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Demonstration Sites Project

NACCHO’s Operational Definition is the framework for the local health department (LHD) national accreditation standards of the Public Health Accreditation Board. LHDs that are planning to become accredited would be well-served to assess the degree to which they have the capacity to fulfill the functions outlined in the Operational Definition, and engage in quality improvement activities as needed to enhance their capacity to this end. 

NACCHO is supporting 10 health department to perform a self-assessment using the LHD Self-Assessment Tool for Accreditation Preparation. Based on the results of the assessment, each local health department will embark on a quality improvement process.

Demonstration Sites:

Berrien County Health Department, MI | Cuyahoga County District Board of Health, OH

Jefferson County Health Department, AL | Lincoln-Lancaster County Health Department, NE |  Manchester Health Department, NH | Northern Kentucky Independent District Health Department, KY |  Saginaw County Health Department, MI | San Antonio Metropolitan Health Department, TX | Wagoner Health Department, OK |

West Allis Health Department, WI

Berrien County Health Department, MI

Berrien County Health Department (BCHD), located in Benton Harbor, Michigan,

serves a primarily rural population of 162,000 in southwestern Michigan. Berrien County Health Department plans to form a Project Management Team that will complete the self-assessment and submit the data to the Project Director.  The Manager of the service area targeted for the quality improvement process will collaborate with the designated Project Director and the NACCHO consultant to implement the specific quality improvement activities.  Responses to the Metrics will be analyzed, a quality improvement project with goal statements prepared, and a full report issued at the conclusion of the project.   Periodic reports will be submitted by the Project Director to the Management Team and to the Board of Health.  Additionally, the BCHD staff will receive status updates through presentations provided at all-staff training days scheduled twice a year.  Visit BCHD at: http://www.berriencohlthdept.org/.

Cuyahoga County District Board of Health, OH

The Cuyahoga County District Board of Health (CCBH) near Cleveland, Ohio, serves a predominantly urban population of approximately 1.4 million. The Cuyahoga County Board of Health will identify performance objectives using the Operational Definition Prototype Metrics.  In addition, an external marketing campaign will be launched, targeting all elected officials of the 56 municipalities in the health district.  The campaign will update community leadership of CCBH’s Continual Quality Improvement (CQI) process and its goals.  Additionally, internal marketing of the initiative will occur through posters displayed in each service area, which highlight the performance goals for 2007-2008; they will be updated appropriately as goals are met.   Quarterly staff meetings will serve to update progress on the written objectives and report the results to their Director and Performance Standards Program Manager for tracking.  For more information on the CCBH, visit: http://www.ccbh.net/ccbh/opencms/CCBH/index.html.

Jefferson County Health Department, AL

Jefferson County Department of Health, located in Birmingham, Alabama, serves an urban area with approximately 662,047 residents. The Jefferson County Department of Health (JCDH) will implement a two-phase project involving all levels of JCDH program leadership in efforts addressing quality improvement for staff: (1) Training and learning.  The main goal is to increase staff awareness, knowledge, and skills related to the Operational Definition Prototype Metrics and Quality Improvement activities.  These include training on the Prototype Metrics, how it relates to JCDH divisions, and the scoring methodology of each Metrics indicator. (2) Quality improvement. The main objective of this second phase is to improve one or two priority areas of JCDH.  This will be carried out by prioritizing all areas and subsequently selecting at least one area for improvement, recording the objectives and action steps, and implementing the steps under the guidance of a Quality Improvement Task force.  Visit JCHD at: http://www.jcdh.org/.

Lincoln-Lancaster County Health Department, NE

Lincoln-Lancaster County Health Department, located in Lincoln, Nebraska, serves an urban population of nearly 285,000 residents. The project will attempt to expand service delivery through increasing early access to care and enhancing systems to track and respond to emerging public health issues, while mitigating poor health outcomes, particularly from complications arising from chronic disease.  The self-assessment will involve several Departmental divisions: Environmental Public health, Health Promotion and Outreach, Community Health Services (Public Health Nursing), Dental Health and Nutrition, Information Management, Health Data and Evaluation, and the Director’s Office.

Assessment results will be reviewed and priority areas for quality improvement identified by the Staff Leadership Team, in collaboration with the NACCO-sponsored quality improvement consultant.  The Team will be comprised of a representative from every departmental division undergoing a self-assessment, the Health Director, and the Assistant Health Director, who will serve as Team Leader.   For more information on the Lincoln-Lancaster County Health Department, please visit: http://www.lincoln.ne.gov/city/health/.

Manchester Department of Health, NH

The City of Manchester Department of Health, located in Manchester, New Hampshire, serves an urban population of approximately 107,000 residents.  The Manchester Department of Health plans to conduct the self-assessment and implementation project in four phases, using a number of methods adapted from national best practices.  The phases are comprised of: assembling a Quality Improvement Team (QIT) to lead the process, utilizing NACCHO’s Operational Definition Prototype Metrics to perform the self-assessment, producing a goal statement and identifying priority areas for quality improvement upon analysis of the self-assessment results, and implementing a quality improvement process and analyzing the results. 

