scholarly journals Longitudinal Evaluation of Quality Improvement and Public Health Accreditation Readiness in Nebraska Local Health Departments, 2011-2016

2018 ◽  
Vol 133 (3) ◽  
pp. 250-256
Author(s):  
Li-Wu Chen ◽  
Abbey Gregg ◽  
David Palm
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Technical Assistance ◽  
Group Discussion ◽  
High Capacity ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Staff Members ◽  
Key Informant

Objectives: Public health accreditation is intended to improve the performance of public health departments, and quality improvement (QI) is an important component of the Public Health Accreditation Board process. The objective of this study was to evaluate the QI maturity and accreditation readiness of local health departments (LHDs) in Nebraska during a 6-year period that included several statewide initiatives to progress readiness, including funding and technical assistance. Methods: We used a mixed-methods approach that consisted of both online surveys and key informant interviews to assess QI maturity and accreditation readiness. Nineteen of Nebraska’s 21 LHDs completed the survey in 2011 and 2013, 20 of 20 LHDs completed the survey in 2015, and 19 of 20 LHDs completed the survey in 2016. We facilitated a large group discussion with staff members from 16 LHDs in 2011, and we conducted key informant interviews with staff members from 4 LHDs in 2015. Results: Both QI maturity and accreditation readiness improved from 2011 to 2016. In 2011, of 19 LHDs, only 6 LHD directors agreed that their LHD had a culture that focused on QI, but this number increased every year up to 12 in 2016. The number of LHDs that had a high capacity to engage in QI efforts improved from 3 in 2011 to 8 in 2016. The number of LHDs with a QI plan increased from 3 in 2011 to 10 in 2016. The number of LHDs that were confident in their ability to obtain Public Health Accreditation Board accreditation improved from 6 in 2011 to 13 in 2016. Although their QI maturity generally increased over time, LHDs interviewed in 2015 still faced challenges adopting a formal QI system. External financial and technical support helped LHDs build their QI maturity and accreditation readiness. Conclusion: Funding and technical assistance can improve LHDs’ QI maturity and accreditation readiness. Improvement takes time and sustained efforts by LHDs, and support from external partners (eg, state health departments) helps build LHDs’ QI maturity and accreditation readiness.

scholarly journals Erratum

2018 ◽  
Vol 133 (4) ◽  
pp. 516-516
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Longitudinal Evaluation

Chen LW, Gregg A, Palm D. Longitudinal evaluation of quality improvement and public health accreditation readiness in Nebraska local health departments, 2011-2016. Public Health Rep. 2018;133(3):250-256. (Original DOI: 10.1177/0033354918754542) There was an error with respect to Figures 2 and 3 in the original published version of this article. The article has been corrected online and in print.

scholarly journals Patterns and Correlates of Public Health Informatics Capacity Among Local Health Departments

2014 ◽  
Vol 6 (3) ◽  
Author(s):  
J. Mac McCullough ◽  
Kate Goodin
Keyword(s):  
Public Health ◽  
Information Exchange ◽  
Health Informatics ◽  
High Capacity ◽  
Local Health ◽  
Health Departments ◽  
Public Health Informatics ◽  
Local Health Departments ◽  
Syndromic Surveillance System ◽  
Service Portfolio

Objective: Little is known about the nationwide patterns in the use of public health informatics systems by local health departments (LHDs) and whether LHDs tend to possess informatics capacity across a broad range of information functionalities or for a narrower range. This study examined patterns and correlates of the presence of public health informatics functionalities within LHDs through the creation of a typology of LHD informatics capacities.Methods: Data was available for 459 LHDs from the 2013 National Association of County and City Health Officials Profile survey. An empirical typology was created through cluster analysis of six public health informatics functionalities: immunization registry, electronic disease registry, electronic lab reporting, electronic health records, health information exchange, electronic syndromic surveillance system. Three-categories of usage emerged (Low, Mid, High). LHD financial, workforce, organization, governance, and leadership characteristics, and types of services provided were explored across categories.Results: Low-informatics capacity LHDs had lower levels of use of each informatics functionalities than high-informatics capacity LHDs. Mid-informatics capacity LHDs had usage levels equivalent to high-capacity LHDs for the three most common functionalities and equivalent to low-capacity LHDs for the three least common functionalities. Informatics capacity was positively associated with service provision, especially for population-focused services.Conclusion: Informatics capacity is clustered within LHDs. Increasing LHD informatics capacity may require LHDs with low levels of informatics capacity to expand capacity across a range of functionalities, taking into account their narrower service portfolio. LHDs with mid-level informatics capacity may need specialized support in enhancing capacity for less common technologies.

