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Role of quality improvement in disease management:: A state-wide tuberculosis control success story

Peter J. Fos, DDS, PhD, Office of Science, Mississippi State Department of Health, 570 East Woodrow Wilson, Jackson, MS 39215, 601-576-8046, pfos@msdh.state.ms.us, Jae Eun Lee, DrPH, Office of Decision Science, Mississippi State Department of Health, 570 East Woodrow Wilson, P.O. Box 1700, Jackson, MS 39215-1700, JungHye Sung, MPH, ScD, Office of Science and Evaluation, Mississippi State Department of Health, 570 East Woodrow Wilson, Jackson, MS 39215, Miguel A. Zuniga, MD, DrPH, Health Policy and Management, Texas A&M University School of Rural Public Health, 3000 Briarcrest Drive, Suite 300, Bryan, TX 77802, and Brian W. Amy, MD, MPH, Mississippi State Department of Health, 570 East Woodrow Wilson, Jackson, MS 39215.

This study describes Mississippi's state-wide latent tuberculosis infection (LTBI) control management efforts to improve treatment outcomes using scientific quality improvement tools. LTBI medication completion rates were observed by month and by 9 health districts for a 12 month period. ANOVA was conducted to see if there was any significant change between pre and post intervention in medication completion rates. Regression was performed for linearity test of change of monthly rate. Statistical process control technology, using quality control charts, was used to identify areas for improvement, and to evaluate and monitor the quality improvement intervention. Within 90 days of the intervention, an increased in the medication completion rate from 84.1% to 95.0% was accomplished. The intervention was a continuous quality improvement process designed to improve the LTBI medication currency rate. The analysis revealed that the mean was significantly increased and variability was decreased across all health districts with minor exceptions. A quality improvement team approach is important in disease management by accomplishing continuous quality improvement in TB medication completion. Quality improvement interventions should be conducted based on scientific methods, precise and valid data, persuasive and clear goal-setting, appropriate feedback, and on-going monitoring.

Learning Objectives:

Keywords: Quality Improvement, Tuberculosis

Related Web page: www.msdh.state.ms.us/

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Mississippi State Department of Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Health Administration Posters in Quality, Social/Behavior Environment and Structural

The 132nd Annual Meeting (November 6-10, 2004) of APHA