Public Health Nursing - Client Services Standards for Public Health and Community Clinics Introduction


In 1988, a visionary committee under the direction of Dr. Robert MacLean, Deputy Commissioner for Programs, published a document entitled "Generic Standards for Health Care." The document was intended to augment program-specific standards and cover common program components that assure the delivery of quality health services and made recommendations for their implementation. The standards became the foundation for TDH's Quality Assurance program and have been widely used throughout the Department. Agencies or contract providers must be aware that companion program standards are available and must be obtained through the respective programs for which they have contracts.

The Standards were renamed "Quality Care: Client Services Standards for Public Health and Community Clinics" and continue to be used in public health and community health settings as:

  • A basis for local public health agencies and private contract providers to use in writing their own standards;
  • A self-assessment tool for local or regional health agencies or private contract providers to review current operations;
  • A tool for evaluating existing health agencies and private providers;
  • A guide for planning new health agencies;
  • A tool for evaluating proposals for new health agencies or programs; and
  • Criteria for client-services contractors.

In 1996, the Community Health Nursing section (now Public Health Nursing) recognized the outdated terminology and references, rules, and laws as well as changes in the health care delivery system. A committee, with the help of many resource people, undertook the study and revision of the Standards. Most of the content remains familiar but with new terminology and changes in laws affecting the delivery of health services.

The Revised Standards document has seven topic areas:

  1. Personnel for employees delivering health and related services;
  2. Clinical operations the physical aspects of the clinic site including environmental characteristics, clinic flow, and location within the community;
  3. Health Record the documentation of health care provided to individual clients;
  4. Client Rights rights under which clients have a just claim, power, or privilege to which they are entitled upon principles of morality, religion, law, or the like;
  5. Coordination of Community Services a process for identifying, informing, and providing access to health services for target populations;
  6. Continuity of Care process for facilitating the movement of the client through the health care system and follow-up activities; and
  7. Quality Assurance process for assessing compliance with standards.

Each standard has six components:

  1. Standard Statement (what) is what must be attained by each program
  2. Standard Components (when and how often) are of what must be done, when and how often by defining the specific content
  3. Data Source (where) indicates where to look to determine if the standard has been met
  4. Evaluative Criteria (what) are what will be examined to determine if the standard has been met
  5. Exceptions include the identification of uncommon situations and how to handle them to meet the standard
  6. References/Recommendations (how to) outlines suggestions for meeting the standard statement or reference laws governing the standard statement