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Board of Sedgwick County Commissioners

A Word in Edgewise

By Commissioner Tim Norton

September 22, 2014

Last week our Health Department was notified that they were awarded Health Department Accreditation after an arduous 5 year process. The Sedgwick County Health Department first started vetting the Public Health Accrediting Board (PHAB) standards and measures and began Mobilizing for Action through Planning and Partnerships (MAPP) assessment process in 2009.

Public Health Accrediting Board (PHAB) is the nonprofit organization dedicated to advancing the continuous quality improvement of tribal, state, local, and territorial public health departments. PHAB accreditation is the measurement of health department performance against a set of nationally recognized, practice-focused and evidence-based standards. These standards are based on the ten essential public health services. The goal of the voluntary national accreditation program is to improve and protect the health of the public by advancing the quality and performance of tribal, state, local and territorial public health departments. Benefits of Accreditation process: accountability and transparency to external stakeholders, documentation of the HD's capacity to deliver the three core functions and ten essential public health services, credibility of HD within the community, relationships with community stakeholders, competiveness for funding opportunities and allows the HD to better identify strengths and weaknesses.

The Sedgwick County Health Department (SCHD) was assessed in many categories. Among the department strengths were:

  • Leadership - The SCHD is seen as a leader in the community, in the state, and by the county authorities including the County Commissioners, County Administrator, and HHS Director. The department staff is described by these individuals as being the experts in public health practice. Community partners and providers look to the department for leadership.
  • External Communication - The SCHD exhibits strong community and partner collaboration in conducting the work of public health and assuring the essential services. The SCHD brings strong leadership, assessment and program/policy development skills to numerous partner coalitions to identify and address community health needs. They work to communicate regularly with providers and partners to assure community knowledge of key public health issues.
  • QI Culture - The SCHD has deliberately and progressively built Quality Improvement in to their operations. Staff and leadership are well versed in QI language and processes. They deliberately are looking at department improvement and building staff capacity across the department to undertake QI efforts.
  • Solid Foundation - The SCHD has a strong foundation with traditional public health services and has made deliberate decisions to build from this strength to assure essential services.  Despite frequent leadership changes and re-organizations they have demonstrated core processes that have been sustained over time.

The PHAB reviewing team also identified areas of future improvement and focus. They were:

  • Normalizing organizational structure - With the most recent reorganization of the SCHD there is a need to develop updated processes to incorporate and strengthen connections to county operations and county commissioners. This work has begun but normalizing these internal functions will continue to support strength in the department.
  • Connections to the public - Advancing and strengthening connections to the community at large, especially those populations at most risk, is needed. With increased diversity in the population the SCHD is encouraged to seek opportunities for greater community empowerment and engagement beyond the "usual" organizational partners. Community partners describe strong connections but many individuals described a sense that the health department was doing only direct service/clinical work.
  • Tracking and evaluation of CHIP/Strategic Plan - SCHD has invested in development of operational and community priorities but have less clarified measurable objectives with plans for tracking, evaluating and revising. Investing in and influencing community partners in ways to monitor and evaluate priorities is essential. Developing systems to monitor, evaluate, report, and revise will build efficiency and effectiveness.
  • Moving from operational to strategic - The SCHD has developed strong operational policies and protocols to assure public health practices and programs. The department has not as clearly demonstrated their ability to be strategic internally or externally through their budget, strategic planning, policy development and program development processes. There is an opportunity to look proactively at gaps and root causes and strengthen work related to health promotion and prevention. The Strategic Plan and Performance Management Plan are currently merged documents and there is a single executive level committee that focuses on these issues which reinforces the challenge.

The Health Department staff worked diligently over the five year process to insure that all requirements of the accreditation were met and exceeded. This is a relatively new process and Sedgwick County was one of the early adopters of seeking accreditation. Other Kansas health departments are going the through the process along with the Kansas Department of Health and Environment.

SCHD demonstrated in their documentation and during their site visit that they are focused on building and maintaining a functioning health department that provides leadership in the community and state.  Their department has a strong history of clinical/individual services and disease investigation capacity.  In their three physical locations in the community, this clinical service has a strong presence.  They now are working to build strength in other parts of the department and have focused on collaborative community health improvement and building capacity and resources to address health priorities.  Despite considerable recent transitions related to actual building location, organizational structure and leadership personnel, the department appears to be continuing to focus on quality. The population is changing in Sedgwick County and the department recognizes a need to address disparate health issues and consider changes in programs and services.   In general, the site visitors felt that SCHD demonstrated strong programs across all areas of the department, a commitment to health priorities identified at the community level, a focus on developing the public health workforce within their department and in the community, and a passion and dedication for improving health.

Thanks for letting me get a word in edgewise.

T.N.