Implementing accreditation in county health departments: The Illinois experience

Illinois is one of the participating states in the Multi-state Learning Collaborative (MLC) funded by the Robert Wood Johnson Foundation. The goal of Illinois' accreditation project is to test accreditation as a performance improvement tool among local health departments (LHD). A total of 50 performance measures and 8 standards were developed during the MLC-1 phase using NACCHO's operational definition of public health, CDC's 10 essential public health services, and the IL certification code. The accreditation project consists of a self-study process, tabletop review, site visit, and evaluation; and implemented in 7 diverse LHDs. The self-study process was designed to help each LHD demonstrate their performance by documenting evidence related to each measure. A self-study tool was designed to identify priorities for improvement. LHDs are required to rate their performance on the 50 measures and prioritize the measures that need improvement. The evidence was reviewed by a panel of experts through a tabletop exercise and the ratings were compared. Site visits were conducted by an expert panel and discrepancies in ratings were addressed. Upon completion of the site visit, recommendations were made by the expert panel to the Illinois Accreditation Task Force (IATF) on whether the LHD meets accreditation status or not. IATF awards accreditation based on recommendations from the site visit panel and additional evidence. An evaluation of each LHD's experience was conducted using qualitative research methods which, yielded rich data regarding the influence of accreditation on performance improvement. The presentation discusses the process of designing, implementing, and evaluating accreditation.