SUPPORTING LONG-TERM QUALITY IMPROVEMENT THROUGH ACCREDITATION PROCESSES

This study examines local health departments (LHDs) advanced in accreditation and quality improvement (QI) efforts, focusing on barriers and facilitators to sustaining improvements and fostering a culture of QI. Using a mixed-methods design, quantitative data were collected from self-report surveys of 22 LHDs across the United States, and qualitative insights were gathered from telephone interviews with 10 QI lead staff. The survey assessed LHDs’ self-ratings across six QI culture domains: leadership commitment, employee empowerment, teamwork and collaboration, continuous process improvement, customer focus, and QI infrastructure. Results showed high self-ratings in leadership commitment and employee empowerment; 86% in teamwork and collaboration; 72% in customer focus; and 64% in both QI infrastructure and continuous process improvement. Qualitative findings identified staff turnover, budget cuts, and emergent crises as primary barriers, while strong leadership, accreditation processes, and dedicated resources emerged as key facilitators. The study concludes that LHDs seeking to build and sustain a QI culture should prioritize leadership support and staff time allocation early in their QI journey, with accreditation serving as a valuable catalyst for embedding a sustained QI culture