At Champ Software’s recent Expert Webinar, Gretchen Sampson, MPH, RN shared Polk County Health Department’s journey through the accreditation process, including tips and resources for other agencies seeking PHAB accreditation.
Gretchen has been with Polk County Health Department since 1977. She graduated with her BSN in Nursing from the University of Wisconsin – Eau Claire and received her MPH in Health Administration from the University of Minnesota, Twin Cities. She became the Director/Health Officer at Polk County in 1996 and in 2015 she took her current position as the Community Services Division Director. Gretchen is a very knowledgeable speaker and we were excited to have her share her experiences and wisdom on how to navigate the accreditation process. Champ Software thanks Gretchen for sharing the content below.
Polk County is a rural county in northwestern Wisconsin, not far from the Minnesota border or Minneapolis-St. Paul. The health department has 22 FTEs with a $2.3M budget. That budget is largely due to Polk County’s aggressive pursuit of grant opportunities; only $910,000 of their budget comes from county tax levies, the remainder of the budget being made up by grants, fees for services, MA/insurance and fiscal agent fees for managing other community collaborative.
In Wisconsin, health departments are classified by levels, with Level I health departments providing basic health services to the community, such as health promotion, disease prevention, and generalized public health nursing, and Level III health departments offering a multitude of services and programs, addressing priorities in the Wisconsin state health plan, adhering to the frameworks for the generalized public health nursing program and environmental health programs, as well as submitting a host of reports. Polk County is a Level III health department.
There is a strong movement towards public health accreditation in the state of Wisconsin. There are now 13 local health departments in the state who have received accreditation. The state included accreditation as part of the Healthiest Wisconsin 2020 goals in the state health plan and is one of 16 states who participated in the multi-state learning collaborative, which, “informed and accelerated the development of accreditation for state and local public health departments and helped make quality improvement a key part of public health.” This participation gave Polk County an awareness of the standards and measures being developed before they ever began the accreditation process.
Polk County was one of the first 14 health departments in the nation to be accredited. While the County’s original goal was to be the first health department in Wisconsin to be accredited, they were actually the third… but this doesn’t take the wind out of Gretchen’s sails. She says, “We don’t think that is too shabby!” Gretchen, a self-proclaimed Achiever, championed Polk County’s move towards accreditation, providing motivation, direction, and administration along the way.
- Selling it:
- Accreditation is a lot of work! A key step in the process is selling the idea of accreditation to staff. You’ll want to put a positive spin on the project and get staff buy-in on the front side. Help staff understand why you’re seeking accreditation and what it means for the department.
- The benefits of accreditation also need to be communicated to your governing body. Polk County ensured buy-in from the board of health and the county board by presenting the positive economic impact and the increase in quality services to the public.
- You’ll need to pull a team together. Make sure the team works well together and can get along – you’ll be spending a lot of time with your team! You’ll want to include subject matter experts as well as people with strengths like computer savviness, detail orientation, and excellent memory.
- You’ll want to create a core team who will champion and lead the project as well as hold the rest of the team together.
- Accreditation is time consuming, intense, and very detailed.
- Strategic Planning:
- Polk County’s strategic plan included a marketing and branding team, a workforce development team, a performance management/quality improvement team, an accreditation team (which has now become the re-accreditation team), public health partners, and leaders/governing bodies, all centered around and working with the core team leaders.
- The County also planned and mapped out a timeline that was integrated into the strategic plan. This created goals that could be referred to and celebrated when they were reached. The strategic plan helped keep Polk County on track.
- Year 1 – Self- Assessment and Process Planning:
- Polk County began the accreditation process in late 2009, starting with assessing where the county was at. The Polk County Health Department completed NACCHO’s Local Health Department Self-Assessment Tool to help ensure they were ready to begin the accreditation process. Polk County wanted to ensure they were finished with the “Big 3”: Strategic Plan, CHA, and CHIP. The county also used a radar graph to visualize strengths and weaknesses in the essential service domains.
- They spent time identifying major gaps, set up an electronic database to organize and monitor their progress in each domain, trained staff and the board on the domains, and created standards and measures.
- The internal electronic database Polk County created was hosted on the agency network with folders for each domain and sub-folders for standards and measures within each domain. Those folders were Polk County Health Department’s “virtual home” for the next 8-12 months.
- Year 2 – Getting it Done:
- This year was spent ensuring the “big stuff” was done (CHA, CHIP, Strategic Plan, etc.) as well as documenting the implementation.
- Year 3 – Gathering and Uploading Evidence:
- Polk County then began gathering and uploading the evidence for each domain in the database. They tried to focus on one domain at a time, scheduling meetings on the calendar each week and month to review their work. They assigned key staff members to each domain, but also pulled in the health officer who acted as a glue, holding the process together and providing an agency-wide perspective to the project. The county provided accreditation updates at each board of health meeting in the year leading up to accreditation.
- It was important to schedule “sacred” time to devote to gathering and documenting evidence. It also helped to set application and final submission dates and stick to the plan!
- “There’s just no getting around it – gathering evidence takes time and effort; all staff need to be involved at some point. Networking with other local health departments doing the same thing is a recipe for maintaining your sanity,” said Gretchen.
- Leadership from both the organization’s leader as well as the accreditation team leader is critical. Staff need inspiration, guidance, and support throughout the process.
- Educate and involve every staff member as well as the board. It is a TEAM effort!
- Partnerships are key – continue to cultivate those relationships! Polk County’s partner meeting during the site visit was an affirmation of their positive influence and effectiveness in the community.
- Written plans are not enough. Plans need to be thoughtfully developed, implemented and evaluated in order to make your life easier.
- Documentation is essential. Write the origin date, the review date, and the revision date on everything!
- Secure a scanner and an email archive program.
- Expect setbacks. There will be times when you realize you didn’t reach the goal you hoped to reach. This just shows you where you need to improve for the next time around.
The Benefits of Accreditation:
Polk County identified several accreditation benefits as a result of survey and evaluation results from health departments that had just completed their site visit or who had been accredited for more than a year. Polk County Health Department is now also seeing these benefits. Accreditation…
- Identifies strengths and weaknesses (aka areas for improvement)
- Strengthens your internal and external partnerships
- Encourages prioritization and address of long-standing concerns
- Provides the stimulus of quality improvement
- Improves management processes
- Increases communication with governing entities
- Creates accountability to external stakeholders
- Fosters teamwork and communication within the department
- It’s REWARDING!
The accreditation process was intense but exciting. The staff rose to the challenge during the process and now have an awareness of what strategies in their day-to-day work affect the accreditation status. The staff has worked extra hard to ensure the work they are doing meets PHAB standards. They also understand how much community partnerships mean to the work of the health department and continue to nurture those community relationships. Gretchen shared, “There is a feeling of pride to hear our partners articulate how much they appreciated working with us on population health issues.”
Tips for Others Considering Accreditation:
- Assess your agency’s readiness- don’t apply too early.
- Achieve staff and administration buy-in
- Budget the accreditation fees
- Identify and secure a mentor health department if possible
- Develop a reasonable timeline
- Follow a workplan
- Stay the course!
- Have fun and don’t take yourselves too seriously
Resources and Presentation Recording:
To view a video of Gretchen’s full presentation (which includes a section on re-accreditation), download her presentation slide deck, and access all of the various excellent resources she’s provided for agencies working towards accreditation, click below. Time stamps are included for each agenda item in the presentation video so you can easily navigate to the portion of the presentation you want to view.