Using QI to Improve Documentation Processes in the Maternal Infant Health Program


Impact Statement: 
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 effective.

Like many public health programs, the Maternal Infant Health Program (MIHP) is threatened by budget cuts. MIHP is a time-intensive program that includes regular home visits by staff to assess the health and living conditions of the program participants. Many of the most vulnerable families in the community could be denied this valuable service if the program is discontinued. The Mid-Michigan District Health Department (MMDHD) was desperate to find a way to sustain the program—possibly by improving staff productivity through increased efficiencies in work processes. The quality improvement (QI) team’s goal was to improve work processes so MIHP staff members could spend less time in the office, thereby increasing the time available to conduct daily home visits. The team wanted to better understand the barriers that MIHP staff members encountered before going into the field to conduct home visits and to address these barriers in a standardized process that would increase productivity within the program. By reducing these barriers, the team thought the MIHP staff members would be able to conduct more home visits per day, which would thereby increase program revenue and financially sustain the program. This change would allow MMDHD to continue providing MIHP services in Gratiot County and potentially expand the program back into the other two counties within the service district, which had previously been discontinued.

Organization that conducted the QI initiative: 

Pope, R. Public Health Quality Improvement Exchange. Using QI to Improve Documentation Processes in the Maternal Infant Health Program. Thu, 03/26/2015 - 13:40. Available at Accessed July 25, 2024.

Submission Status: 
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mschigoda's picture
Submitted by mschigoda on

Great project - thanks for sharing!

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Melissa Schigoda, MS
Public Health Improvement Program Coordinator
National Network of Public Health Institutes (NNPHI)

cgizzi's picture
Submitted by cgizzi on

I loved your use of IF . . . THEN statements in the "lessons learned" section. You also presented a great example of the benefits of standardized processes. Thanks for your work on this project!

Cindan Gizzi, MPH
Community Assessment Manager
Tacoma-Pierce County Health Dept.

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Submitted by lkent on

I'd really like to hear an update on your team's QI efforts and if the MIHP staff are feeling more energized by the improvements in the process and regular communication.

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Submitted by rpope on

This is really two-fold, staff have been pleased with the changes made and the group process utilized however we had to jump right into more quality improvement activities so they are probably getting a little burnt out at this point in time. We are currently focusing on scheduling and promoting the program right now, as demand has declined in our service district with the surrounding providers (LHD's) experiencing this decrease in demand as well. We should really know where we stand at the end of August though.

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Submitted by MelanieJicha on

Very detailed information, which is super helpful!  Thanks

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Melanie Jicha

Submitted by Cherstin on

We are currently in the process of enhancing our electronic health record utilization for our home visiting program.  This is very helpful in determining our workflows. 



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Cherstin Callon
Quality Improvement Specialist
Deschutes County Health Services, Public Health

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