Standard 9.2 Develop and Implement Quality Improvement Processes Integrated Into Organizational Practice, Programs, Processes, and Interventions

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...

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...

A local health department increased early enrollment of pregnant women in smoking cessation programs to reduce risks of pregnancy complications, premature delivery, and their infants being low-birth weight, stillborn, or dying from SIDS.

Clark County Health Department increased the percent of eligible families that are referred to Kentucky’s home visitation program for new and expectant parents from 24% to 56%. Evidence indicates that increased participation in this program will positively impact preterm birth rates, low and very...

This QI project used many QI tools to identify and design improvement actions to increase the redemption of food vouchers by WIC clients. While this project did not achieve the improvement target, , the development and application of tools could be helpful to other community health programs seeking...

In order to simplify and standardize its formal contracts (numbering over 200) with the seven local health districts in Idaho, which led to great frustration and wasted time by both local and state staff in processing multiple different forms for contracts, the Idaho Division of Public Health used...

Taking the whoop out of a Pertussis outbreak and enhancing a community's pertussis mitigation effort by using improved early identification and isolation outcomes methods to decrease the number of days between onset and the report of disease.

The Harford County Health Department used QI to create a more welcoming environment for limited English proficiency populations by focused staff education, training, and standardization of processes, increasing the use translation services three fold.

Using Kaizen Rapid Improvement Event, Denver Public Health not only made the vaccine administrative process more efficient, but helped to ensure the appropriate vaccine and fund source was applied, thereby preserving scarce privately funded vaccines.

WIC enrollment is well below the eligible population in Yellowstone, MT, and a substantial number of those enrolled do not regularly pick up their food coupons, resulting in automatic disenrollment and loss of benefits. Utilizing PDCA, RiverStone Health addressed the root causes of the drop off in...

A local health department in rural Wisconsin was missing opportunities to immunize a significant number of teenagers who would potentially benefit from mandated or optional vaccines. They implemented an improvement project to standardize the process and educate staff in order to decrease missed...

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...

To improve the reach of chronic disease management in Nebraska, an evidence-based chronic disease self-management program, Living Well, was implemented using awareness and communication techniques in Lancaster and Buffalo counties to improve participants' ability to manage their health...

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...

A local health department noted a high rate of early post-partum unintended pregnancies among women in the Women, Infants and Children (WIC) program, and used QI to identify three interventions to reduce the rate.

Denver Health used rapid cycle improvement to implement a brief tobacco cessation intervention (2As &R) in a high risk urban family planning and sexual health clinic. The intervention was enhanced by modifications to the electronic medical record system. They plan to spread this intervention...

A systematic 9- step approach to manage access to prenatal care was the key to improving access to medical exams within the first 2 weeks of a positive pregnancy test. This systematic approach removed previous barriers that caused a delay in the process from pregnancy testing to initial medical...

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...

Through several PDCA cycles, the Madison County Health Department was able to increase revenue from billable service fees in two program areas -- one by 13% and the other by 16%. The process improvements gradually will be applied to all direct service program areas, followed by other improvements...

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.

This mixed semi-urban and rural county had the lowest rate of kindergartners completely immunized in New York State (89%), with baseline data for the immunization rates among schools in the county ranging from 15.4% to 90%. The QI initiative aimed to improve the immunization rate for children...

The CT DPH innovatively improved its ability to collect and report sociodemographic information, so health disparities could be identified throughout the state and efforts could be taken to improve population health and better address health inequities.

The public health community has lagged in using digital communications to make its presence and services delivered known to the general public. Gwinnett, Newton, and Rockdale County Health Departments found that creating a better experience and better information for website visitors was better...

Although located in an area with significant need for teen family planning services, a public health teen clinic in Spartanburg County had low rates of use. The South Carolina Department of Health and Environmental Control followed a Plan-Do-Study-Act (PDSA) approach and used QI tools to understand...

Fast and effective investigations into foodborne illness outbreaks are an important part of a food safety program because they reduce the time that people are exposed to a pathogen. Toledo-Lucas County reduced the cycle time for an effective investigation and closure of foodborne outbreak cases...

