North Central Public Health District (NCPHD) received accredited status from PHAB in September 2017. Since then, and throughout the time spent working on our Action Plan, our use of Domain 9 to guide processes and programs has resulted in positive changes in the realm of quality improvement.
Accreditation has helped us better identify opportunities for quality improvement projects. Before we became accredited, NCPHD staff were already involved in a number of quality improvement projects without necessarily identifying them as such. Engaging in quality improvement training has given us a framework for identifying a problem, thinking strategically about how to solve the problem, implementing a proposed solution, and following up to ensure progress. Accreditation has introduced us to the PDCA (plan-do-check-act) cycle and helped us think critically about how we can improve different processes and procedures in all of our different programs. It has also motivated us to document the progress of existing QI projects so we can see our successes and improvements and identify future QI projects.
For example, our Health Officer and clinic staff took on a quality improvement project to improve lab processes and reduce lab errors. This team clarified lab procedures, presented them to all staff, and began implementing the new procedure. In order to check progress on this project, billing statements and the lab error log were reviewed quarterly. Within several months of beginning this project, no new lab errors were recorded in the error log.
The Home Visiting team is currently involved in a quality improvement project to efficiently receive and follow up with birth notifications from local hospitals. Previously, we did not have a system in place for receiving and following up with birth notifications, as they are not true referrals. Home visiting nurses and community health workers are now in the process of collaboratively developing a procedure to outline the receipt and subsequent follow up of clients that reach us through birth notifications. This project has involved cooperation, peer sharing, and critical thinking to create an appropriate procedure.
Most importantly, engaging in the accreditation process has reinforced the idea of a “culture of quality” at NCPHD. It is not always easy to keep in mind the myriad ways that processes and workflows can be improved. Sometimes, a QI project might seem like extra work. By working with PHAB on accreditation, NCPHD staff and leadership have begun to embrace a culture of quality. We are all moving toward this mindset in our everyday workflows, asking ourselves how we can improve our day-to-day processes. We are acknowledging that we already take on QI projects every day in small ways, and we are challenging ourselves to work collaboratively and use the PDCA cycle to improve how we work.
North Central Public Health District in The Dalles Oregon, was awarded national accreditation through the Public Health Accreditation Board on September 13, 2017.
About the author: Judy Bankman, MPH, is Community Engagement Coordinator at North Central Public Health District in The Dalles, Oregon. Contact her at [email protected].