Formal Agency Wide QI

The number of flu vaccines provided by Cerro Gordo County Department of Public Health (CGCDPH) has risen greatly, with many flu vaccination sites around the rural county. As the number of vaccines rose, the ability to enter the vaccines into the state immunization registry fell, and 57% of flu...

Lorain County Public Health (LCPH) used QI to improve the efficiency of its prenatal/newborn home visiting performance management system, with the result of freeing time that nurses could devote to providing the service, while also improving the quality and utility of the information provided.

Deschutes County Health Services (DCHS) in Oregon improved its process to increase clinic show rates and caseload for clients of the WIC program. This improvement optimized staff time and ensures access to care and benefits for these needed services in the community.

Using a PDCA approach, the Philadelphia Department of Public Health (PDPH) achieved a more efficient process for onboarding new employees. The amount of paper used went from 136 pages to 16 pages, an 88% reduction. The mean monthly staff time dedicated to the onboarding process dropped from 653...

Tarrant County Public Health’s (TCPH’s) North Texas Regional Laboratory (NTRL) decreased the cost of a specific HIV test by 40% by testing and adopting an alternative control test method. NTRL has received level funding for a few years while laboratory expenses have continued to grow. Achieving...

Lake Cumberland District Health Department (LCDHD) in Kentucky receives grant funding for several program activities, and staff realized that it was not unusual for different divisions to apply for the same grant. A QI committee used QI tools to address this issue. New policies and procedures have...

Butte County Public Health Department (BCPHD) in California used QI to expedite the annual medical review (AMR) process for eligibility into the California Children's Services (CCS) program. More children and their families now have improved access to these specialty health care services.

Deschutes County Health Services (DCHS) streamlined the referral process for its Nurse Family Support Services(NFSS) and Oregon MothersCare (OMC) programs. Staff satisfaction with the process has improved and program clients are now more efficiently being served.

Washington County Department of Public Health and Environment led a multi-sector quality improvement project and increased the recycling rate at a county park. Expansion of this model to all county parks will further protect the environment and contribute to Minnesota's statewide goal of a 75...

Customer satisfaction is key to any health department, and ensuring new employees’ satisfaction is no exception to this tenet. Deschutes County Health Services (DCHS) achieved tremendous success in orienting and onboarding these important “internal” customers through a comprehensive process that is...

Cerro Gordo Health Department decreased fear levels of bed bug exposure among field staff. The implementation of a risk reduction plan minimized staff discomfort and facilitated a more effective intervention to bed bug exposure in the community.

Cerro Gordo County Department of Public Health (CGCDPH) worked to improve immunization rates for both types of pneumococcal vaccine recommended for seniors. Through a multifaceted approach that emphasized increased awareness of the vaccine, CGCDPH raised the rate of immunizations with the newest...

By using Kaizen, Cabarrus Health Alliance (CHA) in North Carolina reduced food establishment violations by 22% and further protected residents from foodborne illness.

Communicable disease (CD) follow-up: Staff let their fingers do the walking using social media to significantly improve the timeliness and effectiveness of client contact and case completion procedures for CD clients.

Henry County Health Department’s (HCHD’s) strategic plan included addressing employee turnover and job dissatisfaction. Employee turnover and job satisfaction are related to how confident an employee feels when starting a new position, which links back to the effectiveness of the orientation...

Rapid response to new Salmonella cases is critical to decreasing the spread of disease and reducing the likelihood of an outbreak. The Santa Clara County Public Health Department in California used the Define, Measure, Analyze, Improve, Control (DMAIC)/Six Sigma approach to identify the root causes...

The health department improved the process for tracking data requests from internal and external partners. The interventions made the staff more aware of the tracking process and offered education on the use of the Access database. The results included greater use and an increased number of staff...

When a rabies susceptible animal has bitten a human, it is imperative that health departments responsible for the investigation and quarantine of these animals respond a timely manner. A local health department in Oregon used a PDSA approach to reduce the time to process rabies bites reports by 29...

Client complaints and staff dissatisfaction with prenatal clinic wait times led the Seminole County DOH to use QI to decrease their client visit times. Focusing on modifying the prenatal scheduling matrix, eliminating duplicate charts, and decreasing the physical distance traveled between check-...

Staff are Customers too! How involving all staff in the identification of barriers to completing department offered QI Training resulted in greater acceptance of, participation in, and an increase in the number of staff completing six required training modules.

