PDCA/PDSA Cycle (Plan, Do, Check/Study, Act)

Deschutes County Health Services (DCHS) in Central Oregon is now able to provide more efficient preventive strategies for the county through creating and implementing an online process for reporting foodborne illness, restaurant complaints, hotel and motel complaints, pool and spa complaints, 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...

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...

The number of breastfeeding women who have access to a certified lactation counselor soared when Missoula City-County Health Department staff used QI to improve their internal processes.

Knox County Health Dept. demonstrates how use of partner developed communication standards can improve communication satisfaction among groups participating in a coalition.

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...

Reducing adolescent tobacco use is a priority for Tooele County Health Department (TCHD) in Utah. Staff recognized the need to improve tobacco compliance check pass rates and identified that clerks who possess a valid permit were less likely to sell tobacco products to minors. TCHD used quality...

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...

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.

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.

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,...

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!

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...

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...

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.

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...

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...

This initiative describes how quality leaders at the Salt Lake County Health Department challenged the status quo to transform organizational quality culture. Members of the SLCHD Quality Council identified a need to increase the health department's emphasis on quality after a review and...

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.

Washington County Department of Public Health and Environment improved the process of renewing annual hazardous waste licenses to over 500 hazardous waste generators. Approximately 75% of renewals contained one or more defects which slows the process, consumes unnecessary time by the inspectors...

The local health department noted waning engagement of the coalition working to implement the collaborative 2011 community action plan. Through a PDSA approach they were able to re-energize the coalition by collectively reassessing the community action plan, improving its clarity, re-developing...

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...

Effective tobacco control and prevention outreach is vital to decreasing tobacco use, secondhand smoke exposure, and tobacco-related disease rates. In addition, the loss of significant resources and funding for tobacco control and prevention have made it all the more important to have efficient...

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...

An example of bridging health and health care in rural Nebraska: In order to improve critical health outcomes of “hard to reach” patients with diabetes and high blood pressure, a local health department and a community health center partnered to use the PDSA model and best practices to provide...

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...

Vaccinating children is imperative in the prevention and spread of life-threatening communicable diseases. A rural regional health district conducted an improvement project using PDSA at three public health clinic sites to increase immunization rates among 19–35-month-old children seen at their...

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...

A large county health department used effective data gathering, analysis, and interpretation with PDSA to enable increased WIC caseloads that in turn decreased the number of negative health outcomes among low-income mothers and their families who had not been receiving WIC benefits.

This big city health department used QI to improve their intake processes and obtained dramatic results in connecting the highest risk people with substance use disorders to existing city services, which in turn results in improved outcomes for individuals who are homeless, have co-occurring health...

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...

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.

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...

Increasing participation in public health programs is a goal of many agencies. In this QI project, the Kenosha County Division of Health sought to expand and enhance its prenatal care coordination (PNCC) and reproductive health services. QI resulted in changes in the process with the addition of a...

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.