Local Public Health Department Characteristics Associated With Likelihood to Participate in National Accreditation

Objectives. We examined factors associated with completing, initiating, or intending to pursue voluntary national accreditation among local health departments (LHDs).Methods. We examined National Association of County and City Health Officials 2010 and 2013 profile data in a pooled cross-sectional design with bivariate and multivariable regression analyses. We conducted individual multivariable models with interest in accreditation and likely to accredit as outcome variables, comparing changes between 2010 and 2013.Results. LHDs with formal quality improvement programs are significantly more likely to have initiated or completed the accreditation process (odds ratio [OR] = 7.99; confidence interval [CI] = 1.79, 35.60), to be likely to accredit (OR = 2.41; CI = 1.65, 3.50), or to report an interest in accreditation (OR = 2.32; CI = 1.67, 3.20). Interest was lower among LHDs in 2013 than in 2010 (OR = 0.56; CI = 0.41, 0.77); however, there was no difference regarding being likely to accredit. LHDs with a high number of full-time equivalent employees were more likely to indicate being likely to accredit or interest in accreditation.Conclusions. Quality improvement may facilitate the accreditation process or be a proxy measure for an unmeasurable LHD attribute that predicts accreditation.Efforts to encourage voluntary participation in local health department (LHD) accreditation are under way.1–5 These efforts are motived by the expectation that adhering to accreditation standards will strengthen LHD performance and, in turn, positively affect population health.6–9 Targeted strategies addressing specific LHD barriers to pursuing accreditation are needed for widespread accreditation to occur. An important first step is informing any targeted strategies by having a better understanding of factors that are associated with current LHD intention to apply for accreditation. In addition to facilitating stakeholders assisting LHDs to overcome barriers, understanding these differences addresses several key research questions posed by the Public Health Accreditation Board in its recently published research agenda.10To date, 2 studies have empirically examined the factors associated with intention to seek public health department accreditation. One focused on state health agencies and examined leadership attributes of state health officers who intend to pursue accreditation.11 It found that state health officers with a medical degree were more likely to indicate an intention to seek accreditation than were their counterparts.Shah et al.12 used data collected in the 2010 National Association of County and City Health Officials (NACCHO) Profile Survey to examine the relationship between LHD intention to seek accreditation and the 3 prerequisites that must be completed before submitting an accreditation application: (1) a community health assessment (CHA), (2) a community health improvement plan, and (3) a strategic plan. Shah et al. reported a negative association between recent completion of a CHA or community health improvement plan and the intention to seek accreditation. By contrast, findings also indicated that LHDs’ involvement in performance-related activities, use of quality improvement tools, having 1 or more local boards of health, and having an epidemiologist on staff increased LHD self-reported interest in pursuing future accreditation.12Although the study by Shah et al. was important to an early understanding of factors related to intention to seek accreditation, voluntary public health accreditation had not yet launched when the 2010 Profile Survey data were collected. Since then, the first health departments received accreditation in 2012, and numerous LHDs have either initiated the process or made decisions about whether they plan to do so. Additionally, new data were collected regarding LHD accreditation status and intentions to pursue accreditation that were released in the 2013 NACCHO profile data set, well after the summer 2011 accreditation program launch date.We examined the organizational factors associated with and longitudinal changes in LHDs’ accreditation and intention to seek accreditation. We analyzed secondary 2010 and 2013 data from the NACCHO profile surveys, which allowed us to examine factors that may relate to the intention to participate in accreditation. Our findings will be of particular interest to the Public Health Accreditation Board and other leaders in the accreditation movement as they develop strategies to assist LHDs in planning for accreditation and addressing barriers to the process.     

Public Health Performance

This review examines past, current, and future issues in developing and using public health performance data for improving the public health system. Issues are explored relating to public health performance data collection and analysis, and inferences made from those data, largely by examining public health performance data collected since the Year 2000. More research is needed to improve understanding of the context in which public health systems operate and how that context affects performance and its relationship to health outcomes. There are major areas of concern that must be addressed by the public health practice organizations, governmental public health entities, and the public health systems research communities, such as ensuring that data are collected on public health infrastructure, practice, and performance and that data from various sources are collected in a harmonious fashion. At issue also is the examination of the impact of new arrivals to the public health system, such as accreditation and credentialing of the public health workforce, on public health system performance.     

卫生行政部门的职业卫生法定职责

认真履行《中华人民共和国职业病防治法》赋予卫生行政部门的职责,保护劳动者健康及相关权益,是我国新时期职业卫生工作的核心。通过对卫生行政部门职业卫生法定职责的讨论,分析其特点、内容,突出强化对建设项目的审查、验收,真正落实各级卫生行政部门作为对职业病防治工作监督管理的执法主体作用。     

The Michigan Local Public Health Accreditation Program: many partners--one vision.

The Michigan Local Public Health Accreditation Program ensures the quality of local public health in Michigan by identifying and promoting the implementation of public health standards and evaluating and accrediting local departments' ability to meet them. The program is a collaborative effort between the Michigan Public Health Institute and the Michigan Departments of Agriculture, Community Health, and Environmental Quality. This article presents a case study. From the conceptual stage of designing a mode of collaboration to examining each step in the process, the goal is to provide a basic understanding of objectives of the accreditation program. The article concludes with the early results, providing a platform for future study.     

Accreditation and its implementation in graduate studies in Public Health

This article aims to contribute to a better understanding of the establishment and implementation of accreditation in graduate courses in public health and to encourage discussions to improve quality in this area. The term accreditation is defined, and two of its main thrusts are discussed: quality and competence. The basis for establishing and implementing an accreditation system is described, and some of the key characteristics of the Brazilian experience are presented.