Tips for Using Public Health Accreditation to Orient New Health Department Leaders

July 12, 2018|12:48 p.m.| ASTHO Staff

As of September 2016, the length of time state health officials remained in their positions ranged from two months to nearly 15 years, with an average tenure of 2.7 years. Leadership transitions can be attributed to many factors, but the visibility and political demands associated with the job top the list. Incoming health officials must be familiar with the health department’s internal operations, priorities, partners, stakeholders, and issues impacting the agency early on in their appointments.

When Randall Williams was appointed director of the Missouri Department Health and Senior Services (MDHSS) in 2017, the agency’s performance improvement manager, Susan Thomas, stepped in to support the onboarding process and swiftly orient Williams to the state’s public health system and to MDHSS’ priorities and internal operations. She devised a concise orientation guide by incorporating key plans and leveraging the infrastructure previously developed as part of the health department’s process to achieve accreditation through the Public Health Accreditation Board (PHAB). Keep reading for more on MDHSS’ unique approach and tips for using accreditation as a foundation for orienting health agency leaders to their new roles.

Tip #1: Use key findings gleaned from the accreditation process, such as organizational assessments and PHAB’s site visit report, to inform health officials about the agency’s strengths and opportunities for improvement, as well as the state’s overall public health infrastructure.

Thomas decided to highlight the strengths and weaknesses identified during MDHSS’ strategic planning process and included an overview of feedback provided during PHAB’s site visit to offer an unbiased, external perspective on the agency’s performance in delivering the 10 Essential Public Health Services. She summarized findings from Missouri’s state health assessment to describe the needs and assets of the state’s population. Quality improvement (QI) projects accompanied the summaries to highlight the agency’s commitment to a culture of quality and demonstrate its capacity for improvement.

Tip #2: Walk through important elements of the agency’s accreditation plans and the performance management system to bring new health officials up to speed on current priorities, goals, and, progress toward meeting targets.

Thomas utilized MDHSS’ strategic plan, workforce development plan, and state health improvement plan to provide context on the agency’s priorities and the capabilities of its workforce, as well as to outline the top three priority health areas for Missourians. Each plan was augmented with performance data to illustrate progress toward a set of goals.

Tip #3: Provide a summary of collaborative work with the community and external partners to promote strong partnerships and accountability to stakeholders.

In the orientation materials, Thomas also included a synopsis of community engagement and collaborative efforts undertaken during the accreditation process, enhanced with a high-level overview of feedback collected from community members and partners to show how the agency’s services and the healthcare system were perceived through the lens of external stakeholders. This information allowed Williams to more readily ascertain gaps in the state’s public health services and understand where the system was fragmented. To address these issues, he then created and prioritized opportunities to build partnerships with traditional and non-traditional public health partners.

Within the first five months of his appointment, Williams visited partners across the state, convened 115 local health departments for the first networking conference in over ten years, and established quarterly local public health agency meetings to reduce silos and reinforce partnerships across Missouri’s public health system. During this process, Williams became aware of the alarming prescription drug misuse trends in Missouri. As a result, he worked with the governor to advance prescription drug misuse to the forefront of public health issues in the state and developed an action plan to motivate partners to combat opioid abuse. This work resulted in numerous policy changes and cultivated stronger commitment from leadership at the health department’s partner agencies, making 2017 a pivotal year in the fight to combat opioid abuse in Missouri.

Synthesizing key plans and accreditation documentation to orient a new health official can quickly provide new leaders with a roadmap for understanding the health department’s capacity and how the public health infrastructure affects communities.

To find out whether this approach might be valuable for other jurisdictions, ASTHO consulted two members of PHAB’s board of directors: Celeste Philip, surgeon general and secretary of the Florida Department of Health, and Paul Halverson, previously the state health officer and director of the Arkansas Department of Health and former ASTHO President.

Philip and Halverson agree that having a clear and succinct description of priorities, goals, and objectives supported by performance data is essential to the orientation process for a new health official. Providing this type of information allows incoming health officials to better understand the internal and external factors impacting both the agency and the communities it serves. New health officials can look at the foundational activities embedded in accreditation and get a snapshot of the needs and assets of their jurisdictions, as well as the types of stakeholders and partners that work together to make public health a priority.

The plans developed as part of the accreditation process keep new health officials apprised of previous and current partnerships with other agencies, community groups, and unique populations and highlight new opportunities to address poor health outcomes. Additionally, PHAB’s site visit report and the ongoing annual reports give health officials a feel for the health department’s performance on the standards and measures used for accreditation and can be used to make decisions regarding service delivery and resource allocation.

According to Thomas, without the materials and infrastructure developed through the accreditation process, collecting orientation information would have been a time consuming process, requiring extensive internal data collection from multiple divisions. Accreditation provided a robust foundation to facilitate this process and made it more effective overall. Missouri’s experience shows that documents submitted as part of the accreditation process can be leveraged to support incoming public health leaders.

ASTHO thanks the Missouri Department of Health and Seniors Services, the Public Health Accreditation Board (PHAB), and PHAB’s board members for contributing key insights for this blog.


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