1. Accreditation and Quality Improvement for Public Health Departments
Patrick Libbey

2. “Quality Improvement…is…deliberate and defined improvement…focused on activities that are responsive to community needs and improving population health. It [is] a continuous…effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes and other indicators of quality in services or processes which achieve equity and improve the health of the community.”
The Accreditation Coalition July 14, 2009

3. Poll Question
Do you have a formal quality improvement process in place?
A. Only some programs
B. All programs
C. Organization-wide
D. None at all
Click on the down arrow if you can’t see the response choices.

4. Quality Improvement or Evaluation?
Incentives and disincentives
Consequences
What gets measured gets done

5. Plan-Do-Study-Act: The Quality Improvement Cycle
Prioritization: will accreditation standards help guide us?
Reinvention or replication: how do we use others’ work?
Principle of small scale implementation: does trialability apply?

6. Preparing for the Test or Putting into Practice?
11 domains
capacity
109 measures
process
31 standards
outcome
documen-tation

7. Other Qualitative and Operational Implications
Increased visibility: improving public and partner understanding
Clarification of expectations by policy makers and funders
Changes to system, structure, and service delivery
Other Qualitative and Operational Implications

8. We don’t know what public health is supposed to do
We don’t know what public health is supposed to do. And we don’t know if you’re doing it.
The Joint Commission

9. Accreditation: Internal or External?
Having partner and public involvement in preparation and review
Sharing the results
Creating buy-in and building expectations
Keeping it understandable
Create buy-in & build expectations

10. “I don’t know how he lost the election; everybody I talked to voted for him.”
Patrick Libbey about the outcome of the 1972 Nixon-McGovern presidential race

11. Policy Makers and Funders
Over 50% of local public health costs are funded by local and state government (exclusive of federal pass-through)
State legislatures and local government elected officials establish public health policy, priorities and operating frameworks.
Do we know what they want public health departments to be able to do?
This is an opportunity to shape expectations.

12. Poll Question
In moving forward with accreditation, you envision involving your policy makers.
A. Strongly agree
B. Agree
C. Disagree
D. Strongly disagree
Click on the down arrow if you can’t see the response choices.

13. “Insanity: doing the same thing over and over again and expecting different results.”
Albert Einstein

14. Regionalization
Shared capacities and resources among health departments
Cross jurisdiction services or issue focus, e.g., preparedness
Consolidation of jurisdictions
Changes in local / state roles, relationships, and services

15. “I won't belong to any organization that would have me as a member.”
Groucho Marx