Research Full Report
Quality Improvement and Performance Management
Benefits of Public Health Accreditation: National
Evaluation Findings
Alexa Siegfried, MPH; Megan Heffernan, MPH; Mallory Kennedy, BA; Michael Meit, MA, MPH
ABSTRACT
Objective: To identify the quality improvement (QI) and performance management benefits reported by public health de-
partments as a result of participating in the national, voluntary program for public health accreditation implemented by the
Public Health Accreditation Board (PHAB).
Design: We gathered quantitative data via Web-based surveys of all applicant and accredited public health departments
when they completed 3 different milestones in the PHAB accreditation process.
Participants: Leadership from 324 unique state, local, and tribal public health departments in the United States.
Results: Public health departments that have achieved PHAB accreditation reported the following QI and performance man-
agement benefits: improved awareness and focus on QI efforts; increased QI training among staff; perceived increases in
QI knowledge among staff; implemented new QI strategies; implemented strategies to evaluate effectiveness and quality;
used information from QI processes to inform decision making; and perceived achievement of a QI culture. The reported
implementation of QI strategies and use of information from QI processes to inform decision making was greater among
recently accredited health departments than among health departments that had registered their intent to apply but not
yet undergone the PHAB accreditation process. Respondents from health departments that had been accredited for 1
year reported higher levels of staff QI training and perceived increases in QI knowledge than those that were recently
accredited.
Conclusions: PHAB accreditation has stimulated QI and performance management activities within public health depart-
ments. Health departments that pursue PHAB accreditation are likely to report immediate increases in QI and performance
management activities as a result of undergoing the PHAB accreditation process, and these benefits are likely to be re-
ported at a higher level, even 1 year after the accreditation decision.
KEY WORDS: accreditation, evaluation, public health, quality improvement
T
he national accreditation program, imple-
mented by the Public Health Accreditation
Board (PHAB), is designed to advance the
quality and performance of public health departments
in the United States. To be recognized as an accred-
ited health department, applicants assess themselves
against a set of Standards and Measures that are
Author Affiliation: Public Health Research Department, NORC at the
University of Chicago, Bethesda, Maryland.
This research was conducted by NORC at the University of Chicago with
support from (1) the Robert Wood Johnson Foundation (RWJF) and (2) the
Public Health Accreditation Board through funding provided by RWJF.
The authors declare no conflicts of interest.
Correspondence: Alexa Siegfried, MPH, Public Health Research Department,
NORC at the University of Chicago, 4350 East-West Hwy, Ste 800, Bethesda,
MD 20814 (siegfried-alexa@norc.org).
Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
DOI: 10.1097/PHH.0000000000000692
designed to support and advance the health depart-
ment’s quality improvement (QI) and performance
management efforts.
1
QI in public health is
the use of a deliberate and defined improvement
process … focused on activities that are respon-
sive to community needs and improving population
health. It refers to a continuous and ongoing ef-
fort to achieve measurable improvements in the ef-
ficiency, effectiveness, performance, accountability,
outcomes, and other indicators of quality in services
or processes which achieve equity and improve the
health of the community.
2(p6)
The implementation of QI activities by health de-
partments can lead to positive changes within the
health department, such as improvements in effi-
ciency and effectiveness.
3,4
For example, QI activities
have helped build and develop workforce capacity
5,6
;
Copyright © 2018 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
May/June 2018 • Volume 24, Number 3 Supp www.JPHMP.com S3