The U.S. Army Public Health Command has always been committed to upholding the highest standards of public health practice, preventing disease, prolonging life and promoting health in Army beneficiaries.

To meet these commitments, the command is working with representatives from across the Army to enable Army preventive medicine departments to have their work validated by a third-party entity specifically focused on public health practice. The Public Health Accreditation Board program is a voluntary national public health department accreditation effort and is the first, and currently the only, national accrediting body for governmental public health departments.

PHAB is a nonprofit organization dedicated to improving and protecting the health of the public by advancing the quality and performance of tribal, state, local and territorial public health departments. PHAB and its accreditation program were developed in response to an identified need by public health practitioners and academicians for national performance standards and third-party validation of governmental public health practice. The program launched in fall 2011 after several years of consensus-based development.

"Achieving accreditation from PHAB represents a public health department's commitment to meet standards of quality public health practice," said Lauren Shirey, accreditation lead and lead program evaluator at the U.S. Army Public Health Command.

One of the goals of PHAB accreditation is to certify that a public health department has the necessary capacity to assure or directly deliver the 10 essential public health services as defined by the U.S. Centers for Disease Control and Prevention, outlined below:

1. Monitor health status to identify and solve community health problems.
2. Diagnose and investigate health problems and health hazards in the community.
3. Inform, educate and empower people about health issues.
4. Mobilize community partnerships and action to identify and solve health problems.
5. Develop policies and plans that support individual and community health efforts.
6. Enforce laws and regulations that protect health and ensure safety.
7. Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
8. Assure competent public and personal health care workforce.
9. Evaluate effectiveness, accessibility and quality of personal and population-based health services.
10. Research for new insights and innovative solutions to health problems.

Although an increasing number of state and local public health departments are accredited by PHAB and, as of early October, over 300 more are in process, Army public health/preventive medicine facilities lack this third-party endorsement.

USAPHC is currently facilitating an interdisciplinary team of public health-affiliated representatives from across the Army, including Office of the Surgeon General, other MEDCOM, and USAPHC, in updating the PHAB Standards and Measures for Army use. The proposed Army-specific PHAB Standards and Measures are expected to be released for public comment in a 30-45 day period in December or January. The final Army version is expected to be published by PHAB in summer 2015.

"Our goal is to ensure that Army public health and preventive medicine departments interested in applying the national public health department performance standards to their work and pursuing PHAB accreditation will have standards that are optimally suited to Army public health and that consistent definitions are used in doing so," said Shirey.

USAPHC is also assisting the Fort Riley Department of Public Health (preventive medicine department) staff in their voluntary effort to achieve PHAB accreditation. This department is the first known Army entity to pursue PHAB accreditation. The Fort Riley team submitted its initial application to PHAB in August and is slated to submit their final application by summer 2015.

"We are conducting a case study of the process at Fort Riley, and supporting them throughout the accreditation preparation and review process," said Shirey. "Our goal is for Fort Riley to be a model for public health accreditation and continuous quality improvement at other sites across the Army," said Shirey.

Although the entire process will take about two years to complete, USAPHC personnel said it is well worth the effort.

"We value consistency and quality in our work, continuous process improvement, performance management and third-party validation of our efforts, and the PHAB accreditation program offers a meaningful way for Army public health to demonstrate this," said John Resta, director of the Army Institute of Public Health.