Building a Quality Improvement Program at a Local Health Department: New Orleans' Experience

To increase its capacity to effectively address pressing public health issues, operate as a learning organization and meet national PHAB accreditation standards, the New Orleans Health Department (NOHD) built a department-wide quality improvement (QI) program. When this effort began, NOHD recently had transformed from a clinical to a public health focus and had incorporated grant-funded programs previously under different management. It had a diverse mix of longstanding and new staff. Building a QI program began with department leadership prioritizing QI and dedicating staff time to lead this effort. Key elements informing establishment of the program included PHAB accreditation standards and resources from national organizations such as NACCHO. A cross-functional team called the Quality Council formed to develop and execute a QI plan and foster a culture of QI. This council met monthly and was an opportunity to share experiences and best practices. QI was integrated into the performance management system and the QI plan linked with the strategic plan and the community health improvement plan. Once this infrastructure was in place and a QI training held, a critical next step was to engage in improvement cycles and produce storyboards showing results. In summary, key lessons for building a QI program include communicating support from leadership that QI is a departmental norm; engaging a cross-functional team; implementing improvement cycles as early as possible; developing in-house QI expertise to guide the program; and linking QI with accreditation efforts.