Accreditation Drives Integrated Performance Excellence at the Fairfax County Health Department
By Lila Herndon Vizzard, MPH
Planning for and earning accreditation requires a commitment by staff at all levels to establish a robust, coordinated system of performance management that can respond to emerging needs and trends while ensuring ongoing, high-quality services for the communities we serve. There is an African proverb that says, “If you want to go fast, go alone. If you want to go far, go together.” This adage of collaboration and integration is reflected throughout the Public Health Accreditation Board’s (PHAB) Standards and Measures and is explicitly articulated in Domain 9.
At the Fairfax County Health Department in Fairfax, Virginia, we knew from our accreditation self-assessment that our performance management system (PMS) could be enhanced. While we had been actively working for many years in each quadrant of the PMS–performance standards, performance measures, quality improvement (QI), and reporting progress—demonstrating clear connections among all the components of the system remained challenging. So it was not a surprise that when we were accredited in 2016, PHAB identified the further definition of and coordination among elements of our PMS as areas for improvement.
With PHAB Domain 9 and the Turning Point model as our guides, we developed our PMS policy to not only address the four component areas, but also to incorporate the structural changes necessary to promote a more integrated approach to performance management. These interrelated and interdependent elements work together to set organizational direction; identify standards for performance; measure and report performance; and improve programs, policies, and outcomes.
The PMS policy provided greater clarity to leadership and staff on the parts and functions of the PMS and clearly defined roles and responsibilities for ongoing implementation based on the following newly established organizational structure:
Performance Excellence Leadership Council: the governing body that ensures accountability for, and provides oversight of, the implementation of all aspects of the PMS
Program Performance Committee: the team responsible for the development, analysis, and reporting of performance measures throughout the department
Quality Improvement Committee: the primary administrative body for QI, responsible for the implementation and coordination of QI activities throughout the organization
Strategic Planning Committee: the team involved in the revision, implementation, review, and evaluation of the departmental strategic plan; also provides information to fulfill accreditation and reaccreditation requirements
Workforce and Organizational Development Committee: the team that actively promotes a culture of learning, quality, and performance improvement through training and other workforce development strategies
We held an all-staff videoconference in May 2018 to roll out the new PMS structure and policy to all health department employees and have created tools to more easily communicate about our progress. Based on these efforts, we are revising our staff training curricula and developing new offerings on all aspects of the PMS. In addition, we are establishing an internal performance measurement dashboard for improved reporting, monitoring, and alignment of performance measures across the department. So far, four of the five bodies of the PMS have met and started working toward full implementation— anticipated in 2019 —with representation from across all divisions and programs. While we are confident in how far we can go, accreditation helped us to focus our efforts on better ways to make that journey together.
Fairfax County Health Department in Fairfax, Virginia, was awarded national accreditation through PHAB on May 17, 2016.
About the author: Lila Herndon Vizzard, MPH, is Accreditation andQuality Improvement Coordinator at Fairfax County Health Department in Fairfax, Virginia. Contact her at [email protected].
Other benefits gained as a result of going through the accreditation process:
Enhanced communication and engagement in quality improvement efforts
Increased interest in performance metrics and data analysis throughout the department
Identification of new areas of interest in staff training and professional development
Greater visibility and recognition of public health initiatives