Key Themes of NORC’s Evaluation of PHAB Accreditation

Q&A with Michael Meit, MA, MPH; Alexa Siegfried, MPH; and Megan Heffernan, MPH

NORC at the University of Chicago is a nonprofit social-science research organization that has been evaluating aspects of the Public Health Accreditation Board (PHAB) accreditation program for the past ten years. In the recent supplement to the Journal of Public Health Management and Practice on the impact of public health accreditation, NORC researchers wrote two research reports: “Quality Improvement and Performance Management Benefits of Public Health Accreditation: National Evaluation Findings” and “Benefits and Perceptions of Public Health Accreditation Among Health Departments Not Yet Applying.” In this Q&A, NORC researchers Michael Meit, MA, MPH; Alexa Siegfried, MPH; and Megan Heffernan, MPH highlight some key themes from the evaluation.

JPHMP Direct: What would you say is the most striking finding from the evaluation of accredited health departments?

Meit/Siegfried/Heffernan: The representatives from accredited health departments that have participated in our evaluation describe public health accreditation as “transformational” in their efforts in moving towards quality improvement and performance management, particularly in terms of advancing internal operations and processes. According to respondents, accreditation has enabled their health departments to become higher functioning and more efficient agencies. For some accredited health departments, this has reportedly led to internal efficiencies that include both time savings and cost savings, as well as improved service quality.

JPHMP Direct: How has the accreditation process affected health departments’ quality improvement and performance management activities and culture?

Meit/Siegfried/Heffernan: Nearly all survey respondents described implementing new QI activities as a result of accreditation and noted that accreditation has strengthened the culture of QI within their health department. Some agencies started with smaller QI projects and have built cross-organizational structures for QI as a result of accreditation. Others are implementing new QI strategies that span across program areas and divisions. One of our survey respondents, for example, explained that accreditation has completely changed the way their agency operates, describing that every department follows standard operation procedures, and all staff have been trained on QI and performance management.

JPHMP Direct: In the supplement you and your colleagues describe the results of a survey of health departments that have not applied for accreditation; what did you learn about those health departments?

Meit/Siegfried/Heffernan: We learned that non-applicant health departments are looking to the PHAB Standards and Measures to guide how they organize and implement their activities, particularly for community health assessments (CHAs), community health improvement plans (CHIPs), and strategic plans. Even among those health departments that said they do not plan to apply for accreditation, one-third still noted that they reference PHAB’s requirements when working on the CHA, CHIP, and strategic plan. Based on these findings, we believe that accreditation is creating an expected standard of practice among public health agencies, regardless of their intent to apply.

JPHMP Direct: NORC has had contracts to conduct research and evaluation work for PHAB starting nearly 10 years ago with vetting the beta test Standards and Measures. How have you seen PHAB’s use of evaluation findings evolve over time?

Meit/Siegfried/Heffernan: PHAB practices what it preaches. We have found it notable over the years that PHAB takes a genuine interest in assessing their processes in order to conduct their own performance improvement initiatives. Similarly, PHAB has demonstrated their interest in transparency and learning by sharing of evaluation findings and data with the field.

Read the full issue of our special supplement highlighting the Impact of Public Health Accreditation.

See also:

Michael Meit, MA, MPH

Michael Meit, MA, MPH, is a Senior Public Health Systems Researcher in NORC’s Public Health Research department and serves as Co-Director of the NORC Walsh Center for Rural Health Analysis. He has over twenty years of experience working closely with local, state, tribal, and territorial health departments on issues related to organizational capacity and structure. He leads projects in the areas of rural health, public health systems, and public health preparedness. He has directed projects related to public health accreditation for nearly ten years.


Alexa Siegfried, MPH

Alexa Siegfried, MPH, is a Research Scientist in NORC’s Public Health Research department with expertise in qualitative data collection. She designs and implements multi-faceted research studies and program evaluations on topics including public health systems and services, population health, rural health, and public health emergency preparedness and response. She conducts qualitative and quantitative data collection and analysis; she also synthesizes findings to develop recommendations. She has led projects related to public health accreditation for nearly ten years.


Megan Heffernan, MPH

Megan Heffernan, MPH, is a Principal Research Analyst in NORC’s Public Health Research department. She has expertise in qualitative and quantitative data collection and analysis and designs and implements multi-faceted research studies and program evaluations on health and health care topics including public health systems and services, rural health, and health disparities. For the past three years, she has led data collection and analysis activities for evaluations of the public health accreditation program.



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