title: Relationship between quality improvement implementation and accreditation seeking in local health departments.
abstract: OBJECTIVE
  We examined the relationship between quality improvement (QI) maturity and accreditation attributes of US local health departments (LHDs), specifically those in Nebraska.
  
  
  METHODS
  Using 2011 Nebraska LHD QI survey data, we conducted Spearman correlation analyses between QI maturity domains and accreditation attributes. Using the 2010 National Association of County and City Health Officials' National Profile of LHDs, we conducted logistic regression analyses to examine the relationships between specific QI strategies and attitude toward seeking accreditation.
  
  
  RESULTS
  Leaders' commitment to and length of time engaged in QI were positively associated with LHDs' general attitude toward seeking accreditation. Use of QI strategies and integration of QI policies and practices were positively associated with LHDs' confidence in their capacity to obtain accreditation. LHDs that had used at least 1 QI framework and at least 1 QI technique in the past year were more likely to agree that they would seek accreditation within 2 years of the national accreditation program.
  
  
  CONCLUSIONS
  Experience with and expertise in QI implementation play an important role in LHDs' decision to seek accreditation, and their accreditation-seeking efforts may benefit from prior implementation of systematic QI strategies.
authors.affiliation: Li-Wu Chen, Anh Nguyen, Janelle J. Jacobson, Niodita Gupta, and Sarbinaz Bekmuratova are with the Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha. David Palm is with the Office of Community and Rural Health, Division of Public Health, Nebraska Department of Health and Human Services, Lincoln.
authors.forename: Li-Wu
authors.initials: LW
authors.lastname: Chen
authors.forename: Anh
authors.initials: A
authors.lastname: Nguyen
authors.forename: Janelle J
authors.initials: JJ
authors.lastname: Jacobson
authors.forename: Niodita
authors.initials: N
authors.lastname: Gupta
authors.forename: Sarbinaz
authors.initials: S
authors.lastname: Bekmuratova
authors.forename: David
authors.initials: D
authors.lastname: Palm
mesh_terms: D000068:Accreditation / Q000458:organization & administration* / Q000592:standards; D001290:Attitude; D003299:Cooperative Behavior; D006801:Humans; D007857:Leadership; D009111:Local Government; D009329:Nebraska; D015279:Organizational Culture; D011361:Professional Competence; D011635:Public Health Administration / Q000592:standards*; D058996:Quality Improvement / Q000458:organization & administration* / Q000592:standards; D012111:Residence Characteristics; D013997:Time Factors