Faced with finding a balance between the need conserve scarce resources, while continuing to improve organizational performance and community health, many local health departments (LHDs) in the United States have decided to pursue national, voluntary public health accreditation as a guide to improvement; how to do so in the most efficient way possible remains a question for many LHD leaders.
To answer this question, a team of investigators based at the University of Kentucky College of Public Health engaged employed a participatory action research approach in which LHD directors and accreditation coordinators from seven accredited and three late-stage accreditation-ready Kentucky LHD jurisdictions participated. Their findings appear in the Journal of Public Health Management and Practice.
Working with investigators, participants organized a set of accreditation deliverables into a chronological sequencing of each site’s accreditation readiness process, which was then coded by researchers to identify similarities and differences.
All participating jurisdictions had all-hazards emergency operations plans and public health emergency operations plans – while none had workforce development plans, quality improvement plans, or performance management plans before launching accreditation readiness activities. Also identified were the number of accreditation deliverables attempted, simultaneously, by each site and the importance of specific deliverables having a singular focus. Sequences of work on specific deliverables by the majority of participants included: completing work on the quality improvement plan immediately, followed by the performance management plan, the Community Health Assessment before the Community Health Improvement Plan, and a strategic plan, followed by a workforce development plan. Factors influencing accreditation readiness processes, elements for sustaining processes, and lessons learned throughout the pursuit of accreditation were also provided by participants.
Recognizing the impact of staff availability, staff skill sets, training, and available financial resources on the pursuit of accreditation, participants determined that aggregating lessons learned into a flowchart highlighting the interconnectedness of accreditation deliverables could produce a road map for LHDs. Accreditation deliverables could be attempted in a logical, efficient order particularly valuable to small LHDs with limited resources and yet adaptable for those jurisdictions able to devote more resources to the process.
Dr. Angela Carman, University of Kentucky College of Public Health department of health, behavior & society, is the first and corresponding author of “Pursuing Public Health Accreditation: A focus on HOW,” appearing in the Journal of Public Health Management & Practice. Dr. Carman is also CPH associate dean for practice and workforce development. Co-authors are Dr. F. Douglas Scutchfield, UK CPH department of health management and policy, Dr. Margaret McGladrey, Tufts University, and Mr. Jonathan Vorbeck , Jessamine County Health Department, Nicholasville, Kentucky. The project was funded by the Kentucky Department for Public Health.