Terry Cline at ASTHO: NewPublicHealth Q&A
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?
Cline: For me there really are two separate and distinct components that are equally powerful. One is around performance improvement and the focus on continuous quality improvement throughout the department. We have very limited resources and always have had – and it’s just been particularly hard the last few years and there’s never enough funding. So, we need to always be better, we always need to be smarter, we always need to be more efficient in every way that we can be because of those limited resources. And even if resources were aplenty, we would want to be as focused and as effective as possible. That is very much part of the culture of accreditation.
Some of those goals may be around outcomes and many are around the actual administrative processes that we have in place. When we’re better administratively that allows us to be better at implementing programs. That’s one big piece. The other is really around uniform standards across public health. That then helps give us the credibility to have met these baseline standards in public health. We’ve had essential functions and core functions and other pieces, but we really have not had a standard against which to measure ourselves. That kind of benchmark measuring in accreditation allows us to do that. In some cases, that will be validating for what we’re already doing. In other cases, it may push us to do something that we haven’t done in the past that needs to be done.
NPH: How do you think the health departments of any size could benefit from your lessons learned in the beta test?
Cline: I think one lesson learned is to make sure that you have buy-in from the leadership. Leadership needs to be strongly in support of accreditation. I think that we need to have individuals within the agency to help coordinate all of those pieces. One individual needs to have the responsibility to make sure all of the pieces are in alignment, but at the same time it needs to be diffused throughout the agency so that different segments of the organization are picking up various responsibilities. It all gets pulled back together so that you have coordination, buy-in from leadership and a shared sense of ownership of accreditation.
NPH: Do you expect accreditation will be a big part of the conversations you have with fellow state health officers at the ASTHO meeting?
Cline: I think it very much will be part of the conversation. Last year, while this is in the pre-introductory phases, I did a brief presentation and I had a number of my fellow commissioners who came up to me afterwards, some of whom said, you know, I wasn’t quite convinced that we were ready to go there, but after hearing your perspective, it really has helped me understand the value that accreditation will provide for the agency. So now that accreditation is launched and is available and we’re in those beginning stages, I think there will be a lot more conversation. This is a big piece of the future for public health.
NPH: Can you see, just in those communities in Oklahoma that have already started on the process toward accreditation, improvements for the health departments involved?
Cline: I’ll give you a very concrete example. We have 68 county health departments across the state. Some of those are in very remote areas. When I was at one of our county health departments, a several hour drive from our central office, I had staff ask me questions about the community assessment and they had never asked that type of question in the past. And the fact that they were asking those questions meant to me that accreditation was driving into the local communities.
We’re certainly not at the same level of discussion at all 68 counties, but to me it was very, very encouraging. I didn’t initiate that conversation; it wasn’t me pushing part of that agenda. This had already filtered into and throughout the organization and they were bringing it back to me. That to me is exciting.
NPH: What’s the trajectory for applying for accreditation in Oklahoma?
Cline: We’ll be starting with a handful of those county health departments and then seeing that spread over time. Some are waiting on technical assistance from the state health department and we have limited resources so we can only help so many at a time.
>>For help preparing for accreditation, visit the ASTHO accreditation resources here.
>>Follow NewPublicHealth coverage of the ASTHO Annual Meeting.