Rurality, Quality Improvement Maturity, and Accreditation Readiness: A Comparison Study of Colorado, Kansas, and Nebraska Local Health Departments

Benefits and Impacts of Public Health Accreditation for Small Local Health Departments

OBJECTIVE

This study sought to identify accreditation benefits and impacts among local health departments (LHDs) stratifying by size of population served to determine differences between small, medium, and large LHDs.

BACKGROUND

The Public Health Accreditation Board operates the national accreditation program for public health departments, through which 306 LHDs have been accredited as of August 2022. Benefits of accreditation for LHDs are well documented, despite potential challenges and barriers to seeking accreditation. Research on the benefits of accreditation for small LHDs, specifically, is more limited.

METHODS

All health departments that completed the accreditation process between December 2013 and May 2022 were surveyed following receipt of the accreditation decision. The analytic sample included 266 LHDs (response rate of 93.7%). Data for LHDs were analyzed for specific variables related to experiences, challenges, and benefits, and stratified by size to compare small LHDs with medium and large LHDs. Bivariate analyses were conducted to identify statistical significance.

RESULTS

Generally, small LHDs reported similar outcomes of accreditation to medium and large LHDs. These included improvements in staff competencies, capacity to provide high-quality services, and relationships with partners. Small LHDs were significantly more likely than medium and large LHDs to report that accreditation increased their use of evidence-based practices. LHDs of all sizes reported an increase in quality improvement activities due to accreditation. Challenges for small LHDs included limited staff time or staff turnover and limited funding.

CONCLUSIONS

The public health accreditation program has offered numerous benefits to LHDs of all sizes, including small LHDs. These accreditation benefits may be particularly important for small LHDs because of their critical role in the public health system and the ongoing need to support performance improvement, strengthen infrastructure, and increase resilience.

Supporting Increased Local Health Department Accreditation: Qualitative Insights From Accredited Small Local Health Departments

Accredited health departments now cover 80% of the US population. A relatively modest proportion of these are small local health departments (LHDs), serving fewer than 50 000 people. Despite comprising more than half of all health departments, only 2% of small LHDs are accredited. This brief report is a qualitative inquiry into the enablers of accreditation for small LHDs. We interviewed health department and accreditation leaders from 9 accredited small local LHDs. Interviews were transcribed, verified, and coded by 2 coders. We found that dedicated funding, prework, clear expectations, and peer examples were strong enablers of accreditation for these groups. Additional resources specific to small LHDs may be necessary to expedite application processes and encourage greater uptake from this group.

Impact of Accreditation Certification on Improving Healthcare Quality and Patient Safety at Johns Hopkins Aramco Healthcare

Introduction

Accreditation gained worldwide attention as a means of increasing awareness of medical errors, improving healthcare quality, and ensuring a culture of safety. Johns Hopkins Aramco Healthcare has been accredited by Joint Commission International (JCI) since 2002. The aim of this study was to evaluate the effect of the accreditation process on healthcare quality performance by maintaining compliance with the requirements of JCI's international patient safety goals (IPSGs) over a 4-year period and how this was reflected by patient safety and satisfaction.

Methods

In Johns Hopkins Aramco Healthcare, the six JCI IPSGs are part of the as key performance indicators that reflect organizational performance in different services. For this study, data from January 2017 to the end of 2020 were analyzed apropos performance and correlation with patient experience.

Results

The IPSGs data analysis showed that general performance was maintained above the target values (> 90%-96%) in all IPSGs. This was significantly reflected in high patient satisfaction during this period, with Pearson correlation of 0.9 and p < 0.000.

Conclusions

Maintaining accreditation status over time enhances patients' confidence in an organization and its leadership as providers of safe, quality healthcare services. However, individual staff perception, commitment, accountability, and responsibility have an influence on performance, the organization's accreditation status, and patients' experiences.