Because the City of Manchester has an interest in using performance-based management models in all City Departments, the Health Department plans to share its findings with the Mayor and Board of Aldermen, and to establish the team and its activities as an ongoing process within the Department.  Consequently, the QIT plans to implement other needed quality improvement efforts, as identified through the self-assessment, in order to advance the agency’s capacity in preparation for national accreditation.  Visit the City of Manchester Department of Health at: http://www.manchesternh.gov/CityGov/HLT/.

Northern Kentucky Independent District Health Department, KY

The Northern Kentucky Independent District Health Department is located in Edgewood, Kentucky, just across the Ohio River from Cincinnati, Ohio, and serves a primarily suburban population of approximately 350,000  residents. Northern Kentucky Health Department will designate key management staff to participate in a series of meetings to complete the assessment and planning process.  The instrument used in the process incorporates approaches from multiple sources, including the “Operational Definition Prototype Metrics,” the 10 Essential Public Health Services Standards, Indicators and Illustrative Evidence, as well as the scoring plan of the National Public Health Performance Standards version 2.0.   The combined assessment teams will prioritize areas and develop a subsequent implementation plan to address quality improvement.   Northern Kentucky anticipates the project will persuade the State Department of Public Health to shift their perspectives with regard to program funding, from a relatively narrow categorical approach, to a method that incorporates service delivery as identified by the Operational Definition.   For more information on the Northern Kentucky Health Department, please visit: http://www.nkyhealth.org/mx/hm.asp?id=home.

Saginaw County Health Department, MI

The Saginaw County Department of Public Health (SDCPH), located in Saginaw, Michigan, serves a rural population of approximately 210,000 residents.  SDCPH will conduct a self-assessment, using the Operational Definition Prototype Metrics in a meeting including: the Executive Team, a consultant serving as the main facilitator, three strategic planning facilitators, and the Health Officer. The Operational Definition Prototype Metrics will be disseminated before the meeting to the Executive Team for individual examination, and to enable a discussion from all agency divisions in order to ensure that the application and results of the self-assessment reflect a thorough, multi-disciplinary approach. 

The Executive Team will provide guidance in the identification of goal statements and priority area(s) for quality improvement.  The NACCHO-sponsored consultant will facilitate implementation of the quality improvement steps at SCDPH.   The facilitators will participate in bi-monthly conference with NACCHO staff and other demonstration site grantees to provide progress updates and share lessons learned.  For more information on SDPH, visit: http://saginawpublichealth.org.

San Antonio Metropolitan Health Department, TX

The San Antonio Metropolitan Health District (SAMHD) in San Antonio, Texas, serves an urban population of 1.3 million. A Planning Committee of six Health Department management staff members will oversee both the self-assessment and quality improvement components of the project, while a NACCHO-sponsored consultant will provide technical assistance for the latter phase of the project.  An external consultant who has worked in the past with SAMHD on strategic planning activities related to quality improvement and the Mobilizing for Action through Planning and Partnerships (MAPP) process, will facilitate the self-assessment phase, during which both SAMHD staff and external public health partners (including health service providers, academics, and community stakeholders) will participate. 

To complement the data collected through the Metrics assessment, two additional instruments, the National Public Health Performance Standards Program (NPHPSP) and LHD Contribution Questionnaires, will be also be used to provide background on the status of the overall health system, and will assist in the prioritization of the areas to be targeted for the quality improvement intervention.  After reviewing the self-assessment results, the Planning Committee will prioritize areas for action incorporating key dimensions, such as LHD achievement of standards and perceived importance characterized by pre-established criteria for prioritization.  You may visit SAMHD at: http://www.sanantonio.gov/health/.

Wagoner County Health Department, OK

The Wagoner County Health Department located in Wagoner, Oklahoma, serves a primarily suburban population of approximately 58,000 residents. The National Public Health Performance Standards (NPHPS) for Local Health Departments will be discussed in a staff meeting before the assessment takes place, to ensure that the supervisors are familiar with the standards on which the Operational Definition is based.  The Health Department will utilize a staff member who has researched the NPHPS as an internal consultant, and will request an external consultant to guide the self-assessment process. 

The internal consultant will gather the data, and publish the results for  internal review and discussion. With guidance from program supervisors, the consultant will present goal statements for quality improvement processes involving the priority areas previously identified, and will subsequently assist the Wagoner County Health Department to implement a quality improvement plan.  Results will be distributed to the Local Board of Health.  For Wagoner County Health Department contact information visit: http://www.health.state.ok.us/phone/Chdphone.html#wag.

West Allis Health Department, WI

The West Allis Health Department, located in West Allis, Wisconsin, serves an urban population of approximately 64,000 residents. As part of the project, the Health Department will form an internal interdisciplinary accreditation workgroup that includes two Public Health Specialists as well as staff from administration, environmental health, community health services, and health education departments.  

The project will use the NACCHO Operational Definition Prototype Metrics for the self-assessment; consequently, a staff meeting will be held to discuss the results and the workgroup will identify priority areas for quality improvement.   Planning, development, and implementation of quality improvement processes for the priority areas identified by the workgroup will be carried out in collaboration with a NACCHO-sponsored consultant.   The planning phase will include creating: a logic model, process, output and/or outcome measures, as well as timelines, deliverables, and staff assignments.   For more information on West Allis Health Department, please visit: http://www.ci.west-allis.wi.us/.