La Crosse, WI
I started the fellowship program a little over a year and
a half ago at the La Crosse
County Health Department (LCHD). As
a student of health policy and administration in graduate school I was eager to
learn the inner-workings of a local health department as I hope to be a Health Officer/Director
one day. Before I started work at my
placement site, I knew much of my work would be dedicated towards helping the LCHD become a national (voluntary) Public
Health Accreditation Board (PHAB) accredited health department. This knowledge was exciting as I knew the
accreditation process would allow me to see the daily operations of a health
department. Before I became immersed in
the journey I thought I knew the complexity of this task, but I had dramatically
underestimated the effort and resources needed to become an accredited health
department. With that, I do believe all
of the work, effort, planning, and collaboration was and continues to be worth
it.
What is the purpose of PHAB accreditation you may ask?
The purpose is to, “advance quality and performance within public health
departments. Accreditation standards
define the expectations for all public health departments that seek to become
accredited. National public health
department accreditation has been developed because of the desire to improve
service, value, and accountability to stakeholders”.[i]
We, the LCHD, have met all of our established deadlines
up to this point. After submitting the accreditation application in March 2013, the accreditation coordinator and I traveled to PHAB headquarters in
Virginia to attend accreditation coordinator training. Upon our return to the LCHD we established
domain teams and a system for uploading documentation. Currently we are finalizing documentation
collection and uploading documents into e-PHAB (the electronic database used by
health departments, PHAB staff, and site visitors throughout the final stages
of the process). We hope to have all
documentation uploaded into e-PHAB by March 2014 and a site visit during the
summer of 2014.
The process of becoming accredited is often described as
an enormous
quality improvement project. The process
initiates with a self-assessment to determine the accreditation readiness of a
given health department. In 2010, the
LCHD completed their self-assessment and determined the gaps in their
accreditation readiness to be Domain 7: promote strategies to improve access to
healthcare services; Domain 8:
maintain a competent public health workforce; Domain 9: evaluate and continuously improve processes, programs,
and interventions; and Domain 10:
contribute to and apply the evidence-base of public health. The past three and a half years have been
dedicated to addressing these gaps, building capacity on existing strengths,
and developing sustainable systems to ensure mechanisms are in place to
continuously meet standards and measures established by PHAB for years to
come.
The majority of my time at the LCHD has been spent
addressing the gaps identified in the accreditation readiness
self-assessment. I have helped the LCHD
develop and implement a performance management system. We are embarking on our second year of
implementing this system and are continually striving to improve the method in
place for selecting standards, establishing measures, and reporting on the
progress of the standards. We have
established a quality improvement (QI) committee charged with facilitating and
implementing the quality improvement plan and P & P (policy &
procedure). The QI process has resulted
in over eight QI project proposals being submitted to the QI Committee and three of those have been initiated throughout
the department. We revised and updated
the department’s strategic plan to ensure we are compliant with PHAB’s
standards and measures (The NationalAssociation of County and City Health Officials (NACCHO) developed an
invaluable guide to help us maneuver this process). We also created a workforce development team
consisting of division managers to create, implement, and revise a new department-wide
workforce development plan.
The accreditation process allowed the LCHD to identify
areas of improvement from an established and vetted set of standards
and measures. Without these
universal principles established by PHAB we would not know what systems,
operations, or processes need improving or what goal(s) we should be working
towards. Throughout the entire journey many lessons were learned
by the health department and me. Not
only has the La Crosse County Health Department grown in its capacity to
provide effective, efficient, culturally competent, and equitable services but
the professional journey and skills I have developed and fostered along the way
are invaluable and will guide me throughout my career.
Lessons learned by the La Crosse County Health Department
in their accreditation journey:
· It is necessary to engage staff at all levels whether
it be by developing documentation, creating new systems, collecting documents,
or ensuring they know their role in implementing the various department-wide
plans.
· Following a work-plan/timeline for key milestones
throughout the process is helpful; allowing
for flexibility with deadlines is also important.
· Engage stakeholders, partners, and board members
at the onset of the process as it is critical in obtaining the necessary
resources (staff, fees, etc.).
Lessons learned by me in the accreditation journey:
· The process of becoming accredited ensures
health departments are delivering public health services that meet the needs of
community members, targeting the use of limited resources, and are accountable
to the residents served.
·The work involved in operating, directing, and
overseeing a health department is vast and intricate.
·Developing systems from scratch is complicated,
always evolving, and fun.
· Facilitating the creation of a strategic plan is
the easy part; implementing and evaluating it is more difficult.
In my final months at the La Crosse County Health
Department I am excited to complete the accreditation journey and hopefully
participate in a site-visit by PHAB site visitors. I hope I can update you with the great news
that the La Crosse County Health Department earned accreditation by the end of
2014.
P.S. As of this
poisting, 22 health departments have been accredited nation-wide with 4 of them
being from Wisconsin. GO WISCONSIN!!!!
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