1-3 Initiatives

Using a QI process, the Mercer County Health Department significantly increased the number of survey responses from its customers. This feedback is used to help identify areas for improvement and thus is an important part of the health department's strategy to apply QI to its operations.

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.

Implementing an improved process to collect customer feedback resulted in a staggering increase in customer satisfaction survey responses, from an average of 12 per month to more than 1,000 per month. The feedback will greatly enhance Manatee County Health Department’s (DOH-Manatee’s) performance...

Maricopa County Department of Health (MCDPH) used QI methods to achieve a 90% decrease in callers to the health department who selected the "zero-out" option (transfer of call to a live operator), thereby freeing staff time to focus on other projects and ensuring that more callers quickly...

Charting errors increased in Scott County Health Department's (SCHD's) STD clinic when a new electronic database was introduced. Anticipating the transition to the new database, the STD team implemented a QI effort to identify and correct problems with the charting process before they...

The Boston Public Health Commission worked across departmental areas to improve the invoice payment process for their vendors. Timely payment contributes to improved relationships with these partners to collectively meet the community's health needs.

Kendall County Health Department implemented successive PDSA cycles to better protect their population from West Nile Virus. The QI activities eventually led to a nearly 200% increase in the number of mosquito tests performed. Moreover, the implementation of a GIS management system has led to...

Kansas Health Institute (KHI) strengthened their ability to share information with clients by increasing the efficiency of its publication process and reducing staff stress associated with it.

The Florida Department of Health in Seminole County (DOH-Seminole) improved the timeliness of filing Client Service Records (CSRs), positively affecting customer service and access to care.

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...

The Louisiana Public Health Institute (LPHI), a nonprofit organization dependent on grant funding, engaged in a Kaizen process to decrease the amount of time it takes to prepare a grant proposal. After a 5-day Kaizen event, a new process and job aid were developed, and labor time for proposal...

Working together, the Tulare County Public Health Department’s tuberculosis (TB) team and nurses increased the on-time completion rates from 80% to 100% for referrals of suspected TB cases. The QI project resulted in a newly defined and consistent work process that improved communications and team...

The Stratford Health Department’s aim was to ensure that at least 75% of faith-based organizations (FBOs) were licensed, so they could provide food during public events throughout the year and minimize the risk of food-borne illness. While working through their QI planning project, staff fixed a...

Saginaw County Department of Public Health (SCDPH) conducts strategic planning every 2 years. After noting that not all staff were engaged, the four previous strategic planning groups conducted a PDSA cycle on the strategic planning process. As a result, staff are now more committed to setting and...

The time participants spend waiting for appointments at the WIC clinic can lead to dissatisfaction with the WIC program and could negate efforts to retain program participants. The Marion Public Health WIC team used a fishbone diagram to determine that the primary root cause of long wait times in...

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.

The Whatcom County Health department found that language and cultural barriers were contributing to higher numbers of critical Food Code violations for the almost 18% of non-English and ESL food service operators in Level 3 establishments in the County. The department considered the food service...

This health department was able to achieve a 51% improvement in HIV testing rates, which can result in identifying more people with HIV and better, more immediate treatment. In order to reduce redundancy, the QI project team eliminated one of the demographic forms that had been required, saving...

Review of timely and accurate evaluation data is crucial for health departments to provide effective interventions to improve the health of their communities. The Women’s Health branch of a state health department used several QI methods and tools—including a Kaizen event, multiple PDSA cycles and...

A knowledgeable and involved team, subject matter expertise, and the Kaizen improvement method helped the Madison County Health Department reduce their client no show rates in the Family Planning Clinic. Root cause analysis led the team to create standardized process procedures, client scheduling...

NC Division of Public Health streamlined data collection and improved the quality of reportable data in their Maternal, Infant, and Early Childhood Home Visiting Program resulting in greater use of these data to improve services to children and families.

Client satisfaction data are a critical component of an agency’s QI plan but can be difficult to obtain. Through a 4-day Kaizen event, Northampton County Health Department (NCHD) in North Carolina streamlined and simplified its client satisfaction survey process, resulting in a 100% increase in the...