Cabarrus Health Alliance and partners used quality improvement to streamline their processes for referrals for pregnancy care management to improve overall handoffs and cycle times, resulting in more timely and effective referrals for care management to ensure healthier mothers and babies.

A local health department in North Carolina used PDSA cycles and lean/kaizen approaches to improve their clinic client and community satisfaction survey tools and data collection process. This provided a system-wide framework to enable the organization to better understand their customers’ needs,...

This medium-sized health department tackled the unacceptable wait time in its Primary Care Clinics. The wait time averaged 1.5 hours for new patients and 30–45 minutes for returning patients. The QI team members observed how people are processed through the stations and identified improvement...

Johnson County Department of Health and Environment used a kaizen event to improve the supply ordering process cycle time and increased the order placement and delivery accuracy for all programs in the department. The results included decrease in cycle time – total ordering process time per order...

Clackamas County, Oregon conducted a comprehensive Kaizen project to design and implement a customer feedback system for the entire public health division. The process and tools used for the project are well described and easy to adapt by other health departments. While Clackamas has not yet...

Untreated chlamydia (CT) and gonorrhea (GC) can lead to serious health problems in men and women. In order to effectively track and treat these two sexually transmitted infections, CDC guidelines require that low-priority CT and GC reports be processed by health departments within 30 days of...

Kaizen events lend themselves to rapid improvements in routine health department processes. Tazewell County Health Department utilized Kaizen tools to full advantage--reducing administrative time related to food establishment inspections dramatically, exceeding the project aim. In the first month...

Home visiting programs are an important intervention to improve the health of women and children, but they are generally done in programmatic silos. A state health department used QI to improve the process and systematically address both chronic disease and environmental health risk factors...

Michigan’s Maternal Infant Health Program serves low-income families and pregnant women to improve birth outcomes. A local health district in that state used the PDSA cycle to reduce office-related work and increase time for direct client services in order to make the program more efficient and...

Using QI Tools and PDSA leads to significant improvement in the standardization of Final Inspection Reports.

Tuberculosis is difficult to eradicate, it can have devastating health impacts, and one active TB case can result in budget-breaking expenses for small-to-medium local health jurisdictions. A local health department in Washington state implemented a quality planning and quality improvement project...

The tribal health department used QI to increase the number of parents using car child seats correctly from 30 to 65% using new dramatic visual presentations and enhanced car safety seat installation demonstrations. This will save children’s lives and reduce auto related injuries.

Local health departments play a critical role in responding to public health emergencies and often test their ability to respond during exercises or drills. One local health department in Illinois used the PDCA cycle to improve its ability to assemble staff in a complete and timely manner during...

Local health departments in Washington state monitor the quality of the Vaccine for Children program to ensure vaccines administered by the private sector maintain high quality and immunization rates improve. To eliminate redundancies, decrease inconsistencies between staff and improve clarity of...

In Fillmore County Public Health department, the time from notification to investigation of health problems and environmental health hazards (animal bites, infectious diseases, and nuisances) took longer than desired. Data was collected to understand the current state; investigations ranged from...

The Sedgwick County Health Department improved the quality of the collaborative process related to communication, empowerment, and recruitment of diverse people and organizations so that individuals and organizations critical to the implementation and success of its community's health...

This northern Kentucky health department wanted to increase the percentage of properly licensed mobile food vendors to correct unsafe food handling and prevent foodborne illness related to mobile food vendors such as food trucks. With the large light-industry and numerous warehouses located...

Because surveillance for communicable disease had been provided by the state, the Red Cliff Community health department had limited knowledge of communicable diseases in their community. They used quality improvement to bring communicable disease reporting, surveillance, control and prevention...

By engaging health department staff across all divisions in the process of developing proactive media messages based on local health needs and priorities, the Zanesville-Muskingum County Health Department was able to improve its provision of timely, needed public health information to the community.

Even the implementation of evidence-based public health interventions poses challenges for most health departments. Using rapid-cycle tools and regular status monitoring, Cleveland County Health Department dramatically improved completion of the 5A’s smoking cessation service.

The Allegan County Health Department used QI to increase of the percent of department programs that perform client satisfaction surveys from 33 to 81%. As a result valuable feedback from clients is enabling the department to provide services and programs that better meet the needs of its community.

Compliance with required school immunizations rose after completion of a review of school immunization records was coupled with better methods of contacting parents. As a result, both children and the wider community experienced less spread of diseases.

A local health department in Washington state used QI to increase the percent of department staff who engage in physical activity as part of a worksite wellness program, learning that variety and support are critical for wellness activities to succeed.