QI Resources

Public Health National Organization Online QI Links Journals
General QI and Performance Management Online Resources Books
State and Local and Tribal Public Health QI Websites Articles

 Public Health National Organization Online QI Links:

American Public Health Association (APHA)

QI Initiatives APHA advances quality improvement in both health care delivery and public health and is on the forefront of ensuring quality in public health systems through its standards-setting texts, education programs and policies that promote quality improvement in a range of public health systems. This site provides QI Brochures developed by APHA, with links to APHA’s quality initiatives.

Association of State and Territorial Health Officials (ASTHO)

Accreditation and Performance Tools and Resources ASTHO is dedicated to continually strengthen the public health infrastructure and improve state and territory health agencies’ performance. This is accomplished through advancing participation in national accreditation, facilitating performance management and quality improvement, and increasing systems assessments and enabling states and territories to strengthen their ability to deliver the essential public health services. ASTHO provides resources to support advancement in accreditation preparation, performance management and quality improvement, and increasing public health systems assessments. An overview of resources is provided below. All of the tools and resources can be found on ASTHO’s Accreditation and Performance Resources and Tools Webpage: http://www.astho.org/Programs/Accreditation-and-Performance/Resources-an....

Center for Disease Control (CDC)

National Public Health Improvement  Initiative (NPHII)  This CDC site provides resources on the NPHII including a program fact sheet, a map of awardees, links to state, local, and territory health departments, CDC contacts, and more.

Health and Human Services (HHS)

HHS Public Health System, Finance, and Quality (PHSFQ) Program The program is centered on identifying standardized concepts for quality that can be applied across all sectors providing public health services and programs. Aims are provided to describe the characteristics of what quality should look like and how it can be measured in public health. The priority areas provide direction on what areas to target for improvement.

National Association of County and City Health Officials (NACCHO)

NACCHO Introduction to QI This PowerPoint is intended for local health departments to introduce the basics of QI to their staff. Each slide contains talking points and instructions on how to tailor the slides to a particular department. This resource is one of NACCHO’s training materials designed to save local health departments time in preparing materials prior to presenting to staff.

NACCHO Accreditation and QI Webinars NACCHO’s Quality Improvement (QI) and Accreditation Preparation Webinar Series provides periodic webinars as part of NACCHO's continued commitment to QI and preparing local health departments (LHDs) for national accreditation. NACCHO provides tools, resources, and training opportunities for local health departments to assist in their preparation for accreditation, and in using QI processes to improve performance and meet PHAB standards.

NACCHO Quality Improvement Toolbox  The Toolbox is a free, online collection of local public health tools produced by members of the public health community. Tools within the Toolbox are materials and resources public health professionals and other external stakeholders can use to inform and improve their work in the promotion and advancement of public health objectives. Current examples of tools include, but are not limited to, case examples, presentations, fact sheets, drills, evaluations, protocols, templates, reports, and training materials.

NACCHO “Roadmap to a Culture of Quality Improvement” QI is increasingly being embraced as a means to achieve efficiencies and other improvements with limited resources. Beyond discrete QI efforts, a comprehensive approach to QI – one in which the concepts of QI are ingrained in the shared attitudes, values, goals, and practices of all individuals in the agency – will ensure that QI is institutionalized and becomes part of the way that local health departments do business. To assist local health departments to this end, NACCHO has developed this roadmap.

National Institute for Children’s Health Quality (NICHQ)

The National Institute for Children’s Health Quality (NICHQ) is dedicated to the mission of improving children's health. NICHQ achieves this mission by helping others who are similarly dedicated - typically healthcare professionals and delivery organizations, foundations, government agencies, and community organizations - achieve breakthrough improvements for children and families. NICHQ is an invaluable resources for these organizations and professionals as experts in the "How" and the "What" to improve for children's health.

National Network of Public Health Institutes (NNPHI)

NNPHI and its network of members build capacity for public health accreditation and performance improvement amongst public health institutes, health departments, and other organizations through a variety of webinars, conferences, and trainings. The below items with links provide information on specific performance improvement events and networks.

