PHAB Performance Pathways: A New Way Forward for Health Department Recognition

PHAB Performance Pathways

The Public Health Accreditation Board (PHAB)’s vision is a high-performing governmental public health system that supports all people living their healthiest lives. To help foster performance improvement among all health departments PHAB is developing and launching a new recognition program – the PHAB Performance Pathways Recognition Program (Pathways).

Context for Pathways

By the end of calendar year 2019, only about 3% of health departments serving jurisdictions of 50,000 or less nationwide had applied accreditation. The most frequently reported reasons for this low engagement were the time and effort required, cost of accreditation fees, and the perception that the standards exceeded department capacity. In addition to what the data has shown, PHAB has collected feedback from the field for years about the desire for a product or program that could better meet small and under-resourced health departments closer to where they are in their performance improvement journey without requiring them to engage in the full accreditation process.

While this is not the first time PHAB has explored the option of a program like Pathways, this is the first time PHAB has gotten this far in the development, feedback gathering, and exploration steps of such a program. One reason for this progress was the formation of a Joint Taskforce between PHAB and NACCHO’s Boards of Directors in 2018. This group met several times to review data and discuss ongoing challenges and needs associated with performance improvement for governmental public health departments. The conclusion of this work indicated both a need and ongoing desire for a product like Pathways in the field.

During the early months of the COVID-19 pandemic, PHAB staff spent time reviewing available information, data, and input from the Joint Taskforce to develop proposals for what the Pathways product could look like. These original proposals have evolved over the past year and Pathways is now being considered one piece of a larger package of PHAB process and program changes planned to coincide with PHAB’s upcoming release of the Version 2022 Accreditation Standards and Measures.

Purpose of Pathways

The purpose of Pathways is threefold. First, the program is intended to support performance improvement efforts, strengthen infrastructure, and facilitate public health system transformation, including state-based improvement efforts. Second, Pathways should serve as a performance improvement milestone for local, Tribal, and territorial health departments not yet ready to apply for PHAB accreditation. And, lastly, Pathways will be a method for facilitating accreditation readiness for eligible health departments intending to use the Pathways as a step toward a future accreditation application.

Eligibility for Pathways

Eligibility for Pathways recognition will mirror the current PHAB Accreditation eligibility for local, Tribal, and territorial public health departments as described in the PHAB Guide to National Public Health Department Initial Accreditation. While Pathways is intended to provide an alternative milestone or route to achieving PHAB accreditation for small, rural and/or under-resourced health departments, PHAB will not preclude pursuit of Pathways recognition by other eligible health departments that view Pathways as a feasible and appropriate option for their performance improvement journey.

What’s Assessed?

By engaging in Pathways, eligible health departments will be assessed on their demonstration of a subset of measures from the forthcoming Version 2022 Accreditation Standards & Measures. The intent in launching a program like this now is to provide a different option for encouraging health departments at all levels on their quality and performance improvement journeys. Pathways may be ideal for health departments that want to enhance performance improvement and other capabilities but are not yet ready to apply for accreditation for reasons unique to their department.

Once recognized, health departments will have options for what may or may not come as next steps. Pathways will be one mechanism for recognizing performance improvement efforts among eligible health departments, but completion of Pathways will not be a prerequisite for becoming PHAB accredited. Eligible health departments may pursue PHAB accreditation without going through Pathways and health departments may choose to pursue Pathways recognition without the intention of becoming PHAB accredited in the future. However, it is important to note that Pathways recognition will not be the same as PHAB’s accreditation designation. 

Anticipated Benefits of Pathways Recognition

Whether a health department engages in Pathways with recognition as their goal or with recognition as the first step toward becoming PHAB accredited, the program should contribute to improvements in health department partnerships, performance, and understanding of health equity. These principles are woven throughout PHAB accreditation requirements, and therefore will also be reflected heavily in program requirements and in the training and technical assistance offered for Pathways.

PHAB Performance Pathways

To Learn More and Help Shape Pathways

Two separate models of Pathways are under consideration and being shared with stakeholders for feedback gathering purposes. PHAB is taking this step to make sure the final version of Pathways meets the performance improvement needs of eligible health departments, while also remaining feasible and achievable.

Therefore, PHAB is interested in hearing from health department stakeholders about what program design elements will provide the most value to health departments that are not yet ready to apply for accreditation but may want to engage in a recognition program like Pathways.

Two short videos, the first providing an overview of the background and context for the program, and the second offering an introduction to two separate proposed models for the program’s structure and content are available on PHAB’s website. Feedback session participants are asked to view these videos in advance of the session to allow time to learn about, reflect on, and bring any remaining questions about the two program options to the webinar. 

During the webinar PHAB will answer questions, provide additional information, and facilitate a discussion to gather initial feedback about the proposed structure and content for the Performance Pathways Recognition Program from public health practitioners.  

The information captured during the webinar will help inform final development of the program before its anticipated launch in mid-2022.  

Register now for one of the three scheduled virtual feedback sessions!   

  • Tuesday August 17 | 12:30 – 1:30 PM ET Register>
  • Friday August 20 | 11:30 AM – 12:30 PM ET Register>
  • Tuesday August 24 | 12:30 – 1:30 PM ET Register>

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Author Profile

Chelsey Saari
Chelsey Saari is a Senior Accreditation Specialist at the Public Health Accreditation Board (PHAB). She is responsible for providing technical assistance to site visit teams and health departments engaged in and/or interested in pursuing public health department accreditation. Prior to joining PHAB in 2018, Chelsey was a Public Health Program Supervisor, Accreditation Coordinator, and Academic Health Department Liaison at the Kent County Health Department in Grand Rapids, Michigan. She earned a Doctorate in Public Health Leadership (DrPH) from the University of Illinois at Chicago, a Master’s in Public Health from Des Moines University, and an undergraduate degree in Psychology from Saginaw Valley State University.

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