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.

Wisconsin’s Prenatal Care Coordination (PNCC) program has been shown to decrease low-birth weight among single women, increase family support and involvement of the father, decrease preeclampsia, and decrease smoking among pregnant women. Clark County health department used QI to achieve 100%...

The Snohomish County Health Dept used QI on its immunization process.. By analyzing causes of error, introducing a new and standardized work flow, and using job aids that help to verify client records and data, the immunization error rate was reduced by over 50%.

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.

By improving its grant application process, the Bethlehem Health Bureau increased the success rate of funded grant applications and increased the amount of grant funding received. The improved process now enables the organization to better meet the needs of the community it serves.

By improving processes in its WIC program, the Wood County Health Department has made WIC education more accessible to clients, increased client satisfaction, and freed up staff time to complete other work assignments.

St. Croix County Public Health nurses were concerned that the time needed to complete required paperwork was taking them away from serving postpartum mothers and newborn babies. To put clients first, they conducted a quality improvement initiative that reduced the time for documentation by 37%....

Deschutes County Health Services improved the efficiency and accuracy of entering data on immunizations into the state immunization registry. The interventions tested included eliminating paperwork errors, balancing workload, and improving courier scheduling.

The local health department improved how they got customer satisfaction information from clients at their sexually transmitted disease clinics, enabling them to use the feedback to increase client satisfaction, improve program efficiency and provide culturally-appropriate services.

Yadkin-County Health department used QI tools and methods decrease the time for notifying clients of abnormal Pap smear results, enabling clients to make informed decisions about follow-up care.

SRHD reduced the number of water recreation facilities with violations that required re-inspection, resulting in better efficiency and reduced risk of illness and injury among community members.

By giving women improved information on the prenatal care program and the WIC program, this collaborative increased entry into prenatal care and participation in WIC, thus promoting healthy birth outcomes in the community and synergy between the two programs.

The county has a high percentage of overweight and obese children. Pleasant Street School staff implemented activities related to nutrition education in a school setting. Student knowledge about fruits and vegetables increased, and the school received additional funds to foster healthy eating.

By reducing the time to perform inspections of residential septic and well systems for real estate transactions, the Mahoning County District Board of Health made a positive economic impact in its community and improved customer service relations with local realtors.

This six-county health district department used QI to achieve a 75% increase in response to satisfaction surveys by customers of their environmental health services.

Reducing childhood obesity is a priority for the Oklahoma State Health Department. Staff recognized that children returning for a second year in the afterschool CATCH Kids Club would need a new curriculum and activities to keep them engaged. The Department used QI to design new components and...

This health department found the root cause of the high HIV clinic “no show” to be out of date patient contact information. They developed a simple and timely patient contact update process that dropped the “no show” rate dramatically in 8 weeks.

The health department was concerned about a falling rate of visits by homeless people to the federally funded Health Care for Homeless project despite an increase in the homeless population. They investigated the causes and made several changes including implementing a process for walk-in service...

The state health department developed a training program for public health staff at the state and local levels to apply continuous quality improvement in their delivery of public health services, in turn resulting in better health outcomes for the people of North Carolina.

The Health Department improved the process for obtaining birth and death certificates so customers weren’t forced to miss time from work or take other extraordinary steps to obtain these vital documents in a timely fashion.

In order to improve client satisfaction and increase the efficiency of WIC visits, this medium size local health department used QI to improve their Open Access appointment system. They were able to reduce the time for a complete WIC visit by 25% and increase participant satisfaction to 96%.

An urban local health department found that 35% of mid-level staff did not know who to contact for questions about new department programs and services. This workforce development QI project led to development of a common resource packet that enabled staff to respond more quickly and effectively...

The Alabama state health department trained local health department family planning clinic staff in QI. The QI tools provided helped staff analyze current procedures and identify service delivery bottlenecks and then design interventions resulting in increased capacity and a reduction in waiting...