Designing a Learning Health Organization for Collective Impact

In November 2011, the San Francisco Department of Public Health (SFDPH), Population Health Division embarked on this journey to reorganize the public health division into a high-achieving governmental health department for the future. We used public health accreditation as the catalyst to reorganize, and the new organization structure launched on July 1, 2013. For the staff in the SFDPH, public health accreditation is about the humble and passionate pursuit of results, equity, and accountability for improving community health. This inspired us to call our framework for public health accreditation and improvement REACH (Results, Equity and Accountability for Community Health). Staff are focused on achieving results (impacts, goals, and outcomes); integrating equity into quality improvement efforts; designing accountability into our activities, including community-based evidence (local voice, wisdom, and knowledge) with scienceand practice-based evidence; and protecting and promoting population health. REACH was developed after the SFDPH leadership embraced the idea that public health accreditation could be used as a vehicle to protect and promote the health of all San Franciscans. The San Francisco Health