Patterns of Cross-Sector Collaboration in Local Health Departments: A Cluster Analysis

2020 ◽  
pp. 152483992097298
Author(s):  
Alexis K. Grant
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Determinants Of Health ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Structural Determinants ◽  
Cluster Assignment ◽  
Cross Sectional ◽  
Top Executive

Local health departments (LHDs) are positioned to act as the community health strategist for their catchment area, which requires cross-sector collaboration. However, little research exists to understand how much and what types of cross-sector collaboration occur and its impact on LHD practice. Data from 490 LHDs who participated in the 2016 National Profile of Local Health Departments survey were analyzed to identify patterns of cross-sector collaboration among LHDs. In the survey, LHDs reported the presence of collaborative activities for each of 22 categories of organizations. Factor analysis was used to identify patterns in the types of organizations with which LHDs collaborate. Then, cluster analysis was conducted to identify patterns in the types of cross-sector collaboration, and cross-sectional analyses examined which LHD characteristics were associated with cluster assignment. LHDs collaborated most with traditional health care–oriented organizations, but less often with organizations focused on upstream determinants of health such as housing. Three distinct clusters represented collaboration patterns in LHDs: coordinators, networkers, and low-collaborators. LHDs who were low-collaborators were more likely to serve smaller populations, be unaccredited, have a smaller workforce, have a White top executive, and have a top executive without a graduate degree. These findings imply that public health practitioners should prioritize building bridges to a variety of organizations and engage in collaboration beyond information sharing. Furthermore, LHDs should prioritize accreditation and workforce development activities for supporting cross-sector collaboration. With these investments, the public health system can better address the social and structural determinants of health and promote health equity.

scholarly journals Actionable lessons for the US COVID vaccine program

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Gary L. Freed
Keyword(s):  
Public Health ◽  
Local Health ◽  
National Strategy ◽  
Individual State ◽  
Health Departments ◽  
Local Health Departments ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
The Us ◽  
Vaccine Distribution

AbstractWhen attempting to provide lessons for other countries from the successful Israeli COVID-19 vaccine experience, it is important to distinguish between the modifiable and non-modifiable components identified in the article by Rosen, et al. Two specific modifiable components included in the Israeli program from which the US can learn are (a) a national (not individual state-based) strategy for vaccine distribution and administration and (b) a functioning public health infrastructure. As a federal government, the US maintains an often complex web of state and national authorities and responsibilities. The federal government assumed responsibility for the ordering, payment and procurement of COVID vaccine from manufacturers. In designing the subsequent steps in their COVID-19 vaccine distribution and administration plan, the Trump administration decided to rely on the states themselves to determine how best to implement guidance provided by the Centers for Disease Control and Prevention (CDC). This strategy resulted in 50 different plans and 50 different systems for the dissemination of vaccine doses, all at the level of each individual state. State health departments were neither financed, experienced nor uniformly possessed the expertise to develop and implement such plans. A national strategy for the distribution, and the workforce for the provision, of vaccine beyond the state level, similar to that which occurred in Israel, would have provided for greater efficiency and coordination across the country. The US public health infrastructure was ill-prepared and ill-staffed to take on the responsibility to deliver > 450 million doses of vaccine in an expeditious fashion, even if supply of vaccine was available. The failure to adequately invest in public health has been ubiquitous across the nation at all levels of government. Since the 2008 recession, state and local health departments have lost > 38,000 jobs and spending for state public health departments has dropped by 16% per capita and spending for local health departments has fallen by 18%. Hopefully, COVID-19 will be a wakeup call to the US with regard to the need for both a national strategy to address public health emergencies and the well-maintained infrastructure to make it happen.

Application for Public Health Accreditation Among US Local Health Departments in 2013 to 2019: Impact of Service and Activity Mix

2020 ◽  
pp. e1-e8
Author(s):  
Jonathon P. Leider ◽  
Jessica Kronstadt ◽  
Valerie A. Yeager ◽  
Kellie Hall ◽  
Chelsey K. Saari ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Latent Class ◽  
The United States ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Profile Data ◽  
The Public ◽  
Funding Support

