Accreditation Transforms Delaware Division of Public Health into a Quality-Driven Organization
By Dave Walton, BA
Delaware Division of Public Health (DPH) achieved national public health departmentaccreditation in March 2016 after four years of intensive planning and organizational transformation. The planning and transformation included a deliberate commitment to continuous quality improvement. It was guided by the PHAB Standards and Measures, specifically Standard 9.2: “Develop and implement improvement processes integrated into organizational practice, programs, processes, and interventions.” As a result, DPH built a quality improvement (QI) infrastructure and knowledge base that continues to grow today.
For DPH, the quality improvement transformation included the establishment of a QI program that outlined expectations and responsibilities via policy, and the establishment of an infrastructure inclusive of staff at all levels of the division. DPH leadership created a Quality Improvement Council to guide organizational QI efforts. It is led by one of the agency’s deputy directors and includes representation from a cross-section of DPH staff from multiple levels. There are three permanent members and eight nominated members who serve two-year terms. The nominated members allow the Council to refresh its membership and provide opportunities for new individuals to be involved in organizational QI activities.
To expand staff’s QI knowledge base, the Office of Performance Management (OPM) recruited employees with QI experience and the desire to transform the health department into a quality-driven organization, to become early adopters and champions. Twenty-five employees volunteered to form a Quality Improvement Facilitator Team. Taking advantage of the Public Health Foundation’s QI project facilitator training, the Quality Improvement Facilitator Team took on formal facilitator roles. Today, the Quality Improvement Facilitator Team is comprised of 14 members, 11 of which have earned the Certified Quality Improvement Associate designation from the American Society for Quality (ASQ). The group meets regularly to learn from each other and share the latest quality improvement tools and methods. Using grant resources geared toward continuous organizational improvement, facilitators receive continuing education each year, ASQ membership, and quality certification opportunities.
Committed to continuous improvement and eager for staff to consistently use the Plan-Do-Study-Act quality improvement method, OPM established the DPH Achievement in Quality Improvement Award that is presented at employee recognition ceremonies for successfully completing a QI project. Between 2013 and 2017, DPH completed 10 QI projects. The results of the projects include:
The creation of a more efficient, customer-centric, one-stop online data request process for members of the public. Previous data requests were submitted to various offices, placing an unnecessary and time-consuming burden on the requestor to find the right office in DPH and make multiple follow ups.
A nearly 30 percent increase in our client appointment show-rate. The increase was attributed to instituting evening appointments, transportation assistance and a telephone appointment reminder system.
A 36 percent increase in average monthly customer fee collections. The increase was attributed to strategic placement of signage and a standardized payment request process.
The drive to meet accreditation standards and desire to improve transformed the DPH. The organizational transformation was highlighted in a March 2017 Association of State and Territorial Health Officials Spotlight piece where the Delaware Director of Public Health affirmed that, “One of our greatest accomplishments was becoming accredited.”
The Delaware Division of Public Health Department of Health and Social Services, in Dover, Delaware, was awarded national accreditation through the Public Health Accreditation Board on March 8, 2016.
About the author:Dave Walton is Chief of the Office of Performance Management at the Delaware Division of Public Health in Dover, Delaware. Contact him at [email protected]
Other benefits gained as a result of going through the accreditation process:
Focused workforce development plan based on employee training needs
Dynamic and actionable strategic plan
Community-driven state health assessment and improvement plan