The Role of the Public Health Training Centers in Advancing Public Health Department Accreditation

Introduction

In the past few years, the drive for public health department accreditation has continued to build momentum. As the Centers for Disease Control and Prevention (n.d.) notes, “Engaging in accreditation catalyzes quality and performance improvement within all public health programs and can help health departments be better prepared to proactively respond to emerging and reemerging health challenges.” Public health department accreditation is being led by the Public Health Accreditation Board (PHAB), a nonprofit organization dedicated to advancing the continuous quality improvement of local, state, tribal, and territorial health departments (PHAB, n.d.).

Many organizations are supporting accreditation efforts, including the Public Health Training Centers (PHTCs), funded by the Health Resources & Services Administration (HRSA). In a recent column in Public Health Reports, Dr. Mary Beth Bigley, Director of the Division of Nursing and Public Health, Bureau of Health Workforce, explains,

HRSA established the PHTC in part to respond to quality standards and measures being established by the burgeoning accreditation movement for training and competency of the public health workforce at the state, local, and tribal levels. Since its establishment, HRSA’s PHTC program has worked to advance these competencies. (Bigley, 2016)

The Midwestern Public Health Training Center (MPHTC), based at the University of Iowa College of Public Health, includes academic and practice partners from the HRSA Region VII states of Iowa, Kansas, Missouri, and Nebraska. This article provides an example of the important role that PHTCs play in supporting capacity building for accreditation.

Background

Iowa has been working to address the performance of the governmental public health system since 2004. Originally, this path led to the establishment of the Iowa Public Health Standards, which predated PHAB. The goal of the standards has been characterized by the question “What can every Iowan expect from their local public health department?” Following the development of PHAB, Iowa moved away from using its own set of standards. To increase the resources available to support accreditation activities of local public health departments Iowa applied for and received a grant as part of the Gaining Ground Initiative. The goal of the 2-year grant, managed by the National Network of Public Health Institutes and funded by the Robert Wood Johnson Foundation, was to develop sustainable, statewide systems to catalyze public health accreditation and support performance improvement in local, tribal, and state health departments (National Network of Public Health Institutes, n.d.).

The grant brought together the following partners to create the Iowa Public Health Gaining Ground Coalition:

The final partner in the Coalition was the MPHTC. Coalition members have a rich history of collaboration, which has evolved over the years. Previous collaborations included strategic planning workshops and the development of an online tool kit with strategic planning resources for local public health departments.

MPHTC Support of Accreditation Readiness Activities

MPHTC has expertise in workforce development, including the design, development, and implementation of online training and education. Using this expertise, MPHTC played a critical role in enhancing the Coalition’s capacity to support accreditation readiness activities of local public health departments. MPHTC provided support for three major accreditation readiness activities: accreditation workshops, informational videos on PHAB standards and measures, and competency-based workforce development assessments.

In order to provide more general information to local public health departments on PHAB, the first activity of the Coalition was to develop an in-person Accreditation 101 workshop delivered at six sites across the state. The goal of the workshop was to showcase how the work that health departments do every day actually fits within the PHAB standards. MPHTC helped organize the content for the workshop, delivered parts of the program, and provided evaluation support. To increase reach and provide ongoing access to the materials, MPHTC recorded the workshop and created an electronic tool kit available on a learning management system (www.training-source.org).

Another activity in support of accreditation was development of the video series 12 Domains to PHABulous! The series provides information, tips, and resources to support health departments’ use of the specific performance measures in each domain to advance the quality and performance of their department. The videos are brief, 10 to 20 minutes, and can be accessed online. Once again using its expertise in instructional design and development, MPHTC produced the video series in partnership with other Coalition members and houses the series on a learning management system (www.training-source.org).

Finally, MPHTC works with local public health departments on competency-based workforce assessments used to create the workforce development training plan required for PHAB accreditation. A starting point for the development of the assessment was reviewing tools used by others in the PHTC network. The assessment is based on the Council on Linkages competencies for public health professionals (Public Health Foundation, n.d.) and the public health preparedness and response core competency model (Association of Schools and Programs of Public Health, 2010). The assessment also includes items related to training preferences, barriers to training, specific topics and skills, learning culture and style, and other workforce development activities. MPHTC works individually with each health department to customize the assessment based on the unique needs and characteristics of its workforce. MPHTC’s evaluator also produces a customized report of the assessment results that can be used to inform the development of the training plan.

Discussion

Although the activities discussed in this article represent the work of the MPHTC, similar activities are being carried out throughout the country. The MPHTC example illustrates how PHTCs can play a key role in state-based initiatives to support capacity building for accreditation. By building relationships with the practice community over a number of years, PHTCs are important partners in advancing this work. Additionally, because of their expertise in workforce development, including conducting competency-based assessments and delivering training to meet the needs of the public health workforce, PHTCs continue to be an important resource for the practice community, which does not often have the expertise or resources to carry out these activities.

Given the current and emerging public health challenges, the need for a well-prepared workforce is more important than ever to strengthen the public health system. By engaging in activities to meet the accreditation standards, public health departments will be better positioned to respond to these challenges. PHTCs will continue to have a critical role in capacity building for accreditation.