Date of Completion
Bonnie McRee, David Gregorio, Karen Spargo
Field of Study
Master of Public Health
Background: Accreditation can benefit local health departments (LHDs) through the promotion of a culture of quality improvement (QI); yet LHDs tend not to perform well on QI-related measures (Domain 9 – Evaluate and Continuously Improve Processes, Programs, and Interventions). Methods: This study evaluated whether small/medium LHDs’ performance on Domain 9 impacts their accreditation results or performance on other domains. The qualitative analysis utilized Normalization Process Theory to reveal factors that guide LHDs in accreditation preparations. Results: Small/medium LHDs not required to submit an action plan scored higher on Domain 9. Performance on four domains exhibited a moderately strong correlation with performance on Domain 9 (.40≤r≤.70). Discussion: LHD staff play a pivotal role in accreditation goals, like the development of a culture of QI. Growth of staff commitment can increase QI comprehension, engagement in QI, stimulated action, and feedback loops that move LHDs towards institutional cultures of QI.
Smith, Lina, "Developing a QI Culture in Accredited Local Health Departments: Use of Normalization Process Theory" (2020). Master's Theses. 1483.