Karen Hagos, MPH
Priti Irani, MSPH
New York State Department of Health
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National Public Health Improvement Initiative
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PHAB Accreditation Overview

Building Accreditation Readiness Infrastructure
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Development of Pre-Requisites and Prevention Agenda

Using a Quality Improvement Approach
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Tracking Progress & E-PHAB
“The initiative is intended to strengthen public health
infrastructure and systematically increase performance
management capacity so that public health goals are
effectively and efficiently met.” - CDC
The Performance Management Group (PMG) focuses on
building, institutionalizing, and implementing
performance management and improvement capacity
within the agency.
Acknowledgement: This presentation was supported by funds made available from the Centers for
Disease Control and Prevention, Office for State, Tribal, Local and Territorial Support, under CDCRFA-CD10-101101PPHF12
Disclaimer: The content, findings and conclusions of this presentation are those of the authors and do
not necessarily represent the official position of or endorsement by the Centers for Disease Control
and Prevention.
http://www.cdc.gov/stltpublichealth/nphii/about.html
Public Health Accreditation Board (PHAB)
 Improve service, value and accountability to
stakeholders
 Identify improvement opportunities,
develop leadership
 Gain recognition as high quality, high
performing agency
11 Health Departments Accredited in March
2013
Accreditation: Advancing PH Performance
https://www.youtube.com/watch?v=WgwSivfASM0
Accreditation Domains

Domain 1: Community
Health Assessment
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Domain 2: Investigate
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Domain 3: Inform and
Educate
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Domain 4: Engagement with
Community
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Domain 5: Public Health
Policies

Domain 6: Enforce Public
Health Laws

Domain 7: Access to Health
Care Services

Domain 8: Competent Public
Health Workforce

Domain 9: Performance
Management and Quality
Improvement

Domain 10: Evidence-Based
Public Health

Domain 11: Administrative
and Management Capacity

Domain 12: Engage Public
Health Governing Entity
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Pre-Application
◦ Online orientation
◦ Submit Statement of Intent
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Application
◦ Submit Pre-Requisites: Community Health Assessment,
Community Health Improvement Plan, Strategic Plan
◦ Submit form, fee
◦ Attend Training
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Document Selection and Submission
Site Visit
Accreditation Decision
Reports
Re-accreditation
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Prevent Chronic Diseases
Promote a Healthy and Safe Environment
Promote Healthy Women, Infants and Children
Promote Mental Health and Prevent Substance Abuse
Prevent HIV, STDs, Vaccine Preventable Diseases
and Healthcare Associated Infections
6
For each priority, action plans contain:
 Goals (at least one per priority)
 Measurable objectives including some on
disparities
◦ 3-5 measures per priority: at least one impact/outcome
measure and at least two process measures

Evidence based and promising practices sorted by
sector and by health impact pyramid.
http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/
January 11, 2013
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Community Health Assessment (CHA): Part of a strategic plan
that describes the health of the community by collecting,
analyzing and using data to educate and mobilize
communities, develop priorities, garner resources, and plan
actions to improve public health. Mandated for local health
departments as per New York State Public Health Law §6.
-Working Definition, New York State Department of Health
Assessment : the process of regularly and systematically
collecting, assembling, analyzing, and making available
information on the health needs of the community, including
statistics on health status, community health needs, and
epidemiologic and other studies of health problems.
Source: http://www.health.ny.gov/statistics/chac/glossary.htm#C
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Lessons learned from our processes – good and bad (?)
Time it took for completion, parties involved
1.
2.
3.
4.
5.
Priorities aligned with assessment findings
and clearly articulated
Specific, measurable goals/objectives
Evidence-based or best practice strategies
Explanation of the process in assessment,
priority-setting, and action plan, and the
roles of community partners
Measures to track process and outcomes
and reporting of lessons learned
Community Health Assessment
1.
Description of Community (i.e. Demographics, Health
issues)
2.
Identification of major health challenges
3.
Succinct summary of assets and resources
4.
Documentation of collaborative process and methods
Community Health Improvement Plan
1.
Identification of at least two community priorities. At
least one must address a disparity.
2,4,5 For each priority – goals, objectives, strategies and
practices, performance measures (process, outcome)
3. Community stakeholder roles and responsibilities
6. Process used to sustain engagement
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1.
2.
3.
4.
5.
6.
7.
Mission Statement
Definition of community served
Public Participation (i.e. participants, dates,
process)
Assessment and selection of at least two
community priorities. At least one must
address a disparity.
3-year plan of action
Dissemination of plan to the public
Process to sustain engagement
11
1.
2.
3.
4.
5.
6.
Purpose statement aligned with defined priorities
Specific, measurable goals/objectives
Tracking measures at implementation and
building on lessons learned
Use of best practice and/or evidence-based
strategies
Brief explanation of the collaborative process:
assessment, prioritization, criteria for selecting
priorities, strategies
Description of roles of community partners
12
State Prevention Agenda
http://www.health.ny.gov/prevention/prevention_agenda/2013-2017/index.htm
Community Health Assessment Improvement
Cath. Health Assc. Assessing/Addressing Community Health Needs
http://www.chausa.org/Pages/Our_Work/Community_Benefit/Assessing_and_Addr
essing_Community_Health_Needs/
NACCHO Community Health Assessment and Improvement Planning
http://www.naccho.org/topics/infrastructure/CHAIP/index.cfm
Data Resources
NYS DOH Community Health Indicator Reports
http://www.health.ny.gov/statistics/chac/indicators/
County Health Rankings
www.countyhealthrankings.org/
Evidence-Based /Promising Practices Resources
Guide to Community Preventive Services
http://www.thecommunityguide.org/index.html
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Community Health Assessment and Improvement Process
Community Health Assessment and Improvement Process
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Local health departments have been
submitting periodic reports on collaborative
community health assessment for years
Existing strong relationships with hospitals
and community partners
Access to county-level health status, behavior
risk data
Data interpretation
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Tracking and evaluation of interventions
Balancing process and outcome measures
Adapting evidence-based or best-practice
interventions to local context
Identify tangible roles for partners
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Project Management Tools
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Project Charter
Work Plan
Timeline
Team Membership
Team Structure per Domain
◦ Cross-Cutting Teams
◦ Over 100 internal staff involved in accreditation selfassessment
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Quality Improvement Tools
Brainstorming
“A method for a group to generate a large number of
ideas around an issue of interest.”
Nominal Group Technique
“A process that helps teams prioritize by consensus.”
Improved participation, efficiency, and sense of ownership
over the process.
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SharePoint and Shared Drives for Documentation Storage
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E-PHAB
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Planning within each phase is important
Use tools available to you to structure and
organize (Project charter, QI Tools,
SharePoint)
Involve others to create buy-in and support
Bialek, Ron et al. “The Public Health Quality Improvement
Handbook.” (2009): 162, 175.
National Public Health Improvement Initiative. (2010):
http://www.cdc.gov/stltpublichealth/nphii/about.html