Category Archives: Accreditation
This year’s APHA meeting is the first one since the launch of the Public Health Accreditation Board’s (PHAB) national, voluntary accreditation program for state, local and tribal health departments. At past APHA meetings, attendees have gotten previews on the accreditation standards and rollout plans. This year, it’s finally time to learn how health departments are starting to get organized and ready to apply for accreditation—and what PHAB has been hearing as the program gets underway. Several state health department representatives shared their accreditation plans and activities to date at a session here this morning.
Jack Wilson, from the New York State Department of Health, told attendees that his department is using a strategic planning tool traditionally used in the private sector to align its specific strategies (enforce public health laws, maintain a competent workforce, promote tools to improve health, etc.) to PHAB’s domains. The health department recognizes that it has many disparate programs and initiatives that would benefit from being aligned with larger strategic goals. Despite progress, though, Wilson said that the strategic planning process is time-intensive and can be derailed by unexpected events like this summer’s Hurricane Irene damage in upstate New York.
“The Kentucky accreditation train has departed!” said Rona Stapleton from the Kentucky Department of Public Health(KDPH), sharing that her department plans to apply in 2014. In spring 2010, with help from ASTHO staff and an ASTHO grant, KDPH began developing a plan to sell the idea of accreditation internally; pull together a readiness team; and design a logic model for meeting accreditation goals. Stapelton said she and her colleagues reached out to ASTHO, NNPHI and others who could share best practices so that the department could take advantage of work that had already been done.
Risa Lavizzo-Mourey, MD, MBA, President and CEO of the Robert Wood Johnson Foundation (RWJF) today joins the ranks of Nelson Mandela, the National Association of Community Health Centers, the National WIC Association and families of public health workers everywhere as recipients of the prestigious APHA Presidential Citation.
Risa Lavizzo-Mourey, MD, MBA, President and CEO of RWJF, accepted the award today in a keynote speech in the Opening Session of the American Public Health Association Annual Meeting. This represents the first time that a philanthropy has received the citation.
“To improve Americans’ health, we need to look at where people live, learn, work and play to get at the factors that shape health even more profoundly than the health care we get when we’re sick,” said Lavizzo-Mourey in a Q&A with the APHA blog, Public Health Newswire. “Improving America’s health requires leadership and action from every sector, including public health, health care, education, transportation, community planning, private business and other areas.”
In her acceptance speech, Lavizzo-Mourey congratulated everyone in the hall and beyond for their hard work in advancing public health, even through a tough economic period.
“After all the hard work, after all the progress – the most imminent threat to public health turns out to be something beyond our own control. It’s called the new age of austerity,” said Lavizzo-Mourey. “The resources simply are not there. Basic public health services are in question.”
In her speech, speaking on behalf of the Foundation's grantees, partners and staff, and the public health community, Lavizzo-Mourey emphasized that now more than ever it’s important to make the case for public health. The future of public health – the “new” public health – will depend on collaboration and tearing down silos. The new public health, she said, will be accredited and accountable to communities, it will engage in political process, and it will rely on hard evidence to determine the course of action.
“Your time is ripe. Your time is now. It only seems impossible – until it is done.”
>>Read the full transcript of Risa Lavizzo-Mourey’s speech here.
>>Follow NewPublicHealth coverage of the APHA Annual Meeting here.
Update on 10/31: Scott Burris is at APHA and gave an overview this morning at the 2011 APHA annual meeting on how far the initiative has come since its inception two years ago.
The program has funded somewhere between $8 and 9 million dollars in public health law research so far, said Burris, many of which are starting to bear results. Researchers from Boston University School of Law and Harvard Medical School showed that companies that make antibiotics are encouraging the (over)use of those antibiotics by clinicians, a practice which is known to lead to antibiotic resistance.
PHLR is now focused on creating an online research community called SciVal for sharing methods, best practices and advances in the field. (PHLR staff is showcasing this new app at their booth #2060, so stop by to check it out if you’re here in Washington attending APHA). Burris also encouraged the audience to visit the PHLR website to take advantage of a wealth of resources on methods, all meant to guide this burgeoning field.
Public Health Law Research (PHLR), a Robert Wood Johnson Foundation program based at Temple University, represents an initiative to promote effective regulatory, legal and policy solutions to improve public health. The program will have a strong presence at the American Public Health Association Annual Meeting this year both during meeting sessions and at the Program’s booth on the exhibit floor. NewPublicHealth spoke with Scott Burris, JD, director of the program, about some of the upcoming presentations and booth demonstrations.
NewPublicHealth: Will you have many research results to show at this year’s APHA Annual Meeting?
Scott Burris: This is now Public Health Law Research at age 2.4 years. We are just starting to get results from our grantees, the people we funded in the first round and a few in the second and we have a number of them appearing at APHA this year. Our booth will have a complete guide to PHLR related events at APHA. Our Methods Core Member, Jeffrey Swanson, a professor at Duke University, is getting the 2011 Carl Taube Award for distinguished contributions to mental health services research. At our the booth, #2060, we’ve got a beta version of our Public Health Law Research Community application, which will eventually capture everybody who’s written in Public Health Law Research and all the papers that have been published. We’ll be demonstrating the app at our booth. We’ll also be showing our brand new seven-minute animated video about PHLR—popcorn included.
