Local Surveillance Practice Evaluation in North Carolina and Value of New National Accreditation Measures

Context: Delivery of essential public health services requires collection and analysis of public health surveillance data and delivery of these data to program managers, policy makers, and the community in accessible and useable formats. Much of this work is done by local health department (LHD) staff. We define local surveillance practice as comprising data collection, handling, and dissemination. Traditional surveillance evaluation does not generally assess local surveillance practice. However, new accreditation measures capture many aspects of local surveillance practice and may be useful for assessing this practice. Objectives: To examine the collection of surveillance data in LHDs and the communication of these data to program managers and policy makers, and to describe the extent to which national accreditation measures capture local surveillance practice. Design: Cross-sectional survey sampling comprises 18% of North Carolina LHDs based on a stratified random sample. Setting: Local health departments (LHDs) in North Carolina. Participants: Local health department directors and nursing directors or supervisors. Main Outcome Measures: Local health department surveillance practices and the congruence of accreditation measures for LHDs with these practices. Results: The majority of LHDs used a broad range of data sources and types and delivered surveillance data to government and community recipients. Accreditation measures captured key facets of local surveillance practice. Conclusions: Surveillance and epidemiology are performed at the local level in ways that support essential public health services. Accreditation measures may be useful in evaluating local surveillance practice.