by Jessica Kronstadt, MPP

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Focus on Accreditation and Innovation addresses current issues related to the Public Health Accreditation Board’s national public health department accreditation program, and the Public Health National Center for Innovations. This series highlights the experiences and perspectives of accredited health departments and explores topics related to the Standards and Measures, research and evaluation findings, and the latest innovations in public health practice.

Quality and performance improvement, identification of strengths and weaknesses, improved management practices, and greater internal accountability are among the benefits most frequently cited by health departments that have been accredited for one year by the Public Health Accreditation Board (PHAB). According to data collected by NORC at the University of Chicago as part of its evaluation of PHAB’s accreditation program, 90% or more of respondents reported those benefits. NORC recently published a report on three years of evaluation data, assessing health departments’ experience participating in the accreditation process as well as their achievement of outcomes.

In addition to conducting interviews and focus groups, NORC surveys health departments at three points in time: when they first register in PHAB’s electronic accreditation system, shortly after they are accredited, and one year later. By collecting data at different points in time, NORC is able to observe changes over time. For example, when looking at the health departments that responded to both the first and second survey, there is an increase in the percent of respondents who “strongly agree” that their health department uses strategies to monitor and evaluate effectiveness and quality–from 20% in the initial survey to 67% in the survey completed after the health department’s notification that it was accredited. (At that follow-up survey, nearly all the remaining respondents “agreed” with that statement.)

Below are additional findings from the evaluation:

• More than 70% of health departments surveyed one year after accreditation said it improved their relationships with community stakeholders and their boards of directors.
• 100% of those surveyed after they received their final accreditation decision agreed or strongly agreed that their health department had made the right decision to apply for accreditation. Few reported adverse unintended consequences.
• Approximately half of health departments surveyed one year post-accreditation said they believed it improved their competitiveness for funding. Interviewees indicated that participating in accreditation made them more prepared to respond to grant proposals or increased operational efficiencies.

The evaluation also provided valuable information to PHAB about the accreditation process. Just as health departments that apply for accreditation are expected to demonstrate how they use data about their performance to identify areas for improvement, PHAB has used the evaluation findings to pinpoint opportunities to strengthen the accreditation program, particularly when developing the revised accreditation guide.

While NORC will continue to collect evaluation data from health departments that have begun the application process or are accredited, additional research is needed to better understand the effects of accreditation. Interested researchers are encouraged to review this list of research questions and to read about data available from PHAB for research studies.

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Jessica Kronstadt, MPP, is the Director of Research and Evaluation at the Public Health Accreditation Board (PHAB), overseeing efforts to evaluate the accreditation program and to promote research to build the evidence base around accreditation. Previously, she has conducted research for NORC at the University of Chicago, the Public Health Foundation, the National Academy for State Health Policy, and the Urban Institute. She received her Master of Public Policy from Georgetown University. [Full bio].