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Greetings from PHAB,

Kaye Bender, PHAB President/CEOPatience and attention to detail top this month's themes at the PHAB office. Patience, because we know that you are eagerly awaiting the results of the Beta Test, and attention to detail because we are thoughtfully and methodically going through the evaluation information as we receive it to inform the accreditation launch for 2011. There is still a lot of work to do to best use the wonderful feedback and evaluation information gained from the Beta Test, the website feedback, and the think tanks. We are also working closely with our national partners so that, as they provide the technical assistance to health departments preparing for accreditation, they can do so with the best information we have to offer them. After all, it is the goal of all of us at the national level that health departments who enter the accreditation application process be successful as they go through the steps.

 

In this past month, we held the first Tribal Standards Workgroup meeting, met with our PHAB 5 partners, and convened several key committees of the PHAB Board of Directors. The Beta Test Accreditation Review Committee and the Research and Evaluation Committee met in September to lend their expertise in making recommendations to the Board. The Information Systems Development Committee also held its first meeting with our consultant. It remains a busy time at PHAB!

 

We continue to listen to your questions and to provide the best answers we have to date. "Word on the Street" focuses this month on technical assistance and who provides it. We also answer a question related to the role of the Indian Health Service in accreditation support. We will continue to respond to your questions as they come up, so please call or e-mail us your requests for "Word on the Street!" You can also visit us at Booth #1713 in the Exhibit Hall at APHA in Denver, CO, from November 7-10, 2010. We look forward to seeing many of you there!

 

Thank you for your support and your patience as we work through this next phase of developing public health accreditation.

 

Kaye Bender, PhD, RN, FAAN

President and CEO

Issue #28

October 2010

In This Issue
PHAB Feature
Tribal Standards Workgroup Meeting Update
PHAB Committee Meetings Update
PHAB 5 Meeting Update
Accreditation and QI Panel at ASTHO Annual
Word on the Street

PHAB Feature: APHA Annual Meeting & Exposition Sessions

 

APHA Logo

 

From November 7-10, 2010, you will find PHAB at Booth #1713 in the American Public Health Association's (APHA) Exhibit Hall in Denver, CO. Click here to view a list of sessions on accreditation and performance improvement that maybe of interest. Safe travels to those attending the meeting!

 

Tribal Standards Workgroup Meeting Update 

 

PHAB Tribal Standards WorkgroupMembers of the PHAB Tribal Standards Workgroup are enthused and energized after the conclusion of their first meeting. They met on September 19-20, 2010, in Sioux Falls, South Dakota. Debra Smith, RN, PHN, MSN, a member of the workgroup, said "the meeting was well organized and our assignments are realistic and 'do-able'. This is going to be a FUN project to work on."

 

The charge to the workgroup is to develop a tribal set of standards, measures, documentation, and interpretation to be specific to the unique characteristics of tribal public health departments, with attention to linguistic and cultural appropriateness. PHAB has partnered with the National Indian Health Board (NIHB) in this effort. During the first day of the meeting, workgroup members gained an understanding of PHAB, including its mission and vision of advancing the quality and performance of state, local, and tribal public health departments. Three of the workgroup members formed a panel discussion about their experiences with the PHAB Beta Test. J.T. Petherick spoke about the Cherokee Nation Health Service's experience as a Beta Test site, and Gary Quinn and Glenda Davis shared their experiences as site visitors of tribal Beta Test sites. The discussion informed the other workgroup members about how the standards and measures are applied in a tribal health department. Workgroup members were successful in accomplishing the two deliverables of the meeting: create, through consensus, a description of a tribal health department that is eligible to apply for accreditation; and complete an initial review and revision of the standards and measures in all Domains in the PHAB Guide to Standards and Measures Interpretation.

 

PHAB is very grateful of the representatives from tribal health departments and is pleased to know that the process is of benefit to them as well as to PHAB. Gary Quinn, MSW, Director of the Tohono O'odham Nation Department of Health and Human Services and a member of the workgroup, said "Thank you for the indirect contribution you make to the health of the Tohono O'odham Nation from my work with PHAB. It is a mutual benefit for us to work with PHAB. Thanks for the opportunity."