NPH: Can you point to some key PHLR research projects that will be presented at the APHA meeting?
National public health department accreditation, which launched last month, is a key topic among presenters and participants at the Association of State and Territorial Health Officers Annual Meeting, which began yesterday. Terry Cline, PhD, the Oklahoma Commissioner of Health, was among the speakers at today's session on accreditation and quality improvement.
At the ASTHO session today, Cline said, “It’s a way of thinking, it’s a way of constantly holding ourselves accountable. It’s really changing a mindset, which is incredibly powerful."
"This is the way we are going to raise the bar in population health," said Cline. NewPublicHealth spoke with Cline about the benefits of accreditation and the plans for pursuing the credential in his state.
NewPublicHealth: How has Oklahoma been involved in preparing for public health department accreditation?
Cline: We were actually the only state that was a beta test site for the state level, the local county health department level and the tribal level. So we have been marching down this path as big believers in the power of accreditation and the need for accreditation in public health. At the state and one county level, Comanche County, applications have already been filed.
NPH: What do you think the state and its local health departments stand to gain from accreditation?
Thomas Frieden, MD, MPH, director of the Centers for Disease Control and Prevention (CDC), spoke at the Opening Session of the Association of State and Territorial Health Officials (ASTHO) Annual Meeting yesterday, with a focus on a vision for the public health of the future. NewPublicHealth caught up with Frieden to talk about the CDC’s efforts to move public health into the future, despite economic constraints.
NewPublicHealth: The theme of the ASTHO opening session is a vision for the "new" public health. What does this mean to you and the CDC?
Thomas Frieden: Public health has to consistently and newly demonstrate our value to society, both through the traditional efforts in communicable diseases and environmental health as well as the newer challenges of dealing with cancer, heart disease, stroke and diabetes. What we’ve tried to do is to identify Winnable Battles where we can save a lot of lives and save a lot of money with a big impact on health. We can succeed at these by getting many different parts of society working together. We’re encouraging stories from around the country of getting everything from school boards to housing projects to workplaces to WIC [Women, Infants and Children] programs involved in promoting health.
NPH: This year CDC and other partners launched the Million Hearts initiative to prevent 1 million heart attacks and strokes over the next five years. What are the strategies for accomplishing this goal?
Frieden: Million Hearts is, I think, an incredibly exciting initiative, and I’m confident that within five years, this initiative will prevent one million heart attacks and strokes. It will do that by reducing the number of people who need treatment and improving the quality of care for those who do need treatment. It will reduce the number of people who need treatment through tobacco control and improved nutrition, particularly reducing artificial trans-fats and excess sodium intake.
And it will improve the quality of care by addressing the ABCS – Aspirin, Blood Pressure, Cholesterol and Smoking Cessation. Currently the U.S. does very poorly on the ABCS. Less than half of the people who should be on aspirin are on it, less than half of the people with high blood pressure have it under control, only a third of people with high cholesterol have it under control and less than a quarter of smokers who see their doctor get advice to quit. Now what we know is that highly performing systems can do dramatically better. They can do that by focusing on key outcomes like using health information technology and getting all members of the healthcare team to be used to their fullest potential.
NPH: What will be happening at the community level to meet these goals?
The Cherokee Nation operates the largest tribally-operated health care system in the United States, but now is leveraging that success in medical care to shift to a focus on prevention and building healthier communities. NewPublicHealth spoke with Lisa Pivec, Director of Community Health Promotion for the Cherokee Nation and the Cherokee Nation Healthy Nation program, about her work and how applying for national public health department accreditation has provided the framework for strengthening a prevention-oriented public health system.
NewPublicHealth: How did you begin working with the Cherokee Nation?
Lisa Pivec: I actually started working for the tribe when I was a student, 21 years ago. I grew up in this area and I am Cherokee and basically as I began working in the career of community health it became very apparent to me early on that we were missing some very important infrastructure pieces that would help us do a better job of transforming or improving community health, such as a lot of those are foundational things: surveillance, being able to monitor and respond, share information and how do we communicate. I knew we needed community-based participatory research [a collaborative approach to research that involves the community equally in all phases of research and includes capacity-building efforts] and then we needed to provide feedback back to community members.
NPH: What are some innovations that you’ve been able to introduce since you began your job six years ago?
Today the Public Health Accreditation Board (PHAB) launched the first national accreditation program for local, tribal and state public health departments with a press conference at the National Press Club in Washington, D.C. The goal of the accreditation program, which was initiated and supported by the Robert Wood Johnson Foundation and the Centers for Disease Control and Prevention (CDC), is to protect and improve Americans’ health by advancing the quality and performance of all of the nation’s public health departments.
“PHAB’s vision for accreditation is to create a reliable national standard for public health,” said Kaye Bender, R.N. , Ph.D, FAAN, President and CEO of PHAB. “PHAB supports health departments in achieving this standard by recognizing the important work they do and by providing support to improve their services.”
