Improving Environmental Health Processes in Iowa; A three county pilot

As the push towards national accreditation of public health departments gains momentum nationwide, states are instituting quality improvement programs to monitor and enhance the performance of their services. This presentation describes documentation of standard processes, development of metrics and identification of improvement opportunities for environmental health processes in Iowa. Environmental health services in Iowa include but are not limited to dealing with rabies, mold, issuing septic tank permits, and inspecting spas and tattoo parlors. There is a lot of variability in the way these services are delivered from county to county, and no standard documentation exists. As a result, there is wide latitude in interpretation of procedures, varying levels of risk exposure to the population, and no consistent set of metrics to compare performance across counties. Defining standard work is an important part of quality improvement programs. Documenting processes is a precursor to problem solving, and allows an organization to understand work flow, measure performance, and identify opportunities for improvement. This paper describes the implementation and lessons learned from a pilot project for creating standard environmental health processes with inputs from three environmental health departments in Iowa. A case study from one of these counties further describes the development of process and output measures for environmental health programs and how quality improvement opportunities were identified. Environmental health is an important function of public health, but is rarely studied systematically. The approach described in this presentation can serve as a template for other states to follow.