Is accreditation worth the investment? An economic analysis of implementing accreditation among local health departments in Illinois

Accreditation is one of the latest topics being promoted as a tool for performance management and quality improvement for local health departments. 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 important component of assessing the feasibility of accreditation is the cost and its effectiveness. LHDs want to know if the resources invested in accreditation are worthy of the benefits they will receive. As such, a cost analysis was conducted of the amount of fiscal resources that are required for a LHD to undergo basic accreditation. The presentation discusses the process of designing, implementing, and evaluating a cost analysis of accreditation. Data was collected from all pilot sites on the fiscal resources invested in the process. Money invested and staff time were the two major fiscal resources that were invested. Univariate statistical analysis is being conducted on the data to summarize the results. Results from Illinois will provide an insight in to the costs involved with accreditation and its worthiness. It will be helpful for the LHDs to know the amount of fiscal resources needed to successfully undergo accreditation.