Domain 1
The first domain of health care indicates the need to conduct and disseminate assessments focused on population health status and public health issues facing the community (PHAB, 2011). This domain is comprised of four major standards, which include participating in or conducting comprehensive health assessments, collecting and maintaining reliable data about the status of public health, analyzing data to identify health related trends and utilize results to make recommendations for improving public health policy, process and programs. Essentially, this domain focuses on determining the current state of the public health of the population in order to identify problem areas and develop effective plans of action to address and eliminate public health problems and concerns.
Domain 2
Domain two involves investigating health problems and environmental public health hazards to protect the community (PHAB, 2011). This domain also consists of four standards, which include, conducting timely investigations of public health problems and environmental public health hazards, contain and mitigate health problems and environmental health hazards, ensure access to laboratories and other required resources to facilitate effective investigation, containment and mitigation, maintain a plan with established governance for urgent and non-urgent communications. Specifically, this domain focuses on investigation health issues, particularly those brought on by environmental influences. These influences can be natural in nature, such as floods, hurricanes, tornadoes and the like, or they can be man-made, such as polluted are and water from hazardous waste dumping.
Domain 3
The third domain is intended to inform and education about public health issues and functions (PHAB, 2011). The two standards associated with this domain include providing the public with health education and health promotion policies and programs to facilitate prevention and wellness, and providing information on public issues to multiple audiences using a myriad of relevant approaches. This domain is primarily focused on ensuring the public is aware and well informed of current health issues and concerns by providing comprehensive health education. Additionally, this domain seeks to prevent health issues through education about avoidance and protection. Finally, this domain is intended to provide health related education, programs and policies to increase wellness among the public. Such education can cover concepts such as proper diet and the importance of fitness.
Domain 4
Domain four involves the requirement to engage with the community to identify and address health problems (PHAB, 2011). This domain consists of two main standards, which include collaborating with both the community and the public health system to effectively identify and address health problems and promoting support and understanding among the community about policies and strategies aimed at improving public health. Engaging with the community can provide substantial insights into prevailing health problems and concerns. Collaboration between the community and the public health system can add validity, dimension and scope to these insights in order to more effectively identify health problems and concerns that may affect the entire community as a whole.
Domain 5
The fifth domain indicates the need to develop public health policies and plans (PHAB, 2011). Four key standards are included in the fifth domain, and are characterized as serving as a primary and expert resource for establishing public health policies and practices, conducting in-depth planning processes to develop a health improvement plan, developing and implementing strategic plans for the health department and maintain all relevant emergency plans. In essence, this domain primarily focuses on the planning, development and implementation of specific strategic plans that are necessary to facilitate improvements in public health, improvements in health department operations and functions and enhanced contingency planning in the event of health and environmental emergencies. These emergencies, which can be related to health and hazards, are again typically precipitated by acute events such as floods, hurricanes and tornadoes, but can also be characterized by outbreaks and epidemics of highly contagious illnesses with high risks of mortality among specific groups such as young children, the elderly and the otherwise infirmed.
Domain 6
Domain six involves the enforcement of public health laws (PHAB, 2011). The sixth domain is comprised of three primary standards, which include reviewing existing public health laws and working with government agencies to modify as needed, educating the public and organization on meaning, purpose benefit and compliance relating to public health laws, and conducting and monitoring public health enforcement while ensuring violations are reported to appropriate agencies. In a nutshell, this domain and its subsequent standards are designed to specifically address establishment, maintenance and enforcement of public health laws. Much of this involves the monitoring of organizations to ensure that public health concerns do not develop in the working environment among employees. Additionally, this domain provides a provision to ensure violations of public health laws are reported appropriately so that they may be addressed to avoid undue health risks to the public.
Domain 7
The seventh domain relates to the promotion of strategies to improve access to public health services (PHAB, 2011). This domain possesses two inherent standards, which include assessing current health care service capacity and access to health care services, and identification and implementation of strategies to improve access to public health services. This domain has become increasingly important in recent years as the demand for health care services has risen sharply. This dramatic increase in demand is primarily contributed to the shifting of the aging baby boomer generation into retirement and old age. As a result, health care systems have had to scramble in order to increase capacity and expand availability of health care services to accommodate the influx in demand.
Domain 8
Domain 8 is focused on maintaining a competent public health workforce (PHAB, 2011). As such, this domain is comprised of two critical standards, which include encouraging the development of adequate numbers of public health workers and assessing health care worker competencies to identify and address gaps through organizational training and education. A critical part of ensuring adequate and effective health care services is making sure that sufficient levels of competent health care workers exist to meet growing demands for health care and are able to effectively perform all necessary duties and functions related to providing health care services to diverse patient pools. As such, significant emphasis must be placed on maintaining an adequate number of health care workers to avoid staff shortages, and on ensuring that these health care workers possess the necessary skills, abilities, knowledge and competencies to consistently meet all treatment needs of patients.
Domain 9
The ninth domain indicates the need to evaluate and continuously improve health department processes, programs and interventions (PHAB, 2011). Specifically, this domain is comprised of two main standards, which are using a performance management system to achievement of established objectives and development of a quality improvement process that is integrated into organizational processes, practices and interventions. Continuous improvement is a management tool that has permeated every industry within the global market. As such, it is no surprise that health care systems are seeking the benefits and positive impacts that continuous improvement can have on costs, patient care and overall organizational processes. In particular, Six Sigma has become an effective tool for health care systems to effectively monitor and effect positive change on quality (Harmon, 2007).
Domain 10
Domain 10 focuses on the need to contribute to and apply the evidence base of public health (PHAB, 2011). Two primary standards make up domain ten, which include identification and use of best available evidence in public health care decision making processes and promotion of utilization and understanding of research results and evidence-based practices with appropriate audiences. Particularly, this domain focuses on establishing a reliance on current, relevant and accurate research when engaging in public health decision making. Additionally, emphasis is placed on encouraging continuous research in order to continually build on the body of knowledge in order to promote discovery and exploration of unfamiliar or unclear concepts.
Domain 11
Finally, the 11th domain involves maintaining administrative and management capacity (PHAB, 2011). This last domain is comprised of two primary standards, which are developing and maintaining an operational infrastructure to support public health functions and establishing effective financial management systems. Essentially, this domain primarily focuses on the administrative and management forces that are involved in the public health system, but may not be directly associated with providing public health services or developing public health governance or decision making.
It is critical to ensure that the financial and administrative aspects of public health efforts are effectively managed and maintained to ensure the elimination of waste, excess costs, staffing shortages and any other administrative or system management concern. This domain is dedicated to ensuring that these issues and concerns do not become an issue by assuring adequate administrative and management capacity is maintained.
- Harmon, P. (2007). Business process change: A guide for business managers and BPM and six sigma professionals 2nd ed. New York, NY: Morgan Kaufmann Publishers.
- PHAB. (2011, May). Standards & measures. Retrieved from Public Health Accreditation Board Web site: http://www.phaboard.org/wp-content/uploads/PHAB-Standards-and-Measures-Version-1.0.pdf
