Performance Improvement

Performance Improvement

Public health performance improvement is positive change in public health capacity, processes, or outcomes through the use of clear and aligned planning, monitoring, and improvement activities. Performance improvement relies on the use of evidence and continuous, formal activities that strengthen public health organizations and systems. It can occur and be measured at the system, organization, program, or employee level.


NACCHO Announces 2019-2020 SSSC TA Cohort


NACCHO and the CDC are excited to announce the health departments and communities selected for this year’s Strong Systems, Stronger Communities (SSSC) Technical Assistance (TA) cohort. The SSSC initiative supports local health departments (LHDs) in completing public health performance improvement projects through a tailored in-person and virtual training, TA program and peer networking.

Marion County Public Health Department (Indianapolis, IN), Logan County Health District (Bellefontaine, OH), Florida Department of Health Escambia (Pensacola, FL), Napa County Public Health (Napa, CA), Wauwatosa Health Department (Wauwautosa, WI), Mercer County Health Department (Aledo, IL) and San Juan Basin Public Health (Durango, CO) were selected for this year’s SSSC TA cohort through a competitive process. Through the training and TA provided, these sites will work to address the social determinants of health and health equity on a range of topics including infant health, mental health, food insecurity, and poverty. Each team will hold an Equity Action Lab with their communities, during which they will work with community partners and community members to identify, design and test solutions to make advancements in a short period of time.

Visit the NACCHO SSSC website for more information on the SSSC program and previous sites selected.

Our vision is that local health departments are mission-driven, high-performing organizations with cultures of quality that achieve and celebrate excellence.

NACCHO's Performance Improvement Team helps build the performance improvement capacity of health departments and their partners by providing tailored technical assistance and training, as well as tools, publications, and opportunities for peer networking and learning.

The Performance Improvement team at NACCHO has expertise in the following areas. Click on any of the links below to find our tools, resources, and current and past projects in each of these areas.

Public Health Infrastructure

Mobilizing for Action through Planning and Partnerships

MAPP is a community-driven strategic planning initiative. Find resources like the MAPP Handbook here

Public Health Infrastructure

Mobilizing for Action through Planning and Partnerships

Public Health Infrastructure

Healthy People 2020

Learn about NACCHO's work with Healthy People 2020 and find social determinants of health resources

Public Health Infrastructure

Healthy People 2020

Public Health Infrastructure

Quality Improvement

NACCHO offers local health departments resources for implementing quality improvement processes.

Public Health Infrastructure

Quality Improvement

The NACCHO PI team has a wide range of expertise and extensive experience with providing PI related technical assistance (TA) to LHDs. NACCHO staff are available to take ad-hoc TA requests via phone or e-mail.* Listed below are examples of common TA requests:

  • Expert guidance/consultation – NACCHO staff can provide guidance or advice as you are engaging in PI processes. For example, LHDs may need strategies for gaining partnership buy-in during a community health improvement planning process, completing a QI project, or designing a strategic planning agenda.
  • Peer-to-peer connections – With a multitude of LHD relationships and knowledge of PI activities across the field, our staff are well positioned to facilitate peer-to-peer connections, connecting LHDs working on similar PI goals or challenges.
  • Identifying resources – As LHDs begin to implement PI processes, we can assist in directing you to the most relevant resources based on your needs.
  • Accreditation documentation review – NACCHO staff may serve as an objective third party reviewer of your accreditation documentation, up to 2-3 hours of staff time. For example, we can provide feedback on strategic plans, community health assessments and improvement plans, QI plans, workforce development plans, or other documentation for the PHAB Standards and Measures.

*Please email pi@naccho.org for TA requests and questions. There may be a fee associated with more in-depth TA. NACCHO is also available to provide in-depth, fee based consultation services including in-person trainings and facilitation of performance improvement processes. For more information, please see NACCHO consulting.

