Quality Improvement in Foodborne Illness Prevention, Detection and Intervention: A local health department's quality improvement project

RiverStone Health (the local health department in Yellowstone County, Montana) has struggled to effectively identify foodborne illness outbreaks thereby further reducing the spread of infection. The primary barriers to an effective response are the lack of consistency in reporting procedures and follow-up actions for illness reports. This inconsistency has led to multiple problems including the duplication of work, rework, and the failure to recognize outbreaks early. In 2008 RiverStone Health launched a Quality Improvement (QI) project focusing on foodborne illness prevention, detection and intervention. The short term objectives of this project included early detection of foodborne disease events, reporting events in a timely manner, and intervening to prevent illness. The project worked with a diverse team of public health practitioners and utilized various QI methods including Failure Modes and Effect Analysis, Plan Do Study Act and Fishbone Diagrams. This presentation will describe the QI project with a focus on the challenges faced in implementing a QI project in a local health department (staff resistance, lack of QI training, developing evaluation methods) and the solutions to overcoming these challenges. Data will be presented to show how this project altered staff attitudes regarding QI. In addition, the presentation will explain how the project was used as a catalyst to prepare for accreditation through the Public Health Accreditation Board. This project is a prime example of how to successfully apply QI in a health department and discusses subject area of widespread interest to which every local health department can relate.