Objectives. To examine correlates of applying for accreditation among small local health departments (LHDs) in the United States through 2019. Methods. We used administrative data from the Public Health Accreditation Board (PHAB) and 2013, 2016, and 2019 Profile data from the National Association of County and City Health Officials to examine correlates of applying for PHAB accreditation. We fit a latent class analysis (LCA) to characterize LHDs by service mix and size. We made bivariate comparisons using the t test and Pearson χ2. Results. By the end of 2019, 126 small LHDs had applied for accreditation (8%). When we compared reasons for not pursuing accreditation, we observed a difference by size for perceptions that standards exceeded LHD capacity (47% for small vs 22% for midsized [P < .001] and 0% for large [P < .001]). Conclusions. Greater funding support, considering differing standards by LHD size, and recognition that service mix might affect practicality of accreditation are all relevant considerations in attempting to increase uptake of accreditation for small LHDs. Public Health Implications. Overall, small LHDs represented about 60% of all LHDs that had not yet applied to PHAB. (Am J Public Health. Published online ahead of print December 22, 2020: e1–e8. https://doi.org/10.2105/AJPH.2020.306007 )

scholarly journals An Academic/Government Partnership to Provide Technical Assistance with Pandemic Influenza Planning to Local Health Departments in North Carolina

2010 ◽  
Vol 125 (5_suppl) ◽  
pp. 92-99 ◽  
Author(s):  
Richard T. Rosselli ◽  
Meredith K. Davis ◽  
Kristina Simeonsson ◽  
Morgan Johnson ◽  
Brant Goode ◽  
...  
Keyword(s):  
North Carolina ◽  
Pandemic Influenza ◽  
Technical Assistance ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments

Supporting Local Health Departments to Lead Multisectoral Youth Violence Prevention Efforts

2020 ◽  
pp. 152483992094776
Author(s):  
Allison B. Dymnicki ◽  
Jason Katz ◽  
Xan J. Young ◽  
Mary Thorngren ◽  
Jazmine Orazi ◽  
...  
Keyword(s):  
Violence Prevention ◽  
Organizational Support ◽  
Youth Violence ◽  
Technical Assistance ◽  
Data Sources ◽  
Organizational Level ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Youth Violence Prevention

This article examines organizational-level outcomes achieved during a technical assistance (TA) initiative designed to increase the capacity of local health departments (LHDs) to prevent youth violence (YV) via a multisectoral approach. This effort was designed to address the knowledge gap regarding how to provide effective TA to LHDs, specifically in YV. Twelve communities with high rates of YV were selected to participate using a multistage process. TA provided to LHD representatives (and other community partners) included monthly calls with TA specialists, group online learning events, community-of-practice calls, and access to an online portal offering additional resources. Data sources were used to determine the extent to which communities achieved the initiative’s intended outcomes, including increased infrastructure to support youth violence prevention (YVP) at LHDs and the creation of community-wide violence prevention plans. Data sources included an online TA tracking system, annual semistructured group interviews, and point-of-contact surveys. While results indicated variation in TA uptake across sites, several target outcomes were achieved including increased representation and engagement of diverse perspectives in local YVP efforts and strengthened infrastructure and integration of YVP at LHDs. Findings highlight the importance of supporting LHDs to align YVP work with other priorities and funded activities, building a larger role for leadership in providing organizational support for YV, supporting the development of multisector coalitions or partnerships to decrease silos among different sectors focused on similar populations or communities. Implications from this initiative suggest that LHDs can be supported to convene local, multisector YVP efforts, which can be sustained if local YVP infrastructure is enhanced.

scholarly journals Building Back Better: Local Health Department Engagement and Integration of Health Promotion into Hurricane Harvey Recovery Planning and Implementation

2019 ◽  
Vol 16 (3) ◽  
pp. 299 ◽  
Author(s):  
Mallory Kennedy ◽  
Shannon Gonick ◽  
Hendrika Meischke ◽  
Janelle Rios ◽  
Nicole Errett
Keyword(s):  
Disaster Recovery ◽  
Technical Assistance ◽  
Health Department ◽  
Decision Makers ◽  
Health Impacts ◽  
Local Health ◽  
Health Departments ◽  
Local Health Departments ◽  
Recovery Planning ◽  
Resilient Communities

Disaster recovery provides an opportunity to build healthier and more resilient communities. However, opportunities and challenges encountered by local health departments (LHDs) when integrating health considerations into recovery have yet to be explored. Following Hurricane Harvey, 17 local health and emergency management officials from 10 agencies in impacted Texas, USA jurisdictions were interviewed to describe the types and level of LHD engagement in disaster recovery planning and implementation and the extent to which communities leveraged recovery to build healthier, more resilient communities. Interviews were conducted between December 2017 and January 2018 and focused on if and how their communities were incorporating public health considerations into the visioning, planning, implementation, and assessment phases of disaster recovery. Using a combined inductive and deductive approach, we thematically analyzed interview notes and/or transcripts. LHDs reported varied levels of engagement and participation in activities to support their community’s recovery. However, we found that LHDs rarely articulated or informed decision makers about the health impacts of recovery activities undertaken by other sectors. LHDs would benefit from additional resources, support, and technical assistance designed to facilitate working across sectors and building resilience during recovery.

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