Lessons learned from QI, performance measurement and culture change

The recently launched Public Health Accreditation program is engaging departments of health across the nation to institute Quality Improvement (QI) in their daily work. And the benefits of QI are going beyond the improvement of processes, projects and policies. The QI tools are getting to the root cause of the problems, revealing real challenges, opening the dialogue about the agencies' culture, and fostering innovation to problem solving.

A state health agency used the QI tools to increase the number of programs submitting monthly updates to the performance measures report. Using the PDCA model, and QI tools like the flowchart and fishbone diagram, the process was analyzed and root causes came to light. As a result, the percent of programs submitting monthly data increased from 57% to 75% in a period of six months. While this increase might be modest, QI uncovered and confirmed a real challenge in public health: preparing for accreditation requires a culture shift.

This presentation will discuss: a) the root causes discovered through the QI tools; b) the performance measures strategy used by the public health agency; c) the approaches the agency put in practice to nurture a culture change.

Public health is working with tight budgets and facing multiple demands, but is eager to get better. The lessons learned from this experience illustrate the value and utility of promoting and nurturing a culture change.