Sustaining Accreditation: How Montana and Southern Nevada Are Building Resilient Public Health Infrastructure for the Long Term

April 07, 2026 | Melissa Touma

Public health accreditation is a dynamic process that requires ongoing commitment, strategic planning, and organizational alignment for agencies to uphold consistent quality, accountability, and performance over time. Across the country, health departments are reimagining how they approach accreditation, shifting towards sustainable systems that weave accreditation practice into everyday operations and bolster the agency’s ability to face the common challenges of changing resources, limited funding, and leadership or staff turnover.

During ASTHO’s webinar Tools and Strategies for Building a Sustainable Accreditation Infrastructure, two health departments — Montana Department of Public Health and Human Services and Southern Nevada Health District — described how they leveraged ASTHO’s Guide for Sustainable Accreditation and strategies gained from participating in ASTHO’s Accreditation Sustainability Learning Community to develop plans that strengthen their accreditation infrastructure, improve internal communication, and help maintain momentum beyond each accreditation cycle.

Montana’s Sustainability Plan: From Rodeo to Roadmap

Montana’s sustainability journey began with the launch of its Performance Excellence Program, a strategic initiative to embed the Public Health Accreditation Board’s (PHAB) standards, best practices, and data-driven methodologies into everyday agency operations. After Montana earned reaccreditation, the team launched an effort to transform the agency’s approach to sustaining accreditation.

Their objective was to build an organizational resilience that would support continuous improvement throughout each cycle by fostering shared ownership across the agency and strategically spreading accreditation activities over the five-year timeline. Their plan of action: developing and implementing an accreditation sustainability plan that turned accreditation from a sporadic, rodeo-like scramble into a structured, data-driven ecosystem.

Montana’s Public Health Accreditation Sustainability Plan defines the agency’s accreditation approach and framework by:

• Structuring team roles and defining responsibilities for accreditation coordinators, subject matter experts, and support staff.
• Creating a detailed roadmap with quarterly milestones and annual reporting requirements. Integrating with the agency’s performance management system, AchieveIt, for real-time tracking and accountability.
• Structuring an internal communication plan and campaign to raise awareness and keep staff engaged throughout the five-year cycle.
• Incorporating onboarding and ongoing training to build institutional knowledge.
• Establishing a single-source repository for required documents, templates, and examples.

By having a plan in place, Montana’s Performance Excellence Program improves the agency’s capacity to sustain accreditation by:

• Securing buy-in and support from agency leadership to prioritize accreditation as part of core operations.
• Preventing last-minute scrambles and distributing accreditation work evenly across the cycle instead of backloading tasks.
• Ensuring continuity and preserving institutional memory by providing a clear handoff if staff turnover occurs.
• Improving accountability through dashboards and automated reminders that keep teams on track.
• Building a culture of quality by linking quality improvement projects and performance measures directly to accreditation standards.
• Enhancing transparency by creating a clear, documented process that can be shared internally and externally.

Southern Nevada’s Communications-Driven Strategy

Southern Nevada Health District (SNHD) serves a densely populated region with over 2.5 million residents and 800 full-time staff. During their initial accreditation phase, SNHD’s accreditation team arrived at the process with limited context and institutional knowledge, and a large Accreditation Committee Action Report response with a tight 90-day turnaround time. The experience underscored the need for earlier preparation, better alignment, and a more predictable, agencywide approach to documentation and communication.

Recognizing these lessons, SNHD made a strategic commitment to shift toward building a more organized, proactive, and sustainable accreditation infrastructure. Central to this shift was the development of a robust internal communications strategy designed to increase transparency, strengthen engagement, and create consistent accountability mechanisms that keep accreditation visible, relevant, and understood across the entire organization. This communications-driven model now serves as the backbone of SNHD’s reaccreditation sustainability strategy, ensuring that staff at every level — executive leaders, managers, frontline contributors, and new hires — remain aligned and supported as they collectively move through the reaccreditation timeline.

Key elements of SNHD’s internal communications strategy include:

• Engagement of the Internal Communications Team: SNHD’s communications departments plays a key role in shaping messaging, designing materials, and identifying new channels.
• Quarterly Executive Updates: SNHD’s accreditation manager meets with the executive leadership team every quarter, using this time to share structured progress updates, highlight outstanding contributors, surface challenges, and reinforce why accreditation matters.
• All-Hands Meetings: SNHD hosts virtual all-hands meetings that bring together staff and senior leadership across the organization to share big-picture updates, celebrate accomplishments, and reinforce the value of accreditation.
• Tailored Messaging: Communications are customized for different audiences to ensure relevance and impact. A tailored approach ensures every audience understand the “why” and their role in the “how.”
• Creative, High-Visibility Channels: SNHD utilizes multiple channels to make accreditation part of daily life and reinforce visibility of accreditation as a shared organizational priority.
• Reader Boards: Digital displays throughout offices feature rotating content that keep accreditation visible and engaging.
• Login Bubble Messages: When staff log into their computers, brief, high-impact messages about deadlines, successes, or calls to action reinforce awareness.
• Onboarding Videos: A three-minute accreditation explainer video introduces new hires to PHAB, expectations, and the department’s quality culture from day one.

By treating accreditation as a shared responsibility and leveraging every opportunity to communicate its importance, SNHD has built a communication-driven infrastructure that aims to strengthen organizational cohesion, maintain momentum across all five years, and prepare the department to weather staffing changes, leadership transitions, and shifting priorities. Their approach demonstrates how intentional, consistent communication can help turn accreditation from an isolated project into a unifying force within the agency.

A Shared Vision for Sustainability

As health departments continue to navigate evolving public health demands, sustainability planning has become essential for maintaining accreditation momentum, strengthening organizational resilience, and embedding quality improvement into everyday practice. The experiences of Montana and Southern Nevada demonstrate that with intentional planning, robust internal systems, and clear communication, accreditation can begin to shift from a fragmented documentation collection process to a continuous, agency-wide commitment.

This blog post highlighted the work of Public Health Infrastructure Grant recipients as they strive to develop a resilient accreditation infrastructure for their communities and ensure accreditation becomes a continuous journey. Check out ASTHO’s two-part webinar series to hear how their systems are evolving:

• Tools and Strategies for Building a Sustainable Accreditation Infrastructure (October 30, 2025)
• Sustaining Accreditation Through Smart Documentation Systems (November 6, 2025)

To learn more about ASTHO’s Guide for Sustainable Public Health Accreditation and access tools to support your department’s journey, visit A Guide for Sustainable Public Health Accreditation.

Reviewed by Lindsey Myers, MPH, Vice President, Public Health Workforce & Infrastructure.