What’s financial impact of accreditation?

In Iowa, the movement in the public health community toward accreditation and quality improvement is on a path that seems destined for failure. It is not because good people have not been working on it. The most significant reason for failure will be avoidance of cost control.

In his landmark book on quality improvement, “Out of the Crisis,” native Iowan, W. Edwards Deming wrote about the need to “improve constantly and forever the system of production and service, to improve quality and productivity, and thus constantly decrease costs” in order to transform American business.

At the University of Iowa College of Public Health Fall Colloquium on Nov. 19, I asked a panel that included Christopher Atchison, University of Iowa associate dean for public health practice, Kaye Bender, president and CEO of the Public Health Accreditation Board, and Tom Newton, director of the Iowa Department of Public Health, this question: “What is the financial impact on local public health departments of implementing the proposed voluntary accreditation process?” No one knew.

My expectation is that the distinguished panel would have answered this question before moving Iowa forward. At a minimum, compare the proposed staffing changes resulting from accreditation against current staff pay scales to determine the financial impact. There was no evidence this was done.

Without adequate concern for costs, this public health initiative, despite its promise, may be doomed for disaster.

Paul Deaton, Chair

Johnson County Board of Health

Solon