New Case Studies Detail the Work of the 21st Century Learning Community
by Nicole Pettenati, MSLS
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.
The Public Health National Center for Innovations (PHNCI), a division of the Public Health Accreditation Board, was established to identify, implement, and spread innovations in public health practice to help meet the health challenges of the 21st century in communities nationwide. In 2015, the Robert Wood Johnson Foundation awarded funding to three states (Ohio, Oregon, and Washington) to test and implement transformation of their public health systems through implementation of the foundational public health services (FPHS) framework.
The FPHS framework defines a “minimum package of services” that must be available in health departments everywhere for the health system to work anywhere, and includes foundational capabilities, foundational areas, and programs and activities specific to a community’s public health needs.
PHNCI convened the three states to form the 21st Century (21C) Learning Community, and helped to advance new phases of their public health systems transformation work. Building upon several years of efforts, each state utilized the framework to undertake the task of defining elements of the model based on their public health systems, estimating the cost of providing foundational services, and determining the level of FPHS being provided. In Oregon and Washington, these cost estimations led to legislative requests to fund the gap needed to bring all health departments to the level of providing FPHS statewide, and legislators in all the states allocated funding to further FPHS work and in the case of Ohio, to support accreditation readiness activities and technical assistance. The 21C states also continue to investigate different service delivery models to improve efficiency, reduce costs, and capitalize on the strengths already present in the public health system.
Throughout their work, the states undertook communications campaigns to build awareness and understanding of public health transformation, among the public, policymakers and other public health system partners. A major theme that arose from the 21C work is the importance of language and messaging: terminology means different things to different people, and may carry unintended connotations, so it is important to make sure that everyone involved in the conversations around public health systems change are truly on the same page. Furthermore, clarity in communication matters, especially when discussing different initiatives in public health (eg, FPHS, 10 Essential Public Health Services, accreditation, etc.), and when engaging different audiences like legislators and the public.
The 21C states’ work to define FPHS for their individual states and tailored implementation based on their specific needs and contexts are detailed in newly released case studies. These resources provide an overview of project objectives, results of transforming public health systems through FPHS implementation, challenges encountered, lessons learned, next steps, and implications on national work related to FPHS are now available.
Nicole Pettenati, MSLS, is a Research Analyst at the Public Health Accreditation Board, which administers the national, voluntary accreditation program for state, Tribal, local, and territorial health departments. In that role, she supports efforts to build the evidence base around accreditation, analyzing administrative data, locating and organizing literature and resources related to accreditation, and supporting other research efforts. She also provides support to the Public Health National Center for Innovations (PHNCI). She was previously a National Library of Medicine Associate Fellow, a medical library leadership program at the National Library of Medicine, and served the second year of that fellowship at The Mayo Clinic as a hospital librarian providing research support for staff. She received her Master of Library Science from The University of North Carolina – Chapel Hill.