By Osagie Ebekozien, MD, MPH

In 2013, when the Boston Public Health Commission (BPHC) self-assessed for accreditation readiness, results indicated low compliance with PHAB Domain 9 (Quality Improvement). Although there have been program-specific QI training and activities in the past, it wasn’t a widely-spread practice in the Commission.

Two years later, in 2015, BPHC piloted the first Introductory and Basic QI training which was highly received by staff. An oversight group – the Accreditation and Quality Improvement Committee – was established, which developed the first comprehensive Quality Improvement Plan.

By the time of the PHAB site visit in October 2017, over 60 percent of staff have been introduced to quality improvement, with more than ten formal projects completed. BPHC successfully achieved public health accreditation in November 2017, including full compliance in Domain 9 (Quality Improvement).

Some of the successful completed QI Projects included: increasing the percentage of clients enrolled in a maternal education home visiting program by 20 percent, and improving the efficiency of invoice processing by 32 percent. The QI team has made changes to the training to address health equity considerations and emerging public health issues.

After accreditation, the staffs have been looking for opportunities to contribute to BPHC’s ongoing continuous improvement journey and eager to see “what’s next.” Staff excitement and momentum from accreditation is a true testament to the culture of continuous quality improvement that has blossomed over the past few years at BPHC.

One creative way in which BPHC is continuing this momentum gained post-accreditation and creating an opportunity for staff to contribute is by “Celebrating Small Changes.” The QI team developed postcards to capture daily improvements that do not necessarily happen because of the formal QI project. The postcards feature “Accreditaurus,” our accreditation dinosaur mascot that led much of the staff engagement efforts during accreditation and has become a hallmark for quality improvement initiatives at BPHC. Staff can access the post card from our internal communication site and have been sharing numerous improvements completed post accreditation.

Select changes are featured in BPHC’s monthly Continuous Learning Commission newsletter and entered in a monthly raffle draw. Some examples of small changes submitted include: standardizing submissions to an organization-wide weekly update, transitioning to OneDrive so team members can collaborate and streamline development of creations of weekly reports, and organizing supply cabinets to support office efficiency, etc. ◊

Boston Public Health Commission in Boston, Massachusetts, was awarded national accreditation through the Public Health Accreditation Board on November 14, 2017.

About the author: Osagie Ebekozien, MD, MPH, CPHQ, CPHRM, is the Director of the Office of Accreditation and Quality Improvement at the Boston Public Health Commission. Contact him at [email protected].

• Community Engagement: The process of developing the Community Health Assessment, Community Health Improvement Plan and other major documents have increased the level of engagement between the health department and other key stakeholders.