bay (MI)
Beta Test Feedback
“The standards and measures can be viewed as an operating manual on how to run a good health department. The basics and fundamentals in management are there, so as new leaders come in they don’t have to reinvent the wheel—the standards and measures can provide a consistent roadmap.”
Beta Test Feedback
“ After completing the process, I am even more convinced of the value of this process. In addition to all the known benefits, I believe it will lead to a new level of communication and collaboration between public health agencies and jurisdictions.”
Beta Test Feedback
We've got a very clear roadmap to guide us in the months ahead….It's been such a wonderful journey, with greater awards than I imagined.”
“ . . .had a positive
effect on those staff involved by providing opportunities to learn about the department in-depth and how much we do for the people who live and visit our state.”
“helped jumpstart the
process to create a QI culture for the agency as a whole.”
Public Health
Accreditation Board www.phaboard.org 1600 Duke Street, Suite 440
Alexandria, VA 22314
703.778.4549
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