Brainstorming

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...

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.

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...

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...

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...

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...

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...

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.

Enforcement of food safety regulations plays a significant role in preventing food borne illness outbreaks. A local health department used the Lean method to increase efficiencies, standardize the process and reduce staff time and other costs for the administrative hearing process that enforces...

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.

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...

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...

Pregnant women face economic barriers to receipt of pertussis vaccines, increasing risks for infant transmission of the disease. Using PDSA and rapid cycle improvement, the health department partnered with a prenatal care provider to increase Tdap coverage from 1% to 49% of pregnant women whose...

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...

It has been shown that home visiting and other supportive services provided during pregnancy improve perinatal outcomes. Sullivan County Public Health Services used QI to improve its internal processes for reaching women with high-risk pregnancies, so more mothers and babies can have healthy...

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...

The Washington state health department conducted a Kaizen event to streamline the application process for HIV positive Washington state residents with low incomes to receive coverage. Multiple improvements were made, several target goals were exceeded, resulting in quicker access to life-saving...

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...

Due to a variety of barriers, including inefficient flow of clients during WIC visits, eligible families were not engaging with WIC services. The clinics at this health department improved their processes and exceeded their initial goals, allowing many more families to be able to eat well and be...

Kittitas County Health Department improved their process for Alcohol Drug Dependency Service (ADDS) clients to follow through with Hepatitis C testing so that treatment would be received earlier and the spread of the disease reduced.

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...

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...