Survey 1

Applicant Survey (Survey 1)

Form Approved
OMB No. XXXX-XXXX
Expiration Date XX/XX/XXXX
Welcome
NORC at the University of Chicago (NORC) is asking applicant health departments to participate in a survey about
the national public health accreditation program. The survey includes questions about your experiences with the
accreditation process and the benefits of accreditation. NORC is conducting this survey on behalf of the Public
Health Accreditation Board (PHAB) and the Centers for Disease Control and Prevention (CDC) to evaluate the
outcomes of the national public health accreditation program. The questions and topics in this survey are intended
for the director of your health department, or a designee, if the director is unable to complete the survey. Thank
you for participating in this survey.
Directions
Use your mouse to click on the circle or box to indicate your answer. Click “Next” to advance to the next page, and
scroll to the bottom of each page and click “Previous” to return to the previous page. On the last page of the
questionnaire, click “Done” to complete the questionnaire. Note: once you click “Done,” you will not be able to edit
or return to your questionnaire responses.
If you have technical difficulties, contact Megan Heffernan at heffernan-megan@norc.org or 301-634-9412. Thank
you again for your participation.
Background
The survey is estimated to take 20 minutes or less to complete. Your open and honest feedback is appreciated.
Findings from this assessment will be included in a report to PHAB and CDC and may be publicly available. All data
will be presented in the aggregate; report findings will not be linked to the organization that completed the survey.
For more information about this assessment, please contact Project Director Michael Meit at meitmichael@norc.org.

CDC estimates the average public reporting burden for this collection of information as 20 minutes per response,
including the time for reviewing instructions, searching existing data/information sources, gathering and
maintaining the data/information needed, and completing and reviewing the collection of information. An agency
may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays
a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing burden to CDC/ATSDR Reports Clearance Officer;
1600 Clifton Road NE MS H21-8, Atlanta GA 30333 (ATTN: PRA (0920-xxxx).

Applicant Survey (Survey 1)
Information About Your Health Department

* 1. Name of Health Department:

Note: This information will be used to analyze findings by health department structure, size, and geographic
region; responses will not be linked to any specific health department.

* 2. Respondent Role:
Director of Health Department
Accreditation Coordinator
Other, please describe:

Applicant Survey (Survey 1)
Preparation for Accreditation

3. Please rate the degree to which each accreditation preparation activity was helpful. For
each response option below, please select the appropriate column to indicate whether the
items were Very Helpful, Helpful, Somewhat Helpful, or Not Helpful. If you did not use one of
the preparation items or activities, please select Not Applicable (N/A).

Very Helpful

Helpful

Somewhat
Helpful

Not Helpful

In-person training led by PHAB
Any other in-person workshop led by a
PHAB staff member
Technical assistance (TA) from a PHAB staff
member
Training or TA from a national public health
partner organization (e.g., APHA, ASTHO,
NACCHO, NALBOH, NIHB, NNPHI, PHF,
CDC)
Training or TA from the state health
department
Training or TA from state/regional
organization (e.g., public health institute,
public health training center, state
association)
Training or TA from a consultant
Review of PHAB Standards and Measures to
determine areas of strength and areas for
improvement

4. Other, please describe:

5. Please provide additional clarification for any of your responses, if desired.

N/A

Applicant Survey (Survey 1)
Relationship with Stakeholders

6. Please select the appropriate column to indicate whether you Strongly Agree, Agree,
Disagree, or Strongly Disagree. If you are unsure, please select Don’t Know.
Strongly
Agree

Agree

Disagree

Strongly
Disagree

Our board of health or governing entity has
a working knowledge of our health
department’s roles and responsibilities.
Our local policymakers have a working
knowledge of our health department’s roles
and responsibilities.
The public has a working knowledge of our
health department’s roles and
responsibilities.
Our key partners in other sectors (e.g.,
health care, social services, education) have
a working knowledge of our health
department's roles and responsibilities.
Our health department currently
collaborates with other health departments.

7. Please provide additional clarification for any of your responses, if desired.

Don’t Know

Applicant Survey (Survey 1)
Quality Improvement and Performance Management

8. Please rate the extent to which you agree or disagree with the following statements
regarding your health department's quality improvement (QI) and performance management
activities and culture.
Strongly
Agree

Agree

Disagree

Strongly
Disagree

Don’t Know

Currently, our health department compares
our programs, processes, and/or outcomes
against other similar health departments as
a benchmark for performance.
Before assessing our health department’s
readiness for accreditation, our health
department had implemented strategies for
QI.
Our health department currently uses
strategies to monitor and evaluate our
effectiveness and quality.
Our health department currently uses
information from our QI processes and/or
performance management system to inform
decisions.

9. Indicate the level of familiarity your health department staff members have with QI.
Have no knowledge of QI
Subset of staff have familiarity with QI
Majority of staff have familiarity with QI
Subset of staff are knowledgeable and practice QI
Majority of staff are knowledgeable and practice QI
Majority of staff routinely practice/use QI
Don’t know

10. Currently, QI in my agency is...
Not practiced anywhere in the agency
Talked about, but not required
Conducted informally; sporadic program efforts
Conducted formally in specific areas
Conducted formally and agency-wide
Our culture
Don’t know

11. Approximately what percentage of staff in your organization have received training in
performance management and/or QI?
0–5%
6–25%
26–50%
51–75%
76–95%
96–100%
Don't know

12. Please provide additional clarification for any of your responses, if desired.

Applicant Survey (Survey 1)
Workforce Development and Training

Please answer the following question about your health department’s
workforce development and training.
13. Select the workforce development and training activities currently implemented by your
health department. Select all that apply.
Include education and training objectives in performance reviews
Allow participation in training during working hours
Pay travel/registration fees for trainings
Provide on-site training
Have staff position(s) whose responsibilities include coordinating internal training for employees
Provide employee reward and recognition programs
Other, please describe:

Applicant Survey (Survey 1)
Additional Feedback

Please provide additional feedback about your health department’s
experiences preparing for the PHAB accreditation process.
14. Has your health department faced any challenges in the accreditation process thus far?
Select all that apply.
Leadership changes
Staff turnover or loss of key staff
Limited staff time or other schedule limitations
Lack of perceived value or benefit of accreditation
Not a priority for our health department
Lack of support from elected leaders
Lack of support among health department leadership team
Lack of support from board of health or other governing entity
Selected PHAB Standards and Measures are not applicable to our health department
Difficult for our health department to demonstrate conformity with selected PHAB Standards and Measures
PHAB application fees
Unanticipated costs
Competing priorities
None
Other, please describe:

15. For the challenges selected above, please provide any additional details or clarification
(e.g., if your health department overcame the obstacle, describe how).

16. Has your health department experienced any unanticipated benefits or outcomes as you
prepare to undergo the accreditation process?
Yes
No
Don't know

Applicant Survey (Survey 1)
Additional Feedback

17. Please describe the unanticipated benefits or outcomes you have experienced as you
prepare to undergo the accreditation process.

Applicant Survey (Survey 1)
Thank You

Thank you for your participation!