Public health department accreditation is a key topic on the Association of State and Territorial Health Officials (ASTHO) annual meeting agenda this year. John Wiesman, DrPH, MPH, Secretary of Health for the state of Washington, will participate in a discussion on the issue during the meeting. He speaks with authority, as Washington, along with Oklahoma, is one of only two states recently accredited by the Public Health Accreditation Board.

>>Follow our ASTHO Annual Meeting coverage throughout the week.

In advance of the meeting, NewPublicHealth spoke with Wiesman about the benefits of accreditation to public health departments and the communities they serve.

NewPublicHealth: What are benefits of public health accreditation to share with directors of state health departments who have not yet applied for the credential?

John Wiesman: Honestly, I think accreditation gives you bragging rights in the sense that you’re saying “our organization values quality and outcomes.” For example, you can add that to a grant for a question that asks about quality processes. That states your commitment and that a national organization found that to be true. And it gives you bragging rights with fellow cabinet officers and the governor. To be able to say you are an accredited health department means something and you can value that.

Another critical thing is that for the local public health agencies in your state, the process of going through accreditation and developing a state health improvement plan gives you an opportunity to talk about how you want to improve health in your state and get everyone on the same page. So it’s a way to build relationships with health departments in the state and showcase priorities you want to work on together. In that sense, the process of applying for accreditation goes a very long way.

NPH: What benefit has the state health department accreditation brought to local health departments in your state who are considering applying for the credential?

Wiesman: We have learning collaborative in the state as well as some grants that allow us to work with local health departments on quality improvement to become accreditation-ready. And by having gone through the accreditation process ourselves as a state health department, we bring added credibility to the table and can answer many of their questions, and our firsthand experience gives things more meaning. I think it’s absolutely important for state health departments to become accredited if you want others to do that as well.

Last week the Public Health Accreditation Board (PHAB) awarded five-year national accreditation status to five public health departments, bringing the number of health departments now accredited to 19 since the credential was launched two years ago. Hundreds more health departments are currently preparing to apply for accreditation, which includes a peer-reviewed assessment process to ensure it meets or exceeds a set of public health quality standards and measures. Among the newly accredited is the Chicago Department of Public Health.

"This is an important achievement and recognition that highlights the city of Chicago’s ongoing commitment to health and wellness on the part of all of our residents,” said Chicago Mayor Rahm Emanuel in a statement issued by PHAB.  "We are focused on policies that will help all Chicagoans and their families enjoy the highest quality of life, [and w]e will continue to strive to make Chicago one of the healthiest cities in the world."

NewPublicHealth recently spoke with Bechara Choucair, MD, MS, Commissioner of the Chicago Department of Public Health, about the value of accreditation for improving the health of the community—and about how this effort supports Healthy Chicago, the city’s public health agenda.

>>Read more about Healthy Chicago in a previous NewPublicHealth Q&A with Choucair.

NewPublicHealth: You’re one of the first public health departments to be accredited. How did that happen so quickly?

Bechara Choucair: When we released Healthy Chicago in 2011, one of the strategies we identified was to obtain accreditation. We wanted to be the first big city to earn the credential. It took us 18 months and we are excited that we are the first big city to be accredited and the first in Illinois. And one of the added bonuses of accreditation is a sense of pride. It says a lot to our staff, residents and our mayor.

NPH: A community health assessment is required as part of the accreditation application. What did Chicago’s community health assessments entail?

Public Health Accreditation Board Awards National Accreditation to Five High-Performing Health Departments
The Public Health Accreditation Board (PHAB) this week awarded five-year national accreditation status to five more public health departments. The decisions bring the number of public health agencies now recognized by PHAB as high-performing health departments to 19. PHAB is the independent organization that administers the national public health accreditation program, which aims to improve and protect the health of the public by advancing the quality and performance of the nation’s Tribal, state, local and territorial health departments.

Accreditation status was awarded Aug. 20 to:

• Central Michigan District Health Department, Mount Pleasant, Mich.
• Chicago Department of Public Health, Chicago, Ill.
• El Paso County Public Health, Colorado Springs, Colo.
• Kansas City Missouri Health Department, Kansas City, Mo.
• Tulsa Health Department, Tulsa, Okla.

Read more on accreditation.

Needlestick, Sharps-related Injuries Cost Health Care Industry $1B Every Year
Improved safety-engineered devices, combined with better education and techniques, could save the health care industry more than $1 billion in preventable costs every year, according to a Safe in Common review of U.S. healthcare industry statistics. With approximately 1,000 skin puncture injuries per day in U.S. hospitals, needlestick and sharps-related injuries affect more than half a million health care personnel every year—both physically and emotionally. "The desperate need for attention to the risk of needlestick injuries and their dangerous implications for both patients and personnel are startling when you look directly at the impact to healthcare costs," said Safe in Common chairperson Mary Foley, PhD, RN. "Learning how to permanently prevent these types of injuries—with more education and the introduction of advanced safety devices—will ultimately reduce a significant cost burden and, most importantly, the pain and emotional trauma that the needlestick victims and their families are enduring." Read more on prevention.