See our PI Curriculum and Webinars page for the archived PI curriculum and our archived webinars on a variety of PI topics, listed in chronological order.

Public Health Infrastructure

Curriculum and Webinars

NACCHO's Performance Improvement Curriculum and archived webinars

Public Health Infrastructure

Curriculum and Webinars

Ci  Resources  Writing Utensils

Public Health Infrastructure

Mobilizing for Action through Planning and Partnerships

MAPP is a community-driven strategic planning initiative. Find resources like the MAPP Handbook here

Public Health Infrastructure

Mobilizing for Action through Planning and Partnerships

Performance Improvement Success Stories

Read our new Performance Improvement success stories from Columbus Public Health and Salt Lake City Public Health, where rigorous quality improvement (QI) led to enhanced teamwork and effective fiscal management.
Performance Improvement Success Stories August 2019

NACCHO Stories of PI Impact

Two local health departments share stories of PI impact in the videos below.

Columbus Public Health Success Story

Salt Lake County Performance Improvement Success Story

Addressing Social Determinants of Health: Stories from the Field

NACCHO's Stories from the Field highlights local health department successes, challenges, and innovations. Public health is evolving to take a more holistic approach to population health by focusing on the social determinants of health (SDOH)—the conditions in which people are born, live, work, and age, and which are shaped by the distribution of money, power, and resources. In 2019, NACCHO added Healthy People 2020 SDOH tags, according to the specific SDOH areas addressed through the initiatives, to the Stories from the Field. It is now possible for communities to see how SDOH are being addressed at the local level to ameliorate a broad range of health concerns. Find local examples of SDOH interventions here.

Additional Publications

NACCHO’s Performance Improvement team makes it a priority to monitor and contribute to the latest public health performance improvement research and editorials in the field. These publications, authored by NACCHO staff or related to NACCHO PI programs, are geared toward public health practitioners offering peer reviewed research, the latest trends, and various field perspectives on the latest performance improvement happenings at the local, state, and national levels. Find performance improvement literature here.

Read Now

A Rising Tide: Increasing Rural LHD Capacity to Address SDOH

Lessons learned from rural LHDs engaged in work to address the social determinants of health.

Read Now

A Rising Tide: Increasing Rural LHD Capacity to Address SDOH

Featured Resource

Measuring What Matters in Public Health

NACCHO's practical guide to implementing performance management at your health department

Featured Resource

Measuring What Matters in Public Health

Public Health Infrastructure

Mobilizing for Action Through Planning & Partnerships

All about Mobilizing for Action Through Planning & Partnerships (MAPP)

Public Health Infrastructure

Mobilizing for Action Through Planning & Partnerships

Building Capacity to Apply Patient-Centered Outcomes Research and Comparative Effectiveness Research Findings Through Local Health Departments

This new report illustrates how local health department awareness and application of patient-centered outcomes research (PCOR) and clinical effectiveness research (CER) can help to inform population health decisions. NACCHO conducted research to assess awareness, and found that PCOR and CER information can be valuable to inform LHDs’ work as community health strategists and cross-sectoral partners. PCOR and CER can help LHDs strengthen their programs and services, aligning them to community needs and ensuring they are based in practices effective for the specific populations they serve. Local health departments also provide a unique perspective in a research partnership, and despite barriers to capability, the capacity of LHDs to engage in and use PCOR and CER can be built through individual, organizational, and systemic efforts, and NACCHO and other national organizations can bolster LHD capacity by being educators, conveners, connectors, and advocates.

Local Health Department-Health Center (LHD-HC) Collaboration

Local Health Department-Health Center Collaboration Toolkit: This set of tools is designed to support collaborations between local health departments (LHDs) and health centers to increase access to and quality of critical services for underserved populations.

Collaboration between Local Health Departments and Health Centers: NACCHO, with the Center for Sharing Public Health Services (CSPHS), collaborated to conduct key informant interviews with staff from local health departments (LHDs) and from health centers to identify resources that could support LHD‐health center sharing of services. The objective was to use this information in a future project phase to identify and help inform the development and piloting of service sharing tools between LHDs and health centers.

