Role of planning and quality improvement initiatives among State Public Health Agencies

Limited data exists on State Public Health Agencies (SPHAs) and their use of planning and quality improvement (QI) initiatives. Using the 2007 ASTHO State Public Health Survey, this presentation will describe how SPHAs are performing tasks related to planning, performance management, and quality improvement. A State Health Improvement Plan was used by 80% of respondents with 57% of respondents completing the plan more than three years ago. Sixty-eight percent of respondents developed the plan using results of their state health assessment. Approximately 30% of state plans were linked to all local plans while approximately 30% were linked to some local plans. Approximately half of the respondents used various planning tools such as MAPP, APEXPH, and NPHPSP as a reference rather than implementing them directly. Although eighty-two percent of respondents report having a QI process in place, only 9.8% have it fully implemented department-wide. Twenty-nine percent have a QI process partially implemented department-wide, 21.6% have it fully implemented for specific programs and 33.3% have it partially implemented for specific programs. There is less frequent use of QI methods in non-clinical practice areas than in clinical practice areas (p=.001). Also, less frequent use of progress reports in non-clinical practice areas than in clinical practice areas (p=.025) was reported. More SPHAs employ performance measures than performance standards across a variety of practice areas. Analysis of state health department level planning, performance management and QI initiatives can inform states’ efforts to ready themselves for the proposed voluntary accreditation standards.