We Can All Promote Quality Improvement

Question: 
How can we promote QI use to our peers in ways that don’t require extensive training?
Reply: 
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Jim Butler

Health departments using quality improvement (QI) methods and tools are sometimes faced with a pleasant problem. Their staff members have used QI and have seen the value it adds to their work. Typically, these staff members want to share this newfound knowledge and experience with their peers inside and outside of the health department.

Staff members frequently ask, “How can we promote QI use to our peers in ways that don’t require extensive training?” That’s a great question! Let’s take a look at one way a progressive local health department is doing just that.

For the last 4 years, Jill Almond, the organizational development coordinator for Tulsa City-County Health Department in Oklahoma, has attended an annual conference for worksite wellness programming. She told PHQIX that she had been using QI tools to enhance the health department’s wellness program and wanted to share the positive results her team experienced by leading a conference session that would show attendees how to use QI tools to improve their own programming.

Tulsa Health Department hopes to make QI tool use a standing event at future conferences and will continue to encourage individuals to look to QI tools to enhance their programming efforts.

Jill applied to present at a breakout session of the annual Make It Your Business Employee Health and Wellness Conference. The target audience for this conference includes professionals who lead the worksite wellness effort for their companies’ employees. Most attendees were not public health department employees. Jill used a team approach that encouraged group participation and used both large and small group work. Jill and three additional Tulsa Health Department staff members, Lynnsey Childress (community relations specialist), Nicole Schlaefli (epidemiologist), and Ellen Niemitalo (registered nurse), co-presented.

The team chose brainstorming, fishbone diagrams (cause and effect), and affinity diagrams as their three primary QI demonstration tools.

During the session, Jill and her team asked the approximately 60 participants to create a mock worksite wellness initiative for 250 employees in their second year of an active worksite wellness program. The initiative focused on nutrition and physical fitness. The full group participated in brainstorming and creating affinity diagrams to outline the new program being created. Small groups worked on fishbone diagrams to arrive at the root cause they intended to address. After the small groups reported to the full group, a walking program including the weekly tracking of miles walked, was chosen for employees. Company leadership was involved and participated in the new program. The incentive for reaching the goal was a new pair of athletic shoes.

Results from the evaluation that followed the session all fell into either Strongly Agree or Agree categories based on a five-level point Likert scale.

Participants were asked about their level of agreement or disagreement with the following statements:

  1. The breakout session met my expectations.
  2. I will be able to apply the knowledge learned.
  3. The breakout session objectives for each topic were identified and followed.
  4. The content was organized and easy to follow.
  5. The presenter was knowledgeable.
  6. The quality of instruction was good.
  7. The presenter met the conference objectives.
  8. Class participation and interaction were encouraged.
  9. Adequate time was provided for questions and discussion.

Additional feedback from participants indicated that they liked the session and how interactive it was.

Judd Allen, the conference keynote speaker, attended the QI session, mentioned it in his presentation, and encouraged the attendees to contact the Tulsa Health Department presenters for more information or if they had questions.

Based on the success of the first presentation, the conference planning committee invited the Tulsa Health Department to return for the 2015 conference and offer four breakout sessions instead of one.

In preparation for the 2015 conference, the Tulsa City-County Health Department team conducted a brainstorming session seeking to improve the session scenario. The health department staff members hope to improve the new session by addressing the budgetary constraints of the scenario, allowing more time for the small groups to report to the larger group and selecting small groups by levels of wellness experience.

Tulsa Health Department hopes to make QI tool use a standing event at future conferences and will continue to encourage individuals to look to QI tools to enhance their programming efforts.

Tulsa Health Department

As you continue your QI journey, remember that empowering your staff not only to use QI tools but also to employ quality planning and thinking will help to promote QI use throughout your organization. Encourage your staff to use QI tools and to share their knowledge of the tools with colleagues and peers. Provide staff with the opportunity to learn about new tools and apply them to their everyday work. Celebrate your efforts.

Plan, Do, Study, Act

QI can be done by an organization, a subset of an organization (division, section, or program), and by individuals. QI is a mindset in which you think about your work through a QI prism, constantly seeking to improve. You don’t always need to do a complete Plan, Do, Study, Act cycle; sometimes using a few QI tools helps to bring people together to learn and do QI.

Peruse the PHQIX website for other stories of QI and QI tools all used by people like you—practicing professionals using applying QI to improve everyone’s health and safety.

Thank you, Jill, and thank you, Tulsa City-County Health Department, for allowing us to share your innovative thinking and remarkable story.