*NEW* Local Health Department-Health Center Services Sharing Tools

With support from HRSA, NACCHO partnered with the Center for Sharing Public Health Services (CSPHS) to develop the following suite of tools that support the sharing of services – both clinical and nonclinical – between local health departments (LHDs) and health centers.

Legal Checklist- A guide to assist in developing legal agreements that govern shared services arrangements between LHDs and health centers

Readiness Factors for Shared Services Arrangements- A tool to help evaluate levels of readiness between LHDs and health centers that are considering or are already involved in collaborating through shared services arrangements

Roadmap to Develop Shared Services Arrangements- A guide for those working on or considering a sharing arrangement between LHDs and health centers

Types of LHD-Health Center Shared Services Arrangements- This document introduces four main types of shared services arrangements

Success Factors for Shared Service Arrangements- A guide to those factors or conditions that materially contribute to
successful sharing arrangements between LHDs and health centers

Collaboration Trust Scale for Shared Service Arrangements- A conversation tool for LHDs and health centers containing a series of questions organized under headings which represent areas that should be considered when assessing trust

Are You Ready to Work with Other Health Departments in Your Region?

Public health and systems issues often span jurisdictional boundaries. To improve public health systems and infrastructure, the Centers for Disease Control and Prevention (CDC) has partnered with the National Indian Health Board (NIHB), the National Association of City and County Health Officials (NACCHO), and the Association of State and Territorial Health Officials (ASTHO) to support a collaborative technical assistance opportunity, the Cross-jurisdictional Systems Improvement Partnership (CJSIP) program, as part of its Strong Systems, Stronger Communities (SSSC) initiative. This opportunity aims to improve performance improvement practice and increase innovation in response to systems challenges, and to support progress toward meeting national public health standards among local, tribal, and state health departments. This project is designed to strengthen cross-jurisdictional partnerships among local, tribal, and state health entities to develop and implement a shared action plan toward public health systems improvement. This opportunity requires a shared commitment from at least one tribal, one local, and one state health department to collaborate on a joint public health systems improvement project. Partners are to submit a letter of interest no later than December 6, 2019. The selected partnership will receive in-person and remote performance improvement capacity-building technical assistance provided by NIHB, NACCHO, and ASTHO from January to July 2020, including through at a 2-day in-person workshop. This opportunity does not include direct funding. For more information and to submit a letter of interest please click HERE.

Additional opportunities

Please subscribe to our newsletter, PI Compass, through the link at the bottom of this page to learn of future opportunities.

Join also join our Performance Improvement Peer Learning (PIPL) community to learn about resources and opportunities from NACCHO and our partners.

To get the latest information on public health performance improvement tools, resources, best/promising practices, and funding opportunities, sign-up to receive NACCHO’s PI Compass e-newsletter. Each issue features resources and events under the performance improvement umbrella, including accreditation, quality improvement, performance management, CHA/CHIP, and health equity.

Please forward this information to your colleagues and partners, and encourage them to subscribe. To subscribe, please log-in to your My NACCHO account. If you do not have a “My NACCHO” account you can sign up by clicking here.

  • Once logged on click on “My Subscriptions” in the left navigation menu
  • Check the box for “PI Compass”
  • Click “Save” at the bottom of the page

For more information about our Performance Improvement team, you can use the form above or email pi@naccho.org.

Public Health Infrastructure and Systems

Peter Holtgrave

Senior Director, PHIS

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Public Health Infrastructure and Systems

Pooja Verma

Lead Program Analyst, Performance Improvement

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Public Health Infrastructure and Systems

Deya Greer

Senior Program Analyst, Performance Improvement

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Public Health Infrastructure and Systems

Sarah Weller Pegna

Program Analyst

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