Standard 9.2 Develop and Implement Quality Improvement Processes Integrated Into Organizational Practice, Programs, Processes, and Interventions

Using a QI process, the Mercer County Health Department significantly increased the number of survey responses from its customers. This feedback is used to help identify areas for improvement and thus is an important part of the health department's strategy to apply QI to its operations.

Tazewell County Health Department (TCHD) followed a Kaizen QI process to decrease the time for completing the deposit and receipt process for fee revenue. The number of days from receipt to post decreased from 30 to 5, an 83% reduction. Additional improved outcomes resulted from the Kaizen process.

Using a PDCA approach, the Philadelphia Department of Public Health (PDPH) achieved a more efficient process for onboarding new employees. The amount of paper used went from 136 pages to 16 pages, an 88% reduction. The mean monthly staff time dedicated to the onboarding process dropped from 653...

Maricopa County Department of Health (MCDPH) used QI methods to achieve a 90% decrease in callers to the health department who selected the "zero-out" option (transfer of call to a live operator), thereby freeing staff time to focus on other projects and ensuring that more callers quickly...

The Connecticut Department of Public Health (DPH) significantly reduced the number of steps needed to place student interns. By improving access to job descriptions and applications for preceptors and prospective interns, staff could more easily increase capacity to meet the community's health...

Butte County Public Health Department (BCPHD) in California used QI to expedite the annual medical review (AMR) process for eligibility into the California Children's Services (CCS) program. More children and their families now have improved access to these specialty health care services.

Kendall County Health Department implemented successive PDSA cycles to better protect their population from West Nile Virus. The QI activities eventually led to a nearly 200% increase in the number of mosquito tests performed. Moreover, the implementation of a GIS management system has led to...

Kane County Health Department (KCHD) in Illinois increased staff knowledge of the Emergency Operations Plan (EOP), which improved timely response to emergencies and protection of county residents.

Washington County Department of Public Health and Environment led a multi-sector quality improvement project and increased the recycling rate at a county park. Expansion of this model to all county parks will further protect the environment and contribute to Minnesota's statewide goal of a 75...

Oneida County Health Department’s (OCHD’s) QI team increased QI project submissions from staff, thus strengthening ongoing performance improvement in the agency.

Cerro Gordo Health Department decreased fear levels of bed bug exposure among field staff. The implementation of a risk reduction plan minimized staff discomfort and facilitated a more effective intervention to bed bug exposure in the community.

Cerro Gordo County Department of Public Health (CGCDPH) worked to improve immunization rates for both types of pneumococcal vaccine recommended for seniors. Through a multifaceted approach that emphasized increased awareness of the vaccine, CGCDPH raised the rate of immunizations with the newest...

The Tarrant County Public Health (TCPH) Tuberculosis (TB) Division in Texas improved completion rates for latent TB infection (LTBI) treatment focusing on three targeted populations: homeless shelter residents, refugees, and people exposed to TB cases. Quality improvement of the process and a new...

Columbus Public Health (CPH), a local health department in Ohio, was bogged down by a slow, costly process to administer vaccines to children at schools. By using PDSA and a Kaizen event approach, CPH increased the timeliness and efficiency to document the immunization services and decreased its...

Mobile food units (MFUs) in Houston, Texas, now experience a faster, more efficient inspection process thanks to a Kaizen event held by Houston Health Department. The average time to complete the physical inspection and administrative paperwork has decreased from 3 hours to 30 minutes. Moreover,...

For health department services that have a major impact on citizens, ensuring high client satisfaction is important to the public’s understanding and support for these services. Three state health departments teamed together to improve the timeliness of death data, using the Kaizen method for...

Working together, the Tulare County Public Health Department’s tuberculosis (TB) team and nurses increased the on-time completion rates from 80% to 100% for referrals of suspected TB cases. The QI project resulted in a newly defined and consistent work process that improved communications and team...

Budget literacy of health department staff is a key attribute necessary before decentralizing financial management and program oversight. After an assessment that determined that staff had knowledge gaps, an educational intervention was initiated to increase their financial management competency....

The Stratford Health Department’s aim was to ensure that at least 75% of faith-based organizations (FBOs) were licensed, so they could provide food during public events throughout the year and minimize the risk of food-borne illness. While working through their QI planning project, staff fixed a...

The Kaizen event approach was selected to involve the Minnesota Department of Health (MDH) Public Health Laboratory (PHL) team in reducing the percentage of influenza tests taking longer than 6 days to verify and eliminate testing errors. Within 4 months, errors were eliminated and test time length...

The health department improved the process for tracking data requests from internal and external partners. The interventions made the staff more aware of the tracking process and offered education on the use of the Access database. The results included greater use and an increased number of staff...