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...

Using quality improvement to raise community awareness of the importance of annual private well water testing increased the number of tests performed, assuring a safe water supply for county residents all done without increasing processing costs!

Early intervention has been shown to positively impact outcomes across developmental domains. The Fond du Lac County Health Department increased the number of children being screened for developmental delays from 5 to 9 per month, allowing more children to be appropriately connected with services...

El Dorado County Health and Human Services Agency used a Kaizen event to improve customer satisfaction and reduce labor time in the County “request for information” process. The results of the project mean better and faster information to the incoming caller, so they can make more informed...

The DeKalb County Board of Health used a kaizen event to decrease the labor time and increase the accuracy of filing death certificate registrations. Improving the process resulted in labor savings, better cash flow and improved performance for customers in providing accurate and timely filing. The...

DOH-Seminole County realized savings of $7764 for goods and services from price negotiations during the first quarter following a Kaizen event – almost double the goal set by the QI team. Other improvements in the requisition process included a 38% decrease in process time, in addition to...

Washington County (OR) conducted a Kaizen Event to improve the volume of childcare facilities that used the LHD for their state required inspections. The agency implemented several new policies and protocols to standardize the entire inspection process. As a result, they anticipate a reduction in...

By streamlining their internal computer drive, creating an internal framework for its use/upkeep, and training staff on the efficient and effective use of the computer drive, the Three Rivers District Health Department has increased staff productivity.

WIC coupons for use at famer’s markets are a precious resource for improving nutrition and reducing food hunger in low-income families, as well as supporting local farmers. Deschutes County Health Department noted a decreasing trend of redemption, which meant a literal wasting of coupons that other...

The Maryland Department of Health and Mental Hygiene partnered with its local health departments and WIC clinics to increase the number of WIC clients referred to and receiving appropriate services to meet their needs.

A local health department in Washington was not able to serve all of the WIC-eligible clients in its jurisdiction. Process mapping led to three aims for increasing efficiency to make time for new clients: (1) Decreasing the average percentage of no-show appointments; (2) Increasing the WIC...

Staff from Oregon MothersCare conducted a QI project to improve their processes for prenatal care, which led to decreased errors in tracking and faster flow through the system so that pregnant women received services in a more timely manner. Access to prenatal care was also improved.

Elkhorn Logan Valley Public Health Department improved the return rate of colon cancer screening kits by expanding the work process to include personal phone contact. The process now includes 3 phone attempts, within 3 weeks, to reach the participant. If still unable to reach the participant, the...

Inadequate documentation of policies and procedures is not just a hassle; it can also create confusion and redundancies that bog down staff’s ability to provide effective public health services and programs to the community. A small, rural local health department used quality improvement methods...

This state health department quality improvement (QI) effort sought to improve customer satisfaction and increase use of the Utah state laboratory. The intervention tested was the development of a website for use by local health department (LHD) staff, who achieved both of the QI project goals. In...

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...

Responding to case reports of Lyme disease, the most common tick-borne infection in North America represented a very large time burden for a local health department in northwest New York state. The department used QI tools to decrease the number of steps and amount of time to respond to case...

The Prentiss County Health Department and Mississippi State Department of Health partnered on a project to reduce wait time in their WIC clinics, reassign staff as needed on higher traffic days, and provide customer service training to frontline staff to assure greater satisfaction and...

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.

In an effort to improve customer satisfaction, Carroll County General Health District embarked upon a QI project to decrease waiting time in the reproductive health clinic. Their aim for a 10% reduction in waiting time was nearly achieved by taking a novel approach to addressing the identified...

The Specialty Care clinic at the Florida Department of Health in Seminole County sought to notify clients more quickly of the results from their tests at the sexually transmitted disease clinic. A QI project led to implementation of a confidential no-reply text messaging system which resulted in...

This Michigan Department of Community Health QI project sought to increase the number of grants reaching priority populations in response to requests for proposals (RFP) for tobacco control. The team used a survey to gather data on the biggest barriers to applying for grants that would reach the...