Small Health Department Accreditation Success Strategies

Posted on February 12, 2025 by Peg Allen

This entry is part 3 of 7 in the series Mar 2025

Four small health departments provided their keys to accreditation success and advice for others through interviews between January and March 2024. Although proportionately fewer small health departments seek national accreditation or Pathways Recognition through the Public Health Accreditation Board (PHAB), those that do find that the benefits outweigh the challenges. The 22 people interviewed included leadership team members from two Tribal health departments, a rural multi-county health department, and a single-county health department. The full open access paper, “Reaccreditation and Pathways Recognition Experiences of Small and Tribal Health Departments,” is available to all in the March 2025 edition of JPHMP.

Benefits

Seeking national accreditation or Pathways Recognition provided a roadmap and accountability for excellence in public health practice. Participants said the internal review process helped them identify strengths and improvement areas to provide the best possible approaches to serve their communities. Integrating what is needed to meet accreditation requirements into the year-round work helped them better meet community needs.

Being accredited by PHAB also increased the credibility and public perception of the health department in the community. It demonstrated the health department was “living up to standards and science.” National accreditation “confirms some of our values that are tied to our name” and shows “we’re not just talk.” The PHAB accreditation process was an opportunity to tell the story of the health department’s programs, services, and successes.

Success Strategies

Developed a team approach
Trained new staff in public health overall
Explained why and what of accreditation
Provided PHAB orientation as part of onboarding
Mentored staff one-on-one
Planned ahead
Drew on outside assistance from peer health departments
Dedicated time to work on accreditation
Developed better documentation systems for year-round work

Participants considered a team approach essential since small health department employees have multiple roles and responsibilities. Having team leaders for different plans and documentation sections made the work feasible and best used staff expertise. One health department also contracted with an external accreditation consultant to help prepare staff and work with team leaders after extensive staff turnover during the COVID-19 pandemic. Participants noted other health departments willingly provided advice, shared documents, and were happy to discuss how they met particular measures.

“I think what works really well for us is that we’ve formed a core group of individuals that head up the plans and always come together. We meet very routinely monthly as a team and then quarterly in our different plans. I think sharing that workload, not just having one person in charge, but having a core team of people, I think that’s worked really well for us.”

Additional Tribal Health Department Success Strategies

Collaboration with other Tribal health departments was the most helpful

“Those [meetings with Tribal health departments] have been instrumental

because we are all facing the same kind of challenges being tribal nations

and just bouncing those creative ideas off each other…so that has been

a huge support.”

Team brainstorming to fit unique structures and situations with expectations

“Question after question, we had to really think in a different way to answer it.”

Narratives to explain Tribal health department structures

“Sometimes we had to word things because we’re so differently organized than

a local health department. We would have to word things, really explain it.

This is why we meet the measure because of our organization structure.”

Documentation to support unique solutions

“…our examples are going to be different. Our governance structures are going to be different.”

Consultation with PHAB

Accreditation Advice for Other Health Departments

Much of the advice stemmed from the health departments’ strategies for success:

Use the process as a roadmap for excellence in serving the community and a great way to improve programs and services for their communities
Develop a team approach. This distributes the workload and matches staff expertise to the topics.
Seek support from others. Colleagues in similar health departments readily shared documents, advice, resources, and time.
Establish an organizational system or process.
Keep the needed skills in mind when identifying a staff accreditation coordinator: organizational skills, people skills, writing and oral communication abilities, and Tribal knowledge.

In addition, participants recommended becoming familiar with PHAB Standards & Measures beforehand. For health departments considering initial accreditation or Pathways Recognition, knowing the PHAB Standards & Measures helps people understand the expectations and see if they have the needed foundation.

Don’t let the “perfect” get in the way of the “good.” While participants said it was helpful to plan ahead and figure out their capacity and approaches, they also noted that if health departments waited for the “perfect” time to pursue initial accreditation or Pathways Recognition, it would never happen. They said both the process and outcomes of PHAB accreditation were incredibly worthwhile and that PHAB is looking for improvement not perfection.

Read the Article

Acknowledgments

We applaud the health departments for their outstanding work! And we thank them for talking with us. Our full paper coauthors are Matthew Fifolt and Paul C. Erwin from the University of Alabama at Birmingham School of Public Health, Andrew N. Crenshaw and Ross C. Brownson from the Prevention Research Center at Washington University in St. Louis (WashU), and Britt Lang, Amy Belflower Thomas, and Paul Kuehnert from PHAB. We also thank Mary Adams and Renee Parks at WashU. This project was funded by PHAB and through funding from the Centers for Disease Control and Prevention (CDC) under Grant Number NU90TO0000002 and award number U48DP006395. To learn more, read our open access article in the Journal of Public Health Management and Practice.

About the Author

Peg Allen: Peg Allen, PhD, MPH, is with the Prevention Research Center at Washington University in St. Louis. She conducts applied research with state and local health departments in support of evidence-based public health capacity building and practice, with a focus on organizational supports and collaboration.