Deschutes County Health Services (DCHS) in Central Oregon is now able to provide more efficient preventive strategies for the county through creating and implementing an online process for reporting foodborne illness, restaurant complaints, hotel and motel complaints, pool and spa complaints, and...

When a rabies susceptible animal has bitten a human, it is imperative that health departments responsible for the investigation and quarantine of these animals respond a timely manner. A local health department in Oregon used a PDSA approach to reduce the time to process rabies bites reports by 29...

Staff are Customers too! How involving all staff in the identification of barriers to completing department offered QI Training resulted in greater acceptance of, participation in, and an increase in the number of staff completing six required training modules.

This health department was able to achieve a 51% improvement in HIV testing rates, which can result in identifying more people with HIV and better, more immediate treatment. In order to reduce redundancy, the QI project team eliminated one of the demographic forms that had been required, saving...

Review of timely and accurate evaluation data is crucial for health departments to provide effective interventions to improve the health of their communities. The Women’s Health branch of a state health department used several QI methods and tools—including a Kaizen event, multiple PDSA cycles and...

Cabarrus Health Alliance and partners used quality improvement to streamline their processes for referrals for pregnancy care management to improve overall handoffs and cycle times, resulting in more timely and effective referrals for care management to ensure healthier mothers and babies.

A knowledgeable and involved team, subject matter expertise, and the Kaizen improvement method helped the Madison County Health Department reduce their client no show rates in the Family Planning Clinic. Root cause analysis led the team to create standardized process procedures, client scheduling...

NC Division of Public Health streamlined data collection and improved the quality of reportable data in their Maternal, Infant, and Early Childhood Home Visiting Program resulting in greater use of these data to improve services to children and families.

A local health department in North Carolina used PDSA cycles and lean/kaizen approaches to improve their clinic client and community satisfaction survey tools and data collection process. This provided a system-wide framework to enable the organization to better understand their customers’ needs,...

This medium-sized health department tackled the unacceptable wait time in its Primary Care Clinics. The wait time averaged 1.5 hours for new patients and 30–45 minutes for returning patients. The QI team members observed how people are processed through the stations and identified improvement...

Early intervention has been shown to positively impact outcomes across developmental domains. The Fond du Lac County Health Department increased the number of children being screened for developmental delays from 5 to 9 per month, allowing more children to be appropriately connected with services...

Johnson County Department of Health and Environment used a kaizen event to improve the supply ordering process cycle time and increased the order placement and delivery accuracy for all programs in the department. The results included decrease in cycle time – total ordering process time per order...

Untreated chlamydia (CT) and gonorrhea (GC) can lead to serious health problems in men and women. In order to effectively track and treat these two sexually transmitted infections, CDC guidelines require that low-priority CT and GC reports be processed by health departments within 30 days of...

El Dorado County Health and Human Services Agency used a Kaizen event to improve customer satisfaction and reduce labor time in the County “request for information” process. The results of the project mean better and faster information to the incoming caller, so they can make more informed...

The DeKalb County Board of Health used a kaizen event to decrease the labor time and increase the accuracy of filing death certificate registrations. Improving the process resulted in labor savings, better cash flow and improved performance for customers in providing accurate and timely filing. The...

DOH-Seminole County realized savings of $7764 for goods and services from price negotiations during the first quarter following a Kaizen event – almost double the goal set by the QI team. Other improvements in the requisition process included a 38% decrease in process time, in addition to...

Washington County (OR) conducted a Kaizen Event to improve the volume of childcare facilities that used the LHD for their state required inspections. The agency implemented several new policies and protocols to standardize the entire inspection process. As a result, they anticipate a reduction in...

Kaizen events lend themselves to rapid improvements in routine health department processes. Tazewell County Health Department utilized Kaizen tools to full advantage--reducing administrative time related to food establishment inspections dramatically, exceeding the project aim. In the first month...

WIC coupons for use at famer’s markets are a precious resource for improving nutrition and reducing food hunger in low-income families, as well as supporting local farmers. Deschutes County Health Department noted a decreasing trend of redemption, which meant a literal wasting of coupons that other...

This initiative describes how quality leaders at the Salt Lake County Health Department challenged the status quo to transform organizational quality culture. Members of the SLCHD Quality Council identified a need to increase the health department's emphasis on quality after a review and...

The Maryland Department of Health and Mental Hygiene partnered with its local health departments and WIC clinics to increase the number of WIC clients referred to and receiving appropriate services to meet their needs.

Washington County Department of Public Health and Environment improved the process of renewing annual hazardous waste licenses to over 500 hazardous waste generators. Approximately 75% of renewals contained one or more defects which slows the process, consumes unnecessary time by the inspectors...

Effective tobacco control and prevention outreach is vital to decreasing tobacco use, secondhand smoke exposure, and tobacco-related disease rates. In addition, the loss of significant resources and funding for tobacco control and prevention have made it all the more important to have efficient...

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...

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...