Study: Volunteering Linked to Greater Happiness, Longer Lives
Volunteering is not only linked to greater happiness and improved mental health, but could also help people live longer, according to a new study in the journal BMC Public Health. The analysis of 40 published studies found that volunteers had a 20 percent lower risk of death, as well as lower levels depression and increased satisfaction with their lives. "It is still unclear whether biological and cultural factors and social resources that are often associated with better health and survival are also associated with a willingness to volunteer in the first place,” said leader Suzanne Richards, PhD, of the University of Exeter Medical School in England. "The challenge now is to encourage people from more diverse backgrounds to take up volunteering, and then to measure whether improvements arise for them," she explained. People often cite a desire to give back to their community as a reason for volunteering; gaining work experience and meeting new people are also popular reasons. Approximately 27 percent of U.S. adults and 23 percent of European adults actively volunteer. Read more on aging.

The Three Rivers district health department in Owenton, Kentucky was one of three health departments in that state and eleven in the country to receive national public health accreditation from the Public Health Accreditation Board. NewPublicHealth has been speaking with directors from accredited health departments about the value of the credential; how it can change their operations and outcomes; and what they’d like to share with departments considering applying for the credential. We recently spoke with Georgia Heise, DrPH, Three Rivers’ health director and a vice president of the National Association of County and City Health Officials, about the benefits she sees from both the application process and the new status accreditation confers.

NewPublicHealth: What has the reaction been from community members and policymakers to the news that you’re now accredited?

Georgia Heise: It has been wonderful. Our health department has talked about accreditation from the day we started working on it, so people have been waiting to see what the decision was going to be. We’ve gotten flowers, cards, letters, and emails and there have been celebrations hosted by us and by others. And we did get some attention from policymakers, which was wonderful.

We have, for the past three years now, introduced into the Kentucky legislative process a bill that would require health departments in Kentucky to be accredited by 2020. We haven’t got that bill approved yet, but we continue to work on it and we think we will eventually. But that effort means that the legislators are familiar with the concept of accreditation. While maybe they haven’t paid that much attention to it before, they’re paying more attention now because Kentucky had three health departments receive accreditation in the first round and that’s gotten some attention statewide.

NPH: In terms of the process, what has been harder than you thought and what was easier

In February, the Robert Wood Johnson Foundation honored six communities with the inaugural RWJF Roadmaps to Health Prize, which recognizes outstanding community partnerships that are helping people live healthier lives.

Recently, NewPublicHealth spoke with Claude-Alix Jacob, chief public health officer at the Cambridge, Mass., department of health, one of the six prize-winning communities to be recognized by the Foundation. Mr. Jacob spoke to NPH about how collaborating around and winning the Prize has impacted the community, including resilience in the face of tragedy.

>>Apply to become a winner of the 2013-2014 RWJF Roadmaps to Health Prize. This year's application deadline is May 23, 2013.

NewPublicHealth: What did winning the RWJF Roadmaps to Health Prize mean to your community?

Claude Jacob: It has been great and exiting news for our community. Over the course of the last few months and through National Public Health Week last month we’ve had a chance to celebrate. We’ve been able to share our public health plans and community partnerships, but also under the aegis of the Robert Wood Johnson Foundation, we now have more credibility for all of our efforts. The Foundation is associated with promoting important health improvement efforts nationwide and just to be linked to the Foundation will open doors, especially now that we’re one of the six inaugural prize winning communities.

During National Public Health Week we invited our community stakeholders to celebrate to thank them for their hard work in helping us to prepare for the site visit that was required of prize finalists. So it’s been a phenomenal few weeks.

NPH: How has winning the prize impacted the health improvements of your community?

NewPublicHealth is speaking with directors of several health departments who recently were accredited by the Public Health Accreditation Board. Eleven health departments received the credential so far. We recently spoke with Mary Selecky, director of the Washington State health department, one of the first two state health agencies receive national accreditation status. Ms. Selecky recently announced her plans to retire from the health department.

>>Also read our interview with Terry Cline, health commissioner of Oklahoma, which also was recently accredited by PHAB.

NPH: How do you think accreditation will improve delivery of public health services and care in Washington State? Now that the health department is accredited, do you feel as though you are leaving the department in even better shape than it was?

Mary Selecky: Accreditation is really a quality improvement tool, and the standards that have been set by the Public Health Accreditation Board force you to examine whether you have the right processes in place for continuous, sustained quality improvement. And if you have found that you are not quite up to par in an area, then the processes help you ask what you will do to improve your performance in that area? The process helps you increase your performance, your effectiveness, and your accountability.

Public health touches people every single day—everybody in the state, from the moment they get up until they go to bed at night and even while they’re sleeping. This credential shows us that we have effective programs and measures in place to meet the needs of our communities. Drinking water systems are a good example. We regulate 16,000 drinking water systems, and I have a lot of drinking water engineers who are out in communities checking on water systems. I have to know that they’ve got a common set of operating procedures to assure the public that we’re looking out for their interests and when they turn on their tap from a municipal water system, that the water’s safe to drink. You can only do that when you have some procedures in place and that goes for the engineers, for laboratories or programs to make sure they are operating well in the community. Accreditation touches every part of the department.