Public Health Improvement Training (PHIT) offers interactive learning and skill-building sessions designed for different experience levels and also offers networking opportunities. Annually, PHIT features hands-on sessions and discussion groups that renew commitment to performance excellence and inspire new insight long after the convening ends.

Open Forum for Quality Improvement (Open Forum) focuses on building capacity among public health departments for accreditation and quality improvement activities, Open Forum programming harnesses enthusiasm for national voluntary accreditation and public health performance improvement initiatives. Open Forums focus on the most recent advances, inspirational stories, tools, and cutting edge topics in the field of public health quality improvement.

Public Health Performance Improvement Network (phPIN) is a learning community and peer exchange network for those of you providing leadership in performance improvement in public health.

Public Health Foundation

Public Health Foundation The Public Health Foundation (PHF), a private, non-profit, organization based in Washington, DC, improves the public’s health by strengthening the quality and performance of public health practice. Since 1970, PHF has developed effective resources, tools, information, and training for health agencies, organizations, and individuals to help improve performance and community health outcomes PHF offers many ways to learn about quality improvement providing resources on programs, training, and technical assistance.

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 General QI & Performance Management Online Resources:

American Society for Quality (ASQ) Quality Tools ASQ (American Society for Quality) is a global community of people dedicated to quality who provide the quality community with knowledge, training, and professional certifications. The ASQ Quality tools site provides resources for users to identify causes, understand processes, collect and analyze data, generate ideas, keep projects on track, and make informed decisions for continuous improvement activities.

Balanced Scorecard The Balanced Scorecard Institute (BSI) provides training, certification and consulting services to commercial, government, and non-profit organizations worldwide. BSI helps clients increase focus on strategy and results, improve organizational performance by measuring what matters, align the work people do on a day-to-day basis with strategy, focus on the drivers of future performance, improve communication of the organization’s Vision and Strategy, and prioritize in tough economic times.

Baldrige Performance Excellence The Baldrige Program is the nation's public-private partnership dedicated to performance excellence. Their mission is to improve the competitiveness and performance of U.S. organizations for the benefit of all U.S. residents. The program provides organizational assessment tools and criteria, educates leaders about the practices of best-in-class organizations, and offers global leadership in the learning and sharing of successful strategies and performance practices, principles, and methodologies

Institute for Healthcare Improvement The Institute for Healthcare Improvement (IHI), an independent not-for-profit organization, is a leading innovator, convener, partner, and driver of results in health and health care improvement worldwide. IHI's work is focused in five key areas: improvement capability, person- and family-centered care, patient safety, quality, cost and value, and triple aims for populations (applying integrated approaches to simultaneously improve care, improve population health, and reduce costs per capita).

The Kaizen Institute The Kaizen Institute is a global team of experienced Lean professionals with a passion for reducing waste, creating measurable improvements, developing people and enhancing customer delight. Kaizen Institute USA is a versatile consultancy adept at successfully guiding hands-on design, implementation, and sustainability of both project based and enterprise-wide Lean transformations. They work with their clients to solve problems, and their clients come from virtually every industry, size and type.

Six Sigma Six Sigma is a methodology used to improve business processes by utilizing statistical analysis rather than guesswork. This proven approach has been implemented within a myriad of industries to achieve hard and soft money savings, while increasing customer satisfaction. The goal of implementing Lean Six Sigma is to enhance an organization’s ability to execute its business strategy. Six Sigma programs emphasize a practical approach geared to delivering those real world results.

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 State and Local & Tribal Public Health QI Websites:

Department of Public Health QI (Iowa) The Iowa Department of Public Health’s quality improvement page provides extensive resources including activities on the state and local level, webinar and training materials, and minutes from the state’s 2011 Public Health Learning Congress.

Division of Prevention and Quality Improvement (Kentucky) Established in December 2006, the Kentucky Department for Public Health (DPH) Division of Prevention and Quality Improvement (DPQI) is the cornerstone of state public health efforts to address chronic disease through prevention and assuring health care access for the underserved population. The DPQI provides the organizational focus for DPH to bridge the gap from research, discovery and development to delivery to improve the health status of Kentuckians.

