Faces of Public Health: Jessica Kronstadt, Public Health Accreditation Board
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.
The PHAB evaluation will rely on several data sources including feedback from health departments applying for accreditation, the volunteer site visitors, PHAB staff and other stakeholders. In addition, the online accreditation system captures extensive program information from departments applying for accreditation, including an assessment of how well health departments demonstrate conformity with the standards and measures.
From our very early evaluation findings, we have learned that site visitors and staff from applicant health departments are very pleased to have gone through the process. They have also given us specific suggestions about measures to clarify and potential tweaks to the site visit agenda, for example.
NPH: Why is PHSSR important for evaluating the processes that are required for applying for accreditation?
Jessica Kronstadt: We think that the research community will really help us determine what effect going through the process has for those departments who decide to apply and whether they become more aware of their strengths and weaknesses, and whether being accredited makes a difference in the way that they’re able to serve their community.
The second piece comes in with our standards and measures, which we want to continue to evolve. We will be revising them periodically and we want them to reflect what we know about the evidence base related to public health systems and services. So, as the evidence base grows in an area like workforce or governance, we want to be able to consider revisions to the standards and measures to make sure we are keeping pace with the best new evidence.
NPH: What are some additional research questions that you think the accreditation processes might need to have answered?
Jessica Kronstadt: I will be really interested in having a better understanding of quality improvement and how that works in health departments. I’m sure that there are ways that we can change our processes to encourage health departments to engage in quality improvement. There are changes we can make in standards and measures so that they reflect the most effective quality improvement processes or systems health departments need to have in place so that they can engage in quality improvement and form a culture of quality improvement. I also think a better understanding of the metrics for measuring that a health department is doing quality improvement well will be important to help us analyze the impact of our accreditation program.
NPH: How does the rigor and evidence base needed to apply for accreditation add to the significance of accreditation?
Jessica Kronstadt: PHAB takes very seriously the commitment to evaluating what we’re doing, so that we can continue to improve the accreditation process, but also making sure that we understand what the research base is. I don’t know that all accrediting organizations have that same commitment to research, and I think that is something that sets us apart. It’s important for the field to know that when we work on the standards and measures, we’re doing it based on a consensus-based process involving practitioners and the research community to really make sure that our standards and measures are appropriate, and those really are the foundation of the accreditation system. So that link between having them be consensus-based and research-based really helps affirm the credibility of the accreditation program.
We currently have a set of research questions from 2011 and we’ll be working with some of our committees over the next several months to revisit the questions to see which might need refining and we’ll continue to do that to keep the accreditation absolutely relevant and up to date.