24 Feb North Carolina Accreditation is mandatory and all local health departments, by statute, must obtain and maintain accreditation status
1. North Carolina Accreditation is mandatory and all local health departments, by statute, must obtain and maintain accreditation status. One argument against this is that the system is semi-regulatory and accreditation should be voluntary. Should the NC system be mandatory? What other approaches could encourage LHDs to seek accreditation? What are the pros and cons of a legislatively mandated system of process improvement?
2.A national voluntary public health accreditation program is under development and is expected to be fully operational in 2011. What are some ways that a state-based system could operate within a national system? Should there be a two-tier system with state systems operating separately from the national system? Can one national system provide standards and benchmarks applicable to all public health agencies?
3.One of the purposes of accreditation is to encourage quality improvement in the department. The report given to local health departments has a section of QI suggestions that the department may choose to use. Many health directors have embraced quality improvement and research shows that many have implemented QI initiatives. Yet, many feel that QI lacks real value to the agency. How do we best use an accreditation system to promote QI initiatives? Should we incorporate QI into the accreditation standards?
4.A future goal of accreditation will be the improvement in health-status indicators for our communities. Since health status can be the result of the full healthcare system, of which the health department is but one component, is accreditation a necessary but not sufficient condition to lead to improved health outcomes?
5.The NC Accreditation program is supported by an allocation by the state legislature. As the only source of funding, this dependence led to a disruption in the program when funding was cut during the 09–10 fiscal year. What type of future business models should be used to ensure that the program is sustainable?
6.Since the NC system is mandatory, it is important to have legislator support and funding. Legislators also have expectations for health outcomes and accountability for local health departments. What approach to legislators is best to persuade their support of funding for accreditation?
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