It's okay to be a zero: Using quality improvement to prepare for accreditation

Wisconsin has a long-standing commitment to assessing and improving the quality of services provided by health departments. In addition, a recent change in state statute requires the state health department to provide the ten Essential Public Health Services. With accreditation on the horizon, the Wisconsin Division of Public Health (DPH) recognizes the need to assess and improve its own performance related to the Essential Services.

As part of the national Multi-State Learning Collaborative project (MLC-3), the five DPH regional offices piloted a state level assessment and quality improvement (QI) process. This process included the development of an assessment tool, application of the tool in each regional office, prioritization of opportunities for improvement, and implementation of selected QI projects, all focused on the Wisconsin DPH. Each regional office implemented the assessment and QI projects in slightly different ways, allowing for a comparison of processes as it is related to outcomes.

This presentation will provide a descriptive review of enabling and limiting factors of state health department QI process. Areas of potential difference between regional offices and processes used were considered, and their impact on successful implementation of a QI project was reviewed. Factors included:

•The process used by each regional office prioritize QI projects

•Attitudes, knowledge and experience of regional office staff related to QI

•Level of staff involvement and leadership in projects

•Inclusion of other partners in QI projects

•Knowledge and buy-in by staff of the Essential Services as a framework for State Health Department practice and performance measurement.

The insights gained in this review will be used to modify the assessment and QI process as it is expanded to the Wisconsin DPH as a whole, and may also be beneficial to other states looking to undergo their own assessments and QI process.