NPH: How will you be promoting and explaining accreditation to policymakers?  

During opening remarks at this year’s Keeneland Conference, hosted by the National Coordinating Center for Public Health Systems and Services Research (PHSSR) based at the University of Kentucky in Lexington, Professor Douglas Scutchfield, director of the Center, proudly announced that three of the first health departments to be accredited by the Public Health Accreditation Board (PHAB) earlier this year were in Kentucky. Accreditation had its own track during the conference scientific sessions, including a presentation from Jessica Kronstadt, MPP, PHAB’s director of research and evaluation.

NewPublicHealth caught up with Kronstadt to talk about her presentation on some very early findings from an internal evaluation of the accreditation process.

>>Read more on national public health department accreditation.

NewPublicHealth: What information is PHAB seeking to gain from an evaluation of the accreditation process?

Jessica Kronstadt: Just as we’re asking health departments to engage in quality improvement, PHAB is very much committed to engaging in quality improvement of the accreditation program. So these evaluation efforts will really help us understand what is working well in our accreditation program, and what the experience was like from the perspective of the health departments and the site visitors. This evaluation will allow us to continue to improve the accreditation process.

Yesterday, New York State Health Commissioner Nirav R. Shah, MD, MPH, released the 2013-17 Prevention Agenda: New York State’s Health Improvement Plan—a statewide, five-year plan to improve the health and quality of life for everyone who lives in New York State. The plan is a blueprint for local community action to improve health and address health disparities.

Dr. Shah was joined by New York City Health Commissioner Thomas Farley, MD, MPH, and representatives from leading health care and community organizations at the Charles B. Wang Community Health Center in Manhattan. Among the other speakers were Jo Ivey Boufford, MD, president of The New York Academy of Medicine, and Daniel Sisto, president of the Healthcare Association of New York State.

 >>Read a related Q&A with Commissioner Nirav Shah.

“We’ve all heard the adage—an ounce of prevention is worth a pound of cure,” said Commissioner Shah. “We need to fundamentally change the way we think about achieving better health in our society.”

That fundamental shift toward prevention, said Dr. Shah, requires setting clear goals, promoting active collaborations, and identifying policies and strategies that create opportunities for everyone to live a healthy life.

The Prevention Agenda identifies five priority areas:

• Prevent chronic disease
• Promote healthy and safe environments
• Promote healthy women, infants and children
• Promote mental health and prevent substance abuse
• Prevent HIV, STDs, vaccine-preventable diseases, and healthcare-associated infections

A health improvement plan like the one released by the New York Department of Health is a critical prerequisite for public health department accreditation. Recently, the Public Health Accreditation Board awarded five-year accreditation to 11 public health departments. Those 11 are the first of hundreds currently preparing to become accredited, including New York state.

"Completing the accreditation application, which includes our Prevention Agenda 2013-17, provides the Department of Health a valuable opportunity to engage partners and community stakeholders in our ongoing efforts to improve public health, evaluate the effectiveness of our services and showcase our successes," Commissioner Shah said.

State legislatures recently got underway across the country and many will be considering some critical public health law measures, according to a recent blog post from the Network for Public Health Law.

Critical issues include:

• A smoking ban in Kentucky which could stall in committee
• A bill in Kentucky which could restrict the work of local boards of health.
• A law in Ohio that would require health departments to enter into agreements for shared services and to become accredited.  

>>Bonus Links:

• Read the Network blog post.
• Use the state legislative tracking page from the Association of State and Territorial Health Officials to follow state public health agendas for 2013.

Today the Public Health Accreditation Board (PHAB) granted 5-year accreditation to 11 public health departments. The national program is jointly supported by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention and aims to improve and protect the health of the public by advancing the quality and performance of the nation’s state, tribal, local and territorial public health departments.

The accreditation program sets standards for the nation’s more than 3,000 public health agencies to improve the quality of their services and performance. Since the program’s launch in September 2011, more than 125 health departments have applied to PHAB for accreditation, and hundreds of public health practitioners from across the nation have been trained to serve as volunteer peer site visitors for the program.

NewPublicHealth spoke with Terry Cline, PhD, health commissioner of Oklahoma, about how his department engaged in the accreditation process and what it means for public health in the state.

NPH: Explain the significance of public health accreditation.

Cline: This is that external validation that tells [the public and policymakers] that this isn’t just what we think of ourselves as an organization. This is accreditation from an organization that was developed through a consensus project that developed the standards that are critical to the advancement of public health across our country. Policymakers don’t have the time, and the public typically isn’t able, to evaluate the performance capabilities for health departments, so they rely on other reputable organizations to do that type of assessment. And now the Public Health Accreditation Board is providing that external validation. It’s a peer process, just as we use for peer reviewed journals. Who’s going to be more critical than the actual experts in the field?