Creating quality improvement culture in public health agencies.

Abstract:

OBJECTIVES:We conducted case studies of 10 agencies that participated in early quality improvement efforts. METHODS:The agencies participated in a project conducted by the National Association of County and City Health Officials (2007-2008). Case study participants included health directors and quality improvement team leaders and members. We implemented multiple qualitative analysis processes, including cross-case analysis and logic modeling. We categorized agencies according to the extent to which they had developed a quality improvement culture. RESULTS:Agencies were conducting informal quality improvement projects (n = 4), conducting formal quality improvement projects (n = 3), or creating a quality improvement culture (n = 4). Agencies conducting formal quality improvement and creating a quality improvement culture had leadership support for quality improvement, participated in national quality improvement initiatives, had a greater number of staff trained in quality improvement and quality improvement teams that met regularly with decision-making authority. Agencies conducting informal quality improvement were likely to report that accreditation is the major driver for quality improvement work. Agencies creating a quality improvement culture were more likely to have a history of evidence-based decision-making and use quality improvement to address emerging issues. CONCLUSIONS:Our findings support previous research and add the roles of national public health accreditation and emerging issues as factors in agencies' ability to create and sustain a quality improvement culture.

journal_name

Am J Public Health

authors

Davis MV,Mahanna E,Joly B,Zelek M,Riley W,Verma P,Fisher JS

doi

10.2105/AJPH.2013.301413

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

e98-104

issue

1

eissn

0090-0036

issn

1541-0048

journal_volume

104

pub_type

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