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Quality Improvement

Quality Definition

Quality Improvement in Public Health is the use of a deliberate and defined improvement process, such as Plan-Do-Check-Act, which is focused on activities that are responsive to community needs and improving population health. It refers to a continuous and ongoing effort to achieve measurable improvements in the efficiency, effectiveness, performance, accountability, outcomes, and other indicators of quality in services or processes which achieve equity and improve the health of the community.

Building & Sustaining an Organizational Culture of Quality
The culture of an organization is the embodiment of the core values, guiding principles, behaviors, and attitudes that collectively contribute to its daily operations. Organizational culture is the very essence of how work is accomplished; it matures over several years, during which norms are passed on from one "generation" of staff to the next. Because culture is ingrained in an organization, transforming culture to embrace QI when minimal knowledge or experience with QI exists requires strong commitment and deliberate management of change over time. Here you can view NACCHO's resources for building and sustaining a culture of quality. More »
Topic-Specific Resources for Engaging in Quality Improvement
Several resources exist for health departments engaging in quality improvement. This link contains materials for LHDs as they get started with QI: 

  • Develop a QI Plan – An annual QI plan sets the organizational direction for QI initiatives. Click here to access QI plan templates and LHD examples.
  • Develop a QI Governance Structure – A QI governance committee (e.g. QI Council) leads and oversees all QI initiatives in the organization. Click here for resources and guidance around developing a QI committee.
  • Provide QI Training and Resources to Staff – All staff, from executive leaders to frontline staff, should continuously improve their work. Empowering employees to engage in QI requires the provision of training and resources. Click here for existing QI trainings and resources.
  • Select and Implement QI Projects – QI involves the use of a deliberate and defined improvement process, such as Plan-Do-Study-Act, to achieve measurable improvements in the efficiency, effectiveness, or services and processes. Click here for resources around implementing QI projects. 
  • Develop a System for Performance Management - A fully integrated system for managing performance includes: 1) setting organizational objectives across all levels of the department; 2) identifying indicators and metrics to measure progress toward achieving objectives on a regular basis; 3) identifying responsibility for monitoring progress and reporting; and 4) identifying areas where achieving objectives requires focused QI processes. Click here for performance management resources.

These resources are from a variety of organizations and agencies working across the country to advance public health performance.

Preparing for Public Health Accreditation: Domain 9 (Performance Management & Quality Improvement)
In Domain 9 of its Standards and Measures (version 1.0), PHAB requires documentation of a Performance Management System (Standard 9.1) and a Quality Improvement Culture (Standard 9.2). This link includes information about how LHDs across the country are meeting these standards and provides resources to assist in the development of documentation.