 

PHAB looks forward to working with the workgroup over the next several months through iterative versions of tribal accreditation documents.
Research and Evaluation, Beta Test Accreditation Review, and Information Systems Development Committees Meet in National Harbor, MD 

 

R&E, ARC, and IS Committees

Three of PHAB's committees met on September 28-30, 2010, in National Harbor, Maryland, to continue their important work before the launch of accreditation in 2011. The Research and Evaluation Committee is charged with advising the PHAB Board of Directors on best approaches for evaluating PHAB's accreditation activities, as well as informing the evidence for best and promising practices related to the operations of governmental public health systems. The Committee is co-chaired by Dr. Bill Riley and Dr. Les Beitsch, and is comprised of some of the best public health systems researchers in the country. Their primary work at the meeting was to explore the most appropriate statistical analyses for determining the answers to such questions as: Do the PHAB standards measure what they are intended to measure? Do they reflect the best practices known to date in their respective domains?

 

After completing their initial discussions and developing recommendations, the committee then met jointly with the Beta Test Accreditation Review Committee to discuss potential options for determining the most appropriate scoring and weighting criteria for the final set of the standards and measures. Both committees understand the significance of the recommendations they will make to the PHAB Board of Directors; therefore, the discussions were carefully and thoughtfully held. More work in this area will be done over the next few weeks.

 

In addition to working with the Research and Evaluation Committee, the Beta Test Accreditation Review Committee agreed on final elements of a proposed policy and procedures manual that will guide the process of future decisions about applicants' accreditation status. They reviewed and discussed each of the Beta Test site visit reports to inform their development of the future decision-making process. The proposed policies and procedures manual will be submitted to the Board for adoption. The chair of the Beta Test Accreditation Review Committee is Dr. F. Douglas Scutchfield.

 

The Information Systems Development Committee, co-chaired by Dr. Hugh Tilson and Dr. Leah Devlin, met to begin discussions on the development and implementation of a robust, user-friendly information system to support the accreditation activities, as well as to support public health accreditation related research. PHAB is pleased to have the Public Health Informatics Institute as its key consulting partner to guide this work. Comments from the Beta Test have already been helpful to this process. PHAB will soon invite representatives from the field to join this committee.

PHAB 5 Meeting Update 
 
PHAB 5 (10.06.10)PHAB's ongoing partnership with the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), the National Association of Local Board of Health (NALBOH), and the National Indian Health Board (NIHB) is vitally important to the work of PHAB, and we have worked closely with these organizations as we have monitored the Beta Test activities. PHAB continues to meet quarterly with staff of these partners as we finalize the Beta Test and the associated QI projects in order to share observations, insights, and suggestions for next steps. The latest meeting, held on October 6, 2010, at the ASTHO office, continued the tradition of working together to "get accreditation right." PHAB appreciates the working relationship we have had with these fine staff.
ASTHO Panel Focuses on Lessons Learned from the Beta Test 

 

As ASTHO held its annual meeting in Colorado Springs, CO, on October 20-22, 2010, public health officials from all across the country came together to discuss current and emerging public health issues. Accreditation of health departments was among the leading topics discussed. Lessons learned from the recent Beta Test, described from the lens of two state health officials and from PHAB's funding partners, were the focus of a panel discussion on October 21, 2010. Tom Newton, Director of the Iowa Department of Public Health, discussed the reasons that Iowa participated in the Beta Test, how Iowa plans to use the experience to help prepare for accreditation, and the importance of leadership and communication in a successful accreditation effort. Dr. Terry Cline, Commissioner of Health for Oklahoma, discussed their experience as a Beta Test site, working alongside other Beta Test sites in his state (Comanche County and the Cherokee Nation).  Dr. Cline focused on strategies employed by his staff, board, and partners to prepare for the Beta Test, and discussed the link between accreditation and quality improvement.

