Process maps

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...

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...

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...

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...

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...

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...

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 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...

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...

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...

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.

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...

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...

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...

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...

Because surveillance for communicable disease had been provided by the state, the Red Cliff Community health department had limited knowledge of communicable diseases in their community. They used quality improvement to bring communicable disease reporting, surveillance, control and prevention...

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.

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.

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.

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.

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...

Committed to minimizing the health and social impact of pandemic influenza in its jurisdiction, this health department applied continuous quality improvement (CQI) tools and methods to improve the accuracy, effectiveness, and timeliness of its risk communications plan and messages to staff and...

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.

Challenged by undesired delays for clinic appointments, high no-show rates, client dissatisfaction, and suboptimal productivity, Macon County Public used QI to implement an open access clinic appointment system that allowed them to schedule appointments within 72 hours for all clients and all...

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%.

This 10-county District health department improved the processes of immunization clinic scheduling, preparation and follow-up and reduced the number of “no shows” , leading to greater efficiency and capacity. The improved process and staff training were then standardized across the 10 counties.

The health department discovered that most of its employees were unaware of the many of the Department’s media activities for outreach and education. The department made several changes to increase employee awareness of current and new media efforts and achieved a major improvement on all three of...

The county health department used a QI planning approach to improve their planning processes for community meetings resulting in the community becoming more involved in improving its own health.

The Mid-Michigan District Health Department optimized the performance of the automated telephone system for clients calling the health department to assure mis-routings were minimized, customers were directed to intended recipients, and customer satisfaction was improved.