Population Health Improvement Partners Population Health Improvement Partners traces its origins to the highly successful Center for Healthy North Carolina (CHNC) and Center for Public Health Quality (CPHQ). CHNC has built a strong reputation in helping community coalitions expand capacity to improve health locally, through coalition enhancement and the use of community-appropriate, evidence based interventions. CPHQ has a robust history of providing groundbreaking quality improvement training and technical support to public health organizations in North Carolina as well as across the United States. Today, Population Health Improvement Partners makes all of these programs available and offers many new opportunities for enhancing the agility and effectiveness of health-focused organizations.

Public Health Quality Initiative (Wisconsin) Wisconsin's Public Health Quality Initiative (WIQI) is helping Wisconsin's health departments improve quality and prepare for national voluntary accreditation. The site contains resources on accreditation, performance, and quality, as well as a "Top Ten" list of the most recent, important, and relevant resources across disciplines and communities as determined by both department staff and readers.

Public Health Collaborative on Quality Improvement (Minnesota) This site defines quality improvement and performance management, lists key questions and guiding principles, and provides links to additional QI resources from other organizations.

Tacoma-Pierce County Health Department The Tacoma-Pierce County Health Department offers a number of trainings and resources including quality improvement methods and tools, performance management approaches, and program evaluation methods and tools. The site also offers complimentary recordings of webinars given by their staff that serve as tutorials and overviews of some of these subjects.

Washington State's Public Health Performance Management Centers for Excellence This completed program funded by the U.S. Centers for Disease Control and Prevention supported local public health jurisdictions across the state as they prepared to apply for national accreditation. The initiative produced a searchable online database with information from the rapidly growing number of public health quality improvement projects as well as other performance management resources. Past training materials and other quality improvement and performance management resources remain available through this website.

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Accreditation and QI: Preparing Local Health Departments (NACCHO) CD-ROM This CD-ROM helps local health departments prepare for the voluntary national accreditation program. Through case examples, interviews with experts, literature, and worksheets, this CD-ROM brings together resources from NACCHO and other national organizations and from local health departments experienced in quality improvement, state-based accreditation, and related programs. While the CD-ROM was developed primarily for local health department leaders and staff, the information and tools will prove useful to a variety of audiences, including those involved with state health departments and boards of health.

CDC Patient Flow Analysis for Windows The Patient Flow Analysis (PFA) software was developed in 1979 for clinics providing family planning services under Title X of the Public Health Services Act. CDC is no longer able to provide support and technical assistance to users of the PFA software. This includes distribution of software and related documentation to end-users. However, the software and supporting documentation continue to be in the public domain.

Mindtools MindTools.com teaches the leadership, team management, problem-solving, personal productivity, and team-working skills that are necessary for a happy and successful career. The site includes a toolkit of free resources on topics such as project management, strategy tools, and team management. Additional tools are available for purchase by joining the Mind Tools Club.

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Journal of Public Health Management and Practice The Journal of Public Health Management and Practice publishes articles which focus on evidence based public health practice and research. The journal is a bi-monthly peer-reviewed publication guided by a multidisciplinary editorial board of administrators, practitioners and scientists. It publishes in a wide range of population health topics including research to practice; emergency preparedness; bioterrorism; infectious disease surveillance; environmental health; community health assessment, chronic disease prevention and health promotion, and academic-practice linkages.

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ASQ Quality toolbox The Quality Toolbox is a comprehensive reference to a variety of methods and techniques: those most commonly used for quality improvement, many less commonly used, and some created by the author and not available elsewhere. The reader will find the widely used seven basic quality control tools (for example, fishbone diagram, and Pareto chart) as well as the newer management and planning tools. Tools are included for generating and organizing ideas, evaluating ideas, analyzing processes, determining root causes, planning, and basic data-handling and statistics.

COPE COPE® (client-oriented, provider-efficient services) is a relatively simple process for improving quality in health services. COPE encourages and enables service providers and other staff at a facility to assess the services they provide jointly with their supervisors. Using various tools, they identify problems, find the root causes, and develop effective solutions.