 

Dr. Judy Monroe, Director of the Office of State, Tribal, Local, and Territorial Support (OSTLTS) at the Centers for Disease Control and Prevention (CDC), discussed the importance of focusing on accreditation during tough economic times, as well as in an era of health reform. She emphasized that the public expects government to provide efficient, high quality services; those principles which are included in accreditation preparation and achievement. She described CDC's continuing focus on strengthening the nation's public health infrastructure.

 

Dr. Pamela Russo, Senior Program Officer on the Public Health Team of the Robert Wood Johnson Foundation (RWJF), presented the RWJF's long-standing commitment to accreditation and quality improvement in public health. She described the major initiatives supported by the RWJF in achieving the goal of high performing public health departments. She also discussed the close link between accreditation and quality improvement. Dr. Russo closed by thanking the state health officials for allowing their staff to participate on PHAB workgroups, committees, think tanks, as accreditation coordinators, and other related activities to ensure that the accreditation program is practice-based.

 

ASTHO staff leading the planning for the session included Lindsey Caldwell and Tom Briggs. Dr. Kaye Bender, PHAB President and CEO, moderated the session.

Word on the Street

1. How does the Indian Health Service (IHS) relate to PHAB's accreditation of tribal public health departments?

 

Tribal public health systems include a complex set of services and activities provided by diverse stakeholders and partners that vary by tribe and region. The Indian Health Service (IHS) is a comprehensive, primary care health system of hospitals and clinics located on or near Indian reservations. The provision of primary healthcare services, and some public health services, to the American Indian/Alaska Native population is based on treaties signed by tribal nations and the federal government in which the tribes exchanged vast amounts of land and natural resources for services, including housing, education, and healthcare. As a result, the federal government has a trust responsibility to provide healthcare and other services to enrolled members of federally recognized tribes. Public Law 93-638, the Indian Self-Determination and Educational Assistance Act of 1975, often referred to simply as the Indian Self-Determination Act, enacted authorization for the Secretaries of the Interior and of Health, Education, and Welfare, and other government agencies to enter into compacts and contracts with federally recognized Indian tribes. This allows for the tribes themselves to have greater control in decisions regarding their own welfare rather than allocating the decision making to government officials. PHAB recognizes the importance and role of IHS as primary care providers within tribal public health systems. The PHAB standards and measures describe population focused services. As sovereign nations, tribes are responsible for the overall health and well-being of their members within their jurisdiction, and therefore, PHAB's target applicants are the tribal health departments. Public health, as described by the Ten Essential Public Health Services, is a different scope of services and activities than the provision of healthcare. However, as with state and local health departments, the partnership between the healthcare system and the public health system is vital to improving the health of the total population. PHAB sees IHS as an important national partner in the accreditation efforts and encourages tribal health departments to view their local IHS supported services as important components of the overall health system.

 

2. What types of technical assistance are available to health departments preparing for accreditation?

 

The public health field is fortunate to have a robust menu of technical assistance available to health departments preparing for accreditation. Health departments all across the country are already working with a number of national partner organizational staff and consultants on the pre-requisites for accreditation. All a health department has to do is check the websites or call one of the following organizations to see the array of assistance that is available.

 

  • Association of State and Territorial Health Officials (ASTHO): www.astho.org
  • National Association of City and County Health Officials (NACCHO): www.naccho.org
  • National Association of Local Boards of Health (NALBOH): www.nalboh.org
  • National Indian Health Board (NIHB): www.nihb.org
  • National Network of Public Health Institutes (NNPHI): www.nnphi.org
  • Public Health Foundation (PHF): www.phf.org

 

As soon as PHAB has completed the revision of the standards, measures, and the accreditation process based on the feedback we have received and the Beta Test evaluation, we will be developing training on areas such as: preparing documentation for accreditation; applying for accreditation; interpreting the standards and measures; and other parts of  the process. PHAB expects to have that training developed prior to the launch of the program in 2011.

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