Missoula City-County Health Department Infectious Disease On-Call Team QI


Impact Statement: 
Missoula City-County Health Department used quality improvement to improve the functionality and satisfaction of its infectious disease after hours response team members, thus ensuring that emerging infectious disease issues in the community would be managed appropriately.

The Missoula City-County Health Department ID On-Call team members reported little or no job satisfaction, and the supervisor was fielding frequent and varied complaints. Staff no longer wanted to be on the team. New team members could not be recruited because they perceived team membership as undesirable. The very low staff satisfaction rate was viewed as a potentially destabilizing influence on the overall health of the team. The supervisor was reluctant to move to an involuntary system of recruitment and decided to attempt to resolve the issues using the QI process. 

The team used the Plan, Do, Check, Act (PDCA) QI model. Five issues were identified as having the greatest impact on staff satisfaction. Each issue was a multifaceted problem to be solved, requiring brainstorming, developing an improvement theory, and testing the impact of the improvements on the issue.   

The QI initiative was successful, resulting in new recruits to the team and an improvement in staff satisfaction from 14.29% to 90%.

Organization that conducted the QI initiative: 
Missoula City-County Health Department

VanDomelen, A. Public Health Quality Improvement Exchange. Missoula City-County Health Department Infectious Disease On-Call Team QI. Thu, 11/16/2017 - 13:56. Available at https://www.phqix.org/content/missoula-city-county-health-department-infectious-disease-call-team-qi. Accessed July 25, 2024.

Submission Status: 
1 user has voted.


Submitted by victoria bailey on

Submitted by victoria bailey on Wed, 01/06/2016 - 14:45
An excellent QI project for improving internal team satisfaction and participation and providing a vital service to the public health community.
Question - Is the team comprised of public health nurses only? If so is there an option of opening the team up to the staff epidemiogists or disease intervenion specialists?
Agree that a strong on-call pay; recognition and comp time policy can be a proven incentive for participation and follows hospital and first responder staff compensation policies.
Vicky Bailey, RN, Austin, Texas

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Vicky Bailey

Submitted by klouther on

I agree that incentives make it sometimes easier to get buy in from staff (i.e. pay, extra vacation time, etc).  When our agency merged, staff looked at this issue and decided to have managers take the after hours calls/pages as there was no need to pay overtime whereas with PHNs and other front line staff covered under union contracts and county work rules, they would recieve OT pay for the work they do after hours. 

Nice job addressing each of their concern areas.

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