Embracing Quality in Public Health: A Practitioner's Quality Improvement Guidebook This second edition of Embracing Quality in Public Health provides a guide for all public health practitioners who wish to begin or advance their journey to quality. Its content and structure are flexible enough for use by public health practitioners across the country and at every layer of the public health system. The guidebook has utility within the context of accreditation or performance assessment programs, but may be used absent that context to improve the quality of any public health process, program, organizational capacity, or systems efforts.

Public Health Memory Jogger II A pocket guide expressly for public health agencies that contains quality control and management and planning tools with real-life examples that relate specifically to public health. The book uses graphics and easy-to-understand text to show how and when to use twenty-two different tools to answer your organization’s most-pressing questions.

Public Health Quality Improvement Encyclopedia To support QI efforts, the Public Health Foundation (PHF) released this comprehensive encyclopedia which includes 75 QI tools and an extensive glossary. In this resource, the authors define the purpose of each tool and provide guidance on when and how they should be used. They also explain what should be done after implementing each tool and provide examples specific to public health settings.

Public Health Quality Improvement Handbook This book, a collaboration between the Public Health Foundation (PHF) and ASQ, is an anthology of chapters written by subject matter experts in public health who are successfully meeting client needs, working together to maximize outcomes, and expanding their collaboration with community partners to encourage better health within neighborhoods, counties, and states. The messages in The Public Health Quality Improvement Handbook are from leaders, physicians, practitioners, academics, consultants, and researchers who are successfully applying the tools and techniques they share. The chapters are written to support the leaders and workforce of our public health community.

Implementing Performance Management through Modular kaizen Excerpt from Modular kaizen: Dealing with Disruption, Quality Management Division, May E-Blast, Vol. 1, No. 4. The authors have experimented with numerous quality improvement (QI) approaches to improve working environments which generate a “bad system.” An organization’s response is typically a rapid, reactive, non-data-driven approach which usually makes the problem worse. Many times these quick responses make the situation harder to correct. The authors have developed a concept called Modular kaizen to address the need for continuous improvement within public health’s highly interruptive environment. Chapter 3 of this book documents the beginning of this approach when a major disruption hit a hospital unexpectedly.

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The Improvement Quotient A blog by NICHQ with numerous articles that cover topics such as collective impact, healthy living, infant health, patient and family engagement, public health, quality care, quality improvement, and systems design.

The ABCs of PDCA by Grace Gorenflo and John W. Moran This article is an introduction to quality improvement through the Plan-Do-Check-Act cycle. This quality improvement tool maps a process to help improve processes and eliminate inefficiencies in health departments, and demonstrates the PDCA cycle of quality improvement as it relates to public health.

PDCA Cycle for Change Leaders, The Quality Management Forum, Summer 2012, Volume 38, Number 2. It's Not Always Just the Process: 10 Steps to Dealing with People Challenges,  Process Excellence, June 26,2012 The author presents a set of steps which, when followed, will advise leaders how to effectively manage quality improvement teams with disparate personalities, trust issues, competing agendas, differing core values, and other behavioral issues. Following these steps will allow a team to quickly overcome obstacles and successfully begin performing their duties and achieving goals.

The Four Ingredients of Successful Change, Process Excellence, June 2012 In this article, the author proposes four essential ingredients to making change successful. Although changing an organization’s culture is not a simple task and requires a significant investment in time and energy, the potential payoff is substantial. For change to be successful, the change leader must build the belief within the organization that change is necessary by delivering a clear and consistent message. This will lead to adoption and cultural transformation.

Calculating the Real Value of Process Improvement: Factoring in Intangible Benefits, Process Excellence Network, April 16, 2012 Factoring in intangible benefits will improve the business case for undertaking a PI project. The authors offer a quantifiable approach to account for intangible benefits when implementing a process improvement project. By understanding the difference between tangible and intangible benefits, and comparing their combined impact to the costs of undertaking the project, readers will learn to quantify and measure the potential value of a task or program.

