Refresher for

PHAB Site VisitorsApril 30, 2015

Interactive Site Visitor Webinar

Welcome and Purpose of Webinar

Agenda:

Current PHAB Status and General Update

Site Visitors Role in PHAB’s Risk Prevention

Selected Evaluation Results

Site Visitor Guidance Changes

Changes in Appropriate Documentation

Other Program Updates

Accepting Assignments

Future Topics on PHAB’s Agenda

Questions and Answers

Kaye Bender, President and CEO

Kaye Bender

Jessica Kronstadt

David Stone

Robin Wilcox

Jeff Lake

Presenters

Learning Objectives Describe PHAB’s current status and general updates

Discuss the Site Visitor’s role in PHAB’s risk prevention/reduction

Describe selected PHAB evaluation results and their implications for Site Visitors

Discuss Site Visitor guidance changes, including changes in acceptable program documentation

Discuss PHAB’s needs in terms of planning and accepting review assignments

Describe some potential future topics of interest to Site Visitors

• General PHAB Update

Site Visitor’s Role in PHAB Risk Prevention/Reduction

CREDIBILITY

Staying current

Disclosing professional issues

Completing assignments on time

Being “present” during the Site Visit

Revised SV Agreement Form

CONSISTENCY

Rater reliability

Close attention to the SV Report

Kaye Bender, President and CEO

PHAB intends to provide a menu of refresher options:

Interactive and recorded webinars

Practice case study exercises leading to:―Practice scoring and conformity comment exercises

―Individual consultation

Site visitor refresher info through the PHAB site visitor

portal

New and exciting things to come

PHAB’s Planned Approach to Supporting

Site Visitor Refreshers and Success

Kaye Bender

What We are Learning

To help us improve the process:– We survey Accreditation Coordinators

– We survey Site Visitors

– We contract with NORC at the University of Chicago

Health departments’ view of accreditation is positive– 98% agree or strongly agree: “Our health department

made the right decision to apply for accreditation.”

– 100% agree or strongly agree: “Going through the accreditation process has improved the performance of our health department.”

Jessica Kronstadt, Director of Research and Evaluation

Accreditation Coordinator Survey

Jessica Kronstadt

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Site Visitors were knowledgeable about theaccreditation process and the Standards and

Measures.

Site Visitors encouraged health department staffto communicate openly during the Site Visit.

Site Visitors conducted the Site Visit in aprofessional manner.

Site Visit Report provided an accuraterepresentation of our health department.

Strongly Agree Agree Disagree Strongly Disagree

Site Visitor Survey

Jessica Kronstadt

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

By the time my Site Visit Team submitted theSite Visit Report, my Site Visit Team was in

agreement about the assessment categories forall or almost all of the measures.

The site visit report written by the Teamprovides an accurate picture of the

performance of the health department Ireviewed.

Strongly Agree Agree Disagree

Site Visitors comment that they want more practice to make sure they are assessing health departments consistently

Rater Reliability Critical that Accreditation Committee receives Site Visit

Reports with clear and consistent information

Guidance & Discussion– Information in Standards and Measures

– Training for health departments and Site Visitors

– Tip sheets and other resources

– Q&A with Accreditation Specialists

– Discussions with team about measures not assessed as Fully Demonstrated

– Coming: rubrics

Practice exercises and feedback on those exercises– During training

– After training

– Measure 1.1.2

– Periodic MANDATORY refresher exercises

Review of Site Visit Report

Jessica Kronstadt

Writing Conformity Comments

Tell How

Summarize, not list

Address the requirements

Define what is missing

Domain & Standard Comments

David Stone, Education Specialist

Clarity and consistency of comments

Guidance, with examples

Posted on:

- the site visitor portal

- e-PHAB training module for webinar

Comments = Site Visit Report

David Stone

Revisions of Policies and Procedures

PHAB is a learning organization

Site Visitor, health department, and AS

evaluations

Revise guidance and definitions, as

needed

Robin Wilcox, Chief Program Officer

Accreditation Specialist

The Accreditation Specialist is a member

of the Site Visit Team for:– Quality Assurance

– Consistency within and across Site Visit Reports

– Clarity of information for the Accreditation Committee

SEEK THE ADVICE AND COUNSEL OF

YOUR ACCREDITATION SPECIALIST

– Guidance may very well have changed since

your last Site Visit.

Robin Wilcox

Scope of Authority

PHAB has revised and refined guidance

concerning which activities are within

PHAB’s scope of authority and which are

not

New Tip Sheet (on PHAB’s website)

Robin Wilcox

Public Health Documentation

The focus of PHAB’s Standards and Measures is population-based disease prevention, health protection, and health promotion.

Population-based health are interventions aimed at disease prevention and health promotion that affect an entire population and extend beyond medical treatment by targeting underlying risks, such as tobacco; diet and sedentary lifestyles; and environmental factors. (Turnock BJH. Public Health: What It Is and How It Works. Gaithersburg, MD: Aspen Publishers, Inc.; 1997)

Robin Wilcox

Examples of Core Public Health Programs

access to clinical services

chronic disease prevention and control

community health

environmental public health

infectious diseases

governance

vital records and health statistics

health education

health promotion

injury prevention

management /administration

maternal and child health

PH emergency preparedness

PH laboratory services

See Standards and Measures V 1.5 page 9Robin Wilcox

Not in PHAB’s Scope of Authority for Documentation

1. Individual patient care and associated interventions, whether provided in the clinic, home, or other facility such as a school or correctional facility, or which have case management components, are not included in PHAB’s scope of authority.