National public health accreditation, says Bender, will provide consistent standards so that people in different states and towns have access to the same range and quality of services. Watch an interview with Kaye Bender on the launch of national public health department accreditation:
“With shrinking budgets and a growing number of health challenges to address, there has never been a more important time for public health departments to focus on the best and most efficient ways to keep people healthy,” said James Marks, M.D., MPH, Senior Vice President and Director of the Robert Wood Johnson Foundation’s Health Group. “We believe that accreditation can ensure a strong, transparent public health system and therefore a healthy nation." Watch an interview with James S. Marks on the importance of national public health accreditation to communities:
James Marks, Kaye Bender and Judith Monroe, M.D., F.A.A.F.P., Director of the Office for State, Tribal, Local and Territorial Support at CDC were among the presenters at the accreditation launch to be held at the National Press Club in Washington, D.C., today. Other speakers included health department officers who have already completed many of the steps needed to apply for public health accreditation within the next few months. Their comments include:
- “We are going to use our accreditation credential to show our community that we’re worthy,” said Torney Smith, M.S., Administrator, Spokane Regional Health District, Spokane, Washington.
- "We strive to have a healthy and happy Cherokee nation and a major component of that is advancing the quality and performance of our public health activities," said JT Petherick, J.D., M.B.H., Health Legislative Officer, Cherokee Nation Health Services, Tahlequah, OK.
- "Accreditation is an important tool to use to help build across jurisdictions. Success of public health will be if we use the [accreditation] process to drive performance improvement and along with that are transparent and accountable to others. The potential for future impact from public health accreditation is tremendous," said Paul Jarris, M.D., Executive Director, Association of State and Territorial Health Officers.
- “It’s my hope accreditation will never become an end in itself and that we all will improve the process over time… because the circumstances of protecting us and keeping us safe change over time,” said Bobby Pestronk, M.P.H, Executive Director, National Association of County and City Health Officials. “And I hope accreditation will help others in the community recognize the importance of health departments.”
Watch a Public Health in Action video showcasing health departments working toward health department accreditation:
Next week, hundreds of public health officials will meet in Idaho for the annual meeting of the National Association of Local Boards of Health. NewPublicHealth spoke with Marie Fallon, NALBOH’s chief executive officer, about the role of local boards of health and about the highlights of this year’s conference.
NewPublicHealth: What is the role of local boards of health in keeping their communities healthy?
Marie Fallon: Local, state, tribal and territorial boards of health work as trustees of governmental health departments in almost every state in the nation. Members of boards of health are appointed or elected to oversee, guide and set policy for health departments.
The roles of boards of health vary by state as does their authority to carry out their responsibilities. Some boards can enact rules and regulations, while others (the minority) may advise or make recommendations to the governing body for public health, such as a county commission.
As community representatives, board of health member roles include advocating – being the voice from the community to the health department and from the health department to the community and other community representatives, such as elected officials; aligning community need with programs through community health assessments and strategic planning; program oversight, follow-up and assessment; and fiscal oversight to ensure taxpayer dollars are being used as effectively and efficiently as possible.
All boards of health, regardless of the extent of their legal authority, are obligated to enact or recommend policies that serve the interest of public health in the communities they serve.
NPH: How do boards of health and health departments work together?
The Public Health Accreditation Board (PHAB) is developing a national voluntary accreditation program for state, local, territorial and tribal public health departments, to launch in September 2011. The goal is to improve and protect the health of every community by advancing the quality and performance of public health departments.
Ahead of the launch, NewPublicHealth spoke with Kaye Bender, Ph.D., R.N., F.A.A.N., president and C.E.O. of the Public Health Accreditation Board (PHAB). She provides an update on the progress on accreditation, and what she’s hearing about it from local health departments. Accreditation is grounded in standards and measures – standards are the required level of achievement that a health department is expected to meet, and accreditation is a process to measure performance against those standards, and provide recognition for those departments that measure up.
NPH: You’re gearing up to accept applications for public health department accreditation. Why is accreditation important now?
Kaye Bender: Two Institute of Medicine studies in the past said that public health in this country was in disarray. Accreditation will drive public health departments to continuously improve the quality of the services they deliver to the community, and ultimately improve the health of all Americans. Local health departments participating in state accreditation programs have already seen the benefits – valuable, measurable feedback on strengths and areas of improvement to help them better serve their communities; accountability and credibility; and better staff morale and increased visibility in the community. We expect to see all of these benefits in national accreditation as well.
NPH: Some health departments may not have started thinking about applying for accreditation. Some may say it seems like quite a large task. What would you say to a health department that’s just beginning to think about applying?
Since 2004, North Carolina has been the only state in the U.S. to have mandatory public health department accreditation, requiring local departments to meet standards set by the North Carolina Division of Public Health. Recently, staff members of the North Carolina Institute For Public Health published an article in the American Journal of Public Health about the process and value of local public health department accreditation.
For the study, 48 accredited health departments were surveyed on the impact of accreditation and the benefits and barriers related to the process. Half of the public health departments surveyed reported that they acted on suggestions for improvement received during the accreditation process, and 67 percent conducted quality improvement activities, according to the report. The authors say study results can benefit other states now considering national accreditation through the Public Health Accreditation Board.