Fishbone Diagram

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...

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...

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...

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.

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...

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.

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...

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...

Wicomico County had a salmonella infection rate twice as high as the state average. Their QI project found that by focusing on reducing critical violations in retail food service facilities through increasing its outreach and education services to those facilities, the Wicomico County Health...

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...

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.

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.

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...

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.

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...

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.

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%....

Washington State Department of Health enhanced their ability to lower the risk of clients receiving substandard care in hospital settings. Using a Lean process, staff implemented a host of improvements to increase the rate of hospital inspections conducted within the state-mandated 18-month...

Franklin County Public Health: This QI project sought to improve client satisfaction with Environmental Health programs, focusing for this project on the water quality partnership program. Understanding client satisfaction in programs that are fee-based, such as environmental health, can improve...

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.

TPCHD sped its response time for solid waste complaints, resulting in greater protection of the public’s health, better customer service, and greater accountability to its community members.

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.

By using quality planning to improve the effectiveness of community meetings, this small rural county increased community engagement and participation from 40 to 66% in the county-wide community health assessment and improvement planning process.

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.

Access to prenatal care contributes to successful birth outcomes. A Kansas health department found that patients had challenges completing the application process for the Medicaid Children’s Health Insurance Program. By conducting patient education and assistance with the application, the health...

Cumberland County Health Department achieved dramatic improvements in the quality of services offered by their Adult Health Clinic through a Kaizen event. Prescription refill wait times decreased from as long as 6 weeks to less than 72 hours, and referrals to specialists, many of which had lengthy...

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.

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...