PHAB’s liability does not extend to assuring the capacity of a health department to provide individual patient care services. Even though PHAB recognizes that some health departments are the safety net providers in their communities, standards and measures that would assess patient care would look very different than the population-based standards and measures. Additionally, for health departments who also operate a Federally Qualified Health Center (FQHC), there is an accreditation available through the Joint Commission (JC). For individual services and interventions related to mental or behavioral health interventions, health departments can also consider those specialty accreditations.

Robin Wilcox

Population Based PHFor example:

Dental Health Education

Strategies to Improve Access to Primary Care

Systems and Campaigns to Increase

Immunization Rates

Population-based Substance Abuse Prevention

Family/partner Violence Prevention

Health Education, etc. about, for

example, prenatal care, screenings,

tobacco use

Robin Wilcox

Not Appropriate for Documentation

2. Programs for the reimbursement for health care services, such as Medicaid or other health care insurance programs are outside of the scope of PHAB accreditation.

3. Social services and educational support programs do not fall under PHAB’s accreditation purview. For example,

• developmentally disabled,

• services for disabled adults,

• child welfare programs,

• child abuse intervention,

• domestic violence/intimate partner violence intervention and sheltering,

• low income housing assistance,

• child foster programs,

• adult protective services, and

• food stamps.

Robin Wilcox

Not Appropriate for Documentation

4. Individual professional and facilities licensure and

certificate programs are outside of the scope of PHAB

accreditation (for example, nursing home licenses or

certificate of need).

5. Animal health programs such as animal shelters,

catch-spay-release efforts, rabies vaccination clinics,

are outside of the scope of PHAB accreditation.

Robin Wilcox

Health Department Plans and Systems

Just because some of the public health program aspects cannot be

included in PHAB’s documentation examples doesn’t mean that health

departments shouldn’t include those staff and activities in their overall

accreditation related work. If the activities that we cannot use for

example documentation show up in the following documents, that is

fine:

– Community Health Assessment

– Community Health Improvement Plan

– Agency Strategic Plan

– Quality Improvement Plan

– Workforce Development Plan

– Performance Management System

Robin Wilcox

WIC PHAB has the reputation of not supporting WIC as a good public

health program. That is not the case.

There are three basic components of most WIC programs:– program planning, outreach, and community nutrition education;

– certification of the individual; and

– management of the food distribution.

USDA oversees, through contracts, all of these components. Some health

departments also have a separate breastfeeding promotion grant from WIC.

Program planning, outreach, community nutrition education,

and breastfeeding promotion are all acceptable components

of the WIC programs for PHAB documentation.

Robin Wilcox

You are representing PHAB

Stay on focus with the measures and

documentation

Do not address programs that are out of PHAB’s

scope of authority

Do not share your experiences in health

departments in which you have worked

Do not recommend how the health

department might do things differently

Other Guidance

Robin Wilcox

Don’t “toggle” between Versions 1.0 and

1.5

Report e-PHAB issues to your Accreditation

Specialist right away – even on a weekend

– Team India

Other Guidance

Robin Wilcox

Asking questions clarifies documentation a health

department has uploaded and reopening allows a

HD to upload additional documentation

When in doubt, ask questions or reopen measures

unless beyond scope of measure or solely because

you consider it ‘sloppy’

Use professional judgment, discuss as team

―ask your Accreditation Specialist if you have

questions

Asking Questions and

Reopening a Measure

Robin Wilcox

First step is always vetting potential site visitors with

health department to identify any COI

All assignments made through e-PHAB

When you login and see the health department, notify

Jeff Lake if you think you may have a COI

Timeline for assignment is provided in system e-mail

Accept assignment only when you can commit the time;

leaving team in progress is disruptive

If you have questions or concerns, contact Jeff

before accepting

Accepting Assignments

Jeff Lake, Volunteer Services Manager

Future Topics on PHAB’s Agenda

Army accreditation

Vital records/health statistics accreditation

Potential changes in the review and site visit process aimed at

increasing efficiencies and reducing costs

More visible use of standard metrics to describe the value and impact

of accreditation

Ongoing, and “just in time” refreshers for site visitors

Reaccreditation

Attention to the development of a new accreditation product

for health departments serving less than 50,000 population

Coordination with the Foundational Capabilities work

Coordination with the RWJF work on Culture of Health

Kaye Bender

PHAB is now using a Learning Management

System (Vubiz) http://phab.vubizlearning.com

Enter your e-mail address

Enter PHAB2015 as PIN (you may change)

After you login, you will see a screen titled “My

Enrollments”

Click launch course to access the

mandatory post test. Please complete

promptly (before May 11).

Post Webinar Instructions

Jeff Lake

Discussion

Questions

Thank You

From All of Us at PHAB

PHAB Site Visitor Refresher Training

April 30, 2015