Opportunities to Advance Quality Improvement in Public Health

Evaluation Services, North Carolina Institute for Public Health, Gillings School of Global Public Health, University of North Carolina, Chapel Hill 27599, USA. mary
Journal of public health management and practice: JPHMP (Impact Factor: 1.47). 01/2010; 16(1):8-10. DOI: 10.1097/PHH.0b013e3181c027e6
Source: PubMed
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    ABSTRACT: To advance understanding of public health accreditation, we analyzed data on the North Carolina Local Health Department Accreditation program. We surveyed accredited health departments on barriers to and supports of accreditation preparation, performance on accreditation standards, and benefits and improvements after accreditation. All 48 accredited agencies responded to the survey. All agencies improved policies to prepare for accreditation and met most accreditation standards. Forty-six percent received local funds for accreditation preparation. The most common barrier to accreditation preparation was time and schedule limitations (79%). Fifty percent of agencies acted on suggestions for improvement, and 67% conducted quality improvement activities. Benefits of accreditation included improvements in local partnerships. Agencies of all sizes conducted accreditation activities, were successfully accredited, and experienced benefits resulting from accreditation.
    American Journal of Public Health 09/2011; 101(9):1543-8. DOI:10.2105/AJPH.2011.300199 · 4.55 Impact Factor
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    ABSTRACT: Many state and local public health agencies have developed accreditation systems and are utilizing quality improvement (QI) methods and tools to improve the public health infrastructure. Development of strategies to support and build the capacity of the public health workforce to apply QI can help advance these efforts. This article describes the adaptation and creation of a standardized QI training program for local health departments (LHDs), explores the effectiveness of the program in increasing the confidence of the LHD staff to apply QI methods and tools, and discusses lessons learned from the first cohort of the program. An existing program designed for health care professionals was pilot tested, adapted, and used in 8 LHDs. A formative evaluation of the new public health QI training program was conducted through a hybrid internal and external evaluation model. Pre/postsurveys were used to measure participant satisfaction and the capacity of LHD staff to conduct QI. Staff from 8 LHDs successfully completed the program and 94% of participants reported that they were satisfied with the overall training program. Seventy percent of participants reported a higher perceived confidence in conducting a QI project, and all participants reported sharing QI tools and methods with their coworkers. These findings suggest that QI training programs using methods and tools previously applied in health care and other industries can be successfully adapted to public health. Although additional studies are needed to validate the results, this training model can be used to inform future work in developing a standardized QI training program in public health.
    Journal of public health management and practice: JPHMP 01/2012; 18(1):43-51. DOI:10.1097/PHH.0b013e31822d2e07 · 1.47 Impact Factor
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    ABSTRACT: Quality improvement (QI) has been identified as a key strategy to improve the performance of state and local public health agencies. Quality improvement training effectiveness has received little attention in the literature. To evaluate the effectiveness of 3 QI training types: webinars, workshops, and demonstration site activities on improving participant knowledge, skill, and ability to conduct QI through a questionnaire conducted after training participation. We used a natural experimental design hypothesizing that demonstration site participants would have the greatest gains on outcomes of interest compared with webinar and workshop participants. Bivariate and multivariate models were used to examine outcome differences between questionnaire respondents who participated in various training types. Local health department employees who participated in the 3 training strategies. Measures included knowledge and skill gain, skill application, QI receptivity, and ability to successfully participate in a QI project. Two hundred eighty-four unique individuals who work in 143 health departments completed the questionnaire for a 59% response rate. The majority of these health departments serve midsize populations. Demonstration site respondents had significantly greater gains in knowledge and skills, skill application, and ability to successfully participate in a QI project. Webcast training participants had significantly higher QI receptivity in adjusted models. Respondents who participated in both webcast and demonstration site trainings had higher mean scores on all outcomes when compared with demonstration site single training participants, these differences were significant in unadjusted models. Our findings suggest that QI training for public health agency employees should include both didactic training on QI content and opportunities for QI application. Future research should examine if this approach can effectively increase successful participation in QI projects for staff in LHDs of all sizes.
    Journal of public health management and practice: JPHMP 01/2012; 18(1):E1-7. DOI:10.1097/PHH.0b013e3182249505 · 1.47 Impact Factor
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