The Onondaga County Health Department

Every health department considering or undertaking the journey to accreditation begins with a self-assessment. We develop plans because we want to be a proactive force to help improve our community’s health. The day-to-day activities, deliverables, and public health crises take precedence and sometimes the best intended plans can sit on a shelf. The Onondaga County Health Department (OCHD) took some time to evaluate its core documents and the greatest benefit from the PHAB framework was in how we sought to make our plans come alive and work together for the 200+ staff in our department and for our community.

While our state had already established a community health assessment and community health improvement plan (CHA/CHIP), and we had a well-oiled quality improvement (QI) program for 20 years at the programmatic level, the absence of a system-wide QI and performance management (PM) system was noticeable. We also had a strategic plan (SP) and emergency preparedness plan sitting on our bookshelves, though none seemed alive. Working through PHAB’s domains forced us to dust off those plans. We put our efforts into reassessing our needs and making changes to make them fluid and practical. Gradually the words of each plan started to come alive with a theme of connectivity – from the CHA/CHIP to PM to QI.

One of the most important efforts was the creation of a workforce development (WFD) plan, which has continued to evolve with revisions during the implementation process. This WFD plan, created internally by the OCHD staff, assessed our public health competencies and identified many areas for improvement, including the need for more structured training. Health equity and the social determinants of health became conversation topics and are now regularly integrated into program work plans. All the while, the connection between the WFD, SP, PM, QI and CHA/CHIP grew stronger.

Throughout this process, our focus has been to create system changes outlined in each PHAB Domain, aligning with the 10 Essential Public Health Services, policy making, and connectivity to the governing body for its effectiveness and transparency. The rigorous accreditation process was at times difficult and anxiety provoking, but provided us a unique window of opportunities to question ourselves for efficiency and effectiveness. For example, every health department embarking on the accreditation journey must ask itself: “Do you have all the skills to improve and protect the health of our community?” We cringed, we learned and we improved. After going through the process of accreditation, we now proudly respond: “Yes we do!” The process engaged and empowered each and every staff at every level. We found many new champions among our staff who will be future leaders. We involved partners throughout the community, along with an inquisitive and engaged governing entity, who expressed their confidence in our performance and transparency. This effort was worth it!

Starting from a Gantt chart at the beginning of our accreditation journey, we followed a strict timeline, developed a document review system to evaluate and provide constructive criticism, used technology in new ways to build beautiful PDFs with perfectly aligned bookmarks to demonstrate our performance, and created accreditation poetry! Our plans were not destined for a shelf; they live in our everyday work and for our community. And the journey continues every day.

Onondaga County Health Department in Syracuse, New York, was awarded national accreditation through PHAB on August 21, 2018.

About the author: Indu Gupta, MD, MPH, MA, FACP, is Commissioner of Health at Onondaga County Health Department in Syracuse, New York. Contact her at [email protected].

Accreditation: