Moving toward a culture of quality: Lessons learned from public health accreditation beta test sites

Background: Building systems knowledge and capacity within public health agencies and developing a workforce competent in systems thinking, analysis, leadership, quality improvement (QI) principles and tools is essential toward improving agency performance and competence in order to address health disparities and improve population health outcomes. Aim: A survey of public health accreditation coordinators from seven state or local health agencies identified as beta sites for the Public Health Accreditation Board (PHAB) Accreditation Standards and Measures (Standards) was conducted in summer 2012. Agency accreditation coordinators were asked to describe challenges and successes in preparing to meet Domain 9 of the Standards, including strategies for developing a quality of culture, educating their workforce in quality improvement principles and practices, and identification and development of their agency's QI project. Methods: A purposeful sample of beta sites was identified and their respective accreditation coordinators interviewed via telephone using semi-structured interview questions. Findings: Beta sites identified barriers and conditions to successfully prepare for meeting accreditation standards/measures, and strategies for building a quality culture and for educating the public health workforce. These findings provide insight to guide public health agencies in preparing for accreditation and integrating quality improvement principles into practice.