How to Focus Your Training and Professional Development Efforts to Improve the Skills of Your Public Health Organization, PHF, April 2012 This white paper reports on a series of workshops on focusing limited training and professional development resources to build competence within the public health workforce. To help public health leaders decide where to focus their professional development efforts, a QI tool, the Prioritization Matrix, was leveraged to identify critical Core Competencies for improving the skill levels within their public health organizations. The authors conclude that utilization of the Prioritization Matrix allows the identification of key focus areas for a public health organization and supports the optimal use of limited professional development resources to improve skill levels within the organization.

The PDCA Cycle for a Change Leader, Process Excellence Network, January 17, 2012 Change is critical for the sustainability of any organization. Unfortunately all organizations resist change to some degree. Change leaders must expect this resistance, be adaptable, and position themselves to foster change from within. This article defines the concept of a change leader, and explains the steps of the PDCA Model which allows leaders to implement the changes they desire within their organization.

Problem Solving, ASQ Weekly, November 9, 2011 This web article explores the four steps of the ASQ problem solving model: defining the problem, generating alternative solutions, evaluating and selecting an alternative, and implementing and following up on the solution. The site also provides links to additional problem solving resources, and tutorials designed to complement the model.

Creating an Effective Team Charter, PEX Process Excellent Network, UK, October 2011 The authors of this article advocate the use of a team charter as the starting point for any type of process improvement work, and provide examples of the use of team charter in a public health department. The article also includes the essential components of a team charter that are required for success.

Lean Six Sigma Improvements Through Modular Kaizen, PEX Process Excellent Network, UK, 2011 Modular kaizen is an organizational improvement approach designed for busy workplaces with a high level of interruptions. It has been successfully applied through both the traditional Plan-Do-Check-Act (PDCA) cycle and the more recent Lean Six Sigma (LSS) family of improvement cycles. The authors of this article describe how Modular kaizen minimizes system disruption, explain how to define the impacts of system disruptions, show examples of disruptions, and illustrate tools to analyze disruptions and impacts.

Using the Voice of the Customer to Align Processes in Service Industries, PEX Process Excellent Network, UK, July 2011 Organizations must develop a reliable method to collect regular and timely data for the performance of their most important processes. It is imperative to the survival of the organization that these processes are satisfying both internal and external customer needs. The authors discuss indices for determining if a process is capable of satisfying its customers, how to determine what customers will accept, and how to obtain customer satisfaction in terms of wants, needs, expectations, etc.

Conduct a "personalized" SWOT: Align yourself for professional growth, Quality Management Division, May E-Blast, Vol. 1, No. 4. A useful tool for investigating any conflict between your personal vision and that of your organization is the traditional SWOT (strengths, weaknesses, opportunities and threats) exercise. A personal SWOT provides a structured way to look at the positive and negative drivers that influence your ability to gather, analyze and synthesize observations that come to you in the course of your daily activities. How you make decisions from incoming information is critical for choosing the right alternatives for your future within the company. The authors describe how to create a personal SWOT, and how to leverage that honest self-assessment so as to have a positive impact in your organization.

Force & Effect Diagram Guides Team through Addressing Barriers, Quality Management Division, May E-Blast, Vol. 1, No. 4. Teams are effective for problem solving and decision making. Members of a team often view opportunities or problem solutions differently, which is normal. The Force & Effect (F&E) Diagram is designed to identify barriers to agreement among team members concerning a specific situation. The authors describe how the F&E Diagram displays the current state of a situation, how management can consider all aspects of a situation, and how, ultimately, team agreement can be achieved.

Lean Day In Tulsa, Public Health Foundation, May ,2011 With assistance from the Public Health Foundation, the Tulsa Health Department Quality Improvement Council (QIC) conducted a Lean event in three of its facilities with the objective of beautification of the environment and creating efficiency for the customer. As a result of the Lean event, the QIC discovered several environmental issues. The QIC decided they would continue to use Lean to develop a process for staff to identify and dispose of the waste uncovered in their site visits. This white paper touches on the history of Lean, how the Tulsa Health Department applied Lean methods, and the outcome of the project.

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