Mays GP • January 2, 2014
Abstract: Accreditation is one of the newest instruments in the public health system’s toolbox for reducing undesirable variation in practice, and perhaps also for promoting desirable variation. The ability to define standards of practice, measure conformity with standards, and create incentives for achieving conformity has proved to be a powerful force for quality improvement, accountability and consumer protection in other areas of the U.S. health system as well as in other governmental and private sectors. So how do we know when and where to standardize vs. customize in public health? Learning from the existing variation across the U.S. public health system is a powerful and extremely practical strategy, using both informal experiential learning and more formalized research. The field of Public Health Services and Systems Research (PHSSR) encompasses an expanding body of applied studies that seek to distinguish desirable from undesirable variation in public health practice and to test strategies for spreading the helpful and reducing the harmful variation. Research underway within this field is positioned to help the accreditation movement craft and adapt its standards and its incentives in ways that advance public health practice.
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